Lecture 3

Question 1

risk factors for chronic disease modifiable

Answer 1

Unhealthy diet
Physical inactivity
Tobacco use/alcohol
Overweight

Question 2

risk factors for chronic disease non modifiable

Answer 2

Age
Gender
Family history
Ethnicity

Question 3

cardiovascular changes with age

Answer 3

• vessel changes
• heart changes
• blood pressure
• cardiac output
• stroke volume
• Vo2 max

Question 4

vessel changes

Answer 4

-Arteriosclerosis
-Atherosclerosis
Vein valves deteriorate = varicose veins and blood pooling, fibrosis
-Capillary walls thicken reducing gas exchange
-decreased responsiveness to beta adrenergic receptor stimulation,
a decreased reactivity to baroreceptors and chemoreceptors, and
an increase in circulating catecholamines

Question 5

Arteriosclerosis

Answer 5

reduced elasticity of aorta
and great arteries = increased resistance (BP),
larger left ventricle

Question 6

Atherosclerosis

Answer 6

build up of fatty plaques

(lifestyle related) DVT, PVD

Question 7

heart changes with age

Answer 7

-Lengthened contraction period
-Ischemic myocardium, cardiac cells hypertrophy
-Heart valves become thicker and become stiff
-Loss of atrial pacemaker cells in SA node = decreased intrinsic heart
rate = more likely to have arrhythmias
-Incomplete relaxation during filling (approx 50% between ages 20 and
70)
-Left ventricle hypertrophy

Question 8

heart rate changes

Answer 8

-Resting HR decreases with age
-Max heart rate decreases 5-10 bpm/decade
(major contributor to decline in oxygen use)
-Slower heart rate recovery after exercise

Question 9

blood pressure changes

Answer 9

-Patient can be diagnosed as hypertensive if mean
systolic measure is > 135 mmHg and mean diastolic
measure is >85mmHg
-BP increases with age because of increased rigidity
of vessels (10-40 mmHg elevation in both systolic
and diastolic) (CSEP)
-Baroreceptors (carotid and aortic) less sensitive to
BP changes – can cause orthostatic hypotension

Question 10

cardiac output changes

Answer 10

total amt of blood ejected
from each ventricle/minute
-Small change with age
-Represents ability of the CV system to deliver
O2 to working muscles
CO = SV X HR

Question 11

stroke volume changes

Answer 11

-amount of blood pumped out of
each ventricle with each beat
-Moderate decline with age

Question 12

Vo2 max changes

Answer 12

-Max. capacity to transport O2 during exercise
-Max. oxygen consumption decreases 5-15% per decade after age
30 (Elia, 1991)
-Depends on CO, lung capacity, amt of 02 muscles can use (fibers,
capilarization)
-Highly trained individuals may show little or no decline with age
-Can be increased with moderate to vigorous exercise

Question 13

respiratory changes with age

Answer 13

-Loss of elastic recoil in lung tissue
-Muscles of chest wall become more stiff, less
pliable, atrophied
• Kyphosis reduces lung capacity
• Ossification of costochondral
cartilage
-Small change in alveoli surface
area (for gas exchange)
-Diminished ability to breathe
deeply, cough and exhale
-Increased size and number of mucous glands in
bronchial tree – narrow airways
-Decrease in ciliary function (decreased immune
response = increase chance of infection)

Question 14

lung volume changes

Answer 14

Increased residual volume (amt of air left in -lungs after
complete expiration) esp. with lower chest wall
compliance
-Decreased expiratory reserve volume (amt of air exhaled
with normal expiration)
-Decreased vital capacity (volume of air that can be
expelled after full inspiration)
-4-5% per decade decrease after age 25

Question 15

general physical changes

Answer 15

-Height loss: related to aging changes in the bones, muscles, and
joints. Typical loss: about 1 cm every 10 years after age 40. More quickly after age 70. You may lose a total of 1 to 3 inches as you age
-Body composition: % body fat increases while lean mass and
bone density decrease. Body weight may not change

Question 16

fat men and women

Answer 16

• Fat internalized in trunk (esp. men)

- Women increase fat in lower body

Question 17

uses for fat

Answer 17

• Source of energy
• Storage for some vitamins (storage fat)
• Cell membrane integrity
• Protection of internal organs
• Brain and nervous system component (essential fat)
• Insulation

