Many conditions become more common after age 40, from creeping blood pressure to aches in your knees. The good news is that awareness and early action make a huge difference. By knowing what to watch for and taking preventive steps, you can maintain your health and enjoy midlife and beyond. Below, we’ll break down the most common health problems doctors see in Canadians over 40, with key signs to note and the latest Canadian stats and guidance for each.
Key Health Issues After 40
Heart Disease: Heart disease remains a top concern in midlife. It affects about 2.6 million Canadian adults and is the second leading cause of death in Canada. Risk climbs with age, in fact, 9 in 10 Canadians have at least one risk factor for heart disease or stroke (such as high blood pressure, smoking, high cholesterol, or diabetes). Often called a “silent killer,” heart disease can develop without obvious symptoms until a heart attack or angina occurs. Early warning signs may include chest pain or pressure, shortness of breath, or extreme fatigue on exertion. Don’t ignore these signs. Even if you feel fine, it’s wise to get your blood pressure, cholesterol, and blood sugar checked regularly. Healthy habits and routine screening go a long way to protect your heart.
Type 2 Diabetes: The risk of type 2 diabetes rises sharply after 40. Over 80% of Canadians with type 2 diabetes are diagnosed after age 40. Currently, almost 4 million Canadians live with diagnosed diabetes, a number that has climbed in recent years. Early on, diabetes can be subtle. Classic early signs include unusual thirst, frequent urination, fatigue, and perhaps blurry vision. However, many people have no obvious symptoms at first. Left unchecked, high blood sugar damages blood vessels and can lead to heart disease, kidney trouble, nerve pain, and more. That’s why screening is important – a simple blood test can catch rising blood sugar. Lifestyle is key: being overweight, inactive, or having a family history increases your risk.
High Blood Pressure: Hypertension (high blood pressure) often begins silently in one’s 40s or 50s. About 1 in 4 Canadian adults has high blood pressure, and the proportion increases with age – by seniors, two-thirds have it. Worryingly, high blood pressure usually has no symptoms until it’s dangerously high. You won’t feel it, but uncontrolled hypertension damages arteries and strains the heart over time. It’s a leading cause of heart attacks, strokes, and kidney problems. In Canada, almost 8 million adults have hypertension, and that will rise as the population ages. The risk doubles every decade after 40, and more than 90% of Canadians will develop high blood pressure if they live an average lifespan. The only way to know is to measure it. Make sure your doctor or pharmacist checks your blood pressure regularly.
High Cholesterol: Like blood pressure, cholesterol levels tend to creep up with age. By midlife, many adults have elevated “bad” LDL cholesterol, which contributes to artery plaque. High cholesterol itself causes no symptoms, so you wouldn’t know without a blood test. That’s concerning because long-term, high LDL cholesterol is a major driver of heart disease and stroke. Canadian guidelines, therefore, urge that all adults age 40+ get their cholesterol checked with a simple blood test. Early detection means you can take steps (diet changes, exercise, or medication) to bring levels down. Eating less saturated fat and trans fat, and more fiber, can improve cholesterol.
Arthritis and Joint Pain: Not all health issues after 40 involve blood tests. Many Canadians start to feel the wear-and-tear in their joints. Arthritis becomes very common in mid-life and beyond, about 1 in 5 Canadians have arthritis, and 50% of people over 65 are living with it. The most common type is osteoarthritis, where the cushioning cartilage in joints breaks down over time. Years of activity (or past injuries) often show up as knee pain, hip stiffness, or achy fingers in your 40s, 50s, and beyond. Early signs of osteoarthritis include intermittent joint pain after strenuous activity, morning stiffness that lasts less than 30 minutes, and a crunchy “grinding” feeling in the joint. You might notice it’s harder to kneel or that your hands feel stiff after a long day. While arthritis can’t be “cured,” there are many ways to manage it and slow its progression: staying active (low-impact exercise and muscle strengthening to support joints), maintaining a healthy weight (to reduce stress on weight-bearing joints), using physio or occupational therapy techniques, and pain relief medications or supplements.
Cancer (Colon, Breast, Prostate): Cancer risk increases with age, and certain cancers become more of a concern after 40. The big three for this age group are colorectal cancer, breast cancer, and prostate cancer.
