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December 10, 2017
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community living

Normal aspects of aging

By James D. Lomax, MD

“Always remember that you are absolutely unique. Just like everyone else”

— Margaret Mead

I have always appreciated this quote when discussing aging issues with patients. Each of us varies widely in terms of our physiology at any age, but there are common changes associated with normal aging. More important for each of us is whether a change in body function represents a potential illness. This article will describe common body changes and what might represent a developing health problem.

The simplest way of defining aging is the permanent loss of cells over time. This loss of body cells changes body composition. Examples are an increase in total body fat as our lean muscle mass declines, changes in the strength of our bones and decrease in total body fluid, along with organ functions.

External Changes

We are socialized from childhood to recognize age by skin, hair and body habitus changes. Below are some common external changes:

Skin: With age and sun exposure over the years, the skin becomes less elastic and more lined and wrinkled with easy bruising and abrasions. Also we develop sun-damage related moles, freckling and seborrheic skin spots.

Hair: Hair will thin on the scalp, pubic area and armpits. As hair pigment cells decline in number, gray hair growth increases.

Height: By age 80, we can lose two inches or more in height due changes in posture, narrowing of joint spaces and spinal discs.

Hearing: By age 55, many of us have high-frequency hearing loss requiring us to wear a hearing aid. Environmental exposure to loud noise compounds this loss.

Vision: By age 40, many of us develop a need for reading glasses as the lenses in the eyes become less flexible (presbyopia).

Internal Changes

Aging changes our body systems in predictable ways. If a person develops a chronic disease that affects one or more organ systems, the changes associated with normal aging are compounded by the disease to the point that it affects our overall daily functioning.

Two of the most important criteria for determining whether a symptom you are experiencing is normal vs. “abnormal” are the span of time and intensity in which these changes are occurring. Aging changes occur over years and decades, not days or weeks. Other criteria to consider:

Physical appearance: Rapid changes in appearance can indicate potential underlying health problems. As examples, has there been a noticeable change in weight, bloating, paleness, rapid loss of scalp hair, or noticeable shortness of breath with exertion?

Physical abilities: Recent development of joint pain, difficulty in performing daily activities due to complaint of weakness, a new pain pattern, or recent feeling of instability when walking can all indicate the development of a potential health problem.

Changes in behavior and cognition: Family and friends are often the first to notice changes in our personalities and daily behaviors. This includes changes in appetite, irritability, withdrawal from family and friends, new onset sadness or agitation; all can indicate underlying health problems. Memory loss, change in personal habits and onset of dementia are often subtler and harder to recognize. It often takes an accident or incident to highlight a potential problem.

If there is any question as to whether what we are experiencing is normal or a potential health problem, you need to have this evaluated by your personal physician or health clinic. People often delay this evaluation, saying it is “old age” creeping in. If the symptoms or body changes are occurring over a short period of time, this becomes an urgent or even emergency situation, and medical care needs to sought. All of us fear the unknown when it comes to our health, but early intervention often prevents serious health consequences and saves lives.

Normal body system changes:

Brain and nervous system: Brain weight, nerve distribution, and blood flow decrease to our head beginning in our 30s. Generally, we adapt and notice little change in function. Memory changes are a normal part of the aging process—it’s common to have less recall of recent memories and to be slower remembering names and details.

Heart and blood circulation: Our hearts become less efficient as we age leading to decreased output of blood. The heart has to beat faster and harder to maintain normal blood flow, especially when exerting yourself. In our advanced years, this is experienced as declines in energy and endurance.
Lung: For people not exercising on a regular basis, the lungs become stiffer and less efficient for supplying the body with oxygen. This leads to increased shortness of breath when we exert ourselves.

Kidney: In advanced years, the kidneys decline in size and function. This can result in not being able to eliminate body wastes and some medicines from the blood efficiently.

Urinary Tract: Age-related changes to our urinary track system, decreasing physical mobility and medicine side effects can all lead to urinary leakage and incontinence. Complete incontinence is not a part of normal aging.

Sexual function: We begin to produce lower levels of hormones starting in our 50s. For males, lower testosterone production results in less sperm production and changes in sexual response time. For women, ovulation gradually stops and menopausal changes occur because of a decrease in estrogen production.