Exam 1 Flashcards
Geriatrics
branch of medicine that deals with comprehensive medical/health care of older persons
Gerontology
the study of aging
Sarcopenia
loss of muscle mass and strength with aging
Self-efficacy
self-confident in one’s ability to perform tasks
Growth and Development
occurs in our infant years
Maturation
teenage and young adult years (puberty, hormonal imbalances)
Senescence
natural deterioration (process of growing old)
Primary aging
gradual and inevitable process of bodily deterioration that takes place through life (wrinkles, slowing down, sarcopenia)
Secondary aging (environmental)
pathological aging
- Does not happen to everybody
- The result of trauma or disease
Chronological Age
length of time a person have lived (true age in years)
Function Age
person’s perceived age based on physical and mental function
Biological age
physiological age (based on biomarkers)
Psychological age
person’s capabilities in terms of mental and cognitvie function (memory)
Social age
what society expects from you
Relative age
extent to which an individual is aging faster or slowee than an average person of the same chronological age (comparison)
Baby boomers
are population base of 65+
Ageism
term used to describe the negative perception of older adults within today’s society
10 leading causes of death
- Heart disease
- Cancer
- Covid-19
- Accidents (unintentional injuries)
- Stroke (cerebrovascular diseases)
- Chronic lower respiratory
- Alzheimer’s disease
- Diabetes
- Influenza and pneumonia
- Nephritis, nephrotic syndrome, and nephrosis (kidney disease)
BADL’s
Basic: elemental items of self-care (bathing and eating)
IADL’s
intermediate: tasks essential to maintaining independence (cooking meals, grocery store) → basic chores around the house
AADL’s
Advance: well beyond status for living alone (beyond the other two: working out)
physically dependent
cannot perform some or all of the BADL’s; rely to others → to live, needs a aid
physically frail
can perform all BADL, can perform some but not all IADL’s
physically independent
lives independent, low health and fitness (maybe chronic illness)
physically fit
exercises 2x per week
physically elite
train on a daily basis, competes in tournaments, works physically demanding jobs
Communication tips for older adults
- Don’t use patronizing speech when addressing older adults
- Speak more slowly and use very simple grammar → do not yell
- Do not talk down to older patients
- Make eye contact
- use visual communication to help
- Use “I” language not “you”
- No filler words
How to create a safe environment for older adults
- Reassure patient → lowers risk of embarrassment or ridicule
- Encourage them and remind them of gains → prevents risk of facing diminished physical activities
- Remind and encourage client that they only need to worry about themselves
Biomarkers by Evans and Rosenberg
- Muscle mass
- Strength
- BMR
- Percent body fats
- Aerobic capacity
- Blood sugar tolerance
- Cholesterol
- Blood pressure
- Bone density
- Body temperature
Post menopausal women are more vulnerable
to heart disease and osteroporosis
Skin/Hair
Skin: gets thinner, lose fats, wrinkles → begins early 20s
Hair: turns gray, silver, white
→ younger can get gray due to stress
→ with age, color producing cells cease functioning (makes it white/gray)
Thermoregulation
- Hypothermia: reduction in core temp, danger that the body temp will get too low
- Hyperthermia: abnormally high body temperature due to hot conditions environment
vision
- Presbyopia: farsightedness
- Dry Eyes: dryness can cause redness
- Cataracts: increasingly blurred or misty vision as the eye lens becomes milky
All happens after the age of 40
hearing
Older men more
Likely to have hearing problems than women
Presbycusis- most common type of sensorineural hearing loss
bones/muscles
Bone thinning or loss of bone mineral density begins around age 35 when the body begins to reabsorb bone cells faster than it makes new bones
Psychologically Benefits of physical activity
- Enhances relaxation and mood states
- Reduced stress and anxiety
- Improve mental health
- Cognitive improvements
- Motor control, performance, and skill acquisition
Social Benefits of physical activity
- Empowers older individuals
- Enhances social and cultural integration
- Role maintenance and new role acquisition
- Intergenerational programs
Physiological Benefits of physical activity
- Regulates glucose levels
- Stimulates catecholamine activity
- Improve sleep, cardiovascular endurance, muscle strengthening, flexibility, balance and coordination, velocity of movement
Metabolic Syndrome
⅓ adults in America have metabolic syndrome
Risk facts include:
- Excess body fat: around the waist and abdomen
- High blood pressure
- High cholesterol levels
- High fasting glucose levels
Macarthur
Genes account for ⅓ of the problems associated with aging
⅔ is accounted based on lifestyle choices
Framingham
Performed in 1948 - The study found high blood pressure and high blood cholesterol to be major risk factors for cardiovascular disease.
