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Disease versus Aging
With age, many of the body’s functions decline. The decline that occurs in normal aging, however, is not usually considered the same as disease, although the distinction is not always clear. As people age, blood sugar levels increase more after eating carbohydrates than they do in younger people; however, the very large increases that occur in diabetes are not considered normal aging. Mental decline that includes more difficulty learning new languages and increased forgetfulness is nearly universal with advanced age and is considered normal aging; however, the serious mental decline of dementia, with its extreme loss of short-term memory, ability to learn, and understanding of the environment, although common in late life, is considered a disease. Alzheimer’s disease is an abnormal process,
The average life expectancy of Americans has been increasing dramatically over the past century. A male child born in 1900 could expect to live only 46 years; a female child, 48 years. Today, however, a male child can expect to live more than 73years; a female child, nearly 80 years. Although many of these gains in longevity can be attributed lo the significant decrease in childhood mortality, life expectancy at every age beyond 40 has also increased dramatically. For example, a 70-year-old man can now expect to live until age 83, and a 70-year-old woman to age 85. Despite the increase in average life expectancy, the maximum life span the oldest age to which people can live has changed little. Despite the best genetic makeup and medical care, no one seems to live much beyond 125 years, although some experts suggest that this number may be slowly increasing. Currently, a person has a 1 in 2 billion chance of living to the age of 120.
Several factors influence longevity. One is heredity, which primarily influences whether an individual will contract a disease. For example, inheriting an increased risk of developing high cholesterol levels is likely to result in a shorter life, whereas inheriting genes that protect against heart disease and cancer can help to ensure a longer life. Another important influence on longevity is lifestyle; avoiding smoking, avoiding drug and alcohol abuse, maintaining a healthy weight and diet, and exercising appropriately help people avoid disease. Exposure to environmental toxins can shorten life expectancy even among people with the most robust genetic makeup. Medical care contributes to increased survival by preventing or treating diseases after they are contracted, especially when infectious diseases, cancer are cured.
Bodily Changes
The human body changes in many noticeable ways with age. Often, the first signs of aging involve the musculoskeletal system. By age 35, peak performance, even among superior athletes, begins to decline. Sensory organs also begin to change early in mid-life. A common development, for example, is presbyopia, in which the eye can no longer focus without using reading glasses or changing to bifocals. Another, if later, common development is presbycusis, or age-associated hearing loss, which initially affects the ability to hear the highest pitches and, gradually, the lower pitches as well. Therefore, older people may find that violin music no longer sounds as exciting as if did when they were younger. In most people, the proportion of body fat increase by more than 30% by late age.
The distribution of fat also changes: There is less fat under the skin and more in the abdominal area. Thus, skin becomes thinner, wrinkled (although sun exposure and smoking have a greater influence on wrinkling), and more fragile, and the shape of the torso changes. Not surprisingly, most internal functions also decline with age. These functions generally peak shortly before age 30 and then begin a gradual but continuous decline. Even with this decline, however, most functions remain adequate throughout life, because most organs have considerably more functional capacity than the body needs (functional reserve). For example, even if half the liver is destroyed, more than enough liver tissue remains to maintain normal function.
Disease, rather than normal aging, usually accounts for loss of function in old age. Even so, the decline in function means that older people are more likely to experience side effects from drugs, changes in the environment, toxins, and illness. Although the decline in function of many organs has little effect on how people live, the decline in some organs can greatly affect health and well-being. For example, although the amount of blood that the heart can pump at rest is not greatly reduced in old age, the heart cannot pump as much when pushed to its maximum. This means that older athletes will not be able to perform as well as younger athletes. Changes in kidney function can dramatically affect how well older people are able to eliminate certain drugs from their body. Determining which changes are purely age-associated and which are the results of how a person has lived is often difficult. A sedentary lifestyle, poor diet, cigarette smoking, alcohol and drug abuse can accelerate the aging process.
Disorders that affect elderly people
Alzheimer’s disease and dementia: Brain related disorders leading to progressive loss of memory and intellectual functions
Aortic aneurysm: Dilation of aorta walls leading to rupture and fatality if untreated.
Atrophic urethritis and vaginitis: Thinning of tissues of vagina and urethra leading to burning on urination and difficult intercourse.
Bedsores: Breakdown of skin from prolonged pressure.
BHP – Benign Prostate hyperplasia: Enlargement of the prostate gland blocking flow of urine.
Cataracts: Clouding in the lens of the eye hampering vision.
Chronic lymphocyte leukemia: A long lasting leukemia with many characteristics of cancer.
Diabetes –type 2: usually begins in middle age not requiring insulin injection.
Glaucoma: Elevation of pressure in eye chambers that can decrease vision and lead to blindness.
Hypothyroidism: Under active thyroid glands producing too little hormone. This can lead to anemia , low body temperature and heart failure.
Monoclonal gammopathies: abnormal proliferation of single type of cell producing high levels of immunoglobulin.
Osteo arthritis: Degeneration of cartilage that lines the joints causing pain.
Osteoporosis: loss of calcium from bones making them brittle and leading to easy fracture.
Parkinson’s disease: A slowly progressive brain disease that leads to tremors, muscle rigidity and difficulty in moving.
Prostate cancer: Cancer of prostate gland.
Shingles: a relapse of chickenpox virus leading to rashes and prolonged pain.
Stroke: A blockage or bleeding of blood vessels in the brain leading to weakness, loss of sensation, difficulty in speaking and other neurological problems.
The undesirable body changes associated with old age
Brain: There is decreased blood flow to brain. The levels of many vital chemicals in the brain changes. The central nervous system function significantly decreases.Fainting and loss of conscience can occur more often. There is marked decrease in mental function , ability to maintain posture and even walk properly.
