What is “Normal” About Aging?

By Mary Romelfanger

“I noticed the other day that some colors don’t seem as bright to me . . . wonder if I need new glasses.”

“You know, my family tells me that they think I have ‘selective hearing loss’ because I can hear other things, but I don’t seem to hear them when they ask me to do something.”

“Either I’m shrinking, or my 15-year-old granddaughter is growing like a weed.”

Sound familiar? The ways our bodies work change as we age, but which changes are “normal” and which changes require follow-up by a health-care provider? This article will provide an overview of some of the more common “normal” physical changes associated with aging.

Body Systems and Their Purposes
Nervous system Controls cell and special sense-organ functions with electrical signs
Muscular system Moves bones and maintains posture
Skeletal system Protects major organs, provides levers and support for body movement
Integumentary system Provides a temperature barrier and contains sensory receptors for pain, touch and temperature
Endocrine system Controls cell function with hormones
Cardiovascular system       Transports nutrients, chemical messengers, gases and wastes in blood
Lymphatic system Returns fluid to cardiovascular system, detects and eliminates disease causing organisms
Respiratory system Adds oxygen to and removes carbon dioxide from blood
Digestive system Breaks down food into usable form for absorption
Urinary system          Removes wastes, maintains body fluid volume and chemical balance
Reproductive system   Provides environment for production of new life

The body we had at 50 is a very different body than the one we have at 70. The human body is composed of several separate but incredibly interrelated and interactive systems. Each of these systems works in concert with one or more major organs (heart, brain, kidney, etc.) to keep the body functioning normally.

Numerous factors influence how the aging process affects not only each system but also each person. The variations are endless, which makes the study of normal aging or “gerontology” such an intriguing endeavor. Genetic influences are substantial—not only related to longevity but also to biological and behavioral processes along the life course. For example, some individuals may inherit biological markers that predispose them to develop certain types of cancer, while others may have a predisposition to develop mood disorders.

Social scientists identify many other lifelong variables such as heterogeneity, cumulative disadvantage and ageism that also play a role in how we age (Wilmoth). For example, cultural expectations, such as how older adults are “supposed to” look, act, walk and talk, as well as decreased retirement earnings, increased vulnerability in a fast-paced society and multiple other factors, influence quality of life over time. Essentially, one’s ability to adapt to changing cultural environments, socioeconomic conditions and even how society values or devalues aging individuals is central to successful aging. As the adage goes, “Aging isn’t for sissies.”

We know that lifestyle choices, environmental factors, nutrition and health maintenance majorly influence the optimum functioning and appearance of our bodies, and can play a significant role in predisposing us to early aging. Smoking, for example, can not only create havoc with the heart and lungs but can also cause the skin to wrinkle early and even make your eyes droop. Sun “worshipping” not only invites skin cancer but also wrinkles and toughens of the skin.

The important factor to remember is that due to a variety of factors, such as wear and tear, not only do we each experience the aging process differently, but also some of the organ systems within our own bodies age at different rates. This article will address some age-related changes, or changes that everyone experiences as part of the normal aging process (Luchino). This month we look at age-related changes in the nervous system (senses), muscular system (muscle and skeletal tissue) and the integumentary system (skin).

Generally, age-related changes in body systems and organs affect functional efficiency as a result of diminishing size, flexibility and longer processing or “recovery” time. As organs such as the heart diminish in size and flexibility, when stressed by exercise or other factors, heart rate and blood pressure increase, and the length of time for heart rate and blood pressure to return to their “normal” states is increased.

Sensory Changes (Nervous System)

The five sensory organs—eye, ear, nose, tongue, skin—are each affected to some degree. Gradual changes in vision include decreased visual acuity and depth perception; less ability to discriminate between colors (red and orange are the easiest to see; blue and green the hardest); increased sensitivity to glare; a harder time seeing things that are near, which is why we hold our menus in restaurants as far from us as possible (we don’t need better glasses, just longer arms); and the need for stronger light, something we often notice when reading.

Ever wonder why you’re having a harder time understanding what someone is saying to you? As we age, hearing gradually diminishes, especially for higher frequencies (the human voice) and pitch variation.

