geriatrics 1 Flashcards
geriatrics age range
65+
erikson’s stages (geriatrics)
integrity vs despair
people aged ____ comprised ____ of the US population in ____
65+, 20%, 2020
life expectancy continues to ____ with women having ____ life expectancies than men
rise, higher
for every ___ women aged 65-74 there are ___ men aged 65-74
100 women to 84 men
____% of people aged ___ live in longterm care facilities
15%, 85+
many more community dwelling older ____ live ___ than older___
older women, live alone, older men
Dips in life expectancy in the US
- civil war
- WW1
- Covid
Hayflick limit theory
- cells have limited lifespan
- biological clock in each cell controls the aging process
- at some point, cells lose function which creates aging
Neuroendocrine and Hormonal theory
- hypothalamus controls release of many hormones that regulate body functions via chain reactions
- aging decreases the production of hormones, which decreases ability to repair and regulate body functions
caloric restriction theory
- caloric restriction extends lifespan and slows aging process
- caloric restriction reduces metabolic rate and oxidative stress, improves insulin sensitivity, alters endocrine and neuro function
- unknown mechanisms
- older adults are less likely to restrict calories
Programmed aging theories
- Hayflick limit theory
- Neuroendocrine and hormonal theory
- caloric restriction theory
stochastic aging theories
- free radical theory
- error/catastrophe theory
- somatic mutation theory
- cross linking theory
Free radical theory
- free radicals damage cells via oxidation, eventually killing the cells
- free radicals attach to cells and interfere with normal processes
- free radicals damage begins at birth and continues until death
somatic mutation theory
- genetic damage or mutation results from radiation, accumulates with age
- radiation shortens lifespan and damages DNA, causing aging
Cross linking theory
- aging results from cross-linking of proteins
- cross-links interfere with/slow down normal processes, eventually killing organisms
deconditioning
- for many adults, a substantial portion of “usual” age related decline in functional ability
- most adults do not engage in sufficient physical activity to derive health benefits
- reversible with lifestyle modifications
Successful aging includes
- low risk of disease and deconditioning
- high cognitive and physical function
- active engagement with life
optimal aging according to Brummel-Smith
“the capacity to function across many domains- physical, functional, cognitive, emotional, social, and spiritual - to one’s satisfaction and in spite of one’s medical conditions”
Primary aging
- inevitable
- affects all systems
secondary aging
- lifestyle
- environment
- disease
factors that contribute to healthy aging
- physical activity
- lifestyle
- sense of purpose
- stress management
- social network
- family support
- quality sleep
typical aging
gradual decline in functioning of body systems
- musculoskeletal, cardiopulmonary, integumentary, cognitive, visual, auditory, vestibular, and genitourinary
atypical aging
- may look like typical aging but is due to underlying disease processes
- specifically refers to declines in cognition
- ex: demential/Alzheimer’s and Mild Cognitive Impairment (MCI)
Cardiopulmonary system aging
- heart disease is the #1 leading COD in geriatric adults
- decrease in cardiac output
- decreased blood vessel elasticity
- heart cells thicken and become more fibrotic (leads to dec ability to pump blood)
- decrease in pace maker cells (leads to slower hr)
- decreased chest compliance
- decreased lung capacity
Musculoskeletal system aging
- 5-10% muscle loss between 20-50yrs
- 12-15% muscle loss per decade after age 50
- peak bone density at age 30
- more bone resorption than deposition leads to osteoporosis, osteopenia, and risk of fx
- loss in weight, change in body composition
VO2 max ______ by ___% per decade after age __
declines by 20%, age 20yrs
Neuro Red flags
- Loss of consciousness (LOC)
- confusion
- seizures
- sudden bowel/bladder incontinence
- sudden gait abnormalities
neuromuscular system aging
- decrease in brain weight and volume
- decrease in vascular supply and metabolism
- decrease in nerve conduction and velocity
- risk for neurological diseases increases with age (ex: stroke, dementia, epilepsy, ALS, and Parkinson’s)
gastrointestinal system aging
- Oral: decrease in saliva production and increased risk of swallowing difficulty
- gut: altered digestive hormones, decreased stomach motility, decreased peristalsis
- overall: earlier satiety, impaired olfaction (affects eating)
Visual system aging
- presbyopia
- decreased visual acuity (more light needed and larger test)
- hardening and yellowing of lenses (difficulty distinguishing colors)
Disease in aging of visual system
- cataracts: clouding of lens due to protein build up
- glaucoma: loss of peripheral vision
- macular degeneration: loss of clarity at center of visual field
- retinopathy: damaged blood vessels in the eyes
cataracts occur in ____ of adults age ___
70%, 70+
integumentary system aging
- 15% of body weight
- decreased dermis and epidermis thickness
- fewer blood vessels, oil, and sweat glands (less thermoregulation and hydration)
- decreased cellular turnover (inc healing time and dec barrier function)
- fewer mast cells (inc risk of infection)
- less collagen and elastin (thinner skin and wrinkles)
skin checks
- skin tears
- pressure injuries
- can develop in less than 2 hours (seated every 30 mins for 2 mins)
typical aging: cognition
- slower cognitive speed
- dec word finding ability (verbal retrieval)
- dec selective or divided attention
- difficulty with learning new things
- dec executive cognitive function (decision making, problem solving, planning, sequencing, and multi tasking)
- long term memory and procedural memory are stable
- retention of newly learned material is stable but may take more cueing to recall
- visual recognition of objects remains stable
atypical aging: cognition
- mood changes
- visuospatial changes (lost while driving, bumping into things, dec peripheral vision)
- memory changes (inability to rec people, dec longterm mem)
- communication difficulties
- MCI
Mild Cognitive Impairment (MCI)
atypical cognitive aging
- reduces capabilities of a person compared to their receptive age and education level, but does not interfere with ADLs (can affect IADLs)
- gradual cognitive decline over 6+ months
- inc rln with education
- inc risk of Alzheimer’s