4.2 THE ELDERLY 92 What comes to mind when you think of old age? Walking sticks? False teeth? Retirement? Freedom? Wisdom? Something else? Why do old people today live longer than in the past? Chronological age is based solely on the passage of time; it is a person s age in years. Biologic age refers to changes in the body that commonly occur as people age. Because these changes affect some people sooner than others, some people are biologically older at 65, and others not until a decade or more later. Psychological age is based on how people act and feel. PHYSICAL CHANGES Ageing is a gradual, continuous process of natural change that begins in early adulthood. During early middle age, many bodily functions begin to gradually decline. These changes are a natural part of the ageing process and can vary widely from person to person, depending on genetics, lifestyle, and overall health . People do not become older or elderly at any specific age; traditionally, however, age 65 has been designated as the beginning of older age . What changes? Sarcopenia, the decline in muscle mass and strength. It leads to a decrease in physical stamina and in the ability to perform everyday tasks. Pains in different parts of the body increase and balance is not as steady. Progressive weakening of bones. Bones become more brittle due to the loss of density, and the risk of fractures is increased. Also, changes in posture and gait are common and lead to weakness and slowed movement. Most people lose some height too. Reduction in cardiovascular efficiency. As the heart ages, it becomes less efficient at pumping blood, and blood vessels lose their elasticity. This can lead to higher blood pressure and an increased risk of cardiovascular diseases such as heart attacks and strokes. brittle: fragile gait: andatura stamina: resistenza steady: costante stroke: ictus Reduction in sensory systems efficiency. Vision often deteriorates, with conditions such as cataracts, glaucoma, and age-related macular degeneration becoming more 188 ADULTS AnD ELDERLY PEOPLE common. Hearing loss, particularly in high-frequency sounds, is another widespread issue, which can lead to difficulties in communication and increased social isolation. Reduction in skin elasticity. The skin becomes thinner and less elastic as we age, leading to wrinkles and an increased susceptibility to injuries and infections. Age spots flat brown, grey, or black spots on the skin usually appear on sun-exposed areas, like the backs of hands and the face. Reduction in the ability of the body to heal. Hair colour and hair thickness change. Hair, which helps protect the body and keep its temperature steady, begins to change, becoming thinner and white and even falling. Metabolism slows down and the levels of cholesterol tend to rise while diabetes may develop.