AGING: NORMAL SIGNS AND WHAT TO WATCH OUT FOR

Medically Reviewed and Updated by Dr. Rosmy Barrios - August 16, 2024

Aging is an inevitable process that will affect everyone at one point or another. Besides wrinkles and gray hairs, signs of aging often overlap with symptoms of disease, such as aches, pains, weakness, and other physical problems. This can make it difficult for the aging population to tell the difference between healthy aging and a health condition that needs medical attention.

For these reasons and more, it is crucial to understand the normal signs of aging, as well as the warning signs. In this article, we will discuss what aging is, what to expect of healthy aging, and what the warning signs are across different body systems. Also included are tips on how to slow aging down for a better quality of life after 60.

What is Aging Biologically?

“Aging-or senescence, which more accurately depicts the processes occurring from a biological standpoint—is a chronic, normal culmination of the loss of specific regenerative and bioprotective mechanisms that occur over time in an organism.^[1]" Despite understanding the symptoms, what causes aging is still a mystery and a debate. ^[2]

Possible causes of aging may include:

• Metabolic lifespan is governed by one’s baseline metabolic rate
• Senescent genetics that induce age-related cell changes and the accumulation of aged cells
• The lifelong accrual of oxidative stress, inflammatory damage, and inhibited repair mechanisms
• Hormonal decline
• The length of telomeres (which regulate cell division) and how they shorten fractionally with every division over the lifespan

Normal Aging vs. Pathological Aging

The study of aging has revealed that an aged cell undergoes several gene switches that are linked to healthy aging. These cells have a shorter lifespan, reduced regenerative abilities, and are usually removed by the immune system, which slows aging down. Eventually, the immune system becomes less able to detect and remove aged cells, resulting in a higher number of them, faster aging, and more age-related symptoms. This is what happens during normal aging.

There are two different types of senescent cells: helper cells and deleterious cells. While both types contribute towards signs and symptoms of aging, deleterious cells are known to be more inflammatory than other aged cells and contribute towards the onset of age-related diseases, including arthritis, dementia, heart disease, osteoporosis, and diabetes. Having a higher number of deleterious aged cells is known as pathological aging and determines the difference between normal aging and disease.^[3]

Normal Signs of Aging and What to Watch Out For

Normal signs of aging are reviewed in the below section to help you distinguish them from pathological aging. Warning signs and tips for graceful, healthy aging are also discussed.

Muscles, Joints and Bones

The steady loss of bone density, muscle mass, and strength is one of the most prevalent physical markers of aging. This process typically starts in your 30s and accelerates as you get older^[4]. The primary causes of age-related muscle loss and bone weakness include hormonal changes, reduced physical activity, and poor nutrition.

These changes are accompanied by a slower metabolism, which, together with gradual muscle loss, can make it more challenging to manage your weight. Over time, the cartilage that cushions your joints may experience wear and tear of the cartilage matrix and the reduced capacity of chondrocytes to repair and maintain the cartilage, leading to joint stiffness, decreased flexibility, and eventual deterioration. This can be particularly evident in weight-bearing joints like the knees and hips. 

Warning Signs

While the above symptoms are common and not unexpected, the following warning signs may indicate a more serious health condition that warrants medical attention:

• Severe and rapid muscle loss or wasting
• Chronic joint pain
• Unexplained weight fluctuations
• Sudden weakness or chronic lethargy
• Quick mobility loss

What You Can Do

The following practices can help maintain bone, joint, and muscle health as we age:

Strength Training: Engage in a well-rounded exercise routine that includes cardiovascular, strength, and flexibility exercises. This can help boost immune function and remove faulty aged cells. Strength training, which focuses on weight-bearing exercises, is especially important for preserving muscle mass and bone density. It also helps to lower the strain on the joints and keep weight in check.

Nutritional Support for Muscle and Bone Building: To support the health of your muscles and bones, make sure your diet contains a suitable amount of protein and nutrient-rich fruits and vegetables. You may also want to consider using supplements for bone, muscle, and joint support, including vitamins such as vitamin D3 and K2 and minerals like zinc, magnesium, and potassium.

Lifestyle Modifications: Make changes to your daily routine to lower your risk of injury and falls, such as installing handrails and keeping your home clutter-free.

Heart and Blood

As we age, the heart slowly loses its ability to work efficiently, which causes incremental decreases in the amount of blood that gets pumped around the body. The blood vessels lose their elasticity, stiffen up, and can accumulate plaque, which narrows them and makes it difficult for them to expand and contract as they used to.^[5]

These changes are often accompanied by a slower resting heart rate, reduced lung elasticity, altered breathing patterns, and lower blood pressure or mild hypertension. At older ages, symptoms of light-headedness may become usual when one moves too fast or tries to change positions from sitting or standing too quickly.

