Physiological Changes of Ageing Healthy Ageing Talk Series 1

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Physiological Changes of AgeingHealthy Ageing
Talk Series (1)

• By Dr Frank Sze
• MD (CUHK), MRCP (UK), FRCP (Edin)
• FHKCP, FHKAM (Medicine)

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Ageing

• A developmental process starting at conception
• A genetically determined process
• Environmental factors can accelerate ageing
• Diseases become more common while ageing

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Ageing Skin

• Epidermis thinner and fragile
• Dermis less elastin and flexible
• Hypodermis thinner and less padding
• UV light accelerates skin ageing
• Senile purpura

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Ageing Eye

• Ptosis
• Entropion
• Ectropion
• Dry eye
• Tearing
• Pterygium

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Ageing Eye

• Flatten uneven cornea with light scattering
• Hyperopia (farsightedness)
• Smaller pupil requiring brighter light to read
• Slower dark adaptation
• Reduced contrast sensitivity

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Ageing Ear

• Reduced sweat glands with increased ear wax
  affecting hearing
• Cochlea degeneration causing high tone loss
• Tips to communicate with people with hearing
  impairment
• Obtain attention
• Let the person see your face mouth
• Well illuminated environment
• At about 1 meter away
• Reduce background noise
• Speak slowly

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Ageing Kidney Bladder

• Reduced kidney ability to excrete water, waste
  products and drugs
• Less tolerate water depletion
• Loss of circadian rhythm with nocturia
• Smaller and less expansible bladder with
  frequency of urine
• Less contractable bladder with hesitancy
• Bigger prostate with fair urine stream
• Less able to suppress bladder contraction with
  urgency

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Ageing Bones and Joints

• Continual loss of bone mass from the 4th decade
• Hormonal change with more bone resorption than
  formation
• Less Ca absorption
• Shorter and stoop
• Brittle with easy fracture
• New bone formation at the verge of joints
• Cartilage thinner

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Ageing Brain Nerves

• 30,000-50,000 neurons die each day with
  diminishing reserve
• IQ slowly decline after the age of 25
• Reduced short term memory
• Decreased retrieval ability
• Interrupted and less deep sleep
• Reduced pain, touch, temperature, and vibration
  sensations
• Reduced postural control and balance

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Ageing Heart Vessels

• Heart becomes more rigid with decreased output
• Heart beat less responsive to stress
• Heart beat less variable with each breathing
• Irregular heart beat more common with ageing
• Systolic blood pressure increases with age
• Pulse pressure widened with hardened vessels
• Less efficient venous return prone to postural
  hypotension

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Ageing Lungs

• Lungs become more rigid with early closure of
  small airways
• Less efficient blood gas exchange
• Chest wall becomes more rigid too
• Reduced Lung Volume and Vital Capacity
• Bronchial villi thinner and cough reflex less
  effective
• Reduced ability to cope with challenges like
  climbing stairs, running
• Reduced immunity prone to chest infection

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Ageing Reproductive Organ

• Menopause with hormonal changes and symptoms
• Flushing, sweating, agitation, palpitation,
  insomnia
• Dry vaginal mucosa
• Less sperm count and viability
• Delayed ejaculation
• Decreased libido and climax

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Ageing Digestive Organs

• Saliva glands secret less with dry mouth
• Taste and smell senses decline
• Less heathy teeth affecting chewing/nutrition
• Stomach muscle weakened and less hungry
• Small intestine villi absorb less calcium,
  vitamin B12, folic acid
• Large intestine muscle weakened and secrets less
  mucus prone to constipation
• Less liver blood flow and function with fall in
  toxic substance/drug clearance
• Bile thicker with cholesterol prone to gallstones

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Ageing Immunity

• Both cellular and humoral immunity decline prone
  to infection/reactivation of TB
• Less effective in detecting and destroying cancer
  cells
• Less response to infection with fever
• Autoimmune diseases increase with age

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Summary

• Ageing is a continuous and unavoidable process
• Ageing may be retarded
• Problems associated with ageing can be managed (
  wear glasses, denture, other aids, high fiber
  diet, fruits and green vegetables with rich
  antioxidants, fishes, adequate calcium intake)