Understanding the Old Age

Old age refers to ages nearing or surpassing the life expectancy of human beings and is
thus the end of the human life cycle. Terms and euphemisms include old people, the
elderly (worldwide usage), OAPs (British usage which stands for Old Age
Pensioner), seniors (American usage), senior citizens (American usage), older adults (in the
social sciences), and the elders (in many cultures—including the cultures of aboriginal
people).
Elderly people often have limited regenerative abilities and are more susceptible to disease,
syndromes, injuries, and sickness than younger adults. The organic process of aging is
called senescence, the medical study of the aging process is called gerontology, and the
study of diseases that afflict the elderly is called geriatrics. The elderly also face other social
issues around retirement, loneliness, and ageism.
Old age is not a definite biological stage, as the chronological age denoted as "old age"
varies culturally and historically.
Old age comprises "the later part of life; the period of life after youth and middle age . . .,
usually with reference to deterioration". At what age-old age begins cannot be universally
defined because it differs according to the context. The United Nations has agreed that 65+
years may be usually denoted as old age, and this is the first attempt at an international
definition of old age. However, for its study of old age in Africa, the World Health
Organization (WHO) set 55 as the beginning of old age. At the same time, the WHO
recognized that the developing world often defines old age, not by years, but by new roles,
loss of previous roles, or inability to make active contributions to society.
Senior Citizen
Senior citizen is a common euphemism for an old person used in American English, and
sometimes in British English. It implies that the person being referred to is retired. This in
turn usually implies that the person is over the retirement age, which varies according to
country. Synonyms include old age pensioner or pensioner in British English
and retiree and senior in American English. Some dictionaries describe the widespread use
of "senior citizen" for people over the age of 65.
When defined in an official context, a senior citizen is often used for legal or policy-related
reasons in determining who is eligible for certain benefits available to the age group.
It is used in general usage instead of traditional terms such as an old person, old-age
pensioner, or elderly as a courtesy and to signify continuing relevance of and respect for
this population group as "citizens" of society, of senior rank.
Signs of Ageing
The distinguishing characteristics of old age are both physical and mental. These marks do
not occur at the same chronological age for everyone. Also, they occur at different rates and
orders for different people. Marks of old age can easily vary between people of the same
chronological age.
A basic mark of old age that affects both body and mind is "slowness of behavior". This
"slowing down principle" finds a correlation between advancing age and slowness of
reaction and physical and mental task performance. However, studies from Buffalo
University and Northwestern University have shown that the elderly are a happier age
group than their younger counterparts.
Physical
Physical marks of old age include the following:
1. Bone and joint. Old bones are marked by "thinning and shrinkage". This might result
in a loss of height (about two inches (5 cm) by age 80), a stooping posture in many
people, and greater susceptibility to bone and joint diseases such
as osteoarthritis and osteoporosis.
2. Chronic diseases. Some older persons have at least one chronic condition and many
have multiple conditions such as uncontrolled hypertension, diagnosed arthritis, and
heart disease.
3. Chronic mucus hypersecretion (CMH) "defined as coughing and bringing up sputum .
. . is a common respiratory symptom in elderly persons."
4. Dental problems. May have less saliva and less ability for oral hygiene in old age
which increases the chance of tooth decay and infection.
5. Digestive system. Old age is marked by digestive disorders such as difficulty in
swallowing, inability to eat enough and to absorb nutrition, constipation, and
bleeding.
6. An essential tremor (ET) is an uncontrollable shaking in a part of the upper body. It
is more common in the elderly and symptoms worsen with age.
7. Eyesight. Presbyopia can occur by age 50 and it hinders reading especially of small
print in low lighting. The speed with which an individual reads and the ability to
locate objects may also be impaired by either have a cataract or have had cataract
surgery.
8. Falls. Old age spells risk for injury from falls that might not cause injury to a younger
person. Falls are the leading cause of injury and death for old people.
9. Gait change. Some aspects of gait normally change with old age. Gait velocity slows
after age 70. Double stance time (i.e., time with both feet on the ground) also
increases with age. Because of gait changes, old people sometimes appear to be
walking on ice.
10. Hair usually becomes grayer and also might become thinner. Many men are
affected by balding, and women enter menopause.
11. Hearing. By age 75 and older, 48% of men and 37% of women encounter
impairments in hearing. In the 70–79 age range, the incidence of partial hearing
loss affecting communication.
