ageing Flashcards
how older population has changed
less poverty in older population, more education, more older ppl of ethnic minorities, and working for longer
theories of ageing
PROGRAMMED AGEING- it’s within our DNA, as cells stop dividing at some point as new healthy cells can’t be formed, controlled by TELOMERES: OR DAMAGE/ERROR theories- our cells and DNA accumulates damage eg free radicals
problem with theories of ageing
NO current anti-ageing theories
issues with society due to ageing
dependency ratio ie working life/retirement balance, extending HEALTHY age rather than just life expectancy, caring for older ppl (SANDWITCH GENERATION), medical system desinged for SINGLE ACUTE diseases
issue with working life/retirement balance and link to pension age
to do with dependency ratio ie number of ppl who are retired/in school compared to those working: we are living for longer, so dependency ratio has gone up ie more years spent in retirement, hence pension age has gone up
is life expectancy increasing now
has started to tail off in the UK
link between healthy years of living and wealth
less deprived ppl have more healthy years
social care in the UK
budget has decreased by 40%, as is not free, but rather means tested ie need to pay if you have enough money
sandwich generation- mostly male or female
those who have to take care of their children as well as their parents- mostly women
define frailty
loss of BIOLOGICAL RESERVE in different organs, leading to vulnerability to a stressor- eg older ppl have less nephrons, if sth effects their kidney, they have less of a reserve of nephrons to cope, OR lung capacity (stressor is walking)
how to treat frailty
exercise (increases lung capacity/muscle), nutrition
NON-SPECIFIC PRESENTATIONS of frailty
constant falls (lack of muscle reserve), less mobility, recurrent infections (weaker immune system), confusion
important thing about non-specific presentation of frailty
older ppl less likely to have classic symptoms of disease if they had eg coronary syndrome ie less likely to have chest pain, instead they have more NON-SPECIFIC symptoms , thus diagnosis of eg infarction more difficult
define multimorbidity and significance
2 or more chronic conditions- treatment of 1 condition can affect another ie may not be able to give it, and can lead to POLYPHARMACY (multiple medications)
why older ppl take more drugs
multimorbidity, undetected non-adherence (ie doctor adds extra drugs even though 1 would be enough if it was taken properly), infrequent review (not removing drugs if not needed)
iatrogenic harm and causes
harm due to treatment- occurs due to frailty (ie reduced reserve), and polypharmacy/comorbidities
examples of iatrogenic harm
hospital acquired infections, loss of muscle mass, malnutrition (hospital food not adequate)
comprehensive geriatric assessment- what is it and signficance
multidisciplinary assesment of the patient- look at ALL their problems and come up with a plan- reduces falls and admission to hospital
rehabilitation
often occurs alongside illness rather than after to prevent muscle loss ie DECONDITIONING
changes in ageing brain including grey vs white matter
due to atrophy, VENTRICLES enlarge, and GYRI can be seen more clearly: leads to less white AND grey matter
normal cognitive changes in old ppl
slower processing speed/executive functions, less divided attention ie multitasking, but NO change in language, NON-DECLARATIVE memory ie remembering how to do stuff, and VISUOSPATIAL abilities ie shouldn’t get lost in a familiar environment
define dementia and is it irreversible
decline in ALL cognitive functions, not ONLY memory eg visuospatial- irreversible
screening tests for dementia
AMT, clock drawing test, MOCA (montreal cognitive assessment)
diagnostic test for dementia
ACE (addenbroke’s cognitive examination)
pros of MOCA
covers variety of cognitive functions, and is brief, range of population BUT education/language level can affect results, administration
problems with general cognitive assessmnets
interpretation and context, impairments, numeracy/literacy skills, cultural knowledge
