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Human Disease > Elderly > Flashcards

Elderly Flashcards

1
Q

What % of pop is pensionable?

A

18%

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2
Q

What is fastest growing age segment?

A

Over 80s

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3
Q

How often do over 80s attend hospital?

A

once per week

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4
Q

By 2036, what % change in 60-75yr olds?

A

50% increase

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5
Q

By 2036, what % change in 75+yr olds?

A

75% increase

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6
Q

By 2036, what % change in 15-44yr olds?

A

8% decrease

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7
Q

How many years can a 60yr old male / female expect to live?

A 
Male = 19 more years
Female = 23 more years
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8
Q

What are the 4 personality types of the elderly?

A
  1. Integrated - active, satisfied, flexible, functioning, ok with aging
  2. Armoured - fights aging, preoccupied with loss, eg celebrities
  3. Passive - dependent, low life satisfaction, ‘I’m old, so others will have to do things for me’.

4, Angry - low activity, low life satisfaction, bitter, Mr Meldrew!

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9
Q

What physiological changes happen to skin when aging? (x4)

A
  • Wrinkles
  • Dry
  • Cambell de Morgan spots (red elevated areas)
  • Seborrhoeic Keratosis (thickening of skin, esp on face)

All of above are normal

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10
Q

What changes occur in the mouth with aging? (x6)

A
  • reduced saliva production
  • decrease in taste buds
  • reduced sense of smell
  • impaired muscles of mastication
  • tongue enlargement
  • tooth loss
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11
Q

What changes occur to the body with aging? (x20)

A
  • decline in hepatic drug metabolism (liver)
  • decline in GFR (glomerular filtration rate) by 50% (kidneys)
  • prostate enlargement
  • decreased bladder capacity
  • bone loss
  • thickening of heart valves
  • dilatation / dilation of large elastic arteries
  • increased systolic BP
  • reduced CO
  • reduced cardiovascular response to stress
  • fall in FVC and FEV1 (forced vital capacity / forced expiratory volume in 1 sec)
  • reduced brain weight
  • presbyacusis (hearing loss)
  • hardening of lens (impaired near vision)
  • flatter cornea (astigmatism)
  • reduced lean body mass
  • increase in fat mass
  • reduced ability to control body temp
  • reduced oestrogen levels
  • poor immune system
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12
Q

What happens to IQ with aging?

A

Cross sectional studies - IQ declines
Longitudinal studies - IQ preserved

Verbal abilities are preserved, but speed of response reduces

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13
Q

What are the non specific features of disease presentation in the elderly?

A

The 4 Is:

  • Intellectual failure
  • Incontinence (due to pressure, tumours, brain issues)
  • Immobility
  • Instability

May not be due to age! Look for other diseases

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14
Q

Name atypical presentations of disease in the elderly

A

ie diseases present differently in the old.

MI - without chest pain (still gets dyspnoea (hard to breath), confusion, hypotension)

Infection without increase in white blood cells / temp.

Silent perforation (eg stomach ulcers perforate, but no pain - painful in young ppl)

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15
Q

What symptoms are often mistaken for old age? (mistaken = erroneous)

A 
Hypothyroidism - reduced energy
Anaemia - reduced energy
Bowel issues - could be cancer
Urinary problems
Shortness of breath
Forgetfulness
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16
Q

What single illnesses / event can lead to catastrophic consequences in the elderly? x9

A 
Pneumonia
Delirium / confusion
Postural instability
Fall
Fracture neck of femur (50% die within 2 yrs!)
Immobility
DVT / PE
17
Q

What are the physical signs of age?

A

Small irregular pupils
Reduced vibration sensation
Displaced apex - kyphoscoliosis (outward and lateral curvature of the spine)
Absent ankle reflexes

18
Q

What % of hospital admissions are caused by adverse drug reactions?

A

5-15%

19
Q

What % have adverse drug reactions in hospital?

A

6-17%

Risk of adverse drug reactions increases with age and no. of drugs prescribed

20
Q

How does drug metabolism change in elderly?

A

reduced renal drug clearance
changes to hepatic drug metabolism
changes in volume of distribution

21
Q

What type of dosage should you use on elderly?

A

child dose

22
Q

How is the volume of distribution affected in drug pharmacology? Give drug examples

A

Increase in fat, decrease in lean muscle

  • lipid soluble drugs have an increased vol of distribution (can cross cell mem) and a prolonged effect eg diazepam
  • water soluble drugs have a reduced vol of distribution and a more rapid peak eg digoxin
23
Q

What % of drug - drug interactions result in an adverse effect?

A

10%

NB use BNF - predictable and preventable

24
Q

What % don’t comply with their prescriptions?

A

40-75%

esp if 3+ drug types (25% of elderly)

25
Q

What % of elderly are on 3+ drugs?

A

25%

26
Q

How many drugs is a typical elderly pt on in hospital?

A

8 drugs

27
Q

What % of elderly take prescription drugs meant for others?

A

10%

esp in nursing home / partners tablets

28
Q

What % take drugs not prescribed by physician?

A

20%

29
Q

Why are elderly at increase risk of drug reaction?

A

bodies reduce in size

capacity to metabolise drugs in liver / excrete drugs in kidney

Human Disease (10 decks)

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