Aging Flashcards
Cardiovascular
less heart muscle fibers, heart and vessels less responsible to sympathetic stimulation, more collagen and calcification, less filling capacity, less stroke volume → slower resting and maximum heart rate, higher blood pressure, less ability of heart and vessels to respond to changes, stress.
Respiratory
less chest wall compliance, less alveolar ventilation, less respiratory muscle strength, less elasticity, less ventilation → less effective mucus clearance, reduced capacity for aerobic exercise, higher respiratory rate.
Musculoskeletal
less muscle mass, more body fat, less body H20, less H20 in muscles, tendons, joints, increased bone demineralization, increased joint degeneration, erosion, calcification –> overall stiffness of muscle and joint
Integumentary
decreased elastin, decreased subcutaneous fat, decreased vascularity –> smaller fat cushion, less blood flow, less resilient skin
Hepatic
reduced liver size, reduced blood flow –> reduced metabolic function
Renal
decreased # of nephrons, GFR declines, decreased urine concentration ability, decreased H concentration ability –> decreased excretion
GI
decreased GI motility, decreased saliva production, smaller gastric capacity –> dry mouth, early satiety
Genitourinary
vaginal dryness, longer time to erection, less forceful ejaculation, decreased sperm motility, decreased bladder size, pelvic muscle atrophy –> changes in sex, urinary retention (males), urinary incontinence (females)
Neurological
nerve cells degenerate and atrophy, decrease # of neurons, decrease neurotransmitters, decrease rate of conduction of nerve impulses, loss of taste, hearing issues –> slower processes, vision changes, hearing loss, decreases sensations
Endocrine/Metabolic
decreased BMR, decreased thermoregulation, decreased febrile response –> less appetite, less tolerance to cold, no fever with infection
Immune
Complex alterations in nonspecific and adaptive immune function, increased risk for infection, increase incidence for certain autoimmune diseases, increased risk for malignancies
Sleep
longer time to fall asleep, frequent nighttime awakenings, little or no deep sleep, REM sleep unchanged
Decreased renal function means:
DRUG TOXICITY
Changes in Absorption
Rate - delayed; decreased GI motility; decreased gastric emptying; decreased CYP450; decreased p-gp activity
Changes in Distribution
numerous alterations; decreased albumin; decreased lean body mass and total body water; decreased p-gp expression and activity; increased relative body fat
Changes in Metabolism
difficult to predict how this is effected patient to patient; decreased albumin; decreased protein binding; increased alpha-1-acid-glycoprotein; decreased hepatic blood flow; decreased hepatic metabolism
Changes in Excretion
most important change reduced renal excretion = increased risk of drug toxicity; decreased biliary excretion. serum creatine levels important.
Programmed Senescence Theory
Finite # of times a cell can undergo division; genetically programmed - with each cell division a small amount of DNA is lost at the end of the chromosome; activate by cell damage
Telomeres
“caps” on the end of chromosomes, protective, a tiny bit is cut off with each division, eventually you get to the actual chromosome and it dies.
Reactive Oxygen Species
“Free radicals,” can be caused by many things: UV light, radiation, metabolism, inflammation, air pollution. Can damage: mitochondria, lipids; Unpaired electrons looking for something to react with.
Neuroendocrine Theory
Aging is “decreased ability to survive stress”
- Coordinating Communication
- Programming physiological responses
- Maintaining optimal functional state
HPA, stress master regulator, tired and less effective
