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Lifespan > Age Related Changes > Flashcards

Age Related Changes Flashcards

1
Q

what is aging

A

a decline in homeostasis that affects all of our systems and tissues

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2
Q

what can most age related change be attributed to

A

consequence of lifestyle choices
- lack of physical activity most impactful

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3
Q

what is adaptive homeostasis

A

extent to which body can adapt to physiological stressors and maintain homeostasis influences susceptibility to illness and injury

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4
Q

what is homeostasis

A

physiological processes that maintain a stable internal environment of the body
- internal thermostat

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5
Q

what is the significance of adaptive homeostasis

A

ability to adapt to stressors is what keeps you healthy
- this ability dec w age

decline contributes to inc incidence in dz development in older pop

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6
Q

what is physical stress theory (PST)

A

changes in relative level of physical stress causes a predictable adaptive response in all biological tissue

ability to improve tolerance for physiological stress and provide a wider homeostasis window is possible using PST principles

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7
Q

what impact does successful vs unsuccessful aging have on PST principles

A

successful:
- can maintain high capacity to tolerate physiological stress

unsuccessful:
- has a low tolerance to physiological stressors

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8
Q

what inc the tolerance range per PST principles

A

exercises

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9
Q

what dec the tolerance range per PST principles (2)

A

inactivity
disease

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10
Q

describe the impact exercise has on a healthy aging adult per PST principles

A

robust positive changes w systemic adaptation
- strength + balance inc
- aerobic endurance inc
- ms endurance inc

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11
Q

describe the impact that exercise has on the inactive aging adult w a stable chronic dz per PST principles

A

positive changes but at a lesser magnitude than if they were healthy

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12
Q

what does greater physiological reserve and resilience mean per PST

A

capacity of body to draw on a “well” of immune function, strength, and endurance among other resources

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13
Q

how can a wider window of homeostasis result in a greater chance of survival per PST principles

A
  1. wider window of homeostasis
  2. greater tolerance to physiological stress
  3. higher ability to maintain independence in physical function
  4. greater physiological reserve and resilience
  5. greater chance of survival
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14
Q

skeletal system is susceptible to change in response to which factors (5)

A

nutrition
activity/inactivity
WBing
hormones
meds

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15
Q

when is peak bone mass reached

A

skeletal maturity (20-30yo)

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16
Q

skeletal decline in men vs women after peak bone mass

A

progressive and slow

women:
- post menopause bone loss is most severe likely d/t drop in ovarian estrogen production

men:
- bone loss typically begins after 75yo

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17
Q

what hormone(s) are critical for maintenance of bone mass in both men and women and what is the implication of this

A

estrogen!

in men: testosterone and estrogen are independent mediators of bone health

any condition affecting sex hormones automatically impacts skeletal health

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18
Q

what direct association explains the significance of skeletal changes as we age

A

direct association b/w structure and function

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19
Q

what is an example of how structure and function are directly related

A

joint mobility is directly influenced by changes in any of the related tissues

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20
Q

what are the molecular changes occurring w age in connective tissue (3)

A

change in integrity by:
- inc structural protein cross-linkages
- dec proteoglycan size
- fragmentation of collagen

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21
Q

what are the cellular changes occurring w age in connective tissue (4)

A

dec proliferation
altered control of apoptosis
dec response to growth factors
altered response to loading

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22
Q

how do connective tissue structures change with age overall (4)

A

inc stiffness
dec water content
dec strength
dec cross-sectional area and volume

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23
Q

what are the 4 main total joint changes with aging

A

dec joint space
inc laxity
altered dispersion of loads -> altered joint mvmts of force

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24
Q

why is altered dispersion of loads skeletally likely seen with aging

A

d/t dec water content

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25
Q

how are joint mvmts of force altered with aging

A

unloading of surrounding tissues and joint structures that provide tensile support b/c of dec joint space may predispose joint to dec ROM

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26
Q

what are 5 physiological changes that happen to ms w aging

A

changes in ms fiber atrophy
changes in ms fiber type
- more slow twitch than fast
contractile function
ms structure
composition

27
Q

what do aging physiological changes in the ms impact and what is the implication of this

A

impacts:
- physical performance
- velocity
- force
- strength of mvmt

potentially leads to functional disability

28
Q

median decline in ms mass throughout lifetime in men vs women

A

accelerates >75yo

men lose ms mass at a higher rate (.47 vs .37)
- and at a higher accelerated rate >75yo (.8 to .98 per year vs .64 to .7 per year)

29
Q

what percent decrease in ms mass by 70yo

A

20-40%

30
Q

what are 5 significant ms changes with aging

A
  1. sig dec in ms fiber size at cellular level
  2. sig changes in ms fiber composition
  3. sig dec in absolute and relative contractile skeletal ms content in both males and females
  4. higher levels of intermuscular adipose tissue
  5. age related low grade chronic inflammation
31
Q

how does ms fiber composition change with aging

A

dec in type 2 fibers
- related to strength and power –> needed to rise from a chair or lift heavy loads

