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BPT 17 - Geriatric > 1 - Physiological Changes Of Aging > Flashcards

1 - Physiological Changes Of Aging Flashcards

1
Q

Older adults: def

A

Age > 65y

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2
Q

Subdivisions of older adult pop: 3 categories, age & characteristics of each

A

Young old: 65-74y, Recently retired people, quite active (babysitting grand children, continue working for ≠ reasons)

Mid old: 75-84y, Many may rest during day. Experience more age related change

Old old: over 85y, Many may rest during day. Experience more age related change

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3
Q

3 changes between 3 subdivisions

A
  • Number of hospitalization increases with age (internal medicine & orthopedics)
  • Hospitalization length increases
  • Mortality rate increases
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4
Q

Aging def & characteristics

A

= progressive deterioration of functional properties of body at cellular, tissue & organ levels

  • Related changes are normal & vary with each individual
  • Most visible signs of aging: grey hairs, postural changes (increased flexion), muscle mass,loss & wrinkles
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5
Q

Why important to understand physiological changes

A
  • Promoting healthy aging
  • Developing effective healthcare plans
  • Improvement of quality of life
  • Reducing cost of healthcare
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6
Q

Physiological changes of aging

A
  • Cardiovascular change
  • Nervous system
  • Gastrointestinal changes
  • Skin changes
  • Immune system changes
  • Endocrine system
  • MSK system
  • Thermoregulation control changes
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7
Q

Skeletal muscle consists of:

A
  • Type I aerobic, slow twitch
  • Type IIa aerobic, fast twitch
  • Type IIb anaerobic, fast twitch
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8
Q

Body composition changes

A
  • Normal aging results in muscle mass loss, which starts in 4th decade (after age of 30) of life & advance with age
  • ≈ 3-8% loss / decade
  • > 60s, loss / year is 3%
  • Muscle strength declines by 10% to 15% per decade
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9
Q

Muscle & aging

A

Loss of muscle mass & strength
- Increased percentage of type I fibers
- Decreased size & number of type II fibers
- Metabolic consequences (high % of fat, decreased protein synthesis) - Muscle fibers denervation
In general, aging associated with greater decline in lower body than upper body & extensors compared with flexors strength

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10
Q

Changes & effects of MSK system

A

Tableau

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11
Q

From which decade & how many % decline muscle mass

Which type of fibers most lost

A

3rd to 8th, 30%

Mainly loss of type II muscle fibers resulting in reduced force contraction

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12
Q

Connective tissue & aging

A
  • Skin collagen & elastin synthesis declines
  • Fibers get thicker
  • Increased proteolytic of connective tissue
  • Elasticity off skin affected
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13
Q

Skin & aging: changes & effects

A

Tableau

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14
Q

Clinical relevance of MSK system changes

A
  • Patients prone to cuts & bruises by grazing equipment in gym setting.. (parallel bars because skin so fragile)
  • Patients predisposed to pressure sores
  • Less pain reported due to decrease sensitivity (unaware of cuts & bruises)
  • Slower healing due to decreased circulation
  • Purple bruises under skin following minor trauma
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15
Q

Articular cartilage & aging

A
  • Joint cartilage = cartilage cells embedded in fibrous collagen matrix & water-proteoglycan (proteins) gel
  • Aging: reduced proteoglycans, become shorter, loses ability to hold water
  • Effect: degeneration, thinking/damage & loss of water content in articular cartilage leads to OA
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16
Q

Summary changes & effects of skeletal system

A

Tableau

17
Q

Nervous systems: effects of aging

A
  • Aging associated with many neuro conditions (Dementia, Parkinson’s disease..)
  • Brain’s capacity to transmit & communicate signals reduces
18
Q

Memory, learning & intelligence changes

A
  • Memory performance —> decreased retrieval ability - Cognition decline: observed around 60s
  • Cognitive speed (speed n which person understand & react to info) * Cognitive flexibility (ability to adapt to new situations)
19
Q

