Geriatrics And Physiology Of Aging And Adolescent Health Flashcards
What is homeostenosis?
Old age is associated with diseases, but it is not the cause of diseases.
•There is heterogeneity among the older people as they do not age physiologically at same rate.
•Health problems in one body system tend to have negative effect on the other body systems true or false
The word geriatrics was invented by who and when? Geras means what? Iatrico means what? Which two people were familiar w the common disabilities of later life? Which people commented on age associated illnesses?what did Hippocrates say about aging? What did Aristotle say about aging?
•With advancing age (from age of 30 years) there is constriction of homeostasis (HOMEOSTENOSIS).
Homeostenosis starts the aging process.
HISTORY
•The word “geriatrics” was invented by Ignatz Leo Nascher (1863-1944)
•geras (old age), iatrico (related to the physicians).
•Ancient Egyptians & the author of Ecclesiastes (Chap. 12) were familiar with the common disabilities of later life.
•Doctors and philosophers of antiquity especially in classical Greece commented on age associated illnesses.
•Hippocrates noted conditions common in later life.
•Aristotle offered a theory of aging based on loss of heat.
What is chronology
What is biological ageing?
The British Geriatric Society [BGS] compendium defined geriatrics as what?
Who is an elderly person ?(according to WHO and the UN general assembly)
Chronological Vs Biological Ageing???
•Chronology- number of years spent
•Biological- physiological changes over the period
•The British Geriatric Society [BGS] compendium defined geriatrics as “that branch of medicine which deals with the prevention, diagnosis and treatment of diseases specific to old age”.(take note of the order in the definition of geriatrics. Don’t switch anything)
- The United Nations General Assembly defined an older person as an individual aged 60 years and above.
- World Health Organization defined the elderly as those who have attained age 65 years and above.(use WHOs definition)
What’s the cut off age for developed countries? What about less developed areas? Why do most developing countries use 6p years as the cut off point? State the cut off point for Ghana,for Nigeria,for Europe,Asia,Africa
Developed Countries: ≥ 65 years •Less developed areas esp SSA: ≥ 60 years •Most developing countries use 60 years as the cut-off point because of low life expectancy. •Africa: 51.4 years •Ghana 64.7years •Nigeria: 54.7 years •Asia: 66.3 years •Latin America: 69.2 years •North America: 76.9 years •Europe: 73.3 years
Why is there so much interest in the elderly?
- The elderly group is the fastest growing age group worldwide
- In the year 2005, 13% of world’s population were elderly. This will increase to 20% by 2030.
- Of the elderly population, approximately 8% experience severe cog- nitive impairment, 20% have chronic disabilities and vision problems, and 33% have restrictions in mobility and hearing loss
- 3.14% of Ghanaians were 65 years and older in 2020
- Nigeria is projected to be the only African country that will have an elderly population of more than 15million by the year 2025
- People are living longer.
What is the functional level in early life,what about in adult life , what should you do to help w their functional level in older ages ? What type of aging is the first red line,which is the second,which is the yellow line?
Early life: functionally capacity is now growing and developing
Adult life:maintains the highest possible level of function
Older age: you have to help them maintain Independence or maintain the functional level that was high in adult level and prevent disability
The first red line is successful aging
Second is normal aging
Yellow line is frailty
You aim for successful aging by pushing the yellow line above to the red line levels
Name some morbidities of the elderly
Normal aging includes what changes?
Successful aging is defined as ?
State the types of aging and explain em
HPT,Diabetes,Alzheimer’s,Arthritis,dementia,osteoporosis
-“Normal” aging includes changes caused by the aging process as well as the effects of diseases or unhealthy lifestyle and environmental factors.
•-“Successful” aging is defined as changes due solely to the aging process, generally unaffected by disease, lifestyle, or environmental factors.
Successful ageing
•Process of growing older while retaining satisfactory health, function,and independence.
Normative ageing
•Multiple chronic diseases appear, and function compromised to some degree.
Frailty
•Severe decline in cognitive & physical function, losing independence in ADL, often becoming wheelchair bound or bedridden, requiring assistance and care .
What are the health characteristics of the elderly
HEALTH CHARACTERISTICS OF THE ELDERLY
•The Elderly often present with
•Multiple morbidities
•Atypical presentation of diseases: example there’s a form of HPT associated with elderly people
•Multiple pathologies causing a particular disease
•Prolonged hospital stay
•More complications arising from diseases
•Poor recovery form diseases
•Deranged social factors
What are the six geriatric giants that should be frequently explored in the elderly
INSTABILITY - Falls, Gait problems, CNS problems, decreased blood flow to the brain due to stroke or a chronic condition such as aging.
traumatic brain injury.multiple sclerosis.hydrocephalus.seizures.Parkinson’s disease.cerebellar diseases.acoustic neuromas and other brain tumors.
