exam 1 Flashcards
how does a person emotionally age
psychological
asks the question if personalities are stable over time?
Continuity Theory
yes they are stable over time unless major illness
Older people and society mutually withdraw from each other
Individual gradually disconnects from other people
Gradual disconnection in anticipation of death
Disengagement Theory
___ of men over age 85 have enlarged prostates
90%
how we age at the cellular level
biological
contribute to many arthritic chronic illness
musculoskeletal changes in older adults
50% of men over age __ have enlarged prostates
60
cardiovascular system for older adults there is a decrease in number of cells in the _______ system
Decrease in number of cells in conduction system
Very old 80s-90s –loss of autonomy d/t loss of independence, physical changes, loss of self esteem
frailty
Stage 9
when a patient is fainting, one thing you want to consider is _____
cardiac issue
4 posture changes with older adults
Shortening of trunk
Thin vertebral disks
Stiff and thin cartilage
Forward leaning posture
Slower compensatory mechanisms to hypotensive state due to what 3 things
Less sensitive baroreceptor
ORTHOSTASIS
Changes in sympathetic response
3 immune system changes with aging
Fewer T cells
B Cells-slowed response
Difficulty responding to new/novel pathogens
Adults > 50, lose __-__% of muscle mass & strength per year
1-2%
3 reasons for swallowing troubles with older adults
Aging GI tract
Slow peristalsis
Fewer digestive enzymes
Hayflick 3 phases:
Rapid healthy cell division
Mitosis slows
Senescence-cells stopped dividing but stayed alive for a period of time until trauma or apoptosis occurs
7 skin changes with older adults
Decreased elasticity
Slower healing
Fragile
Shear stress
Dryer skin
Vitamin D synthesis
Less sub q fat
when prescribing medications to older adults, what are the 3 main things
loss of lean muscle mass (consider for protein bound medications)
less body water (loss dose for drugs because drug more concentrated)
Relative > fat (redistributed into abdomen) (psych meds, stays in fat longer)
in older adults __% of women and __% of men say they are unable to lift or carry 10 lb
30% of women and 15% of men say they are unable to lift or carry 10 lb
6 Temperature Regulation changes with older aging
Lower normal body temperature Ability to sense temp changes decreases Ability to respond to temp changes decreases Shivering requires normal muscle mass Atrophy of sweat glands decreased circulation
________ gradually increases until about age 60, which is one of the reasons why adults have increasing trouble on amusement park rides as they age”
Vestibular sensitivity
organisms age because cells accumulate free radical damage over time.
Free Radical Theory
response appears unchanged for long periods
Resting performance
4 Normal CNS Aging Changes
Smaller brain
Fewer neurons
Dendrite abnormalities
Slower central processing
looks at aging as a programmed event (specific point in time where you get old)
nonstochastic theories of aging
the normal progressive decline in function and ability to respond to to intrinsic or extrinsic stimuli.
aging
changes in the bladder with aging
decreased bladder size
increased frequency (slow increase)
nocturia (can also be a sign of disease)
stage of personality where:
Feeling guilt about past
Perceives self as not having accomplished life’s goals
Dissatisfaction and despair
Depression and hopelessness
Despair
2 kidneys, 2 lungs
are examples of
Anatomic reserves
4 age related changes in the GI systemm
decrease in smell
decreased taste
decreased thirst
decreased ability to chew
frailty as the occurrence of three or more of the following:
unintentional weight loss (10 lbs in past year)
self-reported exhaustion
weak-ness (reduced grip strength),
slow walking speed,
low physical activity”
2 normal blood vessel changes in aging
Slight increase in B/P (4-5)
Slower compensatory mechanisms to hypotensive state
what is a fever in an older adult
99.0
theory of aging that believes older adults should stay active for as long as possible (physically and mentally)
activity theory of aging
“The age at which reading glasses are needed because of reduced lens elasticity is between ___ &__
42 and 50.
when prescribing psych medications to older adults, you need to consider the loss of
Relative > fat (redistributed into abdomen) (psych meds, stays in fat longer)
3 changes in the lungs with aging
decreased Elasticity
Fewer alveoli & capillaries
decreased Respiratory volumes & capacity
Most common cause of disability in late life
musculoskeletal changes in older adults
Somewhere between ___-__% of men develop symptoms of BPH
40-50%
two normal aging changes
increased risk for age related disease
diseases that accelerate the aging proces
4 Influences of aging
Vulnerability to illness
Severity of illness
Management of illness
Geriatric syndromes
when prescribing protein bound medications to older adults, you need to consider the loss of
lean muscle mass
___% of older adults have difficulty with common tasks-walking 2-3 blocks
40%
loss of smell with aging is due to
moisture producing cells gradually reduce their ____ output or change it’s ____ . And unbathed olfactory bulbs can’t hold the odor long enough to be picked up by the nerve that carries it to the brain.
moisture producing cells gradually reduce their mucus output or change texture . And unbathed olfactory bulbs can’t hold the odor long enough to be picked up by the nerve that carries it to the brain.
