Cours 14 : Aging and fragility

Question 1

At what age is someone considered a senior?

Answer 1

65+

Question 2

What is going with aging in Canada?

Answer 2

Canada has now more seniors than children
1 in 6 Canadians is at least 65 years old

Question 3

What is the median age of Canadian population?

Answer 3

40, just know that there’s more adults than before

Question 4

What is the most common condition found among the elderly?

Answer 4

Hypertension

Conditions are found with the increase of age

Question 5

What are the top 3 conditions found in seniors?

Answer 5

1. Hypertension
2. Arthritis
3. Heart diseases

Question 6

What is frailty?

Answer 6

Typically found in elderly adults over 65 year old.

It’s the acceleration in physical & cognitive decline due to aging

Diagnosis based on :
muscle weakness
decrease in physical activity
decrease in walking speed
physical exhaustion
unintentional weight decrease

Question 7

What is the holistic definition of frailty?

Answer 7

Increase in vulnerability to internal and external stressors (due to the decrease of physiological nerves)

Question 8

What is an allostatic load?

Answer 8

Refers to the long-term effects of continued exposure to chronic stress on the body

Question 9

What are ways to prevent frailty in seniors?

Answer 9

Exercise, nutrition and socialization

Question 10

What is sarcopenia?

Answer 10

Age related loss of skeletal muscle mass. Associated with an increase of physiological and functional vulnerability

Question 11

What is osteopenia?

Answer 11

Age related loss of bone mineral density . associated with increase risk of osteoporosis. -1 to -2.5 SD (T-score)

Question 12

What are balance disorders?

Answer 12

• Disturbance that causes an individual to feel unsteady, or have a sensation of movement (ex: spinning) when standing or lying down

– Can be caused by certain health conditions (ex: high BP), medications, or a problem in the inner ear or the brain

Question 13

What are nutritional problems?

Answer 13

– Elderly sometimes lose their appetites, and do not eat correctly.

– They may not feel like eating or are simply lonely. They may not have the energy or are on limited budgets

Question 14

What are the physiological changes in the cardiovascular system?

Answer 14

-↓ VO2 peak and Max HR
-↑ Resting and Exercise BP

vo2 peak for frail adult = 14 ml/kg/min

Question 15

What are the physiological changes in the musculoskeletal system?

Answer 15

-↓ Musc Strength, Flexibility,
Balance and Muscle Mass

65 yr old men : decrease by 20%
65 yr old women : decrease in 25% to 50%

Question 16

What are the physiological changes in the nervous system?

Answer 16

-↑ Time of reaction (↓ conduction
speed by 20%)
-↓ Sensory System

decrease in nerve conduction by 20% because of neuronal degeneration

Question 17

What are the physiological changes in the metabolic system?

Answer 17

-↓ Basal Metabolic Rate and Lean
Body Mass, which can lead to increase for diabetes
-↑ Body Fat

Question 18

Which variables has showed the strongest correlation with the risk of falls in older adults?

Answer 18

Increase of time of reaction

Question 19

Which training mode can decrease the risk of reaching the disability threshold?

Answer 19

Strength training

Range of muscle mass and strength between individuals

Question 20

What are the postural changes associated with frail older adults?

Answer 20

Forward head position
Rounded shoulders
Kyphosis (rounded back)
Knee flexion

Question 21

What are the gait changes in the older adult?

Answer 21

Decreased velocity (= speed)
Decreased step length
Decreased step rate (cadence)
Decreased swing phase (time)
Increased stance phase (time)
Decreased hip, knee, ankle flexion
Decreased power generation at
push-off

Question 22

What are the exercise recommendation for frail seniors for aerobic mode?

Answer 22

Increase in functional capacity and independence

Intensity : pre = 9-11
Frequency : 3-5 days/week
Duration : 30 min/session –> 2 x 15 mins or 3x 10 mins
Allow rest periods

Question 23

What are the exercise recommendation for frail seniors for strength mode?

Answer 23

Prevent or reverse frailty

Start program without weight
10-15 reps for 3 sets
3 days/week

Question 24

What are the exercise recommendation for frail seniors for flexibility mode?

Answer 24

Prevent injury (ex : frozen shoulder)

Stretches sustained for 10 to 30 sec (3 to 5 reps)

2-3 times /week

Question 25

What are the exercise recommendation for frail seniors for neuromuscular mode?

Answer 25

Prevent falls

2-3 times/week

reduce and/or distract vision during exercises