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Aging: What to expect
Wonder what's considered a normal part of the aging process? Here's what to 
expect as you get older  and what to do about it.

You know that aging will likely cause you to develop wrinkles and gray hair. 
But do you know how the aging process will affect your teeth, heart and 
sexuality? Find out what kind of changes you can expect in your body as you 
continue aging  and what you can do to promote good health at any age.
Your cardiovascular system
What's happeningAs you age, your heart rate becomes slightly slower and your 
heart might become bigger. Your blood vessels and your arteries also become 
stiffer, causing your heart to work harder to pump blood through them. This can 
lead to high blood pressure (hypertension) and other cardiovascular problems.
What you can doTo promote heart health:
                Include physical activity in your daily routine. Try walking, 
swimming or other activities you enjoy. Regular moderate physical activity can 
help you maintain a healthy weight, lower blood pressure and lessen the extent 
of arterial stiffening.
                Eat a healthy diet. Choose vegetables, fruits, whole grains, 
high-fiber foods and lean sources of protein, such as fish. Limit foods high in 
saturated fat and sodium. A healthy diet can help you keep your heart and 
arteries healthy.
                Don't smoke. Smoking contributes to the hardening of your 
arteries and increases your blood pressure and heart rate. If you smoke or use 
other tobacco products, ask your doctor to help you quit.
                Manage stress. Stress can take a toll on your heart. Take steps 
to reduce stress  or learn to deal with stress in healthy ways.
Your bones, joints and muscles
What's happeningWith age, bones tend to shrink in size and density  which 
weakens them and makes them more susceptible to fracture. You might even become 
a bit shorter. Muscles generally lose strength and flexibility, and you might 
become less coordinated or have trouble balancing.
What you can doTo promote bone, joint and muscle health:
                Get adequate amounts of calcium. For adults ages 19 to 50 and 
men ages 51 to 70, the Institute of Medicine recommends 1,000 milligrams (mg) 
of calcium a day. The recommendation increases to 1,200 mg a day for women age 
51 and older and men age 71 and older. Dietary sources of calcium include diary 
products, almonds, broccoli, kale, canned salmon with bones, sardines and soy 
products, such as tofu. If you find it difficult to get enough calcium from 
your diet, ask your doctor about calcium supplements.
                Get adequate amounts of vitamin D. For adults ages 19 to 70, 
the Institute of Medicine recommends 600 international units (IU) of vitamin D 
a day. The recommendation increases to 800 IU a day for adults age 71 and 
older. Although many people get adequate amounts of vitamin D from sunlight, 
this might not be a good source for everyone. Other sources of vitamin D 
include oily fish, such as tuna and sardines, egg yolks, fortified milk, and 
vitamin D supplements.
                Include physical activity in your daily routine. Weight-bearing 
exercises, such as walking, jogging, tennis and climbing stairs, and strength 
training can help you build strong bones and slow bone loss.
                Avoid substance abuse. Avoid smoking and don't drink more than 
two alcoholic drinks a day.

Your digestive system
What's happening Constipation is more common in older adults. Many factors can 
contribute to constipation, including a low-fiber diet, not drinking enough 
fluids and lack of exercise. Medications  such as diuretics and iron 
supplements  and certain medical conditions  such as diabetes and irritable 
bowel syndrome  also might contribute to constipation.
What you can doTo prevent constipation:
                Eat a healthy diet. Make sure your diet includes high-fiber 
foods, such as fruits, vegetables and whole grains. Limit meats that are high 
in fat, dairy products and sweets, which might cause constipation. Drink plenty 
of water and other fluids.
                Include physical activity in your daily routine. Regular 
physical activity can help prevent constipation and is important for your 
overall health.
                Don't ignore the urge to have a bowel movement. Holding in a 
bowel movement for too long can cause constipation.


Your bladder and urinary tract
What's happeningLoss of bladder control (urinary incontinence) is common with 
aging. Medical conditions, such as diabetes, might contribute to incontinence  
as can menopause, for women, and an enlarged prostate, for men.
What you can doTo promote bladder and urinary tract health:
                Go to the bathroom regularly. Consider urinating on a regular 
schedule, such as every hour. Slowly, extend the amount of time between your 
bathroom trips.
                Maintain a healthy weight. If you're overweight, lose excess 
pounds.
                Don't smoke. If you smoke or use other tobacco products, ask 
your doctor to help you quit.

                Do Kegel exercises. Tighten your pelvic floor muscles, hold the 
contraction for five seconds, and then relax for five seconds. Try it four or 
five times in a row. Work up to keeping the muscles contracted for 10 seconds 
at a time, relaxing for 10 seconds between contractions.
Your memory
What's happeningMemory tends to becomes less efficient with age. It might take 
longer to learn new things or remember familiar words or names.
What you can doTo keep your memory sharp:

                Eat a healthy diet. A heart healthy diet might benefit your 
brain. Focus on fruits, vegetables and whole grains. Choose low-fat protein 
sources, such as fish, lean meat and skinless poultry. What you drink counts, 
too. Too much alcohol can lead to confusion and memory loss.
                Include physical activity in your daily routine. Physical 
activity increases blood flow to your whole body, including your brain. This 
might help keep your memory sharp.

