ageing of body systems

Question 1

What is ageing?

Answer 1

• has biological and social impacts- however individualised
  biological-
• the gradual accumulation of molecular and cellular damage overtime, leading to decrease in physiologcal function and increase in various diseases
• a general decline in the capacity of the individual, leading to death
  social-
  -social role, position, and relationships change
• goals and activities change
• development of new roles, viewpoints, and different social contacts

Question 2

What are the 9 hallmarks of ageing?
(Lopez-Otin, et al, 2013).

Answer 2

1. Genomic instability- the accumulation of genetic damage altering the genetic control of cellular function.
2. Telomere attrition- telomeres are progressively shortened with each replicative cycle. Once lost, further replication of the cell is not possible and it will die.
3. Epigenetic alteration- alterations on gene expression affects the enzymes within the cells and so change the way cells work.
4. Loss of proteostasis- decline in ability of cells to maintain proper protein folding and degradation, therefore affecting function
5. Deregulated nutrient sensing- reduction in control of nutrient use within the cell, leading to metaboilic dysfunction
6. Mitochondrial dysfunction- decline in mitrochondryia function, effecting cells energy production
7. Cellular senescence- stopping the cell cycle at a stable point, resulting in the cells no longer being able to divide, overtime tissue will accumulate senescent cells with a reduction in its function.
8. Stem cell exhaustion- Reduction in the regenerative capacity of stem cells, which play a key role in tissue repair and maintenance
9. Altered intercellular communication- reduces the bodies ability to response to damage and stimuli.
   first 4 are causes of damage, next 3 are responses to thr damage, and last 2 are consequences that ensue with ageing.
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Question 3

What is the WHO definiton of healthy ageing?
(WHO, 2015)

Answer 3

“the process of developing and maintaining the functional ability that enables well-being in older age.”
emphasizes importance of maintaining physical, mental, and social well-being as people age.
it highlights the idea that aging is not just about lifespan, but also about quality of life.
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Question 4

How does ageing affect the reproductive system?
(Hall, 2021)

Answer 4

• testosterone decline in men
• enlarged prostate, causing problems in passing urine
• menopause ends fertility in women- men can father children later into life 60s-70s
• reduced oestrogen production in women
• ## libido decreases with age- can cause relationship problams if partner mismatch

Question 5

How does ageing affect the endocrine system?
(Hall, 2021)

Answer 5

• decline in endocrine function- recued hormone sectretipn, responsiveness to hormones, and changes in central control
• this can lead to changes in other systems

Question 6

How does ageing affect the renal and hepatic system?
(Hall, 2021)

Answer 6

• reduced filtration rates cause decline in renal function
• functional changes in renal tubules mean you are less able to concentrqate or dilute urine and control excretion of drugs
• a 25% reduction in liver weight from 25-60 years
• results in redfuced clearancr of drugs

Question 7

How does ageing affect the gut?
(Hall, 2021)

Answer 7

• gut microbiome changes- may cause irritation
• reduced effecincy in oesophgus causing dysphagia and reflux consequences
• stomach becomes less complaint with delayed emptying, reduced acid production and feeling sull after eating small amounts
• transit time in colon is increased, reducing peristalisis, increasing water reabsorption and making people more p[rone to constipation.

Question 8

How does ageing affect the nervous system?
(Hall, 2021)

Answer 8

• neurodegenerative and cognitive decline
• 50% of adults over 85 have Alzheimer’s
• decline in sensory functions- taste, smell, sight, hearing affected
• decline in motor functions- slower reaction time, slower central processing and movement, affect posture and balance
• slowing of cnetral processing in NS, decline in short-term recall, however normal ageing of the brain occurs in the absense of disease

Question 9

How does ageing affect the musculoskeletal system?
(Hall, 2021)

Answer 9

• age is biggest risk factor in oestoporosis and osteoarthritis
• increased risk of bonefracture
• loss of muscle mass
• progressive reduction in support as posture changes
• decreased strength and physical ability

Question 10

How does ageing affect the cardiovascular system?
(Hall, 2021)

