Framework for Assessing/Managing Older Adults Flashcards
What are chronic conditions?
Persistent, recurring health consequences
Cannot be cured
Can cause significant limitations with ADLs
Often require social, personal, or rehabilitative care Major cause of illness, disability, death
Currently affect nearly 100 million Americans
By 2040, will affect almost 160 million
Most common chronic conditions all ages
All Ages Sinusitis Arthritis Orthopedic impairments Hypertension Hay fever
Most common chronic conditions age 75+
Arthritis: Women > Men Hypertension Heart disease Men > Women Respiratory disease Diabetes mellitus Cancer Stroke
leading causes of death in older adults
Heart Disease Cancer Stroke Chronic Respiratory Disease Pneumonia Influenza DM
Talk about disability in older adults
Limitations on activities
2010: 27% of those >65 report some type of disability; increasing age increases risk for ADL impairments
Functional disability expected to increase by at least 300% by 2049
Severe disability associated with lower income and education
How do chronic conditions affect emotional health?
51-61 year olds with chronic conditions: more likely to rate emotional health as fair or poor
AA women with chronic conditions give least positive assessment
Fair or poor emotional health: highly reported among those who have hearing impairmentsBalancing positive changes with challenges of aging
What are some hallmark atypical presentations of illness in older adults?
Cognitive change Vague symptomatology--weakness Loss of appetite Recurrent falls Activity change Loss of bladder control
What are some impacts of hospitalization of older adults?
Threat of institutionalization Multiple losses Environmental adjustment Social/family/economic crisis Powerlessness Functional decline Re-hospitalization/ER visits
General physiologic changes with age
Decreased temperature response Bone and muscle loss Altered fat distribution Decreased thirst Pharmacodynamic changes Pharmacokinetic (what the body does to the drug) changes: Absorption Distribution Metabolism Elimination
C/V changes with age
Valvular & LV wall thickness Decreased cardiac output Decreased myocardial contractile efficiency Systolic murmurs, S4 Decreased baroreflex sensitivity No change in overall function
Respiratory changes with age
Thoracic size altered Decreased forced expiratory volume Increased residual volume Rigidity of respiratory structures Alveolar loss No change in overall function
Renal changes with age
30% nephron loss 46% decrease in GFR Decreased urine concentration Assess with estimated creatinine clearance Adequate residual function
GI changes with age
Decreased saliva
Decreased gastric secretion & motility
Decreased mucosal surface in small intestine
Mucosal atrophy in colon
Decreased liver metabolic activity
Decreased pancreatic cells
System changes with age – overall
Mobility Skin integrity Sleep-reduced deep sleep Sensory-perceptual changes Independence in activity Nutrition
How are lab values different with age?
Based on healthy, young samples
Consider confidence intervals
Impact of disease, drugs
Many NOT changed with age
