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NMR II > Aging > Flashcards

Aging Flashcards

1
Q

What are some musculoskeletal age related changed?

A
  • Sarcopenia
  • Decreased velocity of muscular contraction
  • Decrease in strength
  • Decreased cross sectional area of muscle fibers
  • Collagen stiffness
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2
Q

In aging population do men or women have a greater loss in bone mass

A

Women - Women experienced greater loss of bone mass following menopause

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3
Q

What percentage of strength is lost per decade in the aging population?

A

10%

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4
Q

What are some cardio/pulmonary age related changes?

A
  • Increased calcification of valves
  • Decreased arterial elasticity
  • Decreased muscle strength
  • Decreased forced expiratory volume (FEV)
  • Increased residual volume following max expiration
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5
Q

What are some neuro age related changes?

A
  • Decreased brain weight & volume
  • Increased ventricular size
  • Decreased nerve speed & conduction
  • Decreased reaction speed
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6
Q

What are some integumentary age related changes?

A
  • Decreased sensory perception
  • More prone to hypo/hyper-themia
  • Impaired thermoregulation (decreased sweat glands)
  • Decreased elasticity & thickness of dermis
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7
Q

What are some metabolic & endocrine age related changes?

A
  • Decreased sensitivity to insulin
  • Metabolism decreases
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8
Q

What some gastrointestinal age related changes?

A
  • Decreased energy/drug metabolism
  • Increased risk of adverse side effect
  • Decreased bowl motility
  • Decreased gastric acid production
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9
Q

What are some genitourinary age related changes?

A
  • Increased size of the prostate
  • Increased incontinence
  • Decreased kidney functioning including filtration rate
  • Decreased bladder capacity
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10
Q

What is most common cognitive impairment associated with aging?

A

Memory loss

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11
Q

Which type of memory is most affected in older adults?

A

Short term - Older adults have difficulty recalling information they learned recently

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12
Q

What is semantic memory?

A

Facts, knowledge of specific information

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13
Q

What is procedural memory?

A

Performance of a specific procedure or skills

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14
Q

What is working memory?

A

Use of relevant information during a task

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15
Q

What is episodic memory?

A

Lived experience, personally experienced

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16
Q

While both working and short term memory decreases, which decrease more?

A

Short term

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17
Q

Of episodic, semantic and procedural which memory is affected the most?

A

episodic

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18
Q

Does sustained and selective attention show a decline in age?

A

No, not in comparison to divided attention

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19
Q

What is sustained attention?

A

Maintaining attention over a long period of time

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20
Q

What is selective attention?

A

Ability to selective disregard items that are relevant to that specific task

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21
Q

What is divided attention?

A

Ability to process two more sources of information at the same time

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22
Q

Which type of attention declines the most?

A

Divided

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23
Q

Deficits in divided attention leads to what risk?

A

Increased fall risk (generally prioritize motor tasks)

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24
Q

Which type of intelligence is know to decline with age? (General, Crystallized or Fluid)

A

Fluid intelligence

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25
Q

What is general intelligence?

A

Broad mental capacity-performance on cognitive ability measure

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26
Q

What is crystallized intelligence?

A

Accumulation of knowledge and skills

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27
Q

What is fluid intelligence?

A

Speed & ability to problem solve

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28
Q

When does general intelligence begin to decline?

A

Sometime between 50s & 70s

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29
Q

What is presbycusis?

A

Progressive loss of hearing

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30
Q

What is tinnitus?

A

Experience ringing; common hearing impairment associated with aging

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31
Q

When does a progressive loss of hearing begin? (Presbycusis)

A

Typically begins in patients 40’s and accelerates overtime

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32
Q

Individuals can differentiate (lower or higher) frequencies better than (lower or higher)

A

Individual can differentiate lower frequency better than high frequencies

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33
Q

What are some things that you should keep in mind when working with individuals with hearing defects?

A
  • Reduce background noice/audio
  • Speak loudly
  • Speak slowly
  • Pronounce carefully
  • Attempt to use lower frequency range
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34
Q

Vision deficits (increase or decrease) with age

A

Increase

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35
Q

At what age will visual impairments increase?

