Ageing: What to Expect in your 40s, 50s, 60s and Beyond

Ageing is more than just grey hairs and counting years of living. It is a natural process of getting older, beginning gradually around the age of 40, when we start to experience many physical, mental, physiological, and social changes. 

With the increase in accessible healthcare services and public awareness, we are fortunately able to somewhat delay the ageing process by minimising health risks. As of 2021, adults 60 years old and above are expected to live much longer and contribute to a bigger population of the age group. 

Some key statistics include:

• Women recorded a higher life expectancy up to the age of 81.8, which is two years older than men.
• Among the major ethnic groups, the Chinese people are predicted to live the longest between 81.2 and 75.9 years old, followed by Bumiputera and Indians. 
• The lowest life expectancy by the state is Perlis with an age range between 69.4 and 75.3, while the highest is Wilayah Persekutuan Kuala Lumpur. 

Ageing in your 40s

The 40s is the new 30s, or so they say. While most of us seem to appear healthy on the outside and still look youthful, here comes our body hitting us with a few of the first signs of ageing.

Slow metabolism rate

Although some recent studies found out that the metabolism rate does not slow down until at least after the 60s, your metabolism might be declining much faster due to a couple of factors.

• Chronic stress: Can take over when pushing our minds and body beyond their capabilities. A rise in your stress hormone (cortisol) switches your body to fight-or-flight mode that temporarily suppresses bodily functions, including your metabolism.
• Sarcopenia: A normal ageing process where we naturally lose muscles as we get older. This means we are not as physically fit as before, indicating that our metabolism is also dropping. That is why in your 40s, you may notice more body aches and get easily out of breath when taking the stairs.

Weight gain and obesity 

A slow metabolism rate will make it harder to lose weight. With poor eating habits and a lack of exercise, you are taking in more calories without burning them out for energy. Over time, these calories will accumulate inside your body as fats and increase your cholesterol levels.  

Obesity can lead to many serious complications, mainly cardiovascular diseases, diabetes, and high blood pressure. For women, weight gain may signal that they are about to hit menopause. 

Skin ageing

Looking in the mirror at this age means facing the truth that your skin will no longer be as radiant, smooth, and plump as it was in your younger days. The outer layer of skin (epidermis) gets thinner, making it more delicate and slowing down the healing process of wounds. 

Wrinkles and fine lines also start to appear more visible as our skin becomes saggy due to a lack of production of collagen and elastin, two proteins important for maintaining skin elasticity. As a lesser amount of sebum (oil) is produced, the ability to retain moisture also diminishes, leaving us with a drier and coarse skin surface. 

Long exposure to the sun or ultraviolet (UV) rays can cause changes in pigment cells (melanin), causing age spots to come out. 

Ageing in your 50s

Body aches, sores and fatigue begin to creep in as you enter your 50s due to several reasons.   

Menopause and andropause

ALL women in their 50s or sometimes late 40s undergo a drastic drop in levels of reproductive hormones, whereby you no longer have menstrual periods for 12 months straight—marking the end of menstruation. While this life-changing phase sounds like a relief, the transition period before menopause brings a long list of discomforts such as hot flashes, night sweats, sleeping troubles, weight gain, and mood swings.

For some men in their 50s, their male hormones (testosterone) begin to decline very slowly from this age. Different from menopause, andropause does not cause infertility nor does it affect all men. While having no periods is irreversible, low testosterone levels can be treated. In fact, other health complications may occur if ignored.  

Reduced bone density

One of the effects of menopause is decreasing level of oestrogen, a hormone that functions to support growth and maintain bone structure. The lesser amount of oestrogen results in low bone density, whereby your bones become thinner, brittle, and weaker. 

Hence, women are more vulnerable to fractures or bone diseases like osteoporosis, compared to men. 

Wear and tear of joints

The spaces between our bones are called joints, containing joint fluids to lubricate the narrow gaps and ensure the smoothness of physical movements. Entering the 50s, we start to lose this fluid, resulting in our joints becoming stiff due to more friction between the bones.

Not only that, the soft tissues in between the bones known as cartilage pads also gradually wear off, reducing the gaps in your joints that may lead to a stooped posture (like hunching). Hence why you may notice your height shrink as you get older.  

