IM NOT PRETTY ANYMORE

LBM 5 (AGING)
STEP 1
Aging Process
social, physic
-

: - accumulation of changes over time by physiologic,

Is a predictable process that involves growth and development of

living organism because of DNA damage. So, they go to some
destruction.
Ex : there is some thelomere the thelomere shortening time makin
lama makin memendek DNA makin banyak yg rusak
accumulation of cellular damage organism damage
Is a physiologic process

STEP 2
1.
2.
3.
4.
5.
6.
7.
8.
9.

Why she feel so dizzy and imbalance?

Why her skin looks more saggy especially around the eyes?
How physiologic of aging process?
Why her weight decrease and her body shape got thinner?
What is correlation between the lost of her period since 5 years ago
and the symptomps?
Why she suffer from blurred, hearing loss, easy to fall, especially from
sitting to standing?
What are the factor that influence the aging process?
What are phase of aging process?
What kind of health life style that can prevent the aging process?

STEP 3
1. How physiologic of aging process?
The aging process is constant and predictable, different in a one people
and the others.
There are 3 theory :
A. Antagonist theory
: is a theory that some gene (ex :
gene P53, normally P53 is a gene .. apoptosis that gene can
prevent cancer in a organism but gene P53 can inhibit he body
ability to renew the tissues. Overcross from normally and with
aging process

B. Neuroendocrin theory
: gene older, hormone decrease in
our body (ex : estrogene in women estrogene have primary
function for keep young in women to keep her elasticity in her
skin)
Hormone can influence neuron o work normally. When the hormone
is decrease neuron cant do normally function.
C. Disposable soma theory
: if the damage of DNA happens
maybe cause oxidative stress or radiation, pollution, make
mistake of replication in the structure of gene. So, if the mutation
happen in ovum and sperm cell, it can will be passed in the next
future generation
2. What
-

are the factor that influence the aging process?

Hormonal
Genetic
Ras
Environment
Radiation
Life style
Medical care

3. What are phase of aging process?

3 fase :
Fase sub klinik umur 25-35 tahun.
Mulai terjadi penurunan fungsi hormone. Ex : Estrogen dan
Growth Hormone
Fase transisi umur 35 45 tahun
Penurunan hormone yg awalnya sedikit turun mjd 25% disertai
penurunan massa otot dan penurunan energy.
Fase klinik 45 tahun keatas
Penurunan densitas tulang cenderung mbungkuk. Penurunan
nutrisi.
4. Why she feel so dizzy and imbalance?
- Dizzy ada perubahan fisik pada wanita yg tua. Ada perubahan
sel, pendengaran, saraf, dan kardiovaskuler.
- KardiovascularKehilangan elastisias pembuluh darah perifer
penurunan oksigenasi perubahan posisi dr duduk ke
berdirimengganggu
- She is decrease of immune system
- Imbalance gangguan keseimbangan in bone atrophy in
muscle and make her slowly and tremor.
- Decrease the density of bone make her weak

- Tendonnya mengerut mengalami sklerosis

- Persendiannya membesar gerakannya menjadi kaku
- Telinga punya 2 fungsi :
1. Hearing
2. Balance
control of person in the inner ear. Fliud and small hair (cilia) in the
semi circular canal / labyriinthi stimulate the nerve, that helps the
brain maintain balance.
5. Why her skin looks more saggy especially around the eyes?
- She lost of her fat and lost of elasticity of her skin because she
los fluid and vascularitation. And she lost sebacea glands
- 3 part of skin : epidermis (pigmen) , dermis (blood vessels and
nerve) , subcutan (sebacea glands and sudorifera, 2 connective
tissue (collagen fibers to support and elastin fibers strength
and elasticity)
- Blood vessel give nutrition in dermis. If there is obstruction
decrease oxigene disribution
- Aging estrogene make epidermis thiner. So connective tissue
decrease and reduce elasticity of the skin.
- Getting older of women decreasing function of glandslost oil
dry skin saggy / slacker skin
- Muncul kerutan penurunan jumlah fibroblast penurunan
serat elastin kulit kendor
- Otot atrofi jar. Lemak subkutan berkuang kehilangan daya
kekenyalan keriput
- Konraksi otot-otot wajah dan tidak disertai kontraksi kulit
menyebabkan kendor
- In epidermis there is melanosit. In aging decreasing melanosit
but became bigger shape.
- UV radiaton makes destruction of elastin and collagen foto
aging (penuaan dini) saggy skin
6. Why her weight decrease and her body shape got thinner?
- 55 years old the amount of muscle tissue is decrease make
her weight decrease.
- Decrease of absorbtion nutrition
7. What is correlation between the lost of her period since 5 years ago
and the symptomps?
Neuroendocrin theory
: gene older, hormone decrease in our
body (ex : estrogene in women estrogene have primary function for
keep young in women to keep her elasticity in her skin)

