Normal Aging versus Effects of Chronic Disease

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    Contrary to popular belief, growing old does not equal being sick. What is your definition of healthy aging? How do you plan to avoid disease and disability as you age?

    The specialty area of gerontology is complex, because it encompasses three levels of complexity:

    1)__ Normal aging changes
    2)__ Chronic diseases
    3)__ Acute exacerbations of chronic diseases (which in turn are the major killers of the elderly, not acute illness).

    It is important to be able to recognize the changes of normal aging versus the effects of disease. Untreated disease can result in "excess disability" and reduce the quality of life in older individuals.

    Everyone ages differently and the rate of aging can vary markedly in individuals. Age-related changes in one system are not predictive of changes in other systems. The rate of changes in function of organ systems can even vary markedly within individuals. (An example of this is a smooth youthful-appearing face with little wrinkles topped by a completely gray head of hair.)

    As a person gets older, changes occur that can be classified as resulting from aging itself ("normal aging") and those that result from diseases. In normal aging, many physiological functions are altered, but do not progress to disease. For instance, some degree of glucose intolerance is thought to be a part of normal aging, but diabetes, though very common, is considered a disease.

    Some common age-related changes are not considered a part of "normal aging." Instead, we see a high correlation of these conditions the older a person gets, such as osteoarthritis, hypertension, cataracts, osteoporosis, and alzheimer's disease. These are called aging-related conditions.

    "Healthy aging" is becoming an issue of increasing importance as the size of the older population continues to grow. It is chronic diseases that can make old age miserable, not the normal changes of aging. Poor health in older life is not inevitable. Much of the illness and disability associated with aging is related to modifiable lifestyle factors that are present in middle age. The rate of physical decline can be drastically modified by lifestyle.

    Most of the normal changes of aging have no impact on normal functioning. These changes will become apparent when the body is placed under stress (such as acute illness or physical exertion). Respiratory function is one of the best predictors of functionality and mortality in old age. This is because the respiratory system reflects changes in many other body systems, including the cardiovascular, nervous, and musculoskeletal systems.

    The normal changes of aging reduce the older person's reserve capacity. This makes the older adult more vulnerable to infection or injury. One acute illness or injury can cause a "cascade of health problems" not seen in younger people and can quickly lead to disability, dependency, or death. For example, reduced reserve capacity causes increased vulnerability to respiratory diseases, particularly pneumonia. Older adults need to be cautioned to seek medical help sooner than later - They are at greater risk from mortality from acute respiratory problems.

    Likewise, aging results in diminished ability to maintain homeostasis and regulate the body systems. As a notable example, older adults are more vulnerable to hypothermia and hyperthermia.

    One definition of healthy aging is the following:
    1) Avoiding disease and disability
    2) Maintaining physical and mental function, and
    3) Continuing engagement with life.

    What is your definition of "healthy aging?" What strategies are you putting into effect to maintain your health and functionality as you age?

    References

    Eliopoulos, C. (2010). Gerontological nursing (7th ed.). Philadelphia: Lippincott Williams & Wilkins.

    Moody, H. R. (2010). Aging: Concepts and controversies (6th ed.). Thousand Oaks, CA: Pine Forge pPess.
    Last edit by VickyRN on Sep 13, '13 : Reason: formatting
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    VickyRN is a certified nurse educator (NLN) and certified gerontology nurse (ANCC). Her research interests include: the special health and social needs of the vulnerable older adult population; registered nurse staffing and resident outcomes in intermediate care nursing facilities; and, innovations in avoiding institutionalization of frail elderly clients by providing long-term care services and supports in the community. She is faculty in a large baccalaureate nursing program in North Carolina.

    VickyRN has '16' year(s) of experience and specializes in 'Gerontological, cardiac, med-surg, peds'. From 'Under the shadow of His wings...'; Joined Mar '01; Posts: 12,046; Likes: 6,486.

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