Physiological Changes During Old Age
The physiological decline in body functions during aging is not uniform.
It varies among different organs. The capacity of the system may not decline
but their ability to respond to a challenge or to maintain homeostasis is
lowered. The physiological changes that occur in various systems are as
follows.
a. Taste and smell
There is a decrease in the number of taste buds
and papillae on the tongue. The ability to taste salt is very much decreased
whereas that to sugar in less altered. Besides there is a reduction in
olfactory sensitivity which decreases the ability to detect the flavour. This
decreases the palatability of the food resulting in poor intake. Diminished
taste and smell decreases the sensory stimulation that may impair metabolic
processes.
b. Salivary Glands
Decrease in salivary secretion or lack of salivation (xerostomia) causes
a feeling of dry mouth, which makes chewing and swallowing difficult. Hence
crunchy, dry and sticky foods are avoided by old people.
c. Teeth
They may
lose teeth or have ill fitting dentures which makes chewing difficult. They may
omit fresh vegetables and fruits. This may lead to vitamin and mineral
deficiency accompanied by decreased gastrointestinal motility and problems in
elimination like constipation.
d. Gastrointestinal function
The secretion of digestive enzymes and digestive juices decline. This
results in incomplete digestion, or food remaining longer in stomach for
digestion. The secretion of hydrochloric acid, intrinsic factor and pepsin
decreases which affects absorption of calcium, protein, iron and vitamin B12.
Above 60 years of age the rate of emptying of liquids is rapid which
again leads to decreased absorption of nutrients.
The pH of proximal small bowel increases and there is
bacterial over growth in the bowel.
In the small intestine there is decreased secretion of enzyme lactase,
which can be a risk factor for developing osteoporosis. Thinning of
gastrointestinal layer decreases gastric motility and prolonged transit through
the colon leading to constipation.
e. Liver and biliary function
There is a decrease in blood flow to the liver. This may lead to minor
structural and biochemical changes. Gall bladder becomes sluggish in releasing
bile, which impairs fat metabolism and increases susceptibility to gall stones.
The activity of drug metabolising enzymes decrease and therefore lower drug
doses need to be prescribed during old age.
f. Metabolic Function
There is a
decrease in metabolic rate and impaired glucose tolerance, which necessitate
dietary modifications. The body protein levels also decrease.
g. Neurological Function
There is a decrease in neuromuscular coordination. They may develop a
state of confusion. There is a decreased synthesis of seratonin. Carnitine
derived from the aminoacids lysine and methionine may be effective in slowing
down mental deterioration. Carotenoids play a protective role related to aging
and cognitive function.
h. Cardiovascular function
Changes in blood vessels such as narrowing of the lumen, thickening of
the arterial walls and replacement of elastic muscle fibres with non elastic
fibres lead to increased rigidity of vessels (atherosclerotic changes) which
reduces their capacity to carry nutrients to the cells. There is decreased
myocardial contractibility and increased peripheral resistance, increasing the
prevalence of hypertension.
i. Renal function
There is a decrease in Glomerular Filtration Rate (GFR) affecting the
elimination of waste products and reabsorption of electrolytes. Moreover, the
body's ability to regenerate nephrons ceases after 40 years of age. Hence
increased solute load on each nephron may lead to necrosis and kidney damage.
j. Skeletal tissue
Demineralisation of bones is more rapid than
mineralisation. The bones become increasingly vulnerable to fractures and the
vertebrae may collapse. This results in decline in height and a stooped or
bowed posture. This posture may affect respiratory function.
k. Pulmonary function
Pulmonary capacity declines by about 40 percent throughout life. Among
elderly this may not have an impact on health but may impose restriction on
energetic exercise.
l. Harmonal changes
Activity of various glands like thyroid, adrenal cortex, islets of
langerhans is decreased resulting in changes in metabolism and metabolic
functions. The hormonal imbalance affects the calcium metabolism leading to
osteoporosis and bone loss. Menopause in women decreases their iron
requirements.
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