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NBCOT > Human development (ch 5)- Aging > Flashcards

Human development (ch 5)- Aging Flashcards

1
Q

Biological changes with aging (3)

A
  • cellular changes (fragmentation of Golgi apparatus and mitochondria; decrease in cell capacity to divide and reproduce; arrest of cell division)
  • tissue changes (accumulation of pigmented materials, lipofuscins, lipids and fats; decreased elasticity of connective tissue; presence of pseudoelastins).
  • organ changes (decrease in functional capacity and homeostatic efficiency).
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2
Q

Premature aging syndromes are called….

A

progeria

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3
Q

Hutchinson-Gilford syndrome is…

A

progeria of childhood

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4
Q

Werner’s syndrome is…

A

progeria of young adults

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5
Q

atherosclerosis is…

A

buildup of WBC’s in arteries

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6
Q

Type I fibers vs Type II fibers (muscle)

A

Type I = slow twitch

Type II= fast twitch

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7
Q

Age-related changes in muscles

A
  • loss of strength
  • loss of power
  • loss of skeletal muscle mass
  • changes in muscle fiber composition (more slow fibers)
  • muscles fatigue more rapidly (lower endurance)
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8
Q

clinical implications of changes in muscles

A
  • movements become slower
  • increased complains of fatigue
  • connective tissue becomes denser and stiffer (risk of muscle sprains, strains, tendon tears; loss of ROM, increased tendency for fibrinous adhesions/contractures)
  • decreased functional mobility, limitations to mvmt
  • gait may be unsteady (changes in balance, strength)
  • increased risk of falls
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9
Q

strategies to slow or reverse muscular aging changes

A
  • improve health (correct medical problems that cause weakness like hyperthyroid, excess steroids, hyponatremia= low sodium; improve nutrition).
  • increase physical activity
  • provide strength training to increase/maintain muscle strength required for functional activity.
  • provide flexibility and ROM exercises to increase ROM needed for functional activity.
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10
Q

Age-related changes in skeletal system

A
  • cartilage changes (decreased water content, stiffer, fragments, and erodes)
  • loss of bone bass and density
  • intervertebral discs flatten, less resilient (loss of water and collagen)
  • senile postural changes (forward head, kyphosis, flattening of lumbar spine, hip/knee flexion contractures with prolonged sitting)
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11
Q

clinical implications of skeletal changes with aging

A

maintenance of weight bearing is important for cartilaginous/joint health and mobility.
Increased fall/fracture risk

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12
Q

strategies to slow/reverse skeletal changes with aging

A
  • postural exercises (stress components of good posture)
  • weight bearing exercise can decrease bone loss in older adults
  • nutritional, hormonal, and medical therapies
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13
Q

Age-related changes in neurological system

A
  • atrophy of nerve cells in cerebral cortex
  • changes in brain morphology (gyral atrophy, ventricular dilation, generalized cell loss in cerebral cortex esp frontal and temporal, lipofuscins, plaques and tangles, cell loss in basal ganglia cerebellum hippocampus locus coeruleus, NOT brain stem).
  • decreased cerebral blood flow and energy metabolism
  • changes in synaptic transmission (decreased synthesis and metabolism of neurotransmitters, slowing of many neural processes)
  • changes in spinal cord/peripheral nerves (neuronal loss/atrophy, loss of motorneurons, slowed nerve conduction velocity, loss of sympathetic fibers).
  • age-related tremors (usually essential tremor)
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14
Q

clinical implications of neurological aging changes

A
  • effects on movement: overall speed/coordination decreased; difficulty w/ fine motor control; slowed recruitment of motorneurons so loss of strength; reduced reaction/movement time; errors in faster movements; more cautionary behaviors.
  • general slowing of neural processing (learning and memory may be affected)
  • problems in homeostatic regulation (heat, cold, exercise could cause harm)
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15
Q

strategies to slow/reverse neurological aging changes

A
  • correct medical problems… improve cerebral blood flow
  • improve health: diet, stop smoking
  • increase levels of physical activity (may slow rate of neural decline and improve circulation)
  • provide effective strategies to improve motor learning/control (allow increased reaction/mvmt time; allow limitation of memory; allow increased cautionary behaviors and give more time when teaching new mvmt skills; stress familiar well-learned skills
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16
Q

