Research by the State of Minnesota reveals that the state’s over 65 population will double by 2030. More people are living longer, and it’s crucial that we know how to live and age well. Dr. Heather Thompson Buum, Interim Division Director of the Division of Geriatrics, Palliative and Primary Care at M Physicians, says that by taking care of our bodies and minds and working with primary care providers, aging can be a positive experience for all Minnesotans.

The 4Ms of Aging

Developed by the Institute for Healthcare Improvement, the 4Ms of Aging is a framework that considers four important factors for older adults. They are: 

  1. What Matters
  2. Medication
  3. Mentation
  4. Mobility

What Matters

The first M focuses on your goals in aging and what matters most to you.

“The goals of care may be different depending on your age, circumstances and world view,” explains Dr. Thompson Buum. “It might not be to live as long as possible. It might be that I want to live to see my granddaughter graduate from college or being functional in my own home as long as I can.”


As we age, it’s common for our list of medications to grow. It’s important to be aware of all the medications we are taking and their potential side effects and drug interactions.

“It’s important for you and your doctor to continually reevaluate your medication list to determine if each medication is really necessary or really beneficial. There’s a lot of medications that can be stopped and probably don’t have a benefit past a certain age,” Dr. Thompson Buum elaborates.

“Oftentimes those are continued indefinitely when you might be able to stop and see how the patient does without it,” she states. Many primary care clinics offer Medication Therapy Management, where a pharmacist meets with patients, reviews their medications and makes suggestions. 


Taking care of our mental health and managing depression and anxiety as we age is crucial.

“Older patients sometimes feel isolated and that can lead to depression,” says Dr. Thompson Buum. “If mobility is impaired and they’re not able to get out and do the things they used to, that affects mental health.”

Additionally, there are tests available to screen for dementia in the outpatient clinic setting, such as the Montreal Cognitive Assessment. Formal neuropsychiatric testing can provide detailed information on memory and cognition.


Mobility is an extremely significant factor in aging, and Dr. Thompson Buum says that it can be difficult to accurately assess in a clinic. Researchers and clinicians like M Physicians’ Dr. James Langland are developing better ways of measuring a patient’s physical fitness during an office appointment. Despite common misperceptions that elderly folks should avoid physical activity to prevent falls, Dr. Thompson Buum says that the key is finding the right type of exercise.

“There’s all kinds of adaptive equipment and exercises out there, like walking sticks or seated yoga. There are programs specifically designed for seniors at most health clubs. Pickleball is another activity that encourages social interaction along with exercise. I encourage my patients to think of something they enjoy and something they’d stick with,” Dr. Thompson Buum remarks. 

Schedule Your Screenings

Dr. Thompson Buum says one of her best pieces of advice for people over the age of 40 is to schedule your age appropriate screenings. Annual screenings for cancer are a critical preventative measure to ensure that we live long, healthy lives, and many patients may not be aware of guideline changes, like beginning colon cancer screening at age 45 instead of 50. But there is also the question of when to consider discontinuing screening. 

“We look at the patient sitting in front of us and consider their possible ten year life expectancy,” she explains. “I have some 80 year-old patients who are quite healthy. They’re probably going to benefit from continuing screening, whereas if a patient has heart failure and lots of comorbidities, that’s probably not going to be as beneficial. Everything is a risk-benefit analysis.”