And your health doesn't necessarily improve with age.

Your bones shrink in size and density, making them more susceptible to fracture. Your muscles lose strength and flexibility. Your vision worsens, and your risk for glaucoma and cataracts increase.

Your skin thins. Your hearing goes. You sleep less soundly.

The list goes on.

"You look in the mirror and you feel like your body has betrayed you," Thompson said.

But while some fiftysomethings react by pumping up the exercise and watching their diets, many tend to be in denial about their age — and their health. They may not be as proactive as they should be about their health and well-being, opting to skip important screenings (see box) or waiting too long to change their unhealthy ways.

According to a national AARP survey, baby boomers — those born from 1946 to 1964 — think of themselves as younger than they really are, on average by seven years. Only three of 10 boomers say their physical health right now is worse than they had anticipated.

"They don't feel like they're old at all," said Barbara Kim Stanton, AARP state director. "Being 50 is the new 30, and that's really true of boomers in Hawai'i."

MARATHON MAN

Before moving to Hawai'i in 1983, Larry Mackey lived a very different life.

Back in Michigan, he was a chain smoker who drank alcohol every day and spent winters planted on his living room couch. His weight had ballooned to 180 pounds.

Today, the 58-year-old competes in triathlons and runs marathons — he's done at least 60 total — and overhauled his diet to include more vegetables and less red meat. He quit smoking and drinking. Now he weighs 143 pounds, boasting 5 percent body fat.

"It's been a major transformation," said Mackey, a building manager for a high-rise in Waikiki. "I'm so much more optimistic about everything."

Mackey admits his primary motivation to lose weight at first was purely vanity. About 20 years ago, he dropped 15 pounds strictly through dieting. But he continued to hit the bars at night.

"I lived on coffee," he said. "I was skinny, but I had no muscle."

When he turned 40, he went to his doctor for a complete physical. Though he dropped the weight, he still had 18 percent body fat. He started reading books and buying running magazines, determined to figure out the best way to get healthy.

He stopped drinking and started eating healthier food. Then he started to run. He was 42 when he competed in his first race — the Honolulu Marathon. He finished the course in just over four hours.

Since then, he's competed in 16 marathons and dozens of other races. He spends thousands of dollars on race equipment, including bicycles and shoes. He works out seven days a week, even on vacations.

"I feel great. I never have a bad day," said Mackey, who trains with his wife, Diane, 54. "It goes back to that ego thing. At least once a month someone questions my age. They all think I'm 45 or 46, and that's great for the male ego. I love that. That makes it all worthwhile."

But he's not without the inevitable health issues tied to age.

Despite his healthy diet, Mackey has high blood pressure and has to take medication daily. And he's avoided getting a colonoscopy, which men at 50 should have done annually.

"It's terrible, I keep putting it off," he said. "But I just don't have the time. I know it's wrong."

COSMETIC HELP

There is more pressure today to look good — even at 50 — than ever before, experts say. That's due, in part, to media images of younger-looking older men and women, which have fueled a shift in perceptions of what 50 should look like now.

"They feel they have to look beautiful and ageless," Thompson said. "But is that reality?"

Like Mackey, men and women, regardless of age, enjoy looking younger than they really are. That's human nature, Thompson said.

But that motivation has also fueled the cosmetic surgery industry, which has seen a significant rise in the number of cosmetic procedures performed on people older than 50.

According to the American Society of Plastic Surgeons, 2.6 million men and women 51 to 64 had some kind of cosmetic procedure in 2004, a 42 percent increase from 2000. About 660,000 people 65 and older had cosmetic procedures done, a 39 percent increase from 2000 and a 58 percent increase from 2003.

Cosmetic surgeries, however, saw a slight decline overall in 2004 for men and women older than 50. But some surgeries exploded in popularity since 2000 among the over-50 crowd, including lifts to their upper arms, breasts and buttocks. Eyelid surgeries, liposuction, nose reshaping and tummy tucks were among the most popular surgeries last year.

Advances in medicine and technology have also, more significantly, contributed to longer, healthier lives for people over 50. The average American's life expectancy is now 77.2 years — an increase of more than 30 years during the last century. In Hawai'i, it's 80, or about three years longer than the national average.

"Truthfully, with medical and technological advances, being 50 isn't what it was like a generation ago," said Carol Orsborn, author and expert on aging. ... A lot of things that would've killed us a generation ago, we're now living with."

WAKE-UP CALL

Five years ago Martha Haberman was diagnosed with lymphoma, a common blood cancer. Suddenly, the busy school principal from the Northern Mariana Islands had to slow down and focus on her health.

"It was my wake-up call," said Haberman, now 56, who reluctantly retired after being diagnosed. "I had to change my life overall."

She moved to O'ahu, initially just for a year, to get treatment for her lymphoma. Her husband and one of her two daughters soon followed.

Haberman joined the Spa Fitness Center and started lifting weights, taking yoga classes and doing tai chi. Last year she signed up for a 12-week fitness program with Try Fitness, a local training group geared toward women. She started jogging, hiking and stretching with other fit-minded females.

Soon, her clothes started to fit better and she had more energy.

With the cancer now in remission, Haberman continues to work out and eat healthfully.

Her motivation to live a healthy lifestyle is stronger than just to look good. She wants to feel good, too.

"I feel fine now," she said. "I have changed a lot."

Screenings and checkups fiftysomethings should log into their Blackberrys, pronto.

FOR MEN AND WOMEN

Why: This determines whether you're overweight and if your weight is a threat to your health. People who are overweight are more likely to have type-2 diabetes, high blood pressure and risk factors for other diseases.

How often: Every two years.

Why: For early detection of high blood pressure (hypertension). The longer high blood pressure goes undetected and untreated, the higher your risk of heart attack, stroke, heart failure and kidney damage.

How often: Every two years.

Why: To evaluate the level of cholesterol in your blood. Undesirable levels of cholesterol raise your risk of heart attack and stroke.

How often: Starting at age 45, every five years. Your doctor may recommend more frequent measurements if your levels are abnormal.

Why: To check for hearing loss.

How often: Every three years after age 50.

Why: To determine if you need glasses or contacts or to identify new vision problems, including glaucoma, macular degeneration and cataracts.

How often: Every two to four years for those 40 to 64. Every one or two years if you're older than 65.

Why: To detect tooth decay and oral cancer or problems with your gums, tongue and mouth.

How often: Regularly, once or twice a year.

Why: To check for high glucose levels, which are an indication of diabetes.

How often: If you're 45 of older, every three years. If you're at risk of diabetes, your doctor may test you at a younger age or more frequently.

Why: To detect cancer and growths (polyps) on the inside wall of your colon that may become cancerous. Colorectal cancer is the second leading cause of cancer-related deaths in the U.S. The exams are fecal occult blood test, flexible sigmoidoscopy, colon x-ray and colonoscopy.

How often: The American Cancer Society recommends a yearly fecal occult blood test, flexible sigmoidoscopy every five years, double-contrast barium enema every five years and a colonoscopy every 10 years. If you're at a higher risk, your doctor may require earlier or more frequent screening.

FOR WOMEN

Why: To detect suspicious changes and to exclude breast cancer.

How often: Every one to two years, starting at age 40.

Why: To detect breast lumps or suspicious changes too small to be detected by physical exams. These small bumps can be the first finding of early-stage breast cancer. Women 50 and older are at a higher risk for breast cancer than younger women.

How often: Every one or two years after age 40, depending on risk. After age 50, your doctor may recommend annual mammograms.

Source: AARP, Mayo Clinic

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Reach Catherine E. Toth at ctoth@honoluluadvertiser.com.