With age comes maturity, acceptance, understanding and a greater respect for health and life. With more life experiences we can have better coping skills, resilience, and a more robust sense of self. Recognising these benefits while accepting and adapting to the challenges can help us to achieve a happier and healthier future. The process of ageing includes a reduction in strength, endurance, speed of reaction, agility, metabolism, sexual activity and hearing acuity. The bones become more brittle, the skin drier and less elastic and the teeth may shed.
Ageing is associated with, or responsible for, the ever-increasing susceptibility to disease and death that accompanies advancing age. There has been increasing discussion and great debate about what age this increased susceptibility begins, and whether this is very different for people who live with HIV.
The impact of HIV on our bodies and on the immune system as we get older is greatly affected by ageing. HIV affects each of us differently. Some people progress to symptoms very quickly, while others live for 20-plus years without any signs of immune suppression or symptoms.
Physical age is different from the length of time a person lives with HIV. For example, a 60 year old who is newly diagnosed may have very different experiences and levels of health than a 60 year old who has been diagnosed for 20 years - this person‘s experience and level of health may also be very different depending on when they commenced treatments or not.
How well we age and how the ageing of our bodies impacts our health is unique to each of us. Therefore, HIV infection - coupled with natural ageing - creates added challenges for maintaining good health.
The similarities between ageing and the courses of HIV infection suggest that HIV infection compresses the ageing process, perhaps accelerating co-morbidities (other illnesses) and frailty. There is a lot of discussion regarding inflammation due to living with HIV and the effect of long-term treatment and the associated toxicities.
Age-related conditions, such as liver disease, kidney disease, cancer, menopause, cognitive function (thinking and understanding), bone mineral density, cardiovascular disease, and lipid and glucose metabolism (process by which food is converted into energy) may be aggravated and/or accelerated by HIV infection itself and by HIV treatments - Antiretrovirals (ARVs).
Other things to consider include that Maori and Pacific Islanders are at higher risk of developing diabetes and cardiovascular disease at an earlier age. Also, middle-aged women, who are HIV positive, have risk factors for cardiovascular disease related both to the menopausal transition and to the HIV infection
Planning ahead, consulting with your doctor and staying in control of your health in the best way you can, is a practical way forward.