AGING PHYSICALLY

The period between 45 and 64 years of age brings with it a variety of subtle changes in the body’s structure and function.  When life is busy and mind is active, these changes are generally not evident.  Even when they become evident, they are not usually the source of profound concern.  Your parents, older students in your class, and people with whom you will be working are, nevertheless, experiencing these changes.

·         Decrease in bone mass and density

·         Increase in vertebral compression

·         Degenerative changes in joint cartilage

·         Increase in adipose tissue-loss of lean body mass

·         Decrease in capacity to engage in physical work

·         Decrease in visual acuity

·         Decrease in basal energy requirements

·         Decrease in fertility

·         Decrease in sexual function

For some midlife adults these health concerns can be quite threatening, especially for those who view aging with apprehension and fear.  Some middle-aged people reject these physical changes and convice themselves they are sick.  Indeed, hypochondriasis is much more common among midlife people than among young people.

Two medical conditions influenced by physical activity, osteoporosis and osteoarthritis, deserve careful examination.

Osteoporosis

 Osteoporosis is a condition often seen in late middle-aged women.  However, it is not fully understood why menopausal women are so susceptible to the increase in calcium loss that leads to fracture of the hip, wrist, and vertebral column.  Half of all women over the age of 50 will likely suffer an osteoporosis-related fracture.

The endocrine system plays a large role in the development of osteoporosis.  At the time of menopause, a woman’s ovaries begin a rapid decrease in the production of estrogen, one of two main hormones associated with the menstrual cycle.  This lower level of estrogen may decrease the conversion of the precursors of vitamin D into the active form of vitamin D, the form necessary for absorbing calcium from the digestive tract.  As a result, calcium may be drawn from the bones for use elsewhere in the body.

Premenopausal women have the opportunity to build and maintain a healthy skeleton through an appropriate intake of calcium.  Current recommendations are for an intake of 1200 mg of calcium per day.  Three to four daily servings of low-fat dairy products should provide sufficient calcium.  Adequate vitamin D must also be in the diet because it aids in the absorption of calcium.

Many women do not take in an adequate amount of calcium.  Calcium supplements, again in combination with vitamin D, can be used to achieve recommended calcium levels.  It is known as calcium carbonate, a highly advertised form of calcium, is no more easily absorbed by the body than are other forms of calcium salts.

In premenopausal women, calcium deposition in bone is facilitated by exercise, particularly exercise that involves movement of the extremities.  Today, women are encouraged to consume at least the recommended servings from the milk group and engage in regular physical activity that involves the weight-bearing muscles of the legs, such as aerobics, jogging, or walking.

Postmenstrual women who are not elderly can markedly slow the resorption of calcium from their bones through the use of hormone replacement therapy (HRT).  When combined with a daily intake of 1500 mg of calcium, vitamin D, and regular exercise, HRT almost eliminates calcium loss.  Women will need to work closely with their physicians in monitoring the use of HRT because of continuing concern over the role of HRT and the development of breast cancer and the increased risk of coronary artery disease and stroke.

Osteoarthritis

Arthritis is an umbrella term for more than 100 forms of joint inflammation.  The most common form is osteoarthritis.  It is likely that as we age, all of us will develop osteoarthritis to some degree.  Pften called “wear and tear” arthritis, osteoarthritis occurs primarily in the weight-bearing joints of the knee, hip, and spine.  In this form of arthritis, joint damage can occur to bone ends, cartilaginous cushions, and related structures as the years of constant friction and stress accumulate.

The object of current management of osteoarthritis (and other forms) is not to cure the disease but rather to reduce discomfort, limit joint destruction, and maximize joint mobility.  Aspirin and nonsteroidal antinflamatory agents are the drugs most frequently used to treat osteoarthritis.

It is now believed that osteoarthritis develops most commonly in people with a genetic predisposition for excessive damage to the weight –bearing joints.  Thus the condition seems to “run in families”.  Further, studies comparing the occurrence of osteoarthritis in those who exercise and those do not demonstrate that regular movement activity may decrease the likelihood of developing this form of arthritis.