Colon Cancer: Colorectal cancer is the second-leading cause of cancer death in Canada, but it’s highly treatable if caught early (over 90% survival when found at an early stage ). Most colorectal cancers occur in people over 50, but the process can start in the decade before, which is why screening is recommended starting at 50 (sooner if you have a family history). Early signs can include a change in bowel habits, blood in the stool, abdominal cramps, or unexplained weight loss – but often there are no symptoms until the cancer is advanced. That’s why routine screening is critical (see the screening section for guidelines). Lifestyle plays a role too: a diet high in fiber and low in red/processed meats, regular exercise, maintaining a healthy weight, moderating alcohol, and not smoking all reduce colon cancer risk. If you’re over 40, talk to your doctor about when to start screening (generally at 50 for average risk).
Breast Cancer: For women, breast cancer becomes a greater concern with age. It is the most common cancer in Canadian women, accounting for about one-quarter of all new cancer cases in women. The lifetime risk for the average Canadian woman is 1 in 8 to develop breast cancer (and about 1 in 35 will die from it). The majority of cases are diagnosed after age 50, in fact, 83% of breast cancers occur in women over 50, but it can occur in the 40s as well. Early detection is key: finding breast cancer at an early stage (small tumor confined to the breast) yields about 89% five-year survival in Canada. Be aware of warning signs: a new lump in the breast or armpit, changes in breast size or shape, nipple changes or discharge, or skin dimpling on the breast. Most lumps turn out not to be cancer, but they should always be checked. Canada has excellent screening programs (mammograms), which have helped improve outcomes. Also, know that your personal risk factors, like a strong family history or the BRCA gene, may mean you need earlier or more frequent screening. For most women at average risk, regular mammograms every 2 years between age 50 and 74 are recommended (some jurisdictions allow screening starting at 40 – see screening section).
Prostate Cancer: In men, prostate cancer is the most common cancer by far in later life. About 1 in 8 Canadian men will be diagnosed with prostate cancer in their lifetime, usually after age 50 (it’s rare before 40). It currently represents about 20% of new cancer cases in men. The good news is that prostate cancer often grows slowly, and when caught early, it’s usually very treatable – the 5-year survival for early-stage prostate cancer is nearly 100%. However, it can sometimes be aggressive, so it’s important to be informed. Typical early-stage prostate cancer has no symptoms, or very subtle ones that men might shrug off as aging. Signs like needing to urinate more frequently (especially at night), weak urine flow, difficulty starting urination, or blood in urine or semen can occur, but these symptoms often only appear with more advanced disease (and can also be caused by non-cancerous prostate enlargement). There is no consensus on routine screening for prostate cancer in Canada: the PSA blood test can find cancer early, but it also has risks of false alarms and overdiagnosis. The Canadian Task Force on Preventive Health Care currently does not recommend routine PSA screening in average-risk men under 55, and makes a weak recommendation against screening ages 55–69 (instead advising an informed personal decision).
Osteoporosis: We often hear about bone health in women after menopause, but bone density actually starts declining subtly in our 40s (for men as well). Osteoporosis is a condition of weakened, fragile bones that can lead to fractures, and it affects roughly 2.3 million Canadians over age 40, about 80% of them women. After menopause, women lose bone at a faster rate due to dropping estrogen, putting them at higher risk. But men aren’t off the hook – especially by their 70s, osteoporosis can impact men significantly too. Early on, osteoporosis is silent. You won’t feel your bones getting thinner. Many people aren’t aware they have it until a minor fall causes a wrist fracture or a vertebra in the spine to collapse. In fact, often the first sign of osteoporosis is a fracture, which is why proactive screening and prevention are vital. Clues that you might be losing bone density include getting shorter (loss of height) or a stooped posture over time (due to spinal bone loss). The good news is we can take steps to strengthen our bones: adequate calcium and Vitamin D, weight-bearing and resistance exercise, and avoiding smoking and excess alcohol all help maintain bone mass. Additionally, Canada recommends bone density testing (a DEXA scan) for women 65+, and earlier if you have risk factors (e.g., a previous “fragility” fracture after age 40, strong family history, steroid medication use, etc.).
