Age Related Changes Flashcards
(74 cards)
1
Q
Gerontology vs Geriatrics
A
Gerontology : the study of aging
Geriatrics: medical trx of aging people
2
Q
Theories of Aging:
A
- progressive decline model
- biological time clock
- free radical theory
- cross-linkage theory
- immune theory
- error catastrophe theory
3
Q
progressive decline model
A
wear and tear
4
Q
biological time clock
A
finite # of cell replications
5
Q
free radical theory
A
O2 radicals contribute to pathophysiological changes
6
Q
cross-linkage theory
A
chemical reactions cause irreparable damage to DNA
7
Q
immune theory
A
breakdown in immune system leads to greater risk of disease and cancer
8
Q
error catastrophe theory
A
errors in cellular RNA trancription lead to fault structures, especially proteins
9
Q
Aging
A
interaction among genetics, environmental influences, lifestyles, and effects of disease process
10
Q
What components are included in the shift in clinical focus for PT
A
- conditions traditionally associated w/aging
- sports and leisure related injuries
- focus on health, fitness, and wellness
11
Q
Geriatric Rehab
A
assisting disabled older adult achieve optimal functional capcities in order to attain meaninful QOL in satisfying environment
12
Q
In geriatric rehab, functional capacities includes:
A
physical, psychological, and social
13
Q
Geriatric Rehab requires…
A
an interdisciplinary approach
14
Q
Components of collaboration w/PTA in geriatric rehab
A
- medically complex patients
- PTA will assist in implementing trx programs
- PTA reporting to PT on responses
- Corresponding w/PT in collaborative manner to determine changes necessary to trx approach based on status
- Supervision of PTA in hospital vs home
15
Q
Collaboration w/ OT and ST
A
coordinate care to address all aspects of rehab needs
16
Q
Collaboration w/Nursing
A
coordinate care and exchange critical patient info
17
Q
Collaboration w/Physician and PA
A
coordinate care and exchange critical patient info
18
Q
Collaboration w/the family
A
- obtain essential info on patient’s PLOF and d/c options
- caregiver involvement in patient care
19
Q
79% of people 70 and older have 1 or more of 7 chronic conditions:
A
- arthritis
- high BP
- diabetes
- lung disease
- stroke
- cancer
7.
20
Q
T/F: 65 and older, 30% have 3 or more chronic conditions making them a medically complex patient
A
True
dementia adds to the complexity
21
Q
Principles of Geriatric Rehab
A
- variability of capabilities
- inactivity / sedentary lifestyle
- optimum health and optimum functional ability
22
Q
variability of capabilites
A
physical, cog, and motivation vary greatly
23
Q
inactivity / sedentary lifestyle
A
inactive lifestyle contributes to debility
24
Q
optimum health and overall well being
A
related to optimum functional ability
25
Geriatric Rehab directed toward:
1. stabilizing primary problems
2. preventing secondary complications
3. restoring lost function
26
Geri Rehab Prep
1. quiet and well lit exam area
2. WC accessibility
3. Adjustable trx table
27
Geri rehab tools
consider patient's cog status when choosing assessment tools
28
Geri Rehab Timing
time of day may impact physical/cog status
29
Geri Rehab: Evaluation considerations
1. endurance may be limited (physical and mental)
2. determine cog status immediately to guide direction of interview questions and physical exam
3. use appropriate p! scales
4. understand difference between depression and dementia
5. keep function at forefront of clinical assessment/decisions
30
Successful aging
1. high capacity to tolerate stressors
2. exercise causes robust positive changes
3. wider homeostatic window
31
unsuccessful aging
1. low tolerance (susceptible to illness)
2. + changes occur at small magnitude
3. narrow homeostatic window
32
Bone Loss in Geriatric population
1. advancing age favors bone catabolism
2. women bone loss accelerated by menopause
3. men bone loss accelerated after 75
4. non-modifiable vs modifiable RF
33
osteoporosis T score
between -1 and -2.5 in LS, total hip, and femoral neck increase risk of fracture
34
Sarcopenia
age related decline in muscle mass
35
Dynapenia
age related decline in strength
36
Loss of Type II
affects strength and power
37
Loss of lean body mass and gain of fat mass
decreased resting metabolic rate of 1-2% per decade after 20 y.o.
38
Cachexia
decline in muscle / body wasting that does not respond to nutritional support
39
When does Cachexia occur?
