Over the Hill, What Hill? I Didn’t See Any Hill.

Here’s a good synopsis of the facts about aging from the American Psychological Association.

“America is aging. The number of Americans over age 65 is increasing dramatically as we approach the millennium. Never in our nation’s history have so many people lived into the later stages of their lives and remained healthy and productive. The proportion of Americans age 65 and over comprises nearly 13 percent of the U.S. population. In fewer than 25 years, those over age 65 will make up 20 percent of the U.S. population. Americans’ living longer and staying increasingly active and productive is a welcome sign for our nation. However, society’s view of “old age” has not always kept up with the reality of older Americans’ health or the fact that while many people over the age of 65 experience some limitations, they learn to live with them and lead happy and productive lives.

Accurate information and continued research on the aging process are critical as Americans age. What’s important to remember about people over age 65 is that while many begin to experience some physical limitations, they learn to live with them and lead happy and productive lives.

As with many stereotypes, the stereotypes about aging are often inaccurate. Most older Americans live independently and maintain close relationships with family and friends. Most peoples’ personalities remain relatively stable throughout their lives. Depression among noninstitutionalized older adults is less prevalent than depression in younger adults. However, most older adults do experience normal, age-related changes that may affect their lifestyle.”

From a variety of sources, I’ve gleaned the following good news and bad news about “the distinguishing marks associated with old age,” which comprise both physical and mental characteristics. These marks do not occur at the same chronological age for everyone. Also, they occur at different rates and order for different people. Because each person is unique, marks of old age vary between people, even those of the same chronological age.

Physical marks of old age include:

  • Bone and joint. Old bones are marked by “thinning and shrinkage.” This results in a loss of height (about two inches by age 80), a stooping posture in many people, and a greater susceptibility to bone and joint diseases such as osteoarthritis and osteoporosis.
  • Chronic diseases. Most older persons have at least one chronic condition and many have multiple conditions. In 2007-2009, the most frequently occurring conditions among older persons in the United States were uncontrolled hypertension (34%), diagnosed arthritis (50%), and heart disease (32%).
  • Dental problems. Less saliva and less ability for oral hygiene in old age increases the chance of tooth decay and infection.
  • Digestive system. About 40% of the time, old age is marked by digestive disorders such as difficulty in swallowing, inability to eat enough and to absorb nutrition, constipation and bleeding.
  • Eyesight. Diminished eyesight makes it more difficult to read in low lighting and in smaller print. Speed with which an individual reads and the ability to locate objects may also be impaired.
  • Falls. Old age spells risk for injury from falls that might not cause injury to a younger person. Every year, about one-third of those 65 years old and over half of those 80 years old fall. Falls are the leading cause of injury and death for old people.
  • Hair usually becomes thinner and grayer.
  • Hearing. By age 75 and older, 48% of men and 37% of women encounter impairments in hearing. Of the 26.7 million people over age 50 with a hearing impairment, only one in seven uses a hearing aid.
  • Hearts are less efficient in old age with a resulting loss of stamina. In addition, atherosclerosis can constrict blood flow.
  • Immune function. Less efficient immune function is a mark of old age.
  • Lungs expand less well; thus, they provide less oxygen.
  • Pain afflicts old people at least 25% of the time, increasing with age up to 80% for those in nursing homes. Most pains are rheumatological or malignant.
  • Sexual activity decreases significantly with age, especially after age 60, for both women and men. Sexual drive in both men and women decreases as they age.
  • Skin loses elasticity, becomes drier, and more lined and wrinkled.
  • Sleep trouble holds a chronic prevalence of over 50% in old age and results in daytime sleepiness. In a study of 9,000 persons with a mean age of 74, only 12% reported no sleep complaints. By age 65, deep sleep goes down to about 5%.
  • Taste buds diminish so that by age 80 taste buds are down to 50% of normal. Food becomes less appealing and nutrition can suffer.
  • Urinary incontinence is often found in old age.
  • Voice. In old age, vocal cords weaken and vibrate more slowly. This results in a weakened, breathy voice that is sometimes called an “old person’s voice.”

Mental marks of old age include:

  • Adaptable describes most people in their old age. In spite the stressfulness of old age, they are described as “agreeable” and “accepting.” However, old age dependence induces feelings of incompetence and worthlessness in a minority.
  • Caution marks old age. This antipathy toward “risk-taking” stems from the fact that old people have less to gain and more to lose by taking risks than younger people.
  • Depressed mood. According to Cox, AbramsonDevine, and Hollon (2012), old age is a risk factor for depression caused by prejudice (i.e., “deprejudice”). When people are prejudiced against the elderly and then become old themselves, their anti-elderly prejudice turns inward, causing depression. “People with more negative age stereotypes will likely have higher rates of depression as they get older.” Old age depression results in the over-65 population having the highest suicide rate.
  • Fear of crime in old age, especially among the frail, sometimes weighs more heavily than concerns about finances or health and restricts what they do. The fear persists in spite of the fact that old people are victims of crime less often than younger people.
  • Mental disorders afflict about 15% of people aged 60+ according to estimates by the World Health Organization. Another survey taken in 15 countries reported that mental disorders of adults interfered with their daily activities more than physical problems.
  • Reduced mental and cognitive ability afflicts old age. Memory loss is common in old age due to the decrease in speed of information being encoded, stored, and retrieved. It takes more time to learn new information. Dementia is a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Its prevalence increases in old age from about 10% at age 65 to about 50% over age 85. Alzheimer’s disease accounts for 50 to 80 percent of dementia cases. Demented behavior can include wandering, physical aggression, verbal outbursts, depression, and psychosis.
  • Set in one’s ways describes a mind set of old age. A study of over 400 distinguished men and women in old age found a “preference for the routine.” Explanations include old age’s toll on the “fluid intelligence” and the “more deeply entrenched” ways of the old.

There are many books for and about people who are approaching or have past the final years of middle age, notably the huge cohort known as “baby boomers.” In Second Wind, Navigating the Passage to a Slower, Deeper, and More Connected Life, Dr. Bill Thomas reminds us how, as a result of our sheer numbers, we’ve changed cultural norms all through our lives. He looks at our behaviors now and categorizes us as “denialists,” “realists,” or “enthusiasts.”

Those of us in denial are encouraged every day by modern media to avoid wrinkles, stay physically and sexually active, fight, fight, fight to stay young and never accept the normal and unavoidable process of aging.

“Realists” are likewise buying supplements, going to the gym, and attending the college for seniors in an effort to extend every aspect of our health as we age and enjoy every minute, but we’re still looking back to younger years for our standard of “the good life.”

“Enthusiasts” Thomas purports are not only accepting old age, but welcoming it as a meaningful next developmental stage in life. There are others writing about aging from a positive perspective (see Sister Joan Chittester  – “The Gift of Years” and Lewis Richmond – “Aging as a Spiritual Practice: A Contemplative Guide to Growing Older and Wiser”), but Bill Thomas’s book seems to me to answer the question “why welcome those final years?” in a brief and easily digested way. Check out his book for a trip down memory lane and a hopeful look at the future as a time to enjoy slower, deeper and more connected days.

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In what ways are you feeling your age?

Are you going over the hill with your foot on the brakes, your eyes on the rear view mirror, or whole-heartedly anticipating the possibilities of whatever experiences you may encounter?