4. Physical Changes Flashcards
Includes chapter 4 and both lectures
1
Q
what are some common changes in vision as a result of primary aging?
A
- more sensitivity to glare
- light/dark adaptation declines
- sensitivity to glare makes it hard to adjust when it’s bright
- decrease in amount of light passing through iris makes it hard to see when it’s dark
- gradual decreasing peripheral vision
2
Q
what is presbyopia?
A
- lens’s ability to adjust and focus declines as the lens stiffens
- harder to see close objects and time it takes for eyes to adjust is longer
- most get reading glasses, but this also affects driving
- result of primary aging, affects the entire population by age 50
- process is accelerated by smoking
- blue-blocking lenses can help
3
Q
what are cataracts?
A
- clouding or opacity in the lens that results in blurred or distorted vision as the retina cannot focus images
- starts as a gradual cloudiness that grows more opaque
- most often white, but can be yellow or brown as well
- bright lights may seem to have a halo around them
- develop as a normal part of aging, cause is not known
4
Q
what is age-related macular degeneration (ARMD)
A
- caused by damage to the photoreceptors in the central region of the retina (the macula)
- there are two forms of ARMD
- “dry” - people develop drusein in the macula (yellow deposits under the retina)
- “wet” - blood vessels in retina leak blood/fluid, progresses rapidly
5
Q
what are some risk factors and prevention strategies for cataracts?
A
- obesity, high blood pressure, high glucose levels, and excess blood lipids can affect the development
- for protection, we can use blue-blocking lenses and beta-carotene and vitamin C
- can be treated and fixed with surgery, only takes an hour and vision recovers within 1-7 days
6
Q
are there any treatments for ARMD?
A
- there are no known treatments but there are preventative measures we can take
- include beta-carotene in the diet and wear protective glasses (from blue and UV light)
7
Q
what is glaucoma?
A
- group of conditions that cause blindness due to destruction of neurons leading from the retina to the optic nerve
- usually destroyed by increased pressure within the eyeball
- develops gradually and painlessly with no symptoms so it is not detected until advanced stages
- causes a loss of peripheral vision and may cause remaining vision to diminish
8
Q
are there any treatments for glaucoma? what makes a person more likely to get it?
A
- causes of some forms of glaucoma can be controlled but not cured, others are successfully treated through surgery
- is more common in men, black people, and people living in urban areas
- also more common in people who are nearsighted, have diabetes, or have a familly history of glaucoma
- arthritis and obestiy are also risk factors
9
Q
what are some common hearing problems that develop with age?
A
- presbycusis and tinnitus
10
Q
what is presbycusis?
A
- degenerative changes occur in the cochlea or auditory nerve leading from the cochlea to the brain
- receptor cells triggered by high frequency stimuli are located toward the front of the cochlea
- associated with loss of hearing of high-pitched sounds
- can result from metabolic changes that affect the tissue in the wall of the cochlea
- leads to less amplification of sound
11
Q
what are some causes of presbycusis and how can we prevent it?
A
- sensory presbycusis is the result of chronic noise exposure
- increasing age in middle to later adulthood is associated with increases in the metabolic form of presbycusis
- best way to minimize risk of developing presbycusis is to reduce exposure to noise
12
Q
what is tinnitus?
A
- individual perceives sounds in the head or ear when there is no external source
- condition can be temporarily associated with use of aspririn, antibiotics, and anti-inflammatory agents
- changes in the bones of the skull due to trauma and the buildup of wax in the ears may also contribute to tinnitus
13
Q
what are some treatments of tinnitus?
A
- treatments are available but there is no cure
- hearing aids can help
- can improve ability to understand speech by using communication strategies
- looking at the person speaking, having enough light to see, turn down background noise
14
Q
how do falls and fear of falling impact older people?
A
- falls are the leading cause of injury among older adults and common cause of TBI
- fear of falling becomes an unhealthy form of identity accommodation
- increases their perceived instability, making them perhaps more physiologically unstable as well
15
Q
what are some factors that contribute to age-related vestibular dysfunction?
A
- dizziness - uncomfortable sensation of feeling light-headed and even floating
- vertigo - sensation of spinning when the body is at rest
- vestibular system is intimately connected to other parts of the nervous system
- people may experience headache, muscular aches in the neck and back, and increased sensitivity to noise and bright lights
16
Q
why do we lose muscle as we age?
