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Developmental concepts > geriatrics 1 > Flashcards

geriatrics 1 Flashcards

1
Q

geriatrics age range

A

65+

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2
Q

erikson’s stages (geriatrics)

A

integrity vs despair

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3
Q

people aged ____ comprised ____ of the US population in ____

A

65+, 20%, 2020

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4
Q

life expectancy continues to ____ with women having ____ life expectancies than men

A

rise, higher

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5
Q

for every ___ women aged 65-74 there are ___ men aged 65-74

A

100 women to 84 men

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6
Q

____% of people aged ___ live in longterm care facilities

A

15%, 85+

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7
Q

many more community dwelling older ____ live ___ than older___

A

older women, live alone, older men

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8
Q

Dips in life expectancy in the US

A
  • civil war
  • WW1
  • Covid
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9
Q

Hayflick limit theory

A
  • cells have limited lifespan
  • biological clock in each cell controls the aging process
  • at some point, cells lose function which creates aging
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10
Q

Neuroendocrine and Hormonal theory

A
  • hypothalamus controls release of many hormones that regulate body functions via chain reactions
  • aging decreases the production of hormones, which decreases ability to repair and regulate body functions
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11
Q

caloric restriction theory

A
  • caloric restriction extends lifespan and slows aging process
  • caloric restriction reduces metabolic rate and oxidative stress, improves insulin sensitivity, alters endocrine and neuro function
  • unknown mechanisms
  • older adults are less likely to restrict calories
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12
Q

Programmed aging theories

A
  • Hayflick limit theory
  • Neuroendocrine and hormonal theory
  • caloric restriction theory
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13
Q

stochastic aging theories

A
  • free radical theory
  • error/catastrophe theory
  • somatic mutation theory
  • cross linking theory
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14
Q

Free radical theory

A
  • free radicals damage cells via oxidation, eventually killing the cells
  • free radicals attach to cells and interfere with normal processes
  • free radicals damage begins at birth and continues until death
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15
Q

somatic mutation theory

A
  • genetic damage or mutation results from radiation, accumulates with age
  • radiation shortens lifespan and damages DNA, causing aging
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16
Q

Cross linking theory

A
  • aging results from cross-linking of proteins
  • cross-links interfere with/slow down normal processes, eventually killing organisms
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17
Q

deconditioning

A
  • for many adults, a substantial portion of “usual” age related decline in functional ability
  • most adults do not engage in sufficient physical activity to derive health benefits
  • reversible with lifestyle modifications
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18
Q

Successful aging includes

A
  • low risk of disease and deconditioning
  • high cognitive and physical function
  • active engagement with life
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19
Q

optimal aging according to Brummel-Smith

A

“the capacity to function across many domains- physical, functional, cognitive, emotional, social, and spiritual - to one’s satisfaction and in spite of one’s medical conditions”

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20
Q

Primary aging

A
  • inevitable
  • affects all systems
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21
Q

secondary aging

A
  • lifestyle
  • environment
  • disease
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22
Q

factors that contribute to healthy aging

A
  • physical activity
  • lifestyle
  • sense of purpose
  • stress management
  • social network
  • family support
  • quality sleep
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23
Q

typical aging

A

gradual decline in functioning of body systems
- musculoskeletal, cardiopulmonary, integumentary, cognitive, visual, auditory, vestibular, and genitourinary

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24
Q

atypical aging

A
  • may look like typical aging but is due to underlying disease processes
  • specifically refers to declines in cognition
  • ex: demential/Alzheimer’s and Mild Cognitive Impairment (MCI)
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25
Q

Cardiopulmonary system aging

A
  • heart disease is the #1 leading COD in geriatric adults
  • decrease in cardiac output
  • decreased blood vessel elasticity
  • heart cells thicken and become more fibrotic (leads to dec ability to pump blood)
  • decrease in pace maker cells (leads to slower hr)
  • decreased chest compliance
  • decreased lung capacity
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26
Q

Musculoskeletal system aging

A
  • 5-10% muscle loss between 20-50yrs
  • 12-15% muscle loss per decade after age 50
  • peak bone density at age 30
  • more bone resorption than deposition leads to osteoporosis, osteopenia, and risk of fx
  • loss in weight, change in body composition
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26
Q

VO2 max ______ by ___% per decade after age __

A

declines by 20%, age 20yrs

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26
Q

Neuro Red flags

A
  • Loss of consciousness (LOC)
  • confusion
  • seizures
  • sudden bowel/bladder incontinence
  • sudden gait abnormalities
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27
Q

neuromuscular system aging

A
  • decrease in brain weight and volume
  • decrease in vascular supply and metabolism
  • decrease in nerve conduction and velocity
  • risk for neurological diseases increases with age (ex: stroke, dementia, epilepsy, ALS, and Parkinson’s)
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27
Q

gastrointestinal system aging

A
  • Oral: decrease in saliva production and increased risk of swallowing difficulty
  • gut: altered digestive hormones, decreased stomach motility, decreased peristalsis
  • overall: earlier satiety, impaired olfaction (affects eating)
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28
Q