32
Q

what is the impact of there being a significant reduction in contractile skeletal ms content

A

dec force per unit area of skeletal ms

33
Q

what are higher levels intermuscular adipose tissue associated with

A

dec in physical performance and limited mobility in older adults

34
Q

what are age related low grade chronic inflammation in muscles associated with

A

pathological remodeling of skeletal ms
- contributes to dec ms function

35
Q

what cellular changes are happening d/t age related low grade chronic inflammation in muscles

A

higher cytokine levels
- associated w lower ms mass and overall strength and physical decline among older adults

36
Q

what is sarcopenia

A

loss of ms mass and:
- loss of ms strength
- dec rate of force development
- dec ms power

37
Q

what does sarcopenia contribute to (3)

A

deficits in mobility
decline in functional capacity
dec in skeletal ms oxidative capacity

38
Q

what does a combo of ms impairments and greater fat mass inc the risk of

A

falling
frailty
development of comorbid conditions (DM2)

39
Q

what is an inherent aspect of aging in the neurologic system

A

slowing of nervous system

40
Q

what have NCS found in older adults w regard to the neurologic system

A

found lower conduction velocities in peripheral nervous system

41
Q

what is a motor unit

A

basic functional unit in the NM system
- allows for production of ms force and mvmt performance

42
Q

what is a motor unit comprised of and what are the impacts of this

A

consists of alpha motor neurons and ms they innervate

43
Q

what are 5 age related changes happening to a motor unit

A
  1. loss of motor units
  2. changes in morphology and properties of motor units
  3. altered input from nervous system
  4. denervation
  5. dec in rate coding (action potential firing rates)
44
Q

what does altered input from the nervous system to the motor unit impact d/t aging

A

power
strength
ms endurance

45
Q

what does denervation d/t aging impact (2)

A

motor unit recruitment
dec fine motor control

46
Q

what does a dec in rate coding in motor units d/t aging alter

A

alters power production and ms contraction speed

47
Q

what is a major clinical manifestation of a slowing nervous system in aging adults

A

slowing of mvmt speed

48
Q

what is the hallmark of aging in peripheral neurologic system

A

slowing of reflex responses

49
Q

what is the slowing of reflex responses d/t in the aging adult

A

declines in density of unmyelinated and myelinated neurons
-> impacts afferent axon potential conduction velocity

50
Q

where does most slowing of the neurologic system occur and what does this mean

A

most occurs centrally
- sloughing of myelin has been seen in peripheral nerves –> this slows conduction velocity

51
Q

what is neuronal atrophy

A

dec in ~40% in volume/size by 80yo

ms weakness not entirely explained by ms atrophy, also d/t impaired communication b/w brain and skeletal ms

52
Q

why is parasympathetic and sympathetic nervous system output altered in the aging adult

A

neuronal atrophy
axonal degen

53
Q

what are the impacts of age related changes in the parasympathetic and sympathetic nervous system (4)

A

slowing gastric motility
issues w bladder control
hyper- and hypotension
deficits in circulation

54
Q

how is sensation to the neurologic system altered with aging

A

somatic sensory input is altered

55
Q

what is the implication of it being common for aging adults to complain of vague somatic sx in one part of body

A

can represent an unrelated event
- challenging for PTs to discern what the cause is in older pts (harder than a vague complaint in younger kids)

56
Q

when do integumentary related impairments typically occur during aging

A

when extrinsic stresses combined w presence of comorbidities are added to aging

ex: stress to skin d/t immobility and incontinence inc risk for pressure injury

57
Q

what is a note about skin changes with aging

A

changes don’t typically cross threshold of impairment

58
Q

what are the 2 skin layers comprising the basement membrane

A

epidermis
dermis

59
Q

epidermis: what is it, 5 functions, lifespan of epidermal cells and why

A

thin outermost layer of skin with 5 sublayers

  1. thermoregulation
  2. sensation
  3. moisture elimination
  4. vitamin D synthesis
  5. protection of deeper structures

epidermis regens every 4-6wks
- doesn’t have blood supply

60
Q

dermis: what is it, function, composition and importance of composition

A

thick, deeper layer of skin responsible for structural integrity of integument

nutrition, hydration, and oxygen to epidermis via diffusion

composed of collagen protein and elastin
- provides tensile strength and allows skin to stretch

61
Q

how does the epidermis change with age and how does this impact its function

A

thins and dec in density of Langerhans cells (which initiate immune response when foreign cells are present)

= dec thickness and immune function
–> less efficacy w protection of body from infection and dehydration

62
Q

how does the basement membrane composition change with age and what are the implications of this

A

composed of many projections (rete pegs) and provide resistance to shearing forces

thins w age bc of flattening of rete pegs
-> inc vulnerability to shear related insults to skin

63
Q

how does the dermis change with age and what are the implications of this

A

thins w age
fewer blood vessels and nerve endings

more prone to hemorrhage
- often site of skin tears
dec perception of light touch and pressure sensation

Lifespan (20 decks)

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