Ageing Flashcards
What is the definition of ageing?
Biological process of growing old with associated changes in physiology and increased susceptibility to disease and increased likelihood of dying
What are the two broad categories for theory of why organisms age?
Damage or error theories- accumulation of damage to DNA, cells and tissues- loss of telomeres or oxidative damage. If we could prevent this damage, we could prevent ageing
Programmed ageing- Genetic, hormonal and immunological changes over the lifetime of an organism lead to cumulative defects we see as ageing. Inescapable biological timetable
What does population ageing refer to?
Increasing age of an entire country due to increasing life spans and falling fertility rates- reflects the successes of public health policies, education and socioeconomic development but brings challenges for societies as they try to adapt
What problems are caused by an ageing population?
Outdated and ageist beliefs/assumptions
Working life/retirement balance
Medical system designed for single acute diseases
Extending healthy old age not just life expectancy
Inadequate or absent services
Lack of accessibility for people with disabilities
What is social care in England?
It is given based on a financial assessment and involves: Home carers Sheltered housing Care home Personal budgets
What is life expectancy?
Statistical measure of number of years a person can expect to live- rising continuously for many years
What is the life expectancy for a man and woman now?
Man- 79
Woman- 83
What is predicted to be the outcome of the increasing life expectancy?
More young people but even more older people
What does a non-specific presentation mean?
Presentations where the underlying pathology is not immediately obvious or clearly linked to the presentation. Falls, delirium and reduced mobility are all common reasons for older people seeking medical attention and can be due to variety of underlying problems including stroke, myocardial infarction, infections and changes to medication
What are the giants of geriatric medicine?
Immobility Intellectual impairment Instability Incontinence Iatrogenic problems
What is the medical meaning of frailty?
Loss of functional reserve among older people which causes impairment of their ability to manage every day activities and increases likelihood of adverse events and deterioration when they are faced with a minor stressor.
What can atypical and non-specific presentations lead to?
Delays in treatment when underlying problem isn’t recognised
What happens to the brain with age?
CT and MRI has shown that volume of cerebral spinal fluid within surrounding brain increases with age, the ventricles enlarge and gaps between major gyri widen
What percentage of normal elderly persons show some degree of white matter?
About 50%
When does the brain attain its maximum weight?
Around 20 years old and it then remains at his weight until 40-50 after which it decreases
What are normal cognitive changes that occur in older people?
Processing speed slows Working memory slightly reduced Simple attention ability preserved but reduction in divided attention Executive functions generally reduced No change in non declarative memory No change in visuospatial abilities No overall change in language
Why have rates of dementia been low in the past?
Misinterpretation, fatalism (can’t do anything about it) and social isolation of older people- 70% of those with dementia have a diagnosis
What is the definition of dementia?
Chronic, progressive, degenerative disease which causes a decline in cognition
What are the most common types of dementia?
Alzheimer’s and vascular
How does dementia commonly develop?
With memory problems and then over time all cognitive functions
What is the definition of delirium?
Acute episode of confusion usually with a clear precipitant such as infection or medication changes
Give examples of tests used for cognitive assessment?
Abbreviated mental test (AMT) and clock drawing tests are brief screening tests for cognitive impairment
Montreal cognitive assessment (MOCA) is a more detailed examination in wide general use
Mini mental state examination is a slightly outdated assessment which is less widely used than previously
Confusion assessment method and 4AT are tools to help distinguish between delirium and dementia
What does an AMT consist of?
DOB Age Current place Year Dates of WW2 Monarch or PM Count 20-1 Recognise 2 people Remember 3 item address
