Age Related Systemic Changes (with Some Diseases) Flashcards
Homeostasis changes in elderly
- impaired baroreceptor reflex
- increased basal NE
- decreased receptor responsiveness
- decrease in C-AMP response
- decrease in thermoregulation
- decrease in thirst response
Skin changes and increased age
- decrease in skin thickness
- solar lentigo
- loss of elasticity
- keratinosis
- decrease in eccrine glands output
- decrease in sebaceous glands
- decrease in moisture content
- nail changes (onychomycosis)-yellow, brittle nails
- prolonged wound healing
Musculoskeletal changes in elderly
- OA
- RA
- Gout
- Osteoporosis
- decrease in muscle weight to body weight
- decrease in muscle fibers-especially type II
- enzyme systems (ATP/LDH) decrease
- cartilage loss
- bone loss
Nervous system and elderly
- loss of brain weight
- blood flow decline
- scattered dendritic loss
- lipofuscin deposition
- neurotransmitter loss
special senses and elderly
- presbycusis
- reduction in olfaction
- reduction in sensitivity to pain and touch
Systolic blood pressure and age
Increases
Diastolic blood pressure nad age
Increases until 50-59 and then decreases
Cardiovascular disease and age
- increase in peripheral resistance
- systolic BP increase
- left ventricular hypertrophy
- stroke volume declines
- max HR decline
- decline in ventricular filling
- greater degree of ventricular arrhythmias
- organ specific declines in blood flow
Ischemic stroke
Thrombotic
Embolic
Hemorrhagic strokes
Subarachnoid
Intracerebral
Ischemic heart disease
MI
Angina
CHF
Among the MOST COMMON causes of hospitalizations >65
peripheral artery disease
Claudication-pain in legs
Phlebitis
Problem in veins, use steroids
NYHA class I: CHF
No symptoms and no limitations in ordinary physical activity
NYHA class II:CHF
Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity
NYHA class III CFH
Marked limitation in activity due to symptoms, even during less than ordinary activity (walking short distances) comfortable at rest only
NYHA class IV CHF
Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients
BNP levels
- below 100pg/mL=no heart failure
- 100-300=heart failure present
- > 300=mild heart failure
- > 600=moderate heart failure
- > 900=severe heart failure
Respiratory system and age
- cartilage calcifies
- decreased alveolar surface area
- loss of parenchyma elasticity
- calcification of rib articulations
- decrease in cilial response
- decrease in vital capacity
- relative respiratory alkalosis
- decrease in oxygen consumption
- stable oxygen saturation
COPD
- emphysema-in smokers
- chronic bronchitis-persistent cough
Pneumonia
From cold weather
Asthma
Comes back when older
TB
Transmits more easily in nursing homes, some with multidrug resistance
GI system and elderly
- LESS CHANGES THAN ANY OTHER SYSTEM
- 40% edentulous (lacking teeth)
- decrease in esophageal peristalsis
- gastric atrophy
- 1/3 have diverticuli
- transit speed is slower in the colon
DI diseases in old
- GERD
- gastritis
- ulcers
- gallstones
- diverticulosis
- hiatal hernia
- constipation
Liver and pancreases and old age
-age related hepatic and pancreatic failure do not occur
0lab tests dont change with age-SGOT, SGGT, bilirubin, ALK PHOS
-drug metabolism is prolonged (BENZODIAZEPINES)
Stage 1 renal failriue
Kidney damage with normal or increased GFR (>90)
Stage 2 renal failure
Mild reduction in GFR (60-89)
Stage 3 renal failure
Moderate reduction in GFR (30-59)
Stage 4 renal failure
Severe reduction in GFR (15-29)
Stage 5 renal failure
Kidney failure (GFR < 15 or dialysis)
Renal function and age
- glomeruli decrease in number
- sclerosis in remaining glomeruli
- renal tubules decrease
- createnine clearance decreases 1% per year
- decreased GFR
- poor response to volume depletion
Genito urinary disease
Incontinence
-major cause of nursing home placement
UTI
Chronic renal failure
Hemopoietic system and age
Blood count stay stable
Reserve for hemopoiesis decreases
Anemia is pathology
Anemia
- anemia of chronic disease-most common in most studies
- nutritional
- folate
- iron deficiency
- b12 deficiency
- unexplained
Psychological changes in age
- Primary (short term) memory declines
- Secondary (long term) memory -intact
- crystallized intelligence intact
- working memory declines
- attention declines
- Speed of processing declines
- longitudinal versus cross-sectional. Try to evaluate longitudinal studies rather than cross sectional
- PERSONALITY STAYS STABLE
