J Korean Med Assoc.  2017 May;60(5):358-363. 10.5124/jkma.2017.60.5.358.

Normal aging: definition and physiologic changes

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. tren125@yuhs.ac
  • 2Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Aging is a process of the progressive functional decline with time, leading to disability, dependence, morbidity, and mortality. While the organ function in the elderly is relatively uncompromised under basal conditions, their ability to tolerate increased physiologic stress is reduced. And the extent and onset of the deterioration in functional reserve is quite diverse from patient to patient. The aging population is rapidly growing and their medical management is becoming one of the greatest challenges to anesthesiologists. The understanding of the normal physiologic changes with aging is essential to frame any discussion of perioperative management in the elderly. In this review, we will focus on the physiologic changes in neurologic, cardiac, pulmonary, renal, and hepatic function, and thermoregulation.

Keyword

Aging; Mechanism; Physiology

MeSH Terms

Aged
Aging*
Body Temperature Regulation
Humans
Mortality
Physiology

Cited by  1 articles

Importance of perioperative management of geriatric anesthesia
Il-Ok Lee
J Korean Med Assoc. 2017;60(5):356-357.    doi: 10.5124/jkma.2017.60.5.356.


Reference

1. Sieber FE, Pauldine R. Geriatric anesthesia. In : Miller RD, Cohen NH, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, editors. Miller's anesthesia. 8th ed. Philadelphia: Elsevier/Saunders;2015. p. 2407–2408.
2. Weinert BT, Timiras PS. Invited review: theories of aging. J Appl Physiol (1985). 2003; 95:1706–1716.
Article
3. Kim KI. Biology of aging: medical perspective. J Korean Med Assoc. 2007; 50:216–220.
Article
4. Perls T, Kunkel LM, Puca AA. The genetics of exceptional human longevity. J Am Geriatr Soc. 2002; 50:359–368.
Article
5. Karasik D, Demissie S, Cupples LA, Kiel DP. Disentangling the genetic determinants of human aging: biological age as an alternative to the use of survival measures. J Gerontol A Biol Sci Med Sci. 2005; 60:574–587.
Article
6. Lieber MR, Karanjawala ZE. Ageing, repetitive genomes and DNA damage. Nat Rev Mol Cell Biol. 2004; 5:69–75.
Article
7. Johnson FB, Sinclair DA, Guarente L. Molecular biology of aging. Cell. 1999; 96:291–302.
Article
8. Sohal RS, Mockett RJ, Orr WC. Mechanisms of aging: an appraisal of the oxidative stress hypothesis. Free Radic Biol Med. 2002; 33:575–586.
9. Schriner SE, Linford NJ, Martin GM, Treuting P, Ogburn CE, Emond M, Coskun PE, Ladiges W, Wolf N, Van Remmen H, Wallace DC, Rabinovitch PS. Extension of murine life span by overexpression of catalase targeted to mitochondria. Science. 2005; 308:1909–1911.
Article
10. Kokoszka JE, Coskun P, Esposito LA, Wallace DC. Increased mitochondrial oxidative stress in the Sod2 (+/−) mouse results in the age-related decline of mitochondrial function culminating in increased apoptosis. Proc Natl Acad Sci U S A. 2001; 98:2278–2283.
Article
11. Graiani G, Lagrasta C, Migliaccio E, Spillmann F, Meloni M, Madeddu P, Quaini F, Padura IM, Lanfrancone L, Pelicci P, Emanueli C. Genetic deletion of the p66Shc adaptor protein protects from angiotensin II-induced myocardial damage. Hypertension. 2005; 46:433–440.
Article
12. Ge Y, Grossman RI, Babb JS, Rabin ML, Mannon LJ, Kolson DL. Age-related total gray matter and white matter changes in normal adult brain. Part I: volumetric MR imaging analysis. AJNR Am J Neuroradiol. 2002; 23:1327–1333.
13. Bentourkia M, Bol A, Ivanoiu A, Labar D, Sibomana M, Coppens A, Michel C, Cosnard G, De Volder AG. Comparison of regional cerebral blood flow and glucose metabolism in the normal brain: effect of aging. J Neurol Sci. 2000; 181:19–28.
Article
14. Peters A. Structural changes that occur during normal aging of primate cerebral hemispheres. Neurosci Biobehav Rev. 2002; 26:733–741.
Article
15. Small SA. Age-related memory decline: current concepts and future directions. Arch Neurol. 2001; 58:360–364.