- before death
- with cancer
- COPD
- end stage disease
40
cachexia is most likely caused by:
massive increase in inflammatory cytokines
41
Geriatrics: decreased water content in CT leads to
decreased height
42
Geri: loss of water in articular cartilage leads to
OA
43
Geri: increased collagen crosslinks+water loss=
joint stiffness and reduced shock absorption
44
reduction of elastin =
saggy, wrinkled skin
45
aging CT contributes to:
1. sports injuries and decreased performance
| 2. displaced internal organs
46
Geriatrics: Exercise Considerations
1. higher intensity exercise = greater strength gains and LBM
2. exercise plays crucial role in controlling intra-abdominal fat
3. achieving end range prevents age related ROM loss
4. CT stiffness increases muscular effort required for movement (red endurance)
5. high impact exercise may not be appropriate w/bone loss or dry CT
47
Geri Changes in CV system
1. decline in MaxHR
2. decline in VO2 Max
3. Stiffer, less compliant vascular tissue
4. Loss of SA node cells
5. Reduced contractility of vascular walls
6. Thickened capillary basement membrane
48
decline in max HR
small aerobic workload
49
decline in VO2 Max
smaller aerobic workload
50
Stiffer, less compliant vascular tissue
1. Higher BP
2. slower ventricular filling time
3. reduced CO
51
Loss of SA node cells
lower max HR
52
reduced contractility of vascular walls
1. slower HR
2. lower VO2 max
3. smaller aerobic workload
53
Thickened capillary basement membrane
reduced arteriovenous O2 uptake
54
Changes in Nervous System
1. sloughing/loss of myelin
2. axonal loss
3. autonomic NS dysfunction
4. loss of sensory neurons
5. slowed response time
55
sloughing/loss of myelin
slowed nerve conduction
56
axonal loss
1. fewer muscle fibers
| 2. loss of fine sensation
57
autonomic NS dysfunction
1. slower systemic function w/altered sensory input
58
loss of sensory neurons
reduced ability to discern hot/cold and p!
59
slowed response time
increased fall risk
60
Changes in sensory function:
| peripheral sensory
```
visual
proprioceptive
auditory
tactile
vestibular
```
61
Changes in sensory function:
| vision
loss of acuity, visual field, and contrast sensitivity
62
Changes in sensory function:
| hearing
presbycusis (slow loss of hearing in both ears)
63
How common is multisensory impairment?
66% have 2+ deficits
64
losses in sensory function lead to
1. depression
2. poor QOL
3. cog decline
4. mortality
65
changes in the immune system
1. Advancing age - increase systemic inflammation
2. Increased IL-1, IL-6, IL-10, C-reactive protein, TNF-alpha
3. Associated with muscle wasting, obesity, and loss of physical function
4. Diminished organ function reduces physiologic reserve
5. Exercise significantly reduces inflammatory markers
6. Habitual exercise results in less systemic inflammation versus being sedentary - creates wider window of homeostasis
7. Visceral fat secretes inflammatory markers– exercise reduces it!
66
changes in endocrine function
1. altered gland function
2. decreased hormone production
3. decreased tissue responsiveness
4. aging hypothalamic-pituitary-gonadal axis
5. (-) effect on muscle mass, bone density, adipose accumulation, insulin sensitivity, LDL metabolism, libido, cognition
6. hormone therapy still an evolving science
66
changes in endocrine function
1. altered gland function
2. decreased hormone production
3. decreased tissue responsiveness
4. aging hypothalamic-pituitary-gonadal axis
5. (-) effect on muscle mass, bone density, adipose accumulation, insulin sensitivity, LDL metabolism, libido, cognition
6. hormone therapy still an evolving science
67
Life Transitions
1. retirement or loss of job
2. parent to grandparent
3. relocation
68
5 guiding principles
1. safety
2. trustworthiness
3. choice
4. collaboration
5. empowerment
69
Trauma Informed Care
understanding:
1. neuro
2. biological
3. psychological
4. social
effects on an individual
69
Trauma Informed Care
understanding:
1. neuro
2. biological
3. psychological
4. social
effects on an individual
70
Geri:
| Depression
1. not a normal part of aging but is common
2. many med conditions contribute
3. can be mistaken for dementia or co-exist w/dementia
4. neg affects PT outcomes
5. exercise/activity can reduce depressive symptoms
71
Geri:
| Suicide
- 17th leading cause of death in 65+ y.o.
- more successful w/attemots
- PTs need to recognize RF and inquire about mental health
71
Geri:
| Suicide
- 17th leading cause of death in 65+ y.o.
- more successful w/attemots
- PTs need to recognize RF and inquire about mental health
