One way to help dispel the myths of aging is to understand how people change during the aging process.
Physical and Biological Changes
The transmission of messages in the nervous system—the body’s communications superhighway—slows down, often resulting in balance problems and slower reflexes.
Sensory losses affect our ability to interact with our environment. By age 65 or 70, 90 percent of adults have some vision loss, and some have significant hearing loss.
There is little change in intellectual ability if we remain healthy. Cognitive changes affect memory, reasoning, and abstract thinking. We need more time to learn new things, and some loss of short-term memory may occur.
The efficiency of the heart muscle decreases, and susceptibility to hardening of the arteries increases. As a result, we are less able to respond to physical or emotional stress, and blood pressure may increase.
Changes in bones, muscles, and lung tissue can result in decreased lung efficiency. Shortness of breath and fatigue may lead to inactivity, which results in further declines in overall function and fitness.
Nutritional status and enjoyment of food are often affected. We need fewer calories, but not fewer nutrients, so ensuring a healthy diet while avoiding excessive weight gain is a challenge.
Normal age-related changes result in skin wrinkles, dryness, and thinning; diminished skin resiliency and an increase in “liver spots”; increased susceptibility to hypothermia and hyperthermia; and loss, thinning, and graying of hair. Nail growth slows, and nails become thicker and more brittle.
Ligaments, joints, and bones undergo structural changes. Bone loss occurs, and there is decreased muscle bulk, strength, speed, strength, and endurance.
While incontinence is not a normal part of aging, there are changes in kidney function and bladder capacity. The message that “you have to go” can be slowed, resulting in greater urgency.
Prostate gland problems in men are more common.
Though there are some changes in both sexual function and response in males and females, people retain the capacity for sexual activity well into old age.
The greater the number of medications, the greater the risk of adverse side effects. Changes in kidney and liver function mean that drugs are not metabolized in the same way as in younger people, and changes in the digestive system may affect the absorption of drugs.
Dementia is a general term characterized by serious memory loss, difficulty with concepts of time and space, problems with speech and hearing, and severe shifts in mood. The two most common types are multi-infarct dementia caused by strokes and dementia caused by Alzheimer’s disease. The latter accounts for more than 60 percent of the cognitive function disorders in the aging population.
Not surprisingly, increasing age is the greatest risk factor for Alzheimer’s disease. Statistics show that:
Someone in America develops Alzheimer’s every 72 seconds; by midcentury, someone will develop the disease every 33 seconds.3
In 2007, an estimated 5.1 million Americans have Alzheimer’s disease. This number includes 4.9 million people age 65 and older and at least 200,000 individuals younger than 65 with early-onset Alzheimer’s. By 2030, the total number could soar to 7.7 million.4
Social and Emotional Changes
As life expectancy increases, so does the period following the end of paid employment. For many, this new phase of life is a time to enjoy more freedom, explore options, spend more time with family and friends, and develop new skills. For others, not working can affect their sense of identity and leave them feeling lost, bereft, and useless.
Those who retire from paid employment may have less money, depending on whether they have saved over the years or have an adequate pension. Social security income alone is seldom sufficient. It may be difficult for an older adult to change his or her lifestyle to accommodate changes in income. Worry over medical expenses and long-term care makes the situation worse.
As we get older, so do our friends and family. Death may occur at any time, of course, but mortality increases with age. In addition to sadness and anger, people who experience loss typically feel lonely and overwhelmed.
Once the limiting effects of normal aging begin, older adults may have to give up driving. Reductions in hearing or vision may make it more difficult for us to do routine tasks such as grocery shop, read the newspaper, go to doctors’ appointments, or go out with friends to the theater. Cognitive changes, too, may make us reluctant to interact with friends and family. None of these limitations has to result in a loss of independence, but the perception of loss and the thought of figuring out accommodations can be daunting. 5