The average life span of people in the Western world today is approximately 80 years. It has increased enormously since the middle of the last century, when the average life expectancy at birth for either sex was only about 40 years. During this century, better medical care and improved working and living conditions have also helped to prolong life significantly.

The human body begins to deteriorate in the 20’s and 30’s, and as age advances, all of the body’s systems become less efficient. One of the major concerns of middle and old age, therefore, is the need to come to terms with these physical, psychological, and social changes and to work with the body to maximize its functions.

Coming to terms with old age is usually made easier by the fact that unless disease or injury damages the brain, most healthy elderly people who remain physically and mentally active probably suffer no serious decline in mental capacity. A person who is mentally alert can often find great pleasure in a life that allows time for peace and reflection, particularly if these are balanced by stimulating interests and adequate physical activity.

A healthy outdoor life can improve longevity, although it may also accelerate the visible effects of age. The wind and sun, in particular, age the skin, as the wrinkled face of this Portuguese fisherman shows.

External changes

Many physical changes are immediately obvious. White hairs appear as hair follicles lose their sources of pigmentation. Wrinkles increase as the skin loses its elasticity. Middle age is often associated with an increase in weight, followed by a significant decrease as old age advances. Older people tend to lose height because of the compression of the vertebrae in the spine that results from the gradual loss of calcium from bone (osteoporosis) which affects post-menopausal women particularly and because of the tendency to stoop as muscle tone is lost.

Aging is accompanied by the gradual physical deterioration of the body. The diagram shows three factors— brain weight, heart output, and reaction time—that deteriorate steadily from age 20. By age 80, these have deteriorated to 85, 65, and 50 per cent, respectively, of what they were 60 years before.

Internal changes

Changes associated with aging also take place within the body’s systems. Many internal organs, such as the kidneys, spleen, pancreas, lungs, and liver, become smaller in normal elderly people and less efficient at performing their tasks. The circulation of the blood is also affected by aging. The heart’s pumping action is less efficient, and its response to exercise or stress, by increasing the heart rate, is more extreme. The blood vessels (veins, arteries, and capillaries) throughout the body lose some elasticity and tend to become convoluted. The bones become more brittle also a result of osteoporosis which makes older people more liable to fractures from falls or other accidents. The body becomes more sensitive to extremes of temperature and may take longer to recover from illness. Susceptibility to infection is increased, and the risk of cancer and some other disorders is greater.

The nervous system

Other changes associated with aging affect the nerves and their related functions. Nerve cells degenerate in old age and are not replaced, and the blood supply to the brain and other parts of the nervous system is affected by any general deterioration for instance, caused by arteriosclerosis that involves the circulation. This tends to reduce the brain’s efficiency, and a decline in intellectual performance may follow the brain’s gradual physical decline. Aspects of intelligence most likely to be affected by aging include logic, understanding three-dimensional images, problems involving numbers, and the ability to grasp new ideas. Other functions related to the brain also lose their efficiency: reflexes and physical movements become slower, and the memory especially for recent events may deteriorate. These conditions may be treatable. In severe cases, this can lead to senile dementia, which is characterized by loss of memory, unreasonable or childlike behavior, disconnected or incoherent speech, and a lack of awareness. The senses, too, are affected. Smell, taste, sight, touch, and hearing all deteriorate, causing increasing isolation of elderly people as everyday tasks and conversations become more difficult.


Menopause literally means “stopping menstruation,” although much more is involved than simply the end of the monthly periods. The menopause usually occurs any time between the ages of 45 and 50, and has various physical and psychological effects. The cause of this “change of life” is an alteration in the usual monthly female hormone cycle, particularly affecting the production of progesterone, estrogen, and FSH (follicle-stimulating hormone). The woman stops ovulating and menstruating, although this rarely happens suddenly. She may also experience insomnia, headaches, severe mood swings,”hotflashes,”and emotional disturbances, all related to hormonal changes. After the menopause, women become more susceptible to heart disease and bone loss.

Prospects for the elderly

Although aging does undoubtedly bring problems, in most cases these are no more than limitations. Furthermore, these limitations tend to be reduced by improvements in communal and personal health care important aspects of which are health screening, improved diet, social networks, and an appreciation of the benefit of exercise to both body and mind and also by medical advances, particularly in combating killers such as cancer and heart disease. Consequently, it is also likely that with life expectancy increasing, people are seeking to ensure that the quality of their lives improves too. To this end, some elderly people engage in social and political activities to improve their circumstances, while others tend to concentrate on developing satisfying leisure pursuits or even starting new careers.