Ovarium isnt responsive with gonadotropin. In older people lost of

function so she lost sexual cycle decrease of primordial follicle so
fast when menopause ovarium isnt make progesterone and 17-Beta
estradiol make estrogene in small amount.
8. Why she suffer from blurred, hearing loss, easy to fall, especially from
sitting to standing?
Hearing loss : atrophy of timpani membrane cause otosklerosis (ada
kekakuan) some collective serumen make obstruction
destruction of hearing.
Gangguan tulang pendengaran.
9. What kind of health life style that can prevent the aging process?
Healty food
Exercise
Drink mineral water
Avoid stress
Medical care
10.
Disease related with aging process (Penyakit yang mempercepat
proses penuaan)
STEP 4

Aging Process

3 Theory

Factor
(environment,
genetic, etc)

symptom

pencegahan

3 phase

STEP 7
1. How physiologic of aging process?
Teori genetic clock
Menua tlh terprogram sec genetik utk spesies2 tertentu.
Tiap species mempunyai di dlm nucleinya suatu jam genetik yg tlh
diputar menurut suatu replikasi tertentu.
Jam ini akan menghitung mitosis & menghentikan replikasi sel bila tdk
diputar, jadi menurut konsep ini bila jam kita itu berhenti maka akan
meninggal dunia.
Pengontrolan genetik umur, rupanya dikontrol dalam tingkat seluler.
Penelitian Hayflick menunjukkan bahwa ada hubungan antara
kemampuan membelah sel dlm kultur dgn umur spesies. Dari
penelitian ini jelas bahwa nukleuslah yg menentukan jml replikasi,
kemudian menua & mati.
Mutasi somatiK (teori Error Catastrophe)
Faktor2 penyebab tjdnya proses menua adalah faktor lingkungan yg
menyebabkan tjdnya mutasi somatik, seperti radiasi & zat kimia yg
dpt memperpendek umur.
Menurut teori ini, tjdnya mutasi yg progresif pd DNA sel somatik, akan
menyebabkan tjdnya penurunan kemampuan fungsional sel.
Menurut hipotesis tsb, menua disebabkan oleh kesalahan2 yg
beruntun sepanjang kehidupan stlh berlangsung dlm waktu yg cukup
lama, tjd kesalahan dlm proses transkripsi (DNA RNA), maupun dlm
proses translasi (RNA protein/enzim).
Kesalahan tsb akan menyebabkan terbentuknya enzim yg salah &
akan menyebabkan tjdnya reaksi metabolisme yg salah pula,
sehingga akan mengurangi fungsional sel.
Bila tjd kesalahan dlm proses translasi (pembuatan protein), maka
akan tjd kesalahan yg makin banyak, shg tjdlah katastrop.
Rusaknya sistem imun tubuh

 Mutasi yg berulang atau perubahan protein pascatranslasi, dpt

menyebabkan berkurangnya kemampuan sist imun tubuh mengenali
dirinya sendiri (self recognition).
Jika mutasi somatik menyebabkan tjdnya kelainan pd antigen
permukaan sel, maka hal ini dpt menyebabkan sist imun tubuh
menganggap sel yg mengalami perubahan tsb sbg sel asing &
menghancurkannya.
Teori menua akibat metabolisme
Menurut McKay, pengurangan intake kalori akan emnghambat
pertumbuhan & memperpanjang umur.
Perpanjangan umur tsb berasosiasi dgn tertundanya proses
degenerasi.

