Lecture 3: The Older Adult Flashcards
What does aging mean?
the process of becoming older, a process that is genetically determined and environmentally modulated
What is the physical stress theory?
a decline in homeostasis, if you don’t use it you’ll lose it
What is successful aging?
able to maintain a high capacity to tolerate physiological stress
At what age does aging start?
55 y/o, physiological changes begin
What is “fun”?
can do anything you really want, as you age have to make modifications but usually not restricted in what you do
What is “functional”?
can do all ADL’s but have limitations
What is fraile?
can’t do all ADL’s but can do most Ex) sit down to shower
can’t meet all demands of daily life
What is “failure”?
unable to keep up with all ADL
ex: can get up out of bed but may be confused or tired quickly
What is major goal of PT in regards to four stages of aging?
goal is to keep pt’s as close to functional as possible as they age
What are changes that happen with aging?
- decreased water in tissues, ROM, speed, reaction time, strength
increased insoluble collagen, increase in number of cross linked fibers (everything stiffer)
What is important in regards to strength with aging?
you can always gain strength even at 100 y/o
What are structural changes to heart?
increased, collagen, fat and wall thickness of myocardium and valves (bigger, thicker heart less efficient)
decreased max SV, CO and excitability
What are electrical changes to heart?
decreased pace maker cells, HR max
no change in resting HR
increased cardiac dysrhythmia
What happens because of an increased size of left ventricle?
less room for blood to fill during diastole, harder to transmit AP and less pacemaker cells
What are some structural changes to the vasculature?
increased proximal vessels( lumen size), increased thickness distally, TPR
decreased elasticity, venous return(OTN)
What does the increased distal thickness lead to?
increased pressure to get through distal vessels, if we all live long enough we would all have HTN
What does diastolic BP do as we age?
rises then falls at age 60
What are changes in pulmonary system?
increase size of alveoli, air flow resistance
destruction of capillary walls
decreaseO2 carrying blood vessels, functional cilia, elasticity of lung tissue, resp muscle strength
Due to aging posture decreases what will this do to pulmonary function?
can’t increase Vt so they will raise RR
What are changes in pulmonary function?
decreased VC (30-50%), FEV1, TLC, PaO2
increased RV, work of breathing
What happens to oxygen saturation as you age?
normal 80-100 mmHG drops 1 mmHG every year after 60
during exercise may increase or stay the same
What happens to RR at age of 85?
it increases slightly
What are changes in aerobic capacity?
decreased oxygen uptake VO2 max, less efficient use of oxygen, decreased max HR and CO
What is number 1 reason for CAD?
lack of exercise
Before we exercise test what must we evaluate?
strength, balance, functional mobility, sensory information
What is a standardized objective test?
a test that is administered and scored in a consistent or standard manner
What 3 things must a standardized test follow?
- valid and reliable
- have established norms
- allow us to compare results to norms, other pts, own pts performance
What is a non-standerdized test?
gives significantly different tests to different test takers, or gives same test under different conditions
ex. ROM, MMT, fnx vital signs
What are some objective measures that are not standardized?
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
What is the 6th vital sign?
gait speed
What are general guidelines with older PTs in regards to intensity?
60-80% of max HR
50-70% in severely deconditioned
What are goals for aerobic exercise in older patients?
150 mins of mod activity
75 min strenuous
20 min intervals
What other components are important in a exercise routine?
strengthening, balance activities, functional mobility, EDUCATION
