geriatrics 1 Flashcards
(97 cards)
1
Q
geriatrics age range
A
65+
2
Q
erikson’s stages (geriatrics)
A
integrity vs despair
3
Q
people aged ____ comprised ____ of the US population in ____
A
65+, 20%, 2020
4
Q
life expectancy continues to ____ with women having ____ life expectancies than men
A
rise, higher
5
Q
for every ___ women aged 65-74 there are ___ men aged 65-74
A
100 women to 84 men
6
Q
____% of people aged ___ live in longterm care facilities
A
15%, 85+
7
Q
many more community dwelling older ____ live ___ than older___
A
older women, live alone, older men
8
Q
Dips in life expectancy in the US
A
- civil war
- WW1
- Covid
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
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
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
12
Q
Programmed aging theories
A
- Hayflick limit theory
- Neuroendocrine and hormonal theory
- caloric restriction theory
13
Q
stochastic aging theories
A
- free radical theory
- error/catastrophe theory
- somatic mutation theory
- cross linking theory
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
15
Q
somatic mutation theory
A
- genetic damage or mutation results from radiation, accumulates with age
- radiation shortens lifespan and damages DNA, causing aging
16
Q
Cross linking theory
A
- aging results from cross-linking of proteins
- cross-links interfere with/slow down normal processes, eventually killing organisms
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
18
Q
Successful aging includes
A
- low risk of disease and deconditioning
- high cognitive and physical function
- active engagement with life
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”
20
Q
Primary aging
A
- inevitable
- affects all systems
21
Q
secondary aging
A
- lifestyle
- environment
- disease
22
Q
factors that contribute to healthy aging
A
- physical activity
- lifestyle
- sense of purpose
- stress management
- social network
- family support
- quality sleep
23
Q
typical aging
A
gradual decline in functioning of body systems
- musculoskeletal, cardiopulmonary, integumentary, cognitive, visual, auditory, vestibular, and genitourinary
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)
25
Cardiopulmonary system aging
- 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
26
Musculoskeletal system aging
- 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
26
VO2 max ______ by ___% per decade after age __
declines by 20%, age 20yrs
26
Neuro Red flags
- Loss of consciousness (LOC)
- confusion
- seizures
- sudden bowel/bladder incontinence
- sudden gait abnormalities
27
neuromuscular system aging
- 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)
27
gastrointestinal system aging
- 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)
28
Visual system aging
- presbyopia
- decreased visual acuity (more light needed and larger test)
- hardening and yellowing of lenses (difficulty distinguishing colors)
29
Disease in aging of visual system
- 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
30
cataracts occur in ____ of adults age ___
70%, 70+
31
integumentary system aging
- 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)
32
skin checks
- skin tears
- pressure injuries
- can develop in less than 2 hours (seated every 30 mins for 2 mins)
33
typical aging: cognition
- 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
34
atypical aging: cognition
- 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
35
Mild Cognitive Impairment (MCI)
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
36
MCI affects ___% of people age ___ and ____% of people age___
19%, 65-74
38%, 85+
37
Dementia
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
diagnostic criteria of dementia
2 or more must be significantly impaired:
- memory
- communication and language
- ability to focus and pay attention
- reasoning and judgement
- visual perception
39
Conditions that may present as dementia
- depression
- uti
- delirium
- medication side effects
- vitamin deficiency
- alcohol/drug abuse
40
delirium
- sudden change in mental function
- often accomplished by decreased level of consciousness, slurred speech, agitation, hallucinations, emotional liability
41
causes of delirium
- UTI or infection
- dehydration
- hospitalization
- drug interactions
42
delirium occurs in ___-___% of hospitalized older adults
11-42%
43
Atypical aging: depression
- 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
depression is the _______ mental health condition in people age ___
most common, 65+
45
__-__% of overall older adult population suffers from ____
11-16%, depression
46
__-__% of older adults in _______ have depression
30-44%, communal living facilities
47
Depression presentation
- sadness, anxiety, irritability, hopelessness
