Module 10: Geriatrics

Question 1

How many old people are there in the US?

Answer 1

37 Million, expected to reach 86 million by 2050.

Question 2

What is the expected life span for men and women?

Answer 2

Men: 74 years old
Women: 79 years old

Question 3

What is the “demographic imperative”?

Answer 3

To maximize not only the life span but also the “health span”. Just as long as it isn’t c-span

Question 4

What does frailty have to do with older people?

Answer 4

NOTHING…it’s a common myth about aging.

Question 5

What is primary aging?

Answer 5

Changes in physiologic reserves over time that are independent of and not induced by any disease. Emerge during periods of stress, fluctuating temperatures, dehydration, and shock.

Question 6

What impairs an older person’s response to heat?

Answer 6

Decreased cutaneous vasoconstriction and sweat production.

Question 7

What is optimal aging?

Answer 7

It occurs in those people who escape debilitating disease entirely and maintain healthy lives late into their 80’s and 90’s. Genes have to do with 20% of it and healthy lifestyle 20-30% of it.

Question 8

What happens with BP as you age?

Answer 8

Systolic BP tends to rise from childhood through adulthood. The arteries stiffen from atherosclerosis. The aorta becomes less distensible, a given stroke col. causes a greater rise in SBP. Systolic hypertension with a widen pulse pressure often occurs. Diastolic BP stops rising at approx. the 6th decade . Orthostatic Hypotension can occur.

Question 9

Does an old person’s resting heart rate change?

Answer 9

No BUT pacemaker cells decline in the SA node and so does maximal heat rate.

Question 10

What about respiratory rate?

Answer 10

No change.

Question 11

What happens with your skin?

Answer 11

Wrinkles and looses turgor. Since the vascularity of the dermis decreases, your skin becomes pale and more opaque. You can develop purple patches/macules called actinic purpura, that fade over time. These spots coe from leaky, weakly supported capillaries.

Question 12

Nails?

Answer 12

Loose luster and yellow and thicken.

Question 13

Hair? I am starting to get depressed here and feel like I need a facelift.

Answer 13

Hair looses pigment, hair loss is genetically determined though! A man’s hairline may start to recede at temples and loss at vertex follows. Scalp hairs decrease in both sexes and diameter of hair decreases.

Question 14

Hair on the rest of the body?

Answer 14

We start to lose hair on the trunk, pubic areas, axillae, and limbs.

Question 15

What are some changes in the eyes/head?

Answer 15

• Atrophy of fat around eyes.
• Eyelids wrinkle
• Fewer lacrimal secretions sooo… c/o dry eyes.
• Corneas lose some of their luster.
• Pupils decrease and can become irregular.

Question 16

What happens to visual acuity?

Answer 16

• Stays constant for 20-50 years.
• Most elderly maintain good vision.
• Near vision blurs
• Lens loses its elasticity and the eye can’t accommodate and focus on nearby objects

Question 17

What is presbyopia?

Answer 17

Lens loses its ability to focus.

Question 18

What increases with age?

Answer 18

-Risk for cataracts, glaucoma, and macular degeneration.

Question 19

How many people does elder abuse affect in the US?

Answer 19

1.2 MILLION. Only 1 in 10 cases are reported.

Question 20

What is EAI?

Answer 20

Elder Assessment Instrument is a 41 item Likert scale. It is made up of seven sections that reviews signs, symptoms and subjective complaints of elder abuse, neglect, exploitation and abandonment.

Question 21

When should you report elder abuse to social services?

Answer 21

• If there is any evidence of mistreatment without sufficient clinical explanation.
• Whenever there is a subjective complaint by the elder of EM.
• Whenever the clinician believes there is a high risk or probable abuse, neglect, exploitation, abandonment.

Question 22

What are the strengths of the EAI?

Answer 22

-Its rapid assessment capacity (the instrument takes approximately 12-15 minutes) and the way that it sensitizes the clinician to screening for elder mistreatment.

Question 23

What are the weaknesses of the EAI?

Answer 23

No scoring system and weak specificity.

Question 24

Are geriatric patient’s sexually active?

Answer 24

YEP!! Don’t assume they are not!

Question 25

Does sexual interaction necessarily mean sexual intercourse?

Answer 25

NOPE.. Those dentures come out for a reason! ;-)

Question 26

Who often initiates sex?

Answer 26

Elderly women.

Question 27

The female sexual response consists in what three phases?

Answer 27

Arousal, orgasm, and resolution.

Question 28

What happens during sexual arousal in women?

Answer 28

Vasocongestion of the genitals. The clitoris and labia minora become engorged with blood and vaginal and clitoral length and diameter increase.

Question 29

How long is a woman’s libido maintained?

Answer 29

Until quite late in the aging process.

Question 30

What happens with aging in women?

Answer 30

• delayed or diminished vaginal lubrication and vasocongestion
• diminished frequency of contraction of the vagin
• decreased frequency of orgasm

Question 31

T or F: It is not certain if estrogen replacement therapy improves sexual function in women.

Answer 31

True.