Geriatrics: pathophysiology of aging

Question 1

Why are people getting older?

Answer 1

○ Increased resources availability​
○ Better economic conditions​
○ Improved screening programs with earlier diagnosis and treatment​
○ Better outcomes following major events​
- Cardiac​
- Stroke​
- Surgery​

Question 2

What are the concequences if an aging population?

Answer 2

• More people survive a major event​

- More people have several co-morbid conditions​

Question 3

what changes happen in older people that are not due to aging?

Answer 3

○ Selective survival

○ Cohort effects

Question 4

What is Primary ageing?

Answer 4

Things that happen because you are biologically getting older

Question 5

What is secondary aging?

Answer 5

Things that happen due to a consequence of primary aging

Question 6

What are the benificial, neutral and detrimental changes that happen due to age?

Answer 6

• Beneficial​
○ Increased experiential learning​
• Neutral​
○ Grey hair​
○ Pastime preference​
• Detrimental​
○ Hypertension
○ Decreased reaction time​

Question 7

What are the two theories of aging?

Answer 7

○ Stochastic ​
- Cumulative damage​
- Random​
○ Programmed​
- Predetermined​
- Changes in gene expression during various stages​

Question 8

What is the physiology of aging?

Answer 8

○ Affects virtually every organ/system​
○ Marked inter-individual variability in both development and magnitude of changes​
○ Inter-individual variability INCREASES with age​
○ Evidence very limited for 80+​

Question 9

What is frailty?

Answer 9

○ The core concept in geriatric medicine
○ A susceptibility state that leads to a person being more likely to lose function in the face of a given environmental challenge
○ Dyshomiostasis 
○ This results in "frailty syndromes"
- Falls 
- Delirium
- Immobility
- Incontinence

Question 10

What is social dyshomiostasis?

Answer 10

○ Difficulty caused by environmental insults not only bio-medical
○ Ageing often associated with whole system dyshomeostasis
- Different ability to compensate for e.g. death of spouse or daughter going on holiday