Lecture 8.23.16 - Elderly Development Flashcards
The number of people over age ___ is increasing greatly.
65
Between 2000 and 2050, the number of older people is projected to increase by ___%.
135%
The population aged 85 and over is projected to increase by ___%.
350%
What are the two major reasons for the increased elderly population?
- Reduced death rates for children and young adults
2. Reduced death rates for the population aged 65-84
What are the consequences of the increased elderly population?
- Economic: fewer people supporting more people
- Social/Political: prioritizing resources
- Healthcare: chronic disease rather than acute illness, workforce issues, long term care
True or false - aging is a disease.
False - aging is a normal and inevitable process.
What are the physical changes to the skin that occur during aging?
- Hair thinning and greying
- Wrinkles due to decreased elasticity and decreased subdermal fat
- More fragile and injury-prone
- Less effective barrier against infection and UV light
- Decreased sweat and sebaceous gland activity leads to dryer skin
- Decreased sensitivity to touch and vibration - can be injured more easily
What are the physical changes to vision that occur during aging?
- Iris more rigid, lens more elastic, leads to presbyopia (difficulty focusing on near objects)
- Pupil smaller and less responsive, more sensitive to glare, harder to adjust to changes
- Decreased sensitivity of retinal cell, less sensitive to contrasts in color
- Dry eyes
- Decreased visual acuity and peripheral vision - implications for driving
What is difficulty focusing on near objects?
Presbyopia
What are the physical changes in hearing that occur during aging?
- Difficulty with higher frequencies
- Difficulty with speech discrimination
- May interfere with communication and contribute to isolation
- May interfere with medical care
- Risk factor for delirium and dementia
What are the physical changes to taste and smell that occur during aging?
- Decreased sensitivity
- May not detect dangerous odors
- Decreased appetite and pleasure in food
- Increased use of salt and sugar
What are the physical changes to the hematopoietic system that occur during aging?
- Loss of bone marrow mass and increase in fat
- Marrow is less responsive to changes like hypoxia or blood loss
- Platelets are less responsive and increased clotting factors (pro-coagulant state)
- Impaired functioning of some white cells leads to a decline in immune function and increases in infection, cancer, and autoimmune disease
What are the physical changes to the GI system that occur during aging?
- Increased risk for tooth decay, potential for malnutrition
- Changes in esophageal muscle and peristalsis, leading to increased reflux
- Altered colon mobility, leading to constipation, diverticulosis
- Decreased liver mass, hepatic blood flow, P450, leads to slowed hepatic metabolism, can affect medications
What are the physical changes to the renal system that occur during aging?
-Decreased renal mass, blood flow, and function, leading to decreased creatinine clearance, can influence medications
What are the physical changes to the cardiovascular system that occur during aging?
- Left ventricular hypertrophy
- Stiffening of large arteries
- Decrease in heart rate and blood pressure variability
- Decrease in intrinsic heart rate and maximum heart rate
- Increase in cardiovascular disease states like coronary artery disease and hypertension
What are the physical changes to the respiratory system that occur during aging?
- Chest wall thickening and decreased compliance
- Decreased surface area for gas exchange, decreased arterial oxygenation, decreased functional reserve
- Reduced effectiveness of cough and mucociliary clearance
- Predisposed to hypoxia and pneumonia
What are the physical changes to the GU system that occur during aging?
- Decreased detrusor contractility, bladder capacitiy, flow rate, increased rates of incontinence
- Changes in urethra related to decreased estrogen (predispose women to UTI)
- Vaginal atrophy and dryness related to decreased estrogen (influence sexual function in women)
- Decreased sperm count and motility, prostate enlargement, more difficulty with erectile function in men
What are the physical changes to the musculoskeletal system that occur during aging?
- Decreased muscle mass, increased body fat, leads to changes in mobility and balance, contributes to insulin resistance, changes volume of distribution for drugs
- Decreased bone mass leads to increased risk for fracture
What are the cognitive changes that occur during aging?
- Slowed information processing
- More difficulty with divided attention and switching tasks (implications for driving)
- Able to sustain attention
- Speech and language processing largely intact, discourse skills may improve
What are the memory changes that occur during aging?
- Decine in working memory
- Impairments in episodic memory (encoding, storage, retrieval)
- Semantic, autobiographical, and procedural memory generally preserved
True or false - basic personality traits stay stable with age.
True
Heinz Kohut felt older adults have to deal with ___ injuries as they adapt to physical, psychological, and social losses.
Narcissistic
Erikson viewed psychosocial development as continuing…
…over the course of a lifespan.
What are some of the mental health issues involved in aging?
Grief/bereavement, anxiety (most common in elderly), depression, substance abuse, suicide
True or false - depression is a normal part of aging.
False
___% of older adults experience significant depressive symtpoms.
8-20%
___ is more common with some medical illnesses and affects overall mortality.
Depression
Up to ___% of older adults abuse substances.
17%
Those over age 65 with moderate to heavy alcohol use are ___ times more likely to die by suicide.
16
Which age group has the highest suicide rate?
Adults 65 and older
What are the 7 risk factors for suicide?
Male, caucasian, medical or mental illness, substance abuse, prior attempt, isolation, access to lethal means
Successful aging involves shifting away from conversations about ___ and ___.
Pathology; decline
Define successful aging according to Rowe and Kahn.
Freedom from disease and disability, high levels of physical and cognitive functioning, and ongoing social and productive engagement