Kerusakan akibat radikal bebas

Wkt tjd proses respirasi, oksigen yg dilibatkan dlm mengubah bahan
bakar mjd ATP. Melalui enzim2 respirasi dlm mitokondria, maka radikal
bebas (RB) akan dihasilkan sbg zat antara.
RB bersifat merusak, krn sangat reaktif, shg dpt bereaksi dgn DNA,
protein, as.lemak tak jenuh, seperti membran sel.
Makin lanjut usia makin byk RB terbentuk shg proses pengrusakan
terus tjd.
(R.Boedhi Darmojo, dkk.2006.Buku Ajar Geriatri, Ilmu Kesehatan Lanjut
Usia.Jakarta:FKUI)
Teori radikal bebas
Produk hasil metabolisme oksidatif yg sangat reaktif (RB) dpt bereaksi
dgn berbagai komponen selular, termasuk protein, DNA, & lipid, & mjd
molekul2 yg tdk berfungsi namun bertahan lama & mengganggu
fungsi sel lainnya.
RB adalah senyawa kimia berisi elektron tdk berpasangan. Krn
elektronnya tdk berpasangan, secara kimiawi RB akan mencari
pasangan elektron lain dgn bereaksi pd substansi lain terutama
protein & as.lemak tak jenuh. Melalui proses oksidasi, RB yg
dihasilkan selama fosforilasi oksidatif dpt menghasilkan modifikasi
makromolekul. Sbg contoh, krn membran sel mengandung sejumlah
lemak, ia dpt bereaksi dgn RB shg membran sel mengalami
perubahan.
Struktur di dlm sel seperti mitokondria & lisosom diselimuti oelh
membran yg mengandung lemak shg mudah diganggu oleh RB. RB jg
dpt bereaksi dgn DNA, menyebabkan mutasi kromosom & merusak
mesin genetik normal dr sel. RB dpt merusak fungsi sel dgn merusak
membran sel atau kromosom sel.

 Tdpt akumulasi RB secara bertahap di dlm sel sejalan dgn waktu, &
bila kadarnya memebihi konsentrasi ambang, maka mereka
berkontribusi pd perubahan2 yg seringkali dikaitkan dgn penuaan.
Teori glikosilasi
Proses glikosilasi nonenzimatik yg menghasilkan pertautan glukosaprotein yg disebut sbg advanced glycation end products (AGEs) dpt
menyebabkan penumpukan protein & makromolekul lain yg
termodifikasi shg menyebabkan disfungsi pd manusia yg menua.
Protein glikasi menunjukkan perubahan fungsional, meliputi
menurunnya aktivitas enzim & menurunnya degradasi protein
abnormal. Ketika manusia menua, AGEs berakumulasi di berbagai
jaringan, termasuk kolagen, Hb, lensa mata. Krn muatan kolagennya
tinggi, maka jaringan ikat mjd kurang elastis & kaku. Kondisi tsb jg dpt
mempengaruhi elastisitas dinding pembuluh darah. AGEs jg dpt
berinteraksi dgn DNA & mengakibatkan terganggunya kemampuan
sel utk memperbaiki perubahan pd DNA.
Teori DNA repair
Menunjukkan bahwa adanay perbedaan pola laju repair kerusakan DNA
yg diinduksi sinar UV pd berbagai fibroblas yg dikultur. Fibroblas pd
species yg mempunyai umur maksimum terpanjang menunjukkan laju
DNA repair terbesar.
(IPD FKUI, Jilid III, Edisi IV)

2. What are the factor that influence the aging process?

factor2 yg mempengaruhi proses penuaan
Endogenic aging
Yang dimulai dengan cellular aging, lewat tissue dan anotomical
aging ke arah proses menuanya organ tubuh. Proses ini seperti
jam yang terus berputar.
Exogenic factor
Dapat dibagi dalam sebab lingkungan (environment) dimana
seseorang hidup dan faktor sosio budaya yang paling tepat
disebut gaya hidup (life style). Faktor exogenic tadi , sekarang
lebih dikenal dengan sebutan faktor resiko
(Buku Geriatri FK UI)

3. What are phase of aging process?

Menurut Organisasi Kesehatan Dunia (WHO)
Lanjut usia meliputi :
- Usia pertengahan (middle age), ialah kelompok usia 45 sampai 59
tahun.
- Lanjut usia (elderly) ialah antara 60 dan 74 tahun.
- Lanjut usia tua (old) ialah antara 75 dan 90 tahun.
- Usia sangat tua (very old) ialah di atas 90 tahun
Menurut Dra.Ny.Jos Masdani (Psikolog UI)
Mengatakan lanjut usia merupakan kelanjutan dari usia dewasa.
Kedewasaan dapat dibagi menjadi 4 bagian.
- Pertama : fase iuventus, antara 25 dan 40 tahun,
- Kedua

: fase verilitas, antara 40 dan 50 tahun,

- Ketiga

: fase prasenium, antara 55 dan 65 tahun,

- Keempat: fase senium, antara 65 tahun hingga tutup usia.

