1. Physiology and Pathology of Aging

Question 1

Define: Physiology and Pathology of Aging (2)

Answer 1

• major categories of impairment that develop with old age and affect the physical, mental, and social domains of the elderly,
• usually due to many predisposing and precipitating factors rather than a single cause

Question 2

Describe Psychiatric Changes Occurring Frequently with Aging (2)

Answer 2

• Physiological Changes:
  
  • Decreased processing speed, cognitive flexibility, visuospatial perception, working memory and divided attention
  • Loss of synaptic plasticity
• Pathological Changes: Increased depression, dementia, delirium, suicidality, anxiety, sleep disruption

Question 3

Describe Musculoskeletal Changes Occurring Frequently with Aging (2)

Answer 3

• Physiological Changes:
  
  • Increased calcium loss from bone
  • Decreased muscle mass, cartilage
• Pathological Changes:
  
  • Increased arthritis, bursitis, osteoporosis, muscle weakness with gait abnormalities, polymyalgia rheumatica

Question 4

Describe Endocrine Changes Occurring Frequently with Aging (2)

Answer 4

• Physiological Changes:
  
  • Increased NE, PTH, insulin, vasopressin
  • Decreased thyroid and adrenal corticosteroid secretion
• Pathological Changes:
  
  • Increased DM, hypothyroidism, impaired stress response

Question 5

Describe Reproductive Changes Occurring Frequently with Aging (2)

Answer 5

• Physiological Changes:
  
  • Decreased androgen, estrogen, sperm count, vaginal secretion
  • Decreased ovary, uterus, vagina, breast size
• Pathological Changes:
  
  • Increased breast and endometrial cancer, cystocele, rectocele, atrophic vaginitis

Question 6

Describe Renal and Urologic Changes Occurring Frequently with Aging (2)

Answer 6

• Physiological Changes:
  
  • Increased proteinuria, urinary frequency
  • Decreased renal mass, creatinine clearance, urine prostate cancer, pyelonephritis, nephrolithiasis, UTI acidification, hydroxylation of vitamin D, bladder

capacity

• Pathological Changes:
  
  • Increased urinary incontinence, nocturia, BPH, prostate cancer, pyelonephritis, nephrolithiasis, UTI

Question 7

Describe GASTRO Changes Occurring Frequently with Aging (2)

Answer 7

• Physiological Changes:
  
  • Increased intestinal villous atrophy
  • Decreased esophageal peristalsis, gastric acid secretion, liver mass, hepatic blood flow, calcium and iron absorption
• Pathological Changes: Increased cancer, diverticulitis, constipation, fecal incontinence, hemorrhoids, intestinal obstruction, malnutrition, weight loss

Question 8

Describe RESPIRATORY Changes Occurring Frequently with Aging (2)

Answer 8

• Physiological Changes:
  
  • Increased tracheal cartilage calcification, mucous gland hypertrophy
  • Decreased elastic recoil, mucociliary clearance, pulmonary function reserve
• Pathological Changes: Increased COPD, pneumonia, pulmonary embolism

Question 9

Describe CARDIOVASCULAR Changes Occurring Frequently with Aging (2)

Answer 9

• Physiological Changes:
  
  • Increased sBP, decreased dBP, HR, CO
  • Decreased baroreflex and autonomic reflexes
  • Decreased vessel elasticity, cardiac myocyte size and number, β-adrenergic responsiveness
• Pathological Changes:
  
  • Increased atherosclerosis, CAD, MI, CHF, hypertension, arrhythmias, orthostatic hypotension, wide pulse pressure

Question 10

Describe SENSES Changes Occurring Frequently with Aging (2)

Answer 10

• Physiological Changes:
  
  • Decreased lacrimal gland secretion, lens transparency, visual acuity, dark adaptation, sense of smell and taste, detection of higher frequency sounds, vestibular function, vestibulospinal reflexes
• Pathological Changes:
  
  • Increased glaucoma, cataracts, macular degeneration, presbycusis, presbyopia, tinnitus, vertigo, oral dryness

Question 11

Describe NEUROLOGIC Changes Occurring Frequently with Aging (2)

Answer 11

• Physiological Changes:
  
  • Decreased brain mass, cerebral blood flow
  • Increased white matter changes
• Pathological Changes:
  
  • Increased insomnia, neurodegenerative disease, stroke
  • Decreased reflex response

Question 12

Describe Integumentary Changes Occurring Frequently with Aging (2)

Answer 12

• Physiological Changes:
  
  • Atrophy of sebaceous and sweat glands
  • Decreased epidermal and dermal thickness, dermal vascularity, melanocytes, collagen synthesis
• Pathological Changes: Increased lentigo, cherry hemangiomas, pruritus, seborrheic keratosis, herpes zoster, decubitus ulcers, skin cancer, easy bruising

Question 13

Name: Activities of daily living (ADLs) (7)

Answer 13

ABCDE-TT

• Ambulating
• Bathing
• Continence
• Dressing
• Eating
• Transferring
• Toileting

Question 14

Name: Instrumental activities of daily living IADLs (7)

Answer 14

SHAFT-TT

• Shopping
• Housework
• Accounting/Managing finances
• Food preparation
• Transportation
• Telephone
• Taking medications