Ageing and the body Flashcards
How does ageing affect health care?
- Natural process - happens to everyone
- Body systems change
- Impacts on how well body copes with new and ongoing insults
- Impacts on how we treat and manage patients
- Implications for ongoing care - increasingly challenging
How does ageing affect the skin?
- Elastic tissue becomes less effective as we age
- Skin becomes less tight and thinner
- More susceptible to damage and therefore more fragile
- Causes skin to tear and bruise easily
How does ageing affect the respiratory system?
- Elasticity in lungs is important for normal function
- Lung compliance is determined by elastic tissue
- Elastic recoil allows for passive exhalation
- Reduction in TLC, FVC, FEV1, vital capacity as we age
- Elastic tissue important in holding terminal airways and alveoli open
What factors affect the lungs other than age?
- Work exposure
- Smoke exposure
- Repeated infections
- Chemical/toxin exposure
- Chest infections become more common as we age - causes damage and scarring to lungs
How does reduced lung function affect older people?
- Patients are at greater risk of respiratory infections
- More likely to be acutely unwell
- More likely to need hospitalisation
- More likely to need oxygen/IV antibiotics
- More prone to post operative complications
- Sedating drugs more likely to cause respiratory problems
Which post-operative complications are elderly people more prone to due to reduced lung function?
- Atelectasis
- Pneumonia
- Pulmonary embolism
How does ageing affect the cardiovascular system?
- Blood vessels become more stiff as we age (especially arteries)
- Elastic recoil is reduced so arteries are less expansile
- Increases resistance to blood flow
- Leads to hypertension
- Increased cardiovascular work
- Increased risk of left ventricular hypertrophy
- Decreased left ventricular volume
- Can lead to heart failure
How does left sided heart failure lead to right sided heart failure?
- Blood backs up and pools in lungs
- Right side of heart has to work harder against pressure
- To get blood through lungs to be oxygenated
What are the risks of uncontrolled hypertension?
- Increased risk of stroke
- Increased risk of MI
- CKD
- Heart failure
- AF - increases risk of stroke
- Vascular disease e.g. abdominal aortic aneurysm
- Damage to vision
- Increased risk of vascular dementia
Outline the pathophysiology of atrial fibrillation
- Hypertension causes increased stretch of the atria
- Atrial stretch causes small areas of damage
- New foci of electrical activity
What are the key features on an ECG which shows AF?
- Wavy baseline
- Absence of P wave
- Irregularly irregular heart rate
How does age affect the renal system?
- GFR decreases as we age
- Structural changes
- Atheromatous vascular disease
- Reduced cardiac output
- Lots of medications are renally excreted
Why is decreased kidney function a problem in elderly people?
- A lot of medications are renally excreted e.g. morphine
- Problem because older patients tend to be on multiple medications
- Takes longer for them to excrete drugs
- Can result in toxic effect
How can we avoid issues in elderly patients with renal problems?
- Find out patients’ renal function before prescribing medications
- Use alternative drugs
Which co-morbidities affect renal function?
- Diabetes - leads to diabetic nephropathy and damage to microvascular structures due to hyperglycaemia
- Hypertension - some antihypertensive medications are nephrotoxic (NSAIDS, ACEi)
