You’re noticing changes: graying hair, a few more wrinkles around your eyes, and when did fine print become totally unreadable? And whether you’ve decided to embrace aging or you’re not into it at all, you may be wondering what other changes are ahead.
What is “normal” aging and what’s not?
You may need to set aside some negative stereotypes about getting older – and even some things you may have noticed in people decades older than you. For instance, you may have read statistics like the fact that more than 94% of adults 60 and older have at least one chronic condition, while nearly 80% have two or more.
But just because certain things become more common with age, it doesn’t mean that it’s inevitable. So what symptoms and issues can you expect, and what can you influence? Learning which ones to pay attention to can help you “live well, fully functional, and enjoy a fantastic life,” says Luigi Ferrucci, MD, PhD, the National Institute on Aging’s scientific director.
Muscles, Bones, and Skin
It’s a fact: With age, your body will change. “There is a decline in muscle mass and there is a decline in muscle strength and there is a decline in bone density,” Ferrucci says.
But you have the power to affect some of these changes.
You will lose some muscle mass and strength due to aging. Doctors call it sarcopenia. The process starts much earlier than you may think: The decline starts slowly by your mid-30s and picks up the pace after 65 in women and after 70 for men. But even though you can’t totally stop this trend, you can improve your strength at any age.
This is why strength training is so important. It can pump the brakes on this aspect of aging. And that, in turn, could help guard against falls, one of the major health threats in older adults.
Strength training may also help with the loss of bone density that Ferrucci mentioned. If your bone mineral density becomes too low, it’s called osteoporosis – and it makes fractures and broken bones much more likely.
Although osteoporosis is most common in older women, it can also happen as men age. Women should get a bone mineral density test when they’re 65, or earlier if they’re at high risk. Although routine screening isn’t recommended for men, those at high risk should talk with their doctor about it. Medication, weight-bearing exercise, good nutrition, not smoking, and limiting alcohol are important if you do have osteoporosis.
Aging also makes your skin less elastic, Ferrucci notes. This may be due to gravity and also to damage from the sun’s UV rays over many years. You may notice that your skin feels dryer, too. And while you can’t undo sun damage from years ago, you can wear sunscreen, a hat, and protective clothing – and limit time in the sun – to avoid future sun damage. Here, too, you’ll want to make sure you don’t smoke, as it can increase wrinkles.
Vision and Hearing Changes
Have you started keeping reading glasses handy all the time? This, too, is one of the normal changes that come with getting older. You may need a new prescription for your glasses or contact lenses. And keep up with your regular eye exams to check for conditions that could affect your vision, like glaucoma, macular degeneration, or cataracts.
As for hearing loss, aging is a possible cause. Doctors call it presbycusis if age is to blame – and not, say, all the stadium concerts from your younger days that you wouldn’t have missed for anything. This type of hearing loss happens gradually. Over time, it can make it harder to hear important information, socialize, and stay safe. If you regularly need to ask people to repeat what they say, have trouble hearing when there’s background noise, or keep cranking up the volume when you watch TV or listen to the radio, it’s time to get your hearing checked.
Brain Changes
Aging does bring changes to the brain – but fewer than you may think. Alzheimer’s and other forms of dementia, while most common late in life, aren’t normal parts of aging.
Having a bit of shrinkage in some parts of the brain is normal. And there’s a change in how your brain’s neurons communicate with each other across synapses; this may become less efficient. That can cause minor thinking problems, like taking longer to learn something.
Still, for many of us, this natural decline is very gradual.
“In some ways, it’s remarkably benign,” says David Reuben, MD, a professor of medicine and chief of the Division of Geriatrics at the University of California, Los Angeles. He recalls once listening to a famous artist in his 90s talk about how “the most astonishing thing about aging, is how gentle, gradual, and benign it was.”
A big part of the biology of aging, Reuben says, “is we get slower.”
But not everything about getting older is benign.
Issues to Watch For
To help flag the issues that need attention most quickly, ask yourself these questions:
Has daily life become harder? Age will slow you down, gradually. But sometimes it seems to happen or worsen quickly, limiting how you function, even at home. That’s a cue to see a doctor.
“Any loss of independent function requires assessment – be it cognitive, or physical, or social,” says Richard Besdine, MD, a professor of medicine and professor of health services policy and practice at Brown University and the former director of Brown’s Division of Geriatrics and Palliative Medicine. (Besdine is healthy and still working, at 84.)
Are you having any new problems with movement? Has it become harder to get in and out of bed, sit down in a chair, or stand up from one? Take note of that, says Richard Marottoli, MD, MPH, a Yale Medicine geriatric medicine specialist and a professor of medicine at the Yale School of Medicine. If that’s happening, Marottoli says, “then the question is, why is that? And what can we do about it? Is there some underlying physical problem that we can deal with?”
Don’t be shy about seeking a medical opinion – such as going to see your primary care doctor – about anything that concerns you, Besdine says. And your primary care doctor shouldn’t dismiss those concerns as simply aging.
“That’s not the kind of physician you want – I think ever – but especially when you get into your late 60s, 70s, and then 80s,” he says. “You want someone who will take it seriously.”
Also remember this: You, or even your partner, might not notice some changes right away.
“The spouse may not notice it because they're seeing that person every day,” Marottoli says. “Whereas the children may come for a visit for a holiday and may say, ‘Wow, you know, that's really different than he was when we saw him 6 months ago.’”
How severe is it? Some changes that come with aging are manageable up to a point. But you’ll want to watch for issues that suddenly become much worse. Or become worse and persist for days or weeks.
“Some of these things are very subtle,” Marottoli says. “Typically, they’ll occur gradually.” But when “it reaches a critical threshold … somebody else notices it.” His advice: “If something happens suddenly, that's always a time to get [the problem] checked out.”
Have your test results changed? You should regularly see a primary care doctor – preferably one who knows you and your health history well. The doctor will track your blood pressure, cholesterol, and blood sugar over time. They may also order certain tests to check on how well your heart and other systems are working.
Based on those results, your doctor may recommend further tests, medications, and other interventions.
The goal is to flag “things that are eminently treatable that can be potentially catastrophic” if they aren’t found and managed, Marottoli says.
High blood pressure is an example. It becomes more common as you get older, affecting 60% of U.S. adults age 65 or older on Medicare, according to the National Council on Aging. If left untreated, high blood pressure could make a stroke, heart attack, or kidney disease more likely. But if you’re aware of it, there are lifestyle steps (such as exercise, nutrition, keeping your weight healthy, and not smoking) that can help – as well as medications, if needed – before the damage gets out of hand.
Physical changes aren’t the only thing to heed. It’s not a normal part of aging, but many seniors become depressed or lonely. If this happens, tell your doctor and consider talking to a licensed mental health counselor.
Are you having serious issues with memory or thinking? Older people will often be especially concerned about changes in memory or thinking skills. But experts say people shouldn’t worry about an occasional lapse in memory such as forgetting a name, or a word, or where you put your keys.
But watch for more serious issues – like not being able to solve common problems, being unable to carry on a normal conversation, or behaving in ways outside of social norms.
And when – for example – you get lost driving home from an errand, that’s cause for concern, Besdine says.
“In general, sort of getting lost – especially for places you used to be able to get to without any difficulty – is often an early marker of issues and concern,” Marottoli says.
These symptoms could have several possible causes, and your doctor can help figure out what’s going on and what you can do to stay as well as possible, for as long as possible.
Also, stay open to the possibility that some things may actually get better as you get older. You can still build physical strength, learn new things, and enjoy rewarding relationships. It may just look a bit different than it did in your past.
