Carl Bourhenne's Fitness and Long Life Manual
Youthful and Attractive
It is no secret that as we age our bodies change, and that the changes in mid-life and middle age tend to be deleterious to our health. Research has also clearly shown that our lifestyle impacts both positively and negatively on these changes. The need to attend to our health by attending to our lifestyle is subscribed to by such revered organization s as the aforementioned American Heart Association, The American Cancer Society, The American Lung Association, and the many other highly regarded health-related organizations with which we are all familiar. We are advised to pay great attention to what we eat, to exercise regularly, not to perform such harmful activities as smoking or using recreational drugs, and so to preserve our physical and mental capabilities.
How Do Our Bodies Change With Age?
What are the changes, and the sequence of the changes that our bodies undergo as we age, and what effect do these changes have on our health status? What are the social implications? Perhaps most important, what are the alternatives?
In order to summarize the many ways our bodies change with age, I have organized the changes according to our body systems.
THE BODY SYSTEMS:
1. The Skin
2. The Skeletal System
3. The Muscular System
4. The Neurosensory System
5. The Gastrointestinal Tract
6. The Cardiopulmonary System
7. The Cerebrovascular System
8. The Urinary System
9. The Endocrine System
10. The Genital System
11. The Immune System
The reasons for, and the details of the physiological processes of these changes are not within the purview or the space allowance of this book, so I will merely state the changes, and address the subsequent issues in their regard.
The reader will please be aware that, not only do people "age" at radically different rates of change, but also within each person, the various parts and systems "age" at different - often radically different - rates.
1. The Skin:
As the skin ages, it flattens due to the loss of: sub-cutaneous fat, skin cells, sebaceous (oil) glands, sweat glands, melanocytes (pigment cells), and hair follicles. Lentigo (senile freckles) occur, blood flow to the skin is decreased, and nerve endings are lost or become less sensitive.
As a result, the skin loses some of its effectiveness: as a protector against bacteria, as an insulator, as a thermal regulator, and as a sensory receptor. Since these losses cause wrinkling, loss of elasticity, freedom of movement and expression are inhibited. The slowing of circulation results in slower healing. The loss of color is also seen, as the hair becomes gray.
The skin generally functions well throughout life though, and most changes in the skin due to aging are not life-threatening. Most of the deleterious changes in the skin are cosmetic, as the drying and thinning result in sagging and wrinkling, the hair becomes sparser and gray or white, and the fingernails become ridged, tend to yellow, and are prone to splitting.
Skin disorders more common in the aging skin are senile pruritis (itching), keratoses (thickening in patches), skin cancer, and decubitus ulcers (pressure sores), and herpes zoster (shingles).
The social implications of these effects are based, in the United States, on a significant cultural tendency toward ageism in virtually all of its forms. One's social life becomes more limited as younger people view elders as "not fun", "slow", "grumpy", and so on. These views spill into the work-place or what might be a potential work-place, as one who looks "old" is not considered as having much to offer.
The alternatives involve personal effort by the elders in making as much of an effort as they are capable in relating to others, social responsibility by the community to understand the limitations of the elderly and provide a social environment based on actual conditions rather than assumed limitations.
The elderly themselves have a direction for alternatives, biologically, to varying degrees. They can avoid excessive exposure to the sun, maintain moisture in the skin, provide adequate nutrition so that the skin can be maintained and repaired, and get regular exercise to maintain circulation in the skin.
2. The Skeletal System:
The primary factor in the aging of the skeletal system is the loss of bone matter. This loss is called osteoporosis, and refers to bone loss. The basic cause of bone loss is the fact that the relative rates of production of osteoblasts (bone forming cells) and osteoclasts (bone dissolving cells) changes so that more bone matter is dissolved than is laid down. This loss is much greater in women than in men.
Other factors in the aging skeletal system are loosened cartilage around the joints, depleted lubricating fluid in the joints, and hardened and contracted ligaments. These factors occur more in men than in women.
