Each indicator can be subtle and easy to miss—and one may even be praised as a good health outcome at first.
From graying hair and wrinkled skin to moments of forgetfulness; some signs of aging are easy to recognize. But experts say early clues that someone’s health is slipping can be far more understated, so it’s worth knowing what specifically to look for.
“Health decline in older adults rarely presents as a crisis, at first,” says Ronald Schwartz, MD, FACP, FAGS, a triple board-certified physician in internal, geriatric, and hospice and palliative care medicine. “It’s the tiny ways daily life starts to feel heavier, slower, or just off.” According to Dr. Schwartz, these changes are often overlooked because they occur gradually, and people dismiss them as a normal part of getting older.
“Families often think the same, [and] busy healthcare settings tend to prioritize disease over daily function,” he says. “Older adults may underreport because they don’t want to be a burden or fear losing independence.”
The good news: If the shifts are recognized early, it’s possible to make healthy changes before more serious problems emerge. Dr. Schwartz emphasizes, “Functional decline is not inevitable, and is often modifiable, especially when caught early.”
When keeping an eye out for changes, he says to consider what has become harder for someone in the past six months. “The answer often reveals more about someone’s future trajectory than any lab report ever could,” says Dr. Schwartz.
To understand what you should monitor at home—for either yourself or a loved one—we asked seven aging experts to share some of the more common signs of declining health that many people miss. Here’s what they said—and what to do if you see any of these traits.
1. Withdrawing socially and apathy
“Some people might assume that older adults naturally slow down or become less interested in things as they age,” explains Karen Lincoln, PhD, MSW, MA, FGSA, a social worker with expertise in gerontology and a professor at the University of California, Irvine. Families might think that their loved one is just tired, adjusting to retirement, or simply taking it easy. Dr. Lincoln says, “Older adults themselves might not see it as a health issue.”
But quiet withdrawal from routines and relationships—such as skipping a weekly card game, avoiding community events, not returning phone calls, or letting everyday tasks pile up—aren’t normal aspects of getting older. Gerontologist Lakelyn Hogan Eichenberger, PhD, says families often notice changes in memory or physical health first, but a gradual pullback from social engagement can also be an early warning sign.
That’s because when apathy and isolation goes unnoticed, it can lead to a downward spiral, Dr. Lincoln says. “We’re learning more and more that apathy can show up early in conditions like depression and dementia.” She says it also can be a sign of physical health issues. “Social isolation is more harmful to your health than smoking 15 cigarettes a day,” she explains.
Dr. Lincoln echoes there are things that can be done if the changes are noticed early. Apathy and social withdrawal may stem from treatable issues such as depression, hearing loss, unmanaged chronic conditions, medication side effects, nutritional gaps, or mobility problems. Even if it “seems small,” noticeable changes to normal routine or activity are “worth paying attention to,” she says.
2. Losing weight unintentionally
“In my experience caring for seniors, weight loss is sometimes dismissed as a normal part of aging or even viewed positively,” says Chisara Adonai, MD, a board-certified family medicine specialist with Conviva Senior Primary Care in Yulee, Florida. “But in older adults, losing weight without trying can be an early signal of serious underlying conditions such as cancer, heart failure, thyroid disease, depression, cognitive decline, or medication side effects.” It’s also a key marker of frailty, which significantly increases the risk of falls, hospitalization, and loss of independence.
Clinically, unintentional weight loss is typically defined as losing 5% or more of body weight over six to 12 months. It occurs in up to 20% of older adults, according to Dr. Adonai. What makes it easy to miss is that it often happens very gradually. By the time clothes start fitting more loosely or friends comment on someone’s appearance, it means that person has likely already undergone a decline in strength, immunity, and resilience.
“I’ve seen patients who might have maintained their quality of life for years experience a rapid decline because an early red flag was missed,” she says. “The encouraging part is that when we identify the cause early, whether it’s a treatable medical condition, medication issue, depression, or nutritional gap, we can often stabilize or even reverse the trajectory.”
3. Weaker grip strength
Loss of muscle strength is another important sign of declining health—but it often goes unnoticed until a major fall or injury. One simple way doctors can detect muscle weakness is by measuring grip strength, says Ohan Karatoprak, MD, a geriatrician and director of family medicine at Holy Name Medical Center in New Jersey.
“Hand grip strength gives information about overall muscle strength and functional capacity,” says Dr. Karatoprak. Without intervening, age-related muscle loss can lead to lower stamina, difficulty performing daily activities, poor balance, falls, fractures, and loss of independence.
Beyond what’s expected with aging, weak grip strength can also be an indicator of arthritis, neurological conditions, nutritional deficiencies, chronic disease, or general physical decline. But small habits and help—such as strength training, nutrition support, and physical therapy—can make a big difference when applied early, Dr. Schwartz says.
4. Less mobility and walking more slowly
A slow decline in movement and mobility can be an early warning of declining health, says Robyn Culbertson, PT, DPT, a spokesperson for the American Physical Therapy Association and board-certified specialist in geriatric physical therapy.
“While a fall would be an obvious sign of a problem, a gradual decline might look more like touching furniture or walls while walking in the home, spending more time sitting or lying down throughout the day, sleeping longer, or not performing usual household tasks,” says Dr. Cullbertson.
Low mobility can also show up as sleeping on the sofa because it’s hard to go upstairs, or no longer cooking meals because standing in the kitchen is difficult. “These could be signs that someone is having arthritis pain, balance issues, visual changes, or cardiovascular problems that, if not addressed, could lead to worsening disability,” she adds.
Slower walking speed is another important clue, adds John Rinker, MD, an internal medicine physician with OSF HealthCare in Pontiac, Illinois. Doctors often measure this with a simple timed test. In Dr. Rinker’s office, “We have the person seated in a chair and then ask them to get up, walk 10 feet across the room, turn around, return to the chair, and sit back down,” he explains. He says the test normally takes less than 10 seconds to perform.
If someone has a slower gait or difficulty standing up, it could be a sign of developing health problems. That’s because mobility changes often point to underlying issues long before more obvious symptoms appear, Dr. Culbertson says. “The good news is, early intervention by family and caregivers can help a patient get evaluated by a physical therapist who can develop a personalized treatment program to help them get back to doing what they love, safely.”
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