What's 'normal' as you age?

These days, medical advances mean we never have to suffer in silence with serious medical conditions, and many everyday ailments can be effectively relieved, if not cured. But when is a change 'normal' and when should you worry?

Whoever said 'getting old is not for the faint-hearted' was only partly right. Maturity has much to commend it - who would want to relive teenage angst? These days, medical advances mean we never have to suffer in silence with serious medical conditions, and many everyday ailments can be effectively relieved, if not cured. But when is a change 'normal' and when should you worry?

A weighty business

Your body mass index (BMI) is a ratio of your weight and height. Your practice nurse will be happy to work yours out for you. It may seem unfair that the 'ideal', 'overweight' and 'obese' weight ranges for a given height don't change as you get older. However, these ranges are based on the life expectancy of millions of people - they actually come from actuarial figures used to calculate insurance premiums. The same weight range gives you the best chance of a long and healthy life, regardless of your age.

Should I tolerate a tum?

Lots of my patients complain of putting on weight after the menopause, but their particular issue is often that most of the weight accumulates round their midriff (ref 1). The hormonal changes of the menopause may make you more prone to being an 'apple' (excess weight on the tummy) rather than a 'pear' (weight on hips and thighs). This can increase your risk of heart disease (ref 2) - fat inside your stomach increases your cholesterol and blood pressure. But putting on weight after the menopause is not inevitable.

As you get older, your metabolic rate - the rate at which your body burns energy - will probably slow. Adjust your meal size and make a resolution to do a brisk daily walk of 20-30 minutes - just a 10% loss in weight will reduce the fat inside your tummy by a whopping 30%!

I'm always tired - should I worry?

When my children were small, I marvelled at their endless supplies of energy - but I never thought it odd that I couldn't match them. You can't expect to be on the go all the time as you get older, but neither should you assume that being tired all the time is normal.

One of the keys that I look for when a patient complains of tiredness is whether it's new or has recently got much worse. Several medication conditions can cause tiredness. These include an underactive thyroid gland (which can also cause weight gain despite eating less, intolerance to cold, constipation and dry skin) and diabetes (other symptoms include needing to pass water more often, feeling thirsty and recurrent minor infections like boils and thrush) . Several medications can also lead to tiredness - beta-blocker tablets for heart conditions and antidepressant tablets are top of the average doctor's list. Stress often leads to tiredness, but so too can depression, which is often closely linked. If you've been feeling down, depressed or hopeless, or don't enjoy social activities as you used to, this could be the culprit .

Oh, my poor old bones

Here's the bad news. By the age of 65, about half of people have osteoarthritis (OA) - the most common 'wear and tear' joint problem in the UK. The good news is that 80% of them aren't significantly affected by it. As you age, your hips, knees, spine and hands are most affected by OA, which can cause pain, stiffness and reduced movement, often worse in the mornings. Simple painkillers, keeping your weight down and staying active are often all that's needed. Symptoms to look out for include pain at rest; sudden severe pain in one joint; and a red, hot, swollen joint.

Don't forget me

Who hasn't had the odd 'senior moment', where you get to the kitchen and forget what you went in there for? That's perfectly normal for most people, especially if we're busy, stressed or getting older. Speak to your doctor if it's happening very often; if you're also having problems concentrating; or if you get confused if you're in a new environment.

Forgetful? You're probably fine!

We all worry about getting dementia, but most of us will never be personally affected, no matter how long we live. In fact, 19 out of 20 over-65s and even four out of five over-80s have perfectly normal memories. If you're concerned that you or a loved one might be affected, look at http://patient.info/health/memory-loss-and-dementia to find out more.

With thanks to 'My Weekly' magazine where this article was originally published.


1) Ley C, Lees B, Stevenson J. Sex- and menopause-associated changes in body-fat distribution. Am J Clin Nutr May 1992vol. 55 no. 5 950-954. http://ajcn.nutrition.org/content/55/5/950.short

2) Canoy D et al. Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk cohort: a population-based prospective study. Circulation 2007 Dec 18;116(25):2933-43

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Dr Sarah is unable to provide medical advice or respond directly to questions concerning your health. If you have health concerns we recommend contacting your GP.