GERI-AGIN Flashcards
(40 cards)
Why do we have a gray crisis?
- improved life expectancy
- decrease in birth rates
- public health improvements (abx, vaccination
What percentage of the population will be over 65yo by 2050?
30%! 82.5 million people
What are the two key theories behind the biology of aging?
Genetic Predisposition:
-things are predisposed to go badly for certain people
Wear and Tear: -accumulated pathology, carcinogens, cellular trauma, etc.
What is the rule of fourths things that impact aging over time?
1/4 disease,
disuse (atrophy),
misuse (injury)
physiology (elasticity, density - things don’t hold up over time)
What are some important characteristics of aging?
- increased mortality with age after maturation
- biochemical composition of tissues changes
- physiological capacity decreases
- decrease in response to environmental stimuli (more likely to hurt themselves because they’re not as sensitive to the outside world)
- increased vulnerability to disease
- epigenetic (telomeres, DNA changes over time, etc.)
What are some important age-related physical changes noted in the slides?
- blood pressure regulation: orthostasis
- volume regulation: dehydration, over-hydration
- thermoregulation: colder
- impaired immune response: increased infection
What are some important age-related sensory changes noted in the slides?
- vision: reduced lens elasticity
- hearing: increased vestibular sensitivity, reduced acoustic sensitivity
- taste: reduced
- smell: reduced
- touch: reduced reflex
How does the heart change with aging?
max HR is 195 in adults; reduces to 155 in geriatrics
How does the skin change with aging?
reduced elasticity - wrinkles!
How do the kidneys change with aging?**
reduced by 50% perfusion
How does the GI tract change with aging?
reduced peristalsis/secretions - elderly pts are often constipated
What happens to body composition during aging?
% body water = decreased
% body fat = increased
What happens to the brain during aging?
weight decreases by 7% atrophy
- more brain damage because there’s more space for the brain to move around and hit things during a fall
What happens to sleep patterns during aging?
markedly reduced stage 3 and 4 sleep more frequent awakenings, reduced sleep efficiency
What happens to bone mineral content during aging?
diminished by 10-30%
What happens to the prostate gland during aging?
increases by 100% - can be up to the size of a grapefruit!
What happens to sexual function during aging?
men: reduced intensity and persistence of erections; decreased ejaculate and ejaculatory flow
women: menopause; reduced lubrication; vaginal atrophy
What does diminished reserve mean?
There’s not as much backup reserve and our systems don’t work as efficiently as they did before
What are some physiological and clinical examples of diminished reserve?
Physiological: -pulmonary capacity
-renal clearance 1/10th of pop: CKD, 8th leading cause of death
Clinical: -increased sleep requirement
-decreased calorie needs (less activity)
-skin alterations that result in decreased protection -nocturia
What can we see as far as brain change on CT of a geriatric pt?
- loss of brain parenchyma
- enlargement of ventricles
- widened sulci
What can we see on imaging of a pt with osteoporosis?
- thinned cortex from inside out
- scanty trabecular
- osteophitic changes
- edges of the bone have a scattered, jagged appearance; they have holes, more bone spurs, etc.
- their bones are more likely to break
What do we see on CXR of someone with CHF?
- interstitial pulmonary edema
- cardiomegaly
- redistribution of pulmonary blood to upper lungs -indistinct hilar margins and blurring of pulmonary vessels
- Kerley B lines at costophrenic angles
- increased central interstitial markings
- HF leading cause of death in the US
What are some important consequences of aging to note?
-atypical presentation of disease
- things do not appear how they do in the textbook! Occam’s Razor - usually the most simple solution is usually the right one but in these pts, we can seldom diagnose one single thing.
Most of their diseases become multifactorial due to comorbidities
-decreased physiological compensation
What is the third leading cause of death (2017) in the US?
HCP-increased risk of iatrogenic consequences of illness polypharmacy
