“That’s Just Part of Getting Older”: What We Blame on Aging May Deserve a Closer Look

More than 2,000 years ago, the Roman playwright Terence wrote a comedy called Phormio. In one scene, an older man named Chremes returns from a long stay on the island of Lemnos. When his brother asks why he stayed so long, Chremes says illness kept him. Asked what illness, he answers, “Senectus ipsa est morbus.” Old age itself is a disease. Then he moves straight on to other news.

How We Use It Now

These days, I notice I say this to myself when I forget something or can’t run as fast as I used to: “That’s just part of getting older.” I also hear it from doctors and friends. It works the way it did for Chremes: it sounds like an answer, and the questions stop.

Now picture this. You mention to your doctor that you are tired most afternoons, your feet tingle at night and your legs cramp when you finally lie down. Your blood work may have come back normal. The doctor answers kindly: “That’s just part of getting older.”

What the Saying Gets Right

Bodies change with age, and some of those changes are permanent: joints wear, and eyes need more light to read. When a change cannot be reversed, treatment, physical therapy or other care can still make daily life easier.

Some health problems also become more common with age. Anemia is one. In a national survey from 1988 to 1994, published in Blood in 2004, researchers found that anemia rose quickly after age 50. About 1 in 10 women 65 and older were anemic, and the rate passed 20 percent at age 85 and older. Most cases were mild.

If the saying stopped there, it would be accurate. The trouble is what it implies next: that because a problem is common at your age, it has no cause worth looking for.

What the Saying Leaves Out

The same anemia study looked for causes. In about one third of the older people with anemia, the researchers found a nutrient deficiency: iron, folate or vitamin B12. Those are causes a doctor can test for and treat.

Vitamin B12 Is One Example

The National Institutes of Health reports that atrophic gastritis, a condition that reduces how well you absorb B12 from food, affects 2 percent of the general population but 8 to 9 percent of adults 65 and older.

Common medications can lower B12 too. According to the NIH, metformin, a widely used diabetes drug, can reduce B12 absorption and blood levels, and acid-reducing drugs can interfere with absorbing B12 from food.

The NIH lists fatigue among the symptoms of low B12, along with numbness and tingling in the hands and feet. It also notes that these nerve symptoms can occur without anemia. So the tired afternoons and tingling feet in that doctor’s visit could come from low B12. They could also come from something else, and only testing and your doctor can tell which.

Magnesium Is Another Example

Magnesium it is one of the minerals I cover in my book, Your Labs Are Fine. You’re Not. The NIH reports that older adults eat less magnesium than younger adults, absorb less of it from the gut, and lose more of it through the kidneys. Older adults are also more likely to take medications that affect magnesium. The early signs of low magnesium the NIH lists include fatigue and weakness, and as the deficiency worsens, numbness, tingling and muscle cramps.

Magnesium is also hard to measure. The standard blood test measures magnesium in your serum, the liquid part of your blood, and the NIH states that serum levels “have little correlation with total body magnesium levels.” The NIH also says that no single method of measuring magnesium “is considered satisfactory.” So a normal result is one piece of information to be read alongside your symptoms, history and medications. The difference between a normal lab report and how you feel is what my book is about.

Fatigue and cramps have many causes, and a deficiency is only one of them. Each symptom deserves a look before anyone concludes it is just age.

What the Belief Does to Us

In December 2019, the University of Michigan’s National Poll on Healthy Aging surveyed 2,035 adults aged 50 to 80 about everyday ageism. Researchers published an analysis in JAMA Network Open in 2022. Eighty-one percent of the adults surveyed held at least one ageist belief about themselves, such as “having health problems is part of getting older.” Those beliefs were linked to worse physical and mental health.

The survey measured people at one point in time, so it cannot show which came first. People in poor health may be more likely to believe health problems come with age. A belief that every new symptom is “my age” can also stop us from asking.

A Better Question

When you hear “That’s just part of getting older,” ask:

What makes us confident this is aging, and what other causes have we considered?

Follow up:

• Could any of my medications be affecting my B12 or magnesium?
• Is there a test that would help, and what would a normal result tell us, and not tell us?
• If this is age, what can we do to ease it or slow it down?

Work with your doctor on the answer. Please do not diagnose yourself from an article or start supplements on your own. Some supplements interact with medications, and some can cause harm in the wrong amount. Keep the conversation going until you have an answer.

More than 2,000 years ago, Cicero answered the idea in Terence’s line. In his dialogue On Old Age, the elderly statesman Cato argues that the weakness people blame on old age often comes from ill health, and that we should resist old age the way we fight a disease. The same goes for the tired afternoons and tingling feet: before anyone calls them old age, someone should look for a cause.

I test sayings like this one against the evidence in my column, Advice on Trial, including a close relative of this one: “It’s probably just stress.”

Your Thoughts:

Has anyone ever told you a symptom was “just part of getting older”? What happened when you asked again?