A
- loss of muscle strength sometimes comes from disrupted signals between the nervous system and muscles for contraction
- another reason for muscle loss is the tendons becoming stiffer, making it harder to move the joint and exert muscular strength
17
Q
why do our bones become more fragile as we age?
A
- we lose the sex hormones responsible for controlling bone remodelling
- bone remodelling - old cells are destroyed and replaced by new cells
- loss of collagen reduces bone’s flexibility in response to pressure
18
Q
how and why do our joints change as we get older?
A
- by the 20s and 30s, the articular cartilage that protects the joints has already begun to degenerate
- fibres in the joint capsule become less pliable, reducing flexibility
- stress and repeated use cause the joints to wear out more rapidly
- lowering body fat can help take some stress off of our joints
19
Q
what is sarcopenia and how can we slow the process?
A
- progressive, age related loss of muscle tissue and strength
- process of primary aging, greater loss of fast twitch fibres (used in speed and strength)
- slowed down by strength training
- increased risks of falls and risk of physical disability
20
Q
what are some possible causes of sarcopenia?
A
- changes in hormones
- not using the muscles enough
- chronic disease
- nutritional deficiencies
21
Q
what is osteoarthritis?
A
- a condition in which the cartilage that cushions the ends of bones in your joints gradually deteriorates
- not necessarily primary aging
- more common in women
- most commonly found in the finger joints, knees, and in the spine
22
Q
what are some factors that increase the risk of getting osteoarthritis?
A
- age, as we get older we are more likely
- sex, women are more likely
- injury
- genetics
- obesity, puts more strain on joints
23
Q
what are the common symptoms of osteoarthritis?
A
- pain
- tenderness
- stiffness
- swelling
- loss of flexibility
- grating sensations
- bone spurs
24
Q
what are some possible treatments of osteoarthritis?
A
- exercise and weight control
- medications for pain management
- injections to reduce swelling
- physical and occupational therapy
- surgery
- receive an injection of a synthetic material into an arthritic joint to replace the loss of synovial fluid
- inject sodium hyaluronate directly into the joint
- replacement of the joint
25
Q
what are ligaments and how do they change?
A
- ligaments - a short band of tough, flexible, fibrous connective tissue that connects two bones or cartilages or holds together a joint
- as we age, ligaments become less elastic → less flexible joints
- prone to damage or tearing
26
Q
how does aging affect the way we walk?
A
- advancing age causes reduced gait speed and step length
- shortens because weakening calf muscles can’t flex the ankles properly
- speed of walking decreases at 70, and decrease 15% each decade
- reduced gait speed helps avoid hazards but can also be less desirable sometimes
27
Q
why does our balance change as we age?
A
- people rely on pressure sensors in their legs and torso to maintain balance
- we reach optimal stability between ages 30 and 60
- we require hearing and vision to maintain balance
- stairs are a challenge because of leg pains, fear of falling, and slow gait
28
Q
how do hip fractures affect the older population, especially women?
A
- almost 50% of women will experience an osteoporatic fracture
- most of them are hip fractures which are the most dehabilitating
- hip fractures increase the risk of dying in the next year by 3x
- due to the lack of movement and mobility and nutrition while healing
29
Q
what is osteoporosis?
A
- a disease characterized by low bone mass (amount) and deterioration of bone tissue (quality)
- happens due to an imbalance between the rates of bone resorption and bone growth
- peak bone bass happens with 18-25
- it’s known as the “silent thief” - bone deterioration happens over time with no symptoms until a bone break happens
30
Q
what is the prevalence of osteoporosis in women and what are some possible causes?
A
- 50% of all women will develop osteoporosis
- 1 in 3 women will break a bone from osteoporosis
causes
- less bone mass compared to men
- greater rate of bone density decreases
- insufficient dietary calcium during developmental years
- less weight bearing activities in developmental years
- low levels of estrogen, especially following menopause
31
Q
what is the prevalence of osteoporosis in men?
A
- 1 in 5 men will break a bone from osteoporosis
- 37% who suffer a hip fracture will die within 1 year
32
Q
what are some of the general risk factors for osteoporosis?