Decreasing perception in the sense of smell and taste is common, especially after the fifth decade (50 percent of our taste buds disappear by age 80). If you’re adding more salt and sugar to your food, that’s because the ability to perceive all four taste qualities (sweet, salt, sour and bitter) diminishes, with sweet and salt decreasing first, followed by the perception of sour and bitter.

And if you’re having a hard time feeling the sensation of hot or cold on your skin or easily get turned around, that’s because thinning and loss of elasticity of the layers of the skin reduce the acuity of the sense of touch, temperature and spatial perception.

Muscle Changes (Muscular System)

If you’re wondering why you can’t keep up with the younger folks in your yoga class, it’s because muscle strength and flexibility decrease with age as we lose 50 percent of muscle mass between the ages of 30 and 75. The elastic fibers in muscle tissue also diminish. Nor can we walk as fast or coordinate our steps up the stairs as well. The good news is that resistance training and endurance exercise can improve muscle mass, strength and balance. In addition, many organs (heart, bladder, lungs) are composed of or rely on nearby muscles to function efficiently.

Skeletal Changes (Skeletal System)

As we age, we get shorter. On average, we lose 2 inches in height between the ages of 20 and 70 because bones thin and shrink in the spinal column and the arms and legs. Changes in the skeletal system occur earlier in women, frequently beginning at age 40. Loss of cartilage tissue on joint surfaces causes “creaky knees” and even changes in the appearance of the ear lobes, which lengthen as we get older.

Skin Changes (Integumentary System)

Ever wonder why a small bump against something causes purple bruising? As noted earlier, the skin (which is the largest of the body systems) thins and loses its underlying support layer of fatty tissue as we age. It also loses strength and elasticity, making it much more susceptible to trauma and bruising. The small blood vessels near the surface of the skin become more fragile and bleed with minor trauma, causing dark purple areas called senile purpura.

We need more lotion as we age, as sweat glands diminish in size and the skin becomes drier and wrinkled. Large pigmented spots (called age spots or liver spots) may appear in sun-exposed areas, revealing our older age even if we keep ourselves trim and dye our hair.

In fact, hair color change is probably one of the most obvious signs of aging. Hair (except nasal and ear hair) thins and changes to gray. Graying is genetically determined, so if your mother didn’t have gray hair until she was 70, you’ll probably have the same experience. How much hair you have on your body and head is also determined by your genes. However, almost everyone experiences some hair loss with aging as the rate of hair growth slows.

Blood supply to the nails diminishes, so they become thicker, yellower, brittle and grow more slowly. Nails, especially toenails, may become hard and thick. Ingrown toenails may be more common, and the tips of the fingernails may split or tear.

In summary, the aging body clearly changes. Some systems slow down, while others lose their “fine tuning.” As a general rule, slight, gradual changes are common, and most of these are not problems. However, sudden and dramatic changes might indicate serious health problems. A program of regular, thorough health check-ups and self-examinations will identify changes that may be cause for concern (Smith).

Finally, lest we get too introspective about how our mirrored reflections have changed over the past 10 years, let’s recall Satchel Paige’s question “for the ages”: “How old would you be if you didn’t know how old you was?”



Wilmoth, J., and Ferraro, K. (2007) Gerontology: Perspectives and Issues (3rd Ed). New York: Springer Publishing.

Smith, S., and Gove, J. (2005) “Physical Changes of Aging.” Physical Changes of Aging-EDIS-University of Florida. Retrieved 12/1/2012 from edis.ifas.ufl.edu.pdffiles/HE/HEO1900.pdf.

Luchino, R. “The Normal Aging Process.” (n.d.) Wahsa.org/agingprocess.pdf. Retrieved 12/12/2012 from http://washsa.org/agingprocess.pdf.

“Aging Hair and Nails” (2010). Retrieved 12/10/2012 from http://www.nlm.nih.gov/medlineplus/ency/article/004005.htm.

Mary Romelfanger, RN, MSN, CS (Gerontology), LNHA, is a clinical specialist with more than 30 years of experience working with the older adult population and health care systems throughout the United States and Canada.