Visual system aging

A
  • presbyopia
  • decreased visual acuity (more light needed and larger test)
  • hardening and yellowing of lenses (difficulty distinguishing colors)
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29
Q

Disease in aging of visual system

A
  • cataracts: clouding of lens due to protein build up
  • glaucoma: loss of peripheral vision
  • macular degeneration: loss of clarity at center of visual field
  • retinopathy: damaged blood vessels in the eyes
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30
Q

cataracts occur in ____ of adults age ___

A

70%, 70+

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31
Q

integumentary system aging

A
  • 15% of body weight
  • decreased dermis and epidermis thickness
  • fewer blood vessels, oil, and sweat glands (less thermoregulation and hydration)
  • decreased cellular turnover (inc healing time and dec barrier function)
  • fewer mast cells (inc risk of infection)
  • less collagen and elastin (thinner skin and wrinkles)
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32
Q

skin checks

A
  • skin tears
  • pressure injuries
  • can develop in less than 2 hours (seated every 30 mins for 2 mins)
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33
Q

typical aging: cognition

A
  • slower cognitive speed
  • dec word finding ability (verbal retrieval)
  • dec selective or divided attention
  • difficulty with learning new things
  • dec executive cognitive function (decision making, problem solving, planning, sequencing, and multi tasking)
  • long term memory and procedural memory are stable
  • retention of newly learned material is stable but may take more cueing to recall
  • visual recognition of objects remains stable
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34
Q

atypical aging: cognition

A
  • mood changes
  • visuospatial changes (lost while driving, bumping into things, dec peripheral vision)
  • memory changes (inability to rec people, dec longterm mem)
  • communication difficulties
  • MCI
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35
Q

Mild Cognitive Impairment (MCI)

A

atypical cognitive aging
- reduces capabilities of a person compared to their receptive age and education level, but does not interfere with ADLs (can affect IADLs)
- gradual cognitive decline over 6+ months
- inc rln with education
- inc risk of Alzheimer’s

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36
Q

MCI affects ___% of people age ___ and ____% of people age___

A

19%, 65-74
38%, 85+

37
Q

Dementia

A

atypical aging
- umbrella term of a collection of symptoms
- affects thinking, behavior, and the ability to preform everyday tasks.
- alzheimer’s is most common type

38
Q

diagnostic criteria of dementia

A

2 or more must be significantly impaired:
- memory
- communication and language
- ability to focus and pay attention
- reasoning and judgement
- visual perception

39
Q

Conditions that may present as dementia

A
  • depression
  • uti
  • delirium
  • medication side effects
  • vitamin deficiency
  • alcohol/drug abuse
40
Q

delirium

A
  • sudden change in mental function
  • often accomplished by decreased level of consciousness, slurred speech, agitation, hallucinations, emotional liability
41
Q

causes of delirium

A
  • UTI or infection
  • dehydration
  • hospitalization
  • drug interactions
42
Q

delirium occurs in ___-___% of hospitalized older adults

A

11-42%

43
Q

Atypical aging: depression

A
  • can mimic or occur with dementia
  • biggest contributing factor in older adults is loneliness, life events, and transitions
  • inc occurence in lower socioeconomic status patients
44
Q

depression is the _______ mental health condition in people age ___

A

most common, 65+

45
Q

__-__% of overall older adult population suffers from ____

A

11-16%, depression

46
Q

__-__% of older adults in _______ have depression

A

30-44%, communal living facilities

47
Q

Depression presentation

A
  • sadness, anxiety, irritability, hopelessness
  • cognitive problems - concentration, memory, indecisiveness
  • low self-esteem, apathy
  • withdrawal from family/friends
  • difficulties sleeping
  • weight changes
  • slowed movement
48
Q

Morbidities in geriatric patients

A
  • heart disease
  • hypertension
  • stroke
  • asthma
  • chronic bronchitis or emphysema
  • cancer
  • diabetes
  • arthritis
49
Q

common geriatric mortalities

A
  1. heart disease
  2. cancer
  3. covid
  4. accidents
50
Q

most common types of cancer in geriatric population

A
  1. breast; prostate
  2. lung cancer
  3. colorectal
51
Q

cancer incidence has increased in older adults by ___% in the past __ years

A

26%, 30yrs

52
Q

older adults are ____x more likely to develop cancer than a younger person

A

11x

53
Q

signs and symptoms of cancer

A
  • constant paint that doesn’t change with movement and can wake you up at night
  • weight loss
  • fever
  • extreme fatigue
  • back pain (spinal metastasize??)
54
Q

risk factors for type 2 diabetes

A
  • obesity
  • family history
  • high BP
  • lack of exercise
  • age over 45
  • African American, American Indian, or pacific islander decent
55
Q

