A Preview of Coming Subtractions

What's "normal" aging and what's cause for concern?

Photo by Jake Hills on Unsplash

[Note to subscribers: While I am on a brief vacation, I am reposting a past column. Don’t worry: the summer rerun season at The EndGame is brief.]

When Bob and I walk together around the neighborhood, meeting our minimum daily requirements for steps, we always compare notes on how we’re faring against the slow, inexorable advance of decrepitude. We each do our “organ recitals,” and then Bob asks the tough question: What’s normal aging and what’s something to worry about?

Today I am attempting to answer Bob’s question. I’ve compiled information from the most authoritative sources on the internet – carefully reviewed by my friend Dr. Carla Rosenthal, an experienced geriatrician - and I’ve separated out normal signs of aging from symptoms that may signal serious health concerns. (Trigger warning: if you are a person, like me, who reads about lung disease and immediately feel short of breath, maybe you should stop reading.) Remember that the list of “normal” events isn’t a prediction; it’s only what happens to many people as they age. You, on the other hand, may have won the genetic lottery and get to take a pass on several of these.

I hope you find this information reassuring that many of these events happen normally and are not cause for alarm.

Executive Summary:

Whatever you had at 30, you have less of it now and will have still less going forward.

That said, let’s look at the details.

Bones

Normal: Bones lose mass (osteopenia), making fractures a higher risk. The losses are speediest in post-menopausal women. You may find yourself a few centimeters shorter.

Worrisome: Hip and wrist fractures are more likely if osteopenia progresses to osteoporosis, or loss of bone density,

Joints

Normal:  You are less flexible, and your joints feel stiff and tight. You feel a kinship with the Tin Man.

Worrisome: Joints become inflamed and arthritic.

Muscle and Fat

Normal: Muscle mass and muscle strength tend to decrease, but not enough to prevent you from performing normal tasks. As the percentage of body fat doubles by age 75, body shape changes. (Like the baggage in the overhead rack, “Items may have shifted during flight.”)

Worrisome: If the increased fat percentage triggers diabetes or other conditions.

 Eyes

Normal: You have trouble reading things up close, or in dim light. You may perceive colors differently. Your eyes feel dry.

Worrisome: You see blurry spot near the center of your field of vision (age-related macular degeneration), cloudy vision (cataracts), or experience any sudden change in vision.

Ears

Normal: Everyone who speaks to you mumbles and you can’t catch all the words. You have trouble hearing in loud environments or over background noise.

Worrisome: You can’t hear most conversations clearly, or what you hear sounds muffled.

Mouth and Nose

Normal: Your senses of smell and taste diminish. Some foods taste bitter, others bland.

Worrisome: You lose interest in eating.

Brain

Normal: Learning takes longer. You draw a blank on a person’s name. You enter a room and forget why you came. You forget where you left your car keys.

Worrisome: You forget that you need keys to drive your car.

Heart

Normal: Your heart doesn’t speed up as quickly or pump as fast as when you were younger.

Worrisome: You have trouble keeping up with regular activities, feel short of breath, feel dizzy or lightheaded, have chest pain when you’re active, or have an irregular or fluttering heartbeat.

Lungs

Normal: You may have more difficulty exercising or breathing at high altitudes.

Worrisome: You experience sudden breathing difficulty.

Digestive System

Normal: You may become lactose intolerant, your metabolism slows, and you may experience constipation. You may have more difficulty swallowing.

Worrisome: You have reflux frequently or inflammation in the colon.

Kidneys and Urinary Tract

Normal: You’re peeing more often, sometimes with greater urgency.

Worrisome: You’re leaking urine before and after you pee.

Reproductive Organs

Normal: Men feel lower sex drive and may have full or partial erectile dysfunction. Women after menopause may feel dryness or itching in the vagina.

Worrisome: You contract a sexually transmitted infection.

Skin

Normal: Your skin wrinkles, dries out, becomes less elastic, and develops age spots. You develop more jowls around your jaw and more hollows around your eyes.

Worrisome: Spots triggered by sun exposure may be malignant.

Teeth and Gums

Normal: Your mouth is dry, your gums begin to recede, and cavities are more likely.

Worrisome: Diseased gums or teeth may be linked to diabetes and heart disease.

Sleep

Normal: Your sleep is interrupted more; you have trouble staying asleep. Your existing tendencies, whether to rise early or stay up late, become even more so.

Worrisome: Not getting enough sleep consistently.

What Can You Do?

You’ve heard it all before, but it’s still true: Eat a balanced diet heavy on the fruits, vegetables, and whole grains; go easy on the dairy, sugar, fried foods, and alcohol. Keep moving. Exercise your body. Exercise your mind. Drink plenty of water. Get all the sleep you need. Reduce stress. Stay current on vaccinations. Use sunscreen religiously. Brush and floss teeth daily.

And keep smiling. Aging may be a bitch, but it still beats the alternative.

Admittedly, this was a whirlwind tour of a complex human system. Here are links for more information:

“The Aging Process: Signs, Effects, and What to Expect as You Get Older,” Greatseniorliving.com

“Changes in the Body with Aging,” MSD Manual Consumer Version

“Aging: What to Expect,” Mayo Clinic