Geriatrics Flashcards
What is aging?
the process that converts healthy adults into frail older persons with diminished reserves in most physiologic systems and increased vulnerability to most diseases
What are the four major features of aging?
it is:
- destructive
- progressive
- partly determined by genetic code
- and universal
What is usual aging?
- a more step-wise form of aging that involves a gradual, consistent decline towards death
- chronically ill or multimorbid as diseases add up until death
What is successful aging?
aging in which there is preserved function and compression of morbidity (long relatively slow decline that ends in a sharp drop off to death)
At what point in our lives are we all most alike? Least alike and most heterogenous?
at birth we are biologically very similar and our heterogeneity increases with age
What part of a history should follow the review of systems if you are dealing with a geriatric patient? Why?
a review of function because these patients have increasing frailty and vulnerability and an therefore an increased risk of impaired function
What is homeostenosis?
a term used to describe a reduced physiologic reserver and a resulting diminished ability to maintain homeostasis during periods of stress
What five vision changes are common during the aging process?
- decreased dynamic visual acuity
- decreased detection of lateral motion
- decreased depth perception
- decreased contrast sensitivity
- increased glare sensitivity
How do vision changes impact the daily lives and medical care of geriatric patients?
- reduces quality of life
- eliminates the possibility of night driving
- increases risk of falls
- causes medication issues (finding pills, reading labels, etc.)
What is presbycusis? Describe it’s onset.
- the loss of high frequency hearing that occurs with normal aging
- it is slowly progressive, bilateral, and symmetrical
What is presbystasis?
- the “dysequilibrium of aging”
- characterized by vestibular degeneration
- it is a diagnosis of exclusion
What two auditory changes are common during the aging process?
- presbycusis (loss high frequency hearing)
- presbystasis (dysequilibrium of aging)
How do the changes in hearing that accompany aging affect geriatric quality of life?
it contributes to social isolation, loss of self-esteem, depression, anger, and family discord
How do taste and smell change with aging?
the threshold for tasting salty and sweet rise
How does the increased threshold for tasting salty and sweet impact the health of geriatric patients?
- take less pleasure in eating and therefore eat less, contributing to weight loss
- add more salt to their diet, potentially contributing to heart failure or hypertension
Name 6 geriatric changes that contribute to physiologic anorexia of aging?
- reduced physical activity
- diminished metabolism
- reduced stretch of the gastric fundus, resulting in early astral filling
- slowed gastric emptying
- increased circulating CCK
- decrease in dynorphins, which regulate eating drive
How does the esophagus change with aging?
- poor swallowing coordination
- presbyesophagus (low amplitude contractions)
What contributes to reduced swallowing coordination in geriatric populations?
- reduced facial strength
- reduced lingual pressure reserve
- pharyngeal swallow delay
What is presbyesophagus?
an age-related decreased in contractile amplitude within the esophagus
At what age might effective esophageal contractions be absent?
after age 80
Why are esophageal changes an important consideration in geriatric populations?
because they increase the risk of micro aspiration and can contribute to physiologic anorexia of aging
List four gastric changes that are seen over the course of normal aging?
- decreased HCl
- delayed gastric emptying
- reduced intrinsic factor production
- disruption of the gastric mucosal barrier
Why are geriatric patients more at risk for a B12 deficiency?
because they produce less intrinsic factor
What gastric conditions are geriatric patients more likely to have because of changes in their mucosal barrier?
- atrophic gastritis
- peptic ulcer disease