Physiology of Aging Flashcards
Reduced Homeostatic Responses Common in Elderly: How do the following change?
1. Baroreceptor responsiveness?
- Thermoregulatory responses?
- Cardiac reserve?
- Thirst?
- Dark adaptation?
- increased postural hypotension
- Higher hypothermia, hyperthermia
- fluid overload
- dehydration
- night driving hazardous
Host Defense Against Infection: How do the following change?
- Skin, mucous membranes?
- Mucociliary defenses?
- Gastric?
- BPH?
- Infection signs that may be absent? 3
- primary barrier – thinner, less blood supply
- cough reflex diminished
- achlorhydria
- residual urine
- Absence of fever
- PMN’s altered,
- t-cells altered
- The most common early sign of aging is what?
2. Hair thinning in men begins often in the what?
- -difficulty staying up all night and
working the next day. - 20’s.
Sign’s of Aging: Early signs in 30s?
5
- Easier weight gain
- Graying hair, thinning hair
- wrinkling forehead and eyes
- concern about biologic clock, financial security, family obligations
- injuries “weekend warrior”
Signs of Aging: 40s?
1. Reflection on mortality, life’s limitations, unreached dreams and goals. Could lead to what?
- Skin changes? 4
- 40’s (cont)
Vision Changes? - Osteoarthritis
By age 40, all adults have OA changes visible in what? - Most of these changes are not symptomatic at this point: Common sites for pain? 3
- mid-life crisis
2.
- sagging, wrinkling
- thinning
- benign and malignant lesions
- sweat glands
- Presbyopia
-Most common age-related eye problem in this age group
Require reading glasses. - radiographs of the cervical spine
- Hands,
- joints,
- back
Signs of Aging: 50’s and early 60’s?
8
- Sense of aging
- Menopause
- Becoming a grandparent
- Death of parents, friends
- Oldest at work
- Physical limitations, medical problems
- Senior citizen discounts!
- AARP membership
Signs of Aging: 70’s and 80’s
1. Common problems? 6
- Pschological and social losses examples? 6
- Arthritis,
- hypertension,
- hearing loss,
- heart conditions,
- visual problems,
- bone problems
- Psychologic and social losses:
- Retirement,
- death of spouse/close family member
- Children moving away,
- friends dying or moving
- Moving into apartment or retirement living
- Inability to socialize from sensory or physical impairments
Aging Changes and the Rule of Thirds
3
1/3 of functional decline is the result of disease
1/3 is due to inactivity (disuse)
1/3 of decline is caused by aging itself
Adaptation to disability and to role losses: Reflects certain advantages that older adults have over younger individuals. Such as?
4
- Greater independence
- Fewer responsibilities
- Reduces concern about day to day inconveniences
- Financial security
- Social security
- Retirement programs
Aging Changes in Organ Systems
Hematologic system
1. After age 65, what decreases slightly? 3
2. WBC’s increase in __________ and decrease in ___________?
-why?
- Total __________ unchanged, subsets change
- ___ increases slightly
- Physiologic anemia of aging
why?
- RBC,
- Hgb,
- Hct
- lobulation, granulation
- impairment of phagocytic activity - lymphocyte
- ESR
- Decreased reserve of red cell mass
Musculoskeletal system: 1. Height – average loss of what? (40-80yrs) Weight 2. Men: peaks in \_\_\_’s, then declines 3. Women: peaks \_\_’s, then declines
- 2-4 inches
- 50
- 60
Musculoskeletal system
1. Increase in density, decrease in the what of connective tissues?
- Loss of skin elasticity, joint stiffness. Why?
- Calcification of connective tissue. From what? 2
- water content
- (increased fibrous tissue)
- Atherosclerotic changes
- Degenerative joint disease
Musculoskeletal system
1. Decreased bone mineral content causes changes leading to?
osteoporosis
- Age 20 bone mass: women>men
- Age 50 women=men
- Age 65 women2x
Bone loss in women due to:
2
- Decreased estrogen production
2. Vitamin D absorption declines = decrease calcium absorption
Describe the effect of estrogen on bone density?
