Clinical Aspects of Aging Flashcards
4 major features of aging?
- destructive
- progressive
- partly determined by genetic code
- universal (mammalian species)
-progressive, universal physiological aging changes
normal/healthy aging
includes disease commonly occurring in aging such as HTN, CAD, T2DM
usual (chronically ill, frail)
preserved function and compression of morbiditiy
successful aging
increased vulnerability and increased risk of impaired function refer to increasing?
frailty
reduced physiologic reserve to maintain homeostasis during periods of stress, physiologic demands associated with exertion and acute illness
homeostenosis
changes in vision in elderly?
decreased visual acuity, lateral motion, depth perception, contrast sensitivity; increased glare sensitivity
implications of vision changes?
quality of life, night driving, fall risk, medication issues (reading, finding white pill in white box)
- loss of high frequencies first
- bilateral, symmetrical, slowly progressive
presbycusis
- dysequilibrium of aging
- vestibular degeneration
- diagnosis of exclusion
presbystasis
increased theshold to tast salt and sweet, gives perception that food is poorly _______, increased salt may have potential negative impact on HF and HTN
seasoned
physiologic anorexia of aging:
- reduced ______ of gastric fundus, early antral filling
- decreased gastric _______
- increased circulating CCK
- decrease in dynorphins - eating drive
stretch/relaxation
emptying
- age related disease of contractile amplitude
- after 80, effective esophageal contractions may not occur after a swallow
- increased microaspiration risk
presbyesophagus
gastric:
- ______ HCl and gastric emptying
- disruption of gastric mucosal _______, increased risk of PUD
decreased
barrier
- reduced absorption of iron, zinc, B12, folic acid, lactose
- reduced vitamin D receptors in gut leads to impaired absorption of _______
- bacterial overgrowth due to long term use of _______
calcium
PPIs
- increased rectal ______ and decreased rectal ________ lead to large volume stool needed for urge, decreased stool frequency, increased stool hardness
- diverticulosis due to decreased ________ of bowel wall, slowed transit, change in contractions
compliance
sensation
tensile strength
how do LFTs, pancreatic exocrine function, absorption of fats and carbs change with age?
no change
changes in age:
- LV compliance?
- LV thickness?
- LV diastolic filling?
decreased
increased
decreased
changes in age:
- LV relaxation?
- max HR?
- max CO?
- exercise vasodilation response?
- SVR?
all decreased, SVR increased
- increased ______ leads to LVH, reducing ventricular compliance and diastolic filling
- reduced diastolic filling means more blood in left atrium at onset of atrial systole
afterload
- thickened LV cannot produce normal output if volumes are _____
- avoid high filling pressures and pulmonary vascular congestion of volumes are ____
low
high
older adults have increased sensitivity to effects of _______ of atrial kick
-most common dysrhythmia in elderly?
loss
a. fib
thickened ________ due to calcium deposits, altered collagen, elastin, smooth muscle hypertrophy
-increased _______ pressure (afterload)
arterial intima
systolic
70% of adults >60 with HTN have this, associated with widening of pulse pressure
ISH: isolated systolic hypertension
- increases fall risk
- baroreceptor sensitivity issues
- blood volume reductions
orthostatic hypotension
-reduced chest wall compliance, mucociliary clearance, alveolar surfae area, lung expansion put elderly at increased risk for?
atelectasis, reduced clearance of viruses and bacteria, pneumonia
-vital capacity, FEV1, and PEFR are ______ in elderly
decreased
elderly have inability to maximally conserve _______ in response to water deprived or hyperosmolar conditions
water
ANP levels increase and and further suppress release of?
aldosterone
- muscle mass to body weight reduced
- due to reduced TBW, fat increases and redistributes
sarcopenia
- cerebral blood flow reduced: results in slowed _______ and reaction times normal
- acute mental status change never normal
information processing
age related structural brain changes?
enlarged subarachnoid space
narrower gyri
wider sulci
enlarged ventricles
