10 - New Stuff Flashcards

1
Q

Areas of demographic growth

Ethnicities with demographic growth

A

South and West USA
Urban areas - all ethnicities
90+ population is fastest growing segment of US pop

Non-white growing much faster than White
-Hispanic pop is fastest growing US pop (passed AA, now 2nd largest)

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2
Q

Theories of aging

-genetic

A

Telomere theory: telomeres shorten with each duplication, over time leads to accumulation of error

Programmed life span (rectangularization of aging)

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3
Q

Theories of aging

-wear and tear/mechanical

A

Human body is like a car - parts wear out

Entropy: errors accumulate with time

Some holes in the theory by itself

E.g. arthritis, heart valves

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4
Q

Theories of aging

-collagen cross link

A

Glucose binds to proteins -> damage to proteins -> incr collagen cross linking

Skin wrinkling
Brain aging

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5
Q

Theories of aging

-free radical

A

Build up in body -> cellular damage

Basis for all vitamin therapies

Has been proven in animal models of caloric restriction

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6
Q

Theories of aging

-cellular

A

Hayflick limit: human cells will only divide a certain number of times (~50) before dying
-can slow down by limiting calories

Development of auto-antibody with aging - supported by autoimmune disease

Membrane theory: cell membranes can’t pass lipid materials as easily with incr age -> incr in lipofuscin
-supported by Alzheimer’s

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7
Q

Theories of aging: match the visual problem with its theory of aging

  • dry eye from Sjogrens
  • presbyopia
  • cataracts
  • vitreous detachment
  • macular degeneration
A

DE: cellular

P: wear-tear

C: cross-link

VD: collagen cross-link

MD: free radical/genetic/wear-tear

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8
Q

Psychophysics and aging

-neural cellular loss (4)

A

Decr quantum catching ability of PRs

PR loss and degenerative changes

GC loss and degenerative changes

Visual cortex cellular loss

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9
Q

Psychophysics and aging

  • VEP and aging graphs
  • S-cone function (blue)
A

Latency incr with age

Peak amplitude of S-cone impulse decr with age

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10
Q

Psychophysics and aging

-color and aging (3)

A

Hue discrimination stays similar with aging

Pure blue, pure red, pure white stay similar with aging

Pure green CHANGES with aging

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11
Q

Psychophysics and aging

-acuity (3)

A

Letter acuity loss

Accentuated at low light levels

Crowding effect

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12
Q

Psychophysics and aging

-optical effects from aging (5)

A

Incr in optical aberrations

Incr lens density

Incr intraocular light scatter

Senile miosis

Presbyopia

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13
Q
Psychophysics and aging
-optical aberrations and aging
—HOAs
—decoupling of \_\_
—spherical aberrations
—coma
A

HOAs incr with aging = corneal, lenticular, and total

Decoupling of lens compensation for corneal aberration with aging

Corneal incr in spherical aberration
Lens slight decr in negative compensating SA

Corneal coma stays stable, negative lens coma decreases

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14
Q

Psychophysics and aging

-spatial contrast sensitivity loss (3)

A

Accentuated at low light level

Most severe at high frequency

Both optical and neural effect

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15
Q

Psychophysics and aging

-temporal sensitivity (4)

A

Decr temporal contrast sensitivity

Decr CFF

Incr contrast threshold for motion

Incr problems with motion detection

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16
Q

Psychophysics and aging

-VF (4)

A

Constricted isopters with kinetic

Static loss throughout field

Static loss incr eccentrically

Loss of functional FOV

17
Q

Psychophysics and aging

-useful FOV (5)

A

A form of divided attention task

Measures visual attention

See and ID a target

Many studies indicate as best predictor of crashes

Sensitvity high, specificity lower

18
Q

Renal failure

  • stage 4
  • stage 5
A

4: severe reduction in GFR (15-29 mL/min)
5: kidney failure (GFR <15 mL/min)

19
Q

Liver and pancreas

-drug metabolism is prolonged, e.g.

A

Benzodiazepines (valium)

20
Q

Among the most common causes of hospitalization >65

A

CHF

21
Q

Eye movement problems in Alzheimer’s (5)

A

Saccadic pursuits

Incr saccadic latency

Hypometric saccades

Fixation instability

Anticipatory saccades

22
Q

Screening for dementia (3)

A

Folstein mini mental state exam

Short blessed

Mattis

23
Q

Eye movement abnormalities in Parkinson’s (3)

A

Gaze palsy - frontal lobe

Saccadic pursuits

Pursuit abnormalities

24
Q

Definition of depression (symptoms)

A

Depressed mood with 3 of:

  • weight gain/loss
  • insomnia
  • psychomotor retardation
  • feeling of worthlessness
  • difficulty concentrating
  • suicidal ideation
25
Q

Vision and aging

-results of visual impairment (5)

A

Incr 5 year mortality risk

Incr length of hospital stay

Incr risk of nursing home placement

Decr performance of IADLs

Decr in physical activity

26
Q

Vision and aging

-refractive error changes

A

Shift to hyperopia 20-70ish

Late shift towards myopia with cataract development

Younger adults 80% WTR
Older adults 80% ATR
-mediated by lid tautness and K cylinder
-not a rotation, but an incr

27
Q

Vision and aging

-heavy glasses causing sores on nose

A

Loss of fat pad around nose

28
Q

Vision and aging

-LOCS III

A

Lens opacities classification system

29
Q

Vision and aging

-cataract sx considerations

A

Most common sx in USA (1.8 million/year)

Expensive to society

Oldest pt was 109 yo
-generally, cost-benefit is up to 95 in men and 96 in women - if pt is healthy/systemic condns are stable, no age limit

30
Q

Vision and aging

-MFIOLs

A

Careful pt selection

Good for most pts wanting independence from glasses, but avoid in:

  • night vision problems (not from cts)
  • poor contrast sensitivity
  • overly critical/exacting
  • be sure to tx dry eye adequately before

Concerns:

  • contrast sensivity decr significantly for MFIOL pts
  • haloes and glare
  • less room for error for surgeon with tilt/residual RE
31
Q

Significant event in 2011 regarding aging

A

First baby boomers becaome 65yo

32
Q

Most current older adults are (ethnicity); what effect does this have

A

White

Now: mac degen in older pops

Later: more glaucoma, etc

33
Q

Life expectancies (general)

A

White > Black

Women > Men