Ageing Flashcards
Define ageing
Ageing is the process of growing older:
- Biological
- Psychological/cognitive
- Social
Define life expectancy
Life expectancy is a statistical measure of how long a person can expect to live
What are the biological theories of ageing?
- Programmed ageing – the idea that ageing is genetically programmed to occur with time, and this process of deterioration eventually leads to death
- Damage or error theories – the idea that external or environmental forces gradually damage cells and organs, leading to ageing and death.
What are the theories explaining the programmed ageing theory?
- Genetic life-span theory
- Genetic predisposition theory
- Telomere theory
- Specific system theories (Neuroendocrine theory)
What are the theories explaining the damage/error theory of ageing?
- Wear and tear theory
- Rate of living theory
- Waste product accumulation theory
- Cross-linking theory
- Free radical theory
- Autoimmune theory
- Error theories
- Order to disorder theory
What challenges does society face as a result of population ageing?
- Working life/retirement balance - not saving enough
- Caring for older people, the sandwich generation
- Extending healthy old age not just life expectancy
- Inadequate or absent services - social care and housing
- Outdated and ageist beliefs/assumptions
- Medical system designed for single acute diseases
- Limited accessibility for those with disabilities
- loneliness and isolation
How does disease presentation change with age?
- Frailty
- Non-specific presentations
What are the difficulties with managing disease in older people?
- Multimorbidity
- Polypharmacy
- Iatrogenic harm (caused by medical examination or treatment)
- Comprehensive geriatric assessment
- 5Rehabilitation
What is frailty?
A physiologic syndrome characterized by decreased reserve and resistance to stressors, resulting from cumulative decline across multiple physiologic systems, and causing vulnerability to adverse outcomes
How does frailty develop?
- Genetic and environmental factors
- Time
- Cumulative molecular and cellular damage
- Reduced physiological reserve
- Physical activity and nutritional factors
- Frailty
What are the “geriatric syndromes”?
Non-specific presentations:
- Falls
- Delirium/confusion
- Fluctuating disability
- reduced mobility
- Weight loss
- Iatrogenic harm
- “Not coping”
Why is frailty a problem?
- Minor illnesses cause more pronounced changes in health
- Increased hospital admissions
- Increased duration of hospital stay
- Increased care needs and dependence
Can frailty be treated?
- Not really
- Prevention rather than sure is best
- Prevention through exercise, nutrition, lack of smoking and drinking is the best way
Using MI and PE as examples, what are the issues with the elderly’s non-specific presentation?
- A wide variety of diseases can present as the same thing i.e. falls
- Less likely to have the textbook symptoms e.g.
- MI - less likely yo have chest pain
- PE - less likely to have pleuritic chest pain or haemoptysis
- More likely to have other symptoms
- MI - more likely to be short of breath
- PE - more likely to have syncope
Why is multimorbidity an issue?
- Conditions impact on one another
- Treatment for one condition may impact on another
- Negative impacts
- Worse QoL - more likely to be depressed
- Increased functional impairment
- Burden of treatment
- Polypharmacy
What are the main types of dementia?
Alzheimer’s
Vascular
