Endocrine Changes of Aging

Aging changes endocrine function gradually, but aging itself does not explain every new symptom. The practical nursing challenge is to recognize expected physiologic change without dismissing diabetes, thyroid disease, osteoporosis, medication toxicity, or hypoglycemia as “just getting older.” Growth hormone and insulin-like growth factor-1 activity decline over time. Sex-steroid production also falls. Together, these changes favor loss of skeletal muscle, increased fat mass, reduced exercise tolerance, and lower bone density. Less muscle also means less tissue available to take up glucose after meals, which contributes to insulin resistance. Glucose regulation often becomes less efficient with age. Post-meal glucose may rise more than fasting glucose because insulin secretion and peripheral insulin sensitivity decline. This is a tendency, not a diagnosis. Persistent hyperglycemia, polyuria, recurrent infections, unexplained weight loss, or a high diagnostic glucose value requires evaluation for diabetes. Bone loss is often silent until a fall causes a fracture. A patient may have no pain while bone strength is declining. Height loss, a new stooped posture, or back pain after minimal strain may signal vertebral compression fractures rather than ordinary stiffness....