Geriatrics & Aging Flashcards
Prevalence of dementia with age?
~50% by the age of 85
What percent of dementia does alzheimer’s account for?
70%
What is alzheimer’s?
- Adult-onset of slowly progressive dementia
○ Associated with diffuse cerebral atrophy on neuroimaging
○ Most common cause of dementia in N. America/Europe
Familial component of alzheimer’s?
- 25%
- Nearly all patients with early onset
Risk of late onset alzheimer’s?
● First degree relatives have a lifetime risk of 15-30%
● Having >2 affected family members probably raises risk
Alzheimer’s treatment?
■ Medications to slow progression, no cure
■ Healthy lifestyle
■ NSAIDs and Omega 3 FA
Height / weight changes with aging?
■ Malnutrition ■ Osteoporosis ■ Doubling body fat from age 20 to 80 because of decline in lean muscle mass ■ Weight tends to decline with age ■ Height decline of 5cm over lifetime
BP changes with aging?
■ Rises from childhood to old age (SBP increases linearly with age, DBP increases until age 60)
■ Large arteries stiffen
■ Less distensible aorta = higher syst, wide pulse pres.
■ HTN affect 15% of whites and 25% of blacks > 65 years.
■ Elderly at risk for orthostatic hypotension
HR change with aging?
■ Pacemaker cells decline in SA node, leading to decreased max HR and response to stress
■ More likely to have abnormal rhythms, which could lead to syncope
● Afib is common
Changes in resp rate / temp in aging?
■ Resp. rate is unchanged
■ Temperature regulation declines, leaving elderly susceptible to hypothermia
Vision change with aging?
■ Entropion and ectropion
● Due to periorbital fat loss and tissue atrophy
● Eyes appear to recede
■ Rigidity of iris and decreased pupil size predisposes to glaucoma, cataracts and macular degeneration
■ Loss of lens elasticity and ciliary muscle atrophy
■ Lens accumulates yellow substances and yellow filtering (changes blue to greenish blue)
■ Fewer lacrimal secretions leads to dry eyes
■ Visual acuity generally remains adequate, but near vision declines drastically and presbyopia is common by
fifth decade
Hearing changes with aging?
■ Early hearing losses of high-pitched sounds
■ Presbycusis usually starts around 50
● Sensorineural loss affects about 40% over 75yo
What is Presbycusis?
Loss of hearing that gradually occurs in most individuals as they grow older
Changes in CV with aging?
■ Neck vessels become torturous: masses / bruits
■ Loss of LV compliance and diastolic dysfunction
■ Decreased early diastolic filling
■ Increased atrial contribution to filling
■ Increased left atrial size–fourth heart sound is “normal”
■ Systolic murmur in 50% due to aortic sclerosis
■ Increased PR interval; decreased adrenergic receptor responsiveness (like a younger person on a ß-blocker
Changes to skin in aging?
■ Dermis thins 20%; 50% decline in epidermal turnover
■ 10-20% per decade loss in melanocytes from age 30 (aging spots–irregularly pigmented melanocyte loss)
■ Slowed wound healing; dryness; loss of stretch