- cognitive problems - concentration, memory, indecisiveness
- low self-esteem, apathy
- withdrawal from family/friends
- difficulties sleeping
- weight changes
- slowed movement
48
Morbidities in geriatric patients
- heart disease
- hypertension
- stroke
- asthma
- chronic bronchitis or emphysema
- cancer
- diabetes
- arthritis
49
common geriatric mortalities
1. heart disease
2. cancer
3. covid
4. accidents
50
most common types of cancer in geriatric population
1. breast; prostate
2. lung cancer
3. colorectal
51
cancer incidence has increased in older adults by ___% in the past __ years
26%, 30yrs
52
older adults are ____x more likely to develop cancer than a younger person
11x
53
signs and symptoms of cancer
- 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
risk factors for type 2 diabetes
- obesity
- family history
- high BP
- lack of exercise
- age over 45
- African American, American Indian, or pacific islander decent
55
Complications of diabetes
- diabetic neuropathy
- diabetic retinopathy
- poor wound healing
- increased risk of stroke
- increase risk of some cancers
56
key hallmark of fraility
decrease in physiologic reserve across multiple organ systems leading to identifiable alterations in physical function
57
signs of fraility
- BMI<18.5
- weakness
- slow gait speed
- low energy
- shrinking
- inactivity
58
fraility can be predictive of
- falls
- hospitality
- death
- disability
59
frailness can affect:
physical, cognitive, and psychological domains
60
Strokes in geriatric populaiton
- leading cause of long term disabilities
- reduce mobility in over half of stroke survivors over age 65
61
stroke risk factors
- age
- high bp
- diabetes
- smoking
- high cholesterol
- heart disease
62
be FAST
(signs of stroke)
Face
Arms
Speech
Time (of symptom onset)
63
UTIs in geriatric patients
- primary infection acquired in hospitals or long term care facilities
- most common cause of hospitalization for a bacterial infection
- more common in women
64
__% of women aged 65+ have had a UTI in the last _____
10%, 12 months
65
signs and symptoms of UTIs
- fever
- flank pain
- hematuria
- change in mental and functional status
- reports of falling or loss of balance
66
primary older adults are ____x more likely to have ________ and ____x more likely to be hospitalized
4x, pneumonia, 5x
67
Pneumonia
- increased risk of aspiration with age
- decreased immune system response
- decreased ability to clear the airway (weaker supportive muscles like diaphragm and intercostals)
68
______ is the second leading cause of hospital acquired infection
pneumaonia
69
pneumonia occurs in ___% of all hospital admissions
8-10%
70
pneumonia leads to roughly ___% of all diagnosis admissions and results in a __% mortality rate
50%, 33%
71
ageism is associated with
- earlier death (7.5 years)
- poorer physical and mental health
- poor health behaviors
72
______ is the #1 leading cause of death in geriatric adults
heart disease
73
heart cells _____ and become more _____, leading to a decreased ability to pump blood
thicken, fibrotic
74
__-__% muscle loss between ages __-__
5-10%, 20-50yrs
75
__-__% muscle loss per decade after age __
12-15%, 50yrs
76
peak bone density at age __
30 yrs
77
the integumentary system accounts for __% of body weight
15%
78
______ dermis and epidermis thickness in geriatric age
decreased
79
____ blood vessels, oil, and sweat glands in old age leads to _____ thermoregulation and hydration
fewer, less
80
_______ cellular turnover in old age leads to an ____healing time and _____ barrier function
decrease, increase, decrease
81
____mast cells in old age leads to an ____
fewer, increased risk of infection
82
____collagen and elastin in old age leads to ____ skin and _____
less, thinner, wrinkles
83
in typical aging, cognitive speed is _______ in old age
slower
84
in typical aging, there is a ______ in word finding ability (verbal retrieval) in old age
decrease
85
in typical aging, there is a _____ in selective or divided attention in old age
decrease
86
in typical aging, ______ with learning new things in old age
difficulty
87
in typical aging, there is a _____ executive cognitive function in old age including
decrease
- decision making
- problem solving
- planning
- sequencing
- multi tasking
88
in typical aging, _____ term memory and ______ memory are stable
long, procedural
89
in typical aging, retention of newly learned material in old age is ________, but _______
stable, may take more cueing to recall
90
in typical aging, visual recognition of objects remains ____ in old age
stable
91
cataracts:
clouding of lens due to protein build up
92
glaucoma:
loss of peripheral vision
93
macular degeneration:
loss of clarity at center of visual field
94
retinopathy:
damaged blood vessels in the eyes
