Cardiovascular and Pulmonary Issues with Aging

Question 1

With increased age, what happens to:
FEV1
FVC
TLC
Vital Capacity
Functional residual capacity
residual volume
DLCO/Va
Alveoli number and size

Answer 1

Decreases
decreases
same
decreases
increases
increases
decreases
increases

Question 2

Why is breathing more difficult with increased age?

Answer 2

Decreased recoil pressure means expiration more difficult
Higher resting volume (FRC), start to resemble COPD
At same time, decreased thoracic compliance and decreased force generation from diaphragm

Question 3

what 4 things determine cardiac workload?

Answer 3

preload, afterload, contractility, heart rate

Question 4

Calculation for cardiac index?

Answer 4

cardiac output (CO)/body mass

Question 5

Calculation for age predicted max HR

Answer 5

220-age+/- 15 add 15 after age 50

Question 6

What changes occur in the cardiac muscle with aging?

Answer 6

• Increased left ventricular thickness
• decreased myocyte number
• decreased compliance
• increased lipid deposition, collagen, and fibrosis

Question 7

What changes occur in cardiac valves with aging?

Answer 7

• increased thickness and calcification

- ->increased afterload on heart due to altered filling and ejection

Question 8

What changes occur in the cardiac conduction system with aging?

Answer 8

• increased fibrosis changes conduction
• decreased number of SA node cells
• increased risk of dysrhythmia
• atrial fibrillation common: 10% of people over 70 years old

Question 9

What changes in vascular system with aging

Answer 9

• increased dilation of arteries means less reserve
• increased heterogeneity of intima (endothelial cells), increased thickness of subendothelial wall, increased size of smooth muscle (media), increased calcification and collagen, atrophy of elastin all–>decreased arterial compliance
• ->hypertension

Question 10

What may we see in cardiovascular function in older individuals with exercise

Answer 10

• -Increased HR at submax workload and decreased max HR
• -increased risk of ECG abnormalities
• WHY? Decreased stroke volume, decreased early diastolic filling=decreased preload/diastolic dysfunction; increased afterload due to hypertension, valve changes

Question 11

what are some neurohumoral changes that occur with aging

Answer 11

• -increased circulating catecholamines lead to decreased postsynaptic response/blunting of B-adrenergic response
• -Decreased PNS activity
• -Decreased baroreceptor responsivity can lead to orthostatic intolerance

Question 12

Some ideas to modify exercise in this population

Answer 12

• increase warm-up and cool-down time (note slower time to physiological steady-state, decreased CV responsiveness)
• be aware of decreased fitness levels
• Note that same training effects can occur in elderly as youger