Vision and Hearing Decline: Along with the internal health issues, some of our senses begin to decline subtly after 40. If you’ve found yourself holding reading material farther away to see it clearly, you’re not alone, presbyopia, the loss of near focusing ability, affects everyone in their 40s. Most people start needing reading glasses or bifocals sometime in their mid-40s. It’s a normal aging change as the lens of the eye stiffens. Beyond the “longer arms” syndrome, the risk of more serious eye conditions like glaucoma, cataracts, and macular degeneration increases with age (especially after 50-60). Prevention tip: Regular comprehensive eye exams can catch issues early, optometrists generally recommend an eye exam every 2 years for adults under 65 (annually after 65, or sooner if you have risk factors).
Hearing is another sense that can decline in mid-life, often so gradually that you don’t realize it. In fact, studies show over half of Canadians aged 40–79 (54%) have at least mild hearing loss in the high-frequency range when tested – but most don’t perceive it because it creeps up. High-frequency hearing loss can make it harder to hear consonants or understand speech in noisy rooms, even if you think your hearing is “fine.” Men tend to have more hearing loss than women, about 63% of men 40–79 have some hearing loss vs 46% of women. If you’re finding you need the TV a bit louder or have trouble when multiple people talk at once, consider having a hearing test. Many hearing losses are treatable with hearing aids, which today are very advanced and discreet, and addressing hearing loss can significantly improve quality of life (and even cognitive function – untreated hearing loss has been linked to cognitive decline ). Beyond aging, protect your ears from further damage by avoiding prolonged loud noise exposure, use earplugs at concerts, and be cautious with volume on headphones.
Weight Gain and Metabolism Changes: A common complaint in middle age is, “I’m eating the same, but my waistline is growing!” It’s not your imagination, our metabolism truly slows down as we age. Starting in our 30s and 40s, we burn calories more slowly and tend to lose muscle mass (which burns more calories than fat). In fact, muscle mass decreases about 3–8% per decade after age 30 (and even faster after 60). This means if you don’t adjust your diet or increase exercise, you’ll likely gain some weight in your 40s, even if your habits haven’t changed. Additionally, many people become less active due to busy schedules, which compounds the issue. The result: by their 40s and 50s, many Canadians carry extra pounds, often around the abdomen (the notorious “mid-life spread”).
Preventive Steps and Screening After 40
Knowing the health risks is only half the battle, the other half is staying ahead of them with proactive steps. The great news is that many of these age-related issues can be prevented or minimized through healthy living and regular screening. Here are actionable tips for Canadians over 40 to take charge of their health:
Healthy Habits to Protect Your Health
Stay Active: Aim for 150 minutes of moderate exercise per week (like brisk walking, cycling, or swimming) plus strength training twice a week. Regular physical activity helps control weight, lowers blood pressure and cholesterol, keeps bones strong, and is a natural mood booster. Even simple habits, taking the stairs, doing yard work, walking the dog daily, add up. Find activities you enjoy and make movement a non-negotiable part of your routine.
Eat a Balanced Diet: Focus on whole foods and a variety of nutrients. Fill half your plate with vegetables and fruits, choose high-fiber whole grains, and include lean protein (beans, fish, poultry) and calcium-rich foods for bone health. Cut back on processed foods high in sugar, salt, and unhealthy fats. A heart-healthy diet (like the Mediterranean diet) not only helps prevent heart disease and diabetes but also fuels you with steady energy. Don’t forget to drink plenty of water and moderate your alcohol intake (no more than 10 drinks a week for women or 15 for men, per Canada’s low-risk drinking guidelines).
Maintain a Healthy Weight: As discussed, metabolism slows down in midlife. We can’t eat like teenagers without consequences! Keep an eye on portion sizes and avoid mindless snacking. If weight is creeping up, make small sustainable changes, for example, cut out one sugary drink a day or take a 20-minute walk at lunch, rather than drastic diets. Even a modest weight loss (5-10% of body weight) can significantly improve blood pressure, blood sugar, and joint strain. The goal is to prevent obesity, which currently affects about 30% of Canadian adults, since excess weight underpins many health problems after 40.
Don’t Smoke (and Limit Alcohol): If you smoke, there’s no better time to quit. Smoking is a leading cause of heart disease, stroke, lung diseases, and cancer. The benefits of quitting at 40 are huge, within one year, your heart disease risk drops significantly, and within 10 years, your lung cancer risk is cut in half. Talk to your doctor about cessation aids if needed; there are excellent supports available. As for alcohol, heavy drinking can raise blood pressure and damage the liver, among other issues.