Eyes: The lenses of the eyes stiffen. The retina becomes less sensitive to light and pupils react more slowly. There is difficulty in focusing on close objects and difficulty in seeing in dim light. There is also difficulty in adjusting to changing light levels.
Ears: There is marked ability to hear high frequency sounds and difficulty in understanding voices.
Mouth: The number of taste buds in mouth decrease thereby many delicious foods may taste bitter or tasteless.
Smell: The ability to smell odors decrease. Many foods may totally taste blind.
Heart: There is lowered pulse acceleration and decreased maximal output of blood. Heart muscles stiffen and there is lowered response to certain stimulants. Incidents of fainting and loss of conscience occur more often. The ability to perform strenuous aerobic activities decreases. Heart failure is more common.
Lungs: There is less air movement with each breath and less oxygen is transferred to blood. There is difficulty I breathing in high altitudes.
Liver: The liver shrinks and there is less blood flow. The enzyme system in liver decreases in quality. There is decreased ability to clear toxins by the liver. The effect of medications last much longer than desired. Drugs reach higher levels in body leading to undesirable effects.
Kidneys: The kidneys shrink in size and there is less blood flow to kidneys. Urine is less concentrated and there is decreased ability to excrete salt from the body. The effects of medication last longer and there is decreased ability to remove toxins. Dehydration is more common and salt levels in blood may reach abnormal levels frequently.
Bladder: Muscles of bladder walls weaken and there is less ability to control and delay urination. There is also more difficulty in urination.
Large intestine (colon) : Ability to pass stools decrease leading to constipation.
Skin: The underlying fat beneath the skin begins to shrink. Wrinkles are more common and skins tends to tear easily. Hypothermia is more common.
Immune system: There is marked decrease in immunity to diseases and infections. The amount of antibody produced decreases. Infections occur more often and more severely. They also tend to spread quickly.
Metabolism: Blood sugar level increases immediately after consuming food. There is decreased Vitamin D level. The absorption of calcium in body decreases. Calcium is easily excreted from the body. There is increased tendency towards diabetes and osteoporosis.
Male reproductive organs: There is enlargement of prostate glands and BPH Benign Prostate hyperplasia. Testosterone levels decrease rapidly and there is decreased blood flow to the penis. Erectile dysfunction and impotence are more common.
Female reproductive organs: There is decreased estrogen production. Ovaries and uterus shrink in size. There is increased risk of vaginal wall thinning and rupture. Breasts become more fatty and fibrous.
Blood: The red blood cell production decreases rapidly. There is slower response to blood loss and low oxygen in blood.
External Factors that accelerate premature aging process
Alcohol, cigarette smoke and drug abuse can damage many organs over time, often more so than aging alone. People who have been exposed to toxins may experience a more significant or more rapid decline in the function of some organs, especially the kidneys, lungs, and liver. People who worked in loud environments are likely to lose more of their hearing. Some decline in bodily functions can be prevented by adopting a healthier lifestyle. For example, stopping smoking at any age, even in one’s 70s, helps improve lung function, decrease the chance of developing lung cancer, and decrease the risk, of heart disease. Weight-bearing exercise helps maintain muscle and bone strength regardless of age and helps prevent falls and. debilitation.
Implications of Illness
Gerontology is the study of aging. Geriatrics is the branch of medicine that specializes in the care of older people. A number of disorders occur almost exclusively in older people and are sometimes called geriatric syndromes or geriatric diseases. Other disorders that affect people of all ages may cause different symptoms or complications in older people. For example, an under active thyroid gland usually causes younger people to gain weight and feel sluggish, whereas in older people it may cause a state of confusion. An overactive thyroid usually causes younger people to become agitated and lose weight; in older people, it may cause them to become sleepy, withdrawn, depressed, and confused. Depression usually causes younger adults to become tearful, withdrawn, and noticeably unhappy. In older people, depression sometimes causes confusion, loss of memory, and apathy without a sense of sadness. The confusion that results from these conditions is often mistaken for dementia in older people.
Acute illnesses that were once likely to result in death for older people, such as heart attacks, hip fractures, and pneumonia, are now often treatable and controllable. In addition, a chronic illness no longer necessarily means disability. Many people with diabetes, kidney problems, heart disease, and other chronic illnesses now find that they can remain functional, active, and independent. Social factors play a major role in the health care of older people. Older people who maintain social contact, whether it be with a spouse, with friends, or through outside interests, have been shown to have fewer medical problems. For example, older people who are married or who live with a roommate tend to be in better health than those who live alone. Older people who do not live alone also have lower rates; of hospitalization and nursing home admissions than those who do live alone.
Education also plays a role in the health of older people. Higher levels of education are -associated with earlier detection of disease and better health outcomes, even when diseases is not detected early. Economic factors affect the way in which older people access health care. Poverty is more common among older people than among the general population. Despite the implementation of such programs as Medicare, Medicaid, and Social Security, some older people do not have adequate health insurance and find it difficult to pay for uncovered aspects of medical care, including drugs. Consequently, otherwise treatable diseases go untreated or are treated at a later stage.
Older people often have more than one disease at a time, each of which may have an effect on die other. For example, depression may make dementia worse, and an infection may worsen diabetes. Additionally, many older people tend to conceal minor problems and do not seek medical care until the problems become major. Psychological factors coexist with and may complicate disease in older people. An older person may become depressed if his illness leads to temporary or permanent loss of independence. For these reasons, geriatricians often recommend multidisciplinary care. With this type of care, a team of medical personnel, which may consist of doctors, nurses, social workers, therapists, pharmacists, and psychologists, plan and implement care—including social services—under the leadership of a primary doctor.
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{ 2009 04 18 }
