What are the normal signs of ageing?

Advances in treatment mean that many serious medical conditions, and many everyday illnesses can be effectively relieved, if not cured. But when is a change 'normal' and when should you worry?

A weighty business

Your body mass index (BMI) is a ratio of your weight and height - use our calculator to work yours out or ask at your GP surgery. The 'ideal', 'overweight' and 'obese' weight ranges for a given height do not change as you get older - these ranges are based on the life expectancy of millions of people.

The same weight range gives you the best chance of a long and healthy life, regardless of your age.

Lots of my patients complain of putting on weight after the menopause, but their particular issue is often that most of the weight accumulates around their middle. The hormonal changes of menopause may make you more prone to being an 'apple' shape - extra weight on your tummy - rather than a 'pear' , where the weight is on your weight on hips and thighs.

This can increase your risk of מחלת לב - fat inside your stomach increases your cholesterol and לחץ דם. But putting on weight after menopause is not inevitable.

As you get older, your metabolic rate - the rate at which your body burns energy - will probably slow. Adjust your meal size and do a brisk daily walk of 20-30 minutes - a 10% loss in weight will reduce the fat inside your tummy by a 30%.

When my children were small, I marvelled at their endless supplies of energy - but I never thought it odd that I couldn't match them. You can't expect to be on the go all the time as you get older, but neither should you assume that being tired all the time is usual.

One of the things that I look for when a patient complains of tiredness is whether it's new or has recently got much worse. Several medicines and the conditions associated with them can cause tiredness.

The key conditions to consider include:

• An underactive thyroid gland - which can also cause weight gain despite eating less.

• Intolerance to cold.

• Constipation and dry skin.

• Type 2 diabetes

Other symptoms include needing to pee more often, feeling thirsty, and recurring minor infections such as boils and thrush.

Several medicines can also lead to tiredness - beta-blocker tablets for heart conditions and antidepressant tablets are top of this list. Stress often leads to tiredness, but so too can דיכאון, which is often closely linked.

If you've been feeling down, depressed or hopeless, or don't enjoy social activities as you used to, this could be the reason.

If you go to bed intending to go to sleep, but you are anxious - and it doesn't really matter what you pin that anxiety to - you've already lowered your chances of falling asleep effectively.

By the age of 65, around 1 in 2 people have אוסטיאוארתריטיס (OA) - the most common 'wear and tear' joint problem in the UK. However 8 out of 10 of these aren't significantly affected by it. As you age, your hips, knees, spine and hands are most affected by OA, which can cause pain, stiffness and reduced movement, often worse in the mornings.

Simple painkillers, keeping your weight down and staying active are often all that's needed. Symptoms to look out for include pain at rest - sudden severe pain in one joint, and a red, hot, swollen joint.

With thanks to 'My Weekly' magazine where this article was originally published.