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Damage to the DNA inside cells builds up over time, causing tissues and organs not to function as well as they previously did. This damage is most commonly caused by free radicals, generated as a result of smoking, pollutants and radiation in the environment. Cell damage in this way is thought to be a significant contributing factor in heart disease and cancer, which are more common in older age.
Decline in immune function
Ever wondered why older people seem to pick up more colds and are at greater risk from the flu? From the age of 40 the loss of T cells – a type of white blood cell – weakens the immune system. This not only leaves older people vulnerable to infection, but cancerous cells are more likely to slip past the immune cells without being detected and inflammation – a key feature in diseases such as arthritis, diabetes and heart disease – increases.
Changes within the brain
Now where were those keys? Although it is not inevitable that someone will develop dementia in old age – only one in fourteen of over 65s and one in six of those over 80 have dementia – physical and chemical changes occur in the brain as we get older. There is a decrease in volume of parts of the brain with age, with some areas reducing by 1% with each year. The saying “if you don’t use it you lose it” holds true, as if areas of the brain are not used in activities, these are vulnerable to deterioration as we age. Nerves within the brain communicate via substances called neurotransmitters such as dopamine and serotonin, and changes within these and their receptors are associated with ageing.
Cardiac output reduces
It’s no wonder that older people are advised not to run for the bus. The heart is less able to pump blood as quickly round the body as it once was. At the age of 20 the heart pumps around 7 litres of blood per minute, but this falls to about 3.5 litres per minute by the age of 85. As the blood provides oxygen and nutrients essential for the functioning of all tissues, this has implication for all organ systems.
Reduced digestive capacity
More sluggish digestion is something that older people frequently complain about. The small intestine is the main site of digestion and absorption of food, allowing the body to use the energy and nutrients it provides. Digestion and absorption of fats and lactose – the sugar present in dairy produce –is reduced due to an age-related decline in the villi – the tiny finger-like projections which usually maximize absorption. The reduced uptake of energy can contribute to the weight loss seen in ageing. Absorption of calcium, iron and folate declines, which increases the risk of osteoporosis and anaemia; two conditions associated with older adults.
There’s only so much that face creams can do. The outer layer of skin thins and the cells that contain pigment decrease in number, so skin appears paler, taking on an almost paper-like appearance. Collagen production declines, as do the natural oils secreted, so skin becomes dry and less elastic, aiding the onset of wrinkles and the skin is at greater risk of damage; wounds take longer to heal and pressure sores are more likely.
Glasses and hearing aids become a lifeline for many in old age. Deterioration within the eyes and ears occurs, resulting in worsening sight, hearing and balance leaving older adults at risk of falls and accidents. After the age of 65 around a third of adults have hearing loss or an eye disease, with macular degeneration, glaucoma and cataracts being amongst the most common.
Loss of muscle mass
Loose clothing, watches and rings aren’t uncommon; though this can be due to a decline in appetite or as a result of disease, it is an inevitable part of ageing. From our 30s our muscle mass begins to decline. In women this loss accelerates after the menopause due to changes in hormone levels and then again in their 60s for both men and women; by the age of 90 muscle mass will typically have declined by as much as 50%. This loss of muscle mass doesn’t just affect mobility, muscle is also more metabolically active, so metabolic rate declines, making weight gain more likely and if so the risk of developing medical conditions such as diabetes and heart disease increases. However, whatever your age, regular exercise can help to promote muscle mass.
Loss of bone density
The bones you have aged 80 are completely different to those you had aged 8. Bones are constantly being turned over; they are being broken down and remade all the time. Until around the age of 30, bone density increases, which strengthens our bones. However, after this age, bone is broken down more quickly, so bones weaken and we are at greater risk of fractures. One in three women and one in twelve men develop osteoporosis, often referred to as brittle bone disease. The risk of this is greater in smokers, those with a high alcohol intake and anyone with a low body weight; certain diseases and medications also increase the risk. Osteoporosis is the main cause of age-related fractures to the wrist, hip and spine and contributes to the characteristic loss of height in old age.
Whole body bone mineral density
Bone mineral density (g/cm2)
Figures from Sanada K et al (2009) Muscle mass and bone mineral indices: does the normalized bone mineral content differ with age? European Journal of Clinical Nutrition, 63(4):465-72.
Wear and tear of joints
Aching joints seem to be part and parcel of ageing. With age the joints become worn and as a result arthritis develops, which is due to the loss of cartilage that protects the surface of the bones at joints. Pain and stiffness are the main symptoms, which can make everyday activities more difficult to complete.
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