June 1996

What is 'Normal' Aging?

Our society is confused about what it means physically and emotionally to grow old. If you've spent much time around people in their 70s, 80s, or 90s, you may have heard them say:

* You know how it is when you get this old. You get dizzy when you stand up.

* My old bones ache all the time.

* I can't go to the movies because I have to go to the bathroom all the time.

* My skin never stops itching. There's nothing I can do.

* It's impossible to be happy. I've given up trying.

In fact, none of these complaints is a normal part of aging. Each is a symptom of a condition or disease that could be addressed and corrected--or at least relieved. Old age is not a popular subject in our culture. We don't like to think about the prospect of growing old, so we put it out of our minds. When it happens to us or a family member, we have no idea of what to expect.

People age at different rates. Aging is a highly individual process that affects people in unpredictable ways. It's the opposite of infancy and childhood, when we can predict physical growth and the development of skills with surprising accuracy. In old age, we have no uniform timetable, and chronological age can be a poor indicator of how someone feels physically. Because organ systems age at different rates, someone in her 80s may have a very "young" heart but very "old" skin. A 65-year-old may have "old" kidneys but a relatively young hormonal system and strong bones.

The one percent rule. Although the "declines" of aging are different and unpredictable, most people do experience them and have to make adjustments as their systems begin to behave less efficiently. The loss of efficiency comes about as some cells wear out and are not replaced. This process is sometimes referred to as the One Percent Rule, meaning that most organ systems lose roughly one percent of their functioning each year, starting at about the age of 30. This is illustrated by athletes, who are less able to draw on the full extent of their reserves sometime in their 30s. If you have an older relative or friend, here are some things to keep in mind:

* Take health complaints seriously. Because indicators of illness change with age, it's common for an older person to be sick without showing classic symptoms such as fever, pain, or nausea. For example, an older person can be having a heart attack without showing any of the classic dramatic signals. Instead, the person may simply become extremely restless, confused and short of breath.

* Look for obvious signs of illness when your parent, relative or friend is not feeling right, but be aware that a change in behavior can signal a medical emergency. In some situations, the only clue that something is wrong may be disorientation, confusion or a change in your parent or friend's mental state that makes it difficult to function normally.

* Be aware that diseases may look alike in older people. Early, subtle signs of Parkinson's disease and arthritis look similar. Depression can seem the same as a neurological or hormone problem. So don't ignore any of these difficulties.

* Screening tests are as important as ever. Encourage your parents or older friends to have an annual physical checkup, even if they are feeling well. Many diseases commonly affecting older people give little warning of their presence.

Adapted from Caroline Rob's book, The Caregiver's Guide (Houghton Mifflin).