President Biden has announced his plan to run for re-election in 2024. If he wins, he will be 82 when he takes office and 86 by the end of his term — making him the oldest person ever elected president of the United States for the second time. (Donald Trump is not far behind; he will turn 78 during the 2024 election and will enter his octogenarians during another presidency.)
President Biden is “a healthy, energetic 80-year-old man,” according to a February report by Dr. Kevin C. O’Connor, the White House physician. Although he has recently been treated for basal cell carcinoma, a common and slow-growing form of skin cancer, Mr. Biden has no major health problems, does not smoke or drink alcohol and exercises at least five days a week.
“Older adults have so different health outcomes,” said Dr. Holly Holmes, professor and chair of gerontology at the University of Texas Health Science Center in Houston. “As we get older, we become less like our peers and it becomes harder to generalize what a ‘typical’ 80-year-old would look like.”
Dr. R. Sean Morrison, professor and chair of geriatrics at the Icahn School of Medicine at Mount Sinai in New York, added that the changes that occur during aging occur in different people at different times. Some 85-year-olds are healthier than some 65-year-olds, and much of the difference comes down to genes and a person’s lifestyle before the age of 60.
However, as people move into their 80s and even their mid to late 70s, some of the standard age-related changes tend to occur, such as muscle loss and decreased bone strength, which make people more susceptible to illness and injury.
Here’s a head-to-toe snapshot of an octogenarian’s body and mind, as well as potential problems for doctors to watch out for.
brain
Most healthy people in their 80s have no difficulty performing complex cognitive tasks such as problem solving and planning, but they may find it more difficult to multitask and learn new things, Dr Morrison said. Some people may have difficulty remembering words. Reaction times are also slower, but usually only slightly — on the order of a fraction of a millisecond, Dr. Morrison said.
Dr. Scott Kaiser, director of cognitive health in aging at the Pacific Institute of Neuroscience, said scientists don’t know exactly why these changes occur, but the brain does shrink slightly with age due to loss of brain cells, so it may play a role. To a certain effect. Santa Monica, California. Interestingly, certain cognitive skills—such as vocabulary and abstract reasoning—may remain constant or even improve with age for unknown reasons, he said.
Dementia does become more common with age, but it still only affects a minority of adults in their 80s. According to the National Trends in Health and Aging Study, 10.9 percent of adults ages 80 to 84 and 18.7 percent of adults ages 85 to 89 had dementia in 2019. “These conditions are not a normal or inevitable part of aging,” Dr. Kaiser said.
eyes and ears
Vision tends to deteriorate over time. People in their octogenarians often need reading glasses and are more sensitive to glare, Dr Morrison said. Nearly 70 percent of adults over the age of 80 suffer from cataracts, clouding of the lens of the eye, but the condition can be effectively treated with surgery, he said.
Age-related hearing loss is another common problem. First, people lose the ability to hear high-frequency sounds like birdsong and alarm clocks; this can start early, even in their 30s or 40s. Low-frequency changes, which affect the ability to hear male voices and the low-mids of music, appear later. Hearing loss can be treated with hearing aids (now available over the counter) or other devices, and doing so is crucial: “We now have more and more data showing that the Living longer is more likely to develop diseases such as dementia or Alzheimer’s disease,” Dr Morrison said.
cardiopulmonary
As you age, your heart rate slows slightly, and the rate at which your heart beats during exercise also slows down, which can make aerobic exercise more challenging. That said, a healthy heart in aging usually “functions well,” says Dr. Lona Mody, a geriatrician at Michigan Medical Center.
Doctors monitor heart disease in octogenarian patient. “Blood vessels stiffen with age, which can lead to increased blood pressure,” says Dr. Modi, which increases the risk of high blood pressure and heart disease. According to the American Heart Association, 83 percent of men and 87 percent of women age 80 and older have heart disease, sometimes requiring medication or surgery. Mr. Biden has asymptomatic atrial fibrillation (irregular heartbeat) and takes apixaban (Eliquis), an anticoagulant drug commonly prescribed to help prevent blood clots and strokes. He also takes rosuvastatin (Crestor) to lower his cholesterol.
Lung capacity typically decreases slightly with age due to changes in the strength and elasticity of lung tissue and diaphragms, which can make breathing a little harder, Dr. Modi said. One condition doctors are focusing on is chronic obstructive pulmonary disease, an inflammatory lung disease that affects less than 11 percent of people 65 and older.
digestive system
People in their 80s tend to eat less than they used to, in part because “food doesn’t taste the same,” says Dr. Morrison. Over time, people lose their taste buds and sense of smell, both of which affect how much they like what they eat, he said. This helps explain why older adults are at increased risk of nutritional deficiencies.