Warning Signs

If any of the following symptoms become chronic, you might need to see a doctor about treating cardiovascular disease:

• Constant shortness of breath
• Irregular heartbeat
• Chest pain or discomfort
• Severe fatigue
• Swelling in the ankles, legs, or abdomen
• Syncope or momentary loss of consciousness

What You Can Do

The following suggestions can help to better preserve cardiovascular health during aging:

Lifestyle Choices: Adopt a heart-healthy lifestyle that includes a balanced diet, regular exercise, stress management, no smoking, and avoiding excessive alcohol consumption.

Gentle Cardio: Regularly opt for gentle physical activities that are geared to supporting cardiorespiratory fitness, such as brisk walking, cycling, dancing, or swimming.

Stay Hydrated: Maintaining blood volume and supporting general health requires proper hydration. Studies suggest that the elderly do not feel as thirsty as younger individuals, and lower fluid intake is common despite fluid requirements remaining the same. It is important to drink enough water, especially if one does not feel thirsty often.

Monitor Blood Pressure: Keep track of your blood pressure at home if recommended by your healthcare provider, and report any unusual readings. Book an appointment with your doctor if your blood pressure is constantly over 130/80 mmHg.

Digestive System

The aging digestive system classically undergoes changes that result in slower digestion, a decreased appetite, and a lower ability to absorb nutrients. Constipation is a main problem that naturally occurs in seniors due to these changes. Reasons for them include the weakening of the muscles that propel food through the digestive tract and sensory changes that affect the perception of hunger, thirst, taste, and smell. Common nutritional deficiencies often left unaddressed in the elderly include vitamin B12, calcium, vitamin D3, amino acids and proteins, omega-3 fats, and fiber.

Warning Signs

As soon as these signs become unmanageable, they might indicate it is time to see a doctor:

• Severe or chronic abdominal pain or discomfort
• Swallowing or chewing difficulties
• Rapid weight loss

What You Can Do

The health of the digestive system impacts the body as a whole. Age-related digestive changes can be better managed in the following ways:

Pay Attention: It is important to notice if certain foods or drinks cause digestive complaints that increase constipation, bloating, or discomfort. Bowel movements should also not be held in for too long, as this can increase digestive problems.

Balanced Diet: Maintain a balanced diet that you can easily digest, rich in fiber, fruits, vegetables, and lean proteins. Adequate fiber intake can help with digestive regularity.

Stay Hydrated: Proper hydration is crucial for digestive health. Drink plenty of water throughout the day.

Regular Exercise: Physical activity can help stimulate digestion and maintain muscle tone in the digestive tract. Exercise that uses the legs and abdomen is especially useful for digestion, such as going for walks (especially after a meal).

Urinary Tract

Age-related changes in the urinary tract include slower urination, weaker pelvic floor muscles (the muscles that control urination), lower bladder capacity for holding urine, and occasional leaks. These symptoms usually peak in the later decades of life and are exacerbated by unhealthy lifestyle choices, medications, pathological changes, and foods or beverages that affect the body’s water balance.

Warning Signs

The following urinary symptoms are entirely abnormal in the context of aging:

• Continuous urinary tract infections or symptoms such as itching or burning in the area
• Blood in the urine
• Daily or frequent incontinence

What You Can Do

Urinary tract function can be enhanced by practicing specific exercises and making a few dietary modifications:

Pelvic Floor Exercises:Kegel exercises can assist in building up the pelvic floor muscles and enhance bladder control.^[6]

Taking Control: If battling to ascertain whether you need to go or not, it might help to insist on a regular schedule. Throughout the day, drinking a lot of water can also be beneficial.

Avoid Foods that Increase Incontinence: These include caffeine-enriched drinks, coffee, carbonated beverages, and acidic foods. Acidic foods extend to sugary foods that can increase the prevalence of UTIs. Consuming a fiber-rich diet that minimizes constipation can also help.

Vision and Hearing

The signs of aging eyes and ears are some of the most obvious. It could get harder to keep the eyes focused on nearby objects starting in your 40s^[7]. As one gets older, night vision and sensitivity to colors might wane as well. Elderly individuals can find it more tricky to be selective with their hearing, finding it difficult to detect high-pitched and soft sounds as well as conversation in a noisy environment.

Warning Signs

The below signs are not usual for healthy aging:

• Sudden vision loss, blurred vision, or an obscured vision
• Light flashes or persistent auras of color
• Spontaneous hearing loss or deafness in one or both ears
• Tinnitus or the hearing of repetitive ringing or other sound effects
• Problems understanding conversations

What You Can Do

The health of the eyes and ears are often extensions of the vascular system. To maintain their health you can:

Manage Chronic Conditions: Conditions like diabetes, cardiovascular disease, and hypertension can affect both vision and hearing. Opt for a healthy lifestyle, engage in regular physical activity, and work with your healthcare provider to manage these conditions effectively if present.