A
- genetics (account for 70% of bone mineral content in adulthood)
- previous falls and broken bones
- smoking
- drinking more than 3 drinks a day
- certain medications
- where you live; demarcations between seasons, ethnicity
33
Q
what medications can affect bone regeneration?
A
- alendronate has worked but can have side effects; bone loss in the jaw
- calcitonin may also be given to help regulate calcium and bone metabolism
- intake of dietary silicon can help promote bone regeneration
34
Q
what ethnicities have a higher likelihood of developing osteoporosis?
A
- european women are at higher risk
- in general, european and asian people are at the highest risk and black and hispanic people are the least
35
Q
how can we prevent the development of osteoporosis?
A
- assessment 65+ (bone density tests, x-rays)
- assessment 50+ if you have a broken bone
- only done if a bone usually would not have broken under that circumstance
- calcium and vitamin D intake - especially important in development
- weight bearing and muscle strengthening exercises
- avoiding smoking and alcohol
36
Q
what is the prevalence in falls in older people?
A
- 1 in 4 north american residents report falling at least once each year
- rates of falling increase with age and poor health
- rates increase for those living in nursing homes
- but, those admitted to nursing homes are usually frail to begin with
- about 5% require hospitalization (usually shoulder, wrist, or hip fractures)
- about 50% of hospitalized live beyond a year
- unintentional injuries are the fifth leading cause of death for elderly
37
Q
what are some common causes for falls?
A
- accidents - environment related (individual has a difficult time navigating the environment)
- difficulties with walking gait or balance
- dizziness, vertigo, faiting, drop attacks
- postural hypotension - when a person’s blood pressure drops after getting up from sitting
38
Q
what are some individual risk factors of falling?
A
- muscle weakness
- balance deficit
- walking gait deficit
- mobility limitations
- vision problems
- postural hypotension
39
Q
what is the prevalence of fear of falling among older men and women?
A
- majority of men don’t have much of a fear of falling
- women are more commonly afraid of falling
- could be because of increased osteoporosis in women or because of men’s increased balance compared to women
40
Q
how does fear of falling affect older people psychologically and physically?
A
- those who were very fearful of falling were more isolated (socially and physically), less satisfied with life and more depressed mood
- felt much more frail
- were more likely to have previous falls
- those with FOF are more likely to report subsequent difficulties with walking
- FOF decreases likelihood of exercise which increases chances of falling
41
Q
how can we help prevent falls?
A
- identify and eliminate environmental risks in residence
- screening and treatment of gait and balance function problems (assistive devices)
- strategies for dealing with orthostatic hypotension
- exercise program focused on strength and balance
- review and modify medication
42
Q
according to mayo clinic, what are some strategies for reducing falls?
A
- make an appointment with your health care provider
- keep moving
- wear sensible shows
- remove home hazards
- light up your living space
- use assistive devices
43
Q
how and why does our height change as we age?
A
- stable until the 50s
- females lose about 2 inches
- males lose about 1 inch
- lose height due too postural changes and spinal compression
- bone strength decreases (osteoporosis) and vertebral disc changes
44
Q
how and why does our weight change?
A
- we have gains then losses across adulthood
- start to have losses around 55 years old
- we usually put on 1-2 pounds per year
- weight gain tends to be in men’s abdomen and women’s hips
- in older age we experience weight loss because of loss of muscle, bone, and some fat
45
Q
how do we determine who is obese and what are rates of obesity like in Canada?
A
- look at BMI to determine categories of weight
- rates of obesity in Canada have been steadily increasing, much like other countries
- canada is ranked 7th in levels of obesity
- rates of obesity per age group follows the same trend as levels of overall weight gain and loss as we age
46
Q
what is excess body weight associated with?
A
- increased number of fatal and non-fatal diseases
- negative effects on longevity, disability-free life-years, quality-of-life, and productivity
- impact on close others
- overall burden on economy and health care systems
- increased rates of diabetes, heart disease, cancer
47
Q
how does the texture of our skin change as we age?
A
- epidermis - outermost layer of the skin that covers and protects the underlying tissue loses regular patterning over time
-
dermis - middle layer of the skin that is made of connective tissue (includes nerve cells, glands, and hair follicles) has changes in two types of proteins
- collagen undergoes cross-linking, skin becomes rigidified and less flexible
- elastin becomes less able to return to it’s original shape after being stretched
- skin is no longer able to return to its original state of tension and begins to sag
- sebaceous glands that provide oils that lubricate the skin become less active
48
Q
how does the colour and opacity of our skin change as age?
