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Growth and Metabolism > Older adults - clinical aspects > Flashcards

Older adults - clinical aspects Flashcards

1
Q

In the 19th century, what was the retirement age?

A

70 years (then 65 years)

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2
Q

What are the exogenous causes of ageing?

A
  • sunlight
  • ionizing radiation
  • cigarette smoke
  • alcohol
  • drugs oxidation
  • iron overload
  • air pollution (O3, NOx)
  • xenobiotica (mycotoxins, paraquat)
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3
Q

What are the endogenous causes of ageing?

A
  • electron transport chain (mitochondria)
  • enzymatic reactions (xanthine oxidase, NADPH oxidase, cytochrome c P450, d-amino acid oxidase)
  • metal catalyst redox reactions (Haber weiss cycle, fenton reaction)
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4
Q

What is health?

A

a state of complex physical, mental and social well being and not merely the absense of disease

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5
Q

What is healthy ageing?

A

the process of developing and maintaining the functional ability that enables wellbeing in older age

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6
Q

What is successful ageing as defined by Rowe and Kahn?

A
  • avoiding disease
  • engagement in life
  • maintaining high cognitive physical functioning
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7
Q

Name the neurological aspects of ageing:

A
  • cortical problems
  • reset pathways
  • dyspraxia/motor planning
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8
Q

Name the muscle/supporting structure situations in ageing:

A
  • reduced tongue strength
  • teeth
  • muscle strength/sarcopenia
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9
Q

What are some devices to aid the outcomes of ageing?

A
  • dentures (teeth)

- nasogastric tubes

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10
Q

Name all the possible outcomes of ageing:

A
  • reduced physical activity/metabolic rate
  • reduced LBM, bone mass, body water
  • increased body fat/redistribution
  • reduced hunger, energy efficiency
  • increased satiation and food specific satiety
  • less efficient taste memory, decline in sensory effectiveness (visual, taste, smell)
  • reduced proprioception tongue and lips
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11
Q

What is frailty as described by Li, 2012?

A
  • multisystem dysregulation
  • decreased physiological reserve
  • heightened inflammatory state
  • immune dysregulation
  • loss of complexity in resting dynamics and maladaptive response to stressors
  • raised IL-6
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12
Q

What is frailty as described by Fried, 2003?

A
  • weight loss
  • exhaustion
  • low energy expenditure
  • reduced muscle strength
  • slow walking (TUG)
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13
Q

What is sarcopenia?

A
  • loss of muscle mass and quality with age
  • contractility decrease more than mass
  • change in muscle balance, catabolism > anabolism
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14
Q

What is the % reduction of contractility as age reduces?

A

33%

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15
Q

What is the % of sarcopenia in those above 80years?

A

50%

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16
Q

In sarcopenia state, what increases protein synthesis?

A

amino acid gradient

17
Q

What is immune modulation?

A
  • impaired glucocorticoid/catecholamine feedback
  • inhibition of macrophage cytokine release
  • reduced effectiveness of iNKT
18
Q

What is dysphagia?

A

transferring food to stomach

19
Q

List out some primary medical factors causing ageing:

A
  • stroke
  • brain injury
  • degenerative neurological (motor neuron disease, parkinson’s disease, multiple sclerosis, dementia)
  • scleroderma
20
Q

List out some secondary medical factors causing ageing:

A
  • cardiorespiratory disease
  • rheumatoid
  • OA/ankylosing spondylosis
  • infection
  • GORD
21
Q

What is the meaning of edentulous?

A

lack of teeth

22
Q

What are some GI changes in ageing?

A
  • reflux and dysphagia
  • oesophagus affected
  • decrease in myenteric neurons
  • decrease in resting UOS pressures
  • pharyngeal dysphagia
23
Q

What are the specific changes in the oesophagus in ageing?

A
  • decrease in in LOS relaxation
  • upward displacement of LOS into thorax
  • delayed emptying of oesophagus
  • increase in non-peristaltic contractions
24
Q

From studying 90 elderly patients, what was the % of those with oral tissue disease?

A

60%

25
Q

From studying 90 elderly patients, what was the % of those with dentures?

A

81%

26
Q

Why is there consequences of nosocomial infections in the elderly?

A
  • long stay ward (malnourished)
  • BMI below <20, increased risk of infection, mortality and dependency
  • eventually organ failure

Growth and Metabolism (12 decks)

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