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PHTY2230 > L2: Ageing Systems and Assessment Part 1 > Flashcards

L2: Ageing Systems and Assessment Part 1 Flashcards

1
Q

What is the definition of an older persons?

A
  • As low as 50 years
  • Commonly ≥60 or ≥65 years
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2
Q

Old age does not mean _____ and _____

A

disability; disease

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3
Q

When can we start to see age-related changes?

A

40 years old

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4
Q

Age related changes are accelerated in some conditions. Give 2 examples.

A

Progeroid Syndromes Down Syndrome)

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5
Q

What are 5 characteristics of healthy ageing?

A
  1. Cognitive Function
  2. Psychological Wellbeing
  3. Physiological and Metabolic Health
  4. Social Wellbeing
  5. Physical Capacity
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6
Q

What are 3 characteristics of cognitive function deterioration during healthy ageing?

A
  1. Processing speed
  2. Episodic memory
  3. Executive function Eg. (How quickly can they respond to instructions; Control behaviour)
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7
Q

What are 4 characteristics of psychological wellbeing deterioration during healthy ageing?

A
  1. Life satisfaction
  2. Quality of Life
  3. Mental Health
  4. Resilience
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8
Q

What are 4 characteristics of physiological and metabolic health deterioration during healthy ageing?

A
  1. Cardiovascular
  2. Respiratory
  3. Body composition
  4. Glucose metabolism
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9
Q

What are 3 characteristics of social wellbeing deterioration during healthy ageing?

A
  1. Social Network, Functioning and Support
  2. Emotional support
  3. Sense of purpose
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10
Q

What are 5 characteristics of physical capacity deterioration during healthy ageing?

A
  1. Strength
  2. Locomotion
  3. Endurance
  4. Dexterity
  5. Balance
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11
Q

_______ Ageing is a more inclusive term than ‘healthy ageing’. Why?

A

Active Applies to individuals & populations

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12
Q

During ageing, there is a(n) _______ increase/decrease in muscle mass/ cross sectional area (CSA)

A

Decrease

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13
Q

There is a decrease muscle fibre ____ (_____) and ____ (____) during ageing.

A

size; atrophy; number; hypoplasia

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14
Q

During ageing, there is significant wasting of all _______ and instead _____ infiltration in muscles

A

muscles; fat

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15
Q

How do we distinguish between sarcopenia and disuse atrophy?

A

In disuse atrophy, there is no decrease in fibre number (just fibre size)

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16
Q

What occurs to fibre number and size in sarcopenia?

A

Decrease in muscle size and number

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17
Q

What occurs to fibre number and size in sarcopenia?

A

Decrease in muscle size but no decrease in number

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18
Q

What are 3 characteristics in muscle fibres during ageing?

A
  1. Decrease satellite cells proliferation
  2. Reduction of growth factors
  3. Decreased in mechanical stimulus
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19
Q

Why both fibre types are affected, which one is most affected by ageing?

A

Type II

  • Greater loss of Type II fibres up to the late 70s
  • >80yrs, Type I fibres also lost: new ‘balance’ between two fibre types reached
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20
Q

Aged muscles have fewer _____ so are smaller & weaker

A

myofibrils

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21
Q

During ageing,_______ become increasingly disorganised

A

sarcomeres

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22
Q

Muscle _____ are smaller and have reduced quantities of oxidative enzymes

A

mitochondria

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23
Q

What are 4 sources of energy that are reduced for contraction in ageing muscles ?

A
  1. ATP
  2. Creatine phosphate
  3. Glycogen (glucose stored in the muscle)
  4. Myoglobin (excess O2 molecules in the sarcoplasm bind to myoglobin)
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24
Q

What is the implications for having reduced sources of energy for contraction in ageing muscles?

A

ADDDDD

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25
Q

In ageing, muscles exhibit more intramuscular_____ and fibrosis

A

fat

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26
Q

What is the 2 implications of intramuscular fat and fibrosis in ageing muscles?

A
  1. Decreased movement (due to increased increased mass)
  2. Decreased blood circulation
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27
Q

What is the problem with having decreased blood circulation due to intramuscular fat and fibrosis in ageing muscles?

A

Muscle injuries heal more slowly and with more scar tissue

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28
Q

In ageing, there are fewer ______ neurons in the spinal cord

A

α-motor

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29
Q

In ageing, some muscle shrinkage may represent _____ atrophy

A

denervation

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30
Q

What are 2 effects on the remaining neurons during ageing?

