Day 62 : Book Excerpt : You’re Looking Very Well

There are few if any organs in our body that do not decline in their function with age, and many deaths are due to age-related illnesses. But not everything is bad news. A major study by ELSA (English Longitudinal Study of Ageing) in the UK is designed to find out about the health of the elderly, and participants are interviewed every two years. It is encouraging and impressive that 60 per cent of those aged 80-plus describe their health as good to excellent. But that does mean that 40 per cent have health problems. The study also found that while arthritis is age-related, joint pain and back pain were not, and were no more common among the elderly than the young.
The study looked at the proportion of people who remain free of certain diseases, including four eye diseases, seven cardiovascular diseases and six other physical diseases. Around half of those aged 50–54 still had none of those diseases, but only around one in ten of those aged 75–79. Wealth and education lead to longer physical functioning, possibly because both lead to better personal care. Money matters: people in the richest part of London live 17 years longer than those in the poorest parts. Individuals who are 50–59 years old and from the poorest fifth of the population are over ten times more likely to die earlier than their peers from the richest fifth. The poor are more likely to be unhealthy, despite a fairly even distribution in the quality of healthcare between different wealth groups.
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Disability and frailty are common problems for the elderly. Those who are ill experience ageing very differently from those who are well. There are 75-year-old joggers and 75-year-olds who are very frail. Frailty is a condition associated with ageing whose symptoms include weight loss, decreased muscle mass and strength, weakness, lack of energy and reduced motor performance. The condition seems to spring from a general weakening of the body, including the skeletal, muscular, blood and hormonal systems. The most commonly used measures of disability are reports of problems with the basic activities of daily living such as mobility, looking after oneself by preparing meals, shopping, managing money and taking medication. While disability indicates loss of function, frailty indicates instability and the risk of loss of function. The frail person is at increased risk of disability and death from minor external stresses. Frailty may also be identified by particular clinical consequences such as frequent falls, incontinence or confusion. In many cases a single factor, such as undetected cardiovascular disease, can be the reason why people become frail. Instead of having classic symptoms such as a heart attack or a stroke, people may have partly blocked blood vessels in the brain or the legs, the kidneys or the heart, which can result in exhaustion or mental confusion or weakness or a slow walking pace. It has been found that those people who had a positive outlook on life were significantly less likely to become frail.
As we age, our cells become less efficient and our bodies become less able to carry out their normal functions. Muscles lose strength, hearing and vision become less acute, reflex times slow down, lung capacity decreases, and the heart’s ability to pump blood may be affected. In addition, the immune system weakens, making it less able to fight infection and disease. Heart pumping giving maximum oxygen consumption declines about 10 per cent every ten years in men, and in females a bit less; maximum breathing capacity declines about 40 per cent between ages 20 and 70; the brain shrinks and loses some cells; kidneys become less efficient and the bladder gets smaller; muscle mass decreases by about 20 per cent between 30 and 70 years, though exercise reduces this; and bone mineral is lost from age 35; sight may decline from 40 and hearing declines when older. These changes in our bodies with age are not due to ill health but are, alas, normal, and they can cause health problems.
Once adults reach 40, they start to lose just over 1 per cent of their muscle each year. This could be due to the body’s failure to deliver nutrients and hormones to muscle because of poorer blood supply. Tendons, which connect muscles to bone, and ligaments, which hold joints together, become less elastic and are easier to tear. We also get slower in physical activities, as I know all too well. The good news is that one in five people aged between 65 and 74 are doing recommended levels of exercise. But physical labour can also have negative effects – lawyers and priests over 55 die at lower rates than blacksmiths and ironworkers, and at even lower rates when over 75. Mammalian muscles can regenerate, but in mice the old muscle regenerates poorly. Joining the muscles of old and young mice together resulted in the old muscle regenerating better, and the young a bit worse.

~~You’re Looking Very Well: The Surprising Nature of Getting Old -by- Lewis Wolpert