Age-related eye diseases

Seeing children and younger adults wearing spectacles is not unusual nowadays due to the increase in screen time on electronic devices. Apart from manageable eye problems like dry eyes and reduced eyesight, ageing also causes major eye disorders that may require laser surgeries for severe cases. If untreated, there is a possibility of total vision loss or blindness. 

Cataracts, glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy are some of the most common ageing-related eye diseases.  

Increasing risks of cancers

Incidence rates of cancer cases begin to rise to start the age of 50s. In order to reduce the risk of chronic illnesses as you age, being in your 50s is a great start to go for health screenings. By detecting early signs and warnings, your doctor can advise immediate treatments as prevention.

Ageing in your 60s and beyond

Quality of life in the 60s and older are greatly affected by a myriad of health concerns. Most of the complications at this age are long-term and can be life-threatening.

Higher risk of chronic illnesses

If you did not start making active changes to your lifestyle early in your 40s, there is a greater chance of getting diagnosed with chronic diseases later in life. 

Primary causes of death among older adults are:

• Coronary heart disease: The narrowing of arteries due to the build-up of fats forces your heart to work harder when pumping blood, resulting in high blood pressure (hypertension). Weaker hearts are susceptible to heart attacks and heart failure.
• Cancer: 2020 statistics reported more than 50% of cancer patients to belong to the age group of 65 years old and above, usually already reaching late or final stages. The most common cancers found are breast cancer, lung cancer, prostate cancer, and bowel cancer.
• Stroke: A type of cardiovascular disease due to restricted blood flow to the brain. Without sufficient oxygen, brain cells can get damaged and affect cognitive, speech, or motor functions. Declared as a medical emergency, stroke can occur in two ways: ischemic and hemorrhagic.

A weakened immune system due to ageing makes your body vulnerable to the spread of infections, which further slows down recovery and reduces the chance of survival. Hence, knowing the warning signs can help receive immediate treatment and reduce fatality.  

Frailty

Frailty is a common ageing-related health condition characterised by:

• low physical energy and strength;
• loss control of bladder and bowel movement (incontinence); as well as 
• slow mobility and reflexes. 

Declining ability to hold onto things more firmly and struggle to balance our body well increase the risk of falling, especially in the bathroom. Such inconvenience may pose fear of moving around, which further discourages a person at this age from being active and taking care of personal hygiene. Hence, long-term care is essential to provide assistance with these activities of daily living.

Cognitive ageing and impairment

Besides deterioration in physical abilities, our cognitive functions slowly decline too—but this does not mean your brain is damaged! It just takes you a long time to process information, retrieve old memories, and easily get distracted. Yet, you are still able to perform daily tasks without any issues. This is what we know as normal cognitive ageing (NCA).

Dementia, albeit common among older adults, is not age-related and therefore not normal. It is a syndrome that interferes with the neural pathway in the brain, preventing the cells from communicating properly with each other. The most prevalent type of dementia Is Alzheimer’s. Symptoms are more severe than NCA, to the point of affecting behaviours, mood and independence. Oftentimes, you are unaware of the condition yourself. 

Mental disorders

In 2009, about 13.9% of older Malaysians were reported suffering from depression, but the number of cases has increased significantly since then, including those undiagnosed. Going through physical and cognitive ageing can leave them feeling helpless as well as isolated, which contributes to a sense of loneliness. 

You probably recognise a change of personality to being extra reserved with less talking as time goes by. Possible reasons may be due to their own disability, worry of troubling other people, loss of friends or life partners, pondering on mortality, and being neglected by family members. 

Other mental illnesses often associated with ageing are anxiety, schizophrenia, and psychosis. 

Sleep problems

Seniors in their 60s and older require the same amount of sleep as most adults do, which is seven to eight hours. Unfortunately, ageing messes up your sleep cycle wherein you wake up ahead of time despite going to bed early the night before—a syndrome called Advanced Sleep Phase Disorder. For example, you hit the sack at the appropriate time of 9 or 10 pm but then get awake by 3 am, causing reduced sleeping hours. 

