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Geriatrics > Physiology of Aging > Flashcards

Physiology of Aging Flashcards

1
Q

Reduced Homeostatic Responses Common in Elderly: How do the following change?
1. Baroreceptor responsiveness?

  1. Thermoregulatory responses?
  2. Cardiac reserve?
  3. Thirst?
  4. Dark adaptation?
A
  1. increased postural hypotension
  2. Higher hypothermia, hyperthermia
  3. fluid overload
  4. dehydration
  5. night driving hazardous
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2
Q

Host Defense Against Infection: How do the following change?

  1. Skin, mucous membranes?
  2. Mucociliary defenses?
  3. Gastric?
  4. BPH?
  5. Infection signs that may be absent? 3
A
  1. primary barrier – thinner, less blood supply
  2. cough reflex diminished
  3. achlorhydria
  4. residual urine
    • Absence of fever
    • PMN’s altered,
    • t-cells altered
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3
Q
  1. The most common early sign of aging is what?

2. Hair thinning in men begins often in the what?

A
  1. -difficulty staying up all night and
    working the next day.
  2. 20’s.
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4
Q

Sign’s of Aging: Early signs in 30s?

5

A
  1. Easier weight gain
  2. Graying hair, thinning hair
  3. wrinkling forehead and eyes
  4. concern about biologic clock, financial security, family obligations
  5. injuries “weekend warrior”
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5
Q

Signs of Aging: 40s?
1. Reflection on mortality, life’s limitations, unreached dreams and goals. Could lead to what?

  1. Skin changes? 4
  2. 40’s (cont)
    Vision Changes?
  3. Osteoarthritis
    By age 40, all adults have OA changes visible in what?
  4. Most of these changes are not symptomatic at this point: Common sites for pain? 3
A
  1. mid-life crisis

2.

  • sagging, wrinkling
  • thinning
  • benign and malignant lesions
  • sweat glands
  1. Presbyopia
    -Most common age-related eye problem in this age group
    Require reading glasses.
  2. radiographs of the cervical spine
    • Hands,
    • joints,
    • back
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6
Q

Signs of Aging: 50’s and early 60’s?

8

A
  1. Sense of aging
  2. Menopause
  3. Becoming a grandparent
  4. Death of parents, friends
  5. Oldest at work
  6. Physical limitations, medical problems
  7. Senior citizen discounts!
  8. AARP membership
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7
Q

Signs of Aging: 70’s and 80’s
1. Common problems? 6

  1. Pschological and social losses examples? 6
A
    • Arthritis,
    • hypertension,
    • hearing loss,
    • heart conditions,
    • visual problems,
    • bone problems
  2. 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
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8
Q

Aging Changes and the Rule of Thirds

3

A

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

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9
Q

Adaptation to disability and to role losses: Reflects certain advantages that older adults have over younger individuals. Such as?
4

A
  1. Greater independence
  2. Fewer responsibilities
  3. Reduces concern about day to day inconveniences
  4. Financial security
    - Social security
    - Retirement programs
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10
Q

Aging Changes in Organ Systems
Hematologic system
1. After age 65, what decreases slightly? 3
2. WBC’s increase in __________ and decrease in ___________?
-why?

  1. Total __________ unchanged, subsets change
  2. ___ increases slightly
  3. Physiologic anemia of aging
    why?
A
    • RBC,
    • Hgb,
    • Hct
  2. lobulation, granulation
    - impairment of phagocytic activity
  3. lymphocyte
  4. ESR
  5. Decreased reserve of red cell mass
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11
Q 
Musculoskeletal system:
1. Height – average loss of what?  (40-80yrs)
Weight 
2. Men: peaks in \_\_\_’s, then declines
3. Women: peaks \_\_’s, then declines
A
  1. 2-4 inches
  2. 50
  3. 60
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12
Q

Musculoskeletal system
1. Increase in density, decrease in the what of connective tissues?

  1. Loss of skin elasticity, joint stiffness. Why?
  2. Calcification of connective tissue. From what? 2
A
  1. water content
  2. (increased fibrous tissue)
    • Atherosclerotic changes
    • Degenerative joint disease
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13
Q

Musculoskeletal system

1. Decreased bone mineral content causes changes leading to?

A

osteoporosis

  • Age 20 bone mass: women>men
  • Age 50 women=men
  • Age 65 women2x
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14
Q

Bone loss in women due to:

2

A
  1. Decreased estrogen production

2. Vitamin D absorption declines = decrease calcium absorption

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15
Q

Describe the effect of estrogen on bone density?

