The worst case I can think of is a half-orc that is maxed age for a wizard(26) and his old age is 30. That's 4 years of in game time. Humans are next at 8 years. So you're looking at a long time.
I personally would ask the players if they wanted it to maybe be an issue or not. I feel most players ignore aging.
We are aware of it, but our in game adventures are rarely over the span of years...
I have one player who often plays casters and maxes out his mental stats by aging... and takes the penalties to his physicals...
In cases like this, I keep track of time... I have had him die of old age in a campaign before... :D
I let people start at whatever age they want, because -6 to physicals and +3 to mentals, in my opinion, is a fair trade.
Honestly, most games in my experience cover a small enough amount of time (in game terms) that aging really doesn't become an issue. However, if I were planning to run a campaign that was specifically designed to possibly take a lot longer (like say Kingmaker), I would definitely track it as a GM. Fortunately, Kingmaker provides an easy means for tracking how much time has elapsed in the campaign.
That aside though, its generally not an issue.
I tend to ignore it. Huang Zhong just got better with age, or at least the legendary version did.
'Expirience' for player characters isn't really a function of time. Rather it is a function of meeting heroic challenges. A character could go from 1st to 20th level in a matter of months, providing those months were significantly challenging.
Probably the slowest adventure path is Kingmaker, which can legitimately take about a decade or so of game time to complete, but even in that path it is unlikely that a typical character would have to deal with changing an age category. Most characters do all of their active adventuring in the span of a very few years. Because of this, unless it is a focus for some reason, I think most people don't bother to worry about aging, because it isn't particularly relevant.
If you want to change things up and have your campaign take place over a longer than typical span, you should probably communicate that clearly at the beginning so people can plan accordingly.
Sometimes curses have an aging effect. Our party gunslinger tasted the water on top of Torch in Iron Gods and suddenly jumped into middle age.
It has only ever happened once in any campaign I have played in (Kingmaker obviosuly). A human oracle turned middle aged. She hated the drop to physical ability scores, but her Charisma was getting so amazing by that point that we made her duchess against her will. Later, she had grown accustomed to rule and pushed our economy utterly to it's limit so she could be a queen when we travelled to Pitax for the tourney.
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You might want to stock up on some Scrolls of Age Resistance if you decide to relive your glory days.