Physiologic Changes in Aging Flashcards
What are some factors that influence aging?
What are the enviornmental factors that can impact age?
- Chronologic age
- Nutrition
- Enviormental
- Illness
- Injury
- Social Support
- Hormone Replacement
- Shift-work
Stress, tobacco, ETOH, sun exposure
What is an important body system to keep in mind when caring for elderly patients?
Psychology and Mental Health
What is Senescence?
What is the short definition?
Term that means predictable age related to changes as opposed to those caused by disease. Not everyone experiences these disease processes, but everyone does undergo senescence. When superimposed, they can exhaust reserve and predispose to poor outcomes.
Everyone gets older whether or not you have pathological changes or not
What is homeostenosis?
What are some causes that may lead to mortality due to homeostenosis?
Reduction in the ability to maintain homeostasis. Stenosis is a narrowing of the resilience window, and increasing vulnerability to additive stress and illness.
Hip fracture, infection
*Examples because they cause death in elderly but not younger adults
What are some normal cardiovascular changes associated with age related changes?
- Decreased arterial elasticity
- Decreased compliance
- Elevated afterload
- Elevated SBP, decreased DBP, widened PP
- LVH (compensatory)
- Decreased beta adrenergic responsiveness
- Decreased resitng HR and max HR
- Decreased baroreceptor reflex
- Decreased number of pacemaker cells in sinus node as well as conduction velocity
What are some common cardiovascular pathophysiology associated with increasing age?
- Atherosclerosis
- CAD
- Essential HTN
- CHF
- Cardiac arrhythmias
- Aortic Stenosis
Does the risk of valvular heart disease (VHD) increase significantly with age?
What is the most common VHD associated with aging?
Yes
Mitral Regurgitation
Decisions about surgical treatment vs medical management of valvular disease requires what?
Shared decision making with a consideration of QOL and life expectancy
Do elderly patients typically have surgery to correct AVR?
What is an alternative?
No, they are not good surgical candidates
TAVR (Transcatheter aortic valve replacement)
What is a reasonable SBP goal in elderly patients?
Why are there different recommendations?
< 120 (functional adult)
< 150 (less functional or higher fall risk)
Fall risk and risk of orthostatic hypotension
What side effects of antihypertensive agents should be considered in elderly patients?
- Fatigue
- Constipation
- Risk for orthostatic hypotension
- Electrolyte abnormalities
- Dizziness
- Falls
What agent can reverse warfarin anticoagulation?
Vitamin K
What agent can reverse DOAC treatment (apixaban/rivaroxaban)?
What agent can reverse Dabigatron?
Andexanet alfa
Idarucizumab
What are first line treatments for AF and VTE?
Why are these preferred to Warfarin?
DOACS
No INR testing and don’t have same response to leafy greens or vit K
What are some normal respiratory physiologic changes that occur with aging?
- Decreased pulmonary elasticity
- Decreased alveolar surface area
- Increased residual volume
- V/Q mismatch
- Increased chest wall rigidity (decreased compliance)
- Decreased muscle strength (diaphragm, intercostal, abdominal)
- Decreased cough
- Blunted response to hypercapnia and hypoxia