3
- Increase in osteoclastic activity,
- parathyroid hormone production,
- decrease in calcitonin
Musculoskeletal system
1. Decrease in muscle mass due to what?
- Change in muscle strength begins age ___?
- Degree of muscles loss varies –Which muscles are affected more?
- reduction in number and size of muscle fibers – 30%
- 35
- Large muscles affected more than smaller muscles
Changes in skin as a person ages?
5
- Decreased tone and elasticity
- Decline in subq adipose tissue- poor thermal insulation (susceptible to hypothermia)
- Yellowing of nails, rigid nails
- Hair loss after 30 in men
- Decrease in pigment
Respiratory system
1. Physiologic work capacity of 70 year old only what of a 20 year old?
- Decrease in what
reduces total surface area for gas exchange? - What decreases progressively 30-70 years old (17%)?
- What decreases due to changes in collagen?
- half
- alveolar size
- Vital capacity
- Elastic recoil
Respiratory system:
1. What increases 60% by age 80,
- What causes decrease in ventilatory function? 3
- How do expiratory flow velocities change?
- All timed pulmonary functions _______ with age?
- Forced residual capacity
- changes in chest wall muscles,
- bone and
- connective tissue
- Reduced
- decrease
CV system
1. What leads to reduced vascular compliance in the aging? 2
- Cardiac output decreases by __% per year between 25-70 years of age
- Stroke volume decreases by ___ %/year
- Change in resting heart rate?
- Maximum heart rate ________?
- Increased collagen in vascular smooth muscle +
- decreased elastic tissue
- 1
- 0.7
- Slight reduction
- decreases
- What causes Decreased organ perfusion?
- Age 80, blood flow reduced by 50% in the _______ 20% in the _____________?
- What leads to increased systolic BP? 2
- (Increased PVR and decreased CO)
- kidneys, cerebral hemisphere
- Increased peripheral resistance +
- decreased vascular compliance
Renal
1. After age ___, decrease in nephron units
- kidney begins to lose what?
- What happens to the renal blood vessels?
- Medullary connective tissue increases, replaces what?
- decrease in medullary ________?
- Loss of what cells?
- Which leads to? 2
- 40
- mass
- Renal blood vessels thicken, lose elasticity
- interstitial cells
- hydration
- juxtamedullary glomeruli
Account for
-decreased renal concentrating ability and
-decreased renal perfusion
Renal:
1. what else declines after age 40 (1%/year)? 2
- By age 80, the glomerular filtration rate has decreased by ___%?
- Creatinine clearance decreased by ___%
- Glomerular filtration rate and
- creatinine clearance decline
- 50
- 33
Renal
1. Peak ________ capacity reduced
- Residual ______ increases
- Blood flow best when?
- why? - What would this lead to? 2
- What doubles in size (20-80 yrs)?
- bladder
- urine
- at night,
- decreased renal perfusion - nocturia,
- frequency
- Prostate gland
Alimentary Canal
1. Loss of teeth occurs secondary to what? 2
2.What percent of the pop > 65 is edentulous?
- Periodontal disease more common in middle and old age. What complication does this cause?
- Which leads to?
- bone and
- connective tissue changes
- ½
- decreases ability to chew food adequately
- All contribute to poor nutritional status
Alimentary Canal
1. What fails to relax with peristaltic waves = uncoordinated?
- What does this cause? 3
- Lower esophageal sphincter
- Delayed entry of food into stomach
- Decrease in gastric emptying time
- GERD
Gastric
1. Age-related changes in stomach lead to what? 2
- Gastric secretions _______?
- Unable to absorb _____!
- atrophic gastritis and
- pernicious anemia.
- reduced (achlorhydria).
- B-12
Colon Changes in aging?
4
- Decreased motor function
- Depression of defecation reflex
- Decreased colonic muscle tone
- Decreased perfusion of GI tract secondary to vascular changes
What do the following lead to:
- Depression of defecation reflex?
- Decreased colonic muscle tone?