A
-
subcutaneous fat - bottommost layer of skin, gives skin opacity and smoothes curves of arms, legs, and face
- starts to thin in middle adulthood
- skin colouring also changes, most visibly in fair-skinned people
- age spots/lentigo senilis - areas of brown pigmentaiton show up on the skin
- also develop moles and angiomas (elevations of blood vessels on skin surface)
-
photoaging - age-related changes in the skin due to radiation from the sun
- sun’s rays accelerate the process of cross-linking
49
Q
how do our nails change as we age?
A
- nails grow more slowly, may become yellowed, thicker, and ridged
- many older adults develop fungal infections in their toenails
- medications and lack of mobility affect caring for feet and lower extremeties
50
Q
how do our bones, cartilage, and teeth change our appearance as we age?
A
- changes in the face are also due to bone loss in the skull (jaw)
- changes in the cartilage of the nose and ears cause them to become longer
- loss of enamel surface in teeth leads to them becoming yellow
51
Q
how does our hair change as we age?
A
- when the production of melanin slows, the number of pigmented hairs diminish and the number of hairs that are no longer pigmented increased
- hair loss results from the destruction of the germination centres that produce the hair in the hair follicle
- hair may appear in more undesirable areas; chin on women, the ears on men
52
Q
what is androgenetic alopecia?
A
- hair loss that occurs according to a pattern
- affects 95% of men and 20% of women
- causes hair follicles to stop producing long, thick, pigmented hair (terminal hair)
- instead produces short, fine, unpigmented, and largely invisible (vellus hair)
53
Q
what are the main areas of change in the face?
A
- eye develop bags and lines (crows feet)
- skin becomes pigmented
- ears and nose become elongated as cartilage changes
- bone loss in the skull, especially the jaw
- muscles of the face are less active
54
Q
what are some factors that influence body image as we age?
A
- sociocultural norms
- gender identity
- social class
- sexual orientation
55
Q
how do sociocultural norms affect our body image?
A
- young, slim, healthy, toned, and wrinkle-free appearances are valued compared to…
- old-looking bodies & faces
- women should look young, men should look strong and competent
56
Q
how do women and men value appearance vs. function differently as we age?
A
- women are more concerned about their appearance while men are more concerned about their function
- concerns for appearance decline for both men and women as they age
- satisfaction with body function and appearance increases as people become even older
- global & appearance related self-esteem increases as men & women age
- men’s body function is more strongly related to depression and +/- feelings than women
- women’s appearance more strongly related to depression
57
Q
how does socioeconomic status affect women’s body image and importance of appearance?
A
- spending power - increases in income → greater investment into appearance practices
-
time horizons - working class focus on short term investment in appearance, upper class focus on long term investement and inner beauty
- makeup, clothes and jewellery vs. posture, physical activity, speech, nutrition
- means for social distinction - lower SES think appearance does not impact social distinction, higher SES are concerned more with appearance for social distinction
58
Q
how does sexual orientation affect women’s body image and importance of appearance?
A
Heterosexual women
- 63% described themselves as ‘‘fat,’’ ‘‘overweight,’’ ‘‘too heavy’’ or ‘‘concerned about getting fat,’’, all of which felt ‘‘bad’’ about aging or themselves because of their weight
- 79% dyed greying hair
Lesbians
- 73% wanted to lose weight
- 73% didn’t associate sense of self with body weight
- 27% dyed greying hair
- differences emphasize relationship between femininity, appearance, and heterosexuality
59
Q
how do young gay men compare to heterosexual men in their body image?
A
young gay men..
- report greater feelings of body dissatisfaction
- are less likely to have a positive body image
- are less likely to be at a desirable weight
- engage in more disordered eating
- are more likely to aspire to a more muscular physique
60
Q
what are some trends for plastic surgery based on age, sex, and ethnicity?
A
- number of plastic surgeries has increased for people older than 20
- there has been an increase in plastic surgery for females and a decrease for men
- it is most common for caucasian people to have plastic surgery, followed by hispanics, african americans, and asian americans
61
Q
how does the cardiovascular system change as we age?
