15.3: Aging

More than 10,000 people turn 65 every day in the United States, and people are living longer, healthier lives. Healthy lifestyles, planning for retirement, and knowing your options for health care and long-term care are more important than ever before.

Across the world, the number and proportion of people aged 60 years and older in the population is increasing. In 2019, the number of people aged 60 years and older was 1 billion. This number will increase to 1.4 billion by 2030 and 2.1 billion by 2050. This increase is occurring at an unprecedented pace and will accelerate in coming decades, particularly in developing countries. This historically significant change in the global population requires adaptations to the way societies are structured across all sectors. For example, health and social care, transportation, housing and urban planning. Working to make the world more age-friendly is an essential and urgent part of our changing demographics.

• Between 2015 and 2050, the proportion of the world’s population over 60 years will nearly double from 12% to 22%.
• By 2020, the number of people aged 60 years and older will outnumber children younger than 5 years.
• In 2050, 80% of older people will be living in low- and middle-income countries.
• The pace of population ageing is much faster than in the past.
• All countries face major challenges to ensure that their health and social systems are ready to make the most of this demographic shift.

Adopting healthy habits and behaviors, staying involved in your community, using preventive services, managing health conditions, and understanding all your medications can contribute to a productive and meaningful life.

Cognitive Health

Cognitive health — the ability to clearly think, learn, and remember — is an important component of performing everyday activities. Cognitive health is just one aspect of overall brain health. Brain health refers to how well a person’s brain functions across several areas.

Aspects of brain health include:

• Cognitive health: how well you think, learn, and remember
• Motor function: how well you make and control movements, including balance
• Emotional function: how well you interpret and respond to emotions (both pleasant and unpleasant)
• Tactile function: how well you feel and respond to sensations of touch — including pressure, pain, and temperature

Alzheimer’s Disease & Related Dementias

Alzheimer’s disease is the most common cause of dementia in older adults. It is a progressive brain disorder that slowly destroys memory and thinking skills. It is not a normal part of aging. Memory problems are typically one of the first signs of Alzheimer’s disease. Scientists believe that a combination of genetic, lifestyle, and environmental factors influence when Alzheimer’s disease begins and how it progresses. Current treatment approaches focus on helping people maintain mental function, manage behavioral symptoms, and slow or delay the symptoms of disease.

Eyes and Vision

As you age, it is normal to notice changes in your vision.

A few common changes for older adults include:

• Losing the ability to see up close
• Having trouble distinguishing colors, such as blue from black
• Needing more time to adjust to changing levels of light

The following eye problems can lead to vision loss and blindness in older adults. They may have few or no early symptoms. Regular eye exams are your best protection.

• Age-related macular degeneration (AMD) can harm the sharp, central vision needed to see objects clearly and to do common things like driving and reading. Your eye care professional will ask about your family history and look for signs of AMD during a dilated eye exam. Treatments are available, and special dietary supplements can help lower your chance of it getting worse.
• Diabetic retinopathy may occur if you have diabetes. It develops slowly, often with no early warning signs. If you have diabetes, be sure to have a dilated eye exam at least once a year. Keeping your blood sugar, blood pressure, and cholesterol under control can prevent diabetic retinopathy or slow its progress in early stages. Laser surgery in later stages can sometimes prevent it from getting worse.
• Cataracts are cloudy areas in the eye’s lens causing blurred or hazy vision. Some cataracts stay small and don’t change your eyesight much. Others become large and reduce vision. Cataract surgery can restore good vision and is a safe and common treatment. If you have a cataract, your eye care professional will watch for changes over time to see if you would benefit from surgery.
• Glaucoma is usually caused by too much fluid pressure inside the eye. If not treated, it can lead to vision loss and blindness. People with glaucoma often have no early symptoms or pain. You can help protect yourself by having dilated eye exams yearly. Glaucoma can be treated with prescription eye drops, lasers, or surgery.
• Dry eye occurs when tear glands don’t work well. You may feel stinging or burning, a sandy feeling as if something is in the eye, or other discomfort. Dry eye is common as people get older, especially for women. Your eye care professional may tell you to use a home humidifier or air purifier, special eye drops (artificial tears), or ointments to treat dry eye. For more severe cases, treatment options might include prescription medication, tear duct plugs, or surgery.

Hearing

Hearing loss is a common problem caused by noise, aging, disease, and heredity. People with hearing loss may find it hard to have conversations with friends and family. They may also have trouble understanding a doctor’s advice, responding to warnings, and hearing doorbells and alarms. Approximately one in three people between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 has difficulty hearing. But, some people may not want to admit they have trouble hearing.

Some people have a hearing problem and don’t realize it.

