E3 Flashcards

1
Q

What is the geriatric population make-up for ages 65, 65-74, 75-84, >85

A
65 = 40.4 mill
65-74 = 21.7 mill
75-84 = 13.1 mill
>85 = 5.5 mill
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2
Q

What are the follow 2030 estimates

Age >65 yo %
Age >85 yo %

A

Age >65 yo % = 20%

Age >85 yo % = 14%

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3
Q

What was the 2017 life US expectancy

A

78.6 yo

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4
Q

How does elderly hospital usage differ from younger individuals

A

Use disproportionately more medical care

40% of inpatient surgical procedures

Greater than 2-3 times more surgical procedures

With >3x cost for hospital care in age >85 yo

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5
Q

What are two primary take-aways about aging

A

-Aging is associated w/ progressive loss of functional reserve in all organ systems

The extent of losses vary greatly between individuals

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6
Q

What are factors affecting aging

A
Genetic makeup
lifestyle choices
Environmental exposure
Nutrition
Chance
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7
Q

What kind of process is aging

A

NOT homogenous

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8
Q

What makes up 75% and 25% of longevity

A
75%:
Lifestyle choices
environmental exposure
Nutrition
Chance

25%
Genetic makeup

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9
Q

How does genetic mutation affect aging

A

Can extend life by more resistant to lethal injury from oxidative agents, heat, heavy metal, or radiation

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10
Q

List mechanisms that lead to defects in aging

A
Oxidative damage
DNA damage and repair
Mitochondrial senescence
Malfunction of proteins 
Environmental factors
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11
Q

How does the process of oxidative damage affect aging

A

Free radicals:
by product of O2 use during energy metabolism

Generation of free radicals:

  • Causes damage to chromosomal DNA
  • Impairs gene function
  • damage to telomeres
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12
Q

Define telomere and free radicals

A

Telomere:

  • Short protective ends on DNA
  • Group of nucleotide sequences protects the end of DNA from unraveling and interacting w/ compounds
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13
Q

How does DNA damage and repair contribute to defects of aging

A

Increases w/ somatic mutations are well recognized

Key enzymes:
Poly-adp ribose polymerase 1 (PARP-1)
Telomere length

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14
Q

How do telomere length and PARP-1 correlate w/ aging?

A

Levels and telomere length correlate positively to lifespan

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15
Q

How does mitochondrial senescence contribute to aging defects

A

INC incidence of mutated mitochondrial DNA located in brain tissues, muscle cells and the gut

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16
Q

How does malfunction of proteins contribute to aging defects

A

Accumulation of malfunctioning proteins which are more difficult to clear as we age

Seen in many age related dx such as Parkinsons dx, Alz, and senile cataracts

17
Q

How do environmental factors contribute to aging defects

A

By utilizing metabolic resources for competing physiological demands (growth , maintenance, reproduction)

18
Q

What is disposable soma theory

A

Natural selection has led to pathways that optimize utilization of metabolic resources (energy) among competing physiological demands.

19
Q

What are age associated physiologic changes r/t age

A

Altered physiologic rhythms
Loss of complexity
Homeostenosis

20
Q

What physiologic rhythms may be impaired in aging

A

Can see changes in the ability to respond to alterations

  • Reset body temp
  • Plasma cortisol
  • Sleep = desynchronization
21
Q

How does physiologic loss of complexity affect aging

A

Decreases variability for HR, BP, response to auditory frequency, response to stress

22
Q

What is homeostenosis

A

Diminished physiologic reserve available to meet the challenges to homeostasis

-diminished ability to compensate w/ change

23
Q

What is frailty syndrome

A

Refers to multi-system loss of physiologic reserves

-makes a person more vulnerable to disability during and after stress

24
Q

What are characteristics and drivers of frailty syndrome

A

Characteristics:

  • Weight loss, fatigue, weakness
  • DEC mobility
  • Poor exercise tolerance
  • unstable balance
  • malnutrition
  • muscle wasting

Drivers:
Chronic inflammation
-endocrine dysregulation

25
Q

What are big predictors of poor outcomes r/t frailty syndrome

A
  • Additional hospitalization
  • Anesthesia
  • Disability
  • Death??? (ummm)
26
Q

Describe how brain structure changes with age

A
  • DEC volume of brain
  • DEC neural plasticity
  • Loss of enzymes, receptors and NTS
27
Q

Describe the progression of volume loss in the brain

A
  • DEC by ~7cm3 per year after 65
  • Greatest loss
  • –frontal and temporal lobe
  • –d/t cell loss and shrinkage of cell vol
28
Q

Describe how neural plasticity is altered with age

A
  • Plasticity DECREASED
  • Connectivity may be INCREASED
  • Neurons may continue to form new connections
  • neuron death > regeneration
  • INC neuronal connectivity may compensate for neuronal loss
29
Q

How do enzymes, receptors, and NTs alter with age

A

LOSS of enzyme, receptors, NTs

  • DEC ACh d/t DEC muscarinic and cholinergic neurons
  • DEC dopamine which impairs motor control and INC susceptibility for EPS SE (tremors)
30
Q

Describe cognitive and behavioral losses and retention that occur with aging

A

Retention:

  • Cognitive testing, procedural primary and semantic memory
  • Skills and abilities we lean, practice and are familiar with
  • judging distance

Losses:

  • Problem solving
  • Reasoning of unfamiliar things
  • multitasking
  • Attention span