Why Does Function Decline?

For most people most of the time, the decline in organ function does not affect the body's ability to function during normal daily activities. People usually notice the decline in organ function only when very demanding tasks are attempted or when a disorder develops. For example, the amount of blood pumped by the heart during vigorous exercise decreases as people age. Older people may notice this change only when they play tennis or jog, not when they take a walk. They may notice changes in brain function only when they try to learn new information, such as a new language.

A noticeable decline in function is more likely to result from factors other than aging itself. The most common culprit is a disorder. A disorder may cause pain or confusion, make movement more difficult, rob a person of energy, or lead to depression.

The psychologic, sociologic, and financial situation of older people affects their behavior. Their behavior, in turn, affects their ability to function. Fear or worry may cause older people to become less active. If older people are less active, their ability to function tends to decline. Older people may fear being hurt or embarrassed, so they withdraw from their favorite activities and stay home. Older people with balance problems may fear that they might fall and break a bone. Older people with urinary incontinence may worry that they could have a wetting accident. Not having a partner with whom to share experiences or not having adequate funds may also stop people from participating in activities. People who participate in meaningful activities tend to remain healthy and live longer, as do people who have social support (married men in particular), adequate funds (those in a higher socioeconomic bracket), and a higher educational level.

Taking preventive measures can help older people remain healthy, active, and able to function. Older people can develop healthy habits and continue to participate in activities. Learning to recognize situations and tendencies (such as fear) that can lead to further problems can help. Having a positive attitude toward aging—expecting life to continue to be full, hopeful, and worthwhile—can also help.

If older people remain fit and well, they do not lose their ability to remember, learn, think, and reason. They can remain physically active and capable. They can adapt to change. They can resist most disorders. When they develop a disorder, they can tolerate and respond to medical and surgical treatments and usually recover.