                Stay mentally active. Mentally stimulating activities help keep 
your brain in shape  and might keep memory loss at bay. Do crossword puzzles. 
Take alternate routes when driving. Learn to play a musical instrument.
                Be social. Social interaction helps ward off depression and 
stress, which can contribute to memory loss. Look for opportunities to get 
together with loved ones, friends and others.
If you're concerned about memory loss, consult your doctor.

ody is the white enamel of the teeth. With age, it wears away nonetheless, 
allowing the softer, darker layers underneath to show through. Meanwhile, the 
blood supply to the pulp and the roots of the teeth atrophies, and the flow of 
saliva diminishes; the gums tend to become inflamed and pull away from the 
teeth, exposing the base, making them unstable and elongating their appearance, 
especially the lower ones. Experts say they can gauge a persons age to within 
five years from the examination of a single toothif the person has any teeth 
left to examine.

Scrupulous dental care can help avert tooth loss, but growing old gets in the 
way. Arthritis, tremors, and small strokes, for example, make it difficult to 
brush and floss, and, because nerves become less sensitive with age, people may 
not realize that they have cavity and gum problems until its too late. In the 
course of a normal lifetime, the muscles of the jaw lose about forty per cent 
of their mass and the bones of the mandible lose about twenty per cent, 
becoming porous and weak. The ability to chew declines, and people shift to 
softer foods, which are generally higher in fermentable carbohydrates and more 
likely to cause cavities. By the age of sixty, Americans have lost, on average, 
a third of their teeth. After eighty-five, almost forty per cent have no teeth 
at all.
Even as our bones and teeth soften, the rest of our body hardens. Blood 
vessels, joints, the muscle and valves of the heart, and even the lungs pick up 
substantial deposits of calcium and turn stiff. Under a microscope, the vessels 
and soft tissues display the same form of calcium that you find in bone. When 
you reach inside an elderly patient during surgery, the aorta and other major 
vessels often feel crunchy under your fingers. A recent study has found that 
loss of bone density may be an even better predictor of death from 
atherosclerotic disease than cholesterol levels. As we age, its as if the 
calcium flows out of our skeletons and into our tissues.
To maintain the same volume of blood flow through narrowed and stiffened blood 
vessels, the heart has to generate increased pressure. As a result, more than 
half of us develop hypertension by the age of sixty-five. The heart becomes 
thicker-walled from having to pump against the pressure, and less able to 
respond to the demands of exertion. The peak output of the heart decreases 
steadily from the age of thirty. People become gradually less able to run as 
far or as fast as they used to, or to climb a flight of stairs without becoming 
short of breath.
Why we age is the subject of vigorous debate. The classical view is that aging 
happens because of random wear and tear. A newer view holds that aging is more 
orderly and genetically driven. Proponents of this view point out that animals 
of similar species and exposure to wear and tear have markedly different life 
spans. The Canada goose has a longevity of 23.5 years; the emperor goose only 
6.3 years. Perhaps animals are like plants, with lives that are, to a large 
extent, internally governed. Certain species of bamboo, for instance, form a 
dense stand that grows and flourishes for a hundred years, flowers all at once, 
and then dies.

The idea that living things shut down and not just wear down has received 
substantial support in the past decade. Researchers working with the now famous 
worm C. elegans (two of the last five Nobel Prizes in medicine went to 
scientists doing work on the little nematode) were able to produce worms that 
live more than twice as long and age more slowly by altering a single gene. 
Scientists have since come up with single-gene alterations that increase the 
life spans ofDrosophila fruit flies, mice, and yeast.

These findings notwithstanding, scientists do not believe that our life spans 
are actually programmed into us. After all, for most of our 
hundred-thousand-year existenceall but the past couple of hundred yearsthe 
average life span of human beings has been thirty years or less. (Research 
suggests that subjects of the Roman Empire had an average life expectancy of 
twenty-eight years.) Today, the average life span in developed countries is 
almost eighty years. If human life spans depend on our genetics, then medicine 
has got the upper hand. We are, in a way, freaks living well beyond our 
appointed time. So when we study aging what we are trying to understand is not 
so much a natural process as an unnatural one. Inheritance has surprisingly 
little influence on longevity. James Vaupel, of the Max Planck Institute for 
Demographic Research, in Rostock, Germany, notes that only six per cent of how 
long youll live, compared with the average, is explained by your parents 
longevity; by 
 contrast, up to ninety per cent of how tall you are, compared with the 
average, is explained by your parents height. Even genetically identical twins 
vary widely in life span: the typical gap is more than fifteen years.

If our genes explain less than we imagined, the wear-and-tear model may explain 
more than we knew. Leonid Gavrilov, a researcher at the University of Chicago, 
argues that human beings fail the way all complex systems fail: randomly and 
gradually. As engineers have long recognized, many simple devices do not age. 
They function reliably until a critical component fails, and the whole thing 
dies instantly. A windup toy works smoothly until a gear rusts or a spring 
breaks, and then it doesnt work at all. But complex systemspower plants, 
sayhave to survive and function despite having thousands of critical 
components. Engineers therefore design these machines with multiple layers of 
redundancy: with backup systems, and backup systems for the backup systems. The 
backups may not be as efficient as the first-line components, but they allow 
the machine to keep going even as damage accumulates. Gavrilov argues that, 
within the parameters established by our genes, thats exactly how human
  beings appear to work. We have an extra kidney, an extra lung, an extra 
gonad, extra teeth. The DNA in our cells is frequently damaged under routine 
conditions, but our cells have a number of DNA repair systems. If a key gene is 
permanently damaged, there are usually extra copies of the gene nearby. And, if 
the entire cell dies, other cells can fill in.

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