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Normal ageing process Flashcards

1
Q

Physiological reserve

A

The potential capacity of a cell, tissue or organ system to function beyond its basal level in response to alterations in physiologic demands

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2
Q

Homeostenosis

A

This is the progressive reduction in an individual’s capacity to maintain homeostasis as they age

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3
Q

T/F aging beings in utero

A

True

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4
Q

Morbidity

A

a diseased state, disability, or poor health due to any cause.

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5
Q

In regard to australia’s aging population, it is estimated that by 2050…

A

the proportion of the population over 65 will increase by 25%
(8,975,000)

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6
Q

What percentage of Australia’s total population in 2020 were aged 65 and over?

A

16%.
(4.2 million)

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7
Q

Trends in the number of older people (65+) in any area are a function of which demographic processes:

A
  • Fertility – the rate at which women in that area were having children 65-90 years ago.
  • Mortality – the rate at which older people are lost to death.
  • Migration – the extent to which older people move into or out of the area.
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8
Q

When did australia’s fertilitaty rate increase between 1901-2012?

A

1950-1960
Post war baby boom

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9
Q

The median age (years) for long term condition demenita

A

83

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10
Q

The median age (years) for long term condition heart disease

A

72

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11
Q

The australian burden of statistics census in 2021 found which long term health condition to have the highest proportion per total population %

A

Arthritis- increasing after 50

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12
Q

What were the top 4 disease rankings by total burden in 2022 by the australian burden of disease study?

A
  1. Coronary heart disease
  2. Dementia
  3. Back pain/problems
  4. COPD
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13
Q

Disability

A

is any condition that makes it more difficult for a person to do certain
activities or effectively interact with the world around them (socially or materially

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14
Q

In 2018, 1 in 9 (11.6%) aged 0-64 had disability. In older australias (65+ years), the prevalence of disability was…

A

Almost 1 in 2

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15
Q

The average life expectancy for indigeonous people born between 1996 and 2001 (M & F)

A

M- 59.4
F- 64.8

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16
Q

Most prevalent long-term health conditions among older Indigenous Australians in 2004–05 were?

A
  • **eye/sight problems **(89%),
  • heart and circulatory problems/diseases (61%),
  • arthritis (49%)
  • diabetes/high sugar levels (36%).
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17
Q

Normal aging within the brain and nervous system

A
  • Decreased brain weight
  • Loss of gray matter
  • ventricle sizes can increase
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18
Q

Normal aging within the Senses

A
  • Presbyopia (far-sightedness)
  • Presbycusis (hearing loss)
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19
Q

Normal aging within - Vestibular function

A
  • Loss of hair cells
  • Decline in vestibular sensitivity
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20
Q

Normal aging for strength

A
  • Loss of lean body mass/skeletal muscle
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21
Q

Males decrease bone mass with age, in women what in particular contributes to bone loss?

A

menopause

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22
Q

Conditions that contribute to a general deterioration in function:

A
  • Vision – glaucoma; atherosclerosis
  • Vestibular – drug toxicity; Meniere’s Disease
  • Peripheral sensation – neuropathy (Diabetes)
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23
Q

Conditions causing marked changes in function:

A
  • Alzheimer’s Disease
  • Stroke
  • Parkinson’s Disease
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24
Q

Theories on ageing:
The immune theory

A

Breakdown in the immune system leads to a greater risk of disease and cancer.

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25
Q

Theories on ageing: Progressive decline model

A

Longer we live = more wear and tear

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26
Q

Biological clock model

A

Aging is directed by biological time and, specifically, cell replication

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27
Q

Cardiovascular (CV) system: Structural changes:

A
  • Decreased elastin, increase collagen levels = vessel membrane thickens resulting in arterial stiffness
  • Decreased myocardial cells
  • LV wall thickens, atria size increases = resulting in increase heart weight
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28
Q

What heart chamber increases in size, and which thickens during ageing?

A

Atria increase
left ventricle thickens

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29
Q

Functional changes to the heart from ageing

A

slightly less able to tolerate an increased workload due to the changes from aging that reduce the extra pumping ability.

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30
Q

Does ageing affect the brain talking to the heart?

A
  • Decreased response to catecholamines
  • Diminished cardiac output with exercise
  • Decreased blood flow to brain, heart, kidney, liver.
  • Slower adaptation to change in activity
  • Conditioning takes longer
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31
Q

Whilst diastolic remains the same, systolic pressure may increase with ageing. It is thought to be due to…

A

thickening arterial wall.