The effects of these changes on our health status are significant. Bones become brittle and less supportive of our activities, resulting in less activity, which in turn results in poorer health. The excess bone taken up tends to reside in the arteries and local blood vessels, causing decreased circulation. As broken bones occur, less mobilization results in other health hazards.
The social implications of these effects are widespread, especially in advanced conditions. One becomes more dependent upon others, who might begin to avoid. One is less able to visit and to participate in social events.
The alternatives to immobilization are difficult. Family, friends, and the community must be open to assisting these individuals, and must be alert to avoid ascribing more limitations than are actual. Other alternatives are preventive techniques.
The following diseases tend to increase the incidence of osteoporosis, and so should be treated diligently: chronic alcoholism, diabetes, hyperthyroidism, uremia, and collagen disease (rheumatoid arthritis).
The current fad of ingesting large quantities of calcium in the diet can be dangerous, and have not been shown to significantly control osteoporosis. In fact, excess calcium ingestion causes calcification of the heart valves.
The most successful deterrent to osteoporosis so far has been the stress placed upon the bones by exercise, which appears to stimulate the activity of osteoblasts (bone forming cells).
3. The Muscular System:
Since muscle cells are postmitotic cells (unable to replace themselves once they are formed), all muscle cell loss is permanent. Even though muscular response gradually slows with age even under the best conditions, the loss of muscular capabilities is by far mostly the result of cell loss due to inactivity. As muscle cells are lost, weakness and slowness increase.
The effects of these changes on our health status are not, in themselves, greatly deleterious. The muscles, however, are the main tools for effecting strong circulation throughout the body.
The social implications of these changes are related both to appearance and to movement.
As the muscles become smaller, including the muscles in the face, and as adipose (fat) tissue accumulates, including in the face, the entire appearance changes to that of an older person, with all the ramifications described above in the description of skin changes. In addition, as muscle fibers decrease, weaken, and slow, it becomes increasingly difficult to keep up with younger people, who may make allowances, but who may also become avoidant.
The alternatives to these conditions can be social allowances and patience, which are sometimes offered; but, social programs such as the Senior Olympics not only help keep seniors healthier and more active, but also more capable of keeping up with younger people and of relating to them better.
The left ventricle of the heart, and the diaphragm do not lose muscle fibers with age, because they are continually active. A well designed, consistently followed exercise program is indispensable for the maintenance of muscle cells, and of good health over time.
4. The Neurosensory System:
The nerve cells (neurons) are postmitotic fixed cells (unable to replace themselves once they are formed). As they age, they lose dendrites, dendritic spines, and end branches; all of which are the intermediary parts necessary for the communication with one another. As the nervous system ages, signal conduction slows, but much more so at the nerve synapses (nerve junctions) than within the nerve cells themselves. We lose taste buds, olfactory cells (sense of smell), nerve endings in the skin, and even brain cells. Our hearing loses sensitivity, especially in the higher ranges, as the ear ossicles harden. Our vision changes as the lens of the eye becomes less flexible and yellows, and we require more light and glasses for close work.
The effects of these changes on our health status impact on the ability to drive, read, and communicate; but the most relevant loss is a lessening of ability to organize and integrate information as well. The subsequent lessening of ability to care for oneself can impact on health in many ways.
The social implications of these changes are especially significant as communications slow and others become impatient with the slowness and memory deficits, which sometimes occur. Others may avoid the elderly, become impatient with them, and the elderly may then become less interested in interacting.
The alternatives are greater social awareness and allowance. It is also important for the elderly to be as mentally active as possible, in order to alleviate the effects of slowing as much as possible. In fact, a mind kept well active need not lose any significant functioning, including memory; and a re-activated mind may regain most or all of its normal functioning, if it is not diseased.
5. The Gastrointestinal Tract:
The mouth, esophagus, stomach, small intestine, gallbladder, liver, pancreas, and large intestine compose the Gastrointestinal tract.