A
  1. produce less acetylcholine
  2. show less efficient synaptic transmission
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31
Q

What is the implication of ageing on neural control (motor neurons)? Why?

A

Muscles are slow to respond to stimulation. Motor neurons die with increasing age

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32
Q

In ageing, there is selective _______ of fibres within the motor unit (particularly Type ___. As a result, fibres either atrophy or are _____ by adjacent neurons

A

II; denervation; reinervated

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33
Q

In ageing, how does neural remodelling occur?

A

Reinervation by axonal sprouting (usually Type I, slow twitch neurons)

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34
Q

In ageing, while there is net loss of functional motor units and fibres, what are 3 features that increase?

A

motor unit size (fibres dispersed throughout a larger territory)  amplitude motor unit action potential  duration of motor unit action potential

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35
Q

What are 4 characteristics of reinnervated slow twitch (Type I) fibres during remodelling (which are originally Type I)?

A
  1. Slower firing rates
  2. Slower to contract
  3. Produce less muscle force
  4. Smaller in size
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36
Q

What are 4 implications of of ‘slow twitch’ remodelling

A
  1. Less efficient motor units
  2. Less precise control of movements
  3. Less force production
  4. Slowing of muscle mechanics
37
Q

What are the 2 functional implications the new “giant” motor units being lost?

A
  1. Loss of balance
  2. Decrease speed of movement
38
Q

What are 3 effects of ageing on the neuromuscular junction?

A
  1. Impaired Ca+ release
  2. Impaired HPR receptor expression
  3. Neurotransmitter release
39
Q

What is an example of systemic inflammation?

A

Infection

40
Q

What is an example of local inflammation?

A

OA

41
Q

What are 4 functional implications of ageing?

A
  1. Loss of strength
  2. Loss of power
  3. Slower Reactions / Movement Initiation
  4. Loss of Endurance
42
Q

What are 3 characteristics of loss of strength as a functional implication of ageing?

A
  1. Inability to carry out ADLs (e.g. carry a load)
  2. Major contributor to falls, increased dependency
  3. Decreased myofibrils, mitochondria, oxidative enzymes
43
Q

What are 4 characteristics of loss of power as a functional implication of ageing?

A
  1. Inability to generate muscle force at speed
  2. Impaired ability to respond to a threat to balance
  3. Increased risk of falls and fracture
  4. Decreased Type II fast twitch fibres
44
Q

What are 5 characteristics of Slower Reactions / Movement Initiation as a functional implication of ageing?

A
  1. Muscle slower to respond to stimuli
  2. Delayed execution of motor response
  3. Impaired ability to respond to perturbations
  4. Increased risk of falls and fracture
  5. Decreased Type II fibres, nerve conduction velocity, acetylcholine, synaptic transmission
45
Q

What are 3 characteristics of loss of endurance as a functional implication of ageing?

A
  1. Difficulty performing repeated movements/activities
  2. Muscle fatigues quicker
  3. Decreased ATP, glycogen, myoglobin etc
46
Q

What is the cycle of fragility (vicious)?

A
47
Q

What are the 2 entry points in the cycle of fragility?

A
  1. General ageing
  2. Diseases (accelerates ageing changes)
48
Q

What are 3 characteristic of sarcopenia?

A
  1. Low muscle mass
  2. Low muscle strength
  3. Low physical performance
49
Q

What are 2 ways that sarcopenia is caused?

A
  1. LIFESTYLE CHANGES
    • Decreased Physical Activity –> Decreased motor units and decreased fibre number
  2. MOTOR NEURON DEATH
    • Normal Ageing –> Decreased fibre number
50
Q

What is the recommended physical activity?

A

150 minutes/ week at least 5 sessions

51
Q

What are 7 reasons for a decrease in physical activity in the older population?

A
  1. Loss of driver’s liscense
    • No incentive
    • Harder to go out
  2. Income after retirement
    • Unable to go to community groups
    • Gym membership
  3. Co-morbidities
    • MSK
    • CV
    • Stroke
  4. Poor accessibility
    • Access to community health, execise services
  5. Fear of environmental challenges
    • Fear of falling –> restriction to physical activity
  6. Loss of friends/spouse
    • Lack of incentive to be social
  7. Change in living conditions
    • Nursing homes
52
Q

What are 6 characteristics of musculoskeletal ageing?