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32
Q

Postural hypotension in elderly is due to…

A

Decreased baroreceptor sensitivity

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33
Q

The prevalence of baroreflex sensitivity to low blood volume & cardiac output decreases with age. If the baroreceptors are not triggered to normative blood pressure, what might an individual experienced?

A

dizziness, syncope, and falls.

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34
Q

Which added heart sounds are normal and abnormal?

A

S3- is abnormal in elderly, but normal in under 40. Results from increased atrial pressure leading to increased flow rates.

S4- normal in elderly. Heart relies on atrial contraction to compensate for diminished LV filling and stiffness. Can be heard
in athletes and healthy children.

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35
Q

Which is the most common cause of S3?

A

Congestive heart failure

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36
Q

sarcopenia

A

loss of muscle tissue as a natural part of aging process

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37
Q

Disengagement social theory on ageing

A

relationship between aging person and society has changed.

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38
Q

Decreased blood flow around the body, the first thing that is generally effected?

A

extremities

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39
Q

Within 3 minutes of standing, what happens to blood pressure?

A

systolic BP drop >20mm Hg
or diastolic BP drop of >10mm Hg

40
Q

What condition is the most chronic cause of chronic leg edema?

A

Chronic venous insufficiency CVI

41
Q

How can Chronic venous insufficiency (CVI) symptoms be alleviated?

A

support stockings, exercise, elevation of legs and good diet (reduce salt)

42
Q

If a patient has acute onset of unilateral leg oedema what should you be suspicious of?

A

DVT

43
Q

In young populations, acute MI typically presents with crushing chest pain and diaphoresis. How can acute MI in elderly patients present?

A

Sometimes dyspnea accompanied by anxiety and confusion

44
Q

Typical structural changes to lungs with ageing

A
  • muscle atrophy and rigidity
  • thick membranes, alveoli, capillary
  • alveolar duct size increases (decrease surface area)
  • mucous increases (cells increase)
  • cilia activity decreases (decline in cilia)
45
Q

Aging affects on the functions of the respiratory system

A
  • compliance
  • lung volume
  • air flow
  • diffussing capacity
  • other lung parameters of function
46
Q

How does a decline in cilia and an increase in mucous producing cells affect the elderly?

A

Increased mucous obstructing airways, makes them more vulnerable to infections

47
Q

A decreased ability to breath due to wall stiffness and decrease lung elastic recoil affects the ability to cough. What affect might this have on older adults?

A

Less aware of bronchoconstriction and are less sensitive to hypoxia. At greater risk for mortality from acute respiratory problems

48
Q

Oesophagus changes

A

Upper sphincter tension decreases (doesn’t have effect)

Reflux is just as prevalent as the younger population.

Drugs can cause injury; higher risk due to delayed transit

49
Q

Stomach changes

A

modest slowing of gastric emptying
achlorhydria
Atrophic gastritis is a stomach disorder

50
Q

Liver changes

A

reduced BF to liver, diminished capacity to regenerate cells
ability to withstand stress decreases-> substances to toxicity is more sensitive

51
Q

Pancreas changes

A

Decrease in overall weight, duct hyperplasia, and lobular fibrosis.

Higher risk of glucose intolerance and type 2 diabetes ( less insulin secretion and insulin resistance increasing)

52
Q

Intestine changes

A
  • prevalence of diverticulosis increases (prevented with high fibre)
  • less lactase from SI
  • excessive growth of bacteria
  • rectum enlarges somewhat
53
Q

Absorption of B12 requires

A
  1. adequate amounts of gastric acid
  2. pepsin enzyme
  3. intrinsic factor
54
Q

GU system changes

A

and size of nephrons decrease

  • kidney BF decreases 10% per decade.
  • number and size of nephrons decrease
  • kidney looses mass.
  • all changes reduce filtration rate from kidneys
55
Q

What effects the ability to control urination

A
  1. Normal anatomy
  2. Normal Nervous System
  3. Recognise and respond
56
Q

Prevalence of incontinence

A

> 60 yo 15-35%

57
Q

How does incontinence affect elderly?

A

-Extreme activity limitation and social isolation.
-Increases fall risks due to urgency.

58
Q

types of incontinence

A

Overflow
Stress
Urge

59
Q

Overflow incontinence

A

Urethral blockage
bladder unable to empty properly

60
Q

stress incontinence

A

relax pelvic floor
increased abdominal pressure

61
Q

urge incontinence

A

bladder oversensitivty from infection
neurologic disorders

62
Q

What is the most common type of incontinence in women?

A

Stress incontinence

63
Q

Overactive bladder is another name for

A

Urge incontinence

64
Q

Which incontinence is rare in women and more common in men?

A

overflow incontinence
(hx of prostate surgery/issues)

65
Q

How does menopause affect bones? How to manage?

