5 Things Men Fear Most About Aging

1: Impotence

"No question that men worry more than women about performing," says Ken Robbins, a University of Wisconsin professor of psychiatry who's also board certified in internal medicine. "When libido starts to diminish or things don't work as well as they did before, it's very common for men to worry that they'll embarrass or humiliate themselves."

Perhaps performance anxiety isn't surprising, given a 2008 British study that showed men think about sex 13 times a day, compared to 5 times a day for women.

The prospect of impotence was scarier than cancer or death to readers of a men's magazine in a 2001 poll. Perhaps there's a good medical reason for this: Otherwise healthy men who have erectile problems have been shown to have abnormal coronary tissue, higher incidence of high blood pressure, high blood fat, and other markers of heart disease.

Fear fighter: Have your cholesterol checked. Three-fourths of men with erectile dysfunction (ED) have abnormal cholesterol. "Two-thirds of men who've had heart attacks had ED that predated angina by at least three years," says urologist John Mulhall, director of the Sexual Medicine Program and the Sexual Medicine Research Laboratory at Weill Medical College of Cornell University in New York City.

2: Weakness

It's said that knowledge is power -- but for men, so is physical power itself. "Men value strength and vigor more -- and when it starts to slide, they take it much harder than women do," Robbins says. "Losing physical strength adds to their overall sense of loss: 'If I can't lift things, what kind of man am I?'"

Feeling weaker was named one of the most dreaded parts of aging for nearly 9 in 10 people surveyed earlier this year by the American Geriatrics Society Foundation for Health in Aging along with Abbott Labs.

Fear fighter: Start (or keep up) resistance training and a healthy diet. Only 25 percent of the 1,000 adults in the AGSF study made strength training part of their everyday routine, even though this basic can protect muscle health.

3: Retirement/irrelevance
The prospect of retiring fires enormous anxiety because it, too, begs the question, "If I'm not my career, what am I?"

Men fear retirement because it's how they define themselves and how they fill their time. Reaching retirement age tends to coincide with having your opinion solicited less and becoming more "invisible". Net result: a huge ego blow.

Women have an easier time giving up work, psychiatrist Ken Robbins adds, because they more quickly fill its gap with friends and children.

Fear fighter: Avoid being sidelined by staying involved, even if it means finding new ways to do so. Try to follow new technologies, stay interested in younger people, reinvent yourself by discovering a new meaning and purpose to your life post-retirement. Or keep working. Above all, stretch yourself to keep social networks strong.

4: Losing wheels (and independence)

From his first souped-up junker to his badge-of-success sports car (or midlife-crisis convertible), what a man drives reflects his very identity. Cars also represent freedom, independence, and the endless possibilities of the open road.

The prospect of having to give all that up -- which many men first think about when they see their own fathers turning in the keys for safety's sake -- is scary indeed.

Driving is also emblematic of another fear: Becoming dependent on others to meet basic needs. "It's no coincidence that the men with the highest social status in assisted-living communities are the ones who have driver's licenses," Robbins notes.

Fear fighter: Consider the facts. Many older adults continue to be able to drive safely into their 70s and 80s. A refresher course can help. But know that this is one area where the greater good -- the safety of others --should trump private fears, when the time comes.

5: Losing your mind (or your wife losing hers)

Perhaps recent headlines are scaring more men into the fear of Alzheimer's: Men are more likely than women to have mild cognitive impairment (MCI) -- sometimes called "pre-Alzheimer's" -- and get it earlier, according to a Mayo Clinic study in the September 2010 journal Neurology. Nearly one in five men ages 70 to 85 have the condition, which falls between normal forgetfulness and early dementia.

More women, on the other hand, actually develop Alzheimer's disease. But that, too, is a scary prospect for their mates, thrust with little preparation into a caregiver role. "Most men haven't done too much caregiving," Robbins says. And nothing dashes the fantasy of a footloose-and-fancy-free retirement like tending full-time to a partner who doesn't even know you.

Fear fighter: Know that only about 15 percent of cases of mild cognitive impairment evolve into dementia each year. (If you're married, you may be protected; MCI is highest in men who were never wed.) No surefire ways to prevent Alzheimer's have been found, but a heart-healthy lifestyle may lower the risk.