Ageing - muscles, bones and joints

What changes happen in our bones, muscles and joints as we age?

Bones

• People lose bone mass or density as they age, especially women after menopause. The bones lose calcium and other minerals.

• The spine is made up of bones called vertebrae. Between each bone is a gel-like cushion (called a disk). With ageing, the middle of the body becomes shorter as the disks gradually lose fluid and become thinner.

• Vertebrae also lose some of their mineral content, making each bone thinner. The spinal column becomes curved and compressed (packed together).

• The foot arches become less pronounced, contributing to a slight loss of height.

• The long bones of the arms and legs are more brittle because of mineral loss, but they do not change length. This makes the arms and legs look longer when compared with the shortened trunk.

Joints

• The joints become stiffer and less flexible. Fluid in the joints may decrease. The cartilage may begin to rub together and wear away. Minerals may deposit in and around some joints (calcification). This is common around the shoulder.

• Hip and knee joints may begin to lose cartilage (degenerative changes).

• The finger joints lose cartilage and the bones thicken slightly. Finger joint changes, most often bony swelling called osteophytes, are more common in women. These changes may be inherited.

Muscles

• Lean body mass decreases. This decrease is partly caused by a loss of muscle tissue (atrophy). The speed and amount of muscle changes seem to be caused by genes. Muscle changes often begin in the 20s in men and in the 40s in women.

• The muscle fibres shrink. Muscle tissue is replaced more slowly. Lost muscle tissue may be replaced with a tough fibrous tissue. This is most noticeable in the hands, which may look thin and bony.

• Muscles are less toned and less able to contract because of changes in the muscle tissue and normal ageing changes in the nervous system. Muscles may become rigid with age and may lose tone, even with regular exercise.

Challenges

Osteoporosis is a common problem, especially for older women. Bones break more easily. Compression fractures of the vertebrae can cause pain and reduce mobility.

Muscle weakness contributes to fatigue, weakness, and reduced activity tolerance.

Joint problems ranging from mild stiffness to debilitating arthritis (osteoarthritis) are very common.

The risk of injury increases because gait changes, instability, and loss of balance may lead to falls.

Some older 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 reflexes can occur.

Involuntary movements are more common in the older people. Older people who are not active may have weakness or abnormal sensations.

People who are unable to move on their own, or who do not stretch their muscles with exercise, may get muscle contractures.

Changes in posture and gait (walking pattern) are common with ageing.

Management

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, balance, and flexibility. Exercise helps the bones stay strong.

Talk to your health care provider before starting a new exercise program.

It is important to eat a well-balanced diet with plenty of calcium.

Stop smoking. Cigarette smoke both accelerates bone loss and blocks treatments from being as affective.

If you've been diagnosed with osteoporosis, your doctor may recommend drugs called to prevent further bone damage.

Start strengthening your bones with diet and exercise while you're still young. As you get older, talk to your doctor about bone density scans, and ask whether you need to take medicine if you're at risk for, or are starting to show signs of osteoporosis.

Over-the-counter pain killers may help relieve the pain.

Pain management may include interventional procedures, treatments, drug therapy or physical therapy.

Before your joints get so stiff and painful that they limit your lifestyle, talk to your doctor about treatment and prevention options that can help you maintain a good quality of life.

References

https://www.mountsinai.org/health-library/special-topic/aging-changes-in-the-bones-muscles-joints