1 - Aging - Holroyd

Question 1

ADLs

Answer 1

Activities of Daily Living

Bathing, dressing, feeding, hygiene

“have to be able to do these before going to school”

Question 2

iADL

Answer 2

Housework, taking meds, manage money, shopping

“Have to be able to do before going to college”

Question 3

Common Changes with Aging

Answer 3

Body comp, fraility, sensory deprivation, falls, polypharmacy, urinary incontinence

Question 4

Body Comp Changes in Aging

Answer 4

Decreased Lean Muscle

Increased Body Fat (abdominal)

Decreased Subcutaneous Fat (hot/cold intollerant)

Decreased Total Body Water

Decreased Protein in Blood

Question 5

What is the pharma consequence of reduced protein in blood?

Answer 5

“higher” dosage

Question 6

Increased Cortisol in Aging

Answer 6

Impairs immune systems

Question 7

How is the brain impacted by medication in aging?

Answer 7

Brain becomes more sensitive to the effects of medication

Question 8

Dementia

Answer 8

two or more areas of deficits in cognition

Memory, Abstract Thinking, Judgement, Language, Visuospatial Functioning

Question 9

Prevalence of Alzheimers

Answer 9

5% > 65

Doubles every 5 years after 65

Age greatest correlator

Question 10

What are main sources of Dementia?

Answer 10

Alzheimers

Vascular Dementia

“mixed” Etiology

Lewy Body Dementia (controversial)

Question 11

Alzheimer’s Dementia

Answer 11

Steady decline over several years, can have VH

Question 12

Lewy Body Dementia

Answer 12

VHs, change in levels of consciousness, falls, Parkinsonism

Question 13

Vascular Dementia

Answer 13

Vascular risk factors or evidene of ischemic changes on imaging.

Sudden Decline

Question 14

Dementia Treatment

Answer 14

Acetylcholinesterase Inhibitor - reduce rate

Prevent delirium

Treat psychiatric symptoms of dementia

work with family

Question 15

Fall Risk in Elderly

Answer 15

Center of gravity gradually declines, increasing fall risk

Hip injuries

Head (brain) injuries

Question 16

Causes for Falls in Elderly

Answer 16

Neurological dysfunction

Cardiovascular disease

Medical illness

Environmental

Medications

Question 17

Medicines that Can Impact Falls in Elderly

Answer 17

Sedating Meds (benzodiasepines), Narcotics, Barbituates, Anticonvulsants, Sleeping Pills, Lithium at toxic doses

Anticholinergic meds (benadryl), antihistamines

Polypharmacy

Question 18

Sleep Chages in Elderly

Answer 18

Deep sleep reduced, with less time N3

Increased latency

Decreased REM sleep

Wake up earlier

Question 19

Urinary Incontinence in Elderly

Answer 19

Bladder doesn’t age well

Infection/UTIs, sleep, toxins

UTI can cause a lot of problems

Question 20

Syncope

Answer 20

Sudden loss of consciousness

Question 21

Spousal Bereavement

Answer 21

51% women, 14% will be widowed

Depressive symptoms peak within months, and decline within a year

Major depression may require treatment

Question 22

Mental Illness in Older Adults

Answer 22

National Institute of Mental Health ECA Study was landmark

12% of older met criteria for mental health diagnosis

Most common anxiety, cognitive impairment

Need to do full work-up, could be other causes–Delium, NOT demented

Question 23

**Depression in Elderly**

(exam)

Answer 23

Not normal part of aging

Main risk factor is vascular risk factors and neurologic disease (stroke/Parkinson/dementia)

Question 24

Delirium

Answer 24

Most common cause of confusion and psychosis

Mistaken for dementia

Caused by medical illness, medication, substances

Other cause: Any medical issue

Risk: Age, dementia, brain damage

Question 25

Pseudodementia (Dementia Syndrome of Depression)

Answer 25

Cognitive Impairment caused by depression

Variable presentation

Less language impairment

15% of older adults

Question 26

Anxiety Orders

Answer 26

Most prevalent psychiatric disorder in older adults, onset occurs earlier

Most common is phobia

Question 27

Alcohol Increase in Elderly

Answer 27

Protein decrease and total body water decrease cause greater effect of intake (4-fold) as compared to young

Question 28

Ageism

Answer 28

Discrimination against older adults

Question 29

Elder Abuse

Answer 29

Act or omission which results in harm or threatened harm to the health or welfar of an elderly person

Physical Abuse, Neglect, Psychological/Emotional, Financial

Most common abusers are family

Can report to Adult Protective Services