Unavoidable vs. Preventable Physical Changes that Accumulate and Interact in the Aging Adult

Amy Blackburn, Gerontologist


Physical changes that occur with aging fall into two categories: normal and pathogenic. Certain universal, inevitable, and irreversible occurrences can be predicted by age alone; they are part of the normal aging process. Preventable physical changes also occur with aging, and some are preventive for a few years rather than eliminated completely. As long as the losses are minimized, interactions with normal aging processes can be minimized. However, conditions still accumulate and interact with each other in the aging adult, causing additional problems. Goals for optimum quality of life in assisted living, and formal/informal caregivers at home, should be to limit the accumulation and interaction of multiple issues during the aging process.

Normal Aging

Unavoidable physical changes can be predicted by age alone and, therefore are labeled as “normal.” Everyone who ages will experience these physical changes. The ultimate physical change that everyone will experience is death.  Other physical changes that result during normal aging include: decreased lean body mass (sarcopenia), increased body fat, wrinkles and age spots, loss of reproductive capacity, decreased function of the central nervous system, decreased ability to regulate body temperature, decreased pain sensitivity, and decreased lung and kidney capacity. The intensity of each of these normal occurrences with aging depends on lifestyle decisions and on differences in external environments. For example, being sedentary, poor nutrition, smoking, drinking, and taking drugs are conscious lifestyle decisions that will affect the intensity of the above-listed physical changes that occur during normal aging.

Sensory systems are also unavoidably affected as one ages. Normal occurrences in vision include: decreased acuity and changes in depth perception, color perceptions, and light/dark adaptation. Hearing loss can be minimal or enough to require a hearing aid. Smell and taste are affected by loss of taste buds. Touch is affected as is sensitivity to pain. The extent of the loss of each sense is dependent on the individual. All of these physical changes are universal, irreversible, and inevitable issues of the normal aging process, capable of accumulating with pathogenic and preventable changes.

Pathogenic Aging

Pathogenic age-related conditions can be unavoidable, yet, not part of the normal aging process. Not everyone who ages will experience disease and sickness. Therefore, pathogenic aging cannot be predicted by age alone. Conditions in this category can be acute or chronic. Acute conditions are short-term; chronic conditions are long-term and persistent. The most common chronic condition, especially among women, is arthritis. Two of the most common conditions, both of which can result in death, are cancer and stroke. Some cancers and strokes can be prevented and included in preventable physical changes.

Preventable Physical Changes

Two major preventable diseases are osteoporosis and heart disease. Both result in physical changes that can drastically alter lifestyles and leisure activities. Osteoporosis can be prevented by weight-bearing exercise, and taking calcium and vitamin D supplements. Women most commonly acquire this disease due to estrogen loss.  Hormone replacement therapy is often used, but this has been known to cause certain cancers. Heart disease can be prevented by healthy eating habits and regular, moderate exercise. However, this is dependent on genetics as well, and cannot be solely prevented by lifestyle modifications.

Physical changes sometimes result from accidents. The most common accidents are falls. Falls are caused by inactivity, visual impairments, medication effects, gait disorders, and/or disease. By strengthening the muscles and working on balance, falls often can be prevented (or at least decrease injuries resulting from them). Healthy eating habits, exercise, and some vitamin supplements can decrease the chances of disease and sickness, or decrease the amount of loss with certain physical changes. When this happens, even if only for a short time, it can greatly minimize accumulation and interaction of additional issues during the aging process.

Physical Changes Collide

The accumulation and interaction of normal and pathogenic, unavoidable and preventable physical changes are what cause eventual death. Aging itself is not a disease; it is not the reason someone dies. For example, hearing and vision loss can interact with acute and chronic pathologies. When surgery is needed for a broken hip, medications and an exercise regimen are required. But some older adults may find it difficult to hear the proper exercise protocols and read proper medication instructions. This is one reason why professional caregivers in the home or at an assisted living facility are often necessary to provide that individualized assistance during times that are so vital to prevent further decline.

When a chronic condition like arthritis is present, exercise may be hindered unless a professional is able to demonstrate and monitor modified movements. Also, something as simple as opening a bottle of medication can be problematic. Even when assistance is provided with multiple medications, various side-effects would require monitoring to prevent interactions causing decline. The goals in acquiring assistance are to stop or slow decline of health. Oftentimes, this is accomplished when progression is emphasized in areas of strength.


Normal physical changes that are universal, irreversible, and inevitable occur in the sensory system, the central nervous system, and other systems, and in addition, obvious outer changes of the muscles and skin occur. Acute and chronic pathologies, on the other hand, produce avoidable physical changes. Examples include osteoporosis, heart disease, and stroke. Regular physical activity can decrease muscle loss, increase bone density, increase balance, and prevent the occurrence of falls. As these changes accumulate and interact, life can become difficult for the older adult and further problems can result. The most important concept to focus on is preventable physical changes, even if negative conditions are only postponed for a few years. If this can only be accomplished through professional programming in assisted living or with well-trained caregivers, it is worth optimum quality of life while aging.