This rule states that, of changes often attributed to normal aging by the general public and in past decades by the medical profession
one fourth is due to _______
one fourth to ______
one fourth to ______
one fourth to ________
one fourth is due to disease
one fourth to disuse
one fourth to misuse
one fourth to physiologic aging
muscle loss related to aging
Sarcopenia
with height;
Between __and ____ years of age, men lose about 1 inch and women 2 inches.
After 80, each may lose another _____
30 and 70
inch
4 joint changes with older adults
Thinning of cartilage
Synovial membrane becomes stiffer
Decreased hydration
Slow repair of injury
3 Neurotransmitter aging changes
< acetylcholine
Memory & learning
< dopamine
Age related motor deficits
< serotonin
Sleep problems & depression
deposits of lipofuscin in the skin
Lentigo
aging related changes in the pineal gland cause
Reduced melatonin resulting in sleep disturbances
is aging a homogenous process
NO
organs in the same person age at different rates, by different mechanisms and are influenced by multiple factors
A healthy individual is considered to attain the peakphysiologic reserveat the age of ___, after which thereservestarts to decline as the individual ages.
25
age related changes in the stomach
Slowed emptying
decreased early satiety
Increase in gastritis r/t medications NSAIDs & Bisphosphonates
Theory of aging where every time a cell divides a piece of the telomere (Specialized DNA sequences at end of chromosomes to protect chromosome) is removed
Telomere Theory
what are the three main theories of aging
biologic
psychological
sociological
More RBC carry a little more O2 than is needed by tissues
Bones store a little extra calcium
are examples of:
physiologic reserves
Stress performance due to loss of physiologic reserve can cause what 4 things
Blunted maximal response
Delays in reaching peak levels
Delays to returning to base level
Endpoint is frailty
where do older adults fit into society (useful vs not useful)
sociological
3 bone changes with aging
Changes in bone metabolism
(Slower osteoblast and faster osteoclast activity Slower rate of repair if fracture occurs)
Loss of mineral
Calcium & Vitamin D
decreased weight bearing exercises often reduced in older adults
renal changes with aging:
Ability to adapt to changes in ____ &____load is compromised
Impact medication_______
Decreased Vitamin____
Older kidney is at higher risk _____
Acid base balance normal at rest but difficult to maintain homeostasis during stress
Ability to adapt to changes in salt and water load is compromised
Impact medication clearance
Decreased Vitamin D
Older kidney is at higher risk for nephrotoxicity
aging related changes in the thyroid gland cause what 4 things
Atrophy
Increased fibrosis and nodules formation
T4 production declines, but clearance is slowed
Serum T4 appears normal
Aging is always true for what 3 things
Universal for everyone
Progressive
Decremental
No age r/t change in ejection fraction, cardiac output, or stroke volume at ______
Slower response to ________stressors, ie exercise, illness
Stiff ______
_______ of muscle wall
No age r/t change in ejection fraction, cardiac output, or stroke volume at rest
Slower response to metabolic stressors, ie exercise, illness
Stiff valves
Hypertrophy of muscle wall
stage of personality where:
Learning to be retired—search for meaning
Contemplating accomplishments
Feeling successful
Wisdom
Ego Integrity
aging is the result of a lot of accidents (everyone is different) random and unpredictable
stochastic theories of aging
Impact of decreased cardiac physiologic reserve
Compromised response to stress
Decreased maximal heart rate decreased exercise tolerance SOB Fatigue Slow recovery from tachycardia
The capability of an organ to carry out its activity under stress is known as____________
physiologic reserve
Significant decrease in_______ cells by age 75
pacemaker
biological aging which is a progressive decline and deterioration of functional properties at the cellular, tissue, and organ level that leads to what 2 things
slow homeostasis (homeostenosis?) < ability to adapt to stimuli
Decreased physiologic reserve
Changes may not be identified til a critical mass
decreased elasticity in aging is due to what 4 things
Weaker respiratory muscles
Weak diaphragm
Stiff chest wall
Decrease elastic recoil
4 renal changes with aging
Kidneys get smaller with age
Slower renal blood flow
Impaired permeability
Serum creatinine may overestimate kidney function in older adults