Complications of diabetes

A
  • diabetic neuropathy
  • diabetic retinopathy
  • poor wound healing
  • increased risk of stroke
  • increase risk of some cancers
56
Q

key hallmark of fraility

A

decrease in physiologic reserve across multiple organ systems leading to identifiable alterations in physical function

57
Q

signs of fraility

A
  • BMI<18.5
  • weakness
  • slow gait speed
  • low energy
  • shrinking
  • inactivity
58
Q

fraility can be predictive of

A
  • falls
  • hospitality
  • death
  • disability
59
Q

frailness can affect:

A

physical, cognitive, and psychological domains

60
Q

Strokes in geriatric populaiton

A
  • leading cause of long term disabilities
  • reduce mobility in over half of stroke survivors over age 65
61
Q

stroke risk factors

A
  • age
  • high bp
  • diabetes
  • smoking
  • high cholesterol
  • heart disease
62
Q

be FAST

A

(signs of stroke)
Face
Arms
Speech
Time (of symptom onset)

63
Q

UTIs in geriatric patients

A
  • primary infection acquired in hospitals or long term care facilities
  • most common cause of hospitalization for a bacterial infection
  • more common in women
64
Q

__% of women aged 65+ have had a UTI in the last _____

A

10%, 12 months

65
Q

signs and symptoms of UTIs

A
  • fever
  • flank pain
  • hematuria
  • change in mental and functional status
  • reports of falling or loss of balance
66
Q

primary older adults are ____x more likely to have ________ and ____x more likely to be hospitalized

A

4x, pneumonia, 5x

67
Q

Pneumonia

A
  • increased risk of aspiration with age
  • decreased immune system response
  • decreased ability to clear the airway (weaker supportive muscles like diaphragm and intercostals)
68
Q

______ is the second leading cause of hospital acquired infection

A

pneumaonia

69
Q

pneumonia occurs in ___% of all hospital admissions

A

8-10%

70
Q

pneumonia leads to roughly ___% of all diagnosis admissions and results in a __% mortality rate

A

50%, 33%

71
Q

ageism is associated with

A
  • earlier death (7.5 years)
  • poorer physical and mental health
  • poor health behaviors
72
Q

______ is the #1 leading cause of death in geriatric adults

A

heart disease

73
Q

heart cells _____ and become more _____, leading to a decreased ability to pump blood

A

thicken, fibrotic

74
Q

__-__% muscle loss between ages __-__

A

5-10%, 20-50yrs

75
Q

__-__% muscle loss per decade after age __

A

12-15%, 50yrs

76
Q

peak bone density at age __

A

30 yrs

77
Q

the integumentary system accounts for __% of body weight

A

15%

78
Q

______ dermis and epidermis thickness in geriatric age

A

decreased

79
Q

____ blood vessels, oil, and sweat glands in old age leads to _____ thermoregulation and hydration

A

fewer, less

80
Q

_______ cellular turnover in old age leads to an ____healing time and _____ barrier function

A

decrease, increase, decrease

81
Q

____mast cells in old age leads to an ____

A

fewer, increased risk of infection

82
Q

____collagen and elastin in old age leads to ____ skin and _____

A

less, thinner, wrinkles

83
Q

in typical aging, cognitive speed is _______ in old age

A

slower

84
Q

in typical aging, there is a ______ in word finding ability (verbal retrieval) in old age

A

decrease

85
Q

in typical aging, there is a _____ in selective or divided attention in old age

A

decrease

86
Q

in typical aging, ______ with learning new things in old age

A

difficulty

87
Q

in typical aging, there is a _____ executive cognitive function in old age including

A

decrease
- decision making
- problem solving
- planning
- sequencing
- multi tasking

88
Q

in typical aging, _____ term memory and ______ memory are stable

A

long, procedural

89
Q

in typical aging, retention of newly learned material in old age is ________, but _______

A

stable, may take more cueing to recall

90
Q

in typical aging, visual recognition of objects remains ____ in old age

A

stable

91
Q

cataracts:

A

clouding of lens due to protein build up

92
Q

glaucoma:

A

loss of peripheral vision

93
Q

macular degeneration:

A

loss of clarity at center of visual field

94
Q

retinopathy:

A

damaged blood vessels in the eyes

Developmental concepts (6 decks)

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