Normal ageing, cognitive decline, dementia and nutrition Flashcards

1
Q

What changes happen to the respiratory system in ageing?

A
  • Decrease in lung and chest wall compliance → causes decreased total lung capacity, forced vital capacity, FEV1 and vital capacity
  • Changes occur due to reduced elastic support → collpase of alveoli and terminal conducting airways
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2
Q

What respiratory problems are more common in the elderly?

A
  • Atelectasis
  • Pulmonary emboli
  • Pneumonia
  • Chance of all of this is increased if a smoker, chronic chest disease or undergoing abdominal/ thoracic surgery
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3
Q

Why is obstructive sleep apnoea more common in the elderly?

A
  • Loss of elastic tissue around the oropharynx leads to collapse of the upper airways
  • Sleep or sedative states may result in complete or partial obstruction of the airway
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4
Q

What changes to pharmacokinetics occur in the elderly?

A
  • Increased sensitivity to CNS depressants
  • Decreased hepatic and renal function- GFR decreases 1% with each year of age
  • Decreased total body water and increased adipose levels alters Vd
  • Decreased plasma protein binding causes increased drug availability
  • Must start doses low and raise them with caution
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5
Q

What changes occur to skin in ageing?

A
  • Skin thins
  • Subcutaneous blood vessles more fragile → easy bruising
  • Reduced collagen → sagging skin
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6
Q

What can extensive bruising be a sign of?

A

Hepatic issue/ medication problems

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7
Q

What happens to the peripheral vasculature of cardiovascular system in ageing?

A
  • Large and medium sized vessles become less elastic and therefore become less compliant
  • Causes raised systetmic vascular resistance and hypertension → in turn leads to left ventricular strain and left ventricular hypertrophy
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8
Q

What changes happent to the heart itself during ageing?

A
  • Reduction in number of cardiac conducting cells
    • heart block, ectopic beats, arrhythmias and atrial fibrillation more prevelent
  • Cardiac output reduced (30%) in patients with AF
  • CO reduces by 3% per decade due to reduced SV and contractility
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9
Q

Why is intravenous anaesthesia achieved more slowly in the elderly?

A

Due to the reduction in cardiac output with age means that arm-brain circulation time for drugs is reduced

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10
Q

What changes occur in the renal system with age?

A
  • GFR decreases 1% each year
  • Decrease in renal cortical glomeruli
  • Increase in hyaline and sclerotic glomeruli
  • Reduction in renal perfusion secondary to reduced cardiac output and atheromatous vascular disease
  • Diabetes mellitus increasingly common
  • NSAIds and ACEi are more nephrotoxic
  • Prostatism in males can cause obstructive nephropathy
  • Dehydration common
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11
Q

What happens to the CNS during ageing?

A
  • Cerebrovascular disease common due to diffuse atherosclerosis and hypertension
  • Neuronal density is reduced by 30% by age 80 → global cerebral atrophy
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12
Q

What happens to basal metabolic rate with aging and what is the consequence of this?

A
  • Decreases by 1% per year after age 30
  • Fall in metabolic activity and reduced muscle mass cause impaired thermoregulation
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13
Q

How many people in the UK are projected with be living with dementia by 2021?

A

1 million

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14
Q

What is malnutrition?

A

Any condition caused by an inbalance between whats eaten and what is required to maintain health

Either eating too little or too much

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15
Q

How many older people in the UK are suffering or are at risk of malnutrition?

A

1 in 10

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16
Q

What is the impact in malnutrition in the elderly?

A
  • Likely to have longer hospital admissions
  • Respond less well to treatment
  • 3x more likely to develop complications after surgery
  • High mortality rate
  • 40% of patients are malnourished on hospital admission
17
Q

What tool do UHL use to screen for malnutrition?

A

The MUST tool

(Malnutrition Universal Screening Tool)