Answer 10

• raasied systolic and pulse pressures due to progressivley rigid, large elastic arteries
• increased cardiac work and oxygen demand
• left ventircular hypertrophy- as heart is working harder to move blood through systemic circulation
• delayed baroreceptor responses- causing poor adaption to pressure changes

Question 11

How does ageing affect the respiratory system?
(Hall, 2021)

Answer 11

• decreased elastic recoil of lungs, rigid chest wall and reduced force from respiratory musculature redult in lunch not emptying fully
• this causes an increased functional residual capacity (FRC)
• smalll airway closes at earlier, at higher volume allowing less ventiliation at the base of lung

Question 12

How does ageing affect the skin?
(Hall, 2021)

Answer 12

• influenced by genetics, environmental exposure, hormonal changes, metabolic processes
• skin becomes thinner
• rate of regenration becomes slower
• greater risk of breakdown
• reduction in collagen and elastin causing dermis to become thinnger, stiffer, and less malleable, less elastic

Question 13

How does ageing affect the nerves?
(Hall, 2021)

Answer 13

• neuronal cell loss occurs
• changes in synpases
• plastcity, not replacement of neurones (rearranging the connections of lost neurones to take over functions)

Question 14

How does ageing affect bone and connective tissue?
(Hall, 2021)

Answer 14

• decalcification of bone increases, reducing bone strength
• thinning of cartilage at joint surfaces
• elastic ligaments lose elastic element
• changed inevitable but can be delayed with exercise

Question 15

How does ageing affect muscle?
(Hall, 2021)

Answer 15

• reduction in number of muscle fibres, fibre size, and replacing active muscle fibres with non-contractile fiburos tissue
• rapid loss of muscle mass after 60
• senile sarcopenia- increases fat, less effecient mitochondria, less blood flow, reduced number of motoneurons

Question 16

How is effective communication with older adults achiveved?
(Daly, 2017)

Answer 16

• hearing loss, visual impairments, and reduced cognition after ofdten experinced by older adults
• reduce background nosie, ensure adequate light, use touch, nposition yoursekf at same level, used preferred names, consider vocabulary being used, pace speak appropriately

Question 17

How can nurses support healthy ageing?
(Hayes, 2021)

Answer 17

• recognise older peopl’s individiual perceptions of health- find this through motivational interviewing and open-ended questions
• interventions should respect older people’s autonomy
• adopting healhy lifestyles reduces the risk of developing chronic illnesses later in life. nurses should promote healthy lifestyles by understanding policies and uding behvaiour change models to influence lifestyle choices
• in older people health promotion initiatives must incorportae lifeftyle modofication, independence, personal growth, mental health, and social well-being.

Question 18

How does nutrition and physical activity minimise the effects of ageing?
(Hammar, 2013)

Answer 18

• Weight-loss therapy that minimizes muscle and bone loss is recommended for older
  persons who are obese and who have functional impairments or metabolic
  complications that can benefit from weight loss.
• Exercise and physical activity can effectively prevent weight gain in older adults
  either in terms of weight loss or maintenance and may also prevent cardiovascular
  disease (CVD), osteoporosis, some malignant diseases and mental disturbances.
• High adherence to a Mediterranean type of diet is associated with reduced risk of
  CVD and some types of cancer, in the elderly.
  The avoidance of a sedentary life style seems at least as important as regualr exercise to reduce risks of NCD development

Question 19

How does portion control and healthy eating infleunce health?
(Hicking, 2021)

Answer 19

• being obese or overweight is associated with increased risk of developing NCD
• Eatwell Guide arranges the five main
  food groups into straightforward pictorial
  health-promotion advice, with the aim of
  assisting individuals to make educated dietary
  choices that support optimal health
• Barriers to achieving long-term dietary
  changes include misconceptions about healthy
  eating, distorted views of portion sizes and the
  importance of achieving value for money
  -Nurses can use the ‘hand-size method’ to
  educate people on appropriate portion
  size, which enables healthy portions to be
  visualised without the need for scales or
  measuring devices