Question 18

obesity is associated with higher levels of

Answer 18

• Some cancers (breast, ovarian, colon)
• Hypertension
• Osteoarthritis
• Cardiovascular disease and stroke
• T2 Diabetes
• Fatty liver disease

Question 19

BMI for seniors

Answer 19

BMI healthiest between 27 – 30 kg/m2

overweight category

Question 20

how much weight do you have to lose to improve health

Answer 20

Some studies say as little as 2-5% of current

weight - better outcomes with 10%

Question 21

what are bones good for

Answer 21

• Structure
• Protection
• Mobility
• Calcium storage

Question 22

with age comes height loss

Answer 22

Height loss:

• Disc compression
• Increased kyphosis
• Muscular weakness
• Bone mass loss 1-3% per year after menopause

Question 23

muscle fiber

Answer 23

• single muscle cell

- collection of myofibrils

Question 24

myofibrils

Answer 24

collection of myofilaments

Question 25

myofilaments

Answer 25

actin (thin) filament | myosin (thick) filament

Question 26

changes in muscle

Answer 26

-sarcopenia -Total muscle mass decreases with age (40% loss of muscle mass, 30% decrease in strength- 1-2% per year after age 50 -More pronounced decline in men than women -Decrease in number of muscle fibres -Muscle fibre size decreases slightly (atrophy) -Type II (fast twitch) fibres lost, but may be re-innervated by slow twitch motor unit nerve endings -Reduced number of motor units (motor neuron death in spinal cord) -Capillarization remains unchanged if active -Number of muscle fibres per motor neuron increases with age -Mitochondrial function decreases

Question 27

sarcopenia

Answer 27

``` age-related loss of skeletal mass and function D ```

Question 28

strength

Answer 28

-Peak strength at around age 25 -Plateaus 30-40 -30% loss of strength by age 70 -Contraction and relaxation of muscle takes longer -Max contraction velocity reduced -Loss of isometric and dynamic muscle strength (40% in leg and 30% in arm between ages 30 and 80)

Question 29

maintained

Answer 29

-Muscles used daily -Isometric strength -Eccentric contraction -Slow velocity contractions -Repeated low level contractions -Strength using small joint angles

Question 30

greater decline

Answer 30

-Muscles used less -Dynamic strength -Concentric contraction -Rapid velocity contraction -Power production -Strength using large joint angles

Question 31

joints

Answer 31

-degradation of the articular cartilage -thickening of the subchondral bone with accumulation of poorly mineralized matrix, -osteophyte formation at the margins of joint surfaces, -variable degrees of synovial inflammation, reduced vascularity -degeneration of ligaments and, in the knee the menisci, with eventual ligamentous rupture and meniscal extrusion -hypertrophy of the joint capsule contributing to joint enlargement -Synovial fluid less viscous

Question 32

what does the nervous system do

Answer 32

Receives (through 5 senses), processes and stores sensory information from inside and outside the body, and decides what to do with that information -Along with endocrine system, provides communication between cells of the body

Question 33

central nervous system changes

Answer 33

-Reduction in cerebral blood flow (decreases about 10-20%, in proportion to neuronal loss) -Decline in memory, reasoning, perception -Disturbed sleep/wake cycle -Increased threshold for many sensory modalities including touch, temperature, sensation, proprioception, hearing, and vision -Overall reduction in brain tissue volume due to decreased neuronal size -Number of neurotransmitters and neuroreceptors diminished even in absence of dementia or other neurological diseases -acetylcholine and serotonin in the cortex, dopamine receptors in the neostriata, and dopamine levels in the substantia nigra and neostriata.

Question 34

other age related changes

Answer 34

-General reduction in hormone production affects use of carbohydrate and proteins for fuel -Decreased ability to gain muscle -Metabolism decreases – more difficult to manage weight -Altered glucose tolerance -Impaired thermoregulation -Hyperlipidemia common

Question 35

progressive RT study

Answer 35

- Older people who exercise against a force (machines, free weights, bands) become stronger - Improve walking, stair climbing and standing up from a chair performance - Also improved complex daily activities such as bathing - Reduced pain in those with osteoarthritis - Insufficient evidence to comment on long term risks or effects of PRT

Question 36

HITT study

Answer 36

-Same benefits as traditional endurance training for seniors (found in some studies): • Increased lipolysis and enhanced insulin sensitivity, improved VO2 peak and stroke volume • Because of short bouts, less time for hemodynamic response (BP) • Big benefit – less time to workout