Signs of Aging by Organ System

Emmanuel Osei-Boamah, M.D., primary care physician with Mercy Family Care in Baltimore, is double board certified in geriatric and internal medicine. Recently, he provided insights to questions from the New York Post about common signs of aging.

Aging is characterized by a progressive decline in physiological function across multiple organ systems. A person's 40s and 50s represent a critical window when many age-related changes first become apparent or accelerate.

Clinical signs of aging by organ system

Cardiovascular

• Vascular stiffness and diastolic dysfunction
• Increased blood pressure
• Decreased maximal heart rate and reduced stroke volume
• Diminished cardiac reserve and exercise tolerance
• New onset palpitations and increased risk of atrial fibrillation
• Increased ventricular wall thickness
• Atherosclerosis
• Endothelial dysfunction
• Conduction system alterations

Musculoskeletal

• Sarcopenia (loss of skeletal muscle mass and strength, including grip strength)
• Impaired balance or coordination
• New joint stiffness or pain (osteoarthritis)
• Joint contractures
• Osteoporosis

Neurological

• Cognitive decline that impairs processing speed, memory, and executive function
• Difficulty with multitasking
• Dementia
• Unstable gait
• Subjective memory complaints

Sensory

• Decline in hearing (presbycusis) that initially affects high frequency sounds
• Decline in vision (presbyopia)
  • Lens thickens and yellows, reducing light transmission to the retina  
  • Increased susceptibility to glare increases, risk of glaucoma, age-related macular degeneration

Immune system

• Chronic low-grade inflammation
• Compromised immune function
• Blunted immune response
• Increased susceptibility to infection

Renal

• Reduced glomerular filtration rate
• Altered renal metabolism

Pulmonary

• Decreased ventilatory capacity
• Ventilation–perfusion mismatching

Metabolic / endocrine

• Hormonal dysregulation
• Homeostatic imbalance
• Declining resting metabolic rate
• Hot flashes
• Night sweats
• Sleep disruption
• Mood changes
• Vaginal dryness
• Cognitive complaints
• Metabolic syndrome
• Reduced lean mass visceral fat and bone density

Gastrointestinal

• Decreased taste and smell perceptions
• Slow gastric emptying
• Constipation
• Diverticulosis
• Fecal incontinence

Body composition

• Decreased lean body mass
• Increased fat redistribution
• Lipodystrophy

Skin

• Fine wrinkles
• Hyperpigmentation (age spots, etc.)
• Skin laxity
• Skin texture irregularity
• Increased vascular markings (spider veins, etc.)
• Alopecia
• Hair graying
• Dryness (xerosis)

The cumulative effect of these changes manifest as frailty, defined by reduced physiological reserve and increased vulnerability to stressors. The frailty phenotype includes:

• Unintentional weight loss
• Exhaustion
• Weakness
• Slow walking speed
• Low physical activity

Frailty is potentially preventable through physical activity, cognitive engagement, optimal nutrition, and regular health care.

Five signs someone is aging well

Aging well is characterized by:

• Preservation of functional independence
• Cognitive vitality
• Physical capability
• Psychosocial engagement
• Physiological resilience across the life span