What to Expect While Aging - Part I

In 1984, Murkoff and Hathaway’s wildly popular book, What to Expect When Expecting, was published. According to Amazon, this book “…is a perennial New York Times bestseller and one of USA Today's 25 most influential books of the past 25 years. It's read by more than 90% of pregnant women who read a pregnancy book—the most iconic, must-have book for parents-to-be, with over 14.5 million copies in print”. This book has likely helped many women over the years.

When I did a quick look through the offerings of books on aging on Amazon and researched the popularity, the number of copies sold, I discovered many of these books gather dust. They simply aren’t that sellable. Why is a book about pregnancy relevant, yet, a book on aging doesn’t seem to be important? We don’t all experience pregnancy, but, we all experience aging. Perhaps reading about the good/bad/ugly of aging is too depressing for some people, so, they pretend they aren’t going to age like everyone else, or, they may be terrified of death approaching as they age. Unfortunately, that’s like an ostrich sticking its head in the sand to avoid the truth.

I get it. Aging is not a topic many people want to think about. Especially in the USA, aging is considered abhorrent and the aged are shoved to the side of society as though they are no longer relevant. That’s a sad aspect of the culture in this country. This week's bog essay looks at how we age and some tips on maintaining health mentally, physically, emotionally, and sexually. We all age, so, staying informed about what may be coming or what's happening in us now can help us navigate well through the aging process.

As you may guess, aging is different in women from how men age. According to one article, “Beauty standards aside, there is a difference in how women and men go through the aging process on a cellular level. Men have higher levels of testosterone, which can help thicken the skin. According to the International Dermal Institute, it’s about 25% thicker. One of the major causes behind visible signs of aging is the thinning of the skin, so men often appear to be aging slower than women. Men’s skin can also have a higher collagen density which can contribute to their slower visible aging, and the increased amount of lactic acid in their sweat can lead to a natural moisturization of their skin. Proper moisturizing and moisture retention are vital to cell health; a lack in this area can lead to wrinkles and sagging skin. Aging also occurs faster in women due to menopause. Menopause is a period of major hormonal changes that occur in women, usually over the age of 50; however, there is no male equivalent of hormonal changes causing signs of aging to set in quickly. As a result, signs of aging are less noticeable in men because they occur over a larger period of time. While this may seem unfair, and heavily weighted in favor of men, there are some perks for women. While menopause can be an uncomfortable phase, once a woman goes through this period in her life, aging begins to settle while men are only getting started. Around age 30, testosterone levels in men decrease about 1% each year—this minuscule change contributes to their slow signs of aging; however, by age 55-60, these levels have dipped low enough to begin causing wrinkles, grey hairs, sagging skin, and hair loss. By the time they reach 50, about 50% of men will have some hair loss, and by age 70 nearly all (80%) will be showing signs of male pattern baldness…From a young age, we learn boys and girls begin to mature at a different rate, with girls becoming more mature much more quickly than boys do. But does the same thing apply to men and women aging and growing old? We took a look at how men age differently than women, and why they age differently. It is well known that the primary hormone in women is estrogen and the primary hormone in men is testosterone, however both men and women do carry both hormones, with women simply carrying more estrogen and men carrying more testosterone. When it comes to aging, women’s levels of the estrogen hormone begin to decline much earlier and much more quickly than men’s levels of the testosterone hormone do. This quicker decline in hormone levels is the reason that men seem to age much more slowly than women do. Women’s estrogen levels begin to decline around age 40 or 50, whereas men’s testosterone levels do not begin to decline until around age 55 or 60. Men have the clear advantage when it comes to signs of aging in their skin. A man’s higher testosterone levels help make their skin about 25% thicker than a woman’s skin is. These higher levels of testosterone and thicker skin also cause men to produce more collagen, elastin, and sebum (oil) – which means men have an advantage with the most important components of firm, glowing, healthy, and youthful looking skin. Testosterone also stimulates the growth of facial hair in men which can help protect their skin from the damaging effects of the sun and air pollutants. As we previously discussed, men’s hormone levels decrease later and at a slower rate than women’s hormone levels decrease, and this causes women’s collagen and elastin to break down more quickly, causing premature lines, wrinkles, sagging skin, and discoloration. When it comes to our hair, men lose hair much more than women do overall, and at a much quicker pace than women do. It is natural for both men and women to lose some amount of hair and thickness to their hair as they age, but men tend to experience pattern baldness whereas women simply experience a thinning of their hair on the top and crown of their heads. Women’s hair loss will rarely progress to total baldness, whereas complete baldness is not uncommon in men. Approximately half of all men will experience some level of hair loss by the time they reach age 50, and about 80% of men show signs of male pattern baldness by age 70. Another advantage that women have over men in the aging process is that their lifespans tend to be longer than men’s. According to the CDC, the average life expectancy for men in the U.S. is 76.4 years of age, while the average life expectancy for women in the U.S. is 81.2 years of age. There are many different speculations as to why women live longer than men ranging from women being able to manage and handle stress better, to women getting more regular health checkups, to men experiencing higher rates of mortality from cancer – but no matter what the reason may be, the World Health Organization agrees that women outliving men is the trend worldwide.” (https://brandonessentials.com/key-differences-in-how-women-men-age/). That is so unfair that many women age faster than many men age! Of course, men may point out that it’s unfair that many women live longer than many men.