Menjadi tua adalah suatu proses natural dan kadang-kadang tidak tampak
mencolok. Penuaan akan terjadi pada hampir semua sistem tubuh
manusia dan tidak semua sistem akan mengalami kemunduran pada
waktu yang sama. Meskipun proses menjadi tua merupakan gambaran
yang universal, tidak seorangpun mengetahui dengan pasti penyebab
penuaan dan mengapa manusia menjadi tua pada usia yang berbedabeda
Sumber : Sri Surini Pudjiastuti, SMPh, S.Pd, Budi Utomo, AMF.
Fisioterapi pada Lansia, Penerbit Buku Kedokteran EGC, 2003.
Terdapat beberapa istilah yang digunakan oleh gerontologist ketika
membicarakan proses menua
a Aging ( bertambah umur ): menunjukkan efek waktu, suatu proses
perubahan, biasanya bertahap dan spontan
b Senescense ( menjadi tua ) : hilangnya kemampuan sel untuk
membelah dan berkembang ( seiring waktu akan menyebabkan
kematian )

c Homeostenosis : penyempitan / berkurangnya cadangan

homeostasis yang terjadi selama penuaan pada setiap system
organ
Sumber : Buku Ajar Ilmu Penyakit Dalam JILID 1 EDISI V, 2009,
Ari W.Sudoyo dkk, FKUI

4. Why she feel so dizzy and imbalance?

pusing karena sirkulasi otak pada orang tua sangat rentan terhadap
perubahan2, baik perubahan posisi maupun factor lain mis:tekanan darah
seperti fungsi jantung bahkan fungsi otak sendiri yang berkaitan dengan
pengaturan tekanan darah, gerakan leher tertentu ,akibat a.vertebrales
yang berkelok2 dapat berakibat insufisiensi sirkulasi di daerah batang
otak yang dapat menimbulkan pusing atau kepala terasa ringan dan tiba2
jatuh.
Sumber : Buku ajar GERIATRI R.Boedhi Darmoyo,H.Hadi
Martono FKUI
5. Why her skin looks more saggy especially around the eyes?
With aging, the outer skin layer (epidermis) thins even though
the number of cell layers remains unchanged. The number of
pigment-containing cells (melanocytes) decreases, but the
remaining melanocytes increase in size. Aging skin thus appears
thinner, more translucent. Age spots or liver spots may appear in
sun-exposed areas. Changes in the connective tissue reduce the
skin's strength and elasticity. This is known as elastosis and is
especially pronounced in sun-exposed areas.
http://adam.about.net/encyclopedia/Changes-in-face-withage_1.htm
6. Why her weight decrease and her body shape got thinner?
Regulation of food intake changes with increasing age, leading
to what has been called a physiological anorexia of aging.
The amount of circulating cholecystokinin, a satiating hormone,
increases in the circulation.

Other substances are also thought to cause satiety.

The interplay between the brain and the gut is gaining increasing
attention as a mechanism of anorexia and subsequent weight loss. A
highly complex process involving taste sensation, neural and humoral
signals from the gastrointestinal tract, and neurotransmitters and
peptides in the hypothalamus or other brain regions regulates food
intake and, consequently, energy homeostasis.
Psychosocial and spiritual distress can also influence the sensation of
hunger, appetite, or satiety.
Loss of lean body mass is common in older people.
Advancing age is also associated with a decrease in the basal metabolic
rate as well as with changes in the senses of taste and smell.
Overly restricted diets, such as those that are low in fat and salt, may
cause decreased intake; therefore, a special or restricted diet (low in
cholesterol, salt, or concentrated sweets) often reduces food intake
without significantly improving the clinical status.
The role of inflammatory cytokines, including tumor necrosis factor
(TNF, formerly cachectin), interleukin-1 (IL-1), and interleukin-6, has also
been postulated.
Physiological changes in the regulation of food intake take place, even in
the presence of the increased body fat and the increased rates of
obesity that occur with age, some of which can be explained by altered
patterns of physical activity.
Generally speaking, individuals aged 65 years and older experience a
mild loss of weight, a near doubling of adiposity, and a significant nonfat mass loss of 5% to 15%.
Sarcopenia, the loss of skeletal muscle massand thus leading to a loss
of proteinmay play an important role in IWL. Muscle loss can be the
result of negative nitrogen balance that occurs with normal aging and
with inadequate protein intake, which is commonly observed among the
elderly.
Agerelated changes in anabolic hormones may contribute to nonfat
mass loss. Low testosterone levels in men correlate with the loss of lean
body mass, and loss of estrogen during menopause is associated with
non-fat mass loss in women.
Growth hormone appears to play an important role in body composition;
growth hormone levels may decrease by 14% per decade.
It has been found that replacement of growth hormone in older people
results in increased lean body mass and reduced fat mass.