12. Hearts can become less efficient in old age with a resulting loss of stamina. In
addition, atherosclerosis can constrict blood flow.
13. Immune function. Less efficient immune function (Immunosenescence) is a
mark of old age.
14. Lungs might expand less well; thus, they provide less oxygen.
15. Mobility impairment or loss. "Impairment in mobility affects 14% of those
between 65 and 74, but half of those over 85." Loss of mobility is common in old
people. This inability to get around has serious "social, psychological, and physical
consequences".
 16. Pain afflicts old people at least 25% of the time, increasing with age up to 80%
for those in nursing homes. Most pains are rheumatological or malignant.
17. Sexuality remains important throughout the lifespan and the sexual expression
of "typical, healthy older persons is a relatively neglected topic of research". Sexual
attitudes and identity are established in early adulthood and change minimally over
the course of a lifetime. However, sexual drive in both men and women may decrease
as they age. That said, there is a growing body of research on people's sexual
behaviors and desires in later life that challenges the "asexual" image of older adults.
People aged 75–102 continue to experience sensuality and sexual pleasure. Other
known sexual behaviors in older age groups include sexual thoughts, fantasies, and
erotic dreams, masturbation, oral sex, vaginal and anal intercourse.
18. Skin loses elasticity, becomes drier, and more lined and wrinkled.
19. Wounds and injuries take longer to heal. Wounds and injuries are more likely
to leave permanent scars.
20. Sleep trouble holds a chronic prevalence of over 50% in old age and results in
daytime sleepiness. By age 65, deep sleep goes down to about 5%.
21. Taste buds diminish so that by age 80 taste buds are down to 50% of normal.
Food becomes less appealing and nutrition can suffer.
22. Over the age of 85, thirst perception decreases, such that 41% of the elderly
drink insufficiently.
23. Urinary incontinence is often found in old age.
24. Voice. In old age, vocal cords weaken and vibrate more slowly. This results in a
weakened, breathy voice that is sometimes called an "old person's voice".
Mental
Mental marks of old age include the following:
1. Highly Adaptable is what describes most people in their old age. Despite the
stressfulness of old age, the words  "agreeable" and "accepting" are used commonly to
describe people of old age. However, the dependence that comes with old age induces
feelings of incompetence and worthlessness in a minority from having to rely on
others for many different basic living functions. 
2. The caution follows closely with old age. This antipathy toward "risk-taking" stems
from the fact that old people have less to gain and more to lose by taking risks than
younger people because of the remaining length of their lifespan that is left.
3. Depressed mood. Old age is a risk factor for depression caused by prejudice (i.e.,
"deprejudice"). When people are prejudiced against the elderly and then become old
themselves, their anti-elderly prejudice turns inward, causing depression. "People
with more negative age stereotypes will likely have higher rates of depression as they
get older." Old age depression results in the over-65 population having the highest
suicide rate.
4. Fear of crime in old age, especially among the frail, sometimes weighs more heavily
than concerns about finances or health and restricts what they do. The fear persists
although old people are victims of crime less often than younger people.
5. Increasing fear of health loss.
Mental disorders afflict about 15% of people aged 60+ according to estimates by the World
Health Organization. Another survey taken in 15 countries reported that mental disorders
of adults interfered with their daily activities more than physical problems.
Reduced mental and cognitive ability may afflict old age. Memory loss is common in old age
due to the decrease in the speed of information being encoded, stored, and retrieved. It
takes more time to learn the same amount of new information. Dementia is a general term
for memory loss and other intellectual abilities serious enough to interfere with daily life. Its
prevalence increases in old age from about 10% at age 65 to about 50% over age
85. Alzheimer's disease accounts for 50 to 80 percent of dementia cases. Demented
behavior can include wandering, physical aggression, verbal outbursts, depression, and
psychosis.
Set in one's ways, or stubbornness describes a mindset many people have in old age. A
study of over 400 distinguished men and women in old age found a "preference for the
routine". Explanations include old age's toll on the "fluid intelligence" and the "more deeply
entrenched" ways of the old.  
Perspectives
Middle-age
Many books written by authors in middle adulthood depict a few common perceptions of
old age.  One writer notices the change in his parents: they move slowly, they have lost
strength, they repeat stories, their minds wander, and they fret. Another writer sees her
aged parents and is bewildered: they refuse to follow her advice, they are obsessed with the
past, they avoid risk, they live at a "glacial pace".
