Abstract

This paper looks at the different ways older adults react to physical aging, mainly in regard to the changes an older adult would see when looking in the mirror. The physical changes seen can include wrinkles, age spots, sagging skin, thinning hair and hair loss, and change in hair color. These physical changes can be drastic, and change the way the outside population perceives an older adult. They also influence aging adults’ self esteem. This paper explores the ways aging adults can prevent some of the unwanted signs of aging by exercising often, consuming a nutritious diet, and avoiding damaging environmental factors. Treatment of the physical signs of aging are possible, and can range from topical treatments to invasive surgery. This paper will be looking at how older adults choose to cope with the changes that aging brings.

How Older Adults Manage the Physical Signs of Aging

The physical effects of aging are drastic. The most typical external signs of aging are wrinkles, muscle loss, sagging skin due to loss of elastin and collagen, age spots, hair thinning, and loss of hair pigmentation (Flament, 2013). Many older adults try to compensate for age related changes by taking preventative measures or treatment of the unwanted signs. Preventative measures for aging include exercise, proper nutrition, using topical skin and hair treatments, avoiding excessive sun exposure (Flament, 2013), limiting alcohol and drug use, and living in an environment with relatively low levels of stress (Cavanaugh and Blanchard-Fields, 2015). This paper looks at further understanding the options older adults have to manage any unwanted physical signs of age. Older adults can treat signs of aging through cosmetic surgeries and procedures, topical treatments, hair dye, and cosmetics. It is hypothesized by the researcher that cosmetic procedures for aging will soon be more prevalent for older adults.

Preventative Measures for Signs of Aging

The most effective preventative measure for aging and overall longevity is exercise (Breen and Phillips, 2013).  According to Breen and Phillips (2013), sarcopenia is a result of muscle atrophy due to prolonged periods with a negative balance of muscle protein synthesis. Aerobic or resistance exercise is a way to increase the rate of muscle protein synthesis. Heavy weightlifting can compromise joints and bones in older adults who are untrained, leading to injury. Therefore, older adults should focus on endurance based training with high volume and low loads, to ensure type two muscle fibers are activated. Low impact, aerobic activity allows older adults to increase their muscle protein synthesis, while preserving their joints and ligaments. This activation of type two muscle fibers can reduce the risk of sarcopenia, and in relation reduce the risk of disability, arthritis, osteoporosis, and vascular disease.

A second effective measure to prevent the negative physical effects of aging is nutrition. More specifically, protein and vitamins play a key role in ensuring the body can maintain homeostasis, muscle mass, and low levels of body fat (Welch, 2014). Chronic muscle loss is unavoidable with aging. A decline in muscle mass begins in middle adulthood, and then continues at a steady rate after about fifty years of age. Older adults can minimize this decline in skeletal muscle mass by consuming enough protein. According to the journal of Clinical Nutrition and Metabolic Care, older adults with sarcopenia can increase their muscle mass by increasing their protein and supplementing with vitamin D (Morley et al., 2017). Researchers from Clinical Nutrition and Metabolic Care have discovered that vitamin D, vitamin E, and vitamin C are key nutrients that are protective factors for muscle loss.

Stress is a concept that is immeasurable, yet the long term effects of stress can do damage physically to the body. Chronic stress is damaging to telomeres in genes, the nervous system, and the immune system. (Cavanaugh and Blanchard-Fields, 2015). According to the journal of Experimental Gerontology, biomarkers of aging can be seen through stress associated molecules called Oxylipins (Simm and Campisi, 2014). The study Simm and Campisi (2014) conducted found Oxylipins to be responsible for chronic disease progression. Further research by Simm and Campisi (2014) discovered a positive correlation with stressful life events and an earlier death. Overall, stress has a negative impact on the reproduction of cells, and cell loss in the skin is one of the leading causes of wrinkles as a person ages naturally. Moderate exercise however, (Cavanaugh and Blanchard-Fields, 2015) can slow this process of telomere damage down, and thereby slow down the aging process.

One of the most damaging factors that affects the appearance of skin is sun exposure (Flament, 2013). Ultraviolet rays are responsible for eighty percent of visible facial aging signs, such as facial wrinkles, degradation of skin texture, sagging tissue, and pigmentation issues. Many adults can prevent the harmful effects of the sun by avoiding direct sun exposure, especially during the most intense hours of the day. Another way to protect from sun damage is to wear a hat and sunscreen whenever sun exposure is necessary.

