Lecture 4 - Ageing And The Body Flashcards
What are the 2 types of ageing?
Intrinsic and extrinsic
What are some causes of intrinsic ageing?
Chroniclogical ageing
Biochemical degenerative process
Cortisol and hormone levels
DNA damage
Telomere shortening
Oxidative stress
What are some causes of extrinsic ageing?
Biochemical process
Environmental
Mechanical
Lifestyle
Behaviour
What generally happens to the skin as you age?
Progressive structural and functional degeneration
What structural changes occur in the skin with aging?
Atrophy of epidermis
Destruction of dermal-epidermal junction on
Dermis thickens decreases (colllegn fragmentation and elastin degradation)
What is the function of telomeres?
Sections of DNA at the end of chromosomes which help protect the DNA from ROS and mutations
What respiratory changes occur with aging?
Reduced chest wall compliance (changes in lung volumes)
Structure of lungs:
Reduced lung compliance
Senile hyperinflation
Infection susceptibility
Gas exchange more impaired
Medications
What are the likely lung volumes that are going to change with ageing?
Increased RESIDUAL VOLUME
Increased FUNCTIONAL RESIDUAL CAPACITY
Reduced VITAL CAPACITY
What is seen on slide 11, image with asterisk?
Senile purpura
What can lead to the reduced chest wall compliance with age?
Calcification of costal ligaments
Reduced vertebral height
What is senile hyperinflation?
Loss of supporting tissue in the lungs like elastin
Why do old patient is have increased respiratory infection susceptibility?
Reduced alveolar macrophages
What are some structural changes expected to see in the heart with ageing (Cardiovasucalr)?
Ventricular hypertrophy
Interventricular septal hypertrophy
Sympathetic innervation
Aortic sclerosis
What are some functional changes expected to see in the heart with ageing (Cardiovasucalr)?
Diastolic dysfunction
Decreased CO
Dec max HR
Inc cardiac workload
Baroreceptor response
What are some electrophysiological CVS changes with ageing?
SAN atrophy
AP prolongation due to L type Calcium Channels taking longer to deactivate
What are some vascular changes with ageing?
Large arteries dilate
Arterial walls thicken
Dec arterial compliance
Endothelial vasodilation impaired
What are some renal changes with ageing?
Dec vol and weight of kidneys
Decline in total of glomeruli per kidney (REDUCED GFR)
Drug interactions
Tubular function decline (reduced glucose thereshold)
Urinary incontinence
BPH
Comorbidities that can affect kidneys (diabetic nephropathy, hypertensive nephropathy)
What are some changes to the oesophagus (GI) during ageing?
Decreased peristalsis
Delayed transit time
Decreased relaxation of lower oesophageal sphincter on swelling
What are some changes to the stomach (GI) during ageing?
Atrophic gastritis (loss of gastric glands in stomach)
Predisposes to gastric malignancy
What are some changes to the liver and biliary tract (GI) during ageing?
Atrophy (loss of mass and volume)
Means need to consider reducing doses offf drugs for olde patients
What are some changes to the colon (GI) during ageing?
Decreased intestinal motility (inc risk of constipation since more water removed)
Diverticulosis
What is diverticulosis?
The presence of diverticula which are outpouchings of the large intestine
What is diverticulitis?
Infection/inflammation of the diverticula
What are some changes to the brain (neurology) during ageing?
Brain shrinks (areas related to learning and complex metal activities)
Reduced brain volume (inc risk of subarachnoid haemorrhage)
Neuronal density reduces
What 4 structural changes occur to the brain during ageing?
Ventricular enlargement
Cortical thinnning
Volume loss
Sulcal widening
What are the 4 main types of dementia?
Alzheimer’s
Vascular
Fronto-temporal
Lewy body
How May considering renal and liver function of an elderly patient influence drug prescribing?
Reduce renal and liver function means reduced rate of durg excretion so lower dose needed
What is malnutrion?
State of nutrition in which a definciyt or excess of energy, protein and other nutrients that cause measurable adverse effects on tissue/body form, function and clinical outcome
What are the consequences of malnutrion?
Impaired immune response
Reduced muscle strength
Inactivity (bed bound inc risk of pressure sores)
Impaired wound healing
Loss of temperature regulation
Impaired psycho-social function
What is the MUST score?
Identifies adults that are underweight/overweight at the risk of malnourishment to help decide if they’d benefit from nutritional intervention
What does the MUST score consider?
Height
Weight
Weight loss
Effect of acute disease