Other writers treat the perceptions of middle-aged people regarding their own old age. In
her, The Denial of Aging, Dr. Muriel R. Gillick, a baby boomer, accuses her contemporaries
of believing that by proper exercise and diet they can avoid the scourges of old age and
proceed from middle age to death. Studies find that many people in the 55–75 range can
postpone morbidity by practicing healthy lifestyles. These discourses take part in a general
idea of successful aging. However, at about age 80, all people experience similar
morbidity. Even with healthy lifestyles, most 85+ people will undergo extended "frailty and
disability".
Old-age
Early old age is a pleasant time; children are grown, work is over, and there is time to
pursue interests.  Many people are also willing to get involved in community and activist
organizations to promote their well-being. In contrast, perceptions of old age by writers 80+
years old (old age in the real meaning of the term) tend to be negative.
Societal
Based on his survey of old age in history, Georges Minois concludes that "it is clear that
always and everywhere youth has been preferred to old age." In Western thought, "old age
is an evil, an infirmity and a dreary time of preparation for death." Furthermore, death is
often preferred over "decrepitude, because death means deliverance". 
"The problem of the ambiguity of old age has . . . been with us since the stage of primitive
society; it was both the source of wisdom and of infirmity, experience, and decrepitude, of
prestige and suffering."
In the Classical period of Greek and Roman cultures, old age was denigrated as a time of
"decline and decrepitude".  "Beauty and strength" were esteemed and old age was viewed as
defiling and ugly. Old age was reckoned as one of the unanswerable "great mysteries" along
with evil, pain, and suffering. "Decrepitude, which shrivels heroes, seemed worse than
death."
The Medieval and Renaissance periods depicted old age as "cruel or weak".
Historical periods reveal a mixed picture of the "position and status" of old people, but there
has never been a "golden age of aging".  Studies have disproved the popular belief that in
the past old people were venerated by society and cared for by their families.  Veneration for
and antagonism toward the aged have coexisted in complex relationships throughout
history. "Old people were respected or despised, honored or put to death according to
circumstance."
In ancient times, although some strong and healthy people lived until they were over 70,
most died before they were 50. The general understanding is that those who lived into their
40s were treated with respect and awe. In contrast, those who were frail were seen as a
burden and ignored or in extreme cases killed. People were defined as "old" because of their
inability to perform useful tasks rather than their years.  
"The Olympians did not like old people." Their youth rebelled against the old, driving them
off or killing them.
Although he was skeptical of the gods, Aristotle concurred in the dislike of old people. In
his Ethics, he wrote that "old people are miserly; they do not acknowledge disinterested
friendship; only seeking for what can satisfy their selfish needs."  
For Thomas More, on the island of Utopia, when people are so old as to have "out-lived
themselves" and are terminally ill, in pain, and a burden to everyone, the priests exhort
them about choosing to die. The priests assure them that "they shall be happy after death."
If they choose to die, they end their lives by starvation or by taking opium.
In the Modern period, the "cultural status" of old people has declined in many
cultures.   Joan Erikson observed that "aged individuals are often ostracized, neglected, and
overlooked; elders are seen no longer as bearers of wisdom but as embodiments of shame."  
Research on age-related attitudes consistently finds that negative attitudes exceed positive
attitudes toward old people because of their looks and behavior. In his study Aging and Old
Age, Posner discovers "resentment and disdain of older people" in American society.
Americans have an "automatic preference for the young over old" and that attitude is true
worldwide. The young are "consistent in their negative attitude" toward the
old. Ageism documents that Americans generally have "little tolerance for older persons and
very few reservations about harboring negative attitudes" about them.
Frailty
Most people in the age range of 60–80 (the years of retirement and early old age), enjoy rich
possibilities for a full life, but the condition of frailty distinguished by "bodily failure" and
greater dependence becomes increasingly common after that.
A group of geriatricians proposed a general definition of frailty as "a physical state of
increased vulnerability to stressors that results from decreased reserves and
disregulation in multiple physiological systems". 
Old age survivors on average deteriorate from agility in their 65–80s to a period of frailty
preceding death. This deterioration is gradual for some and precipitous for others. Frailty is
marked by an array of chronic physical and mental problems which means that frailty is
not treatable as a specific disease. These problems coupled with increased dependency on
the basic activities of daily living (ADLs) required for personal care add emotional problems:
depression and anxiety.
Frail people require a high level of care. Medical advances have made it possible to
"postpone death" for years. This added time costs many frail people "prolonged sickness,
dependence, pain, and suffering".
