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Flashcards in Adulthood & Aging Deck (43):
1

Objectives

  1. Discuss health factors related to the aging population and the elderly
  2. Discuss functional implications of age-related changes in skeletal muscles
  3. Relate age-related changes to the cardiovascular, pulmonary and nervous systems to physical functioning and differences in cognition and motivation
  4. Explain how changes associated with aging can be challenging for patients and patient’s families or caregivers

fyi

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Rate of physiologic function decline is highly variable

Aging

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  1. In 2000, median age rose to highest level ever. 35.3 y/o
  2. Fastest growing segment of population is those over age 85. In 1995 it was 3.6 million and projected for 2050 at 18.2 million. Those over 100 (1995) were 54,000 and by 2020 it is projected to be 214,000.
    • That’s a lot of people to assist out of bed!!

STATS

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  1. The incidence of chronic disease INCREASES with age.
  2. Disability & need for assistance also INCREASES with age.
  3. There is a high coorelation between increasing age, decreasing physical activity and increasing disability.
  4. Inactivity & disuse mimic the physiologic changes observed w/aging. Gilligan et al reported that “disuse accounts for about ½ the functional decline that occurs between 30 & 70, and aging causes the other ½.”

Maladies 

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Aging study 

Rowe & Kahn (researchers) found that successful aging was determined by an? 

  1.  active engagement with life
  2. high cognitive & physical function
  3. avoiding disease & disability

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what increases with age?

  1. Increased systolic BP
  2. Increased stiffness
  3. Increased fat mass
  4. Increased risk of CVA, HTN, & AMI
  5. Increase of 30-50% residual capacity
  6. Increased risk for hypercholesterolemia & atherosclerosis

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what decreases with age?

  1. 2-4 bpm of resting HR
  2. cardiac heart muscle & volume
  3. elasticity of blood vessels
  4. capillary/muscle ratio
  5. 40-50% vital capacity
  6. size & # of mitochondria
  7. bone mineral content
  8. cartilage water content
  9. 25-40% muscle mass
  10. 10-15% NCV
  11. 15% BMR
  12.  30-50% renal function

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Decreased cardiac output, stroke volume, and max heart rate together w/increased systolic & diastolic BP represent age-related _________  _________changes.

CARDIOVASCULAR CHANGES

OR 

CV 

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Aerobic or functional capacity is greatly affected by age & disease-related processes. The measure of functional capacity is often measured in

 METS

 

(metabolic equivalent units)
1 MET = utilization of 3.5 ml O2 per kilogram of body weight per minute
Example- walking 2 miles per hour requires 2.5 METs

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lungs

In the absence of disease, declines in the___________system are not noticeable until the individual reaches 60, 70 or even 80 y/o. 

pulmonary

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Decreased mobility of the bony thorax can change the resting position of _________  __  _________, therefore influencing function of the lungs

muscles of respiration

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Loss of the _______- _______ ________ & increased alveolar size secondary to destruction of the walls of individual alveoli are the major forms of lung deterioration found w/aging. 

alveoli-capillary interface 

&

increased alveolar size

13

Lung compliance or ability of lungs to expand, increases w/age & @ same time elastic recoil ?

decreases 

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  1. Dehydration, especially during exercise, is common in the elderly
  2. Electrolyte imbalance associated w/dehydration are also common w/aging
  3. Less lean body mass & less metabolically active tissue contribute to a decline in metabolic rate & energy requirements of the body. 

Body composition

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OSTEO JT problems

Osteopenia, osteoporosis, osteoarthritis.

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Cross-linking collagen fibers increases w/loss of motion. If loss of motion, then nutritional exchange of articular cartilage are reduced adding to degenerative changes in _________  _________joints.

weight bearing

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  • Strengthening the muscles around the joint help resist decrease the risk of injury to the joint by supporting it.
  • name 3 forces acting on the bone during normal activity:

Gravity
Weight bearing
Pulling forces of the muscle on the bone

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recurring anterior vertebral compression fractures of t-spine lead to wedging & kyphosis

Kyphosis-

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flattens w/age in L-spine
 

Lordosis

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narrowing of the central canal

Central stenosis

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Water content of nucleus pulposus decreases or increases?

decrease

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Neuromuscular junction changes & nerve conduction slows :

name  6 gait changes:

  1. Mild rigidity & less body motion proximally than distally
  2. Arm swing decrease in amplitude & speed
  3. BOS becomes wider to improve stability
  4. Step length becomes smaller
  5. More time is spent in double support stance w/decreased swing to stance ratio
  6. Decreases in speed of gait

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In aging nervous systems, neurons get smaller & fewer

true of false

true

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there is Decrease in what type of  fibers

type II fibers

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Functionally- neuro changes result in generalized 

  1. weakness,
  2. impaired mobility & balance,
  3. poor endurance,
  4. fractures
  5. impaired ability to perform ADL’s. 