A

75 years and older

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36
Q

What can visual deficits lead to?

A
  • Falls
  • Depression
  • Decline
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37
Q

What happens to the pupils as people age?

A

They become smaller & less responsive which leads to more difficulty to see in the dark

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38
Q

As people age they have an (Increased or decreased) time to accommodate to bright or dark environments

A

Increase time

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39
Q

What are some common diseases of the eye?

A
  • Cataracts
  • Glaucoma
  • Macular degeneration
  • Diabetic retinopathy
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40
Q

Why does the aging population have impaired depth perception?

A

Loss of contrast

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41
Q

Name some visual impairment interventions

A
  • Environmental & behavioral modifications can decrease the risk of injury
  • Contrasting colors to highlight barriers, edge of steps, threshold, and transitions
  • Remove throw rugs & uneven surfaces that are not secured to the floor safely
  • Use night lights or motion sensor lights
  • Allow for extra time when transitioning between light & dark areas
  • Maintain clear steps, hallways, & floors
  • Add handrails & grab bars to assist
42
Q

With increased age, the size & number of taste buds (increase or decrease) which leads to (increased or decreased) sensitivity to tastes

A

Decrease and decrease

43
Q

T/F: Saliva production increases leading to increased taste sensitivity in aging population

A

False- Saliva production decreases leading to a dry mouth and decreased taste sensitivity

44
Q

T/F: Decreased ability to smell and detect odors, and decreases taste sensitivity occurs with aging

A

True

45
Q

Decreased taste sensitivity leads to decreased desire to eat what can cause what to happen?

A
  • Negatively affect their nutrition as a whole
  • Patients may add more salt for flavor which can negatively impact them
46
Q

As patients age they have an (increased or decreased) sensation to touch, pain, vibration, pressure, proprioception & temperature

A

Decreased

47
Q

Impairments with vision, touch and somatosensation lead to what?

A
  • Increased fall risk and decreased balance
48
Q

T/F: As patients age they are at a decreased risk for injuries including burns & pressure ulcers

A

False - Increase

49
Q

What are some geriatric issues with pharmacology?

A
  • Larger quantity of medications
  • Larger quantity of diagnoses or impairments being treated
  • Altered response to medications
  • Side effects
  • Adverse effects
50
Q

What is polypharmacy?

A

taking multiple medications, often defined as 5 or more medications

51
Q

What is rational polypharmacy?

A

Multiple medications to treat multiple medical issues or to treat a single medical issue where each drug works together to control symptoms

52
Q

What is irrational polypharmacy?

A

Excessive, duplicate or contradicted medications are prescribed to treat the same condition

53
Q

What are the 4 categories of pharmacokinetics?

A
  • Absorption (movement of drug into blood stream)
  • Distribution (Transport of drug to various tissues)
  • Metabolism (drug clearance primarily from liver)
  • Excretion (Primary completed by renal system)
54
Q

What is pharmacokinetics?

A

Study of what happens to the drug once it is in the human body

55
Q

Name some reasons that pharmacokinetics change as we age

A
  • Decreased absorption through GI tract
  • Decreased total body water
  • Decreased total body mass
  • Decreased plasma protein concentrations
  • Increased fat affects lipid and water soluble medications
  • Reduced ability for kidneys to excrete drugs
56
Q

What two things does changes in pharmacokinetics cause?

A
  • Changes cause increased time period for medication half life
  • Increased incidence of adverse drug effects
57
Q

Name some common adverse drug reactions in seniors

A
  • GI symptoms
  • Sedation
  • Confusion
  • Depression
  • Orthostatic hypotension
  • Fatigue & weakness
58
Q

What are 3 strategies to coordinate PT with drug treatment in the elderly?

A
  • Distinguish drug effects from symptoms
  • Schedule sessions around dose
  • Educate & facilitate compliance with drug therapy
59
Q

When scheduling sessions around dosage of medication what should you keep in mind?

A
  • pain medications (important to be proactive rather than reactive)
  • Avoid rollercoaster of pain management
  • Parkinson’s disease (mindful of timing of levodopa)
60
Q

What are some common problems when it comes to nutrition for older adults?

