9 - Ageing Flashcards
What is senescence?
The biological process of growing old
Also known as ageing
Associated with increased susceptibility to disease and likelihood of dying
What are the two categories of theories as to why organisms age?
THEORIES OF AGEING
Damage or error theories describe the accumulation of damage to DNA, cells and tissues, for example loss of telomeres or oxidative damage, as the cause for ageing. Damage theories implicitly hold that if we could prevent or repair this damage then we could prevent ageing.
OR
Programmed ageing theories describe how genetic, hormonal and immunological changes over the lifetime of an organism lead to the cumulative deficits we see as ageing. Programmed ageing theories tend to suggest this is part of an inescapable biological timetable, just as growth and puberty are programmed to occur.
What is population ageing?
POPULATION AGEING
The increasing age of an entire country, due to increasing life spans, and falling fertility rates.
Population ageing reflects the successes of public health policies, education and socioeconomic development, but brings big challenges for societies as they try to adapt. The costs alone are a major challenge to all societies.
What is life expectancy?
LIFE EXPECTANCY
A statistical measure of the number of years a person can expect to live.
Life expectancy has been rising continuously for many years
This graph shows the impact of this; it’s predicted there will be small increases in the number of younger people, but the largest increase will be in older people
What is a non-specific presentation?
A non-specific presentation means presentations where the underlying pathology is not immediately obvious, or clearly linked to the presentation.
Falls, delirium and reduced mobility are all very common reasons for older people seeking medical attention, and can be due to a huge variety of underlying problems, including stroke, myocardial infarction, infections and changes to medications.
What are the so-called “giants of geriatric medicine”?
Immobility
Intellectual impairment
Instability
Incontinence
Iatrogenic problems.
Why can non-specific presentations lead to delays in treatment?
Non-specific presentations can mislead both doctors and patients, when they attribute symptoms to another cause or “old age”, and lead to delays in treatment.
What are iatrogenic problems?
IATROGENIC PROBLEMS
Iatrogenic problems are illnesses caused by receiving healthcare treatments and are more common in older people.
They include mistakes in providing care, and known complications of treatment.
Define ‘frailty’ in a medical context
FRAILTY
It refers to the loss of functional reserve among older people which causes impairment of their ability to manage every day activities, and increases the likelihood of adverse events and deterioration when they are faced with a minor stressor.
What happens to the amount of CSF surrounding the brain with age?
Volume of cerebral spinal fluid within the surrounding brain increases with age
The ventricles enlarge
The gaps between the major gyri widen.
What percentage of elderly people show white matter changes?
About 50% of elderly people show white matter changes
What happens to the weight of the brain throughout life?
The brain attains a maximum weight at about 20 years of age
Remains at this weight until 40-50 years of age
After which it decreases in weight at a rate of 2-3% per decade eventually reaching a value of some 10% below maximum by age of 80 years
Is signficiant impairment of cognitive function normal with ageing?
Some aspects of cognition change as a person ages, but significant impairment of cognitive function is not normal, even in the oldest old, and indicates that there is a problem.
Why have rates of dementia diganosis been low historically?
Rates of diagnosis of dementia have been low historically, due to a combination of:
- misinterpretation (it’s normal for older people to have poor memory)
- fatalism (we can’t do anything about it so what’s the point in diagnosing it)
- social isolation of some older people, such that they have no one to notice any problems
Locally, around 70% of those with dementia have a diagnosis
What is dementia?
Dementia is a chronic, progressive, degenerative disease which causes a decline in cognition.
The most common types of dementia (Alzheimer’s and vascular) often start with memory problems, but over time will include all cognitive functions.
Dementia is more common with increasing age.
Mild cognitive impairment is a specific term used to refer to people who have mild problems which do not interfere with their day-to-day life and don’t meet the diagnostic criteria for dementia.