- Decreased perfusion of GI tract secondary to vascular changes?
- Lead to chronic constipation
- leads to diverticulosis
- bowel ischemia
Pancreas
1. Decrease in pancreatic lipase activity = May affect what?
- No alteration in hepatic or biliary function, however increased incidence of what?
- may have effect on digestion
2. cholelithiasis.
Men
1. Increase in fibrous tissue of what of testes?
- Thickening of the basement membrane around the seminiferous tubules = leads to?
- Sperm production only decreases ___% from age 20 - 80
- intertubular spaces
- decrease in sperm transport
- 50
Parathyroid hormones
1. At age 20, _____ as high in women vs men
- Levels decrease in women at age ___?
- Rise in __________, very high in those who develop __________?
- In men, progressively rise until age ___, then decline
- twice
- 40
- late middle age, osteoporosis
- 60
Decrease cerebral blood flow (20%)
1. By age 80, 7% reduction in what mass?
- What, especially in basal ganglia, decrease?
- Delay in what? leading to?
- Motor time ________ with aging
- What does this cause?
- cerebral hemisphere
- Neurotransmitters, esp dopamine
- monosynaptic reflex arc, slowed reflexes
- increases
- slowing of activity from reduction in conduction velocity.
Sensory and motor changes?
4
1. Decreased vibratory sensation Decreased 2. hand grip, 3. strength, 4. coordination, writing
90% of older adults complain of some problems sleeping
What causes this?
- Slowing of the alpha rhythm and altered sleep patterns
- More time in bed, less time sleeping
- Frequent night time urination
- Arthritic pain
What is a symptom of normal aging rather than Alzheimer’s, which the sufferer is generally unaware of any mental impairment?
Worrying about memory loss itself
Ocular changes
Common problems?
3
- Cataracts (most common in the world/DM in the US)
- macular degeneration (amsler grid)
- decrease in visual receptors
- Presbyopia
- Decreased number of retinal rods, dark vision
- Amount of light reaching the retina diminished by ____%
- Reduced ____________?
- What happens to the lens? 2
- 70
- pupillary size
- Yellowing
- clouding
Hearing
Decrease with age, varies with individual
1. What sounds specifically?
2. Descrease in vestibular function becaus of?
3. Leads to what problems?
- High pitched sounds
- Loss of hair cells in crista ampullaris
- Leads to balance problems
Taste
1. What descreases on the tongue (70%)? 2
- Issues with this?
- Olfaction declines
Leads to?
Don’t want to eat because they can’t taste or smell
Leads to weight loss
- Number of tongue papillae and taste buds
- adverse effect on appetite and nutrition
- poor nutrition
Psychological Aspects of Aging
5
- Role Changes - Retirement
- Coping with Medical Illness
- Loss of spouse
- Friends dying
- Children are adults and far away or occupied with their own family matters.
Laboratory Value Changes
1. Which increase? 3
- Which decrease? 3
- ESR increases
- Blood Glucose rises
- Cholesterol rises
- Albumin falls
- T3 falls
- Creatinine Clearance decreases
Successful or healthy aging appears to include three factors?
- Low probability of disease and disability
- Higher cognitive and physical functioning
- An active engagement in life
What is the disengagement theory? 3
What is Prototypical disengaged person? 3
What is the activity theory?
What is the Continuity theory? 2
Disengagement theory
1. Voluntary cutting back on work, social and even family ties.
2 Becomes more satisfied with vicarious activities and especially with reminiscence.
3. Comes to terms with and accepts past failures.
Prototypical disengaged person
- Well known
- Loved by neighbors
- Happily spends all day rocking on the front porch, offering a cheerful word to everyone who passes by.
Activity theory
- Staying as active as possible
- Continued professional or volunteer work
- Social activities, family , hobbies
Continuity theory:
1. Successful psychologic adaptation to aging involves allowing personal preferences from earlier years to manifest themselves as the individual responds to the stress and challenges of older age.
- Thus, some individuals will remain more active because it suits their personality, whereas others will become more disengaged.