A
  1. Joint degeneration
  2. Degradation of articular cartilage and subchondral bone
    • Cartilage gets worn away –> exposes bone –> rubbing
  3. Narrowing of joint space
  4. Loss of fluid/mineral content (vertebrae)
    • Shrinking and reduced height Very prominent kyphosis
  5. Formation of bony spurs/osteophytes
  6. Decreased Bone mass or density (OP)
    • Bones become more brittle
53
Q

What are 4 symptoms of musculoskeletal ageing?

A
  1. Pain
  2. Reduced ROM
  3. Altered posture
  4. Risk of fractures
54
Q

What is the difference between osteopenia and osteoporosis?

A

Osteopenia (first stage) and osteoporosis (Brittle and callous bones)

55
Q

What are osteoblasts? What happens in osteoporosis?

A

building blocks (bone formation) –> become less active

56
Q

What are osteoclasts? What happens in osteoporosis?

A

bone deleting –> becomes more active

57
Q

What are 2 characteristics of sensory ageing (vestibular)?

A
  1. Impaired Vestibular Function
  2. Loss of Hearing & Sound Location
58
Q

What are 3 characteristics of impaired vestibular function (sensory ageing vestibular)?

A
  1. Decreased Ability to enhance/suppress VOR
    • Unable to maintain fixed eye view when head moves –> eyes follow head
  2. Decreased reactivity to rotational stimulation
  3. Balance impairments: Risk factor for falls
59
Q

What are 3 characteristics of Loss of Hearing & Sound Location (sensory ageing vestibular)?

A
  1. Restriction of social interaction: increased disablement
  2. Shared pathology: vestibular & auditory systems
  3. Perceptual effects: increased likelihood of being startled (If deaf –> startle effect –> loss of balance)
60
Q

What does a Macular Degeneration (sensory ageing- vision) look like?

A
61
Q

What does a cataracts (sensory ageing- vision) look like?

A
62
Q

What does a glaucoma (sensory ageing- vision) look like?

A
63
Q

What does a diabetic retinopathy (sensory ageing- vision) look like?

A

White patches over view

64
Q

What are 8 characteristics of visual perception in ageing?

A
  1. Decreased Useful visual field area
  2. Decreased Colour discrimination
    • Specifically blue, green, violet (due to natural yellowing of lens)
  3. More light needed for functional activities
    • Less light reaching retina
  4. Reflected light/glare increase difficulty in ‘seeing’
  5. Decreased Visual acuity
    • Inability to see objects/foot placement
  6. Impaired colour discrimination ◦ Misinterpretation of changes in floor level
  7. Slow pupillary light reflex
    • Difficulty adapting to various levels of lightness/darkness
  8. Difficulty in depth perception
    • Altered perception of objects, their positions and movement in space (Eg. trying to cross the road, car coming towards –> unable to judge how car away the car is)
65
Q

What are 6 effects of ageing on Muscle Spindles & Articular Receptors (somatosensation)?

A
  1. Increased Capsular thickness
  2. Decreased No. intrafusal fibres
  3. Decreased Spindle diameter
  4. Modified myosin chains
  5. Altered distal sensory axons
  6. Decreased No. all joint receptor types
66
Q

What are 4 somatosensatory ( Muscle Spindles & Articular Receptors) clinical observations of ageing?

A
  1. Decreased Joint Position Sense (JPS) great toe
  2. Decreased JPS ankle (weight bearing & nonweight bearing)
  3. Decreased JPS knee (partial weight bearing)
  4. Decreased JPS in older adults with knee OA
67
Q

What are 4 somatosensatory (Muscle Spindles & Articular Receptors) functional implications of ageing?

A

BALANCE PROBLEMS

  1. Decreased Ability to detect position of body segments in space
  2. Decreased Sensitivity to rotation about ankle joint (postural sway- Use ankle strategy instead of hip strategy )
  3. Altered movement control in response to balance threats
  4. Decreased Postural control: Increased Risk of falls and related injury
68
Q

What are 2 effects of ageing on Cutaneous Receptors (sensosensation)?