Age-related sensory system changes

A
  • loss of function of sense…
  • may lead to sensory deprivation, isolation, disorientation, confusion, appearance of senility and depression
  • may strain social interactions
  • may lead to decreased functional mobility and increased risk of injury
  • alters quality of life
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17
Q

Vision changes with aging

A
  • general decline in visual acuity (gradual to age 60, rapid b/w 60-90)
  • presbyopia: visual loss characterized by inability to focus properly and blurred images
  • decreased ability to adapt to dark/light
  • increased sensitivity to light/glare
  • loss of color discrimination (esp blue/green)
  • decreased pupillary responses
  • decreased sensitivity of corneal reflex
  • diminished oculomotor responses
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18
Q

Cataracts

A

opacity, clouding of lens due to changes in lens proteins; results in gradual loss of vision (central first, then peripheral), problems with glare; general darkening of vision; loss of acuity. Surgery!!

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19
Q

Glaucoma

A

increased intraocular pressure, with degeneration of optic disc, atrophy of optic nerve; results in loss of peripheral vision. If untreated, can progress to blindness. Surgery and medication can be effective if tx early.

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20
Q

Macular degeneration

A

loss of central vision associated with age-related degeneration of the macula compromised by decreased blood supply or abnormal growth of blood vessels under retina; typically retain some peripheral vision; increased sensitivity to glare, and difficulty adjusting to light change; may progress to blindness.

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21
Q

Diabetic retinopathy

A

damage to retinal capillaries, growth of abnormal blood vessels and hemorrhage leads to retinal scarring and finally retinal detachment; central vision impaired, vision blurred; complete blindness is rare.

22
Q

CVA, homonymous hemianopsia

A

loss of 1/2 visual field in each eye (toward same side- 1 nasal 1 temporal); produces an inability to receive info from right or left side; corresponds to side of sensorimotor deficit.

23
Q

Medication can impair vision or make it fuzzy… these meds would be….

A

antihistamines antipsychotics, antidepressants, steroids

24
Q

Clinical implications/compensatory strategies for vision loss

A
  • assess for visual deficits (acuity, peripheral vision, light/dark, depth perception, diplopia, eye fatigue, eye pain)
  • maximize visual function (assess for use of glasses and needed enviro adaptations)
  • sensory thresholds are increased (allow extra time for visual discrimination/response)
  • work in adequate light and reduce glare
  • use large, high contrast print for writing
  • provide magnifying glasses
  • eye patch for diplopia
  • decreased peripheral vision may limit social interactions, so stand in front and at eye level
  • assist patient with color discrimination (use warm colors- yellow, orange, red)
  • provide other sensory cues when vision is limited (verbal descriptions, touching, talking clocks)
  • provide safety education to reduce fall risk.
25
Q

Hearing changes with aging

A
  • occur as early as 30’s. affects a lot of elderly.
  • outer ear- buildup of cerumen (ear wax) can result in hearing loss
  • middle ear- minimal degenerative changes of bony joints
  • inner ear- significant changes in sound sensitivity, understanding speech, and maintenance of equilibrium; atrophy of cochlea and vestibular structures; loss of neurons
26
Q

What is conductive hearing loss?

A

mechanical hearing loss from damage to external auditory canal, tympanic membrane or middle ear ossicles; results in hearing loss; tinnitus maybe.

27
Q

What is sensorineural hearing loss?

A

central or neural hearing loss from multiple factors (noise damage, trauma, disease, drugs, arteriosclerosis, etc)

28
Q

What is presbycusis hearing loss?

A

sensorineural hearing loss associated with middle and older ages; characterized by bilateral hearing loss, esp at high frequencies at first, then all frequencies; poor auditory discrimination and comprehension, esp with background noise; tennitus.

29
Q

What is otosclerosis?

A

immobility of stapes (bone in middle ear) resulting in profound conductive hearing loss.