In a Great Senior Living article, a list of the effects of aging in these areas is discussed:

“ Skin

Hearing

Teeth and gums

Digestive system

Bladder and urinary tract

Kidneys

Lungs

Cardiovascular system

Reproductive system

Body composition

Joints and connective tissue

Immune system

Sleep

Brain and nervous system

Vision”

The article continues by highlighting the differences between ‘life span’ and ‘health span’: “The science of aging is filled with paradoxes. For example, as we've extended the average life span, many illnesses, including Alzheimer's disease, have become more common. In fact, about 85 percent of seniors have a chronic health condition that can impact their quality of life. So although we're living longer (on average), we're not necessarily living healthier. That's why many seniors choose to focus on their ‘health span’ instead of their ‘life span.’ Health span is often considered to be a measure of how long a senior can function independently, without a debilitating chronic condition. For many older Americans, successful aging is the ability to extend their health span and enjoy life comfortably in an environment they choose. That's why as we grow older, the choices we make regarding our lifestyle become even more important. Although much of the aging process is out of our control, many choices we face can lead to a more fulfilling health span. As well, geriatric researchers talk about an 'aging paradox.’ That's the phenomenon in which people are more likely to rate their health as ‘good’ when they get older—even if their health has actually gotten worse. Some of this dynamic might be the result of older people comparing themselves to their frailer peers. And some of it might be due to the stereotypes that many people have about aging.

In other words, because society tends to label ‘old age’ as a time of sickness and frailty, many people are surprised to discover that they're still thriving and enjoying life” (https://www.greatseniorliving.com/articles/aging-process#life-span-health-span).

Why do some people seem to age more swiftly than others? “As you can see, many things change as you grow older. And a lot of those things can vary from person to person. But why is there so much variation? And how much can you control your own aging process? Scientists believe that about 25 percent of how we age is due to genetic factors. However, environmental and genetic factors are intricately intertwined, so it's difficult to come up with an exact formula for determining how an individual person will age. So although you can look to your parents if you're wondering what to expect at 70 years old and beyond, there are no guarantees. The aging process is unique to each individual precisely because so many different factors are involved. Still, we can do many things to improve our odds of experiencing good health during our senior years. Although you can't change the genes you are born with, you can make choices that affect how your genes react to the aging process. While learning how aging can affect different aspects of your body, you've probably noticed some common themes when it comes to protecting your health. That's because the various parts of our bodies work together as a whole unit. What helps one aspect of our health is usually good for other aspects. So regardless of your age and health concerns, eating well, getting moderate exercise, abstaining from smoking, and dealing effectively with stress can help you cope with physical changes. With aging, it's important to act on the things you can control. (Some lucky people seem to thrive in old age despite not following medical advice on living a healthy lifestyle. But public health research focuses on the big picture—what, on average, will benefit a person's health. It's usually better to follow that advice than to focus on the experiences of statistical outliers.) One important factor that is often overlooked is the importance of your attitude toward growing older. Your feelings about aging can actually shape how you age. A study in The Journals of Gerontology: Series B found that older adults did worse on tests that measured things like memory and gait after they were exposed to words that reinforced negative stereotypes about aging. And in a study in the Journal of Personality and Social Psychology, participating seniors with the most negative attitudes about aging died an average of 7.5 years before the participants with the most positive attitudes. In other words, although some of the aging process is ultimately out of your control, making healthy lifestyle changes and keeping a positive attitude can go a long way toward helping you enjoy and extend your senior years” (https://www.greatseniorliving.com/articles/aging-process#life-span-health-span).

The prestigious Mayo Clinic shared what to expect as we get older and what we may be able to do about it now: “ Wonder what's considered a normal part of the aging process? Here's what to expect as you get older — and what to do about it. You know that aging will likely cause wrinkles and gray hair. But do you know how aging will affect your teeth, heart and sexuality? Find out what changes to expect as you continue aging — and how to promote good health at any age.

Your weight

How your body burns calories (metabolism) slows down as you age. If you decrease activities as you age, but continue to eat the same as usual, you'll gain weight. To maintain a healthy weight, stay active and eat healthy.