3

A
  1. Increase in osteoclastic activity,
  2. parathyroid hormone production,
  3. decrease in calcitonin
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16
Q

Musculoskeletal system
1. Decrease in muscle mass due to what?

  1. Change in muscle strength begins age ___?
  2. Degree of muscles loss varies –Which muscles are affected more?
A
  1. reduction in number and size of muscle fibers – 30%
  2. 35
  3. Large muscles affected more than smaller muscles
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17
Q

Changes in skin as a person ages?

5

A
  1. Decreased tone and elasticity
  2. Decline in subq adipose tissue- poor thermal insulation (susceptible to hypothermia)
  3. Yellowing of nails, rigid nails
  4. Hair loss after 30 in men
  5. Decrease in pigment
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18
Q

Respiratory system
1. Physiologic work capacity of 70 year old only what of a 20 year old?

  1. Decrease in what
    reduces total surface area for gas exchange?
  2. What decreases progressively 30-70 years old (17%)?
  3. What decreases due to changes in collagen?
A
  1. half
  2. alveolar size
  3. Vital capacity
  4. Elastic recoil
19
Q

Respiratory system:
1. What increases 60% by age 80,

  1. What causes decrease in ventilatory function? 3
  2. How do expiratory flow velocities change?
  3. All timed pulmonary functions _______ with age?
A
  1. Forced residual capacity
    • changes in chest wall muscles,
    • bone and
    • connective tissue
  3. Reduced
  4. decrease
20
Q

CV system
1. What leads to reduced vascular compliance in the aging? 2

  1. Cardiac output decreases by __% per year between 25-70 years of age
  2. Stroke volume decreases by ___ %/year
  3. Change in resting heart rate?
  4. Maximum heart rate ________?
A
    • Increased collagen in vascular smooth muscle +
    • decreased elastic tissue
  2. 1
  3. 0.7
  4. Slight reduction
  5. decreases
21
Q
  1. What causes Decreased organ perfusion?
  2. Age 80, blood flow reduced by 50% in the _______ 20% in the _____________?
  3. What leads to increased systolic BP? 2
A
  1. (Increased PVR and decreased CO)
  2. kidneys, cerebral hemisphere
    • Increased peripheral resistance +
    • decreased vascular compliance
22
Q

Renal
1. After age ___, decrease in nephron units

  1. kidney begins to lose what?
  2. What happens to the renal blood vessels?
  3. Medullary connective tissue increases, replaces what?
  4. decrease in medullary ________?
  5. Loss of what cells?
    - Which leads to? 2
A
  1. 40
  2. mass
  3. Renal blood vessels thicken, lose elasticity
  4. interstitial cells
  5. hydration
  6. juxtamedullary glomeruli
    Account for
    -decreased renal concentrating ability and
    -decreased renal perfusion
23
Q

Renal:
1. what else declines after age 40 (1%/year)? 2

  1. By age 80, the glomerular filtration rate has decreased by ___%?
  2. Creatinine clearance decreased by ___%
A
    • Glomerular filtration rate and
    • creatinine clearance decline
  2. 50
  3. 33
24
Q

Renal
1. Peak ________ capacity reduced

  1. Residual ______ increases
  2. Blood flow best when?
    - why?
  3. What would this lead to? 2
  4. What doubles in size (20-80 yrs)?
A
  1. bladder
  2. urine
  3. at night,
    - decreased renal perfusion
    • nocturia,
    • frequency
  5. Prostate gland
25
Q

Alimentary Canal
1. Loss of teeth occurs secondary to what? 2

2.What percent of the pop > 65 is edentulous?

  1. Periodontal disease more common in middle and old age. What complication does this cause?
    - Which leads to?
A
    • bone and
    • connective tissue changes
  2. ½
  3. decreases ability to chew food adequately
    - All contribute to poor nutritional status
26
Q

Alimentary Canal
1. What fails to relax with peristaltic waves = uncoordinated?

  1. What does this cause? 3
A
  1. Lower esophageal sphincter
    • Delayed entry of food into stomach
    • Decrease in gastric emptying time
    • GERD
27
Q

Gastric
1. Age-related changes in stomach lead to what? 2

  1. Gastric secretions _______?
  2. Unable to absorb _____!
A
    • atrophic gastritis and
    • pernicious anemia.
  2. reduced (achlorhydria).
  3. B-12
28
Q

Colon Changes in aging?

