Clinical features of normal ageing
- Cardiovascular system
- Muscles
- Immune system
- Genito-urinary system
- Liver
- Sensory - Ears
- Sensory - Eyes
- Lungs
- Bones
- Nervous system
- Skin
Cardiovascular system
There are various effects of ageing in the cardiovascular system, which include:
- A slightly enlarged heart, which does not pump as efficiently during exercise.
- Stiffer arteries.
- Isolated systolic hypertension (where the blood pressure rises when the heart contracts).
Muscles
There is a decrease in muscle strength and power, and lean body mass (up to 30 to 40%), and an increase in fat body mass, with ageing. The process is known as sarcopenia, and results in decreased functional capacity.
Immune system
The immune system changes, and becomes more dysfunctional. There is an age- related decline in a particular cell, which combats infection, and this is a consequence of shrinkage, and greatly reduced function of the thymus gland (behind the breastbone or sternum).
Infectious disease, such as bronchopneumonia and influenza, is up to 10 times more likely to be the cause of death in older people, and people are more likely to have a reactivation of certain diseases such as shingles, and tuberculosis. There is an increase in occurrence of autoimmune diseases and cancers.
Genito-urinary system
By the age of 80 years, between 10 to 30% of the glomeruli in the kidneys, (which filter waste products from the blood) no longer work. 25% of the kidney mass is lost, due to shrivelling of the outer part of the kidney. Generally the kidneys are still able to regulate the fluid levels in the body, and reduced function will only be apparent in times of stress to the body.
Benign enlargement of the prostate gland occurs in 25 to 50% of men over 65 and this leads to incomplete emptying of the bladder and a weak stream of urine, or signs of irritation with frequency of urination.
Because of age- related atrophy of the uro-genital system in females, there is more susceptibility to urinary and vaginal infections.
Liver
Though there is a 25% reduction in the mass of the liver, function remains within normal limits, protein (albumin) production is slightly reduced, and there is an impaired metabolism of some drugs through the liver.
Sensory - Ears
There is impaired hearing in a third of over- 65’s and 80% of 80 year- olds and this is known as presbyacusis –decline in hearing with age is a very common age- related change. Loss of high- frequency sounds occurs first, and hearing loss is more common in older men than women. Degenerative changes in the inner ear may also lead to some impairment of balance, resulting in falls, which again is a common problem in older people.
Sensory - Eyes
Normal Age- Associated Changes in the Eyes:
- The lens stiffens, and this causes presbyopia (difficulty in focussing on near objects) and from around the age of 40, people find that they need reading glasses to focus easily,
- The retina becomes less sensitive to light, which causes older people to have difficulty seeing in low or dim light, and to distinguish objects of low contrast from each other,
- The pupils react more slowly, which means that an older person has difficulty adjusting to changes in light levels. This could result in difficulty with night driving,
- Peripheral and colour vision may become less sensitive with age. A change in peripheral vision is due to a smaller pupil, more opaque lens and less sensitive retina, while colour perception is a result of yellowing of the lens, which occurs with age.
Lungs
The changes in the ageing lung (in healthy older people) are similar to the changes seen in mild chronic obstructive pulmonary disease, with decreased elastic recoil of the lung tissue, stiffening of the chest wall, weakening of the muscles of respiration, resulting in reduced lung volumes and flow rates. The ability to exercise is reduced by around a third, between the ages of 20 and 70.
Bones
Osteoporosis (thinning of bones) is a reduction of bone mass with a deterioration of bone tissue, causing increased fragility of the bones, and a susceptibility to fracture. Women are especially affected after the menopause; osteoporosis affects men more slowly. With increasing age, blood calcium comes from bone more than from diet. Calcium supplements can be very helpful in this age group and along with vitamin D has been noted to reduce incidence of falls in patients living in residential homes.
Nervous system
There is a decline in performance, and many changes occur in both the central and peripheral nervous system. Some are:
- A decrease in the size and mass of the brain,
- Loss of neurones (nerve cells) with fewer connections in both the brain and spinal cord,
- Slower thought processes,
- Slower reaction time,
- Decreased vibration and position sense,
- Reduced sensitivity to temperature changes.
Skin
There is the formation of wrinkles, thinning and reduced strength, and elasticity of the skin. It is more fragile and more susceptible to damage. Wound healing takes longer. The fat layer generally lessens, but fat accumulates in particular areas (stomach, under the chin). Pigment cells are fewer but clump together, giving an appearance of paler skin with age spots. The skin is drier and more susceptible to flakiness, sense of pain is lessened and temperature regulation is less efficient. Hair and nail growth slows down, hair thins, nails thicken and become more yellow. The skin is less able to withstand infections and malignant change as the immune function declines. Skin becomes dry, itchy and bruises more easily.
Other useful links
- Effects of ageing
- Normal ageing
- Ageing and disease
- Effects of multiple conditions
- Side effects of treatment
- Case example
