Normal ageing, cognitive decline, dementia and nutrition Flashcards
What changes happen to the respiratory system in ageing?
- Decrease in lung and chest wall compliance → causes decreased total lung capacity, forced vital capacity, FEV1 and vital capacity
- Changes occur due to reduced elastic support → collpase of alveoli and terminal conducting airways
What respiratory problems are more common in the elderly?
- Atelectasis
- Pulmonary emboli
- Pneumonia
- Chance of all of this is increased if a smoker, chronic chest disease or undergoing abdominal/ thoracic surgery
Why is obstructive sleep apnoea more common in the elderly?
- Loss of elastic tissue around the oropharynx leads to collapse of the upper airways
- Sleep or sedative states may result in complete or partial obstruction of the airway
What changes to pharmacokinetics occur in the elderly?
- Increased sensitivity to CNS depressants
- Decreased hepatic and renal function- GFR decreases 1% with each year of age
- Decreased total body water and increased adipose levels alters Vd
- Decreased plasma protein binding causes increased drug availability
- Must start doses low and raise them with caution
What changes occur to skin in ageing?
- Skin thins
- Subcutaneous blood vessles more fragile → easy bruising
- Reduced collagen → sagging skin
What can extensive bruising be a sign of?
Hepatic issue/ medication problems
What happens to the peripheral vasculature of cardiovascular system in ageing?
- Large and medium sized vessles become less elastic and therefore become less compliant
- Causes raised systetmic vascular resistance and hypertension → in turn leads to left ventricular strain and left ventricular hypertrophy
What changes happent to the heart itself during ageing?
-
Reduction in number of cardiac conducting cells
- heart block, ectopic beats, arrhythmias and atrial fibrillation more prevelent
- Cardiac output reduced (30%) in patients with AF
- CO reduces by 3% per decade due to reduced SV and contractility
Why is intravenous anaesthesia achieved more slowly in the elderly?
Due to the reduction in cardiac output with age means that arm-brain circulation time for drugs is reduced
What changes occur in the renal system with age?
- GFR decreases 1% each year
- Decrease in renal cortical glomeruli
- Increase in hyaline and sclerotic glomeruli
- Reduction in renal perfusion secondary to reduced cardiac output and atheromatous vascular disease
- Diabetes mellitus increasingly common
- NSAIds and ACEi are more nephrotoxic
- Prostatism in males can cause obstructive nephropathy
- Dehydration common
What happens to the CNS during ageing?
- Cerebrovascular disease common due to diffuse atherosclerosis and hypertension
- Neuronal density is reduced by 30% by age 80 → global cerebral atrophy
What happens to basal metabolic rate with aging and what is the consequence of this?
- Decreases by 1% per year after age 30
- Fall in metabolic activity and reduced muscle mass cause impaired thermoregulation
How many people in the UK are projected with be living with dementia by 2021?
1 million
What is malnutrition?
Any condition caused by an inbalance between whats eaten and what is required to maintain health
Either eating too little or too much
How many older people in the UK are suffering or are at risk of malnutrition?
1 in 10