Smoking cigarettes is another extremely damaging factor that affects the appearance of age. Cigarettes are the leading preventable cause of mortality and disability in older adults (Cataldo, 2003), and cigarette smoking has a toxic effect on the connective tissue in the face, resulting in loose skin and premature facial wrinkling (Seitz et al., 2012). Seitz at al. (2012) conducted a study that looked at identical twins to compare the effects of smoking cigarettes on wrinkles. The overall finding by Seitz et al. (2012) is that smoking is associated with increased likelihood of facial wrinkling, and an appearance of having a higher chronological age. In aspect to prevention, it is found that by avoiding excessive sun exposure, not smoking cigarettes, maintaining levels of stress, exercising often, and having a nutritious diet, older adults will put themselves at a great advantage to prevent the outward signs of aging.

Treatment of Signs of Aging

There are many ways older adults attempt to treat the signs of aging when the damage, or natural processes, have already occurred. Many older adults turn to plastic surgery and cosmetic treatments in an effort to hide or eradicate signs of aging. Face lifts, fillers, botulinum toxin (Botox), skin creams, and laser treatments are growing increasingly popular (Chrisler et al., 2012).

The most common non surgical treatment of wrinkles is Botox (Fan et al., 2016). It has fewer complications than surgery and laser treatments. Botox has an effect by inhibiting the release of acetylcholine, which causes temporary chemical denervation, forcing the muscles in the face to relax and temporarily paralyze. Older adults also turn to topical treatments such as wrinkle creams and skin lightening creams to treat wrinkles and age spots, respectively. Hyaluronic acid (Restylane) injections are commonly used for treating wrinkles, thinning lips, and fat loss in the face and hands. Laser treatments are used in many dermatologist offices to burn the outer layer of skin and stimulate production of collagen and elastin in new skin, resulting in new growth of a tighter layer of skin with no age spots.

Cosmetic surgery is on the extreme end of treatment. It is expensive, invasive, and has many complications, including a difficult recovery for older adults (Wan et al., 2015). Some of the complications that come with facial surgery are high blood pressure, nerve injury, and infection. With this in mind, many aging adults continue to turn to cosmetic surgery in hopes of looking younger and more attractive (Zimm et al., 2013). According to a study done by Zimm et al. (2013), the average amount of years taken off of apparent age after a facial cosmetic surgery is over three years. The face lift, brow lift, chin lift, and neck lift are common facial cosmetic procedures older adults undergo. Another study was performed with middle aged American women to gather information about the prevalence of cosmetic procedures and their acceptability (Chrisler et al., 2012). The results of the study found that over one third of the sample had already undergone some type of cosmetic surgery or treatment, and eighty-one percent of the sample stated they would undergo a procedure if cost was not an issue. This study supports the hypothesis by the researcher that cosmetic procedures for aging are becoming less taboo, and more of a societal norm. 

Many adults experience hair thinning and a loss of pigmentation (melanin) in the hair during the aging process (Cavanaugh and Blanchard-Fields, 2015). Thin hair, bald spots, and grey hair make a person look older, and many people associate this with looking less attractive. Many older adults dye their hair to counteract this loss of pigmentation. Thinning hair affects males and females alike, but genetically, men are more likely to go bald as they age (Wells et al.,1995). Wells et al. (1995) conducted a study with the finding that balding or bald men are rated less favorably on physical attractiveness, and may be disadvantaged when it comes to first impressions. Some men report using hair growth treatments, and others undergo a hair transplant to receive hair plugs, or wear a hairpiece. Rogaine is a topical treatment has been found to prevent hair loss in men and women, and help with hair regrowth, but is it only effective in a small percentage of users (Bergfeld et al., 2016). Getting a hair transplant, topical creams, wigs, hair dye, or acceptance are the options older adults have when they experience changes age brings to their hair.

Interview

An interview was conducted with Nancy, a woman above the age of seventy. She has experience working in research labs of hospitals, being a school teacher, is a mother of two boys, and a grandmother to six young adults. She currently resides in Huntington Beach, California. This area of California, Orange County, is very affluent, as five of the country’s wealthiest cities are located in the county (Lansner, 2016). This contributes to a large part of the culture placing a focus on appearance.

