Principles of Aging Outline .
o What is “old?”
o Subgroups of Late Adulthood
o Young old – 65 to 74 years
o Middle old – 75 to 84 years
o Old old – 85 to 99 years- FASTEST GROWING SUBGROUP/ “FRAIL ELDERLY”
o Getting much better at treating illnesses, lots of different homes
o Elite old – 100 years +
Theories of Aging-why does it happen?
Biological Theories
o “Programmed” versus damage/ error
o Senescence: biological aging of the body
o The gradual deterioration of function characteristic of most complex lifeforms that on the
level of the organism increases mortality after maturation.
o Cells in the body become disorganized or chaotic
o Cells no long replicate
o Cellular death occurs
o Biological theories- bodies functioning
Oxidative Stress (free radicals) Theories
◦ Mitochondria are both producers and targets of reactive oxidative species (free radicals).
◦ Oxidative stress attacks mitochondria, leading to increased oxidative damage ultimately resulting
in the cell no longer being able to function.
◦ The number of ROS is increased by external factors such as pollution and cigarette smoke and by
internal factors such as inflammation.
◦ Damage appears to be random and unpredictable, varying from one cell to another, from one
person to another.
◦ Resulting in the cell not being able to function
◦ External factors (pollution, smoking, inflammation) make you age faster
◦ A free radical is any atom or molecule that has a single unpaired electron in an outer shell.
Immunological Theory
◦ Aging is a result of an accumulation of damage to the immune system, or immunosenescence
◦ A chronic state of inflammation, combined with increasing number of ROS in the cells, appears
to be a key factor in the aging process and the development of many health problems common in
later life
◦ Autoimmune Theory: progressive deficiency in immunological tolerance results in the inability
to distinguish self from foreign structures
◦ Immune system as we age is less tolerant to antigens and mount an immune response
more easily
◦ Antibodies develop, attack, and destroy the normal cells in the body
DNA & Aging
◦ Growing evidence suggesting that ROS alone do not trigger the aging process but lead to DNA
mutations that cause errors in reproduction
◦ Area of great research interest
◦ Do telomeres have their own “biological clock?”
◦ Is there a relationship between oxidative stress and the development of disease?
, Normal Changes with Aging
◦ Do not necessarily represent pathology “disease”
◦ Symptoms that they develop most think it’s due to age even though they need more
investigating and are not normal
◦ Ex- depression, dementia, fatigue (can be a symptom of depression, SOB, and
exercise intolerance
◦ With imposition of acute and chronic illnesses, including hospitalization, older adults
may be predisposed to disability
◦ Older adults may arrive not only with an acute illness, such as pneumonia, but
also with ongoing chronic “geriatric syndromes,” such as urinary incontinence,
fragile skin, confusion, problems with eating or feeding, falls, and sleep disorders
◦ If these syndromes are not identified early, an older adult may have functional
decline much earlier than they should
Skin Changes of Aging
◦ The result of genetic (intrinsic) and environmental (extrinsic) factors
◦ Epidermis
◦ Thins, blood vessels and bruises more visible (why we see a bunch of little bruises)
◦ Fewer melanocytes result in a lighter appearance of the skin
◦ Age spots or liver spots (lentigines) appear on the backs of hands, wrists, face
◦ Seborrheic keratoses and thick, brown, and raised lesions appear
◦ Dermis
◦ Loses about 20% of its thickness
◦ Dermal blood vessels are reduced: results in skin pallor and cooler skin temperature
◦ Collagen synthesis decreases and doesn’t bounce back as easy
◦ Elastin fibers thicken and fragment- loss of stretch, resilience, “sagging”
◦ Hypodermis-main use is fat storage
◦ Areas atrophy, increased sensitivity to cold
◦ Sebaceous (oil) glands atrophy
◦ Don’t sweat as much
Aging Skin, Hair, Nails
◦ Hair
◦ Thins on the head
◦ Increased hair in the ears, nose, and eyebrows
◦ Loses pigmentation (graying occurs)
◦ Women develop chin hair, and leg, axillary, and pubic hair decrease
◦ Nails
◦ Become harder, thicker, dull, and more brittle
◦ Vertical ridges appear
◦ Growth slows
◦ Watch cutting nails in diabetic pt’s, should see a professional for clipping
Musculoskeletal Changes
◦ Although not life-threatening, they can affect one’s ability to function and quality of life
◦ Exercise helps
◦ Changes are influenced by many factors: age, sex, race, environment
◦ Changes
◦ Ligaments, tendons, and joints become dry, hardened, and less flexible
o What is “old?”
o Subgroups of Late Adulthood
o Young old – 65 to 74 years
o Middle old – 75 to 84 years
o Old old – 85 to 99 years- FASTEST GROWING SUBGROUP/ “FRAIL ELDERLY”
o Getting much better at treating illnesses, lots of different homes
o Elite old – 100 years +
Theories of Aging-why does it happen?