A
  1. Pacinian Corpuscle:
    • Decreased Number
  2. Meissner’s Corpuscle:
    • Decreased Concentration
    • Decreased Size and number
69
Q

What are 3 somatosensatory (Cutaneous Receptors) clinical observations of ageing?

A
  1. Decreased Vibration threshold testing
  2. Decreased Monofilament testing
  3. Decreased 2-point discrimination testing (Decrease light touch sensation)
70
Q

What are 4 somatosensatory (Cutaneous Receptors) functional implications of ageing?

A
  1. Decreased Tactile information about supporting surface
  2. Decreased Ability to detect change in location of foot pressure
  3. Decreased Information to inform response to balance threats
  4. Decreased Postural control: Increased Risk of falls and related injury
71
Q

During sensory reweighting, older adults are prone to loss of balance. What are 2 scenarios?

A
  1. Unable to quickly select appropriate sensory cues when the sensory environment changes
  2. Unable to use alternative sensory information in the presence of sensory impairment
72
Q

During sensory reweighting, Sensory manipulation, what happens in healthy older adults?

A

Healthy older adults: unstable, 2 senses manipulated

73
Q

During sensory reweighting, Sensory manipulation, what happens in fall-prone older adults?

A

Fall-prone older adults: unstable, 1 sense manipulated

74
Q

What is the potential source of sensory reweighting?

A

◦ Degradation of ≥1 peripheral sensory systems ◦ Slowing of central processing mechanisms

75
Q

What age-related cognitive deficits could impact dual-task performance in older adults (cognitive ageing)?

A

Decreased Memory • Decreased Executive function • Decreased Processing speeds • Decreased Ability to share attention • Decreased Visuo-spatial awareness

76
Q

What are 2 effects of ageing on the endocrine system?

A
  1. Decreased Growth & reproductive hormones
  2. Thyroid function (Increased or decreased)
77
Q

What are 3 characteristics of a Decreased Growth & reproductive hormones (endocrine system) due to ageing?

A
  1. Decreased strength, bones, increased risk of OP
  2. Decline in target cell sensitivity
    • E.g. Diabetes
  3. Menopause & steroid use → OP
78
Q

What are 5 characteristics of a thyroid function- hypothyroidism (endocrine system) due to ageing?

A
  1. Hypothyroidism: Decreased attention, concentration, memory, language, perceptual & executive function
  2. Depression
  3. Muscle weakness, pain, cramps & stiffness
  4. Tiredness
  5. Unsteadiness
79
Q

What are 3 characteristics of vitamin D metabolism due to ageing?

A
  1. ↓ Muscle strength & bone mineralisation (↑ Risk of OP)
  2. ↓ Psychomotor function
  3. ↑ Postural sway (↑ Risk of falls/fractures)
80
Q

What are 3 characteristics of decreased innate and adaptive immunity due to ageing?

A
  1. ↑ Susceptibility to bacterial infection
  2. Chronic (low-grade) inflammatory state
  3. Prolonged healing times
81
Q

What is the difference between innate and adaptive immunity?

A

Innate: already in place

Adaptive: More cell specific –> comes in after innate defences are broken down

82
Q

What are 6 effects of the GIT due to ageing?

A
  1. Loss of teeth & decreased saliva
  2. Decreased Gastric contraction
  3. Decreased Pancreatic lipase
  4. Decreased Liver weight, glycogen, ascorbic acid
  5. Malnutrition
  6. Constipation
83
Q

What is the effect of loss of teeth and decreased saliva affect on the GIT due to ageing?

A

Preliminary digestion preparation

84
Q

What is the effect of decreased gastric contraction affect on the GIT due to ageing?

A

Delayed stomach emptying

85
Q

What is the effect of decreased pancreatic lipase on the GIT due to ageing?

A

Less effective fat absorption

86
Q

What is the effect of decreased liver weight, glycogen, ascorbic acid on the GIT due to ageing?

A

Decreased Protein synthesis (e.g. drugs)

87
Q

What is the effect of malnutrition on the GIT due to ageing?

A

Decreased Mobility, loss of appetite, anaemia, ↓ immunity

88
Q

What is the effect of constipationon the GIT due to ageing?

A

Decreased Muscle tone & weaker peristalsis of the colon

89
Q

What are 4 key aspects of geriatrics?

A
  1. Immobility
  2. Falls
  3. Incontinence
  4. Confusion

PHTY2230 (24 decks)

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