Americans fear health and financial woes will weigh on living a long life, as could becoming burdens to their families.

A new study from BMO Wealth Management, The Aging Economy: Improving With Age, finds that Americans aren’t approaching retirement without some substantial fears for how that retirement will go.

Higher life expectancy — 76 years old for men and 81 years old for women — offers the potential of a long retirement (18 years), but also presents its own problems.

According to the report, 46% fear a decline in their quality of life as they age and being snowed under by the cost of health care; 45% fear burdening families with their care and 44% worry about running out of money during retirement.

Spouses and partners don’t always agree about long-term financial goals, with the most common disagreement reported in the study being when and how much to save for the future (28% of couples disagreed). Retirement goals followed, at 27%, with the distribution of personal assets and possessions to heirs coming in third at 25%.

And when it came to investment and retirement issues, maximizing retirement income was the biggest concern. That was followed with the fear of outliving their savings in retirement and the impact of long-term care costs on personal finances.

Among the suggestions BMO offers to alleviate some of those fears are making sure that financial plans, investment policy statements and written estate documents are up to date; considering working past traditional retirement age to stretch retirement assets; understanding what effects one’s personal and family medical history can have on the likelihood of illness and its effects on retirement spending; discussions with spouses, family members and support networks about end-of-life planning; and talking with financial professionals about the financial implications of a longer life.