A
  • Changes to taste/smell
  • Meds may reduce appetite
  • Decreased sense of thirst
  • Intolerance and GI distress
  • Difficulty chewing
  • Financial concerns
61
Q

Why may older adults be vulnerable to malnutrition?

A
  • Decrease energy requirements
  • Decrease lean body mass
  • Decrease metabolic rate
  • Need for certain nutrients
62
Q

How is frailty defined?

A

Clinically recognizable state of increased vulnerability resulting from aging-association decline in reserve and function across multiple physiologic systems such that the ability to cope with everyday or acute stressors is compromised

63
Q

Frailty is defined as meeting 3/5 of what characteristics?

A
  • Low grip strength
  • Low energy
  • Slowed walking speed
  • Low physical activity
  • Unintentional weight loss
64
Q

What are 4 challenges when it comes to frailty in adults?

A
  • More infections & diseases
  • Their injuries take longer to heal
  • Surgery is more risky
  • Hospital stays are longer & more money
65
Q

Name some recommendations to improve nutrition

A
  • Drink more liquids
  • Portion control
  • Plan healthy meals
  • Softer food
  • Use herbs & spices
  • Eat socially
  • Eat safe
  • Read labels
  • Speak with mD
66
Q

Name 3 reasons for dehydration in older adults

A
  • Decreased thirst
  • Dilute urine
  • Medications
67
Q

Name some symptoms of dehydration in older adults

A
  • Confusion
  • Lethargy
  • Rapid weight loss
  • Functional decline
  • Decreased skin turgor
  • Decreased BP (critical)
  • Orthostatic hypotension (critical)
  • Tachycardia (Critical)
68
Q

Name some symptoms of UTI

A
  • Pain with urination
  • Increased frequency
  • Persistent urge to urinate
  • Hematuria
  • Foul smell
  • Cloudy urine
69
Q

What is stress incontinence?

A

Urine leaks out when you jump, cough, laugh or strain

70
Q

What is overactive bladder (urge) Incontinence?

A

Strong urge to urinate even when your bladder isn’t full

71
Q

What is mixed incontinence?

A

symptoms of both stress and overactive incontinence

72
Q

What is overflow incontinence?

A

Bladder never completely empties, urine leakage, with or without feeling a need to go

73
Q

What is functional incontinence?

A

Your urinary tract is functioning properly but other illnesses or disabilities prevent you from staying dry

74
Q

What is osteoporosis?

A
  • Metabolic conditions that presents with a decrease in bone mass that increases risk of fracture
  • Decrease in osteoblast function with less calcium & phosphate salts will cause bones to become brittle
75
Q

What is osteopenia?

A
  • Low bone mass but not low enough to classify as osteoporosis
  • Individual may not have actual bone loss but lower bone density than norms naturally
76
Q

What are signs and symptoms of osteoporosis?

A
  • Compression & other bone fx
  • Low back pain
  • Thoracic pain
  • Decreased lumbar lordosis
  • Kyphosis
  • Decreased height
77
Q

What are the most common bones affected by osteoporosis?

A
  • Primarily affects trabecular bone in postmenopausal women but seen in trabecular and cortical bone in geriatric population
  • Vertebrae, distal radius/ulna, and femoral neck
78
Q

What can cause secondary osteoporosis?

A

Prolonged drug therapies like heparin, corticosteroids

79
Q

What are some rehabilitation principle for patients with osteoporosis?

A
  • Decrease risk of falls (mobility training & AD)
  • Exercise
  • Trunk orthoses (Short term pain relief & long term weakness and deconditioning)
80
Q

What should be avoided during the rehabilitation of patients with osteoporosis?

A
  • Excessive forward bending
  • Exercising trunk in flexion
  • Trunk flexion with rotation
  • Prolonged immobilazation
81
Q

What exercise should be done for rehabilitating patients with osteoporosis?

A
  • WB aerobic exercises
  • Postural training
  • Progressive resistance training
  • Gentle stretching
  • Balance training
82
Q

What is dementia?

