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Aging itself is not a disease. It’s normal, and it happens. That’s what UW Health Geriatrics physician Dr. Alexis Eastman likes to remind her patients when they discuss the changes they are experiencing, from memory loss to sexual activity.
Here is the science behind eight key aspects of aging and what you can do to adapt and stay healthy from head to toe.
Osteoporosis (or, Why Did I Break My Hip?)
The Science
As we age, it becomes more difficult to get enough Vitamin D, both through the skin, and through the foods we eat. The way bones cycle and turn over also changes, leading to more fragile bones.
What You Can Do
There are many things you can do to protect your bones without medication or hospitalization, Eastman says. Exercise is key, especially weight-bearing exercise, like walking, climbing stairs or weight lifting. It’s also important to get your recommended 1,200 mg of calcium daily. Foods rich in calcium include milk, cheese, yogurt, collard greens, canned salmon, black-eyed peas and almonds.
Muscle Loss (or, Where Did My Muscles Go?)
The Science
Muscle loss is a normal part of aging, Eastman says, and we all lose muscle at the same rate, starting in our 30s. Our muscles become less elastic and less able to repair themselves, and endurance and power decrease.
What You Can Do
Studies show aerobic exercise, balance training and weight training can improve physical function and reduce frailty. Eastman points to one study that found 10 weeks of resistance training could more than double muscle strength. Another discovered exercise can reduce fall risks by 50 percent.
Problems with Pills (or, Why do I Experience More Side Effects?)
The Science
Our metabolism changes as we age, and our organs aren’t as efficient as they once were. The liver is less able to break down toxins; the heart is less able to regulate blood pressure and control rhythm; fewer kidney cells are functioning; fat-soluble medications stick around longer; and medications that shouldn’t permeate and affect the brain actually do.
What You Can Do
First, ask your doctor which medications may no longer be necessary. If there is no longer a clear benefit, or if the long-term benefit does not outweigh the short-term risk, it may be time to reevaluate your daily routine.
Medications themselves can often prove tricky, too: they might be small in size, need to be cut in half or quartered, come in variable doses or have the risk of interacting with other drugs. Eastman recommends also asking your doctor or pharmacist for help with these challenges.
Aging of the Gut (or, Why Am I Constipated?)
The Science
Eastman describes the normal aging of the gut as a “recipe for constipation.” A decrease in lactase production often means more problems with dairy. Changes in the intestines, from water absorption to muscle strength, can all lead to constipation. And, as we age, it often takes a larger stool volume in the colon to trigger the urge for a bowel movement.
What You Can Do
It’s far easier to prevent constipation than to cure it, Eastman cautions. Daily exercise – especially walks after meals – may help. You should also try to use the bathroom at the same time every day, which can help you feel more in touch with the urge to go. Plenty of water, and a mix of soluble fibers (oats, apples or prunes) and insoluble fibers (bran or veggies) are important parts of your diet, though she warns if you’ve been missing out on high-fiber foods, you should slowly ease into a diet change over a few days. People on opiate pain medication should also try a daily regimen of Metamucil, Miralax or the like.
Aging of the Bladder (or, Why Do I Leak Urine?)
The Science
Reduced muscle tone, capacity and elasticity are all normal when it comes to the aging of the bladder. Uninhibited bladder contractions, or leaks, become more common, and the part of the brain that tells the bladder to hold it in stops functioning as well as it used to. Brain changes can also increase urinary volume overnight. And men often face urinary problems because of an enlarged prostate.
What You Can Do
Eastman recommends men and women both practice Kegel exercises. (The magic number? Around 40 daily, though they can be split up throughout the day.) Try to drink more water earlier in the day, while still being careful not to become dehydrated, and drink less caffeine and alcohol. Eastman also suggests using the bathroom once every three hours, even if you don’t feel the urge to go.
Skin Health (or, Why Do I Bruise?)
The Science
The epidermis, or top layer, of the skin becomes thinner; the fat layer under the epidermis decreases, leading to more wrinkles; those wrinkles stick around because elasticity decreases and skin doesn’t bounce back so easily; blood vessels thin; a decrease in sweat glands leads to drier or more itchy skin; some pigment cells decrease, while others get bigger, leading to age spots; and many people experience more skin tags, rough areas and general lumps and bumps.
What You Can Do
First, stay hydrated. As you age, it takes much more water loss to feel thirsty, so drink water even if you don’t seem to need it. It’s also important at any age to wear sunscreen, eat your vegetables and do not smoke. And if you do find yourself with dry skin, use creams or ointments, instead of lotions, and apply them while skin is still damp.
Sex (or, What Do I Need to Know About Sex?)
The Science
Surveys show about half of people ages 65 to 74 are sexually active, along with 25 percent of people over the age of 75. And it’s not rare either: sexually active adults over age 60 have sex three-to-four times a month. (By comparison, men and women ages 19 to 59 on average have sex six times a month.)
After menopause, estrogen and testosterone decreases in women, and many experience vaginal atrophy, decreased lubrication and decreased clitoral vasocongestion, or the rush of blood to the clitoris. Testosterone in men drops about one percent every year after age 30, and they may experience erectile dysfunction, decreased erotic tissue sensitivity and decreased amount and force of ejaculate.
What You Can Do
About 70 percent of men, and 60 percent of women, report their sex lives have improved after treatment, says Eastman. For women, that could mean using topical lubricants (make sure it is water- or silicone-based when used with condoms), oral hormone replacement or a newer type of physical therapy called vaginal rehabilitation. Eastman recommends men speak with their urologist before trying things like injectables, testosterone replacement, implants or vacuum pumps.
Communication is also important, Eastman says. “All of us experience changes as we age, so it’s important to talk to your partner and explore these changes in intimacy together,” she explains. Expand your definition of foreplay to include dinner and a movie, for example, and recognize arousal may take longer than it used to. Experiment and try new things. And, above all else, ditch the idea that sex is only for the young, and practice thinking of yourself as a sexual being at any age.
Eastman also wants to stress that sex can be risky at any age, so it’s important to use protection. Fewer than 10 percent of people over the age of 61 use condoms regularly, but the incidence of sexually transmitted diseases, such as syphilis and chlamydia, among older patients has been rising dramatically over the past few decades, and one in seven new cases of HIV in the uses are found in people over 50 years old.
Memory (or, Is My Forgetfulness Normal?)
The Science
Eastman describes our brains as overstuffed libraries, with decades of facts and memories that were never properly shelved. But there is a difference between normal aging of the brain, and memory disorders. She says it’s perfectly normal to experience occasional or temporary memory lapses, such as forgetting why you walked into another room. Processing speed, some problem-solving and recall speed all decline with age.
Memory disorders, however, are abnormal. People who have a mild neurocognitive disorder may have some lapses, but no major effect on daily life, and about half of those who fall into this category go on to develop dementia. Dementia is classified as major Neurocognitive disorder, and is defined as a deficit in two or more areas of cognition. The majority of people in this category have Alzheimer’s dementia.
What You Can Do
Once again, exercise has been found to be helpful – even as good as memory medications, according to some studies. Eastman says it’s also important to manage the diseases you already have, since things like high blood pressure and diabetes can damage the brain. Social activities, brain games – especially new ones – and playing or listening intently to music can all stretch your brain and keep it active.
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