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Age Related Changes Flashcards

1
Q

Gerontology vs Geriatrics

A

Gerontology : the study of aging

Geriatrics: medical trx of aging people

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2
Q

Theories of Aging:

A
  1. progressive decline model
  2. biological time clock
  3. free radical theory
  4. cross-linkage theory
  5. immune theory
  6. error catastrophe theory
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3
Q

progressive decline model

A

wear and tear

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4
Q

biological time clock

A

finite # of cell replications

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5
Q

free radical theory

A

O2 radicals contribute to pathophysiological changes

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6
Q

cross-linkage theory

A

chemical reactions cause irreparable damage to DNA

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7
Q

immune theory

A

breakdown in immune system leads to greater risk of disease and cancer

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8
Q

error catastrophe theory

A

errors in cellular RNA trancription lead to fault structures, especially proteins

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9
Q

Aging

A

interaction among genetics, environmental influences, lifestyles, and effects of disease process

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10
Q

What components are included in the shift in clinical focus for PT

A
  1. conditions traditionally associated w/aging
  2. sports and leisure related injuries
  3. focus on health, fitness, and wellness
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11
Q

Geriatric Rehab

A

assisting disabled older adult achieve optimal functional capcities in order to attain meaninful QOL in satisfying environment

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12
Q

In geriatric rehab, functional capacities includes:

A

physical, psychological, and social

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13
Q

Geriatric Rehab requires…

A

an interdisciplinary approach

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14
Q

Components of collaboration w/PTA in geriatric rehab

A
  1. medically complex patients
  2. PTA will assist in implementing trx programs
  3. PTA reporting to PT on responses
  4. Corresponding w/PT in collaborative manner to determine changes necessary to trx approach based on status
  5. Supervision of PTA in hospital vs home
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15
Q

Collaboration w/ OT and ST

A

coordinate care to address all aspects of rehab needs

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16
Q

Collaboration w/Nursing

A

coordinate care and exchange critical patient info

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17
Q

Collaboration w/Physician and PA

A

coordinate care and exchange critical patient info

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18
Q

Collaboration w/the family

A
  • obtain essential info on patient’s PLOF and d/c options

- caregiver involvement in patient care

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19
Q

79% of people 70 and older have 1 or more of 7 chronic conditions:

A
  1. arthritis
  2. high BP
  3. diabetes
  4. lung disease
  5. stroke
  6. cancer
    7.
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20
Q

T/F: 65 and older, 30% have 3 or more chronic conditions making them a medically complex patient

A

True

dementia adds to the complexity

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21
Q

Principles of Geriatric Rehab

A
  1. variability of capabilities
  2. inactivity / sedentary lifestyle
  3. optimum health and optimum functional ability
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22
Q

variability of capabilites

A

physical, cog, and motivation vary greatly

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23
Q

inactivity / sedentary lifestyle

A

inactive lifestyle contributes to debility

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24
Q

optimum health and overall well being

A

related to optimum functional ability

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25
Q

Geriatric Rehab directed toward:

A
  1. stabilizing primary problems
  2. preventing secondary complications
  3. restoring lost function
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26
Q

Geri Rehab Prep

A
  1. quiet and well lit exam area
  2. WC accessibility
  3. Adjustable trx table
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27
Q

Geri rehab tools

A

consider patient’s cog status when choosing assessment tools

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28
Q

Geri Rehab Timing

A

time of day may impact physical/cog status

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29
Q

Geri Rehab: Evaluation considerations

A
  1. endurance may be limited (physical and mental)
  2. determine cog status immediately to guide direction of interview questions and physical exam
  3. use appropriate p! scales
  4. understand difference between depression and dementia
  5. keep function at forefront of clinical assessment/decisions
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30
Q

Successful aging

A
  1. high capacity to tolerate stressors
  2. exercise causes robust positive changes
  3. wider homeostatic window
31
Q

unsuccessful aging

A
  1. low tolerance (susceptible to illness)
    • changes occur at small magnitude
  3. narrow homeostatic window
32
Q

Bone Loss in Geriatric population

A
  1. advancing age favors bone catabolism
  2. women bone loss accelerated by menopause
  3. men bone loss accelerated after 75
  4. non-modifiable vs modifiable RF
33
Q

osteoporosis T score

A

between -1 and -2.5 in LS, total hip, and femoral neck increase risk of fracture

34
Q

Sarcopenia

A

age related decline in muscle mass

35
Q

Dynapenia

A

age related decline in strength

36
Q

Loss of Type II

A

affects strength and power

37
Q

Loss of lean body mass and gain of fat mass

A

decreased resting metabolic rate of 1-2% per decade after 20 y.o.

38
Q

Cachexia

A

decline in muscle / body wasting that does not respond to nutritional support

39
Q

When does Cachexia occur?