In addition to everyday care, frail elderly people and others with disabilities are particularly
vulnerable during natural disasters. They may be unable or unwilling to evacuate to avoid
a hurricane or wildfire.
Death
Old age, death, and frailty are linked because approximately half the deaths in old age are
preceded by months or years of frailty.
 Religiosity
Generally speaking, old people have always been more religious than young people. At the
same time, wide cultural variations exist.  
Participation in organized religion is not a good indicator of religiosity because
transportation and health problems often hinder participation.
Psychosocial aspects
According to Erik Erikson's "Stages of Psychosocial Development", the human personality
is developed in a series of eight stages that take place from the time of birth and continue
on throughout an individual's complete life. He characterizes old age as a period of
"Integrity vs. Despair", during which a person focuses on reflecting back on his life. Those
who are unsuccessful during this phase will feel that their life has been wasted and will
experience many regrets. The individual will be left with feelings of bitterness and despair.
Those who feel proud of their accomplishments will feel a sense of integrity. Successfully
completing this phase means looking back with few regrets and a general feeling of
satisfaction. These individuals will attain wisdom, even when confronting death. Coping is a
very important skill needed in the aging process to move forward with life and not be 'stuck
in the past. The way a person adapts and copes reflects his aging process on a psycho-
social level.
Newman & Newman also proposed a ninth stage of life, Elderhood. Elderhood refers to
those individuals who live past the life expectancy of their birth cohorts. There are two
different types of people described in this stage of life. The "young-old" are healthy
individuals who can function on their own without assistance and can complete their daily
tasks independently. The "old-old" are those who depend on specific services due to
declining health or diseases. This period of life is characterized as a period of "immortality
vs. extinction". Immortality is the belief that your life will go on past death, some examples
are an afterlife or living on through one's family. Extinction refers to feeling as if life has no
purpose.
Benefits
Originally, the purpose of old-age pensions was to prevent elderly persons from being
reduced to beggary, which is still common in some underdeveloped countries, but growing
life expectancies and older populations have brought into question the model under which
pension systems were designed.
Assistance: devices and personal
Many new assistive devices made especially for the home have enabled more old people to
care for their own activities of daily living (ADL). Some examples of devices are a medical
alert and safety system, shower seat (making it so the person does not get tired in the
shower and fall), a bed cane (offering support to those with unsteadiness getting in and out
of bed), and an ADL cuff (used with eating utensils for people with paralysis or hand
weakness).
People who view assistive devices as enabling greater independence accept and use them,
whereas those who see them as symbols of disability reject them.
However, organizations like Love for the Elderly aim to combat such age-related prejudice
by educating the public about the importance of appreciating growing older, while also
providing services of kindness to elders in senior homes.
There are many options for such long-term care for those who require it. There is home
care in which a family member, volunteer, or trained professional will aid the person in
need and help with daily activities. Another option is community services which can provide
the person with transportation, meal plans, or activities in senior centers. A third option
is assisted living where 24-hour round-the-clock supervision is given with aid in eating,
bathing, dressing, etc. A final option is a nursing home that provides professional nursing
care.
Ageing and Its Effects
Ageing or aging (see spelling differences) is the process of becoming older. It connotes a
biological and social construct. It is usually associated with dynamic changes in the
biological, psychological, physiological, environmental, behavioural and social processes. In
humans, ageing represents the accumulation of changes in a human being over time] and
can encompass physical, psychological, and social changes. Reaction time, for example,
may slow with age, while memories and general knowledge typically increase. Ageing
increases the risk of human diseases
The causes of ageing are uncertain; current theories are assigned to the damage concept,
whereby the accumulation of damage (such as DNA oxidation) may cause biological
systems to fail, or to the programmed ageing concept, whereby problems with the internal
processes (epigenomic maintenance such as DNA methylation) may cause ageing.
Programmed ageing should not be confused with programmed cell death (apoptosis).
Additionally, there can be other reasons, which can speed up the rate of ageing in
organisms including human beings like obesity and compromised immune systems.
Biologically, ageing results from the impact of the accumulation of a wide range of
molecular and cellular damage over time. Thus, this leads to a gradual decline in physical
and mental capacity, a growing risk of diseases, and ultimately, death. These changes are
usually consistent, and they are associated with a person’s age in years. While some people
aged 70 years may be strong and enjoy good health, others who are 70 years may be weak
and require others to help them.