A

Rapid loss due to oestrogen withdrawal.
Replacement therapy (doesn’t effect symptoms of menopause)

66
Q

Andropause

A

Gradual decline in testosterone.
Features can include loss of muscle, fatigue, depression, anaemia, poor libido.

67
Q

The decrease GH secretion leads to

A
  • reduction of protein synthesis
  • decrease in lean body/bone mass
  • decline in immune function.
68
Q

Common symptoms of menopause

A

hotflushes, hotskin, sweating, increase heart rate

69
Q

Hot flushes can last

A

2 minutes to half an hour, may occur through day or several times a week

70
Q

Hot flushes is preceded by a

A

surge in LH

71
Q

Regarding the GU system, oestrogen deprivation may lead to?

A

dysuria, urinary frequency and incontience.

72
Q

oss i

Oestrogen deprivation in postmenopausal women can cause, and why?

A

loss of libido (ovarin function stopping)

73
Q

Somatopause

A

the progressive decline in GH secretion

74
Q

GH hormone on peripheral tissue is mediated by

A

IGF-I

75
Q

What happens to GH and IFG-I concentrations with ageing?

A

decline by 50% in healthy older adults.

76
Q

Adrenopause

A

age-related change in adrenal cortex - decreases DHEA biosynthesis (steroid hormone) - by 80 levels are ~ 20%

77
Q

Function of DHEA?

A

steroid hormone; acts directly as neurosteroid to cardioprotective, antidiabetic, anti obesity and enhance immune properties.

78
Q

Changes to skin in elderly

A

thinner epidermis and flatter basement membrane.
fewer langerhans cells.
dermal blood supply diminised
decreases collagen and elastin in dermis

79
Q

Hair changes
and nail changes

A

hair loss, coarse changes.
dry brittle nails

80
Q

An patient with hair loss should be distinguished from diffuse hair loss due to?

A
  • iron deficiency
  • hypothyroidism
  • chronic renal failure
  • undernutrition
  • certain drugs
81
Q

Difference between fast bone loss and slow bone loss

A

Slow bone loss is normal from ageing that affects equal sexes.

fast bone loss is a transient/more rapid, occuring approx 35% of early postmenopausal women and some men who develop hypoonadism.

82
Q

At what age is the average peak bone mass?

A

~ 30

83
Q

What type of bone does menopause affect?

A

trabecular

84
Q

Benefits for physical activity for elderly

A
  • acrobatic activity involves motor learning
  • stimulating environments
  • cognitive challenges
  • aerobic activity
85
Q

What is the most common sensory change in older adults?

A

vision

86
Q

What are vision changes seen in older adults/

A
  • hardening of lens reduce ciliary body effect
  • discolourated cornea lens: yellow tint to the visual field
  • alterered colour perception
  • decrease night vision
  • decrease contrast
  • light adaptation (less light into eyes)
87
Q

Presbycusis

A

age-related , gradual, bilateral, symmetric, and predominaty high frequency hearing deficits

88
Q

Changes to ear from ageing

A
  • thinning of canal
  • obstruction of canal
  • thicken tympanic membrane less responsive
  • cochlear function ( loss of hair stiffness, calfication, neuron loss)
  • atrophic changes in the temporal auditory cortex
89
Q

Changes to taste and smell from ageing is due to?

A

Reduction in the olfactory receptors.

90
Q

Anosmia

A

complete loss of smell and taste

91
Q

Age related deficits in nasal function can adversely affect?

A

affect sleep, eating, and breathing, and significantly alter patient quality of life.

92
Q

Changes to touch in ageing

A
  • There is a decrease in the number of skin receptors, particularly free nerve
    endings and Pacinian corpuscles, resulting in elevated detection thresholds and a slower stimuli-response reaction.
  • Other changes include physical properties of skin and PSN and CNS systems that result from reduced blood supply to neurons.
93
Q

Benefits of exercise in older adults on cardiovascular?

A
  • VO2 max and cardiac output
    improves
  • Improves blood pressure
  • Decreased risk of CAD
94
Q

Benefits of exercise for Diabetes Mellitus Type 2 –

A
  • Improves glycaemic control
  • Improves insulin sensitivity
95
Q

Benefits of exercise in older adults on osteoporosis

A
  • Moderates bone density loss
  • Reduces risks of falling
96
Q

Benefits of exercise in older adults on Osteoarthritis

A
  • Improves functional capacity
  • Reduces pain
97
Q

Benefits of exercise in older adults on Neuropsychologic health

A
  • Improves sleep
  • Improves cognitive function

Exam theory (9 decks)

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