Ageing I Flashcards
Define ageing? And life expectancy
Simply the process of getting lder 3 main components : biological Physchological/cognitive Social
life expenctancy is a statistical measire of how long a person will life for (will depend on the age at which you ask ofc-babies have a much higher one than elderly)
What contributes the people living longer?
Over the past 100 years-main one better public health (sanitation)
Nutrition, better education (of the elderly) also -reduction of poverty
More complex/nuance retirement process-people also work for longer
Advances in medicine isnt a big contributor
What is the biological theories explaining ageing?
Programmed ageing and damage and error theory
What is the programmed agering theory of ageing?
Based on observations that cells in vitro will only divide a certain amounts of time before dying-Hayflick number
based on telomere size which reduces at each division
So cause ageing because cells count how much they divide and will stop at one point–>then wont have enough cells etc (cancer protection tho)
Implication-stop ageing by modifying telomere shortening
What is the damage or error theory of ageing?
theoretically could have unlimmited lifespan, but cells accumulate damage during their lifes (from environement, etc) – all of that damage accumulates until cell death (DNA damage, protein crosslinking, etc)
no specific evidence of it
Implication-if you can stop ALL the damage-could extend life
Does everyone age at the same rate?
Not really-everyone differes- chronological age (a smoker, drinker, etc will accumulate more damage and aged faster) and biological age (like from genes-does have a genetic basis)
Can ageing be prevented?
Not real applications to stopping it
but good diet, exercise, no smoking and less alchohol
What challenged does society face with ageing population?
Retirement/pension mismatch-more ageing people and age of retirement not increasing with.
Extending OLD age not just life expentancy-better QOL in elderly, not just living longer in hospital bed. Reduce time of illness (not random-genes, health behaviours, where you live)
Caring for old people -3% of over 65 in care homes. but social care is not great. Less and less people want to take these jobs. Not free, bad working conditions. “sandwhich generation”-caring for their children and taking care of elderly, and working)
pretty much non ov it was planned like this
also ageist belifefs
medical system designed for acute diseases
=> increases demand of primary, secondary and tertiary care
Increasing complexity of cases, multimorbidty
What is frailty?
Loss of biological reserve across mutliple organ systems-leading to vulnerability to physiologcal decompensation and functional delince AFTER A STRESSOR EVENT
Genetic factor+ environemental factors (job, behaviour, etc)
Combine lead to accumulative cellular damage -> loss of reserve (like start with few million nephrons-lose them as age-function is fine but no backup-more likely to develop renal failure), (lung become stiffer and alveoli destroy)–cant cope with events as well
Very old people can have loss so much reserve than minor events can push over the edge-like UTI causes them to not be able to move at all anymore
Why does frailty matter to doctors?
The more frail a person is the more likely they weill need insitutional care
also less frailty means longer survivability – 4x more likely if not frail
Can we prevent/treat frailty?
Prevent-yea with exercise and stuff
treat-yes but very hard –need exercise, nutrition, drugs
Prevention is better
not all old people are frail-
What are some non-specific presentations common in eldery?
falls, reduced mobility, reccurent infection, confusion, weight loss, not coping, iatrogenic harm
–old people much more likely to come in with that than any other symptoms-no matter the disease
these are giaretric giants
These are presentations not diagnoses (like fall-why)
Old people also to tend to NOT have the classical symptoms of other issues (like chest pain in MI)
What is multimorbidity and its impact on health?
multiple conditions at same time-older a lot more likely
And condition feed one another and create new ones
Treatment for one impact another
cummulative worse QoL, depression
Increased functional impairment, burdern of treatment and polypharmacy (taking way to many medication at the same time)
Why do older people take more drugs?
Multimorbidity
Guidlines/NICE-drive prescription up because more guidlines give 1 drug for 1 condtion
Undetected non adherence-keep giving more drugs but theyre not even taking it-need to ask
Infrequent review-uneeded/outdated drugs-deprescribing
Poor communication
What is potentially innapropriate polypharmacy?
Up to 40% of prescription are innapropriates
associated with bad outcomes-increases duration of stay, mortality, delirium