In the mouth, taste buds and teeth are lost. Problems with the esophagus in aging can be dysphagia (difficulty swallowing), substernal pain, heartburn, belching, and general epigastric discomfort. Atrophic changes in the stomach, especially hypoacidity and achlorhydria, are common as we age. Cell replacement is active in the small intestine, so few changes occur with aging; but obstructions are not uncommon.
Gallbladder problems are most marked after age 65, rather than in middle age. Also, the body's largest gland, the liver, maintains most of its weight until about age 70, and for the non-alcoholic can remain quite healthy and normal. Problems with the pancreas usually begin to develop about age 40 if they do occur, but they do tend to increase with age, especially if the Islets of Langerhans are damaged, or if they become over stressed by excess sugar consumption. In those instances, diabetes develops.
The large intestine is most susceptible to disease with aging, but is also most amenable to preventive measures. Obstructions of the bowel - carcinogenic or otherwise, diverticular disease, hemorrhoids, and Gastrointestinal discomfort are common in the elderly, as is fecal incontinence. These latter problems can cause a severe strain on one's self-image, but many can often be avoided by simply avoiding straining at the stool early in life.
The effects of these changes on our health status can be far-reaching, because they can affect our nutritional sustenance. Every aspect of our health is endangered by severe problems in the gastrointestinal tract.
The social implications of these effects relate mainly to the results of most illnesses, except for fecal incontinence, with its obvious discomforts and embarrassments, but which is often easily prevented by not straining at the stool early in life. Straining at the stool weakens the sphincter muscle over time.
The alternatives to the problems of these illnesses are, again, some re-education and change of attitudes in the community. The alternatives from a biological perspective are, as mentioned, preventive; with the greatest opportunities for prevention being in the regular consumption of fiber.
6. The Cardiopulmonary System:
Heart disease is the most common cause of death in people 65 and over, and is also the most frequent cause of activity limitations. The heart muscles reduce in size and the aorta loses some of its elasticity. Coronary artery disease increases as activity declines. Plaques accumulate on the interior of the arteries (atherosclerosis), and the arteries harden as they lose their elasticity (arteriosclerosis); both of these factors resulting in lessened blood flow.
Hypertension (high blood pressure) also increases with age. Several factors can stimulate the onset of congestive heart failure, and all are related to excessive demand on the right side of the heart.
The respiratory system also undergoes changes with age. The air sacs, airways, and tissues lose elasticity and become more rigid. In general however, serious disease notwithstanding, the respiratory system can serve one well throughout life. The effects of these changes on our health status need not be severe without such abuses as smoking.
The social implications of the effects of these changes are often not such as would hamper reasonable normal functioning.
The alternatives are not socially demanding, and the biological changes can be greatly diminished by a regular, strenuous exercise regimen that causes deep breathing over a period of time.
7. The Cerebrovascular System:
Atherosclerosis (plaque formation inside the arteries) and arteriosclerosis (hardening of the arteries) in the blood vessels that supply the brain is called cerebrovascular disease, and causes strokes. Prior to the complete occlusion of the blood vessels, the brain is deprived of adequate blood flow resulting in less than optimal brain functioning, such as confusion, disorientation, and memory loss. Strokes may result in hemiplegia (paralysis), aphasia (speech disorder), and sensory deprivation in varying degrees.
The effects of these changes on our health status can be drastic, ranging from slight discomfort to death.
The social implications of these effects can also be severe, as those suffering these indignities become less functional both mentally and physically; and are, in varying degrees a burden to others. Social interactions are doubly inhibited, as from inside, the patient is less able to interact; and from outside, family, friends, and others may be less interested in interacting.
The alternatives are an enhancement of understanding by the community and, before the fact, preventive measures such as diet and exercise, which have been shown to decrease or even prevent cerebrovascular accidents.
8. The Urinary System:
The bladder, urethra, urinary tract, prostate, and kidneys all show decremental incidence in most people with age. Urinary incontinence and urinary tract infections are the most common problems encountered. The capacity of the bladder reduces by half in the elderly, so there is a need to urinate more frequently.
From the age of 50 on prostate problems increase in frequency in men. A decrease in the number of nephrons, the filtering module of the kidney, results in decrease efficiency of the kidneys.
