Our population is ageing. People are living for longer and with more complex medical problems, and this is placing increasing pressure on health services. It has never been more important for clinicians to understand what constitutes normal ageing. An understanding of normal ageing can help us to anticipate future healthcare needs, promote health and independence, and differentiate age-appropriate physiology from pathology. This article aims to highlight how ageing affects different body systems. Special consideration is then given to how such changes affect the use of medications and the interpretation of laboratory tests in older adults. Ageing affects every system within the human body. It produces changes in anatomy and physiology, and these changes have functional consequences. Figure 1 summarises the normal changes of ageing that this article will explore. Vascular changes Age-related changes in the structure of blood vessels affect blood pressure. One of the main functions of large arteries is to smooth out surges in blood flow. Elastin in the arterial wall allows arteries to stretch during systole, and so cushion the surge in blood from the heart. Arteries then recoil during diastole. Over time, the elastin in blood vessels fragments, with the damaged elastin being replaced by collagen. With age, arteries thus become stiffer (a condition called arteriosclerosis) and this affects blood pressure.
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