The queen of England is 90 years old — and for the first time in many years she did not attend the traditional Christmas morning church service near her Sandringham estate in rural Norfolk, England, because of a bad cold — thus raising worries about her health, the Associated Press reported Sunday.

The service is “a cornerstone of the royal family’s Christmas celebrations and brings the monarch into contact with locals who gather outside for a glimpse of her,” AP noted in its report.

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“The queen continues to recover from a heavy cold and will stay indoors to assist with her recovery,” Buckingham Palace said in a statement.

The queen, however, had been expected to participate in a Christmas lunch during the day.

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Elizabeth has generally enjoyed good health over the years, but lately has been traveling less often than in the past. She also recently gave up her work as patron for some 20 charities and groups in an effort to decrease her workload.