What you can do to maintain a healthy weight:

* Include physical activity in your daily routine. Regular moderate physical activity can help you maintain a healthy weight.

* Eat a healthy diet. Choose vegetables, fruits, whole grains, high-fiber foods and lean sources of protein, such as fish. Limit sugar and foods high in saturated fat.

* Watch your portion sizes. To cut calories, keep an eye on your portion sizes.

Your sexuality

With age, sexual needs and performance might [will likely] change. Illness or medication might affect your ability to enjoy sex. For women, vaginal dryness can make sex uncomfortable. For men, impotence might become a concern. It might take longer to get an erection, and erections might not be as firm as they used to be.

What you can do to promote your sexual health:

* Share your needs and concerns with your partner. You might find the physical intimacy without intercourse is right for you, or you may experiment with different sexual activities.

* Get regular exercise. Exercise improves the release of sexual hormones, cardiovascular health, flexibility, mood and self-image — all factors that contribute to good sexual health.

* Talk to your doctor. Your doctor might offer specific treatment suggestions — such as estrogen cream for vaginal dryness or oral medication for erectile dysfunction in men.

Your Cardiovascular System

The most common change in the cardiovascular system is stiffening of the blood vessels and arteries, causing your heart to work harder to pump blood through them. The heart muscles change to adjust to the increased workload. Your heart rate at rest will stay about the same, but it won't increase during activities as much as it used to. These changes increase the risk of high blood pressure (hypertension) and other cardiovascular problems.

What you can do to promote heart health:

* Include physical activity in your daily routine. Try walking, swimming or other activities you enjoy. Regular moderate physical activity can help you maintain a healthy weight and lower your heart disease risk.

* Eat a healthy diet. Choose vegetables, fruits, whole grains, high-fiber foods and lean sources of protein, such as fish. Limit foods high in saturated fat and salt.

* Don’t smoke. Smoking contributes to the hardening of your arteries and increases your blood pressure and heart rate. If you smoke or use other tobacco products, ask your doctor to help you quit.

* Manage stress. Stress can take a toll on your heart. Take steps to reduce stress, such as meditation, exercise or talk therapy.

Get enough sleep. Quality sleep plays an important role in the healing and repair of your heart and blood vessels. Aim for seven to nine hours a night.

Your Bones, Joints, and Muscles

With age, bones tend to shrink in size and density, weakening them and making them more susceptible to fracture. You might even become a bit shorter. Muscles generally lose strength, endurance and flexibility — factors that can affect your coordination, stability and balance.

What you can do to bone, joint, and muscle health:

* Get adequate amounts of calcium. The National Academy of Science, Engineering, and Medicine recommends at least 1,000 milligrams (mg) of calcium daily for adults. The recommendation increases to 1,200 mg daily for women age 51 and older and men age 71 and older. Dietary sources of calcium include dairy products, broccoli, kale, salmon and tofu. If you find it difficult to get enough calcium from your diet, ask your doctor about calcium supplements. Get adequate amounts of vitamin D. The recommended daily intake of vitamin D is 600 international units for adults up to age 70 and 800 IU for adults over 70. Many people get adequate amounts of vitamin D from sunlight. Other sources include tuna, salmon, eggs, vitamin D-fortified milk and vitamin D supplements.

* Include physical activity in your daily routine. Weight-bearing exercises, such as walking, jogging, tennis, climbing stairs and weight training can help you build strong bones and slow bone loss.

* Avoid substance abuse. Avoid smoking and limit alcoholic drinks. Ask your doctor about how much alcohol might be safe for your age, sex and general health.

[writer’s note: Even quality research shows conflicting information about the efficacy of taking vitamins and supplements. So, it is best to get your vitamins and minerals through the food you consume rather than relying on supplements.]

Your digestive system

Age-related structural changes in the large intestine can result in more constipation in older adults. Other contributing factors include a lack of exercise, not drinking enough fluids and a low-fiber diet. Medications, such as diuretics and iron supplements, and certain medical conditions, such as diabetes, also might contribute to constipation.

What you can do to prevent constipation:

* Eat a healthy diet. Make sure your diet includes high-fiber foods, such as fruits, vegetables and whole grains. Limit high-fat meats, dairy products and sweets, which might cause constipation. Drink plenty of water and other fluids.

* Include physical activity in your daily routine. Regular physical activity can help prevent constipation.

* Don’t ignore the urge to have a bowel movement. Holding in a bowel movement for too long can cause constipation.

Your bladder and urinary tract

Your bladder may become less elastic as you age, resulting in the need to urinate more often. Weakening of bladder muscles and pelvic floor muscles may make it difficult for you to empty your bladder completely or cause you to lose bladder control (urinary incontinence). In men, an enlarged or inflamed prostate also can cause difficult emptying the bladder and incontinence. Other factors that contribute to incontinence include being overweight, nerve damage from diabetes, certain medications, and caffeine or alcohol consumption.

