Bruce Horovitz

Nelson Mail - - CATALYST -

For 93-year-old Joseph Brown, the clear­est sign of age­ing was his in­abil­ity one day to re­mem­ber he had to have his pants un­zipped to pull them on.

For 95-year-old Caro­line Mayer, it was de­cid­ing at the age of 80 to put away her skis, af­ter two hip re­place­ments.

And for 56-year-old Dr Thomas Gill, a geri­atrics pro­fes­sor at Yale Univer­sity, it’s ac­cept­ing that his daily 9 kilo­me­tre jog now takes him up­ward of 50 min­utes – never mind that he long prided him­self on run­ning the dis­tance in well un­der that time.

Is there such a thing as nor­mal age­ing?

The phys­i­o­log­i­cal changes that oc­cur with age­ing are not abrupt, Gill said.

The changes hap­pen across a con­tin­uum as the re­serve ca­pac­ity in al­most ev­ery or­gan sys­tem de­clines, he said. ‘‘Think of it, crudely, as a fuel tank in a car,’’ Gill said. ‘‘As you age, that re­serve of fuel is di­min­ished.’’

Draw­ing on their decades of ex­pe­ri­ence along with the lat­est med­i­cal data, Gill and three geri­atric ex­perts in the US agreed to help iden­tify ex­am­ples of what are of­ten – but not al­ways – con­sid­ered to be signs of nor­mal age­ing for people who prac­tice good health habits and get rec­om­mended pre­ven­tive care.

Gill recog­nises that he hit his peak as a run­ner in his 30s and that his mus­cle mass peaked some­where in his 20s. Since then, he said, his car­dio­vas­cu­lar func­tion and en­durance have slowly de­creased. He’s the first to ad­mit that his loss of stamina has ac­cel­er­ated in his 50s. He is re­minded, for ex­am­ple, ev­ery time he runs up a flight of stairs.

In your 50s, it starts to take a bit longer to bounce back from

Ex­perts iden­tify the in­di­ca­tors of nor­mal age­ing for people who have good health habits and get rec­om­mended pre­ven­tive care.


in­juries or ill­nesses, said Stephen Kritchevsky, 57, an epi­demi­ol­o­gist and co-di­rec­tor of the J. Paul Sticht Cen­ter for Healthy Ag­ing and Alzheimer’s Preven­tion at Wake For­est Univer­sity.

While our mus­cles have strong re­gen­er­a­tive ca­pac­ity, many of our or­gans and tis­sues can only de­cline, he said.

Dr David Reuben, 65, ex­pe­ri­enced al­ti­tude sick­ness and jet lag for the first time in his 50s. To re­duce those ef­fects, Reuben, di­rec­tor of the Mul­ti­cam­pus Pro­gram in Geri­atrics Medicine and Geron­tol­ogy and chief of the geri­atrics divi­sion at UCLA, learned to stick to a reg­i­men – even when he trav­els cross­coun­try: he tries to go to bed and wake up at the same time, no mat­ter what time zone he’s in.

There of­ten can be a slight cog­ni­tive slow­down in your 50s, too, Kritchevsky said. As a spe­cial­ist in a pro­fes­sion that de­mands men­tal acu­ity, he said, ‘‘I feel I can’t spin quite as many plates at the same time as I used to.’’ That, he said, is be­cause cog­ni­tive pro­cess­ing speeds typ­i­cally slow with age.

There’s a good rea­son why even healthy people age 65 and older are strongly en­cour­aged to get vac­cines for flu, pneu­mo­nia and shin­gles: sus­cep­ti­bil­ity and neg­a­tive re­sponse to these dis­eases in­crease with age.

Those vac­cines are crit­i­cal as we get older, Gill said, since these ill­nesses can be fa­tal – even for healthy se­niors.

Hear­ing loss is com­mon, Kritchevsky said, es­pe­cially for men.

Reach­ing age 60 can be emo­tion­ally try­ing for some, as it was for Reuben, who re­calls 60 ‘‘was a very tough birthday for me. Re­flec­tion and self-doubt is pretty com­mon in your 60s,’’ he said. ‘‘You re­alise that you are too old to be hired for cer­tain jobs.’’

