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Aging Adult > Aging Adult (Week 2) > Flashcards

Aging Adult (Week 2) Flashcards

1
Q

What leads to decreased brain weight?

A
  • Neuron loss (dec gray matter)
  • Myelin loss (dec white matter)
  • Nerve cell Shrinkage
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2
Q

What are some CNS changes with the agin adult?

A
  • delayed impulse conduction and velocity
  • reduction/altered balance of neurotransmitters
  • decreases hemisphere size
  • vestibular changes (decreased hair and gangllion cells)
  • decreased cerebral blood flow
  • decreased blucose metabolism
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3
Q

What are some functional implications with CNS change?

A
  • Delayed recall (needs time)
  • Rote memory decreases
  • altered gait, balance, and fine motor control
  • diminshed motor learning
  • decreasing activity level
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4
Q

What are the top 4 pathologies of the aging adult?

A
  • CVA (stroke)
  • TBI
  • Parkinsons disease
  • Dementia
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5
Q

What are the PNS changes with again?

A
  • Axonal degeneration ( and myelin)
  • Greater iternodal length
  • slower conduction velocity
  • Decreased ability to adap to environment (or visceral changes) - vagus nerve
  • decreased neuros per muscle fiber (fiber grouping) - take on fiber from other
  • Decrased Ruffini, pacinain, golgi reeptors
  • INCREASED Sympathetic Acitivty
  • decreased cerebral blood flow
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6
Q

Functioal impliations of PNS changes

A
  • increased recruitment of motor units )more work to do task)
  • increase CO-CONTRACTION at ankle
  • Altered motor control and postural stability
  • Decreased LE proprioception, vibration, discriminative touch and balance
  • Increased risk of falls
  • resting BP rises with age
  • Delayed response to pain
    • unaware of pain signals
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7
Q

PNS changes with aging

A
  • Decreased number and dentisy of mylinated nerve fibers
  • Decreased thickness of remaning fibers
  • decreased nerve conduction velocity and action potentials
  • INCREASED H Reflex latency
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8
Q

Vision changes with PNS

A
  • Beings in 3rd decarde
    • Neuron los in visual cortex
    • presbyopia - decreased flexibility of lens (common)
    • Decreased elasticity of lens
    • Decreased recovery from glare
    • Decreased tear production
    • Decreased acuity
    • Decreased visual fields
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9
Q

What are cataracts

A

Disorted vision - environment looks dusty or cloudy (common but not normal)

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10
Q

What is age related macular degeneration (AMD)?

A
  • Central field of vision is impaired, reading and fine motor task are more difficult
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11
Q

What is glaucoma?

A

Loss of peripheral vision (may lead to tunnel vision or blindness)

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12
Q

What is diabetic retinopathy?

A

Person with diabetes has blindspots or scotomas, visual skills fluctuate, may be associated with dpressed mood

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13
Q

What is retinal detachment?

A
  • Tearing or separing of retina from underlying tissue caused by trauma
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14
Q

Describe the functioal impact of sensory loss on balance and function?

A
  • Errors in proprioception have BIGGER effect on balance than errors in vision
  • Impairement associated with increased fall risk and functional decline
  • PTs need to provide older adults with sensory strategies to increase sensory information
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15
Q

What are the sensory changes with Hearing?

A

Presbycusis - hearing decline with age

BOTH genders but men lose higher frequencies (typical)

  • Difficulty turning out background music
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16
Q

Sensory changes with Semll and taste

A
  • Decreases with age - linked to 3 types of dementia
  • high prevelanece of hyposmia (deceased smell) + anosmia (loss of smell)
  • Impairs taste in food (leads to malnutrition)
  • Thirst declines
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17
Q

What are the normal cognitive changes with aging?

A

Loss of synaptic connections

  • creates memory impairment (slow but intact)
  • Evidence of mild decline in executive functioning

Exectutive - intiate activty, planing, problem solvingm figuring out consequences

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18
Q

What are the pathological cognitive changes with aging?

A
  • Certain growth factors in brain are inhibited
  • death and loss of neurons
  • dementia
19
Q

What are the 3 most common types of dementia

A
  • Dementia is not normal
  • alzheimers
  • vascular
  • lewy body
20
Q

What are the common affects of dementia?

A
  • memory and language
  • aphasia
  • apraxia
  • disturbance of executive function
21
Q

What is Alzheimers Diease?

A
  • Common form
  • has early onset 30-60 years olf
  • late onset

Risk factors include:

  • women > men
  • family history
  • > african american and hispanic population
22
Q

What is the clinical presentation of an alzheimers patient?

A
  • Memory impairment
  • lapse in judgement
  • personality changes
  • depression possible
  • language problems
  • Difficulty with aDLs
  • Visual spatial problems
  • Short tempered, hostile
  • Loss of motor function (swallowing, bowel/bladder)
23
Q

What are the risk factors for Vascular Dementia?

A

(2nd most common)

  • HTN
  • smoking
  • hypercholestermia
  • diabetes
  • CV disease
  • cerebrovascular diease
24
Q

How does a vascular dementia patient present?

A
  • Impairments in
    • memory
    • abstract thining
    • judgement
    • impulse control
    • personality changes

More by abrupt onset, step by step deterioration, flucutating course, and emotional lability

25
Q

What is Lewy Body dementia?