But older people also need fewer calories than younger people due to loss of lean muscle mass and slower metabolism. According to the government’s Dietary Guidelines for Americans, women age 60 and over should eat at least 1,600 calories a day and men age 60 and over should eat at least 2,000 calories a day (minimum 1,800 for women and 2,400 for men) 19 to 30-year-old men).
Older adults are at greater risk for heartburn and gastrointestinal reflux. Mr. Biden, who occasionally coughs and clears his throat with gastroesophageal reflux, takes famotidine (Pepcid) as needed to treat his symptoms.
People in their octogenarians also digest food more slowly. Research shows that 34% of women and 26% of men experience constipation by the age of 84 or older.
bones and joints
Bones become more fragile as we age. The body begins to reabsorb the minerals that fortify them, such as calcium and phosphate, partly because the gut cannot absorb what it needs from food as efficiently as it used to. For women, the drop in estrogen after menopause accelerates this degeneration, which reduces bone density.
Decreased bone density puts older adults at increased risk of fractures and osteoporosis. In 2020, when Mr. Biden was the president-elect, he had a hairline fracture in his foot, requiring him to wear a walking boot as he healed. The bone injury doctors worry most about is hip fractures, with more than 300,000 victims each year65 Americans over the age of 10 were hospitalized. “Hip fractures are one of the most common causes of hospitalization for people age 85 and older,” said Dr. Susan Wehry, a geriatrician at the University of New England. Recovery is often difficult because of complications such as infections (sometimes hospital admissions) and internal bleeding, or because of slow healing from conditions such as heart disease.
Joints can also become more painful as the bones and cartilage that make up the joints begin to wear down. Nearly half of all Americans over the age of 65 have been diagnosed with osteoarthritis, which causes joint pain and stiffness, according to the Centers for Disease Control and Prevention. President Biden has been diagnosed with osteoarthritis of the spine, which has made his gait stiff.
skin
As people age, the risk of skin cancer increases. The average age for Americans to be diagnosed with melanoma, a potentially deadly form of skin cancer, is 65. Men have a higher risk of melanoma than women. Dr. Holmes recommends that people in their 80s visit their doctor or dermatologist once a year for a skin check.
Non-melanoma forms of skin cancer, such as basal cell carcinoma and squamous cell carcinoma, affect more than 3 million Americans each year. These cancers grow more slowly than melanoma and are curable if caught and removed early. In February of this year, President Biden underwent surgery to remove basal cell carcinoma of the chest. Biden has said that he often basked in the sun when he was young. He also had several other non-melanoma skin cancers removed before becoming president.
strength and balance
Most healthy people in their 80s can and should be physically active, and many are still strong and agile, says Dr. Holmes. She encourages patients to engage in cardio and weight training a few days a week and to stretch at least once a week, but sometimes recommends modifications for patients with pain, orthopedic issues, or heart problems.
As they age, adults “start to lose muscle and start to gain fat,” Dr. Morrison said. Between 42% and 62% of people in their 80s have sarcopenia, a condition characterized by loss of muscle mass and strength. Common symptoms include difficulty walking, climbing stairs, and carrying shopping bags.
Additionally, the spaces between the vertebrae dry out and become compressed, causing people to lean forward, which can affect their balance, Dr. Morrison said. People in their 80s tend to walk slowly and have a short gait, which can also worsen balance, he added.
In some older adults, the insulating layer (called myelin) that surrounds nerves and helps them communicate with each other begins to break down. This slows down reflexes and makes a person clumsy, Dr. Kaiser said.
“An important consequence of these age-related changes in the brain and whole nervous system — as well as changes in other systems and a wide range of other factors — is an increased risk of falls,” Dr. Kaiser said, which in turn may become more dangerous because Bones are weaker and more likely to break.
Stress, stamina and sleep
Dr Morrison said people in their 80s tended to have more energy than younger people and were therefore more prone to fatigue.
Dr. Mody added that stress and changes in daily life can be “harder to recover from,” because tissues and organs in older adults take longer to recover after stress or injury. People may also take longer to recover from colds, Covid-19 and other infections because the immune system becomes less responsive with age.
Many older adults don’t sleep well, in part because they spend less time in deep slow-wave sleep, which makes them more likely to wake up in the middle of the night. “Octogenarians tend to get about an hour less sleep than younger people,” says Dr. Morrison.
Still, it’s important to remember that everyone ages differently, and age doesn’t determine a person’s health. Many people in their 80s are healthier than their 20s, Dr. Mody says, and the choices they make later in life matter: Studies show that adopting healthy behaviors even at age 90 can extend a person’s lifespan.
Many octogenarians are “really resilient,” Dr. Holmes said.
