Lecture 3: The Older Adult

Question 1

What does aging mean?

Answer 1

the process of becoming older, a process that is genetically determined and environmentally modulated

Question 2

What is the physical stress theory?

Answer 2

a decline in homeostasis, if you don’t use it you’ll lose it

Question 3

What is successful aging?

Answer 3

able to maintain a high capacity to tolerate physiological stress

Question 4

At what age does aging start?

Answer 4

55 y/o, physiological changes begin

Question 5

What is “fun”?

Answer 5

can do anything you really want, as you age have to make modifications but usually not restricted in what you do

Question 6

What is “functional”?

Answer 6

can do all ADL’s but have limitations

Question 7

What is fraile?

Answer 7

can’t do all ADL’s but can do most Ex) sit down to shower

can’t meet all demands of daily life

Question 8

What is “failure”?

Answer 8

unable to keep up with all ADL

ex: can get up out of bed but may be confused or tired quickly

Question 9

What is major goal of PT in regards to four stages of aging?

Answer 9

goal is to keep pt’s as close to functional as possible as they age

Question 10

What are changes that happen with aging?

Answer 10

• decreased water in tissues, ROM, speed, reaction time, strength

increased insoluble collagen, increase in number of cross linked fibers (everything stiffer)

Question 11

What is important in regards to strength with aging?

Answer 11

you can always gain strength even at 100 y/o

Question 12

What are structural changes to heart?

Answer 12

increased, collagen, fat and wall thickness of myocardium and valves (bigger, thicker heart less efficient)

decreased max SV, CO and excitability

Question 13

What are electrical changes to heart?

Answer 13

decreased pace maker cells, HR max

no change in resting HR

increased cardiac dysrhythmia

Question 14

What happens because of an increased size of left ventricle?

Answer 14

less room for blood to fill during diastole, harder to transmit AP and less pacemaker cells

Question 15

What are some structural changes to the vasculature?

Answer 15

increased proximal vessels( lumen size), increased thickness distally, TPR

decreased elasticity, venous return(OTN)

Question 16

What does the increased distal thickness lead to?

Answer 16

increased pressure to get through distal vessels, if we all live long enough we would all have HTN

Question 17

What does diastolic BP do as we age?

Answer 17

rises then falls at age 60

Question 18

What are changes in pulmonary system?

Answer 18

increase size of alveoli, air flow resistance

destruction of capillary walls

decreaseO2 carrying blood vessels, functional cilia, elasticity of lung tissue, resp muscle strength

Question 19

Due to aging posture decreases what will this do to pulmonary function?

Answer 19

can’t increase Vt so they will raise RR

Question 20

What are changes in pulmonary function?

Answer 20

decreased VC (30-50%), FEV1, TLC, PaO2

increased RV, work of breathing

Question 21

What happens to oxygen saturation as you age?

Answer 21

normal 80-100 mmHG drops 1 mmHG every year after 60

during exercise may increase or stay the same

Question 22

What happens to RR at age of 85?

Answer 22

it increases slightly

Question 23

What are changes in aerobic capacity?

Answer 23

decreased oxygen uptake VO2 max, less efficient use of oxygen, decreased max HR and CO

Question 24

What is number 1 reason for CAD?

Answer 24

lack of exercise

Question 25

Before we exercise test what must we evaluate?

Answer 25

strength, balance, functional mobility, sensory information

Question 26

What is a standardized objective test?

Answer 26

a test that is administered and scored in a consistent or standard manner

Question 27

What 3 things must a standardized test follow?

Answer 27

1. valid and reliable
2. have established norms
3. allow us to compare results to norms, other pts, own pts performance

Question 28

What is a non-standerdized test?

Answer 28

gives significantly different tests to different test takers, or gives same test under different conditions

ex. ROM, MMT, fnx vital signs

Question 29

What are some objective measures that are not standardized?

Answer 29

functional mobility assessments- ambulation, transfer, bed mobility

subjective assesments- “foot is red”, “foot is hot”

• have to use these b/c life is not black and white

Question 30

What is the 6th vital sign?

Answer 30

gait speed

Question 31

What are general guidelines with older PTs in regards to intensity?

Answer 31

60-80% of max HR

50-70% in severely deconditioned

Question 32

What are goals for aerobic exercise in older patients?

Answer 32

150 mins of mod activity

75 min strenuous

20 min intervals

Question 33

What other components are important in a exercise routine?

Answer 33

strengthening, balance activities, functional mobility, EDUCATION