There are multiple ways to define ageing. Functional age measures age by capability and
takes into account social, psychological, and physiological age. Chronological age is based
on the calendar year, from an individual's birth date to death date.
Mortality can be used to define biological ageing, an organism's increased rate of death as it
progresses throughout its life cycle. The processes and performance decline and bodily
structure changes typical to chronological age.
Another way to define ageing is through two types of functional definitions:
The first describes how varying types of deteriorative changes that accumulate in the life of
a post-maturation organism can leave it vulnerable, leading to a decreased ability of the
organism to survive. 
The second is a senescence-based definition; this describes age-related changes in an
organism that increase its mortality rate over time by negatively affecting its vitality and
functional performance.
An important distinction to make is that biological ageing is not the same thing as the
accumulation of diseases related to old age; disease is a blanket term used to describe a
process within an organism that causes a decrease in its functional ability.
Effects
Old age and Signs
1. Comparison of a normal aged brain (left) and a brain affected by Alzheimer's
disease (right).
2. A number of characteristic ageing symptoms are experienced by a majority or by a
significant proportion of humans during their lifetimes.
3. Teenagers lose the young child's ability to hear high-frequency sounds above 20 kHz.
4. Wrinkles develop mainly due to photoaging, particularly affecting sun-exposed areas
(face).
5. After peaking in the mid-20s, female fertility declines.
6. After age 30 the mass of a human body is decreased until 70 years and then shows
damping oscillations.
 7. Muscles have a reduced capacity of responding to exercise or injury and loss of
muscle mass and strength (sarcopenia) is common. Maximum oxygen utilization and
maximum heart rate decline.
8. Hand strength and mobility are decreased during the ageing process. These things
include, "hand and finger strength and ability to control submaximal pinch force and
maintain a steady precision pinch posture, manual speed, and hand sensation"
9. People over 35 years of age are at increased risk for losing strength in the ciliary
muscle of the eyes which leads to difficulty focusing on close objects, or presbyopia.
Most people experience presbyopia by age 45–50. The cause is lens hardening by
decreasing levels of alpha-crystallin, a process that may be sped up by higher
temperatures.
10. Around age 50, hair turns grey. Pattern hair loss by the age of 50 affects about
30–50% of males and a quarter of females.
11. Menopause typically occurs between 44 and 58 years of age.
12. In the 60–64 age cohort, the incidence of osteoarthritis rises to 53%. Only 20%
however report disabling osteoarthritis at this age.
13. Almost half of the people older than 75 have hearing loss (presbycusis)
inhibiting spoken communication. Many vertebrates such as fish, birds and
amphibians do not suffer presbycusis in old age as they are able to regenerate
their cochlear sensory cells, whereas mammals including humans have genetically
lost this ability.
14. By age 80, more than half either has a cataract or have had cataract surgery.
15. Frailty, a syndrome of decreased strength, physical activity, physical
performance and energy, affects 25% of those over 85.
16. Atherosclerosis is classified as an ageing disease. It leads to cardiovascular
disease (for example stroke and heart attack) which globally is the most common
cause of death. Vessel ageing causes vascular remodelling and loss of arterial
elasticity and as a result, causes the stiffness of the vasculature.
Recent evidence suggests that age-related risk of death plateaus after age 105. The
maximum human lifespan is suggested to be 115 years.  
17. Dementia becomes more common with age. The spectrum ranges from mild
cognitive impairment to the neurodegenerative diseases of Alzheimer's
disease, cerebrovascular disease, Parkinson's disease and Lou Gehrig's disease.
Furthermore, many types of memory decline with ageing, but not semantic
memory or general knowledge such as vocabulary definitions, which typically
increases or remains steady until late adulthood (see Ageing
brain). Intelligence declines with age, though the rate varies depending on
the type and may in fact remain steady throughout most of the lifespan, dropping
suddenly only as people near the end of their lives. Individual variations in the rate of
cognitive decline may therefore be explained in terms of people having different
lengths of life. There are changes to the brain: after 20 years of age, there is a 10%
reduction each decade in the total length of the brain's myelinated axons.
