Aging changes (Changes in the elderly)

Effects of aging

All cells are subject to natural processes of aging. Aging is believed to be caused by the accumulation of DNA damage, hormonal changes, and internally programmed cellular changes. Aging affects all organ systems and leads to progressive functional decline.

Aging bones, muscles, and joints

To help prevent sarcopenia, regular exercise, a protein-rich diet, vitamin D, creatine, and omega-3 fatty acids are essential and can all improve muscle growth!

Aging skin

Aging nails and hair

Aging cardiovascular system

  • Vascular sclerosis and stiffness, which increases systolic blood pressure
  • Left ventricular hypertrophy and progressive stiffening with a 10% increase in wall size
  • Mitral and aortic valve thickening and calcification
  • Marked decline in stress-induced and exercise-induced maximal heart rate due to decreased response to the action of catecholamines
  • Lipofuscin deposits in cardiac muscle

Aging respiratory system

Aging genitourinary system

Aging immune system

Aging endocrine system

Aging nervous system

  • Presbycusis: progressive high frequency hearing loss due to loss of hair cells at the cochlear base
  • Presbyopia: impaired accommodation (near object focusing) due to decreased elasticity of the lens; decreased ciliary muscle strength
  • Decreased sense of smell and taste
  • Reduced ability to detect vibration, touch, temperature, and pressure changes (increased risk of pressure ulcers, hypothermia, and burns)
  • Decrease in cerebral blood flow and brain volume
  • Altered sleep patterns: earlier morning awakening, later sleep onset, ↓ REM, and ↓ slow-wave sleep
  • Decline in executive function, working memory, processing speed, and attention span after the 6th decade of life
    • However, no clinically significant distress or impairment in social, occupational, or other areas of functioning in normal aging
  • Suicide risk; : Physical and mental illnesses (particularly depression), functional impairment, and stressful life events (e.g., loss of a partner) increase the risk of suicide in the elderly.


  • 1. Watad A, Bragazzi NL, Adawi M, et al. Autoimmunity in the elderly: Insights from basic science and clinics - A mini-review. Gerontology. 2017; 63(6): pp. 515–523. doi: 10.1159/000478012.
  • 2. Eisen HN. Affinity enhancement of antibodies: How low-affinity antibodies produced early in immune responses are followed by high-affinity antibodies later and in memory B-cell responses. Cancer Immunol Res. 2014; 2(5): pp. 381–392. doi: 10.1158/2326-6066.cir-14-0029.
  • 3. Montecino-Rodriguez E, Berent-Maoz B, Dorshkind K. Causes, consequences, and reversal of immune system aging. J Clin Invest. 2013; 123(3): pp. 958–965. doi: 10.1172/jci64096.
  • 4. Mehr R, Melamed D. Reversing B cell aging. Aging. 2011; 3(4): pp. 438–443. doi: 10.18632/aging.100313.
  • 5. Bulati M, Caruso C, Colonna-Romano G. From lymphopoiesis to plasma cells differentiation, the age-related modifications of B cell compartment are influenced by “inflamm-ageing”. Ageing Res Rev. 2017; 36: pp. 125–136. doi: 10.1016/j.arr.2017.04.001.
  • 6. Kogut I, Scholz JL, Cancro MP, Cambier JC. B cell maintenance and function in aging. Semin Immunol. 2012; 24(5): pp. 342–349. doi: 10.1016/j.smim.2012.04.004.
  • UpToDate. Updated January 1, 2012.
  • Lewis. Physiologic Changes in the Elderly. url: Accessed April 22, 2019.
last updated 04/22/2019