Biology Of Aging Flashcards
What is Aging?
PATTERN of LIFE CHANGES that occurs as one grows older
Gerontology
Study of INDIVIDUAL and
COLLECTIVE *aging processes
5 types of ages
1) functional 🏃🏾♀️
2) social - society’s expectations of when something should occur ( becoming parents at a certain age;graduate from high school, college, retire)
3) psychological- cognitive ( ability to learn and remember )and emotional( ability to manage feelings)
4) legal 🍷
5) biological - age of your body’s systems
Geriatrics
MEDICAL SCIENCE that focus on OLDER ADULTS
Do the aspects of the aging process makes us more vulnerable to illness and disease?
Yes
Is PATHOLOGY inevitable with age?
No
What are physical changes of an aging population is related to what?
Lifestyle choices
What makes the biggest impact on someone’s aging?
Lifestyle choices
Normal age-related changes of Head(2)
1) skull thickens
2) head size increases
Normal age-related changes of the Brain (1)
Brain decreases in size
Normal age-related changes of Hair (2)
1) gray and thinner
2) men may go bald
Normal age-related changes Eyesight (2)
1) lenses HARDEN; YELLOW;LOSE TRANSPARENCY
2) ability to see close objects diminishes
Normal age-related changes of the Ears (1)
Ability to hear HIGH frequency sounds diminishes
Normal age-related changes of Lungs(1)
VITAL capacity declines
Normal age-related changes of Urinary system(2)
1) Kidneys filter blood more SLOWLY
2) Bladder’s capacity DECLINES
Normal age-related changes of Bones(1)
Bones become less dense
Normal age-related changes of joints(1)
Wear and tear can cause breakdown of joint CARTILAGE
Normal age-related changes of Face(2)
1) NOSE and EARLOBE become longer
2) WRINKLES from facial expressions and sun exposure develop
Normal age-related changes of Skin (3)
1) Skin becomes THINNER and loses ELASTICITY
2) ⬇️FAT deposits under the skin
3) Age Spots on skin develop
Normal age-related changes of Heart (1)
⬇️Stroke Volume
Normal age-related changes of Reproductive System in Men (1)
⬇️testosterone levels ( ability to attain and maintain erection⬇️)
Normal age-related changes of Reproductive System in Women (3)
1) Menopause leads to ⬇️in estrogen levels that can cause hot flashes or mood swings
2) Vaginal secretions diminish and Vaginal walls become less Elastic
3) Breasts are LESS FIRM
Name 3 BIOLOGICAL changes of Vision that ARE NON-Normative aging ( not normal to aging):
1- cataracts
2- glaucoma
3-macular degeneration
Name 2 BIOLOGICAL changes of Hearing that ARE NON- Normative aging ( not normal to aging):
1-Tinnitus- due to certain disease or medications
2-SIGNIFICANT hearing loss- due to damage to ear structure
Name 1 BIOLOGICAL change of TASTE that ARE NON-Normative aging ( not normal to aging):
Dry mouth due to ⬇️saliva production
Is dry mouth a normative biological change?
No, non- normative due to decreased saliva production
Name 1 normative BIOLOGICAL change of Vision and when does it occur?
Presbyopia occurs in the 40s
Name 1 Normative BIOLOGICAL change of hearing and when does it occur?
SUBTLE changes in hearing usually beginning in the 40s and progresses gradually with age
Name 1 Normative BIOLOGICAL change of Smell and 2 reasons why:
Odor identification
- likely due to environmental factors and
- olfactory receptors not being replaced as COMPLETELY as younger adults
Name 1 or probably 2 BIOLOGICAL changes of Smell that are Non-Normative and 3 reasons why:
1) loss of Smell
2) and likely Taste
Due to 1- URI
2- head trauma
3- nasal/sinus disease
Name 1 Normative BIOLOGICAL change of Taste and when does it occur?
⬇️ in sense of Taste around 60-70 as Taste receptors change
Are there any changes in TOUCH/ SKIN and if so why?
Changes in TOUCH and SKIN RECEPTORS is thought to take place gradually. There MAY BE SOME loss of receptors requiring more stimulation to elicit a response.
What does Physiologic Reserve allows
It allows us to maintain HOMEOSTASIS ( bounce back) in the presence of
- Environmental
- Emotional
- Physiological STRESS
What happens to Physiologic Reserve as we INCREASE in age?
Physiologic Reserve DECREASES
What is Physiologic Limit?
