Ageing Flashcards
What is ageing?
Ageing or senescence is the process of growing older, with increased susceptibility to disease and increased likelihood of dying.
Biological.
Psychological/cognitive.
Social.
What is life expectancy?
Life expectancy is a statistical measure of how long a person can expect to live.
Has been rising continuously for many years.
What is the life expectancy of a baby girl born today compared to in 1998?
83 years now, compared to 80 years in 1998.
What is the life expectancy of a baby boy born today compared to in 1998?
79 years now, compared to 75 years in 1998.
Why do people age? (What are the theories of ageing)?
Programmed ageing theory.
Damage or error theories.
No single theory explains all that we know about ageing, and there is widespread, active research into ageing from molecular to societal levels.
Lots of theories, likely a combination of all.
Clinical relevance currently limited.
People age at different rates
Chronological age vs. biological age.
What is the theory of programmed ageing?
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 are damage or error theories of ageing?
Damage or error theories describe the accumulation of damage to DNA, cells and tissues, e.g. loss of telomeres or oxidative damage, as the cause for ageing.
e.g. free radicals damage mitochondrial DNA, cell can’t produce energy and cell dies.
e.g. protein crosslinking.
Damage theories implicity hold that if we could prevent or repair this damage then we could prevent ageing.
What is population ageing?
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 big challenges for societies as they try to adapt.
Happening much more quickly than in the past.
What challenges does society face as a result of population ageing?
Working life/retirement balance.
Caring for older people, the sandwich generation.
Extending healthy old age not just life expectancy.
Inadequate or absent services.
Outdated and ageist beliefs/assumptions.
Medical system designed for single acute diseases.
Limited accessibility for those with disabilities.
What factors influence how we age?
Genetic inheritance Health behaviour Access to health care Where we live Who we are
How is disease presentation altered with age?
Frailty
Non-specific presentations
Summarise the difficulties in managing disease in older people.
Multimorbidity Polypharmacy Iatrogenic harm Comprehensive geriatric assessment Rehabilitation
What is frailty?
Loss of biological reserve across multiple organ systems, leading to vulnerability to physiological decompensation and functional decline after a stressor event.
Why is frailty a problem?
Associated with increased risk of falls, worsening disability, care home admission and death.
Conflicting data on hospital admission.
Can we treat frailty?
Exercise
Nutrition
Drugs (possibly)
Prevention is better than cure
What is non-specific presentation of disease, and why is it a problem in older people?
A non-specific presentation means 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.
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.
