1 - Aging - Holroyd Flashcards
(30 cards)
ADLs
Activities of Daily Living
Bathing, dressing, feeding, hygiene
“have to be able to do these before going to school”
iADL
Housework, taking meds, manage money, shopping
“Have to be able to do before going to college”
Common Changes with Aging
Body comp, fraility, sensory deprivation, falls, polypharmacy, urinary incontinence
Body Comp Changes in Aging
Decreased Lean Muscle
Increased Body Fat (abdominal)
Decreased Subcutaneous Fat (hot/cold intollerant)
Decreased Total Body Water
Decreased Protein in Blood
What is the pharma consequence of reduced protein in blood?
“higher” dosage
Increased Cortisol in Aging
Impairs immune systems
How is the brain impacted by medication in aging?
Brain becomes more sensitive to the effects of medication
Dementia
two or more areas of deficits in cognition
Memory, Abstract Thinking, Judgement, Language, Visuospatial Functioning
Prevalence of Alzheimers
5% > 65
Doubles every 5 years after 65
Age greatest correlator
What are main sources of Dementia?
Alzheimers
Vascular Dementia
“mixed” Etiology
Lewy Body Dementia (controversial)
Alzheimer’s Dementia
Steady decline over several years, can have VH
Lewy Body Dementia
VHs, change in levels of consciousness, falls, Parkinsonism
Vascular Dementia
Vascular risk factors or evidene of ischemic changes on imaging.
Sudden Decline
Dementia Treatment
Acetylcholinesterase Inhibitor - reduce rate
Prevent delirium
Treat psychiatric symptoms of dementia
work with family
Fall Risk in Elderly
Center of gravity gradually declines, increasing fall risk
Hip injuries
Head (brain) injuries
Causes for Falls in Elderly
Neurological dysfunction
Cardiovascular disease
Medical illness
Environmental
Medications
Medicines that Can Impact Falls in Elderly
Sedating Meds (benzodiasepines), Narcotics, Barbituates, Anticonvulsants, Sleeping Pills, Lithium at toxic doses
Anticholinergic meds (benadryl), antihistamines
Polypharmacy
Sleep Chages in Elderly
Deep sleep reduced, with less time N3
Increased latency
Decreased REM sleep
Wake up earlier
Urinary Incontinence in Elderly
Bladder doesn’t age well
Infection/UTIs, sleep, toxins
UTI can cause a lot of problems
Syncope
Sudden loss of consciousness
Spousal Bereavement
51% women, 14% will be widowed
Depressive symptoms peak within months, and decline within a year
Major depression may require treatment
Mental Illness in Older Adults
National Institute of Mental Health ECA Study was landmark
12% of older met criteria for mental health diagnosis
Most common anxiety, cognitive impairment
Need to do full work-up, could be other causes–Delium, NOT demented
**Depression in Elderly**
(exam)
Not normal part of aging
Main risk factor is vascular risk factors and neurologic disease (stroke/Parkinson/dementia)
Delirium
Most common cause of confusion and psychosis
Mistaken for dementia
Caused by medical illness, medication, substances
Other cause: Any medical issue
Risk: Age, dementia, brain damage
