Geriatrics- Ch. 5 Flashcards
The leading causes of death in persons over 65 in order of frequency
- Coronary heart disease (CHD)- 31%
- Cancer- 20%
- Cerebrovascular disease (Stroke)- 20%
- Chronic obstructive pulmonary disease (COPD)
- Flu/Pneumonia
Decreased activity levels are referred to as _____ and causes muscular system changes in older adults more so than the aging process itself
Hypokinesis
___ help enable long-endurance feats such as distance running, while ____ fatigue faster but are used in powerful bursts of movements like sprinting. Older adults have changes in muscle fiber composition which causes a decrease in Type II with an increase in Type I.
Slow-twitch muscles (Type I)
Fast-twitch muscles (Type II)
To improve the muscular system, we can 1) improve health by ____, ____, and ____ 2) increase levels of physical activity while ____ and _____ 3) provide strength training by ____ and ___ 4) provide flexibility training and ROM exercises by ____ and ____.
Correcting medical problems that may cause weakness
Improving nutrition
Addressing alcoholism and substance abuse
Gradually increasing intensity
Including adequate warm ups/cool downs
Using isometric, progressive resistive exercises
Using high intensity training programs.
Using slow, prolonged stretch
Using heat prior
Age is not a limiting factor when it comes to strength training! However, ____ gains are slower with older adults.
mobility
You always want to maintain ____ and ____ within functional activities
strength and ROM
Neurological changes include slowed nerve conduction where the _____ loss is greater than ____
Sensory
Motor
Types of tremors include rest tremors, action tremors consisting of ____, ____ and ____.
Postural, kinetic and intention
___ is present while voluntarily maintaining a position against gravity, i.e. arm outstretched.
Postural tremor
____ occurs during movement of a body part.
Kinetic Tremor
Age related tremors affect the ____, ____ and ____. They are _____.
hands, head and voice
progressive
Neurological system changes negatively affect ___ and movement, specifically decreased _____ , ____ and ____.
Strength
Speed and coordination
Fine motor control
Reaction time
To improve the neurological system, we can 1) improve health by ____ and ____ 2) increase levels of physical activity to ____ 3) improve motor learning and control by ____, ____ and ____.
Correcting medical problems, e.g. improving cerebral blood flow
Improving diet, smoking cessation
Improve cerebral circulation
Allowing for increased reaction and movement times to improve motivation/accuracy
Allowing for limitations of memory avoiding long movement sequences
Stressing familiar well learned skills using repetitive movements
In terms of skeletal system changes, ______ changes occur in more than 60% of older adults.
degenerative joint
____ occurs in the thoracic spine and ___ occurs in the lumbar spine
Kyphosis
flattening
Maintenance of _____ is important for joint health and mobility since there is an increased risk of ___.
Weight bearing
Falls/fractures
Strategies to improve skeletal system are ____, ____ and ____.
Postural exercises (decreases intervertebral disk flattening)
Weight bearing exercises (decreases bone loss)
Nutritional/hormonal/medical therapies
Farsightedness caused by loss of elasticity in the lens
Presbyopia
Vision related changes include decreased ____ in corneal reflex and _____ responses that cause ____, ___ and ____.
sensitivity
oculomotor
Ptosis, restricted upward gaze, reduced pursuits
The number one cause of vision loss in adults over 60 years of age. A progressive and irreversible loss of central vision causing central scotomas (dense localized visual deficit that creates a blind spot) due to degeneration of the macula.
macular degeneration
Caused by clouding over the lens of the eye, decreasing the amount of light passing through the lens and limiting vision. The most common form of cataracts affects distant vision, then near vision, eventually causing blurriness and muted colors throughout the entire visual field. Affects central vision first and then peripheral
Cataracts
Caused by an increase in intraocular pressure due to fluid buildup in the eye, resulting in compression of and damage to the optic nerve. Causes peripheral vision loss (tunnel vision) and in end stages, may impact central visual field as well. The most frequent cause of visual field damage and the second leading cause of blindness; is commonly referred to as “the silent thief” since peripheral field loss is harder to notice.
Glaucoma
Affects ~40% of all individuals with diabetes. Affects the small blood vessels in the retina, causing floaters from blood leakage and can result in impairment ranging from mild to total blindness. Vision may fluctuate based on dysregulated sugar levels, and the field of view that is affected depends on the areas of the retina that are affected so can have loss of central or peripheral vision.
Diabetic Retinopathy
Sensory cues to assist someone with vision difficulties include ____ and ____.
Verbal descriptions
Touching to convey listening
____ hearing loss occurs when there is damage along the route through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles). Along with hearing loss it can also cause ___.
Conductive
Tinnitus
____ hearing loss is caused by damage to the inner ear or the nerve from the ear to the brain.
Sensorineural
___ is usually a sensorineural hearing disorder associated with middle/older age that causes ___ hearing loss, auditory discrimination problems and ____. It is most commonly caused by gradual changes in the inner ear.
Presbycusis
bilateral
tinnitus
Immobility of stapes causing conductive hearing loss
Otosclerosis
___ AND ___ can also result in hearing loss
Paget’s disease (bone disorder)
Hypothyroidism (low thyroid hormone production)
Sensory cues to assist someone with hearing difficulties include ____ and ____.
non-verbals
written and demonstrated instructions
Episodic attacks of tinnitus, dizziness and pressure in ears causing vestibular/balance loss
Menieres disease
A very common vestibular disorder causing brief episodes of vertigo
Benign paroxysmal positional vertigo
Other causes for vestibular loss include __, __, and __
Cerebrovascular disease (TIA, stroke) Cardiac disease (heart conditions that include diseased vessels, structural problems, and blood clots.) Cerebellar dysfunction (controls coordination and balance)
Somatosensory changes include decreased sensitivity to touch and joint receptor sensitivity, especially in ___..
lower extremities
Conditions that cause sensation loss include:
Peripheral neuropathy in diabetes
Central sensory loss in CVA
Peripheral vascular disease (A circulatory condition in which narrowed blood vessels reduce blood flow to the limbs)
Those with decreased sensation have increased thresholds (point at which they feel sensation) for __ and ___. Therefore, they may benefit from extra time for responses during treatment
pain and vibration
Sensory cues to assist someone with sensory difficulties include ____.
Using touch to communicate by maximizing physical contract (rubbing, stroking, tapping) -_-
Conditions that result in loss of taste and smell
Smoking Chronic allergies Respiratory infections Dentures CVA that involves hypoglossal nerve
___ and __ are usually harder to remember
Short term memory
Novel tasks
To improve cognition, we can 1) improve health by ____ and ____ and ____ 2) increase levels of physical activity 3) increase mental activity by __ and ____.
Correcting nutritional deficiencies
Decreasing use of multiple drugs, tobacco and alcohol
Keeping mentally engaged/cog training
Maintaining social life
MULTIPLE sensory cues to assist someone with cognitive difficulties include ____, ____ and ___.
Visual discriminations
Written instructions
Verbal cues
Cardiopulmonary changes are more due to ____ and ____ than old age.
Inactivity
Disease
Common cardio changes include __, __ and ___.
Orthostatic hypotension (Decreased BP within 3 minutes of standing)
Systolic ejection murmur
Anemia
Respiratory responses to exercise is similar to younger adults at ___ and ___ intensities
low
moderate
Strategies to improve cardiopulmonary changes include an ____ and ____.
Developing individualized exercises prescription
Developing aerobic training programs
Heat, cold, excess exercise can be life threatening due to decreased ____ and _____.
sweat production
homeostasis