Apart from getting lack of sleep, your sleep quality at night is also disturbed by various factors including: 

• Long daytime napping
• Frequent night urination (nocturia)
• Muscle cramps or joint pains
• Medication side effects
• Sleep discomforts such as Restless Leg Syndrome and sleep apnea 
• Anxiety and depression

Hearing loss 

Passing through 65 years old and above, we experience a common ageing process called presbycusis, where we slowly lose our sense of hearing. Structural changes in the inner ears and impaired nerves from the inner ears to the brain (auditory nerve) are usually the main causes. 

This explains why our elderly have a hard time listening to conversations when there are noises around because they only hear people mumbling instead of talking. Difficulty to hear high-pitched sounds like the ringing of the telephone or car honks can also happen. 

Hearing loss cannot be cured, but there are ways to improve hearing through the use of hearing aids (for mild to moderate loss) and cochlear implants (for severe loss).

Dental and oral problems

It is possible to have a healthy and full set of teeth even at an older age, depending on how well we observe oral hygiene and the kinds of food we eat since young. If we often consume sugary foods and skip daily brushing, the condition of our teeth can get damaged faster like:

• Erosion of the outer layer of teeth (enamel) leads to increased sensitivity to cold sensations like ice cream and iced drinks. 
• Eating hard crunchy foods can also cause our teeth to crack easily. 

A common age-related oral problem is receding gums, whereby your gum is pulled back until the lower part near the roots of your tooth can be seen. Bits of food can get trapped within the exposed gaps, attracting bacterial growth which develops tooth decay. Having fewer teeth makes chewing a struggle that can kill your appetite, thus we see many seniors suffer from poor diet. 

Other than bad eyesight and hearing, your sense of taste grows faint as well, due to taste bud cells no longer reproducing as quickly. You may notice that adults in their later years tend to crave anything sweet as foods taste bland. Some medications can also alter your ability to taste flavours. 

Aside from triggering thirst, a decrease in saliva production leaves your mouth dry and prevents rinsing out remaining food crumbs, which gives rise to oral infections.

Ways to healthy ageing

Ageing does look like you have a lot of health warnings to look out for, but the key is to start young. Some of these useful tips sound basic and simple (you might have already heard of them thousand times before), yet crucial in ensuring a more thriving and potentially longer life. 

1. Stay physically active to put the muscles to work. Ensure there are always bodily movements each day, be it through exercising, walking, or gardening. 
2. Stimulate your mind by having hobbies like reading newspapers and doing crossword puzzles. Apart from reducing stress, actively using your brain is important to avoid ‘rusting’ of memory and thinking ability. 
3. Engage in conversations. Being social helps to reduce feelings of loneliness and lift up your mood. If you are a caregiver, talking to them daily can encourage communication and self-confidence. Sharing stories and exchanging thoughts can also keep the mind sharp in the long run. 
4. Stay hydrated and eat a balanced diet. A lack of vitamins, nutrients, and water can cause tiredness. Stay away from high-sugar and high-sodium meals, or anything that leads to high cholesterol. Instead, top up on leafy greens, fibre, and calcium to keep your body weight in check. Alcohol consumption should be reduced to none.
5. Establish a hygiene routine. Brush your teeth daily using a soft toothbrush and shower twice a day. If you can, visit the dentist for dental check-ups as well as to make sure your dentures are well fit. 
6. Stick to your sleep schedule. Try to avoid long nap times during the day and go to bed at regular hours. You can also do plenty of activities in the evening so that you will get tired and sleep easier at night.
7. Say no to smoking. Not only does it lead to heart diseases and lung cancer, but the chemicals can also impair your brain too. Smoking worsens wrinkles, which can make you appear older fast. 
8. Protect your skin with a good skincare regime. Apply sunscreen daily even when you are indoors. Practise using products containing ingredients, like hyaluronic acid and ceramides, that attract hydration as well as locking moisture to avoid dry itchy skin. 
9. Do not skip doctor appointments to check your health progress, particularly high blood pressure, cholesterol and sugar levels. This is when you inform the healthcare provider of any abnormalities to reduce potential health risks in the future.
10. Go for eye checkups and ear examinations once you start to notice changes in your eyesight and hearing. Blurry vision can increase the risk of falling while hearing loss prevents you from being alert to your surroundings.
11. Try to keep a positive mindset. We all know that is not an easy thing to do, even for younger adults, but looking at the brighter side of things improves your attitude and makes your life a more meaningful one. 

Ageing with Homage

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