Life may or may not begin at 40, but a new federal study says getting on in years does not mean a person has to get old in the sense of getting sick and frail.

A committee of the Institute of Medicine said in a report released Monday the fact is that research, health promotion and education can head off much of the illness and disability associated with aging."Our misplaced pessimism gives rise to the particularly troubling consequence that many more individuals who could experience a fulfilling maturity are denied the chance by these stereotypes," the committee report said.

"We should not let pessimism become an obstacle to the introduction of new research on interventions to restore and maintain function among physically or mentally impaired older people."

Since American society is gradually aging, the report said, the medical community should promote healthy lifestyles not only for the young but for all ages.

The committee made recommendations in 13 areas:

- High Blood Pressure: Since high blood pressure often precedes stroke and heart attack, the committee said there should be programs of education, detection and treatment among those over age 50. It said Medicare and private insurance should reimburse the expense of doctor visits to evaluate blood pressure, and that more research is needed on treating hypertension in the elderly.

- Medications: Age should be taken into account in testing drugs. Health care workers and elderly patients should be more aware of the combined effects possible from combinations of medications.

- Infectious Diseases: All people over 50 should be immunized against pneumonia and influenza. Better infection controls should be used in hospitals and nursing homes.

- Osteoporosis: Older people should be instructed about measures to prevent thinning of the bones, such as adequate calcium and vitamin D intake, and the need to maintain physical activity. More research is needed about how to best treat fractures caused by osteoporosis.

- Sensory Loss: Better services should be provided to those losing sight and hearing, and public and private insurers should cover more of these costs.

- Oral Health: More research is needed to achieve and maintain dental health among the elderly. Dental loss now is largely preventable in the elderly.

- Cancer Screening: More aggressive cancer checkups should be instituted among the elderly.

- Nutrition: Further research is needed on the minimum nutrition requirements of the elderly.

- Smoking: Even the elderly should be encouraged to stop. Advertising of tobacco products should be banned.

- Depression: Doctors should be trained to recognize and treat depression among the elderly, and some limitations on Medicare and insurance reimbursements for psychiatric care should be removed.

- Physical Inactivity: Sedentary lifestyles can damage health. Health care workers should promote programs to encourage elderly to get regular exercise.

- Social Isolation: Isolated individuals should be identified and means found to give them more social contact. Loneliness, the report said, can play an important role in development of disease and disability.

- Falls: "Falls among the elderly are a major cause of mortality, morbidity and disability," the report said. It recommends more research on methods of preventing falls, and studies on how best to treat injuries that result from falls.