Dr. Maria- “fit for life”
First study that showed that you can exercise at any age
Ball State
Study compared heart health and muscular fitness
Lifestyle Choices
- Exercise
- Healthy diet
-Get enough and the right vitamins - Drink enough water
- No smoking
- Avoid excessive sun exposure
- Reduce stress
-Challenge the mind - Alcohol in moderation
- Satisfying relationships
- Quality sleep
Power 9
- Move naturally
- Purpose
- Downshift
- 80% rule
- Plant slant
- Wine at 5
- Belong
- Loved ones first
- Right tribe
Preventive behavior
do stuff to prevent disease (exercsie and dieting)
Illness behavior
actions b/c you think your ill (go to doctors, take medicine)
Sick-role behavior
actually sick (treatment for sickness)
Predisposing factors
Intrapersonal variable that provides the rationale or motivation for a person to act
Reinforcing factors
Rewards and feedback received by the learner following adaptation of a behavior
pos/neg reinformance
Enabling factors
Skills, resources, or barriers that can help or hinder the desired behavioral or environmental changes
Can be harmful changes in your life (pos/neg)
Health Enhancing
Conveys health benefits or otherwise protect individuals from disease
Ex. exercise, fruit and veggie consumption, condom use for STD
Health Impairing
Have harmful effects on health or otherwise predispose individuals to disease
Ex. smoking, excessive alcohol consumption, and high dietary fat consumption
Transtheoretical model
- Precontemplation - not ready for change
- Contemplation - not engaging in behavior but considering
- Preparation - initiated a change and began process
- Action - consistently engaging in behabior
- Maintenance - successful, sustained lifestyle changes
Maintenance support
- Prevents relapse
- Social support (accountability, motivation, pushing one another)
- Utilize rewards
5 modes of fitness
- Cardiovascular endurance → jogging/wlaking
- Flexibility → stretching
- Static
- Ballistic
- Dynamic
- PNF (proprioceptive neuromuscular facilitation) - Strength training → arm curl (amount of rest: 48 hours in between)
- Dexterity → fine motor skills (threading a needle)
- Balance and gait → 6 min walk test
Types of contractions
Isometric: contracting, no shortening or lengthening → wall sits
Isotonic:
- Concentric: contracting
- Eccentric: elongates
1 Cause of injury in those 65+
Falls
Purpose of Pre-screen/assessment
- Establish a baseline
- Judge progress
- Early detection of physical weakness
- Identify contraindications to exercise
- Design and evaluate individual programs
- Enhance motivation
Medical Assessment
- Present disease or conditions
- History of previous health problems
- Medications
- Family medical history
Lifestyle Assessment
- ADL’s
- Working or retired
- Home life
- Recreational activities
- current/previous fitness levels
Gold standard of body composition
Overrated: BMI
good: DEXA
Rate of Percieved Exertion (RPE)
This is an exertion scale that was developed to determine an individual’s intensity during exercise
10 = max effort activity
9 = very hard activity
7-8 = vigorous activity
4-6 = moderate activity
2-3 = light activity
1= very light activity
Fullerton
Test both static and dynamic balance under varying sensory conditions
Berg
designed to assess static balance and fall risk in adults populations
- More commonly used to evaluate lower function in older adults
Senior Fitness Test
A simple, easy use battery of test items that asses the functional fitness or older adults
Assesses the key physical abilities needed to perform common daily activities
Dynamic Gait Index
To assess the likelihood of falling in older adults
Medication Side Effects
-Headache
-Drowsiness
-Loss of coordination
-Fatigue
-Impaired vision and hearing
-Nausea
-Irregular heartbeat
-Orthostatic hypotension
Pharmacokinetics
physiological changes that affect pharmacokinetics of medications
1. Decrease in lean body mass as body fat increases
2. Reduction in total body water
3. Decreased efficiency of the gastrointestinal tract
4. Decreased cardiac output
5. Decreased efficiency of the liver and kidney
Analgesics
Relieves joint pain
Beta Blockers
Treats angina pectoris, hypertension, cardiovascular disease, cardiac arrhythmias
Q: how beta blocks affect exercise?
