By Christina Nowak MScPT, CSCS, PhD (student)
Aging is an interesting concept. There are a lot of preconceptions, stereotypes and thoughts around what it means to get older. As we age, some of our systems stop working as effectively as they used to. It happens. Things appear to start breaking down. As a physiotherapist, I start having the conversations with my clients about what is a “normal” part of the aging process and what isn’t.
In my clinic I hear this all the time, “I have X or Y, but that’s just a part of getting older! “
But is it?
What we’re starting to see is that with increasing age comes increasing diversity. The accumulation of experiences and behaviours across a lifetime make it so that one person at 68 can look VASTLY different than another person at 68. Individuality is a given but you also see this big spread in terms of ability levels and function in older age.
So with this large amount of diversity in this age group, can we really start talking about what are “normal” parts of the aging process? Are they really the norm?
This article is going to be the beginning of a series that looks at different parts of the aging process that are often seen as norms. It is not my idea to try and say that people are lying about how common these concepts are and some may be inevitable. It is my idea to start a conversation about what we DISMISS because we think it’s normal when really we could be seeing improvement; not be just “dealing with it”.
So here’s my list, each week I will be elaborating, looking into the research on the topic and sharing some of my thoughts on these issues. I hope that this will spark debate and discussion. I do not claim to be an expert in all of these areas, just a voice in a collective of health care professionals looking to advocate for their clients.
With sayings like “I’m no spring chicken”, I can see why it can be the common conception that we have less energy as we get older. Our systems are less efficient, and our recovery time can be slower when we do activities and therefore we may get fatigued more easily.
The flip side is that as we get older we also tend to sit more and become less active. Low physical activity and high sedentary activity can contribute to tiredness and fatigue. You get into a feedback loop where less activity causes more tiredness, so you move less and around and around you go.
So which came first? The chicken or the egg?
Weakness can be subjective or objective. Being away from lifting weights and coming back to it a couple weeks later can create a subjective feeling of weakness. There can also be low strength as measured by a strength test which would fall into a more objective measure. We have some age-based norms for this.
As we get older, the force we can produce in our muscles and how efficient we are in getting our muscles to do what we want them to do goes down. That’s just a consequence of age. But here is the very important part. We can SIGNIFICANTLY slow down this progression through training, specifically strength training.
There are older adults who have trouble getting out of a chair, while they’re friends still squat over 100 lbs. The expectation that we get weaker with age can be a dangerous concession. We can STAVE OFF those decreases in strength with training, and have fun doing it too!
3. Leaking and Lack Bladder control
Leaking or lack of bladder control, also known as urinary incontinence, is when small amounts of urine cannot be controlled from escaping from the bladder or a feeling of being unable to hold one’s bladder. A common concern for older adults and a reason why many older adults find themselves getting up many times throughout the night to void their bladder. This is also a common concern post pregnancy.
The muscles that control the bladder are still muscles and therefore do lose efficiency with age. Pelvic floor physiotherapists have tips and tricks to help you increase the strength of these muscles and plan when you drink to help you get a good night’s rest.
So the question becomes, instead of masking these symptoms with Depends and other brands that try to make us feel happy that we have a “solution” to our urinary issues, can we improve it?
4. “Preventative” Medications
Now I know that this is a controversial issue so I’m just going to open up the conversation. Disclaimer, I am not a doctor. I have seen clients who tell me they have never had high blood pressure or high cholesterol and yet are put on these medications (sometimes for decades!) for “preventative” reasons.
Do we know what the efficacy of these treatments are? Are there any studies to show that these pre-emptive medications actually lower the risk of heart attack or stroke? It’s a question I’m going to explore further!
5. Memory issues
Some of my clients complain the most about losses in memory. That as they get older, they start losing their keys more easily or go upstairs into a room and forget why they went up there. This is often not dementia or cognitive impairment but rather seem as a normal consequence of aging.
Now Alzheimer’s and dementia are HUGE public health concerns. Healthy lifestyle practices have been show to help decrease the incidence of dementia as well as slow its progression. There is a genetic component here too.
But there is a HUGE variation here too!
Some physicians actually think that its MORE of a norm of aging than we currently recognize. Something on the complete other end of the spectrum.
Right now the jury is still out.
My point with opening up this conversation in this series is to try to ask you to not place yourself into this box and to not let your health care professionals do the same. As we continue to explore these issues, I hope to empower people to open up these conversations. Reflect and evaluate on their own biases, what their doctors’ biases are, if any.
You are most likely stronger than you think you are.