7. What is correlation between the lost of her period since 5 years ago
and the symptomps?
8. Why she suffer from blurred, hearing loss, easy to fall, especially from
sitting to standing?
Penurunan pendengaran merupakan kondisi yang secara dramatis
dapat mempengaruhi kualitas hidup. Kehilangan pendengaran pada
lansia disebut presbikusis.
Berikut ini merupakan perubahan yang terjadi pada penglihatan akibat
proses menua:
Pada

telinga

bagian

dalam

terdapat

penurunan

fungsi

sensorineural, hal ini terjadi karena telinga bagian dalam dan

komponen saraf tidak berfungsi dengan baik sehingga terjadi
perubahan konduksi. Implikasi dari hal ini adalah kehilangan
pendengaran

secara

bertahap.

Ketidak

mampuan

untuk

mendeteksi volume suara dan ketidakmampuan dalam mendeteksi

suara dengan frekuensi tinggi seperti beberapa konsonan (misal f,
s, sk, sh, l).
Pada telinga bagian tengah terjadi pengecilan daya tangkap
membran timpani, pengapuran dari tulang pendengaran, otot dan
ligamen menjadi lemah dan kaku. Implikasi dari hal ini adalah
gangguan konduksi suara.2
Pada telingan bagian luar, rambut menjadi panjang dan tebal, kulit
menjadi lebih tipis dan kering, dan peningkatan keratin. Implikasi
dari

hal

ini

adalah

potensial

terbentuk

serumen

sehingga

berdampak pada gangguan konduksi suara

Sumber : Pringgoutumo, dkk. 2002. Buku Ajar Patologi 1
(umum), Edisi 1. Jakarta. Sagung Seto

Normal Changes in the Aging Eye What We All Can Expect

Losing Focus
The most common age-related vision change presbyopia happens to
almost everyone beginning between the ages of 40 and 50. A natural result
of aging, the lens begins to lose elasticity, making it harder to focus vision up
close for such activities as reading. But presbyopia can be corrected easily
with reading glasses or glasses with bifocal, trifocal or progressive (no-line)
lenses.
Declining Sensitivity
The lens of the eye also becomes increasingly dense and more yellow with
age. These changes may affect color perception and contrast sensitivity. For
instance, the color blue may appear darker and harder to distinguish from
black. And it may become difficult to tell where an object ends and its
background begins, making it difficult to see curbs or steps, for example.
Needing More Light
As the eye ages, the pupil gets smaller, resulting in the need for more light
to see well, along with more time to adjust to changing levels of illumination
(going from daylight into a dark theater or dimly lit restaurant, for example).

HEARING

With aging, ear structures deteriorate. The eardrum often thickens and the
inner ear bones and other structures are affected.

Your ears have two jobs. One is hearing and the other is maintaining balance.
Hearing occurs after vibrations cross the eardrum to the inner ear. They are
changed into nerve impulses and carried to the brain by the auditory nerve.
Balance (equilibrium) is controlled in a portion of the inner ear. Fluid and
small hairs in the semicircular canal (labyrinth) stimulate the nerve that
helps the brain maintain balance.
As you age, your ear structures deteriorate. The eardrum often thickens and
the bones of the middle ear and other structures are affected. It often
becomes increasingly difficult to maintain balance.
Hearing may decline slightly, especially that of high-frequency sounds,
particularly in people who have been exposed to a lot of noise when younger.
This age-related hearing loss is called presbycusis. Some hearing loss is
almost inevitable. It is estimated that 30% of all people over 65 have
significant hearing impairment.
The sharpness (acuity) of hearing may decline slightly beginning about age
50, possibly caused by changes in the auditory nerve. In addition, the brain
may have a slightly decreased ability to process or translate sounds into
meaningful information. Impacted ear wax is another cause of trouble
hearing and is more common with increasing age. Impacted ear wax may be
removed in your doctor's office.
Sensorineural hearing loss involves damage to the inner ear, auditory nerve,
or the brain. This type of hearing loss may or may not respond to treatment,
but function can be helped by hearing aids.
Conductive hearing loss occurs when sound has problems getting through
the outer and middle ear to the inner ear. Surgery or a hearing aid may be
helpful for this type of hearing loss, depending on the specific cause.
Persistent, abnormal ear noise (tinnitus) is another fairly common hearing
problem, especially for older adults. It is usually a result of mild hearing loss.

