Ageing & You: Know the facts

Knowing Ageing : The First Step for healthy living 

     Ageing is growth of the body with time and not synonymous with old age. Ageing is inevitable. Every day, 24 x7 we are ageing.  Whoever is borne in this world will pass through the cycle of birth, childhood, youth, old age and finally good bye (death); the four stages of life. Evidence exists that we can live long and become a centenarian. (Refer post on secrets of centenarians). Unfortunately our faulty life styles have made ageing synonymous with old age.

     We should be able to preserve youth as we age and delay effects of old age as far as possible. A sound knowledge of ageing process is the first step to longevity.

Physical changes in body with ageing affecting health

     Till 18-20 years of age growth and maturation takes place. Peak of growth is achieved by 25-30 years, thereafter, a gradual decline in functions takes place with ageing. This decline is primarily determined by genes; but lifestyle choices have a powerful impact on the ageing process. One can expect following major changes which affect our health with ageing:-

  • Atherosclerosis sets in.  Atherosclerosis
    Atherosclerosis
    Atherosclerosis is root cause of hypertension, PVD and stroke

    (deposition of fat like material in blood vessels) starts from birth and increase gradually with time, causing gradual reduction in the lumen of the blood vessels reducing the blood flow to organs. Coronary arteries (arteries supplying blood to heart) are main victim of atherosclerosis. As the time passes, narrowing down of coronary arteries leads to chest pain, during exertion (also called angina) which is cry of heart for more oxygen.  With age, risk factors like cholesterol,  high blood sugar and triglycerides start rising and accelerate atherosclerosis. Atherosclerosis is responsible for diseases like Hypertension (high blood pressure), heart attacks, peripheral vascular diseases (PVD) and stroke.

  • Catabolism Takes over Anabolism. With age catabolism (destruction of tissues) becomes more pronounced than anabolism (formation/repair of body tissues) leading to slower replacement of body cells & repair of tissues. Consequently slow healing of wounds takes place due to decrease in anabolic activity.
  • Skin. The skin looses elasticity and become more lined and wrinkled.
  • HearingOver time, changes in the ear make high-frequency sounds harder to hear and changes in tone and speech less clear. These changes tend to speed up after age 55.
  • Vision.  After the age of 40 people require reading glasses (presbyopia). Night vision and visual sharpness also decline with age. Cataract and glaucoma (major causes of blindness) usually occur.
  • Sleep. Changes in sleep and circadian rhythm occur as one age. One will probably sleep less at night, and may not sleep as deeply as young.
  • Bones and Joints.  After the age of 30, 2-3% reduction in bones and muscle mass occurs every decade. As people enter their 40s and 50s, the bones gets thinner leading to thin, fragile and weak bones (Osteoporosis). After menopause in females this process is accelerated. A trivial fall may lead to fractures of bones, (bones in the hip, backbone and wrist) resulting in loss of independence, disability and even death. Arthritis, (inflammation of joints causing pain, swelling, stiffness & deformity) affects majority of old people in one form or other.  Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when cartilage begins to become ragged and wears away leaving bones to rub against each other causing pain. Rheumatoid Arthritis (RA) is an autoimmune disease; that means the body attacks the lining of a joint thinking it to be foreign material.
  • Metabolism and Body Composition.  Metabolism slows down and body typically needs less energy. It leads to increase in weight and obesity ; popularly perceived as middle age spread.  As obesity sets in, increase in risk factors for heart diseases like cholesterol, blood sugar, triglycerides also occur, which aggravates atherosclerosis. After age of 35 such abnormalities are common. For every extra 1 kg of fat, one tends to produce    20 mg more cholesterol per day. Slowing of metabolism also renders elderly people susceptible to cold intolerance.
  • Brain and Nervous System.  Starting in the third decade of life, the brain’s weight and its blood flow decreases. Memory changes are a normal part of the ageing process. It’s common to have less recall of recent memories and to be slower remembering names and details. When these processes become severe, diseases like Alziemers may occur.
  • Heart and Blood Circulation.  The heart naturally becomes less efficient as it ages, and has to work a little harder during activities than it did in the past. This makes the heart muscle a little larger. A gradual decline in energy or endurance occurs from one decade to the next.
  • Lungs.  Lung elasticity and lung compliance reduces overtime supplying the body with less oxygen.
  • Immune System. Immune system cells identify and destroy foreign substances such as bacteria, other infecting microbes, and probably cancer cells.  The immune system slowdown reduces efficacy of vaccines, making older people more prone to some infections, such as pneumonia and influenza and more number of cancers in old age.
  • Reproductive Organs.
    • Women.  After 40-45, when the levels of female hormones (particularly estrogen) decrease dramatically, menopause sets in. The menstrual periods end permanently and pregnancy is no longer possible. The ovaries and uterus shrink. The tissues of the vagina become thinner, drier and less elastic (a condition called atrophic vaginitis). The breasts looses firmness and tend to sag. This change makes finding lumps in the breasts difficult. Some of the changes that begin at menopause may interfere with sexual activity.  Breast cancer and uterine cancer are dreaded diseases in older females.
    • Men.  In men, there is a gradual decline in the levels of testosterone (male hormone), resulting in fewer sperm and a decreased sex drive (libido). Erectile dysfunction (impotence) becomes more common as men age and but it is primarily due to a vascular disease or diabetes. There is a gradual enlargement of prostrate gland that surrounds the tube (urethra) that passes urine. This condition is called Benign Prostatic Hypertrophy (BPH). Progressive enlargement of prostrate may squeeze the urethra causing problems in passing urine. As a result, older men tend to urinate with less force, take longer to start the stream of urine, dribble urine at the end of the stream, and urinate frequently. Older men are also more susceptible to urinary retention. Urinary retention is painful condition and requires immediate medical care. In some unfortunate ones Prostate Cancer may develop.

Psychological and social effects of Ageing

     Old people are hit not only by physical disabilities but also psychological and social problems as well. Children grow up. Daughters get married and leave them. The sons also leave them for jobs. Old parents living alone in villages and cities are common scene. After retirement, parents require support from their children, but may not get it as children are busy with their own affairs. The children may not support them at all. In some households physical abuse of elderly people is not common. Remember the bollywood movie ‘Bagwan (a must see movie), which reflects true colour of society and informs us not to expect anything from children. In the movie the father (who is now retired) wants to live with his children, but none of them want to keep them. Tortured by children, he returns back to his original home.  Loss of partner and good time friends may occur in due course of time. Loneliness and depression are common in elderly people.

Summary

     Major changes affecting health discussed earlier are inevitable. Often the first sign is graying of hair which is not disabling. In spite of decline, however, the body functions remain adequate because the body has considerable functional reserve. For example, if one kidney is destroyed, the remaining one can maintain normal functions of the body. Even though most functions remain adequate, the decline in function means that older people are less able to handle various stresses, including strenuous physical activities, extreme temperature changes in the environment and are more likely to experience side effects from drugs. If you are above 45 years you would have been feeling the difference.

     Our lifestyle is responsible for accelerating the decline of functions. Chronic disease like hypertension, diabetes, arthritis and cancers rather than normal aging, is main cause for disabilities in old age. The preparation for old age starts from younger days itself. We should aim to slow down the age related decline in functions, and prevent or or at least delay the onset of chronic diseases.

You grow old not by ageing : you become old when you stop growing

In our next post we will bring you about the secrets of long life from the land of centenarians

Acknowledgement : The photograph on atherosclerosis has been taken from  http://tran-bio3u-fall09.wikispaces.com/Atherosclerosis.

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