E3 Flashcards
(30 cards)
What is the geriatric population make-up for ages 65, 65-74, 75-84, >85
65 = 40.4 mill 65-74 = 21.7 mill 75-84 = 13.1 mill >85 = 5.5 mill
What are the follow 2030 estimates
Age >65 yo %
Age >85 yo %
Age >65 yo % = 20%
Age >85 yo % = 14%
What was the 2017 life US expectancy
78.6 yo
How does elderly hospital usage differ from younger individuals
Use disproportionately more medical care
40% of inpatient surgical procedures
Greater than 2-3 times more surgical procedures
With >3x cost for hospital care in age >85 yo
What are two primary take-aways about aging
-Aging is associated w/ progressive loss of functional reserve in all organ systems
The extent of losses vary greatly between individuals
What are factors affecting aging
Genetic makeup lifestyle choices Environmental exposure Nutrition Chance
What kind of process is aging
NOT homogenous
What makes up 75% and 25% of longevity
75%: Lifestyle choices environmental exposure Nutrition Chance
25%
Genetic makeup
How does genetic mutation affect aging
Can extend life by more resistant to lethal injury from oxidative agents, heat, heavy metal, or radiation
List mechanisms that lead to defects in aging
Oxidative damage DNA damage and repair Mitochondrial senescence Malfunction of proteins Environmental factors
How does the process of oxidative damage affect aging
Free radicals:
by product of O2 use during energy metabolism
Generation of free radicals:
- Causes damage to chromosomal DNA
- Impairs gene function
- damage to telomeres
Define telomere and free radicals
Telomere:
- Short protective ends on DNA
- Group of nucleotide sequences protects the end of DNA from unraveling and interacting w/ compounds
How does DNA damage and repair contribute to defects of aging
Increases w/ somatic mutations are well recognized
Key enzymes:
Poly-adp ribose polymerase 1 (PARP-1)
Telomere length
How do telomere length and PARP-1 correlate w/ aging?
Levels and telomere length correlate positively to lifespan
How does mitochondrial senescence contribute to aging defects
INC incidence of mutated mitochondrial DNA located in brain tissues, muscle cells and the gut
How does malfunction of proteins contribute to aging defects
Accumulation of malfunctioning proteins which are more difficult to clear as we age
Seen in many age related dx such as Parkinsons dx, Alz, and senile cataracts
How do environmental factors contribute to aging defects
By utilizing metabolic resources for competing physiological demands (growth , maintenance, reproduction)
What is disposable soma theory
Natural selection has led to pathways that optimize utilization of metabolic resources (energy) among competing physiological demands.
What are age associated physiologic changes r/t age
Altered physiologic rhythms
Loss of complexity
Homeostenosis
What physiologic rhythms may be impaired in aging
Can see changes in the ability to respond to alterations
- Reset body temp
- Plasma cortisol
- Sleep = desynchronization
How does physiologic loss of complexity affect aging
Decreases variability for HR, BP, response to auditory frequency, response to stress
What is homeostenosis
Diminished physiologic reserve available to meet the challenges to homeostasis
-diminished ability to compensate w/ change
What is frailty syndrome
Refers to multi-system loss of physiologic reserves
-makes a person more vulnerable to disability during and after stress
What are characteristics and drivers of frailty syndrome
Characteristics:
- Weight loss, fatigue, weakness
- DEC mobility
- Poor exercise tolerance
- unstable balance
- malnutrition
- muscle wasting
Drivers:
Chronic inflammation
-endocrine dysregulation