Essential Screenings in Your 40s, 50s and 60s (Canadian Guidelines)
Blood Pressure Checks: Have your blood pressure measured at least once a year, or at every doctor’s visit. High blood pressure often starts in the 40s with no symptoms, so regular checks are a must. You can get this done at your family doctor, many pharmacies, or even consider a home blood pressure monitor if recommended. Optimal BP is around 120/80; if yours is creeping up (e.g., consistently 130/85 or higher), your doctor will guide you on lifestyle changes or medications to control it.
Cholesterol Test: The Canadian Cardiovascular Society recommends a fasting cholesterol blood test for all adults starting at age 40 (earlier if you have risk factors). If results are normal, your doctor will advise how often to repeat it (typically every 5 years, or more frequently if levels are high). This test checks LDL (“bad” cholesterol), HDL (“good” cholesterol), triglycerides, and total cholesterol.
Blood Sugar (Diabetes) Test: Diabetes Canada advises screening for type 2 diabetes every 3 years starting at age 40 (earlier or more often if you have risk factors like obesity or family history). A common screening method is a fasting blood glucose or an HbA1c test. These can catch “prediabetes” or early diabetes before you have symptoms. With early detection, you can often reverse prediabetes with lifestyle changes or start managing diabetes to prevent complications. Given that almost half of adults with diabetes may be undiagnosed, this is a vital screening as you hit mid-life.
Colon Cancer Screening: Everyone aged 50 to 74 at average risk should be screened for colorectal cancer. In most provinces, the recommendation is a stool test every 2 years (either a FIT or FOBT kit that you use at home and send in to detect hidden blood in stool). If the stool test is positive, you’d then get a colonoscopy. If you have a family history of colon cancer (parent or sibling), you might need to start screening earlier (e.g., at 40 or 10 years before the age your relative was diagnosed) – ask your doctor..
Breast Cancer Screening: If you’re a woman in your 40s or older, talk to your healthcare provider about breast cancer screening. For women 50 to 74 at average risk, mammograms every 2 years are the standard recommendation across Canada. Mammography can detect tumors when they’re very small, often years before they’d be felt. In some provinces, women 50+ are automatically invited to screening programs. Women in their 40s: guidelines vary – the Canadian Task Force in 2018 suggested routine screening start at 50 for average-risk women, but many provinces allow women 40-49 to be screened if they wish (some require a doctor’s referral).
Cervical Cancer Screening (Pap Test): Cervical cancer is highly preventable with screening. Women (or anyone with a cervix) aged 25 to 69 should have a Pap test every 3 years in most jurisdictions. (If you’re 70 or older and have had regular, normal Pap smears, you can usually stop.) The Pap test looks for abnormal cell changes caused by HPV that could progress to cancer. It’s been a huge public health success – rates of cervical cancer have plummeted in Canada thanks to screening. Make sure you’re up to date: many women get busy and forget if it’s been 5+ years since their last Pap. Mark it on your calendar or sign up for reminders if your province offers them.
Prostate Cancer Discussion: There’s no one-size screening test to recommend for prostate cancer at this time, but men around age 50 (or 45 if high risk) should have a frank talk with their doctor about PSA testing. The Canadian guideline currently leans against routine PSA screening due to potential harms, but they also emphasize informed choice. If you decide to proceed with screening, typically a PSA blood test is done every 1–2 years between age 50 and 69.
Eye Exams: Don’t forget your eyes! It is generally recommended to have a comprehensive eye exam every 2 years between the ages of 40–65 (and yearly after 65). Even if your vision is 20/20, an optometrist can catch early glaucoma, macular degeneration, cataracts, and other issues. In many provinces, eye exams are not covered for adults under 65 unless you have a medical condition, but it’s a worthwhile preventive investment.
Hearing Check: While there isn’t an official hearing screening program for adults, consider getting a baseline hearing test in your mid-40s or 50s, especially if you’ve had significant noise exposure in your life (concerts, loud work environments, etc.) or notice any difficulty hearing. As noted, unperceived hearing loss is common – over 8 million Canadians 40–79 have measurable hearing loss, but most aren’t aware. If your test is normal, great – you can test again in a decade. If not, you can address it early (maybe using hearing aids in certain situations, or protecting against further loss).