Easy to fall
Hip and knee joints may begin to lose joint cartilage (degenerative changes).
The finger joints lose cartilage and the bones thicken slightly. Finger joint
changes are more common in women and may be hereditary.

Some joints, such as the ankle, typically change very little with aging.
Lean body mass decreases, caused in part by loss of muscle tissue (atrophy).
The rate and extent of muscle changes seem to be genetically determined.
Muscle changes often begin in the 20s in men and the 40s in women.
Lipofuscin (an age-related pigment) and fat are deposited in muscle tissue.
The muscle fibers shrink. Muscle tissue is replaced more slowly, and lost
muscle tissue may be replaced with a tough fibrous tissue. This is most
noticeable in the hands, which may appear thin and bony.
Changes in the muscle tissue, combined with normal aging changes in the
nervous system, cause muscles to have less tone and ability to contract.
Muscles may become rigid with age and may lose tone, even with regular
exercise.
EFFECT OF CHANGES
Bones become more brittle and may break more easily. Overall height
decreases, mainly because of shortening of the trunk and spine.
Inflammation, pain, stiffness, and deformity may result from breakdown of
the joint structures. Almost all elderly people are affected by joint changes,
ranging from minor stiffness to severearthritis.
The posture may become more stooped (bent) and the knees and hips more
flexed. The neck may become tilted, and the shoulders may narrow while the
pelvis becomes wider.
Movement slows and may become limited. The walking pattern (gait)
becomes slower and shorter. Walking may become unsteady, and there is
less arm swinging. Older people become tired more easily, and have less
energy.
Strength and endurance change. Loss of muscle mass reduces strength.
However, endurance may be enhanced somewhat by changes in the muscle
fibers. Aging athletes with healthy hearts and lungs may find that
performance improves in events that require endurance, and decreases in
events that require short bursts of high-speed performance.
COMMON PROBLEMS
Osteoporosis is a common problem, especially for older women. Bones break
more easily, and compression fractures of the vertebrae can cause pain and
reduce mobility.

Muscle weakness contributes to fatigue, weakness, and reduced activity

tolerance. Joint problems are extremely common. This may be anything from
mild stiffness to debilitating arthritis (see osteoarthritis).
The risk of injury increases because gait changes, instability, and loss of
balance may lead to falls.
Some elderly people have reduced reflexes. This is most often caused by
changes in the muscles and tendons, rather than changes in the nerves.
Decreased knee jerk or ankle jerk can occur. Some changes, such as a
positive Babinski's reflex, are not a normal part of aging.
Involuntary
movements
(muscle
tremors
and
fine
movements
called fasciculations) are more common in the elderly. Inactive or immobile
elderly people may experience weakness or abnormal sensations
(paresthesias).
Muscle contractures may occur in people who are unable to move on their
own or have their muscles stretched through exercise.
PREVENTION
Exercise is one of the best ways to slow or prevent problems with the
muscles, joints, and bones. A moderate exercise program can help you
maintain strength and flexibility. Exercise helps the bones stay strong.
Consult with your health care provider before beginning a new exercise
program.
A well-balanced diet with adequate amounts of calcium is important. Women
need to be especially careful to get enough calcium and vitamin D as they
age. Postmenopausal women, and men over age 65, need 1,200 - 1,500 mg
of calcium and 400 - 800 international units of vitamin D per day. If you have
osteoporosis, talk to your doctor about prescription treatments.
References
Minaker KL. Common clinical sequelae of aging. In: Goldman L, Ausiello D,
eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap
23.

