The first few wisps of gray hair are a sign of the inevitable. We age and our bodies change. Our waistline may become a little rounder, or we may wake up during the night, or feel a little stiffer in the morning. However, as we adjust to our new reality, we shouldn’t view every symptom as further evidence of aging.
How do you know when to ignore a physical flaw or when to seek medical advice? What is normal aging and what is not?
“Aging itself is a subtle, quiet process,” says Mary Bernard, MD, deputy director of the National Institute on Aging. If you experience sudden changes or pain, that’s a red flag, she says.
“I have a lot of patients come to me complaining of knee pain. They say, ‘This is how old I am,'” said Bernard, a geriatrician. “The fact is that both knees are the same age. Why does one knee hurt but the other doesn’t?
Kenneth Minack, MD, director of geriatric medicine at Massachusetts General Hospital in Boston and associate professor of medicine at Harvard Medical School, said we should not think of aging as a failure of the body’s systems. “Aging is a life-saving process,” he said. “It’s a lifelong process of adaptation that prevents us from developing deadly cancers.”
Natural changes in cells may slow them down or alter their capabilities, he said. Most people reach their peak functioning around age 30.
How often you notice age-related changes in endurance, strength or sensory perception depends on your personal health choices, your medical history and your genes, Minack says.
Your access to health care and education, income, neighbors, and community may also have an impact on your health. These are what experts call the “social determinants of health” in the population. Social determinants of health may contribute to health disparities. The Centers for Disease Control and Prevention defines health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities for optimal health among disadvantaged groups in society.” For example, certain conditions, such as diabetes and high blood pressure, are more common among certain minority groups than among white people.
Some age-related symptoms are common, while some are not caused by aging at all. Here are some suggestions on how to tell the difference:
By the age of 40 or so, almost everyone wears reading glasses. Presbyopia occurs when the lens becomes stiff and cannot adjust to refocus from far to near vision. When you reach age 60, cataracts or clouding of the lens may begin to affect your vision. Prolonged exposure to the sun increases the risk of cataracts, which can be corrected through lens replacement surgery.
If you find that your peripheral vision is worse than your central vision, or vice versa, you may have a serious eye condition that requires treatment. Glaucoma occurs when pressure inside the eye increases and causes damage to the optic nerve. Both forms of macular degeneration affect the center of the retina, causing central vision loss.
The bottom line: “If you experience blurred vision or vision loss, you should get your eyes checked,” says Hilary Beaver, M.D., associate professor of clinical ophthalmology at Weill Cornell Medical College at Houston Methodist Hospital. It’s also a good idea to get preventive checkups, she says, especially if you have diabetes or a family history of glaucoma or macular degeneration.
About one-third of people aged 60 or older have some degree of hearing loss. This condition is called presbycusis and may be caused by the loss of sensory receptors in the inner ear. At first, some sounds may appear muffled, and higher-pitched sounds may be more difficult to understand. Men are more likely to experience hearing loss than women.
Robert Doby, MD, professor of otolaryngology at the University of Texas Health Science Center at San Antonio, warns that pain, ear discharge, or rapid hearing loss may be signs of a tumor or infection. If hearing in one ear is significantly worse than the other, that’s one reason to get tested, he said.
“If people just notice, ‘My hearing isn’t as good as it was a few years ago,’ that’s part of the aging process,” Dobie said. “If my hearing isn’t as good this week as it was last week, that’s not the aging process.”
As we age, we lose muscle tissue and our muscles become stiffer and less elastic. Weight training and stretching can improve strength and flexibility, but we can’t completely counteract this natural aging process.
Our organs also lose extra reserves. As we age, the walls of the heart become thicker, the arteries become stiffer, and the heartbeat slows down. Aging of the heart is a major reason why as we age, it may be difficult for us to exercise as vigorously as we did when we were 20 years old.
When should you worry? If you have chest pain, especially dizziness, nausea, shortness of breath, or fainting, get evaluated right away. These may be signs of a heart attack. Heart rate problems may cause dizziness, lightheadedness, or fatigue.
One in 10 people aged 65 or older has anemia, or low levels of oxygen-carrying red blood cells. It causes fatigue and can be treated with iron supplements or medications to stimulate the body to produce more red blood cells.
Aging is not a disease, but changes in our bodies make us susceptible to certain diseases.
One example is essential hypertension, or high blood pressure. The exact cause of essential hypertension is unknown. Several factors play a role, including genetics, obesity, salt intake and aging. As we age, blood vessels tend to become less elastic, and this stiffness can lead to high blood pressure.
More than half of people age 60 and older have high blood pressure – a reading of 130 (systolic blood pressure) over 80 (diastolic blood pressure) or higher.
A low-sodium diet, exercise, and maintaining a healthy weight can help prevent high blood pressure.
Can’t remember where you put your keys? Forgot the name of an acquaintance you haven’t seen in a while? Those brief lapses are normal.
There’s no need to worry unless forgetfulness affects your daily life, said Dr. John Q. Trojanowski, co-director of the Center for Neurodegenerative Disease Research and professor of geriatrics and gerontology at the University of Pennsylvania in Philadelphia. “Many of us have memory impairment, but it’s not dementia or disease,” he said.
Generally speaking, information processing slows down as we age, and older adults have more difficulty multitasking. But cognitive function varies greatly. For example, it’s no surprise that older people generally have better understanding of the world than younger people.
A red flag for Alzheimer’s-related dementia is the inability to learn and retain new information. Episodic memory problems are a sign of mild cognitive impairment and may be a precursor to the disease, according to new guidelines for diagnosing Alzheimer’s disease.
Trojanowski said people with Alzheimer’s disease also have other cognitive deficits, such as problems with language or recognizing objects. Biomarkers detected through imaging or cerebrospinal fluid testing can help diagnose Alzheimer’s disease.
If you have memory problems and a family history of Alzheimer’s disease, you may need to be evaluated. Alzheimer’s disease rarely occurs in people under 65. Alzheimer’s disease.