18. Age can result in visual impairment, whereby non-verbal communication is
reduced, which can lead to isolation and possible depression. Older adults, however,
may not suffer depression as much as younger adults and were paradoxically found
to have improved mood despite declining physical health. Macular
 degeneration causes vision loss and increases with age, affecting nearly 12% of those
above the age of 80. This degeneration is caused by systemic changes in the
circulation of waste products and by the growth of abnormal vessels around the
retina. Other visual diseases that often appear with age would be cataracts and
glaucoma. A cataract occurs when the lens of the eye becomes cloudy making vision
blurry and eventually causing blindness if untreated. They develop over time and are
seen most often with those that are older. Cataracts can be treated through surgery.
Glaucoma is another common visual disease that appears in older adults. Glaucoma
is caused by damage to the optic nerve causing vision loss. Glaucoma usually
develops over time but there are variations to glaucoma, and some have a sudden
onset. There are a few procedures for glaucoma but there is no cure or fix for the
damage once it has happened. Prevention is the best measure in the case of
glaucoma.
A distinction can be made between "proximal ageing" (age-based effects that come about
because of factors in the recent past) and "distal ageing" (age-based differences that can be
traced to a cause in a person's early life, such as childhood poliomyelitis).
Biological basis
Main article: Senescence
The factors proposed to influence biological ageing fall into two main
categories, programmed and damage-related.  Programmed factors follow a biological
timetable, perhaps one that might be a continuation of the one that regulates childhood
growth and development. This regulation would depend on changes in gene expression that
affect the systems responsible for maintenance, repair and defence responses. Damage-
related factors include internal and environmental assaults to living organisms that induce
cumulative damage at various levels.
Programmed factors
Studies by Becca Levy, an associate professor of epidemiology and psychology at the Yale
School of Public Health, have found that positive beliefs about ageing may also increase life
span.
Telomeres: In humans and other animals, cellular senescence has been attributed to the
shortening of telomeres at each cell division; when telomeres become too short, the cells
senesce and die or cease multiplying. The length of telomeres is, therefore, the "molecular
clock", predicted by Hayflick. Another study following nearly 1000 humans for ten years
showed that while some humans do shorten their telomeres over time, a third of the
participants did not.
The reproductive-cell cycle theory argues that ageing is regulated specifically by
reproductive hormones that act in an antagonistic pleiotropic manner via cell cycle
signalling, promoting growth and development early in life to achieve reproduction, but
becoming dysregulated later in life, driving senescence (dyosis) in a futile attempt to
maintain the reproductive ability. The endocrine dyscrasia that follows the loss of follicles
with menopause, and the loss of Leydig and Sertoli cells during andropause, drive aberrant
cell cycle signalling that leads to cell death and dysfunction, tissue dysfunction (disease)
and ultimately death. Moreover, the hormones that regulate reproduction also regulate
cellular metabolism, explaining the increases in a fat deposition during pregnancy through
to the deposition of centralised adiposity with the dysregulation of the HPG axis following
menopause and during andropause. This theory, which introduced a new definition of
ageing, has facilitated the conceptualisation of why and how ageing occurs at the
evolutionary, physiological and molecular levels.
Autoimmunity: The idea that ageing results from an increase in autoantibodies that attack
the body's tissues. A number of diseases associated with ageing, such as atrophic
gastritis and Hashimoto's thyroiditis, are probably autoimmune in this way.
The cellular balance between energy generation and consumption (energy homeostasis)
requires tight regulation during ageing.
Skin ageing is caused in part by TGF-β, which reduces the subcutaneous fat that gives
skin a pleasant appearance and texture. TGF-β does this by blocking the conversion
of dermal fibroblasts into fat cells; with fewer fat cells underneath to provide support, the
skin becomes saggy and wrinkled. Subcutaneous fat also produces cathelicidin, which is
a peptide that fights bacterial infections.
Damage-related factors
DNA damage theory of ageing: DNA damage is thought to be the common basis of both
cancer and ageing, and it has been argued that intrinsic causes of DNA damage are the
most important drivers of ageing. Genetic damage (aberrant structural alterations of the
DNA), mutations (changes in the DNA sequence), and epimutations can cause abnormal
gene expression. DNA damage causes the cells to stop dividing or induces apoptosis,
often affecting stem cell pools and hence hindering regeneration.
Genetic instability: genetic damage (particularly gene loss) is almost certainly (or probably
the) central cause of ageing."
Accumulation of waste:
A buildup of waste products in cells presumably interferes with metabolism. For example, a
waste product called lipofuscin is formed by a complex reaction in cells that binds fat to
proteins. This waste accumulates in the cells as small granules, which increase in size as a
person ages.
Overproduction of certain proteins.