16. Lautenbacher S, Peters JH, Heesen M, Scheel J, Kunz M. Age changes in pain perception: a systematic-review and meta-analysis of age effects on pain and tolerance thresholds. Neurosci Biobehav Rev. 2017; 75:104–113.
Article
17. Tsui BC, Wagner A, Finucane B. Regional anaesthesia in the elderly: a clinical guide. Drugs Aging. 2004; 21:895–910.
18. Dai DF, Chen T, Johnson SC, Szeto H, Rabinovitch PS. Cardiac aging: from molecular mechanisms to significance in human health and disease. Antioxid Redox Signal. 2012; 16:1492–1526.
Article
19. Frenneaux M, Williams L. Ventricular-arterial and ventricular-ventricular interactions and their relevance to diastolic filling. Prog Cardiovasc Dis. 2007; 49:252–262.
Article
20. Martin RS, Farrah JP, Chang MC. Effect of aging on cardiac function plus monitoring and support. Surg Clin North Am. 2015; 95:23–35.
Article
21. Nakou ES, Parthenakis FI, Kallergis EM, Marketou ME, Nakos KS, Vardas PE. Healthy aging and myocardium: a complicated process with various effects in cardiac structure and physiology. Int J Cardiol. 2016; 209:167–175.
Article
22. Brandes RP, Fleming I, Busse R. Endothelial aging. Cardiovasc Res. 2005; 66:286–294.
Article
23. Kovacic JC, Moreno P, Nabel EG, Hachinski V, Fuster V. Cellular senescence, vascular disease, and aging: part 2 of a 2-part review: clinical vascular disease in the elderly. Circulation. 2011; 123:1900–1910.
24. Low PA, Tomalia VA. Orthostatic hypotension: mechanisms, causes, management. J Clin Neurol. 2015; 11:220–226.
Article
25. Rooke GA. Cardiovascular aging and anesthetic implications. J Cardiothorac Vasc Anesth. 2003; 17:512–523.
Article
26. Rooke GA. Autonomic and cardiovascular function in the geriatric patient. Anesthesiol Clin North America. 2000; 18:31–46.
Article
27. Lee SH, Yim SJ, Kim HC. Aging of the respiratory system. Kosin Med J. 2016; 31:11–18.
Article
28. Teramoto S, Yoshida K, Hizawa N. Update on the pathogenesis and management of pneumonia in the elderly-roles of aspiration pneumonia. Respir Investig. 2015; 53:178–184.
Article
29. Zaugg M, Lucchinetti E. Respiratory function in the elderly. Anesthesiol Clin North America. 2000; 18:47–58.
Article
30. Fredman B, Lahav M, Zohar E, Golod M, Paruta I, Jedeikin R. The effect of midazolam premedication on mental and psychomotor recovery in geriatric patients undergoing brief surgical procedures. Anesth Analg. 1999; 89:1161–1166.
Article
31. Schwartz RS, Jaeger LF, Veith RC. The importance of body composition to the increase in plasma norepinephrine appearance rate in elderly men. J Gerontol. 1987; 42:546–551.
Article
32. Kerckhoffs DA, Blaak EE, Van Baak MA, Saris WHM. Effect of aging on β-adrenergically mediated thermogenesis in men. Am J Physiol. 1998; 274:E1075–E1079.
33. Beaufrere B, Morio B. Fat and protein redistribution with aging: metabolic considerations. Eur J Clin Nutr. 2000; 54:Suppl 3. S48–S53.
Article
34. Forbes GB, Reina JC. Adult lean body mass declines with age: some longitudinal observations. Metabolism. 1970; 19:653–663.
Article
35. Epstein M. Aging and the kidney. J Am Soc Nephrol. 1996; 7:1106–1122.
Article
36. Martin JE, Sheaff MT. Renal ageing. J Pathol. 2007; 211:198–205.
Article
37. Morley JE. Dehydration, hypernatremia, and hyponatremia. Clin Geriatr Med. 2015; 31:389–399.
Article
38. Schmucker DL. Age-related changes in liver structure and function: implications for disease? Exp Gerontol. 2005; 40:650–659.
Article
39. Shafer SL. The pharmacology of anesthetic drugs in elderly patients. Anesthesiol Clin North America. 2000; 18:1–29.
Article
40. Blatteis CM. Age-dependent changes in temperature regulation: a mini review. Gerontology. 2012; 58:289–295.
Article
41. Sessler DI. Perioperative thermoregulation. In : Silverstein JH, Rooke GA, Reves JG, McLeskey CH, editors. Geriatric anesthesiology. 2nd ed. New York: Springer;2008. p. 109–120.
42. Korea National Statistical Office. Population projections for Korea 2001-2050: based on the 2005 population census. Daejeon: Korea National Statistical Office;2006.
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr