Health and Ageing

Question 1

chronological age is based on…

Answer 1

passage of time

Question 2

biological age is based on…

Answer 2

physical and physiological changes

Question 3

psychological age is based on…

Answer 3

behaviours, attitudes and outlook

Question 4

brain shrink is particularly evident in what area of the brain?

Answer 4

Frontal cortex

Question 5

men have greater affects of brain atrophy in what areas?

Answer 5

Frontal and temporal lobes

Question 6

women have greater affects of brain atrophy in what areas?

Answer 6

hippocampus and parietal lobes

Question 7

What are the main mechanisms of brain change?

Answer 7

1. changes in neurotransmitter levels
2. neurons are less able to produce energy
   3 changes in hormones
3. reduced cerebrovascular efficiency

Question 8

What are white matter lesions (especially in the frontal lobes) linked to?

Answer 8

reduced cerebral blood flow
higher blood pressure
poor cognition

Question 9

What are the main cognitive changes in normal ageing processes?

Answer 9

Deficits to working memory,
episodic memory (poor encoding and storage)
semantic memory (slower retrieval)
autobiographical memory (difficulties with detail)
slower processing and reaction times

Question 10

What is the most typical type of age related hearing loss?

Answer 10

Symmetrical high-frequency hearing loss due to sensory, neural and metabolic changes in the cochlear
Also earwax
difficulties with perception (changes in central auditory system making background noise more difficult)

Question 11

What is astigmatism?

Answer 11

changes in corneal curvature affecting focus on vertical elements

Question 12

What may lens opacification result in?

Answer 12

Cataracts

Question 13

What may presbyopia result in?

Answer 13

lens hardening

Question 14

What may changes in the retina result in?

Answer 14

decreased visual acuity (sharpness) and contrast sensitivity (interfering with depth perception)

Question 15

What is iatrogenic illness?

Answer 15

Illness caused by medical treatment - common in the elderly

Question 16

What is the most common symptom of ischaemic heart disease?

Answer 16

angina (tight or crushing pain in chest)

Question 17

What is COPD?

Answer 17

Chronic obstructive pulmonary disease - respiratory condition characterised by breathing difficulties

Question 18

What is prebyphagia?

Answer 18

When the normal ageing process results in slower speed of swallowing movements and increased transit time

Question 19

What might cause presbyphagia?

Answer 19

atrophy of muscles (e.g. jaw, tongue)
slower initiation of laryngeal and pharyngeal events
airways opening for too long
reduced sensation
reduced smell and taste
Xerostomia (as a side effect of medication)

Question 20

What is end of life care?

Answer 20

supportive management of health and other issues for people whose life expectancy is likely to be less than 12 months

Question 21

What are the basic principles of end of life care?

Answer 21

Quality is more important than quantity
Focus on short term rather than long term issues
prioritise the patients and carers needs
Manage symptoms in the least invasive way

Question 22

What is main involvement of SLT in end of life care?

Answer 22

Safe swallowing or alternatives to oral nutrition
Capacity for informed decision making
Facilitating communication

Question 23

What is the loss of grey matter related to?

Answer 23

Neuronal cell death
Decreased neuronal volume
Changes in the number of synapses

Question 24

What is the loss of white matter related to?

Answer 24

Deterioration in myelin sheath

Subclinical ischemia

Question 25

What chemicals are related to changes in neurotransmitter levels?

Answer 25

Dopamine and serotonin

Question 26

What is reduced energy generation related to?

Answer 26

Impaired glucose metabolism | Mitochondrial dysfunction

Question 27

What type of memory does normal ageing effect the most?

Answer 27

Episodic and working memory

Question 28

What are some considerations SLT’s should take when working with normal ageing adults?

Answer 28

Environment (background noise), pace, ability to retain new information, working memory limits, task variety (including attentional load), use of contextual cues

Question 29

What is presbycusis?

Answer 29

progressive, bilateral, age related hearing loss

Question 30

Where do the most significant effects of age related changes in hearing occur?

Answer 30

In the cochlea

Question 31

In age related hearing - peripheral changes result in..

Answer 31

High frequency hearing loss

Question 32

In age related hearing loss, central changes result in...

Answer 32

Reduced compensation for high frequency hearing loss

Question 33

Astigmatism =

Answer 33

Cornea damage - difficulty with vertical elements

Question 34

Cataracts =

Answer 34

Lens opacification

Question 35

Presbyopia =

Answer 35

Reduction in near vision (i.e. less short sighted with age)

Question 36

Retina changes =

Answer 36

Less visual acuity and decreased constraint sensitivity

Question 37

Dry AMD =

Answer 37

Accumulation of debris and pigment in macula -> central vision is impaired

Question 38

Wet AMD =

Answer 38

Swelling and haemorrhage

Question 39

What are the two common consequences of heart muscle ischemia?

Answer 39

Arrlythmius = irregular heart rhythms | Congestive heart failure

Question 40

What does left sided heart failure result in?

Answer 40

Results in a build up of fluid in the lungs -> shortness of breathe and cough (particularly when lying down)

Question 41

What does right sided heart failure result in?

Answer 41

Gravity dependent oedema in extremities -> particularly in the ankle and feet

Question 42

What is emphysemus?

Answer 42

Damage to the alveoli leading to shortness of breath and a dry cough

Question 43

What is chronic bronchitis?

Answer 43

Inflammation of the airways - resulting in shortness of breath, sneezing, most cough and chest infections

Question 44

What are analgisic medications?

Answer 44

Pain meds E.g. mild opioid = cosine Strong opioid = morphine NB opioids have side effects

Question 45

Adjuvant Therapy is...

Answer 45

A helper drug, enhancing or supporting treatment -e.g. anticonvulsant or antidepressant meds

Question 46

What is Cheyne-Stokes respiration?

Answer 46

Cyclical breathing pattern in which respiratory rate speeds up and slows down

Question 47

What is an advanced decision?

Answer 47

It is a living will It is legally binding - signed and witnessed Can only be overridden by the patient themselves

Question 48

What is an Advanced statement

Answer 48

Statement of end of life wishes It is not witnessed and does not have to be signed (although good idea to) It’s not legally binding Can be overridden with sufficient justification