By John Brusch, MD

CHA Primary Care Physician (Internal Medicine, Geriatrics) and Assistant Professor of Medicine, Harvard Medical School

It is common to attribute an older adult's medical problems to his or her aging. At times this may be true. However, in many cases these assumptions lead to missed opportunities to prevent functional decline as we get older. That's why it is important to know what is to be expected and not expected as our birthdays add up.

What changes should we expect in our bodies
as we age?

Wrinkling, hair loss, and graying of the hair are all things that occur with age. The heart's ability to quickly react to demands may be decreased. The lungs usually lose mass, elasticity, and respiratory muscle strength, resulting in mild shortness of breath with heavy exertion and increased risk of lung infection.

Other changes that could also occur include:

• Loss of muscle mass
• Decrease in defenses against viral and bacterial infections
• Decrease in brain mass leading to slower processing of information
• High frequency hearing loss
• Taste and smell decline

However, it is important to remember that everyone does not age the same. There is great variability among the rates of changes as we age.

What things should not be considered part of
"normal aging"?

There are many things that are considered common that are actually not normal as we age. Here are a few examples:

• Falls: Any type of fall is not an inevitable part or consequence of aging. A fall is actually due to failure of one or more body systems.

• Dementia: Alzheimer's disease and other dementias are not part of the normal aging process.

• Heart failure and significant lung failure (COPD)

• Severe osteoporosis: This is usually associated with inactivity, decreased calcium intake, and a diet low in calcium and vitamin D and may lead to hip fractures.

How can I help my patients or clients make the most of their PCP visits to detect possible issues?

I suggest bringing a list of questions and concerns to the visit. For instance, the new onset of fatigue or any falls should be regarded as a "warning light" of potential significant physical problems such as heart failure, kidney failure, or a disturbed neurological system. These symptoms should be appropriately investigated. Be sure to prioritize the concerns, starting with the most important issues you feel affect your ability to perform normal activities. Also, make sure to bring a list of your current medications and dosages. Your PCP will stop medications that you no longer need.

What tips can I suggest to my patients or clients to stay healthy as they age?

Although we cannot stop the inevitable signs of aging like wrinkles and hair loss, there are some things older adults can do to stay healthy:

• Exercise: Mild to moderate physical activity is essential to maintaining muscle mass and good cardiovascular functioning.  Two things I suggest are 1) walking fast for 15 minutes a day on level ground and 2) upper arm exercises with 3 - 5 pound weights to maintain upper body strength.

• Vitamins: Vitamin D and supplemental calcium may be beneficial. However, I suggest prior to taking any vitamins or herbal extracts to discuss it with a primary care provider first.

• Stay social: Participate in community events, volunteer, take advantage of the wide range of activities offered at the local senior centers. Just because you are retired from work doesn't mean you are retired from life.

Thank you for reading. I hope you found this helpful. If you have any questions, please feel free to contact me via email at jbrusch@challiance.org.