Ageing Flashcards

1
Q

Define ageing

A

Process of growing older

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2
Q

Define life expectancy

A

Statistical measure of the number of years a person can expect to live

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3
Q

How is the older population changing?

A

Living longer bc better public health

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4
Q

What challenges does society face as a result of population ageing?

A
  • 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  • Outdated and ageist beliefs/assumptions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
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5
Q

How does disease presentation change with age?

A
  • Non-specific presentation
  • Multi-morbidity
  • Frailty
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6
Q

What are the difficulties in managing disease in older people?

A
  • Multimorbidity
  • Polypharmacy
  • Iatrogenic harm
  • Comprehensive geriatric assessment
  • Rehabilitation
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7
Q

What are the key physical changes associated with the ageing brain?

A
  • Neurones shrink
  • Decreased connections between neurones
  • Ventricles enlarge
  • Gaps between major gyri widen
  • More CSF surrounding brain
  • Decrease in grey + white matter
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8
Q

What are the key issues associated with cognitive assessment of alder adults?

A
  • Most assessments assume numeracy and literacy
  • Not valid in acute illness
  • Not all cover all cognitive functions
  • Need tests in many different languages
  • Education + language levels
  • Practice/coaching effects
  • Floor + ceiling effects - if highly educated, SKIP
  • Blind/deaf
  • Ideally, want multidisciplinary assessment –> problem list –> plan
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9
Q

How is the demography of society changing?

A
  • Population is ageing
  • Increase in average life expectancy
  • Fertility rates are dropping
  • People are living longer bc better public health
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10
Q

What are the key cognitive changes associated with the ageing brain?

A
  • Slightly decrease in problem solving ability
  • Decreased processing speed
  • Slight decrease in working memory
  • Decrease in divided attention
  • Decrease in executive functions: plan, adapt
  • Dementia = decrease in all cognitive functions, not just memory
  • No change in nondeclarative memory, visuospatial abilities, language (some reduction in verbal fluency)
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11
Q

What are some non-specific signs/symptoms of disease in the elderly?

A
  • Weight loss
  • Confusion
  • “Not coping”
  • Iatrogenic harm
  • Recurrent infections
  • Reduced mobility
  • Falls
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12
Q

What are the main causes and theories of ageing?

A

Multiple theories about why organisms age fall into 2 broad categories:

  1. Programmed ageing theories
    - Describe how genetic, hormonal + immunological changes over lifetime lead to cumulative deficits we see as ageing
    - Theories tend to suggest this is part of an inescapable biological timetable, just as growth and puberty are programmed to occur
    - Hayflick limit to no. of divisions (telomeres + telomerase counts)
    - Allows cell to divide if it needs to - prevents cancer
    - Insulin + IGF1
  2. Damage/error theories
    - Describe accumulation of damage to DNA, cells and tissues, e.g. loss of telomeres or oxidative damage, as cause for ageing
    - implicitly hold that if we could prevent or repair this damage then we could prevent ageing
    a) Smoking, HIV, RA
    - Free radicals generated by mitochondria
    - NO, O2, H2
    - Damage mio
    - Damage mito DNA
    - No repair mechanism for mito DNA
    damaged - cells can’t make energy –> cell death
    b) Protein cross-linking –> damage –> non-functional
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13
Q

What is frailty?

A
  • Loss of functional reserve among older people
  • Causes impairment of ability to manage every day activities
  • Increases likelihood of adverse events + deterioration when faced w/minor stressor
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