They include Eugene Louderback, 80, who has memory troubles associated with dementia and had a pacemaker put in about five years ago. His wife, Leota Louderback, 75, has diabetes and kidney problems, and has undergone two back surgeries and angioplasty for a heart condition.

The Louderbacks' story isn't only one of struggle, though. They took charge of their health problems by acknowledging that they could no longer do everything for themselves. They changed their living arrangements and got help.

The affectionate couple, married for 59 years, moved out of the Waipahu home where they'd lived for decades and into an assisted-living apartment this year.

Both feel fortunate to be as relatively healthy as they are. They smile fondly at one another and get past their differences without too much stress.

When they each recall an incident differently, Leota moves past it with a useful phrase: "We don't remember it the same."

The Louderbacks set a good example — and Flynn encourages other seniors to follow their lead. He suggests seniors prevent problems and maintain the best possible health and well-being as they age by actively communicating with their doctor, staying connected with family and community and remaining active.

Flynn advises people to keep walking or practice yoga or tai chi to improve balance and prevent falls, which can prove devastating.

Flynn also urges patients to read, go to museums, do crossword puzzles and spend time with friends and family. "Being socially active is very good for the brain," he said.

He also urges seniors to ask for help as challenges develop.

People don't need to choose between living in their homes without help and moving to a full-care facility, he said. Home care is becoming more available for people who are aging but who can still live independently by having helpers go to them.

Even medical professionals can attend to seniors in the community. "As a physician, I can come out and do home visits," he said.

Flynn encourages the elderly to be frank with their doctors and their family members about how they are feeling and coping. "Take simple forgetfulness. Could that be a warning that there's something more serious like dementia or Alzheimer's?"

Flynn worries that many people older than 65 won't talk about health concerns, including some that can be treated. Loss of bladder control is one of those major issues.

"Patients are ashamed or they assume that it's something normal as you grow older," Flynn said. "That isn't normal; you should be able to control your urine throughout life."

Although incontinence is a physical issue, it can make people isolate themselves socially, Flynn said, causing other problems. He said patients are surprised to find that something as simple as an infection could cause the problem, and that it can be easily treated and cured.

Managing medications is a particular concern for Raymond Bihis, a registered nurse who is a care-management manager for University Health Alliance, one of the state's smaller health insurance companies. Bihis, who helps members understand chronic illnesses that often come with aging, stresses the importance of taking medications properly and checking to see that prescriptions don't conflict.

Even over-the-counter medications like Benadryl can have side effects for the elderly, including extreme dizziness, Flynn warns. "We react very differently than when we were younger," he said.

He also warns against sharing medications — a practice that sometimes goes on at senior clubs. A doctor may tell a patient that he is prescribing a medication to strengthen the heart of a patient. She chats with a friend who says: "I'd like my heart to be stronger too." Flynn's advice: don't share.