Limit Artificial Light Exposure: Too much artificial light emitted from electronic devices can increase inflammation in the eyes, promote eye strain, and increase the risk of age-related visual problems. It is advisable to limit exposure and to get sunlight at the correct times of the day.

Protect Your Ears: If you work in noisy environments or have noisy hobbies, try to limit your exposure to loud noises or wear hearing protection.

Limit Earwax Buildup: Excess earwax can contribute to hearing problems. Avoid using cotton swabs, which can push wax deeper into the ear canal, and consult a healthcare professional for safe earwax removal if necessary.

Memory and Cognition

It is a typical age-related change for memory and cognition to decrease, yet it is not usually enough to get in the way of daily activities. In fact, the signs are often not as noticeable as others and even happen to younger people, including occasional forgetfulness and taking it slower with respect to learning, multi-tasking, finding the right words, and other similar mental tasks. The quality of memories may also begin to decline. As one reaches later decades, these occurrences may pick up in frequency.^[8]

Warning Signs

If sudden and extreme symptoms of rapid cognitive decline appear, it can be an early sign of dementia. These are easily distinguishable from the signs of healthy aging and should not be overlooked. Examples include:

• Persistent and significant memory loss
• Frequent disorientation
• Severe difficulty with familiar tasks
• Noticeable personality changes

What You Can Do

Strategies for maintaining cognitive function include:

Stay Mentally Active: Take part in activities that are mentally challenging, including crossword puzzles, puzzles, reading, and language or skill learning.

Physical Exercise: Regular physical activity has been linked to better cognitive function. Aim to combine both cardiovascular exercise and strength training.

Healthy Diet: A well-rounded diet of antioxidants, omega-3 fatty acids, and vitamins E and folate can help maintain brain function.

Adequate Sleep: Prioritize quality sleep since it is essential for improving memory and cognitive performance.

Social Engagement: Loneliness, isolation, a lack of social motivation, depression, and anxiety can all detract from mental well-being and cognition. Maintain social connections and engage in meaningful conversations and interactions with friends and loved ones.

Stress Management: Chronic stress can affect cognitive function. Practice stress-reduction techniques like mindfulness meditation or yoga.

Sleep

As one age, it is usual to need less sleep (7-8 hours) and for the quality of sleep to change. The elderly may go to bed earlier and wake up earlier, as well as experience more frequent awakenings throughout the night. These changes do not make sleep less important for health, and sleep should still be prioritized.

Warning Signs

It is abnormal for seniors to suffer from symptoms of insomnia or conditions that prevent them from sleeping, The following symptoms, if persistent, ought to be seen as warning signs warranting a doctor’s appointment:

• Difficulty falling asleep on a frequent basis
• Not being able to get back to sleep
• Waking up too early
• Constant waking throughout the night, especially due to breathing difficulties, restless movements, or spasms

What You Can Do

The following tips can help to promote healthy sleep habits:

Create a Relaxing Bedtime Routine: Try to relax before going to bed by reading, listening to soft music, or using relaxation techniques. Maintain a fixed sleep schedule, even on weekends.Reduce screen time before going off to sleep since the blue light that phones, tablets, and TVs emit can disrupt the production of melatonin.

Limit Stimulants: Avoid caffeine and nicotine close to bedtime, as they can interfere with sleep.

Create a Comfortable Sleep Environment: Ensure your bedroom is dark, quiet, and cool. Invest in a comfortable mattress and pillows.

Limit Naps: If you need to nap during the day, keep them short (20-30 minutes) to avoid interfering with nighttime sleep.

When Close to Sleep: Avoid heavy or spicy meals close to bedtime, and consider a light snack if hunger is keeping you awake. Better sleep can be facilitated by regular exercise, but avoid strenuous activities right before bed.

Regular Health Check-Ups and Screenings

It is critical to speak with a healthcare provider as soon as any of the warning signals listed above start to persist. Even when taking all the above into consideration, some age-related warning signs can still be missed. Older adults are advised to go for regular health checkups to keep tabs on their well-being and ensure early disease detection and swift treatment.

Conclusion

It is important to distinguish between age-related illness and natural indicators of aging because symptoms are frequently overlooked by the elderly owing to aging. As we age, we may have more stiffness in joints, muscles, and blood vessels, less strength, and a lower appetite. We may be more forgetful on average, get less sleep, and have mild difficulties with seeing and hearing like we used to. These are natural signs of aging.

Severe and sudden loss of any ordinary bodily functions is abnormal and warrants immediate medical attention. Annual check-ups are recommended to keep tabs on overall well-being. Despite being able to do less, the elderly are still encouraged to participate in regular physical activity that emphasizes gentle aerobics and weight-bearing exercises.

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