4

A
  1. Decreased motor function
  2. Depression of defecation reflex
  3. Decreased colonic muscle tone
  4. Decreased perfusion of GI tract secondary to vascular changes
29
Q

What do the following lead to:

  1. Depression of defecation reflex?
  2. Decreased colonic muscle tone?
  3. Decreased perfusion of GI tract secondary to vascular changes?
A
  1. Lead to chronic constipation
  2. leads to diverticulosis
  3. bowel ischemia
30
Q

Pancreas
1. Decrease in pancreatic lipase activity = May affect what?

  1. No alteration in hepatic or biliary function, however increased incidence of what?
A
  1. may have effect on digestion

2. cholelithiasis.

31
Q

Men
1. Increase in fibrous tissue of what of testes?

  1. Thickening of the basement membrane around the seminiferous tubules = leads to?
  2. Sperm production only decreases ___% from age 20 - 80
A
  1. intertubular spaces
  2. decrease in sperm transport
  3. 50
32
Q

Parathyroid hormones
1. At age 20, _____ as high in women vs men

  1. Levels decrease in women at age ___?
  2. Rise in __________, very high in those who develop __________?
  3. In men, progressively rise until age ___, then decline
A
  1. twice
  2. 40
  3. late middle age, osteoporosis
  4. 60
33
Q

Decrease cerebral blood flow (20%)
1. By age 80, 7% reduction in what mass?

  1. What, especially in basal ganglia, decrease?
  2. Delay in what? leading to?
  3. Motor time ________ with aging
    - What does this cause?
A
  1. cerebral hemisphere
  2. Neurotransmitters, esp dopamine
  3. monosynaptic reflex arc, slowed reflexes
  4. increases
    - slowing of activity from reduction in conduction velocity.
34
Q

Sensory and motor changes?

4

A 
1. Decreased vibratory sensation
Decreased 
2. hand grip, 
3. strength, 
4. coordination, writing
35
Q

90% of older adults complain of some problems sleeping

What causes this?

A
  1. Slowing of the alpha rhythm and altered sleep patterns
  2. More time in bed, less time sleeping
  3. Frequent night time urination
  4. Arthritic pain
36
Q

What is a symptom of normal aging rather than Alzheimer’s, which the sufferer is generally unaware of any mental impairment?

A

Worrying about memory loss itself

37
Q

Ocular changes
Common problems?
3

A
  1. Cataracts (most common in the world/DM in the US)
  2. macular degeneration (amsler grid)
  3. decrease in visual receptors
  4. Presbyopia
  5. Decreased number of retinal rods, dark vision
38
Q
  1. Amount of light reaching the retina diminished by ____%
  2. Reduced ____________?
  3. What happens to the lens? 2
A
  1. 70
  2. pupillary size
    • Yellowing
    • clouding
39
Q

Hearing
Decrease with age, varies with individual
1. What sounds specifically?
2. Descrease in vestibular function becaus of?
3. Leads to what problems?

A
  1. High pitched sounds
  2. Loss of hair cells in crista ampullaris
  3. Leads to balance problems
40
Q

Taste
1. What descreases on the tongue (70%)? 2

  1. Issues with this?
  2. Olfaction declines
    Leads to?

Don’t want to eat because they can’t taste or smell
Leads to weight loss

A
  1. Number of tongue papillae and taste buds
  2. adverse effect on appetite and nutrition
  3. poor nutrition
41
Q

Psychological Aspects of Aging

5

A
  1. Role Changes - Retirement
  2. Coping with Medical Illness
  3. Loss of spouse
  4. Friends dying
  5. Children are adults and far away or occupied with their own family matters.
42
Q

Laboratory Value Changes
1. Which increase? 3

  1. Which decrease? 3
A
    • ESR increases
    • Blood Glucose rises
    • Cholesterol rises
    • Albumin falls
    • T3 falls
    • Creatinine Clearance decreases
43
Q

Successful or healthy aging appears to include three factors?

A
  1. Low probability of disease and disability
  2. Higher cognitive and physical functioning
  3. An active engagement in life
44
Q

What is the disengagement theory? 3

What is Prototypical disengaged person? 3

What is the activity theory?

What is the Continuity theory? 2

A

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

  1. Well known
  2. Loved by neighbors
  3. Happily spends all day rocking on the front porch, offering a cheerful word to everyone who passes by.

Activity theory

  1. Staying as active as possible
  2. Continued professional or volunteer work
  3. 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.

  1. Thus, some individuals will remain more active because it suits their personality, whereas others will become more disengaged.

Geriatrics (16 decks)

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