Will lower hr of a person so use RPE (talk test) to see intensity of it
Diuretics
Treats hypertension and CHF
Antidepressants
Treats depression
Hypnotics and tranquilizers
Treats anxiety, alcohol withdrawal, and seizures (can also relieve muscle spasms
Polypharmacy
higher risk of side effects and adverse drug reactions
Physiological changes affecting nutrition- sensory
Olfaction (smell):
- Hyposmia: diminished smell
- Anosmia: complete loss of smell
- Dysomia: distortion of smell
Gustation (taste):
- Hypogeusia: diminished taste
- Ageusia: absent taste
Physiological changes affecting nutrition- Structural
GI System:
- Loss of appetite
- Increase amt of satiety
Renal System:
- Increase risk of dehydration
- Irregular fluid balance
Muscular system:
- Decreased bone density
- Loss in muscle tone
-Changes in joint
Physiological changes affecting nutrition- dental
- Impaired ability to chew/swallow
- Decay teeth
- Poor fitting dentures
- Poor oral hygiene
- Oral cavity pain
- Inflammation
My Plate for Older Adults
50% fruits and veggies
25% grain (emphasis on whole grains)
25% protein-rich food → nuts, beans, fish, lean meats, poultry, and low-fat or fat-free dairy products
Fluid Intake
sense of thirst is lost so elders do not drink as much as they should
Supplements
Calcium, Vitamin D, B12
Protein/Antioxidant
what is an antioxidant?
natural substance found in food that may help protext against some disease
Staurdated Fats
Fats that are solid at room temperature and in foods like:
Solid fats (butter, coconut oil, pal oil)
Animal products
Combination meals, processed foods
Unsaturated Fats
Fats that are liquid in room temp and in food like:
Cooking oils
Avocados
Nuts and seeds
Fatty fish
FITT Principle
Frequency → how often will you exercise?
Intensity → the amount of effort or work that must be completed in a specific exercise
Time → how long each session is (duration)
Type → what type of exercise are you doing? (mode - cardiovascular, flexibility, etc)
Individuality
since we are all unique, we have different response to exercise programs. Each program should be based on individual difference
Overload
the body will adapt to the workload placed on it. A greater than normal stress or load on the bod is required for adaption
Specificity
how you exercise should be specific to your goals. To become better at a particular exercise or skill, you must perform that exercise or skill
Progression
there is an optional amount to be achieved in a certain time frame. A gradual increase will result in improvements
Ace Recommendations for Seniors
Warm up → 10-15 mins
Cool down → 15 mins
Chair exercise → avoid training seniors in chairs without good reason
Problems specific to working with older adults
- drugs/medicine
- Posture
- Joint stiffness
- Falls
- Longer recovery time
- Underlying weakness and old injury
- Poor nutirion
- Socialization → is vital to many older adults for exercise to start and continue
Minutes you should be working out
150 mins of moderate intensity per week
70 mins of vigorous exercise per week
Safety for seniors
- Over 40 should have a medical exam
-Need specific medical guidelines for exercise if have certain medical conditions
-Have proper warm up and cooldown
-Dress, food, drink, and temp considerations
-All instructors, trainers, PT’s, etx. Must be trained for emergencies
-Monitor patient during exercise
Common mental health issues in older adults
- Depression
- Anxiety
-Bipolar
- Schizophrenia
Factors that affect mental health:
1.Biological factors
2. Life experience (trauma/abuse)
3. Social isolation/lonliness/neglect
4. Experiencing discrimination or stigma
5. Social disadvantage, poverty, or debt
6. Bereavement (loss of a loved one)
7. Severe or long-term stress
8. Drug or alcohol misuse
9. Unemployment or losing a job
common signs and symptoms of mental illness
- Unusual avoidances
- Difficulty making basic decisions
- Unexplained stomach distress
- agitation/irritability or moodiness
- Change in appetite or sleeping patterns
- Hallucinations or delusions
- Sudden changes in behavior and attitude
why is working out important for mental health?
- Reduce risk of cognitive decline
- Endorphins released which trigger positive feelings
- Strong social support is important
- Research shown that exercise is an effective but often underused treatment for mild to moderate depression