The interviewee has noticed marked changes in appearance with age. When asked to list these changes, she responded:

“I have noticed lines on my face, a double-chin, and a limp due to my bad hip. I have no grey hair, but that is only because I spend a lot of money on it to make sure it is not grey. I go to the salon often to have a hairdresser dye it. As I have aged, I don’t care as much about what people think of my appearance, but there are not any physical changes that I like. In response to the changes aging has brought, I have been getting facials twice a week, I do not run six miles a day anymore, and I have been doing the same thing with my skincare routine for the past few years. I moisturize and protect my skin from the sun.”

This supports the research by Chrisler et al. (2012) that found more older adults are turning to cosmetic treatments in an effort to decrease the visible signs of age on the face. The interviewee receives facials from a dermatologist twice a week to maintain their skin. The interviewee states that they protect from damaging sun exposure (Flament, 2013) by wearing sunscreen. They have not allowed any grey hair to show. In an effort to look younger, they go to the hair salon often to have their hair dyed. This statements supports the research that shows many older adults dye their hair when it turns grey due to the body ceasing to produce melanin (Cavanaugh and Blanchard-Fields, 2015).  The interview continues:

“My least favorite thing about aging is that I am not able to do the physical activities I used to enjoy. I have broken one hip from falling while riding my bike, so I do not ride my bike or run anymore. I have recently had a hip replacement surgery and plan to have my other hip replaced in the near future.”

This contradicts the research conducted by Breen and Phillips (2013), as they found low load, high volume exercise to be strengthening to the bones and skeletal muscle of older adults. However, a fall on concrete is still damaging to a person of any age. There are possible unknown ailments the interviewee has avoided by staying active the majority of their adult life.

“There are some changes that I try to hide, like my hair, but as a realistic person you have to accept that you will age and it will make your life easier. I am lucky that we (my husband and I) have enough money so that I don’t have to worry about the price of treatments or surgery in my older age. There is nothing I look forward to appearance wise, but seeing grandkids graduate, and other life milestones of my family members is something I look forward to experiencing.” (Personal Communication, November 10, 2016)

 It is helpful the interviewee has the support of her husband, other family members, Medicare, and social security to have the resources necessary for physical maintenance. If she had been unable to have a hip replacement surgery, she would be immobile for the duration of her life. Walking without assistance would be impossible in the near future. Chronic health problems such as osteoporosis are debilitating physically and mentally. “People’s state of health influences their quality of life…their well being and life satisfaction” (Cavanaugh and Blanchard-Fields, 2015). The hip replacement surgery, facials, and hair dye, all contribute to the interviewee’s subjective and objective health, happiness, and positive self esteem. The interview revealed this older adult takes an optimistic, yet realistic point of view on the aging process.

Conclusion

The interview revealed that with financial security, the aging process can be less stressful to cope with or treat. The interviewee was very active in their adult life, running six miles a day, but currently has bad hip problems due to the stress that running put on their body. She has had one hip replaced, and is planning on having the other hip replaced in the near future. After conducting this interview, it brings to light an interesting thought, as it is possible aerobic exercise was more harmful than beneficial in this case. The injury was sustained during a fall while riding a bike, but the interviewee had some joint issues prior to the fall. It is not surprising to learn from the interview that there were no physical signs of aging they enjoyed, however the older adult continues to look forward to new life experiences.

The physical changes older adults experience are often viewed negatively. Anecdotally, women treat the aging process as aversive, while men are more accepting of the physical changes. When older adults know what to expect during the aging process, they tend to be more realistic and accepting of their changes in appearance. There are many ways to prevent or treat some of the physical effects of aging. Avoiding the sun, cigarettes, drugs, alcohol, and excessive stress are key preventative measures. Exercising often and having proper nutrition have many long term, all encompassing benefits. Treatments of physical signs of aging can include dermal fillers, elective cosmetic surgery, and topical hair and skin treatments. When external signs of aging do make an appearance, older adults can choose to embrace or hide these changes. However, wrinkles, sagging skin, and a loss of melanin in the hair are inevitable once the body reaches a certain point in life. It is healthier to choose to embrace the signs of aging and regard them as a token of living a long, successful life, full of experiences.

It is possible the future will bring new advancements in skin care technology to treat wrinkles and sagging skin in a way that is not as invasive as surgery. As a future medical equipment sales representative, it is exciting to see the technology that is already available for older adults, such as fillers, Botox, and laser treatments. Working in the medical field is a great opportunity to have the possibility to see these advancements firsthand, and have the choice to use them in the future. Although the best way to manage the physical effects of aging is prevention and acceptance, self esteem is very important when it comes to happiness and successful aging. Every person should have the option to look their best and age gracefully.

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