S2 L1 Older People's Health and Dementia Flashcards Preview

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Flashcards in S2 L1 Older People's Health and Dementia Deck (16)
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1
Q

What are some changes that occur in the respiratory system during ageing?

A
  • Loss of elasticity so compliance of lung decreases, TLC/FVC/FEV1 all fall

- Atelectasis, PE and pneumonia all common post op conditions in the elderly due to changes in structure. Complications more common in smokers and those with abdominal/thoracic surgery

- Obstructive sleep apnea common as loss of elastic tissue around oropharynx so may collapse in sleep so be carefule with sedative medicatin

2
Q

What are some changes as we age that we need to think about when prescribing drugs to the elderly (pharmacokinetics)?

A
  • Elderly patients have increased sensitivity to CNS depressant drugs so alter dose, e.g benzodiazepenes and opiates

- Reduced hepatic and renal function so slower metabolism of drugs

  • Reduced CO so delay in IV anaesthesia and reduced dose needed
  • Reduced total body water and increased adipose so changes in volume of distribution of drugs
  • Plasma proteins reduced so increased free drug availability
3
Q

What are some changes in the skin as we age?

A
  • Skin thins and loses collage fibres so loss of thermoregulation and elasticity
  • Subcutaneous blood tissues fragile so bruise easily and hard to get cannula access
4
Q

What are some changes in the cardiovascular system as we age?

A

- Decrease in cardiac conducting cells so can get heart block, ectopics, AF etc

  • Reduction in CO by 30% due to lack of atrial contraction in AF so 1/3 less ventricle filling

- CO output falls by 3% each year as reduced SV and contractility

  • Large and medium vessels less elastic and compliant leading to hypertension which can lead to LV hypertrophy
5
Q

What are some changes in the renal system as we age?

A
  • Glomerulosclerosis
  • GFR drops by 1% a year after age 20
  • Reduction in CO leads to decline in renal function
  • DM, NSAIDs, ACEis, Prostatism and dehydration all common diseases/drugs in elderly that can damage kidneys
6
Q

What are some changes in the CNS as we age?

A
  • Neuronal density reduces
  • Cerebral atrophy
  • Cerebrovascular disease due to diffuse atherosclerosis and hypertension
7
Q

What are some changes in the endocrine system as we age?

A
  • BMR falls by 1% per year after the age of 30 so reduced muscle mass, impaired thermoregulatory control
8
Q

How can we slow natural cognitive decline? (not caused by underlying disease like dementia)

A
9
Q

What is dementia and how is it diagnosed?

A
  • A chronic disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning

- Cognitive assessment, blood tests and imaging to rule out other diagnoses

10
Q

What can be some signs of dementia?

A
  • Delay in visual processing
  • Difficulty with facial recognition (agnosia)
  • Apraxia

NOT JUST ISSUES WITH MEMORY LOSS

11
Q

What is malnutrition and how can we screen for it in the UK?

A

Any condition caused by an imbalance in what an individual eats and what the individual requires to maintain health (can be over and under nutrition)

12
Q

Why is it important to consider malnutrition in the elderly?

A
  • Will have longer hospital admissions
  • Respond less well to treatment and 3 times more likely to develop complications following surgery
13
Q

What are the different types of dementia and what parts of the brain do they affect?

A

- Alzheimers: hippocampus so memory

- Frontotemporal: frontal and temporal lobe

- Vascular: widespread infarcts over the brain affecting white matter

- Lewy Body: substantia nigra in the mid brain leading to Parkinsons

14
Q

How can we make hospital care less stressful for staff and family of patients with dementia?

A
  • Ask the family if the patient has routines or preferences Share strategies that work with the rest of the team
  • If it really is in the patient’s best interest to have care that they do not want get it done as quickly and respectfully as is possible
  • Make sure you are continually talking to the patient about what you are doing and why
  • Stay calm and engaged with the patient whilst delivering care
15
Q

What are some common causes of malnutrition in the elderly?

A
  • Poor appetite
  • Poor dentition or dysphagia
  • GI disorders
  • Poverty
  • Lack of knowledge about cooking or can’t shop
  • Physical disability
  • Neurological disorders e.g dementia and Parkinson’s
16
Q

What are the five steps of the MUST tool?

A