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“People have a perception … that aging equals decline,” said Jeanne Wei, a geriatrician who directs the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences. “That’s just wrong.”
Of course, peoples’ bodies do change as they get older. But this is a gradual process. If you suddenly find your thinking is cloudy and your memory unreliable, if you’re overcome by dizziness and your balance is out of whack, if you find yourself tossing and turning at night and running urgently to the bathroom, don’t chalk it up to normal aging.
Nearly one-third of people age 51 and older experience fatigue, according to a 2010 study in the Journal of the American Geriatrics Society. (Other estimates are lower.) There are plenty of potential culprits: Sleep problems, pain, gastrointestinal reflux and medications for blood pressure can induce fatigue, as can infections, arthritis and other conditions, an underactive thyroid, poor nutrition and alcohol use.
“If someone comes into my office walking at a snail’s pace and tells me, ‘I’m old; I’m just slowing down,’ I’m, like, ‘No, that isn’t right,’ ” said Lee Ann Lindquist, a professor of geriatrics at Northwestern University’s Feinberg School of Medicine in Chicago.
This puts you at risk of developing nutritional deficiencies and frailty, and it raises the prospect of an earlier-than-expected death. Between 15 and 30 per cent of older adults are believed to have what’s known as the “anorexia of aging.”
Physical changes associated with aging — notable declines in vision, taste and smell, all of which make food attractive — can contribute. So can other conditions: decreased saliva production (a medication-induced problem that affects about one-third of older adults); constipation (affecting up to 40 per cent of seniors); depression; social isolation (people don’t like to eat alone); dental problems; illnesses and infections; and medications (which can cause nausea and reduced taste and smell).
If you had a pretty good appetite before and that has now changed, pay attention, said Lucy Guerra, director of general internal medicine at the University of South Florida in Tampa. Treating dental problems and other conditions, adding spices to food, adjusting medications and sharing meals with others can all make eating a more enjoyable and healthy experience.
Depression in later life can have profound consequences, compounding the effects of chronic illnesses such as heart disease, leading to disability, affecting cognition and, in extreme cases, resulting in suicide.
Half a century ago, it was believed that “melancholia” was common in later life and that seniors naturally withdrew from the world as they realized that their days were limited, Callahan explained. Since then, researchers have shown that older adults tend to be happier than people in other age groups: Only 15 per cent have major depression or minor variants.
Late-life depression is typically associated with a serious illness such as diabetes, cancer, arthritis or stroke; deteriorating hearing or vision; and life changes such as retirement or the loss of a spouse. While grief is normal, persistent sadness that is accompanied by apathy, withdrawal from social activities, disturbed sleep and self-neglect is not, Callahan said.
With treatments such as cognitive behavioural therapy and antidepressants, 50 to 80 per cent of seniors can expect to recover.
You may have sarcopenia — a notable loss of muscle mass and strength that affects about 10 per cent of adults older than 60. If untreated, sarcopenia will affect your balance, mobility and stamina, and raise the risk of falling, becoming frail and losing independence.
Age-related muscle atrophy, which begins when people reach their 40s and accelerates when they’re in their 70s, is part of the problem. Muscle strength declines even more rapidly — slipping about 15 per cent per decade starting around age 50.
Other causes of weakness can include inflammation, hormonal changes, infections and problems with the nervous system.
Watch for sudden changes. “If you’re not as strong as you were yesterday, that’s not right,” Wei said. Also, watch for weakness on only one side, especially if it’s accompanied by speech or vision changes. That could be a sign of a stroke, which would require immediate medical attention.
Taking steps to address weakness doesn’t mean you’ll have the same strength and endurance as when you were in your 20s or 30s. But it may mean that doctors catch a serious or preventable problem early and forestall further decline.