The limit BEYOND which homeostasis cannot be restored
What is Homeostenosis?
When an INSULT/STRESS happens that pushes the elderly beyond their FUNCTIONAL CAPACITY/ Physiologic Limit causing :
Decompensation
Disease
or Death
What is NORMATIVE Aging?
A SERIES of Time-dependent 1)Anatomic and 2)Physiologic CHANGES that:
Reduce:
1) Physiologic Reserve and
2) Functional Capacity
What happens when there is a ⬇️ in Physiologic Reserve and ⬇️ in Functional Capacity?
There is a ⬆️ in risk of SOME disease , but NO Disease is normal with aging.
Name 5 criteria of Frailty: and How many criteria must be present?
1- Unintentional Weight loss (10 lbs in past year)
2- Self-reported Exhaustion
3-Weakness ( grip strength)
4- Slow walking Speed
5- Low Physical activity
Frailty is what kind of syndrome?
Clinical syndrome
Frail older adults are at increase Risk for what 5 things
1- ⬆️risk of Falls 2-Worsening mobility 3-ADL ( activity of daily living) disability 4-Hospitalization 5- Death
Which PharmacoKinetic parameter is LEAST affected by AGE-Related PHYSIOLOGICAL changes?
- absorption
- distribution
- metabolism
- excretion
Absorption
Which benzodiazepines are “preferred” among older adults?
LOT
lorazepam
Oxazepam
Temazepam
5 Physiological changes relating to Absorption in GI with aging:
1-⬆️ gastric PH (less acidic) 2-⬇️gastric acid secretion 3-⬇️gastrointestinal BLOOD flow 4-⬇️gastrointestinal MOTILITY 5-⬇️gastric surface area
Pharmacokinetic Consequences of Physiological changes with aging in Stomach?
Potential for DELAY in absorption ( RATE); But NO change in the EXTENT of absorption
Which 3 classes of drugs might be needed less in Aging adults because of ⬆️ gastric PH?
PPI
H2 antagonist
Antacids
Name an absorption problem with ⬆️ gastric PH:
You can see a decrease in absorption of Calcium carbonate, Iron and different vitamins and minerals; decrease absorption of calcium carbonate can cause CONSTIPATION
How is absorption affected at IM injection site? Give examples of 2 drugs.
Because there is ⬇️muscle mass with aging , the rate of absorption may be ⬇️ with IM injections.
Benzathine penicillin and cefuroxime
True or False: Most drugs are well absorbed in the presence of AGE-RELATED changes ONLY.
True
Can the RATE of absorption be delayed for ALL drugs and ALL patients with AGE-RELATED changes?
The Rate of absorption can be changed for SOME drugs and SOME patients
Is the EXTENT of absorption changed in age-related changes?
NOT significantly
What 2 things together can ⬆️ the variability in drug absorption?
Age- related changes and concurrent diseases ( ex : skin condition)
What is a debate about systemic absorption of topical steroids in age related changes in the skin?
Thinning skin can result in higher absorption, but there is a ⬇️in BLOOD flow to the area which can balance things out
Name 4 areas of distribution that Aging can effect and tell whether ⬆️ or ⬇️
1-body water ⬇️
2-lean body mass⬇️ ( lean means muscle)
3-albumin ⬇️
4-fat stores ⬆️
How does ⬇️body water effect Volume of distribution (Vd) of a drug? Which drugs are effected and give 2 examples?
⬇️ volume of distribution for HYDROPHILIC drugs
Ethanol, lithium
How does ⬇️lean body mass effect Volume of distribution (Vd) of a drug? Which drugs are effected and give 1 example?
⬇️Vd for drugs that bind to Muscle; digoxin
How does ⬇️albumin effect Volume of distribution (Vd) of a drug? Give 3 examples:
⬆️ the % of UNBound or FREE drug ( unbound or free drug is active)
1- valproic acid
2-phenytoin
3-warfarin
How does ⬆️in Fat stores effect Volume of distribution (Vd) of a drug? Which drugs are effected and give 1 example?
⬆️Vd for LIPOPHILIC drugs
Diazepam
Does alcohol have higher or lower concentration in older adults and why?
Alcohol have a higher concentration because it is a hydrophilic drug. Since less body H20 causes lower Vd.
Distribution may be altered by AGE-RELATED Physiologic changes only?
No, distribution may be altered by both age-related Physiologic changes AND concurrent disease
Does the protein albumin increase or decrease with age
The amount of Albumin decrease with age