The odds of suf­fer­ing some form of de­men­tia dou­bles ev­ery five years be­gin­ning at age 65, Gill said, cit­ing an Amer­i­can Jour­nal of Pub­lic Health re­port. While it’s hardly de­men­tia, he said, people in their 60s might be­gin to recog­nise a slow­ing of in­for­ma­tion re­trieval.

‘‘This doesn’t mean you have an un­der­ly­ing dis­ease,’’ he said. ‘‘Retriev­ing in­for­ma­tion slows down with age.’’

Many people in their mid-70s func­tion as people did in their mid60s just a gen­er­a­tion ago, Gill said. But this is the age when chronic con­di­tions – like hy­per­ten­sion or di­a­betes or even de­men­tia – of­ten take hold. ‘‘A small per­cent­age of people will en­ter their 70s without a chronic con­di­tion or without hav­ing some ex­pe­ri­ences with se­ri­ous ill­ness,’’ he said.

People in their 70s are los­ing bone and mus­cle mass, which makes them more sus­cep­ti­ble to sus­tain­ing a se­ri­ous in­jury or frac­ture in a fall, Gill said.

The 70s are the piv­otal decade for phys­i­cal func­tion­ing, Kritchevsky said. To­ward the end of their 70s, many people start to lose height, strength and weight. Some people re­port prob­lems with mo­bil­ity, he said, as they de­velop is­sues in their hips, knees or feet.

At the same time, roughly half of men aged 75 and older ex­pe­ri­ence some sort of hear­ing im­pair­ment, com­pared with about 40 per cent of women, Kritchevsky said, re­fer­ring to a 2016 re­port from the Cen­ters for Dis­ease Con­trol and Preven­tion.

Another prob­lem com­mon to the 70s: People tend to take an in­creas­ing num­ber of med­i­ca­tions used for ‘‘pre­ven­tive’’ rea­sons. But these med­i­ca­tions are likely to have side ef­fects on their own or in com­bi­na­tion, not all of which are pre­dictable, Gill said.

‘‘Our kid­neys and liver may not tol­er­ate the meds as well as we did ear­lier in life,’’ he said.

Per­haps the big­gest emo­tional im­pact of reach­ing the age of 70 is fig­ur­ing out what to do with your time. Most people have re­tired by 70, Reuben said, ‘‘and the big­gest chal­lenge is to make your life as mean­ing­ful as it was when you were work­ing’’.

Fear of fall­ing – and the emo­tional and phys­i­cal blow­back from a fall – are part of turn­ing 80.

If you are in your 80s and liv­ing at home, the chance you might fall in a given year be­comes more likely, Kritchevsky said. About 40 per cent of people 65 and up who are liv­ing at home will fall at least once a year, and about 1 in 40 of them will be hos­pi­talised, he said, cit­ing a study from the UCLA School of Medicine and Geri­atric Re­search Ed­u­ca­tion and Clin­i­cal Cen­ter.

The study notes that the risk in­creases with age, mak­ing people in their 80s even more vul­ner­a­ble.

By age 80, people are more likely to spend time in the hospi­tal – of­ten due to elec­tive pro­ce­dures such as hip or knee re­place­ments, Gill said, bas­ing this on his ob­ser­va­tion as a geri­atric spe­cial­ist. Be­cause of di­min­ished re­serve ca­pac­i­ties, it’s also tougher to re­cover from surgery or ill­nesses in your 80s, he said.

By age 90, people have roughly a 1-in-3 chance of ex­hibit­ing signs of de­men­tia caused by Alzheimer’s dis­ease, Gill said, cit­ing a Rush In­sti­tute for Healthy Ag­ing study. The best strat­egy to fight de­men­tia isn’t men­tal ac­tiv­ity but at least 150 min­utes per week of ‘‘moder­ate’’ phys­i­cal ac­tiv­ity, he said. It can be as sim­ple as brisk walk­ing.

At the same time, most older people – even into their 90s and be­yond – seem to be more sat­is­fied with their lives than are younger people, said Kritchevsky.

– Kaiser Health News


In your 50s, it starts to take a bit longer to bounce back from in­juries or ill­nesses.

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