- Gender - Genetics - Lifestyle

Intro. to Geriatrics Flashcards by Ryan C

T/F: Old age or being a geriatric is defined as 60 years and over.

False; 65 years old!

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When does medical care dramatically rise amongst all age groups? (Hint it’s in the geriatric range)

75 years old

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T/F: Women outlive men

True

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By 2050, the percent of white elders will ______ by 20% and Asians & Hispanic percent rate will _______ by 300%.

Drop; Increase

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As we get older, we get obese and unhealthy. Womp womp womp. Why?

We are overfed and undernourished!

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The percentage of income that Social Security provides differs from total income depending upon income level.

And in modern times, less elders are in the low-income/poverty level. And the high income groups have increased.

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T/F: Better healthcare is extending lives

False! This change is due to changes in public health.

Cleaner Water
Better nutrition
Less poverty
Improved Prenatal Care
Childhood Immunizations
Smoking Less
Safety Measures

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On a very basic level, what is the cause of human aging?

Disruption of homeostasis

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Factors of aging:

Gender
Genetics
Lifestyle

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Common causes of death since the 1940s

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Common Sensory Impairments due to Aging

Presbycusis (50%)
Presbyopia (20%)
Memory Impairment (10%)
No natural teeth (33%)

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Common Geriatric Syndromes

Falls
Urinary Incontinence
Confusion
Immobility
Sleep Disorders
Fatigue
Weight Loss

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T/F: Generally, minority group members die later in life from preventable causes

False; They die earlier

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Goal of geriatrics:

Older adults will maintain full function and live active lives in their homes and communities

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Two foundations of Geriatric Medicine

Ethical Decision Making (can vs. should)

2. Patient-Centered Care

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What to consider with Patient-Centered Care? (FIFE)

F- Feelings (hopes and fears)
I- Ideas about what’s going on
F- Function (How is the illness affecting their life?)
E- Expectations

When assessing the older adult, what should we focus on?

***Healthy or successful aging – Quality of Life

Understand and mobilize family, social, and community supports
Important of skill directed to functional assessment
Opportunities for promoting older adult’s long-term health and safety

Geriatric/Aging Changes of Blood Pressure

Widened Pulse Pressure

Geriatric/Aging Changes of Heart Rate and Rhythm

Rhythms Change in multiple ways!

Maximum Rate decreased!

Geriatric/Aging Changes of Respiratory Rate and Temperature

RR Unchanged

Basal Temp lowered

Geriatric/Aging Changes of Integumentary System

Think Skin
Grey Hair
Thick Nails
Sun Damage starts catching up

Geriatric/Aging Changes of Eyes

Increased incidence of degenerative diseases

- Presbyopia

Geriatric/Aging Changes of Ears

Presbycusis

Geriatric/Aging Changes of Thorax and Resp System

Increased Chest Wall Stiffness
Osteoporosis and Kyphosis can reduce the thoracic capacity
Osteoporosis, kyphosis, and alveolar stiffness leads to “senile emphysema” with FEV1/FVC < 70% of the predicted for age and gender.

Respiratory Problems are associated with all cause mortality and specifically with:

- CVD - COPD - Lung Cancer

Geriatric/Aging Changes of the CV System

- Reduced Cardiac Output - Increased BP - Increased Peripheral Vascular Resistance

Geriatric/Aging Changes of Male and Female Genitalia

- Female: Menopause between aged 48-55 - Male: ED - common after 4th decade -- important marker for CVD - Prostate: BPH

Geriatric/Aging Changes of MSK

- Loss of height - Loss of Muscle Mass - Osteoarthritis - Osteoporosis - Increased risk for fracture

Geriatric/Aging Changes of Neuro

- Neuronal loss is normal in the aging brain but ability to learn remains generally unchanged - Recall memory declines - Increased incidence of dementias

Geriatric/Aging Changes of Renal System

- Decreased renal mass and size - Mostly loss of renal cortex - 40% less glomeruli by age 80 - Reduced Renal Blood Flow (dec 10% reduction per decade after 20) - Less Urine Concentration

Geriatric/Aging Changes of GI

- Decreased Global Functions (secretion/absorption)

Geriatric/Aging Changes of Endocrine

- Hypothyroidism - DM has an increased incidence - Vitamin D absorption - Parathyroid Issues - Androgen/Estrogen lessens

Geriatric/Aging Changes of Immune System

- Global Decrease in immune function and response to antigens

Things to think about when treating the elderly

- They can undergo most surgeries that younger patients can - Treat infections AGGRESSIVELY - Mental Status Changes, you should think urgent/emergent disease

ADLs

- Bathing - Dressing - Toileting - Transferring - Continence - Feeding

IADLs

- Using Telephone - Shopping - Preparing Food - Housekeeping - Laundry - Transportation - Taking Medications

Health Promotions and Counseling

- Encourage regular health screening exams - Assess vision and hearing - Encourage immunizations (flu- annually, pneumococcal single does) - Encourage household safety - Encourage cancer screening - Assess for depression - Assess for dementia and mild cognitive impairment - Assess for elder mistreatment

Things older patients should do, that you should advocate for with every visit:

1. Exercise! Some is better than none! We need to maintain maximal muscle mass 2. Maintain Careful Hydration 3. Maintain Nutritional Status 4. Avoid excess weight gain, but protect weight loss unless morbidly obese.

A drop in LDL, TG, and/or albumin are red flags for?

Senescence and decline