Intro to Geriatrics

Question 1

What is aging

Answer 1

A progressive and insidious decline in cellular processes after reaching sexual maturity
Cells → tissue → organ → system → organism

Question 2

What does aging result in

Answer 2

Decreased homeostatic balance
Decreased reaction to tissue injury
Increased vulnerability to environmental changes
↓’d organ/system reserve
Less specific causes of disease with greater individual variation

Question 3

Antagonistic Pleiotropy

Answer 3

one gene having multiple functions and the ability to switch function from increased fitness in the young to decreased physiological function with aging

Question 4

Cocoon hypothesis

Answer 4

There’s a decline in natural selection forces
From ↓’d immobility with aging
↓’d environmental risk
Air-conditioners, heating, vaccines, preventive care

Question 5

Brain and spinal cord function that change with aging

Answer 5

Reactive gliosis
Dural meningeal fibrosis
Brain atrophy
↓’d peripheral nerve conduction velocity

Question 6

endocrine function that changes with aging

Answer 6

Decreased hormonal secretion
Decreased receptors
Deceased efficacy and efficiency
Interstitial fibrosis, parenchymal atrophy

Question 7

cardiovascular function that changes with aging

Answer 7

Decreased cardiac muscle contractility
Myocardial interstitial fibrosis
Atherosclerosis/arteriosclerosis
Conduction abnormalities

Question 8

sensory biomarkers of aging

Answer 8

↓’d hearing (presbycusis)
↓’d vision
↓’d taste
↓’d smell
↓’d touch and vibration

Question 9

renal system changes with aging

Answer 9

Interstitial fibrosis
glomerular sclerosis
↓ Creatinine clearance and GFR 10 ml/decade

Question 10

gastrointestinal system changes with aging

Answer 10

Mucosal atrophy
Decreased emptying, hormonal secretion and hydrochloric acid
Hyperplastic polyps
Colorectal adenomas

Question 11

Biomarker of Aging: Oxidative Stress

Answer 11

Obesity increases oxidative stress
Oxidative stress disrupts cellular growth regulation
Decreased ability to neutralize “radical oxygen species”

Question 12

Decreased cellular function is significant risk for?

Answer 12

Dementia
Parkinson’s Disease
Age related macular degeneration, Cataracts
COPD, emphysema
Presbycusis
Arteriosclerosis
T2DM
Heart failure

Question 13

What are body composition changes with aging?

Answer 13

↓LBM, fat distribution, BMI, waist circumference, muscle strength testing, ↓ insulin sensitivity
↓ Functional capacity and mobility
↓ Metabolic rate
Correlated with mortality, illness = ↑metabolic rate and demand
Adipokines (leptin, adiponectin) = ↓ cognitive function

Question 14

What is the concept of frailty

Answer 14

When there is > 1 disruption in physiological domain

Example: ↓’d wt, LBM, fatigue, impaired grip strength, physical activity, gait impairment

Question 15

Characteristics of urinary incontinence

Answer 15

Involuntary voiding
♀ > ♂
50% of ♀ will have some type of UI over a life-time
Increased physical, functional and psychological morbidity

Question 16

risk factors for UI

Answer 16

Childbirth, ↑age, white race, obesity, UTIs, medical co-morbidities

Question 17

what are 3 types of UI?

Answer 17

stress incontinence
urge incontinence
overactive bladder

Question 18

Stress incontinence

Answer 18

Sphincter failure with ↑ abdominal pressure = ♀
↓ pelvic floor muscle strength
Prostate surgery

Question 19

Urge incontinence

Answer 19

Sudden sensation of need to urinate
Detrusor muscle over-activity
Lack of neurological inhibition
Local irritation, inflammation

Question 20

Overactive bladder

Answer 20

Urine dribbling after micturation or constantly
Impaired detrusor contractility usually d/t denervation
Bladder outlet obstruction

Question 21

what does under nutrition and anorexia result in with aging

Answer 21

↓ muscle function, ↑ falls
↓ bone marrow
↓ immune function
Anemia
↓ cognitive function
↓ wound healing