Medicine in the Elderly* Flashcards Preview

Year 3 Human Disease > Medicine in the Elderly* > Flashcards

Flashcards in Medicine in the Elderly* Deck (18):
1

3 areas of implications of ageing population

-healthcare costs
-social/homecare costs
-economic

2

4 personality types of old people

-integrated: active, satisfied, flexible, functioning
-armouredL fights ageing, preoccupied with loss
-passive: dependent, low level of life satisfaction
-angry: low activity, low life satisfaction, bitter

3

4 skin changes

-wrinkles
-dry
-cambell de morgan spots
-seborrhoic keratosis

4

6 changes in mouth

-dec saliva production
-impaired mm mastication
-tooth loss
-decreased taste buds
-less sense of smell
-enlargement of tongue

5

21 other physiological changes

-less hepatic drug metabolism
-less GFR (Glomerular filtration rate) 50%
-prostate enlargement
-decreased bladder capacity
-bone loss
-thickening of valves AS
-dilation of large elastic arteries
-increased systolic BP
-reduced stroke volume/ CO
-decline in carviovascular stress response
-fall in forced vital capacity FVC and FEV1 forced expiratory volume
-reduced brain weight
-presbyacusis (hearing loss)
-hardening of lens (impaired near vision)
-flatter cornea (astigmatism)
-reduced lean body mass
-increase fat mass
-impaired ability to maintain body temp
-reduced oestrogen levels
-inc immune deficiency

6

4 IQ changes

-cross sectional studies suggest decline
-longitudinal studies suggest preserved
-verbal scores preserved
-tests requiring speed of response deteriorate

7

5 specific features of disease presentation

-non specific presentation
-atypical presentation
-multiple pathology
-symptoms attributed to old age
-single illness leading to catastrophic outcome

8

4 Is of non specific presentation

-Intellectual failure
-Incontinence
-Immobility
-Instability

9

3 atypical presentations

-myocardial infarction without chest pain (dyspnoea, confusion, hypotension)
-infection without inc WCC or temp
-silent perforation (eg stomach ulcers

10

6 symptoms erroneously attributed to old age

-hypothyroidism
-anaemia
-bowel problems
-urinary problems
-shortness of breath
-forgetfulness

11

8 single illness leading to catastrophic consequences

-pneumonia
-delirium
-postural instability
-fall
-fracture neck of femur
-immobility
-DVT/ PE
-death

12

5 physical signs of ageing

-small irregular pupils
-absent ankle reflexes
-reduced vibration sensation
-displaced apex (kyphoscoliosis)
-pulmonary crackles

13

drug reaction stats

5-15% of hospital admissions caused by adverse drug reactions
6-17% have adverse drug reactions in hospital

14

altered pharmacology with ageing 3

-less renal drug clearance
-variable changes to hepatic drug metabolism
-changes to volume of distribution
(use child doses)

15

change in volume of distribution 3

-more fat, less lean muscle
-lipid soluble drugs have inc volume of distribution --> prolonged effect eg diazepam
-water soluble drugs have smaller volume of distribution --> more rapid peak eg digoxin

16

figures by 2036

60-75 inc by 50%
>75 inc by 75%
15-44 dec by 8%

17

% of drug interactions resulting in adverse effect

10%

18

issues of drug compliance 4

40-75% compliance due to :
-lots of drugs to take
-dementia --> forget to take drugs
-10% of elderly take drugs prescribed for someone else
-20% of elderly take drugs not currently prescribed