Biological Theories
o “Programmed” versus damage/ error
o Senescence: biological aging of the body
o The gradual deterioration of function characteristic of most complex lifeforms that on the
level of the organism increases mortality after maturation.
o Cells in the body become disorganized or chaotic
o Cells no long replicate
o Cellular death occurs
o Biological theories- bodies functioning
Oxidative Stress (free radicals) Theories
◦ Mitochondria are both producers and targets of reactive oxidative species (free radicals).
◦ Oxidative stress attacks mitochondria, leading to increased oxidative damage ultimately resulting
in the cell no longer being able to function.
◦ The number of ROS is increased by external factors such as pollution and cigarette smoke and by
internal factors such as inflammation.
◦ Damage appears to be random and unpredictable, varying from one cell to another, from one
person to another.
◦ Resulting in the cell not being able to function
◦ External factors (pollution, smoking, inflammation) make you age faster
◦ A free radical is any atom or molecule that has a single unpaired electron in an outer shell.
Immunological Theory
◦ Aging is a result of an accumulation of damage to the immune system, or immunosenescence
◦ A chronic state of inflammation, combined with increasing number of ROS in the cells, appears
to be a key factor in the aging process and the development of many health problems common in
later life
◦ Autoimmune Theory: progressive deficiency in immunological tolerance results in the inability
to distinguish self from foreign structures
◦ Immune system as we age is less tolerant to antigens and mount an immune response
more easily
◦ Antibodies develop, attack, and destroy the normal cells in the body
DNA & Aging
◦ Growing evidence suggesting that ROS alone do not trigger the aging process but lead to DNA
mutations that cause errors in reproduction
◦ Area of great research interest
◦ Do telomeres have their own “biological clock?”
◦ Is there a relationship between oxidative stress and the development of disease?
, Normal Changes with Aging
◦ Do not necessarily represent pathology “disease”
◦ Symptoms that they develop most think it’s due to age even though they need more
investigating and are not normal
◦ Ex- depression, dementia, fatigue (can be a symptom of depression, SOB, and
exercise intolerance
◦ With imposition of acute and chronic illnesses, including hospitalization, older adults
may be predisposed to disability
◦ Older adults may arrive not only with an acute illness, such as pneumonia, but
also with ongoing chronic “geriatric syndromes,” such as urinary incontinence,
fragile skin, confusion, problems with eating or feeding, falls, and sleep disorders
◦ If these syndromes are not identified early, an older adult may have functional
decline much earlier than they should
Skin Changes of Aging
◦ The result of genetic (intrinsic) and environmental (extrinsic) factors
◦ Epidermis
◦ Thins, blood vessels and bruises more visible (why we see a bunch of little bruises)
◦ Fewer melanocytes result in a lighter appearance of the skin
◦ Age spots or liver spots (lentigines) appear on the backs of hands, wrists, face
◦ Seborrheic keratoses and thick, brown, and raised lesions appear
◦ Dermis
◦ Loses about 20% of its thickness
◦ Dermal blood vessels are reduced: results in skin pallor and cooler skin temperature
◦ Collagen synthesis decreases and doesn’t bounce back as easy
◦ Elastin fibers thicken and fragment- loss of stretch, resilience, “sagging”
◦ Hypodermis-main use is fat storage
◦ Areas atrophy, increased sensitivity to cold
◦ Sebaceous (oil) glands atrophy
◦ Don’t sweat as much
Aging Skin, Hair, Nails
◦ Hair
◦ Thins on the head
◦ Increased hair in the ears, nose, and eyebrows
◦ Loses pigmentation (graying occurs)
◦ Women develop chin hair, and leg, axillary, and pubic hair decrease
◦ Nails
◦ Become harder, thicker, dull, and more brittle
◦ Vertical ridges appear
◦ Growth slows
◦ Watch cutting nails in diabetic pt’s, should see a professional for clipping
Musculoskeletal Changes
◦ Although not life-threatening, they can affect one’s ability to function and quality of life
◦ Exercise helps
◦ Changes are influenced by many factors: age, sex, race, environment
◦ Changes
◦ Ligaments, tendons, and joints become dry, hardened, and less flexible