Neurons atrophy

A
  • Decreased size & number of dendrites, decreased connections —> declined reception of information
  • Decreased blood flow in brain
  • Brain starts to shrink after 40 y.o
20
Q

Synaptic change

A
  • Changes in number of strength of connection, speed & efficiency of info can be affected
21
Q

Neurotransmitter changes

A
  • Changes in production, release & reception of neurotransmitters such as serotonin, acetylcholine
  • Decreased memory
  • Declined perceptual motor skills (timed tasks)
22
Q

Myelin degeneration

A
  • Slower nerve conduction / slower signal transmission —> reduced coordination & speed processing
  • Reduced neuroplasticity —> difficulties with adaptation & new info
  • Cellular damage & cell death contributing to neuro diseases & memory / cognition loss
23
Q

Peripheral nervous system

A
  • Motor, sensory & autonomic fibers lost
  • Reduced both afferent & efferent conduction velocity
  • Reduced number of innervated muscle cells —> muscle atrophy & denervation
24
Q

Autonomic nervous system

A
  • Increased activity of sympathetic nervous system resulting in increase systemic vascular resistance & increased arterial blood pressure
25
Q

Key changes of nervous system: changes & effects

A

Tableau

26
Q

Organs of endocrine system & functions of each

A

Tableau

27
Q

Effects of aging in endocrine system: changes & effects

A

Tableau

28
Q

Key points of endocrine system

A
  • Build up of body fat
  • Lower bone density
  • Sleep disturbances
  • Increased risk of
  • Insomnia
  • Fractures
  • Types II diabetes
  • Cognitive changes
29
Q

Temperature control & aging

A
  • Loss of thermoregulation resulting in hypo/hyperthermia
  • Decrease number of sweat glands —> overheating
  • Decrease blood flow to surface of skin —> overheating
  • Thinking of skin (loss of insulation)
  • Decrease in muscle mass & production of internal heat (less shivering)
30
Q

Digestive system: effect of aging, changes & effects

A

Tableau

31
Q

Taste & smell changes

A
  • Loss of taste common among adults
  • Salt detection declines
  • Bitter is exaggerated
  • Saliva glands produce less saliva
    => Eating becomes less interesting
32
Q

Urinary system: kidneys changes

A
  • Reduction in renal mass
  • Decreased renal cortical thickness
  • Reduction in number of glomeruli
  • Tubural atrophy & fibrosis
  • Global glomerular & vascular sclerosis
  • Decline in glomerular filtration rate (GFR) —> blood not filtered properly
33
Q

Urinary system, kidneys, changes & consequences

A

Tableau

34
Q

Urinary system: bladder changes

A
  • Fibrosis of bladder wall & decreased elasticity
  • Reduced badder capacity (cannot hold as much urine as before)
  • Decreased urinary flow rate
  • Sphincter function decreases
  • Detrusor muscle tone reduced

In men:
- Prostate gland enlargement
- Difficulty to start micturition
- Urinary frequency
- Difficulty will fully emptying bladder

35
Q

Vision changes

A
  • Changes in eye result in presbyopia (= losing ability to see up close)
  • Declined glare tolerance, color discrimination & attentional visual field
    —> Driving, reading & balance effects
    —> Increased incidence of fall depression, social isolation & dependency
36
Q

Vision: changes & consequences

A

Tableau

37
Q

Ear changes: changes & consequences

A

Hearing impairments associated with impaired balance & thus increased risk of falls

Tableau

38
Q

Key points of physiological changes

A
  • All organs system undergo physiological changes at different rates
  • Caused muscle mass & strength reduction = important physiological change, increasing rates of falls in elderly
  • Older patients move slower compared to younger patients, additional time for assessment required
39
Q

Key messages of physiological changes

A
  • Communication: speak slowly & clear. Use lower pitch voice
  • Consider slower healing times & progression of treatment program
  • Home exercise program: consider vision impairments, use larger font handout

BPT 17 - Geriatric (11 decks)

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