9. What kind of health life style that can prevent the aging process?

The concept of successful ageing can be traced back to the 1950s, and
popularised in the 1980s. Previous research into ageing exaggerated the
extent to which health disabilities, such as diabetesor osteoporosis, could be
attributed exclusively to age, and research in gerontology exaggerated the
homogeneity of samples of elderly people.[32][33]
Successful ageing consists of three components:[34]
1. Low probability of disease or disability;
2. High cognitive and physical function capacity;
3. Active engagement with life.
A greater number of people self-report successful ageing than those that
strictly meet these criteria.[32]
Successful ageing may be viewed an interdisciplinary concept, spanning
both psychology and sociology, where it is seen as the transaction between
society and individuals across the life span with specific focus on the later
years of life.[35] The terms "healthy ageing"[32] "optimal ageing" have been
proposed as alternatives to successful ageing.
Six suggested dimensions of successful ageing include:[19]
1. No physical disability over the age of 75 as rated by a physician;
2. Good subjective health assessment (i.e. good self-ratings of one's
health);
3. Length of undisabled life;
4. Good mental health;
5. Objective social support;
6. Self-rated life satisfaction in eight domains, namely marriage,
income-related work, children, friendship and social contacts, hobbies,
community service activities, religion and recreation/sports.

You can't change genetics, but you can make healthy lifestyle choices
to delay aging or reduce the opportunity for ill health. Avoid tobacco
products and alcohol abuse. Choose to eat healthy and nutritious foods
and stay fit.
Drink lots of water to maintain healthy skin. Use moisturizers and
sunscreen. Visit the foot doctor (podiatrist) regularly to assure good

foot care. After all, you use your feet all day to get around in this
world.
Keep your heart active by doing aerobic exercises. Aerobic exercises
keep the heart working, which keeps the blood pumping, which brings
oxygen to the lungs, which makes breathing easier, which makes a
person feel more energetic. It reduces the risk of stroke, heart disease
and CHF. As Martha Stewart says, "Its a good thing." See your doctor
before starting any aerobic activities.
Stay physically active throughout the age span. Work to maintain
strength in muscles and lungs to promote deep breathing and getting
oxygen to the blood. The result will be an increase in energy and vigor,
feeling better about life, and a greater ability to do preferred activities.
Avoid smoking, being near smokers and polluted environments. Take
slow deep breathes regularly. Wake up and smell the roses.
Regular physical exercise throughout the lifespan helps reduce the
negative effects of age related changes. So, the best tip is to stay
physically active. Work on maintaining muscle strength and joint and
muscle flexibility. Tai Chi is an excellent resource. To prevent
constipation, drink lots of water. Water really does help. Remember to
try to drink at least 5-6 eight ounce glasses of water a day.
To keep healthy bones, it is important to stay active. Weight bearing
activities that make the muscles and joints move around can help to
maintain healthy bones. Take a look at calcium supplements. All
boomers and people 65 or older should see a doctor for medical advice
before starting an exercise program.
Eat lots of greens and orange foods such as spinach,
asparagus, and carrots. Pay attention to declining driving
skills, because unsafe driving is a skill that can kill.
More of the same, stay active, eat small amounts of food throughout
the day to maintain an energetic metabolic system, and drink lots of
water.

http://ist-socrates.berkeley.edu/~aging/ModuleProcess.html#anchor157481
Dr. Vanessa M. Dazio, OTD, OTR SAFE Aging, Inc. 2006 9330 Regency Park Blvd. Suite C, Port Richey, FL 34668
727-848-

10.
Disease related with aging process (Penyakit yang mempercepat
proses penuaan)
Penyakit sistem paru dan kardiovaskuler.
a. Paru-paru

Fungsi paru-paru mengalami kemunduran disebabkan berkurangnya

elastisitas jaringan paru-paru dan dinding dada, berkurangnya
kekuatan kontraksi otot pernafasan sehingga menyebabkan sulit
bernafas. Infeksi sering diderita pada lanjut usia diantaranya
pneumonia, kematian cukup tinggi sampai 40 % yang terjadi karena
daya tahan tubuh yang menurun. Tuberkulosis pada lansia
diperkirakan masih cukup tinggi.
b. Jantung dan pembuluh darah (kardiovaskuler).
Pada orang lanjut usia, umumnya besar jantung akan sedikit menurun.
Yang paling banyak mengalami penurunan adalah rongga bilik kiri,
akibat semakin berkurangnya aktivitas dan juga mengalami penurunan
adalah

besarnya

sel-sel

otot

jantung

menurunnya kekuatan otot jantung.