A
  • before death
  • with cancer
  • COPD
  • end stage disease
40
Q

cachexia is most likely caused by:

A

massive increase in inflammatory cytokines

41
Q

Geriatrics: decreased water content in CT leads to

A

decreased height

42
Q

Geri: loss of water in articular cartilage leads to

A

OA

43
Q

Geri: increased collagen crosslinks+water loss=

A

joint stiffness and reduced shock absorption

44
Q

reduction of elastin =

A

saggy, wrinkled skin

45
Q

aging CT contributes to:

A
  1. sports injuries and decreased performance

2. displaced internal organs

46
Q

Geriatrics: Exercise Considerations

A
  1. higher intensity exercise = greater strength gains and LBM
  2. exercise plays crucial role in controlling intra-abdominal fat
  3. achieving end range prevents age related ROM loss
  4. CT stiffness increases muscular effort required for movement (red endurance)
  5. high impact exercise may not be appropriate w/bone loss or dry CT
47
Q

Geri Changes in CV system

A
  1. decline in MaxHR
  2. decline in VO2 Max
  3. Stiffer, less compliant vascular tissue
  4. Loss of SA node cells
  5. Reduced contractility of vascular walls
  6. Thickened capillary basement membrane
48
Q

decline in max HR

A

small aerobic workload

49
Q

decline in VO2 Max

A

smaller aerobic workload

50
Q

Stiffer, less compliant vascular tissue

A
  1. Higher BP
  2. slower ventricular filling time
  3. reduced CO
51
Q

Loss of SA node cells

A

lower max HR

52
Q

reduced contractility of vascular walls

A
  1. slower HR
  2. lower VO2 max
  3. smaller aerobic workload
53
Q

Thickened capillary basement membrane

A

reduced arteriovenous O2 uptake

54
Q

Changes in Nervous System

A
  1. sloughing/loss of myelin
  2. axonal loss
  3. autonomic NS dysfunction
  4. loss of sensory neurons
  5. slowed response time
55
Q

sloughing/loss of myelin

A

slowed nerve conduction

56
Q

axonal loss

A
  1. fewer muscle fibers

2. loss of fine sensation

57
Q

autonomic NS dysfunction

A
  1. slower systemic function w/altered sensory input
58
Q

loss of sensory neurons

A

reduced ability to discern hot/cold and p!

59
Q

slowed response time

A

increased fall risk

60
Q

Changes in sensory function:

peripheral sensory

A 
visual
proprioceptive
auditory
tactile
vestibular
61
Q

Changes in sensory function:

vision

A

loss of acuity, visual field, and contrast sensitivity

62
Q

Changes in sensory function:

hearing

A

presbycusis (slow loss of hearing in both ears)

63
Q

How common is multisensory impairment?

A

66% have 2+ deficits

64
Q

losses in sensory function lead to

A
  1. depression
  2. poor QOL
  3. cog decline
  4. mortality
65
Q

changes in the immune system

A
  1. Advancing age - increase systemic inflammation
  2. Increased IL-1, IL-6, IL-10, C-reactive protein, TNF-alpha
  3. Associated with muscle wasting, obesity, and loss of physical function
  4. Diminished organ function reduces physiologic reserve
  5. Exercise significantly reduces inflammatory markers
  6. Habitual exercise results in less systemic inflammation versus being sedentary - creates wider window of homeostasis
  7. Visceral fat secretes inflammatory markers– exercise reduces it!
66
Q

changes in endocrine function

A
  1. altered gland function
  2. decreased hormone production
  3. decreased tissue responsiveness
  4. aging hypothalamic-pituitary-gonadal axis
  5. (-) effect on muscle mass, bone density, adipose accumulation, insulin sensitivity, LDL metabolism, libido, cognition
  6. hormone therapy still an evolving science
66
Q

changes in endocrine function

A
  1. altered gland function
  2. decreased hormone production
  3. decreased tissue responsiveness
  4. aging hypothalamic-pituitary-gonadal axis
  5. (-) effect on muscle mass, bone density, adipose accumulation, insulin sensitivity, LDL metabolism, libido, cognition
  6. hormone therapy still an evolving science
67
Q

Life Transitions

A
  1. retirement or loss of job
  2. parent to grandparent
  3. relocation
68
Q

5 guiding principles

A
  1. safety
  2. trustworthiness
  3. choice
  4. collaboration
  5. empowerment
69
Q

Trauma Informed Care

A

understanding:

  1. neuro
  2. biological
  3. psychological
  4. social

effects on an individual

69
Q

Trauma Informed Care

A

understanding:

  1. neuro
  2. biological
  3. psychological
  4. social

effects on an individual

70
Q

Geri:

Depression

A
  1. not a normal part of aging but is common
  2. many med conditions contribute
  3. can be mistaken for dementia or co-exist w/dementia
  4. neg affects PT outcomes
  5. exercise/activity can reduce depressive symptoms
71
Q

Geri:

Suicide

A
  • 17th leading cause of death in 65+ y.o.
  • more successful w/attemots
  • PTs need to recognize RF and inquire about mental health
71
Q

Geri:

Suicide

A
  • 17th leading cause of death in 65+ y.o.
  • more successful w/attemots
  • PTs need to recognize RF and inquire about mental health

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