The effects of these changes on our health status range from mild to severe. While 50% of the elderly have no significant urinary health problems, less than 4% have no deterioration.
The social implications of these effects can be mild, or severe if there is great incontinence or severe kidney failure.
The alternatives must include great compassion and understanding in either case, but the best course of action is good health practices throughout life to maintain the urinary system in good health.
9. The Endocrine System:
To some researchers the endocrine system is the most exciting area of research into the basic cause of aging. The pituitary, thyroid, and adrenal glands do, however, tend to function adequately throughout life. While size of the thyroid gland does decrease significantly with age, it is the young and middle aged who experience thyroid problems rather than the elderly.
The effects of these changes on our health status can by significant, especially in the event of diabetes; otherwise however, the endocrine system serves us well in our old age.
The social implications of these effects are not a major cause for concern for most people. Diabetics require special consideration in severe instances, but for most caregivers and social interactions this is not a large problem.
The alternatives to be dealt with are primarily the self-care factors for avoiding the onset of diabetes. It is prevalent with urbanization, civilized work patterns, sedentary lifestyles, and a modern diet.
10. The Genital System:
The changes in the genital system tend to be non-problematic, especially if sexuality has been practiced without long periods of abstinence. The changes that do occur are not as age related as they are sexuality related. Generally, responses slow gradually in both men and women, but both can have normal sexual relations as long as they are healthy, at any age. The subject of optimal sexuality is not an issue of this book, and is not truly an issue of aging. It is more an issue of education and psychological response, since the body changes are not age significant.
In men, the prostate may enlarge, and may create urinary problems. More changes occur in women than in men. In women the uterus atrophies some, and several changes occur in the vagina; but all can be dealt with, especially if the woman has maintained some regular level of sexual activity. If after the age of about 40 a woman abstains from intercourse for prolonged periods, 3 to 5 years, the ability to secrete lubricating fluids, and much of the elasticity of the vagina are permanently lost. Masturbation can effectively help to maintain both of these capabilities, especially if object insertion is included. Since most research shows that less than 50% of women practice object insertion during masturbation, these women who also abstain from intercourse lose some vaginal elasticity, even with regular masturbation.
The effects of these changes on our health status are not significant, given the above conditions. In the case of prostate problems in men, difficulties can occur.
The social implications of these effects need not be severely problematic in most cases, remembering that most sexual problems are social or psychological problems which occur at all ages.
In the event that the woman has been sexually abstinent for a period of 3 to 5 years or more, the use of K-Y Jelly or some other non-alcoholic, non-petroleum lubricant designed for compatibility with the chemistry of the vagina may adequately alleviate discomfort in sexual intercourse. Petroleum products such as baby oil and vaseline must never be put in or on the vagina, as they will upset the pH balance of the vagina, making it susceptible to yeast infections and other problems.
The alternatives to these effects are activity, especially continued regular sexual activity, exercise, good nutrition, and good health habits.
11. The Immune System:
The earliest deterioration in our bodies is seen in the thymus - the heart of the immune system. The thymus begins significant involution in all of us by the age of three years. Two types of white blood cells, B cells and T cells of the immune system malfunction and weaken with age. B cells lose their vigor in attacking bacteria, viruses, and cancer cells; and the T cells lose their vigor in attacking cells foreign to the body, such as cancer cells and transplant cells. B cells and T cells also malfunction and attack normal healthy body cells.
Since our immune system is strongly impacted by our emotions and our moods, less enthusiasm for life or depression over reduced vigor or lost relationships can promote a circle of lessening health.
The old saying, "Use it, or lose it" is evermore confirmed by the ongoing research which continues to show that age-related losses in body functioning, and thus in health and long life, are very often a result of disuse, or of a lack of oxygen, nutrients, or body chemicals due to an insufficiency of circulation of the blood throughout the body, as a result of inactivity. If we use, and so maintain our functions, many of the problems related to aging would be experienced for a much shorter period of time, and many not at all.
Carl Bourhenne, MA
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