•IMMOBILITY- Arthritis, Immobile elderly people often suffer from a number of diseases which worsen their mobility. Pain from Arthritis, osteoporosis, hip fracture, stroke and Parkinson’s disease are among the most common causes of immobility in old age This can increase the risk of falls and the development of pressure ulcers.,
•IATROGENIA - Polypharmacy/ ADRs(The elderly are particularly at increased risk of adverse drug reactions (ADR)
•INTELLECTUAL IMPAIRMENT- Cognitive impairment
•INCONTINENCE - Urinary, Faecal & Dual incontinence
•INFECTION - UTIs, Pneumonia & Septicaemia
What is the difference between Gerontolescents and Adolescents
Name four characteristics of aging
Gerontolescence- Changing roles…
yesterday’s Adolescents – today’s Gerontolescents
•The difference is that while adolescence lasts for a decade, gerontolescence will last for 2 to 3 decades.
Increased mortality with age after maturation
•Changes in biochemical composition
•Progressive decrease in physiological capacity
•Reduced capacity to respond adaptively to environmental stress (maintain homeostasis)
What is the impact of physiological changes in the aging
Instability and falls – MSS & CNS
•Cognition
•Incontinence
•Effort intolerance – CVS, RS & MSS
•Body composition – drug volume of distribution: With age, body fat generally increases and total body water decreases. Increased fat increases the volume of distribution for highly lipophilic drugs (eg, diazepam, chlordiazepoxide)
•Susceptibility to and clinical presentation of infection
Theories of aging have been around for how many years?
State the five theories of aging and where it’s shown,state the period it came about
Theories of Aging have been around for > 2000 years.
•Galen (129 – 199 A.D.)- “Aging was due to changes in body humours that began in early life.”
•Roger Bacon (1220 -1292 A.D.) “wear and tear” theory. “Aging is the result of abuses and insults to the body system and that good hygiene might slow the aging process.”
•Charles Darwin (1809 – 1892 A.D.) “Attributed aging to the loss of irritability in the nervous and muscular tissue.”
•There had been many theories of ageing, but none had been able to independently explain why ageing occurs
THEORIES OF AGING
•STOCHASTIC:aging process is due to biological things that can happen to the body
•Somatic mutation and DNA repair
•Error- Catastrophe
•Protein modification
•Free Radical (oxidative stress) & Mitochondrial DNA
- DEVELOPMENTAL-GENETIC: aging process is in the genes so some people have genes that make them age faster and some have genes that make them live longer
- Longevity Genes
- Accelerated Aging Syndromes
- Neuroendocrine
- Immunologic
- Cellular Senescence
- Cell death
What are the types of aging processes and explain em
Ageing process: primary and secondary ageing.
•Primary or true ageing: an interaction b/w intrinsic (genetic) and extrinsic (environmental) influence.
•Intrinsic influence: presence of familial longevity pattern, premature ageing genetic disorders (Progeria & Werner’s syndrome)
•Extrinsic influence: people of different environments exhibit varying ageing patterns with the ability to alter age-related morbidity pattern by manipulation of their environment.
AGEING PROCESS- CONTD
•Secondary Ageing
•The body does not detect and repair all of the ravages of time and makes some compensatory changes to the loss of some functions of the body especially the psychological function.
•These compensatory changes are the adaptive response by individuals to overcome the deleterious effects of the primary ageing.
What’s re neuromuscular changes that occur in the elderly and the changes in the supportive tissue
MUSCLE
• muscle mass – loss of muscle fibers
- fiber size
• IIb (fast glycolytic(fast-fatigable)) : IIx fiber ratio
•↓ ATP, ↓ ATP : ADP,↓ glycogen & creatinine phosphate
MOTOR UNIT
• MU number and innervation ratio
MOTOR NERVE
• conduction velocity ( cell membrane electrical resistance)
CORTICOSPINAL TRACT
• excitability threshhold
SUPPORTING TISSUE
•Changes in connective tissue
•↑ extracellular component of body water
•↓ ground substance (muco-polysaccharides/fibrous protein)
•↑ reticular fibre density
•↑ elastin fibre density & rigidity
•↑ collagen fibres with ↓ solubility of collagen
•Hyaline cartilage → fibro cartilage
•↑ fragility of blood vessels (loss of s/c support tissue)→ bleeding with minor trauma
•Calcification in media of arteries
What’s are the CNs changes in the elderly
- Age-related changes in CNS cytoplasm
- Accumulation of lipofuscin & abnormal filaments
- neurofibrillary tangles
- eosinophilic inclusions
- electron dense granules
- Parenchymal structures
- neuritic plaques (degenerative neurites with amyloid core) may be found in hippocampus & limbic system
State what happens to the eye and the ears in the elderly and what it leads to
Eye: morphology-arcus senilis (lipid precipitation on periphery of the cornea)
Reduced pupil size
Growth of lens
Lens opacification
Leads to increased need for illumination Increased susceptibility to glare Hyperopia Reduction in fields of vision Reduction in accommodation Reduction in visual acuity Reduced color sensitivity Reduced depth perception
Ear: atrophy of external auditory meatus
Increased obstruction of the Eustachian tube
Reduced elasticity of tympanic membrane
Degenerative changes of the ossicles
Atrophy of cochlear hair cells
Degeneration of organ of Corti
Loss of auditory neurons
Leads to
Reduced frequency Acuity
Difficulty discriminating words if there’s background noise
What is the white coat effect in elderly
What is white coat syndrome? Some people find that their blood pressure is normal at home, but rises slightly when they’re at the doctor. This is known as white coat syndrome, or the white coat effect.