What you can do to promote bladder and urinary tract health:

* Go to the toilet regularly. Consider urinating on a regular schedule, such as every hour. Slowly, extend the amount of time between your toilet trips.

*Maintain a healthy weight. If you're overweight, lose excess pounds.

* Don’t smoke. If you smoke or use other tobacco products, ask your doctor to help you quit.

* Do Kegel exercises. To exercise your pelvic floor muscles (Kegel exercises), squeeze the muscles you would you use to stop passing gas. Try it for three seconds at a time, and then relax for a count of three. Work up to doing the exercise 10 to 15 times in a row, at least three times a day.

* Avoid bladder irritants. Caffeine, acidic foods, alcohol and carbonated beverages can make incontinence worse.

* Avoid constipation. Eat more fiber and take other steps to avoid constipation, which can worsen incontinence.

Your memory and thinking skills

Your brain undergoes changes as you age that may have minor effects on your memory or thinking skills. For example, healthy older adults might forget familiar names or words, or they may find it more difficult to multitask. [That’s okay; we aren’t built to multitask well, even though we think we can.]

What you can do [to] can promote cognitive health by taking the following steps:

* Include physical activity in your daily routine. Physical activity increases blood flow to your whole body, including your brain. Studies suggest regular exercise is associated with better brain function and reduces stress and depression — factors that affect memory.

* Eat a healthy diet. A heart-healthy diet may benefit your brain. Focus on fruits, vegetables and whole grains. Choose low-fat protein sources, such as fish, lean meat and skinless poultry. Too much alcohol can lead to confusion and memory loss.

* Stay mentally active. Staying mentally active may help sustain your memory and thinking skills. You can read, play word games, take up a new hobby, take classes, or learn to play an instrument.

* Be social. Social interaction helps ward off depression and stress, which can contribute to memory loss. You might volunteer at a local school or nonprofit, spend time with family and friends, or attend social events.

* Treat cardiovascular disease. Follow your doctor's recommendations to manage cardiovascular risk factors — high blood pressure, high cholesterol and diabetes — that may increase the risk of cognitive decline.

* Quit smoking. If you smoke, quitting smoking may help your cognitive health.

If you're concerned about memory loss or other changes in your thinking skills, talk to your doctor.

Your eyes and ears

With age, you might have difficulty focusing on objects that are close up. You might become more sensitive to glare and have trouble adapting to different levels of light. Aging also can affect your eye's lens, causing clouded vision (cataracts). Your hearing also might diminish. You might have difficulty hearing high frequencies or following a conversation in a crowded room.

What you can dot o promote eye and ear health:

* Schedule regular checkups. Follow your doctor's advice about glasses, contact lenses, hearing aids and other corrective devices.

* Take precautions. Wear sunglasses or a wide-brimmed hat when you're outdoors, and use earplugs when you're around loud machinery or other loud noises.

Your teeth

Your gums might pull back from your teeth. Certain medications, such as those that treat allergies, asthma, high blood pressure and high cholesterol, also can cause dry mouth. As a result, your teeth and gums might become slightly more vulnerable to decay and infection.

What you can do to promote oral health:

* Brush and floss. Brush your teeth twice a day, and clean between your teeth — using regular dental floss or an interdental cleaner — once a day.

• Schedule regular checkups. Visit your dentist or dental hygienist for regular dental checkups.

Your skin

With age, your skin thins and becomes less elastic and more fragile, and fatty tissue just below the skin decreases. You might notice that you bruise more easily. Decreased production of natural oils might make your skin drier. Wrinkles, age spots and small growths called skin tags are more common.

What you can do to promote healthy skin:

* Be gentle. Bathe or shower in warm — not hot — water. Use mild soap and moisturizer.

* Take precautions. When you're outdoors, use sunscreen and wear protective clothing. Check your skin regularly and report changes to your doctor.

* Don’t smoke. If you smoke or use other tobacco products, ask your doctor to help you quit. Smoking contributes to skin damage, such as wrinkling.

You can't stop the aging process, but you can make choices that improve your ability to maintain an active life, to do the things you enjoy, and to spend time with loved ones” (https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/aging/art-20046070).

Thank you for reading this blog essay; if you read this on social media, please type your comments below. Or, if you read this in your subscription, please share your thoughts in an email to me at reimaginelife22@gmail.com.

Next week’s blog essay will be Part II of What to Expect While Aging; in that essay, I will share what people 55 years and older say about their personal experiences with aging. And, I’ll share some of my thoughts on aging along with some resources and tools.