Autophagy induction can enhance clearance of toxic intracellular waste associated with
neurodegenerative diseases and has been comprehensively demonstrated to improve
lifespan. Autophagy is enhanced in obese by caloric restriction, exercise, and a low-fat diet.
Wear-and-tear theory: The very general idea that changes associated with ageing are the
result of chance damage that accumulates over time.
Accumulation of errors: The idea that ageing results from chance events that escape
proofreading mechanisms, which gradually damages the genetic code.
The mitochondrial theory of ageing: free radicals produced by mitochondrial activity
damage cellular components, leading to ageing.
DNA oxidation and caloric restriction: Caloric restriction reduces 8-OH-dG DNA damage in
organs of ageing. Thus, the reduction of oxidative DNA damage is associated with a slower
rate of ageing and increased lifespan. DNA damage is now considered the single most
important driver of the degenerative processes that collectively cause ageing.
Prevention and Delay
Lifestyle
Caloric restriction substantially affects lifespan in many animals, including the ability to
delay or prevent many age-related diseases. No lifespan data exist for humans on a calorie-
restricted diet, but several reports support protection from age-related diseases. The
National Institute on Aging (NIA), found no effects of caloric restriction on longevity. It is
suggested that genetics and dietary composition, not merely a decrease in calories, are
factors in longevity.
The Mediterranean diet is credited with lowering the risk of heart disease and early death.
The major contributors to mortality risk reduction appear to be a higher consumption of
vegetables, fish, fruits, nuts and monounsaturated fatty acids, i.e., olive oil.
The amount of sleep has an impact on mortality. People who live the longest report sleeping
for six to seven hours each night. Lack of sleep (<5 hours) more than doubles the risk of
death from cardiovascular disease, but too much sleep (>9 hours) is associated with a
doubling of the risk of death, though not primarily from cardiovascular disease. Sleeping
more than 7 to 8 hours per day has been consistently associated with increased mortality,
though the cause is probably other factors such as depression and socioeconomic status.
Physical exercise may increase life expectancy. People who participate in moderate to high
levels of physical exercise have a lower mortality rate compared to individuals who are not
physically active. Moderate levels of exercise have been correlated with preventing ageing
and improving quality of life by reducing inflammatory potential. The majority of the
benefits from exercise are achieved with around 3500 metabolic equivalents (MET) minutes
per week. For example, climbing stairs for 10 minutes, vacuuming 15 minutes, gardening
20 minutes, running 20 minutes, and walking or bicycling for 25 minutes on a daily basis
would together achieve about 3000 MET minutes a week. Other research seems to suggest
a relationship between regular physical exercise and cognitive functioning in old age.
Avoidance of chronic stress (as opposed to acute stress) is associated with a slower loss
of telomeres in most studies, and with decreased cortisol levels. A chronically high cortisol
level compromises the immune system, causes cardiac damage/arteriosclerosis and is
associated with facial ageing, and the latter in turn is a marker for increased morbidity and
mortality. A meta-analysis shows that loneliness carries a higher mortality risk than
smoking. Stress can be countered by social connection, spirituality, and (for men more
clearly than for women) married life, all of which are associated with longevity.
Aging and society
 
Different cultures express age in different ways. The age of an adult human is commonly
measured in whole years since the day of birth. Arbitrary divisions set to mark periods of
life may include juvenile (via infancy, childhood, preadolescence, adolescence), early
adulthood, middle adulthood, and late adulthood. More casual terms may include
"teenagers", "tweens", "twentysomething", "thirtysomething", etc.
Most legal systems define a specific age for when an individual is allowed or obliged to do
particular activities. These age specifications include voting age, drinking age, age of
consent, age of majority, age of criminal responsibility, marriageable age, age of candidacy,
and mandatory retirement age. Admission to a movie, for instance, may depend on age
according to a motion picture rating system. A bus fare might be discounted for the young
or old. Each nation, government and non-governmental organisation have different ways of
classifying age. In other words, chronological ageing may be distinguished from "social
ageing" (cultural age-expectations of how people should act as they grow older) and
"biological ageing" (an organism's physical state as it ages).