30
Q

clinical implications/compensatory strategies for hearing loss

A
  • assess acuity, speech discrimination/comprehension, tinnitus, dizziness, vertigo, pain.
  • asses for use of hearing aids; check if working!
  • minimize auditory distractions
  • speak slowly and clearly at eye level
  • use nonverbal communication
  • provide written and demonstrated directions
  • orient person to topics of conversations he can’t hear to reduce isolation/fear
  • provide assistive devices to compensate and ensure safety (flashing fire alarms, telephones, doorbells).
31
Q

Vestibular/balance control changes with aging

A
  • degenerative changes in otoconia of utricle and saccule; loss of vestibular hair-cell receptors; decreased number of vesitbular neurons; VOR gain decreases; begins at age 30!
  • diminished acuity, delayed reaction times
  • reduced function of vestibular ocular reflex (VOR); affects retinal image stability with head movements and produces blurred vision
  • altered sensory organization (older adults more dependent on somatosensory inputs for balance)
  • less able to resolve sensory conflicts when presented with inappropriate visual or proprioceptive inputs due to vestibular losses
  • postural response patterns for balance are disorganized (increased postural sway)
32
Q

what is Meniere’s disease?

A

episodic attacks characterized by tinnitus, dizziness, and a sensation of fullness or pressure in the ears; may also have sensorineural hearing loss.

33
Q

what is benign paroxysmal positional vertigo (BPPV)?

A

brief episodes of vertigo (less than 1 minute) associated with position change; common in older adults.

34
Q

what medications cause potential loss in vestibular sensitivity?

A

antihypertensives; anticonvulsants; tranquilizers, sleeping pills; aspirin, NSAIDS

35
Q

other things that can cause loss of vestibular sensitivity are cerebrovascular disease, cerebellar dysfunction, migraine, and cardiac disease

A

just know that :)

36
Q

Somatosensory changes with aging

A
  • decreased sensitivity of touch associated with decline of peripheral receptors (LE more than UE)
  • proprioceptive losses (beginning age 50; greater in LE than UE)
  • loss of joint receptor sensitivity (in LE could cause fall)
  • cutaneous pain thresholds increased (greater in UE/face than LE)
37
Q

pathology that could cause loss of sensation…

A
  • diabetes (peripheral neuropathy)
  • CVA (central sensory losses)
  • peripheral vascular disease (peripheral ischemia)
38
Q

clinical implications/compensatory strategies for somatosensory issues in aging

A
  • assess carefully- check for sensory losses
  • allow extra time for responses
  • use touch to communicate
  • provide augmented feedback through appropriate sensory channels (ex. extra grip silverware)
  • teach compensatory strategies to prevent injury
  • provide AE and enviro modifications for fall prevention
  • provide biofeedback devices as appropriate
39
Q

Taste and Smell changes in aging

A
  • gradual decrease in taste sensitivity

- decreased smell sensitivity

40
Q

Conditions resulting in additional loss of taste/smell sensation

A
  • smoking
  • chronic allergies, respiratory infections
  • dentures
  • CVA, involvement of hypoglossal nerve
41
Q

clinical implications/compensatory strategies for taste/smell changes

A
  • asses for identification of odors, tastes, somatic sensations (temp, touch)
  • decreased taste/enjoyment of foods can lead to poor diet/nutrition
  • older adults frequently increase use of taste enhancers (salt/sugar!)
  • decreased home safety (gas leaks, smoke)
42
Q

Age-related cognitive changes

A
  • no uniform decline in intellectual abilities throughout adulthood
  • no changes typically until mid 60’s; signif declines around early 80’s
  • terminal drop= most signif changes in years preceding death
  • tasks involving perceptual speed show early declines (by age 39); longer times to complete tasks
  • numeric ability peaks in mid 40’s; stable until 60’s
  • verbal ability peaks at age 30; maintained until 60’s.
  • memory impairments typically short-term memory; task dependent (typically problems with new tasks)
  • learning… all ages can learn!
43
Q

clinical implications of age-related cognitive changes

A

older adults utilize different strategies for memory: context based strategies vs memorization (young adults)