hingga

menyebabkan

Pada lansia,tekanan darah

meningkat secara bertahap. Elastisitas jantung pada orang berusia 70

tahun menurun sekitar 50 % dibanding orang berusia 20 tahun.
Tekanan darah pada wanita tua mencapai 170/90 mmHg dan pada
pria tua mencapai 160/100 mmHg masih dianggap normal.
Pada lansia banyak dijumpai penyakit jantung koroner yang disebut
jantung iskemi. Perubahan-perubahan yang dapat dijumpai pada
penderita jantung iskemi
adalah pada pembuluh darah jantung akibat arteriosklerosis serta
faktor pencetusnya bisa karena banyak merokok, kadar kolesterol
tinggi, penderita diabetes mellitus dan berat badan berlebihan serta
kurang berolah raga. Masalah lain pada lansia adalah hipertensi yang
sering ditemukan dan menjadi faktor utama penyebab stroke dan
penyakit jantung koroner.
2. Penyakit pencernaan makanan.
Penyakit yang sering terjadi pada saluran pencernaan lansia antara
lain gastritis dan ulkus peptikum, dengan gejala yang biasanya tidak
spesifik, penurunan berat badan, mual-mual, perut terasa tidak enak.
Namun keluhan seperti kembung, perut terasa tidak enak seringkali
akibat ketidakmampuan mencerna makanan karena menurunnya
fungsi kelenjar pencernaan. Sembelit/konstipasi kurang nafsu makan
juga sering dijumpai.

3. Penyakit sistem urogenital.

Pada pria berusia lebih dari 50 tahun bisa terjadi pembesaran kelenjar
prostat (hipertrofi prostat), yang mengakibatkan gangguan buang air
kecil, sedang pria lanjut usia banyak dijumpai kanker pada kelenjar
prostat.Pada wanita bisa dijumpai peradangan kandung kemih sampai
peradangan ginjal akibat gangguan buang air kecil. Keadaan ini
disebabkan berkurangnya tonus kandung kemih dan adanya tumor
yang menyumbat saluran kemih.
4. Penyakit gangguan endokrin (metabolik).
Dalam sistem endokrin , ada hormon yang diproduksi dalam jumlah
besar di saat stress dan berperan penting dalam reaksi mengatasi
stress. Oleh karena itu, dengan mundurnya produksi hormon inilah
lanjut usia kurang mampu menghadapi stress. Menurunnya hormon
tiroid juga menyebabkan lansia tampak lesu dan kurang bergairah.
Kemunduran

fungsi

kelenjar

endokrin

lainnya

seperti

adanya

menopause pada wanita, sedang pada pria terjadi penurunan sekresi

kelenjar testis. Penyakit metabolik yang banyak dijumpai ialah diabetas
melitus dan osteoporosis.
5. Penyakit pada persendian tulang.
Penyakit pada sendi ini adalah akibat degenerasi atau kerusakan
pada permukaan sendi-sendi tulang yang banyak dijumpai pada
lansia. Lansia sering mengeluhkan linu-linu, pegal, dan kadang-kadang
terasa nyeri. Biasanya yang terkena adalah persendian pada jari-jari,
tulang

punggung,

sendi-sendi

lutut

dan

panggul.

Gangguan

metabolisme asam urat dalam tubuh (gout) menyebabkan nyeri yang

sifatnya akut. Terjadinya osteoporosis menjadi menyebab tulang-tulang
lanjut usia mudah patah. Biasanya patah tulang terjadi karena lanjut
usia tersebut jatuh, akibat kekuatan otot berkurang, koordinasi
anggota badan menurun, mendadak pusing,penglihatan yang kurang
baik, dan bisa karena cahaya kurang terang dan lantai yang licin.
6. Penyakit yang disebabkan proses keganasan.
Penyebab pasti belum diketahui, hanya nampak makin tua seseorang
makin mudah dihinggapi penyakit kanker. Pada wanita, kanker banyak

dijumpai pada rahim, payudara dan saluran pencernaan, yang

biasanya dimulai pada usia 50 tahun. Kanker pada pria paling banyak
dijumpai pada paru-paru, saluran pencernaan dan kelenjar prostat.