26

Integumentary system: name some aging relations

  1. Epidermis flattens & thins, therefore making it susceptible to shearing forces
  2. Dermis also atrophies & has diminished vascularity
  3. Loss of collagen & elastin fibers
  4. Lentigos—flattened pigmented age spots.  Increase with exposure to sun 

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lattened pigmented age spots.  Increase with exposure to sun 

Lentigos

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  1. Slowing down & deterioration of movement
  2. Decline in size & weight of brain
  3. Decline in cerebral blood flow, oxygen needs, & glucose utilization by the brain
  4. Ventricles become larger. Sulci & gyri become less defined peaks & valleys
  5. Neuronal loss from thalamus, forebrain & hippocampus
  6. Loss of purkinje fibers from the cerebellum
  7. Fibers play a role in control of movement
  8. Volume of myelin decreases

CNS

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  1. Presbyopia
  2. Size of pupil decreases
  3. Photoreceptors in the retina and related projections to the thalamus & visual cortex lose ½ of their cells
  4. Color discrimination is harder due to the lens of the eye changes
  5. Lens becomes more opaque and yellow
  6. Cataracts
  7. Glaucoma
  8. Macular degeneration

eyes

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physiologic loss of accommodation or ability to focus on near objects

Presbyopia

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visual cortex lose

 ½ of their cells

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degenerative opacity of the lens causing obstruction & scattering of light to the retina. Images are blurred & acuity is reduced

Cataracts

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one of the leading causes of blindness in persons over 35. Damage of  the optic nerve causes blindness.

Glaucoma

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3rd major source of visual disability. Sees gray shadows in CENTER of visual field but can see outer borders okay. Makes TV & computer work much more difficult

Macular degeneration

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Auditory

  1. Presbycusis—inner ear age related decline in auditory acuity & most common cause of hearing loss in adults.
  2. Incidence of hearing loss is 50-60% in persons 71-80 y/o
  3. Hearing loss is the 3rd most prevalent chronic condition in older adults. 

36

  1. Presbyastasis—disequilibrium.
  2. 20% reduction in hair cells in the ear that sense linear acceleration and 40% loss of hair cells in semicircular canals.
  3. Fear of falling is reported to be 29-92% in older adults. Results in a decrease in  health status & functional decline

  1. Presbyastasis—disequilibrium.
  2. 20% reduction in hair cells in the ear that sense linear acceleration and 40% loss of hair cells in semicircular canals.
  3. Fear of falling is reported to be 29-92% in older adults. Results in a decrease in  health status & functional decline

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  1. Hyposmia—decreased sensitivity to smell that occurs in olfactory system
  2. Hypogeuia—decreased sensitivity to taste that occurs in the gustatory stystem
  3. Both make food taste less appealing and may lead to poor nutrition

Olfactory & gustatory 

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  1. Difficulties with orientation to time
  2. Capacity for cognitive reserve decreases
  3. Ability to learn & improve cognitive performance continues
  4. Demonstrate diminished performance in timed learning tasks, in learning that is new, and in understanding new methods or situations. 

Cognition

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the ability to subconsciously screen out extraneous information while focusing on important cues is developed in adolescence. On divided attention tasks, the performance of the older adult decreases with a more rapid decline after age 70. 

Selective attention

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Performance on vigilance  tasks decreases w/age & does not seem to be changed by practice to support the skill. 

Vigilance

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  1. Depression in  the elderly tends to manifest related to thoughts, ideas & guilt.  
  2. A link….?
  3. Some studies involving low blood pressure & depression…

Depression

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this was a slide with questions /see if you can answers

  1. Name a health factor related to the aging population and the elderly
  2. List a few functional implications of age-related changes in skeletal muscles
  3. List two age-related changes to the cardiovascular, pulmonary and nervous systems to physical functioning and differences in cognition and motivation

smile the end

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