A UNFPA report about ageing in the 21st century, highlighted the need to "Develop a new
rights-based culture of ageing and a change of mindset and societal attitudes towards
ageing and older persons, from welfare recipients to active, contributing members of
society". UNFPA said that this "requires, among others, working towards the development of
international human rights instruments and their translation into national laws and
regulations and affirmative measures that challenge age discrimination and recognise older
people as autonomous subjects". Older people's music participation contributes to the
maintenance of interpersonal relationships and promoting successful ageing. At the same
time, older persons can make contributions to society including caregiving and
volunteering. For example, "A study of Bolivian migrants who [had] moved to Spain found
that 69% left their children at home, usually with grandparents. In rural China,
grandparents care for 38% of children aged under five whose parents have gone to work in
cities."
Economics
Population ageing is the increase in the number and proportion of older people in society.
Population ageing has three possible causes: migration, longer life expectancy (decreased
death rate) and decreased birth rate. Ageing has a significant impact on society. Young
people tend to have fewer legal privileges (if they are below the age of majority), they are
more likely to push for political and social change, to develop and adopt new technologies,
and to need education. Older people have different requirements from society and
government and frequently have differing values as well, such as for property and pension
rights.
In the 21st century, one of the most significant population trends is ageing. Currently, over
11% of the world's current population are people aged 60. Ageing has occurred due to
development that has enabled better nutrition, sanitation, health care, education and
economic well-being. Consequently, fertility rates have continued to decline and life
expectancy has risen. Life expectancy at birth is over 80 now in 33 countries. Ageing is a
"global phenomenon", that is occurring fastest in developing countries, including those with
large youth populations, and poses social and economic challenges to the work which can
be overcome with "the right set of policies to equip individuals, families and societies to
address these challenges and to reap its benefits".
As life expectancy rises and birth rates decline in developed countries, the median age rises
accordingly. A rising median age can have significant social and economic implications, as
the workforce gets progressively older and the number of old workers and retirees grows
relative to the number of young workers. Older people generally incur more health-related
costs than do younger people in the workplace and can also cost more in worker's
compensation and pension liabilities. In most developed countries an older workforce is
somewhat inevitable. In the United States, for instance, the Bureau of Labor
Statistics estimates that one in four American workers will be 55 or older by 2020.
Among the most urgent concerns of older persons worldwide is income security. This poses
challenges for governments with ageing populations to ensure investments in pension
systems continues in order to provide economic independence and reduce poverty in old
age.
Due to the increasing share of the elderly in the population, health care expenditures will
continue to grow relative to the economy in the coming decades. This has been considered
a negative phenomenon and effective strategies like labour productivity enhancement
should be considered to deal with the negative consequences of ageing.
Self-perception
As humans age, their bodies begin to break down and their skin begins to look different,
but people do not always welcome these changes to their appearance.
Beauty standards have evolved over time, and as scientific research in cosmeceuticals has
increased, the industry has also expanded; the kinds of products they produce (such as
serums and creams) have gradually gained popularity and become a part of many people's
personal care routine.
The increase in demand for cosmeceuticals has led scientists to find ingredients for these
products in unorthodox places. For example, cryptomphalus aspersa secretion (or brown
garden snail secretion) has been found to have antioxidant properties, increase skin cell
proliferation, as well as increase extracellular proteins such as collagen and fibronectin
(important proteins for cell proliferation). Another substance used to prevent the physical
manifestations of ageing is onobotulinumtoxinA, the toxin injected for Botox.
Generally, aversion to ageing is a Western attitude. However, in other places around the
world, old age is celebrated and honoured. In Korea, for example, a special party
called hwangap is held to celebrate and congratulate an individual for turning 60 years old.
Positive self-perceptions of ageing are associated with better mental and physical health
and well-being. Positive self-perception of health has been correlated with higher well-being
and reduced mortality among the elderly.
As people age, subjective health remains relatively stable, even though objective health
worsens. In fact, perceived health improves with age when objective health is controlled in
the equation. This phenomenon is known as the "paradox of ageing". This may be a result
of social comparison; for instance, the older people get, the more they may consider
themselves in better health than their same-aged peers. Elderly people often associate their
functional and physical decline with the normal ageing process.
Successful ageing
The concept of successful ageing can be traced back to the 1950s and was popularized in
the 1980s. Traditional definitions of successful ageing have emphasized the absence of
physical and cognitive disabilities. In their 1987 article, Rowe and Kahn characterized
successful ageing as involving three components: a) freedom from disease and disability, b)
high cognitive and physical functioning, and c) social and productive engagement. There
are some differences in cultures which of these components are the most important. Most
often across cultures social engagement was the most highly rated but depending on the
culture the definition of successful ageing changes.