Aging and Cardiopulmonary disease (Mod 3) Flashcards
What are general considerations for the Geriatric population?
Increasing vulnerability to accidents and disease
- age increases susceptibility to disease
- Hard to differentiate between normal aging and pathological process
- Longer recovery periods
What are the general effects of ageing?(10)
- Renal function decline
- Falls/Injury
- Bone mass loss
- Sensory impairment
- Cognitive decline
- Hearing loss
- Polypharmacy
- Loss of muscle mass and strength
- Decreased immunity
- Psychosocial implications
What can occur with renal function decline with age?
- Drugs don’t clear out as fast
- Decreased U/O
- Electrolyte imbalance
- May need dialysis after treatments
- More susceptible to Dehydration
General anatomical/physiological changes to the respiratory system as a result of ageing?
- Increased airway reactivity
- Increased risk of pharyngeal collapse; OSA
- Decreased ciliary number and activity
- Diminished airway reflexes
- Dysphagia
- Cervical spine stenosis/stiffness
What changes can be expected with age?
- Calcification of cartilage in tracheal walls and bronchi
- Functional changes in airway receptors
- Drug admin may need to be adjusted
What altercations can be expected to the Alveoli with a age?
Number of alveoli remain unchanged
- Alveolar ducts and alveoli wider, shallower
- Decrease gas exchange surface area
How are the functions of respiratory muscles affected by aging?
Decreased total muscle mass and muscle strength (muscle atrophy)
- Decreased strength of cough
- Decreased MIP
- Decreased proportion of fast twitch fibres
- Intercostal/Diaphragmatic muscle atrophy (EMG activity reduced by 50%)
How is the Thoracic cage affected by aging?
- Slide 9
- Calcification of costal ligaments
- Kyphosis
- Decreased range of motion for thoracic rib articulations
- Thoracic vertebral height loss
- Increased anteroposterior chest diameter
- Decreased elasticity of intercostal muscles
- Flattened curvature of the diaphragm
How is lung function affected by aging alterations?
- Decreased chest wall compliance; increase in RV
- Recall; chest wall compliance +.Lung = compliance
- Increased AC membrane thickness; DLCO decline
- Senile emphysema?
What are the affects of Senile emphysema?
- Degeneration of elastic fibres, enlargement of air spaces
- Increase of closing capacity -> decreases max. insp. Flow-air trapping
- FEV1 and FVC both decrease (FEV1/FVC only to a small degree)
- TLC unaffected
- RV and FRV increase-decreased VC
Why does RV increase with ageing?
Decreased chest wall compliance increases RV and FRV but decreases VC because of senile emphysema
- Degeneration of elastic fibers enlarges air spaces
- Increase of closing capacity decreases max insp. = flow air trapping
How is Ventilatory response with ageing?
- Increased shunt (senile emphysema)
- Anatomic dead space increases Vd/Vt
- PaO2 declines w/age, P(A-a)O2 increases at rest
- Diminished ventilatory response to PaO2 and PaCo2
How is immunity affected with ageing?
- Increased immunoglobulin content
- Decreased alveolar macrophage population
How is the Cardiovascular system affected by ageing?
- Heart wall thickness increases (especially L ventricle)
- Heart valve thickening and calcification (Mitral, Aortic)
- Arterial collagen content increases-stiffening, high systolic pressure
- Postural hypotension
Polypharmacy issue with aging
patient swallow reflex gets dulled as they get older so they are more vulnerable to aspirations
- many come in with micro aspirations, and get repeated pneumonia which is a first sign that they’re micoaspirating
- Decreased immunity, recommend they get more vaccines than other populations