You should see your doctor if you:

• Have trouble hearing over the telephone
• Find it hard to follow conversations when two or more people are talking
• Often ask people to repeat what they are saying
• Need to turn up the TV volume so loud that others complain
• Have a problem hearing because of background noise
• Think that others seem to mumble
• Can’t understand when women and children speak to you

Common types of hearing loss include:

• Sudden sensorineural hearing loss, or sudden deafness, is a rapid loss of hearing. It can happen to a person all at once or over a period of up to 3 days. It should be considered a medical emergency. If you or someone you know experiences sudden sensorineural hearing loss, visit a doctor immediately.
• Age-related hearing loss comes on gradually as a person gets older and usually occurs in both ears. It seems to run in families and may occur because of changes in the inner ear and auditory nerve. The loss is gradual, so someone with presbycusis (age-related hearing loss) may not realize that he or she has lost some of his or her ability to hear.
• Tinnitus is also common in older people. It is typically described as ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It can come and go. It might be heard in one or both ears, and it may be loud or soft. Tinnitus is sometimes the first sign of hearing loss in older adults.

Healthy Aging

Many factors influence healthy aging. Some of these, such as genetics, are not in our control. Others — like exercise, a healthy diet, going to the doctor regularly, and taking care of our mental health — are within our reach. Research supported by National Institute on Aging (NIA) and others has identified actions you can take to help manage your health, live as independently as possible, and maintain your quality of life as you age, these include both physical and mental health strategies.

Take care of your physical health:

• Get moving: Exercise and physical activity
  • Physical activity is a cornerstone of healthy aging.
  • As people age, muscle function often declines. Older adults may not have the energy to do everyday activities and can lose their independence. However, exercise can help older adults maintain muscle mass as they age.
  • A study of adults 40 and older found that taking 8,000 steps or more per day, compared to only taking 4,000 steps, was associated with a 51% lower risk of death from all causes^[7].
• Healthy eating: Make smart food choices
  • Making smart food choices can help protect you from certain health problems as you age and may even help improve brain function.
  • A 2021 study analyzing the eating patterns of more than 21,000 participants found that people closely following the Mediterranean-style pattern had a significantly lower risk of sudden cardiac death^[8].
  • A low-salt diet called Dietary Approaches to Stop Hypertension (DASH) has also been shown to deliver significant health benefits
• Getting a good night’s sleep
  • Getting enough sleep helps you stay healthy and alert. Even though older adults need the same seven to nine hours of sleep as all adults, they often don’t get enough.
  • A study, which looked at data from nearly 8,000 people, showed that those in their 50s and 60s who got six hours of sleep or less a night were at a higher risk of developing dementia later in life^[9].
• Quit smoking
  • It doesn’t matter how old you are or how long you’ve been smoking, research confirms that even if you’re 60 or older and have been smoking for decades, quitting will improve your health. Quitting smoking at any age will:
    • Lower your risk of cancer, heart attack, stroke, and lung disease
    • Improve your blood circulation
    • Improve your sense of taste and smell
    • Increase your ability to exercise
    • Set a healthy example for others
• Alcohol and other substances
  • Like all adults, older adults should avoid or limit alcohol consumption. In fact, aging can lead to social and physical changes that make older adults more susceptible to alcohol misuse and abuse and more vulnerable to the consequences of alcohol.
• Go to the doctor regularly
  • Going to the doctor for regular health screenings is essential for healthy aging.
  • A 2021 study found that getting regular check-ups helps doctors catch chronic diseases early and can help patients reduce risk factors for disease, such as high blood pressure and cholesterol levels. People who went to the doctor regularly also reported improved quality of life and feelings of wellness^[10].

Take care of your mental health:

• Social isolation and loneliness
  • As people age, changes such as hearing and vision loss, memory loss, disability, trouble getting around, and the loss of family and friends can make it difficult to maintain social connections. This makes older adults more likely to be socially isolated or to feel lonely.
  • A 2021 study of more than 11,000 adults older than age 70 found that loneliness was associated with a greater risk of heart disease^[11].
• Stress
  • Research shows that constant stress can change the brain, affect memory, and increase the risk of developing Alzheimer’s or related dementias.
  • A meta-analysis funded by the National Institute of Mental Health supports the notion that stress and anxiety rewire the brain in ways that can impact memory, decision-making, and mood^[12].
• Depression and overall mood
  • Although depression is common in older adults, it can be difficult to recognize. For some older adults with depression, sadness is not their main symptom. Instead, they might feel numb or uninterested in activities and may not be as willing to talk about their feelings.
  • A 2020 longitudinal study demonstrated a link between positive mood and better cognitive control^[13].
• Leisure activities and hobbies
  • Your favorite activities are not only fun — they may also be good for your health. Research shows that people who participate in hobbies and social and leisure activities may be at lower risk for some health problems.
  • A study showed that older adults who spent at least an hour reading or engaged in other hobbies had a decreased risk of dementia compared to those who spent less than 30 minutes a day on hobbies^[14].