H3 Book Index:: Chapters 1-29
Different manifestations of old age have been catalogued for many years, but scientific attention was not directed to them until a half-century ago. A New York physician, Ignatz Leo Nascher, coined the word "geriatrics" (from the Greek "geron," meaning old man) and applied it to that special branch of medicine which deals with the typical diseases of the advanced years. The word" gerontology," meaning" study of old man," was derived, naturally, from this root. Thus, while the former - geriatrics - denotes the practice" of medical means to alleviate the results of aging, the latter term (gerontology) categorizes the theory of aging.
The most perplexing questions facing medical science today concern the causes of old age and the precise measurement of the process of aging in the human
body. We are all familiar with the manifestations of
age, but we are not sure whether its signs and symptoms are inevitable, as believed until quite recently, or whether they can perhaps be postponed, or
even completely prevented. The growing number of biologists and physicians who advocate the latter
believe that the signs of old age are merely indications of a sickness which should yield if properly treated. They point out that chronological and biological age do not necessarily coincide-that some people, in appearance, attitude and behavior, seem younger than they really are, while others appear older. Why this should be so, has never been answered satisfactorily.
The aging process actually begins at birth, but at the onset these changes lead to growth and maturity. Once the latter stage has been reached, a slow decline sets in-affecting different parts of the body at different times, sparing some organs until a fairly advanced age. Thus, it has be-en found that hearing is best at the age of 10, vision at 20, muscular strength and coordination at 25, and reproductive functions at 30. These few examples suffice to show that aging is a slow process, and that it does not affect the entire organism at any single specific time. We speak of "normal aging" and "accelerated aging;" but although our yardstick for the former is still rather vague, there is general agreement that the latter is due to morbid changes in the body.
While the true causes for the decline of vigor in man are not known, we do know that the symptoms which accompany his slow but steady decline usually gain momentum during the fifth decade of his life. The first evident changes are connected with his appearance: hair becomes sparse and grey, shoulders develop a slight stoop, the skin shows wrinkles and the gait loses its earlier buoyancy. Man begins to "look old," although at this stage of the aging process he may not feel old. In fact, because he maintains his activities at the high level of youth, without much change in his way of life, he may well be laying the groundwork for future illness. (An investigation into the dynamics of "middle-age medicine" is another program still to be developed.)
Other symptoms enter the picture: the metabolism is less active, recuperative powers slow down, the energy used up by the body is replaced at a much slower rate, thereby rendering the tissues of the individual organs more flaccid. The skin becomes thinner and, due to a reduction in the secretion of some of its glands, drier. As the years progress, muscles fail to maintain the body in its former erectness, motions lose some of their power and sureness. The thorax is no longer expanded as before, partly due to increased muscle weakness, partly to an ossification of the costal cartilages. Thus, the lungs do not receive as much oxygen, the walls of their air cells become thinner, breathing is less thorough, and the respiratory metabolism slows down.
Bones become more brittle, they decrease in volume and weight, almost all cartilages lose their elasticity and, in certain spots, calcify. A great many of the capillaries in which blood is transported to distant parts of the body become clogged, preventing an even blood supply (the reason for circulatory troubles in the extremities, as well as opacity of the cornea, which leads to cataracts). The digestion, too, becomes impaired; teeth are no longer as efficient as they formerly were; liver, gall bladder, spleen and pancreas are weakened; the absorption of essential vitamins and minerals from the intestines is reduced. The slowing down of the metabolism as a whole also affects the mental acuity and an increase in forgetfulness; the severest, psychosis and regression to infantile behavior. Between these two extremes we find apathy, confusion, hostility, restlessness, sloppiness, asocial attitudes, sexual aberration, and persecution feelings.
Why some people become senile and others do not is still unknown. Social and psychological stresses play a part, but of primary importance are the changes in the body. Hormonal disturbances, a malfunctioning enzyme system, and lowered activity of the brain cells (stemming from a reduction of the cerebral blood flow) seem to be the main causes of man's mental deterioration.
Dr. William Malamud of Boston University has stated that the incidence of mental disorders in old age has been rapidly increasing for the last three decades and, particularly since the end of World War II, "has skyrocketed to a degree totally out of proportion to any of the other types of personality disturbances."
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H3 Book Index:: Chapters 1-29
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