44
Q

strategies to slow or reverse cognitive changes

A
  • improve health (correct medical problems… imbalances b/w oxygen supply & demand in CNS; assess pharmacological changes; reduce tobacco and alcohol use; eat right!)
  • increase physical activity
  • increase mental activity (keep mentally engaged; maintain engaged social life; use cognitive training activities)
  • provide multiple sensory cues to compensate for decreased sensory processing and sensory losses
  • provide stimulating, enriching enviro; avoid enviro dislocation
  • reduce stress; provide counseling and family support
45
Q

Age-related cardiopulmonary system changes

A

-changes due more to inactivity and disease than aging
-degeneration of heart muscle with accumulation of lipofuscins
-decreased coronary blood flow
-cardiac valves thicken and stiffen
-changes in conduction system (loss of pace maker cells in SA node)
-changes in blood vessels (arteries thicken, less distensible; slowed exchange capillary walls; increased peripheral resistance)
-resting blood pressures rise (systolic greater than diastolic)
-decline in neurohumoral control (decreased responsiveness of end-organs to beta-adrenergic stimulation of baroreceptors)
-decreased blood volume, hemopoietic activity of bone
increased blood coagulability

46
Q

clinical implications for cardiovascular changes in aging

A
  • changes at rest are minor (resting heart rate and cardiac output relatively unchanged; resting BP increase)
  • CV responses to exercise are blunted, decreased heart rate acceleration, decreased maximal O2 uptake and heart rate; reduced exercise capacity; incr recovery time
  • decreased stroke volume due to decreased myocardial contractility
  • max heart rate declines with age
  • cardiac output decreases, 1% per year after age 20!
  • orthostatic hypotension is common
  • increased fatigue; anemia common
  • systolic ejection murmur common
  • possible ECG changes
47
Q

pulmonary changes in aging

A
  • chest wall stiffness, declining strength of respiratory muscles, increased work of breathing
  • loss of lung elastic recoil
  • changes in lung parenchyma (alveoli enlarge, become thinner; fewer capillaries for delivery of blood)
  • pulmonary bv’s thicken, less distensible
  • decline in total lung capacity
  • forced expiratory volume (air flow) decreases
  • decreased homeostatic responses
  • blunted immune responses (decreased secretory immunoglobulins and ciliary action)
48
Q

clinical implications for pulmonary changes

A
  • respiratory responses to exercise similar to younger adult at low/mod intensity; more difficult at higher intensity
  • blunted clinical signs of hypoxia (look for mental changes instead)
  • cough mechanism impaired
  • gag reflex decreased (incr risk of aspiration)
  • recovery from respiratory illness prolonged
  • signif changes in function w/ chronic smoking and enviro toxins
49
Q

strategies to slow/reverse changes in cardiopulmonary systems

A
  • assessment (careful about maximal testing)
  • individualized exercise prescription is essential. program based on fitness, cv disease, musculoskeletal limits, and goals. walking/exercises/yoga/swimming all good. consider multiple modes of exercise to keep interest.
  • aerobic training programs can signif improve cardiopulmonary function.
  • improve overall daily activity levels for indep living
50
Q

Age-related integumentary changes

A
  • dermis thins with loss of elastin
  • decreased vascularity (easy bruising)
  • decreased sebaceous (oil) activity and in hydration
  • dry, wrinkled, yellowed, and inelastic; age spots
  • general thinning and graying of hair due to vascular insufficiency and decr melanin
  • nails grow more slowly, brittle and thick
  • loss of skin effectiveness as protective barrier (decreased touch sensitivity, heals more slowly, decr sweat production)
51
Q

Age-related GI changes

A
  • decreased salivation, taste, poorer swallowing reflex may result in poor nutritional intake
  • esophagus reduced motility and control of lower sphincter (acid reflux)
  • stomach reduced motility, delayed gastric emptying, decreased digestion/absorption; indigestion common
  • decreased intestinal motility; constipation common
52
Q

Age-related renal, urogenital changes

A
  • kidney loss of mass and total weight with nephron atrophy; decreased renal blood flow; blood urea rises; decreased excretory and reabsorptive capacities
  • bladder muscle weakness; urinary frequency; increased retention (difficulty with emptying); incontinence common; increase in UTI’s.

NBCOT (16 decks)

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