A
  • Global decline in cognitive capacity in clear consciousness
  • Impaired ability to complete ADL’s
83
Q

What are some common symptoms of dementia?

A
  • Difficulty with comprehension of language
  • Decreased ability to problem solve
  • Behavioral disturbances
  • Memory deficits
  • Increases with age
  • Normal speech in early stages
84
Q

What is delirium?

A
  • Transient state of fluctuating cognitive abilities
  • Memory, orientation, & arousal may be impacted
  • Cognitive status may fluctuate day to fay
  • Can occur after a hospitalization, surgery, or side effect of new medications
85
Q

What are some risk factors for delirium?

A
  • Age > 70
  • Decreased cognitive staus
  • Depression
  • Alcohol abuse
86
Q

What is the difference between dementia and delirium?

A
  • Dementia: slow gradual onset of diminished ability to reason and make sound judgements, loss of social skills and develop of regressed or antisocial behavior
  • Delirium: Transient mental disorder with relatively rapid onset, fluctuates typically and brief duration of hours to 4 weeks. Reduced ability to pay attention to external stimuli and to shift attention to new stimuli
87
Q

What is Alzheimer’s Disease?

A

Progressive disease process typically causing dementia

88
Q

What is Alzheimer’s Disease characterized by?

A
  • Memory
  • Language
  • Visuospatial skills
  • Personality
  • Cognition
89
Q

What motor changes occur in patients with Alzheimer’s Disease?

A
  • Slow movements
  • Halting gait
  • Generalized weakness
  • Increased risk of falls (decrease postural reflexes, awareness of self & environment, ability to navigate obstacles)
90
Q

What are the primary goals for treatment of Alzheimer disease?

A
  • Improve quality of life
  • Maximize functional performance
  • Foster a safe and secure environment
  • Decrease risk for fall & re-hospitalization
  • Caregiver training
91
Q

What communication techniques should one employ interacting with a person with Alzheimer’s Disease?

A
  • Speak clearly in a calm tone
  • Introduce yourself everytime
  • Be aware of body language
  • Use visual cues
  • Use patients name
  • Eliminate distraction
  • Single Step commands
  • Break tasks into parts
  • Avoid confrontation
  • Maintain a routine
92
Q

What is a geriatric syndrome?

A
  • Non-disease clinical condition of older persons characterized by multiple causes determining a unified manifestation
  • Encompasses a group of signs and symptoms variably occurring together and characterizing a particular abnormality
93
Q

Name some signs of caregiver stress

A
  • Lack energy
  • Overwhelming fatigue
  • Sleep problems
  • Changes in eating
  • WIthdrawing
  • Feeling overwhelmed
  • Anxiety
  • Depression
  • Mood swings
  • Becoming unusually impatient, irritable or argumentative
  • Anxiety about future
  • Difficulty coping with everyday things
  • Lowered resistance to illness
94
Q

What is ageism?

A

Form of discrimination based on stereotypes of age

95
Q

What is physical abuse?

A

Causing bodily harm by hitting, pushing or slapping. This may include restraint an older adult against their will

96
Q

What is emotional abuse?

A

A caregiver saying hurtful words, yelling, threatening or repeatedly ignoring the older adult. Keeping that person from seeing close friends & relatives

97
Q

What is neglect?

A
  • When caregiver does not respond to older adults needs
  • May include physical, emotional, & social needs or withholding food, medication or access to health care
98
Q

What is abandonment?

A

Leaving an older adult who needs help alone without planning for their care

99
Q

What is sexual abuse?

A

Caregiver forcing an older adult to watch or be part of sexual acts

100
Q

What is financial abuse?

A
  • Happens when money or belongings are stolen or social security benefits or using a person’s credit cards & bank account without their permission
  • Includes changing names on a will, bank account, life insurance policy or title to a house without permission
101
Q

Name some signs of elder abuse

A
  • Unexplained injuries
  • Annoyance/avoidance of personal questions
  • Malnutrition/ Dehydration
  • Poor hygiene
  • Soiled or inappropriate clothing
  • weight loss
  • Trouble sleeping
  • bed sores or preventable conditions
  • Seems depressed, confused or withdrawn

NMR II (14 decks)

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