IM NOT PRETTY ANYMORELBM 5 (AGING)STEP 1Aging Process: - accumulation of changes over time by physiologic, social, physic 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 21. Why she feel so dizzy and imbalance?2. Why her skin looks more saggy especially around the eyes?3. How physiologic of aging process?4. Why her weight decrease and her body shape got thinner?5. What is correlation between the lost of her period since 5 years ago and the symptomps?6. Why she suffer from blurred, hearing loss, easy to fall, especially from sitting to standing?7. What are the factor that influence the aging process?8. What are phase of aging process?9. What kind of health life style that can prevent the aging process?

STEP 31. 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 processB. 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 tahunPenurunan hormone yg awalnya sedikit turun mjd 25% disertai penurunan massa otot dan penurunan energy. Fase klinik 45 tahun keatasPenurunan 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. Hearing2. Balancecontrol 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 foodExerciseDrink mineral waterAvoid stressMedical care

10. Disease related with aging process (Penyakit yang mempercepat proses penuaan)

STEP 4

pencegahanFactor (environment, genetic, etc)Aging Processsymptom3 phase3 Theory

STEP 71. 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 glukosa-protein 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 repairMenunjukkan 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 agingYang dimulai dengan cellular aging, lewat tissue dan anotomical aging ke arah proses menuanya organ tubuh. Proses ini seperti jam yang terus berputar. Exogenic factorDapat 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 : 1. Usia pertengahan (middle age), ialah kelompok usia 45 sampai 59 tahun. 1. Lanjut usia (elderly) ialah antara 60 dan 74 tahun. 1. Lanjut usia tua (old) ialah antara 75 dan 90 tahun. 1. 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. 1. Pertama: fase iuventus, antara 25 dan 40 tahun, 1. Kedua: fase verilitas, antara 40 dan 50 tahun,1. Ketiga: fase prasenium, antara 55 dan 65 tahun,1. 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 berbeda-bedaSumber : 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 menua1. Aging ( bertambah umur ): menunjukkan efek waktu, suatu proses perubahan, biasanya bertahap dan spontan1. Senescense ( menjadi tua ) : hilangnya kemampuan sel untuk membelah dan berkembang ( seiring waktu akan menyebabkan kematian )1. 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 FKUI5. 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-with-age_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 alteredpatterns 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 non-fat 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 suaraSumber : Pringgoutumo, dkk. 2002. Buku Ajar Patologi 1 (umum), Edisi 1. Jakarta. Sagung Seto

Normal Changes in the Aging Eye What We All Can ExpectLosing FocusThe 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 SensitivityThe 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 LightAs 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 calledpresbycusis. Somehearing lossis 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. Impactedear waxis 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 fallHip 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 normalaging 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 CHANGESBones 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 PROBLEMSOsteoporosisis a common problem, especially for older women. Bones break more easily, and compressionfracturesof 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 (seeosteoarthritis).The risk of injury increases becausegait changes, instability, andloss of balancemay 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 positiveBabinski's reflex, are not a normal part of aging.Involuntary movements (muscle tremors and fine movements calledfasciculations) 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.PREVENTIONExercise 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.Awell-balanced dietwith 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.ReferencesMinaker 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 ofsuccessful ageingcan be traced back to the 1950s, and popularised in the 1980s. Previous research into ageing exaggerated the extent to which health disabilities, such asdiabetesorosteoporosis, could be attributed exclusively to age, and research ingerontologyexaggerated the homogeneity of samples of elderly people.[32][33]Successful ageingconsists 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 bothpsychologyandsociology, 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. Goodmental health;5. Objectivesocial support;6. Self-rated life satisfaction in eight domains, namelymarriage, 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 hingga menyebabkan menurunnya kekuatan otot jantung. 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.