Many people are living longer, healthier and being more active than ever. In fact, the American Psychological Association predicts that one out of every four 65-year-olds today will live past age 90.

However, being healthy enough to be socially active in later years comes with certain risks, such as getting the flu.

No one expects to get a cold or the flu. However, unless you live like a hermit, getting the flu may be inevitable.

This flu season has been particularly harsh, regarding both the number of people getting the flu and its severity.

QUESTION: Why do those over 65 years have an increased risk of getting the flu and experiencing more serious complications?

ANSWER: Having enough energy to be active is not always equal to having a healthy immune system. The fact that many people over 65 years have a less efficient immune system increases their risk of getting the flu. Interestingly, a recent University of Maryland study found that flu transmission does not necessarily require that you come into contact with a cough, sneeze or surface contaminated with the virus. This study showed that the flu virus can be spread merely by breathing the virus in air exhaled by an infected person. Just being in close proximity increases your risk.

As people age, they are more likely to have conditions that challenge the immune system, such as diabetes, heart disease, respiratory problems or a combination. Even if your immune system is only marginally compromised, being more socially active and out in public gatherings increases your risk of getting the flu.

Additionally, the physical stress of the flu in addition to any underlying chronic conditions can increase a person’s risk of severe complications, such as pneumonia, heart attack, hospitalization and death.

Q:What helps you to avoid the flu? And what do you do if you catch it?

A: There are a number of ways to decrease flu risks besides becoming antisocial. Prevention is key. Talk with your doctor about getting flu and pneumonia shots. Also, take steps to strengthen your immune system.

>> Improve your diet. Many of us don’t eat as well as we should. This is especially true for those with lower calorie needs and a limited variety of foods in their diet.

Eating healthfully does not mean just eating so-called superfoods. Maintaining health requires consuming all of the essential nutrients in adequate amounts.

As we age, choosing a healthier diet can become a challenge. Fruits and vegetables are important, but getting adequate quality protein is more important than ever, and research indicates that protein needs are somewhat greater in older people. Also, it can make sense to take a multi-vitamin mineral-type supplement to fill potential nutrient gaps.

>> Start or continue to exercise moderately, especially in ways that build or help maintain muscles.

>> Be a bit obsessive about washing your hands and keeping your hands away from your face.

>>Have an emergency bad-day or flu box tucked away, so you don’t need to go out shopping for food. Foods can include boxed fluids, ready-to-eat chicken soup and other ready-made or easy-to-prepare, shelf-stable foods.

If you think you are coming down with the flu, get to your physician or emergency room within 48 hours to see if an antiviral medication like Tamiflu would be appropriate. Also, if you are around others with the flu, some physicians will recommend taking Tamiflu to reduce your risk of infection by the flu virus.

Alan Titchenal, Ph.D., C.N.S., and Joanne Dobbs, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii-Manoa. Dobbs also works with University Health Services.