We are indeed growing older. Perhaps wrinkles and gray hairs are appearing. Maybe it's new aches and pains, or extra pounds. The process of aging necessarily causes changes; some of these changes can be significantly slowed. Lifestyle, environment, genetics...let's explore aging.*As we age, our heart muscle becomes less efficient and works harder to pump the same amount of blood throughout our body. Blood vessels lose elasticity, making them stiffer. This can lead to high blood pressure and heart problems. *Our bones shrink in size and density, which makes them more susceptible to fracture. We may lose height due to thinning of cartilage between vertebras of the spine - approximately ½ inch per decade, after age 30. *Our eyes make fewer tears and become drier. The retina thins, and lenses become less clear, possibly leading to cataracts. Focusing on close objects becomes more difficult as the eye muscles get stiffer, so that daily newspaper gets held at arm's length. Hearing diminishes, especially in the higher frequencies, which is likely responsible for the jokes about husbands not listening to their wives! The mouth becomes drier, making teeth more susceptible to decay. *Skin thins and becomes less elastic and more fragile, so we may bruise more easily. We produce less natural oil, so our skin is drier and more wrinkled. Age spots can occur, along with a variety of growths. Almost half of those over 65 have some form of skin cancer, and there is an increased incidence of shingles. The simplest and cheapest way to keep our skin healthier is to stay out of the sun from childhood onward, and it's never too late to protect ourselves from the sun's harmful rays. Note also that wrinkles dramatically increase with the quantity of cigarettes smoked and the number of years one has been a smoker. *Maintaining a healthy weight becomes more difficult. Muscle mass tends to decrease with age, leading to an increase in fat. Since fat tissue burns fewer calories than muscle does, we need to reduce the number of calories consumed and increase physical activity. *Sexuality needs, patterns and performance may change. Illness or medication can affect the ability to enjoy sex. Constipation becomes more likely, perhaps due to a lower fiber diet, consuming less fluid, lack of exercise, and a variety of medications. Loss of bladder control is common, caused by obesity, constipation, chronic cough, menopause in women, and enlarged prostate in men. While life expectancy does tend to run in families, environment and lifestyle are far more important than the genes that we're born with. Environment and lifestyle can be modified, and opportunities to change our aging process are plentiful. Even a strong genetic predisposition toward a particular disease can be modified by changes in these areas. Growing bodies of evidence shows that regular exercise helps to decrease the tendency toward diabetes, lessen osteoporosis, decrease fall risk, and even delay the onset of dementia, cancer, and depression. Moreover, moderate exercise helps to decrease risk factors for heart disease such as high blood pressure, obesity, smoking, and high blood lipids. Muscle strength and bone mass actually begin to decline by the time we reach our 30's. Falls can come as a result of other changes in the body: Sight, hearing, muscle strength, coordination, and reflexes aren't what they once were. Balance can be affected by diabetes and heart disease, or by problems with the circulation or nervous system. Some medicines can cause dizziness. The sedentary nature of most Americans of all ages may explain in large part the losses of function often blamed on aging. However, those who are able to keep more of their muscle strength, flexibility, and aerobic capacity not only live longer, but also are able to preserve their independence longer, and pursue more activities. Their aging is slowed. What about our brainpower? There are different types of intelligence. Crystallized intelligence relies on the use of previously stored information. It remains relatively stable or even improves throughout our lives until we reach, perhaps, our 70's. In contrast, fluid intelligence, which requires the manipulation of new information and unfamiliar concepts, begins to deteriorate as early as our 40's. By young adulthood, we have generated all of the neurons that we will ever have, and 50,000 to 100,000 of these neurons are lost every day. As a result, brain atrophy occurs over time, resulting in a 10% loss of brain volume between early adulthood and old age. Mild memory difficulties are typical, including difficulties with problem solving, multitasking, selective attention, and flexible thinking. However, when and how fast these changes occur varies, depending on personality, social skills, lifestyle, etc. Unfavorable factors might include social isolation due to death of friends and relatives, financial loss and mental isolation due to retirement, and physical isolation due to illness and declining physical abilities. While there is no magic that allows us to stay completely healthy and cognitively intact, research has clearly shown a path for increasing our chances of aging more gracefully. Maintaining good physical and mental health requires that we manage our medical risk factors. We need to control hypertension, atherosclerosis, and diabetes, all of which lead to cognitive and physical decline. We want to incorporate regular physical activity. We benefit from environments that are cognitively and socially challenging. Retirement can be an opportunity for a second, mentally stimulating career, lessening the chances of depression and boredom. To stay young, maintain a healthy mind in a healthy body! The goal is not to live forever, but to live well. I urge you to address your risk factors, manage your medical problems, maintain social involvement, and pursue regular physical exercise. Let's do whatever is necessary to age as slowly and gracefully as possible! Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

********** Published: November 8, 2012 - Volume 11 - Issue 30