Old age, far from being a twilight time of suffering, can be a period of joy – if we are prepared for it. Growing old is a new career, and we all need to know how to handle this part of our lives. Just as we prepare for adult life with schooling, we should be ready to face old age with a positive attitude.

I think women live longer than men because they never retire. A woman still has her house to run and maintains a constant purpose in life. Many men, however, see their work as the sole motivating force in their life and, after retirement, find they cannot cope with all the spare time. Those who have planned their retirements with new interests, hobbies, travel, and so on are seldom bored and are healthier and happier.

An active brain is a tremendous stimulant to enjoyable old age, but it is as well to be aware of the mental and physical changes and diseases that occur with advancing years.

Cancer, which becomes increasingly common with age, is thought to arise from the body’s cells undergoing mutation – a change in genetic structure. Our immune system recognizes these new cells as “foreign”, and destroys them. Mutations are believed to happen all the time, but a cancer does not develop unless the immune system fails to deal with a new cancer cell and the others it produces.

Once the cancer has developed, the body’s immune system may improve in efficiency and control it. This it may do spontaneously, or only after most of the tumor cells have been destroyed by surgery or radiation.

Cancer in the young often grows and spreads rapidly, whereas in the elderly the same type of cancer may progress slowly.

As we age, our skin becomes thin, wrinkled, and likely to react badly to any small insult. But in this country, skin changes are from the effects of the sun rather than the passing of time.

We can prepare our skin for old age only by caring for it during our youth and early adulthood. The sun-worship which gives the lovely teenage tan also leads to the old-before-its-time, wrinkled, thin skin of middle age.

The sun may also cause those white, scaly plaques called solar keratoses, which may later undergo a malignant change. Skin cancer is common in the older age group – mostly related to exposure to the sun’s ultraviolet light.

Eczema is another skin disorder that becomes more prevalent with age. It may develop around the ankles, sometimes in association with an ulcer, because of varicose veins and poor skin circulation.

Rupture of superficial blood vessels, because of the loss of elastic tissue, is common, and leads to bruising on the backs of the hands and forearms.

One of the great problems of age in men is the changes to the prostate gland, which lies at the base of the bladder. The prostate produces fluid which adds to the volume of the semen and nourishes the sperm.

Enlargement of the prostate is common, and this obstructs the flow of urine through the urethra, the tube that passes from the bladder through the prostate to the outside. Because of this, the bladder is not completely emptied, so urine has to be passed frequently both day and night. Backpressure of the urine on the kidneys causes the build-up of waste products in the blood.

Cancer may develop in the prostate – further blocking the urine flow – and this tends to spread to the bones. The obstruction can be overcome by operation, and the cancer symptoms are often relieved by the use of female hormones.

This treatment can, in some cases, prolong life. But, more importantly, it stops the pain in the bones due to the secondary spread of cancer. Unfortunately, female hormones take away the sexual urge and function.

Sexual function and interest may wane in both men and women with advancing age, but need not necessarily disappear. Men who continue to lead an active sexual life find they can retain the ability longer than those who abstain.

Urinary problems are not confined to males. Infections of the kidneys and bladder are common in women at any age, but more so in the elderly. One frequent complaint that causes a great deal of distress is inflammation in the urethra and at the base of the bladder. This may result in frequency, burning when the urine is passed, and precipitancy – the urgent desire to pass urine which, if not satisfied, may lead to incontinence.

Examination of the urine and X-rays may fail to detect infection, but a correct diagnosis can be made by looking directly into the bladder with an instrument called a cystoscope. In treating this complaint, antispasmodics, antibiotics, and chemicals are sometimes helpful. But most relief is obtained by dilating (stretching) the urethra. The condition is not cured, but relief can be obtained.

Old age can bring many emotional problems. The commonest is depression. This may be related to loss of self-esteem following retirement and the resulting reduction in income and lack of purpose in life. Loneliness may arise from children leaving home or the death of a partner.

Many drugs the elderly take for physical illnesses can also lead to depression, which may show itself as physical symptoms, lack of sleep, or agitation. These may cause the doctor to prescribe sedatives and tranquilizers, further depressing the patient.

This condition usually responds well to antidepressant drugs, but smaller doses than younger people can tolerate are needed. This applies to most drugs.

Many elderly people are worried by lack of sleep. They go to bed early and become concerned when they regularly wake up at two or three in the morning.

To remedy this, they ask their doctors for sleeping tablets and, though these may prolong the sleeping period, they frequently result in prolonged drowsiness. Often, tablets are unnecessary because, as we grow older, our bodies appear to need less sleep. So going to bed later, and rising at the same time as others, can be the answer.

The simple rules of life for the young which help to promote good health should help us to maintain that health as we age. Giving up cigarette smoking, taking more exercise, eating wisely, and losing excess weight is good living at any age.

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