A
  • Cognitive decline with:
    • Fluctuations in alterness and attention (drowsy or lethargic)
    • Visual hallucinations
    • parkinsonian motor symptoms

Gait and balance issues, visual spatial issues, poor executive functionin, sensitive to antipsychotics, depressed possibly

26
Q

What is delurium?

A

Sudden, rapid change in mental function

associated with:

  • medical illness
  • recovery from surgery
  • hospital admission

Short term

Shouting, resisting, refusal to cooperate with emdical care, potential to be injured fallingm combative

27
Q

What is the mini cog?

A
  • 3 item recall: memory
  • clock drawing (10 after 11)
  • 3 min
  • scoring 0-2 postive dementia
  • 3-5 negative
28
Q

What is the moca test?

A

16 item test, 10 min

>26 = normal

29
Q

What is the MMSE?

A
  • 11 questions to assses
  • 24-30 no impairment
  • 18-24 mild
  • 0-17 severe
30
Q

What are ways to manage depression?

A
  • Pharmacology (SSRI’s, SCA’s) can have hypotensive side effects
  • Psychotherapy - less likely to seek this option
  • EXERCISE AND ACTIVITY
31
Q

What is the two question depresison test?

A

“over the past two weeks have you ever felt down, depressedm or hopeles?

“have you felt little interest or please in doing things?”

YES = follow up with MD or referral

32
Q

What are 2 depressions screening tools?

A
  • Geriatric depression scale
  • 20-30 = severe depression
  • CES-D
  • >16 questions needs referral
  • higher scores = more depressed
33
Q

What are some differences working with dementia patients?

A
  • Wont perform well with variety and randomness
  • Unable to tranfers
  • Need guidance
  • need simple adnd cuntioanl feed back
  • NO MENTAL PRACTICE
  • Massed, constant, blocked practice
34
Q

What is sarcopenia?

A

Age related loss of skeletal muscle mass and strength

Not completely age related

  • decreased PA
  • Co-mobiities

Results in decreased protien reserves

  • Challenge to meet protien synthesis demands with injury or disease
35
Q

What is normal muscle aging?

A
  • muscle reduced from 50% to 25% by age 75-80
  • Icnreased body fat
  • Type II atrophy > Type I (normal)
  • Denervation and reinervation of alpha motor neaurs
  • decreased muscle activation (less agnoist more coactivation of anatonist
  • decreased muscle strength and power
36
Q

Describe normal metabolic changes with aging?

A
  • Decreased resting metabolic rate
    • Less lean muscle mass
  • Insulin Resistance (common in older adults)
    • increased body fat further contributes
    • regulator of protein metabolism and important for protien gain and muscle growth
  • Decreased GH
  • Decreased Estrogen and testosterone
  • Vit D deficiency
37
Q

What is occuring int he skeletal system with normal aging?

A
  • Decline in bone minreal
  • increased osteoCLAST and decreased osteoBLAST
  • Osteopenia = increased risk of osteoperosis
    • load absorption decreased
    • decreased load dispersion
    • results in increased bone loading
38
Q

Describe the connective tissue with aging?

A

Decreased activity of osteoblasts and chrondroblasts

Increased osteoclasts and chrondoclasts

deceased response to growth factors

  • alters repair of tissue

Altered response to tissue loading

Decreased ability to retain water

  • decreased glycoconjugates that maintain fluid

Fragment of college sands and decreased turnover

Increased crosslinking between collagen molecues (INC STIFFNESS)

Calficication of articular disk

39
Q

What is the joint ROM like for the aging adult?

A
  • C spine - all motions decrease
    • greatest reduction in ext and lat flex
  • Thoracic and lumbar spine
    • extension becomes limited
    • no or very little change in motion
  • Hip
    • EXT decreses (Slower walking speed)
  • Ankle
    • DF decreases
  • Shoulder
    • Flex and ER (also from kyphosis)

KNEE ROM STABLE!

40
Q

Describe what habitual postures lead to

A
  • Forward head posture
  • Thoracic Kyphosis
    • inc >40 years of age Women > Men
    • Correlated with increased fall risk
    • associated with osteoposos and vertebral fx
  • Lumbar flattening (dec lordosis)
    • Decreased IV space (nerve root integrity)
41
Q

What altered function comes from altered posture?

A
  • diffivulty bending, lifting, climbing
  • HYPERKyphosos
    • spine extensors lengthened
  • FHP
    • Challenges swallowing, breathing, supine/prone positioning
  • Decreased Lumbar lordosis
    • pain, nerve root impingement
    • spinal stenosis
    • standing
42
Q

What is Osteoporosis?

A

skeletal decrease low bone mass and microarchitectural deterioration of bone

  • INC fx
  • Anterior verebral body
  • avoid/cautious of ADLs in flexed position
43
Q

What is OA

A
  • Failure of articular cartilage
  • load bearing joints
  • can lead to total joint arthroplasty
44
Q

What are some ways to test/measure postural alignment?

A
  • Plumb line
  • Wall Occiput DIstance
    • >0 increase liklihood of fx

Aging Adult (2 decks)

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