A
- left ventricle is the chamber that pumps oxygenated blood out to the arteries, it’s performance is key to the efficiency of the system
- the walls of the left ventricle lose their ability to contract enough to accomplish an efficient distribution of blood through the arteries
- arteries accommodate less blood flow because fats circulating through blood form hard deposits called plaque
62
Q
what is cardiovascular efficiency dependent on?
A
- aerobic capacity - maximum amount of oxygen that can be delivered through the blood
- cardiac output - amount of blood that the heart pumps per minute
- aeorbic capacity declines about 5-10% per decade
63
Q
what are the different types of cholesterol and how do they affect us?
A
- high-density lipoproteins (HDLs), good cholesterol, transport lipids out of the body
- low-density lipoprotiens (LDLs), bad cholesterol, transport cholesterol to the arteries
- measures of an individual’s cholesterol levels reflect the ratio of HDLs and LDLs
- blood levels of triglycerides reflect the amount of fat stored in the body’s cells
- cholesterol and lipid metabolism is very important, exercise can be beneficial
64
Q
how does the respiratory system change as we age?
A
- as we age, the respiratory muscles lose the ability to expand and contract the chest wall, lung tissue is less about to contract and expand
- by age 40, all measures of lung functioning in adulthood tend to show age-related losses
- losses are more severe in women
65
Q
what is lung age and why is it important?
A
-
lung age - mathematical function showing how old your lung is based on a combination of your age and forced expiratory volume
- individuals can determine how much they are placing themselves at risk by engaging in behaviours such as smoking
66
Q
how does the urinary system change as we age?
A
- as we age there is a change in blood flow through the kidneys and a decrease in the ability to raise and lower the urine’s concentration
- aging can also make the elasstic tissue of the bladder no longer able to retain or expel urine efficiently
- many men experience hypertrophy (enlargement) of the prostate which puts pressure on the bladder
67
Q
what is urge incontinence and stress incontinence? how can they be treated?
A
- urge incontinence - individual experiences a sudden need to urinate and may even leak urine
- stress incontinence - individual is unable to retain urine while engaging in some form of physical exertion
- a condition related to urge incontinence is overactive bladder; need to urinate more frequently than ntomal
- treatment includes medication, exercise, and behavioural control
68
Q
how does the digestive system change as we age?
A
- saliva production decreases with age which can lead to difficulties in eating and less efficient processing of food
- esophogus is less able to contract and expand as food moves down into the stomach
- fewer gastric juices are secreted and digestive products leave more slowly
69
Q
how can fetal incontinence be controlled and why does digestive health change?
A
- fecal incontinence can be controlled with behavioural changes and amount of fibre in the diet
- lifestyle factors that change in middle and later adulthood contribute to overall digestive health
- families typically become smaller as children move out of the home
- financial resources may decrease when people retire
- age‐related mobility and cognitive problems can make cooking a more difficult task
70
Q
how does smell change as we age? what contributes to these changes?
A
- the area of the olfactory epithelium shrinks with age and the total number of receptors becomes reduced throughout the adult years
- 13% of 60‐ to 69‐year‐olds and 39% of those 80 and older showing some form of olfactory dysfunction
- potential contributors are: a history of smoking, sinus problems, certain medications, and chronic disease
71
Q
how does taste change as we age?
A
- dentures are another cause of loss of taste sensitivity because they may block the receptor cells of the taste buds
- older adults often experience an increase in detection ability for sour and bitter tastes
- makes them prefer sweet and salty foods
72
Q
how does touch change as we age?
A
- changes in the receptors under the skin cause an inability to discriminate touch as we age
- loss of touch sensitivity in the hands is greater for men than for women
- changes in touch sensitivity in the feet can contribute to difficulties with balance
73
Q
how does our sensation of pain change as we age?
A
- chronic back pain is exacerbated by osteoarthritis in the hip
- experience of pain can also interfere with cognitive performance
- pain can be hard to detect in older people with major cognitive impairments
- symptoms of benign pain may diminish along the aging process because they become used to daily aches and pains of bones, joints and muscles
- cohort factors may interact with ages changes to alter the likelihood that complaints about pain will be expressed
- obesity is highly associated with chronic pain, even after controlling for education and related conditions like diabetes, arthritis, and depression
