What Changes Are Normal With Age?

With some baby boomers now in their 60s, their parents in their 80s or 90s, and people living longer than in the past, there's lots of talk these days about aging.

So what are the typical signs of aging, and what signals that something's wrong?

"A lot of times, people dismiss things, saying 'Oh, it's OK, because she's getting older,'" said Jennifer Reynolds, manager of Senior Care Services at Mary Washington Hospital. "But you shouldn't be losing functionality just because you're older."

According to Mary Beth Reckmeyer, nurse practitioner with Senior Care Services, there's a relatively simple rule of thumb.

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"You should be able to do what you've always done, even if you do it more slowly or less frequently," she said. "You can slow down, but you shouldn't lose abilities. If someone has lost any basic skills, there's something that needs to be checked."

For caregivers or friends, anything that catches your attention should be noted. If there's rotting food in the refrigerator, burned pots and pans in the kitchen, or your loved one is suddenly argumentative, don't ignore it.

"There's a reason something catches your attention," Reynolds said. "Don't just let it go."

But it's difficult for caregivers to pressure their older friends or loved ones into seeking assistance.

"It's a delicate balance for caregivers," Reynolds said. "There's a level of respect, particularly if this is parents you're dealing with. But sometimes you have to have that role reversal."

Here are some specifics about what's normal, and what's not, when it comes to getting older

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Memory and Cognitive Abilities
It's typical, as a person ages, for cognitive abilities and recall to slow, according to Dr. Timothy Salthouse, of the Salthouse Cognitive Aging Lab at the University of Virginia.

"Memory tends to be a little less accurate, particularly in retrieving names for people or objects," Salthouse said. "And people will experience a slowdown in how quickly they're able to do things like arithmetic or searching for something in a display."

There are great extremes in the level of memory problems, Salthouse said.

"If you can't remember where your keys are, don't worry," he said. "If you're holding your keys in your hand, and you don't recognize what they are, that's a problem."

Research has shown there are some "protective factors" that are associated with higher performance and slower declines over time, Salthouse said.

For instance, people who are physically active, eat a healthy diet, and participate in brain-stimulating activities like book clubs and playing Bridge tend to stay cognitively healthy longer.

The outlook for cognitive and memory health is good as the aging population grows. There are medications that can slow the progression of diseases like Alzheimer's, and research into dementia shows there are changes in a person's brain before there are physical symptoms.

"There is the promise, eventually, that we can intervene before behavioral symptoms disrupt their lives," Salthouse said. "The goal for people in my field is to keep people functioning at as high a level as possible into their last days of life."

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Signs of Depression
Many seniors experience depression as friends and family members die.

"That's situational, and we give them time to grieve," Reckmeyer said.

But clinical depression can cause seniors to isolate themselves, lose their appetite, stop caring about their appearance and develop other problems.

"When someone stops participating in things they once enjoyed, stops participating in their own lives, there's a problem," Reckmeyer said.

Depression and cognitive problems often go hand-in-hand, and one can mask the other. Reckmeyer said depressed people may not pay attention to a conversation around the dinner table, for instance, and because they're not paying attention, may ask questions about something that's just been discussed. So, someone who seems unaware or confused may be depressed instead.

Hearing and Vision
Eye problems such as cataracts and glaucoma are common in older people.

"People need to have an annual eye exam, whether or not they wear glasses," Reckmeyer said. "Glaucoma is a silent kind of thing. You don't have problems until it's too late."

As for hearing, an inability to hear some tones is normal as people age. But anything more than that should be checked.

Sometimes, a person who appears to be having difficulty remember conversations simply may not have heard them. Or someone who asks a question that's just been answered may not have heard the original discussion.

People experiencing sensory deprivation can start to isolate themselves, so it's important to get the ears and eyes checked.

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Staying on Your Feet

Falling is not normal.

Falls can be caused by a number of issues, including sensory deprivation, neurological issues or joint pain.

They can even be caused by nutritional issues, such as a vitamin D deficiency.

Some medications also can leave older adults feeling dizzy or disoriented. The Beers list includes medications or ingredients in medications that may be inappropriate for seniors. You can find it many places online, including on the Duke Clinical Research Institute site at dcri.duke.edu. (Type "beers list" into the search box.)

Consult a physician regarding medications if you're worried about falling.

Aches and Pains
Some aches and pains are common to everyone as they grow older. However, chronic pain should be addressed. There could be a problem such as arthritis or degenerative disc disease, which are treatable.

Pain also can lead to insomnia, a common problem among seniors, and one that should be addressed, as poor sleep negatively affects overall health.

Chronic pain also can cause seniors to withdraw.

Some women and men experience leaky bladders, and it's often thought to be a normal part of aging. But it's generally a sign of an underlying problem, according to the Mayo Clinic. In men, for instance, it can indicate problems with the prostate.

Inflammation, tumors and a variety of diseases, including diabetes, can lead to incontinence. Even something seemingly unrelated, like arthritis, can be a factor, if pain makes it difficult for a person to unzip his or her pants.

Lifestyle changes, medications and minimally invasive procedures are among the treatment options.

Eating Well
Many people who live alone may not eat regularly or may not eat well. That may be a symptom of depression, or the inability to prepare a proper meal.

Weight-loss can also signal other medical problems, so it's wise to get unexplained weight loss checked out.

If you're worried about proper nutrition, some local groups offer lunchtime gatherings, which give seniors a nutritious meal, as well as socialization among peers. Both are beneficial.


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