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Flashcards in Ageing Deck (38)
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What is ageing/senescence

Process of growing old


2 theories behind ageing

- accumulation of damage to DNA for example loss of telomeres or oxidative damage
- programmed ageing describe how immunological, genetic and hormonal changes over time lead to ageing


Main difference between 2 ageing theories

DNA theory suggests that ageing could be reversed


What does population ageing refer to

Increasing age of a whole country due to increasing life spans and falling fertility rates


Define life expectancy

Statistical measure of the number of years a person can expect to live


What is the challenge of an elderly persons presentation

Very often is atypical and there is a non-specific presentation of disease


What does a non-specific presentation mean

Underlying pathology is not immediately or clearly linked to the presentation. Falls, delirium and reduced mobility are very common reasons for elderly people seeking medical attention but underlying problems can actually be the cause


What are the giants of geriatric medicine

Intellectual impairment
Iatrogenic problems


Problems with the giants of geriatric medicine

Mislead patients and doctors as they attribute symptoms to old age which can delay treatment


What is frailty in medical terms

Loss of functional reserve among older people causing impairment of their ability to manage everyday activities. Increases the likelihood of adverse events and deterioration when faced with minor stressor


What is special about medicine for the elderly

Multidisciplinary team consisting of doctors, nurses, therapists and social workers etc


Need for multidisciplinary team in medicine for elderly

Most of the time present with a large range of symptoms


Problems associated with drug treatments for the elderly

Changes in pharmacodynamics and pharmacokinetics can make drug treatments in the elderly more likely to harm them- doctors have to think twice about prescribing them
Most drug trials have few elderly people in so evidence for their effects on the elderly are very understudied


What changes does the brain undergo in ageing

Increased volume of CSF
Widening of ventricles
Widened major gyri


Changes in the size of brain throughout life

Reaches maximum weight around 20 years of age and remains at this weight until40-50years. Decreases by 2-3%/decade following this


What is abnormal about cognitive development in the elderly

Changes in cognitive ability are normal but severe impairment indicates a problem


Reason for low rates of dementia diagnosis

Combination of misinterpretation- its normal for the elderly to have memory problems
Fatalism- we cant do anything about it so no point diagnosing it
Social isolation- no one is around them to notice


Difference between dementia and delirium in terms of onset

Dementia chronic and progressive
Delirium is acute


Difference between dementia and delirium in terms of cause

Dementia- alzheimers and vascular (can be unclear)
Delirium- infection or medication changes (normally a clear precipitant)


What group of people is delirium common in

Dementia sufferers- delirium can also lead to dementia


Progression of dementia

Starts with memory issues then leads to include all cognitive functions


Name given to condition where people dont quite meet the dementia criteria

Mild cognitive impairment- have mild problems but dont yet impair their day to day life


2 tests for cognitive impairment

Clock drawing
Abbreviated mental test


Tools used to distinguish between dementia and delirium

Confusion assessment method


What is 4AT test

Clinical test used to rapidly diagnose delirium


What is name given to more detailed cognitive assessment test

Montreal Cognitive Assessment


Outated assessment test that is used much less

Mini Mental State Examination


Changing nature of elderly population

Increased education of eldery people
Reduction of poverty
More people work for longer
More complex retirement process


Challenges facing society from ageing population

Balance between working life/retirement
Healthy old age is extended
Have to care for older people- sanwich generation where have to care for older relative and raise children at same time
Outdated ageist beliefs
Medical system designed for single acute diseases


Problems facing health care services

Increasing demand for all degrees of healthcare
Increasing complexity of disease
Navigating health and social care divide