Section 4 Flashcards
chronic disease
- > illness that is not contagious, of long duration that progresses slowly and is typically a result of genetics, environment, or lifestyle
- CD pose a risk to reduce life expectancy
- incorporating PA into your lifestyle reduces risk factors
non-modifiable risk factors of chronic disease
age
sex
ethnicity
mortality rates of cancer and infectious disease
mortality from infectious diseases have decreased
cancer rates are increased but mortality rates of cancer have decreased
% of older adults in nursing homes
7%
- > biases in the media make it seem higher
when was the peak of #of years living in a nursing home
of years in a nursing home peaked un 1996 and has been trending downward ever since
- > people are living longer, not necessarily better
average years older Canadians spend in sickness, disability and/or immobility
they spend their last 10 yeards in sickness, disability and/or immobility
- > however, more than 60% indicate living healthier is preferable to living longer
% of Canadians that would say that their doctor would consider them healthy
80%
- > however, looking at the 5 key risk factors for chronic disease, only 3% of north Americans meet all requirements
5 key risk factors for chronic disease
- > inactivity
- > smoking (the highest risk factor)
- > poor diet
- > stress
- > excessive stress
how does the aging process affect body parameters
aging causes all parameters (aerobic capacity, muscle strength, glucose tolerance, ect) to DECREASE
- > fat mass will increase as you age
things you should consider during your pre-prescription assessment
- > more resistance training than aerobic training has been shown to be beneficial in older populations
- > vitals/consent/questionnaire
- > MEDICATIONS
*majority of medications will influence BP or HR
how many prescriptions are filled in NB every year
more than 12 million (not all are filled)
- > 65% of senior have 5 or more classes of medication drugs for multiple chronic conditions (one to help with side effects of another medication; and so on)
why do we prescribe so many older people BP medications
it doesn’t cost a lot to produce and it can help if they end up having heart attack, ect. also reduces impact on healthcare system if it reduces severity
safety considerations when working with older adults
- > older adults have a lower proportion of total body water, thus they are more susceptible to dehydration
- > older adults are more susceptible to injury from cold weather
- > it is important to consider surface areas, slips and falls can be devastating for older adults and is very expensive for health care system
frailty
a state of increased vulnerability and functional impairment caused by cumulative declines across multiple systems
what us the best resource you can use for 65+ ppl physical assessments
Senior Fitness Test
- > it is valid and reliable
- > shows norms for 65+
% of Canadians that are at risk for cardiovascular disease (CVD)
90% of canadians have at least one risk factor for heart and stroke while nearly 40% have 3+ risk factors
- > so high because there are so many different avenues you can take to get there
- > regular aerobic activity and increase aerobic fitness, endurance and CV function in most cases at risk of CVD, it also reduces impact oh heart, and decreases symptoms of angina
angina
s a type of chest pain caused by reduced blood flow to the heart
- > Angina is a symptom of coronary artery disease.
- > Angina pain is often described as squeezing, pressure, heaviness, tightness or pain in the chest.
intensity of exercise for older populations
- > if HR from stress test is not available then be extremely conservative (HRrest +20bpm)
- > if client has a pacemaker, stay 10bpm below limit
- > light-moderate intensity training is more appropriate for aerobic and RT
type 1 vs type 2 diabetes
Type 1
- > body does not produce any insulin (since birth)
Type 2 (develops)
- > body doesn’t produce enough insulin or doesn’t utilize it effectively
why must you modify PA routines if someone is diebetic
exercise “acts as insulin” and naturally reduces blood sugar
- > if a diabetic already doesn’t produce enough insulin and we make them do HIIT then they’re probably go into diabetic shock or pass out
- > doesn’t act right away, maybe 2-4hrs after which is why diabetics don’t exercise at night so they don’t fall into a coma while they sleep
typical blood sugar reading before exercise
should eat something (carbs) before exercise if BS is less than 5.5 (easily absorbed carbs)
- > delay exercise if BS is higher than 14mmol/L
disability definition
the interaction between individuals with a health condition, personal and environemental factors
frequency of disability in canada
4% of 15-24 y/o live with a disability in canada
42% of 75+
Major factors that you should be aware of when working with people with disability
- > get involved in disability in your community
- > one person experiencing disability is NOT equal to someone with the same disability
- > acknowledge what biases we hold
- > while having physical access to aid/assistive devices is important, just be cause someone has one doesn’t automatically make their life better
disability terminology
most appropriate is terminology USED BY THE CLIENT in describing the disability
what do we recommend for prevention of weight gain, weight loss and prevention of weight regain
PA and Exercise
effective weight management programs should include ________
an combination of
- > reducing sedentary behaviour
- > caloric restrictions
- > RT and Aerobic
- > nutrition
weight loss of 0.5 - 1kg/week is advisable for _________
- > preserving lean body mass
- > avoiding a slowing of metabolism (especially when large amounts of weight is lost)
- a modest approach to WL can help weight adherence and decrease likelihood of regain
What should you consider when starting/creating a WL regiment
- > calculate how many calories they need to survive (RMR) + their anthropometrics
- > cut 500kcal from consumption or via exercise each day (3500kcal/week)
- > amount of exercise and PA needed depends of the goal of the client (moderate WL = 150mins/week; vigorous WL = 250mins/week)
- > add resistance to preserve lean body mass, increase the loss of fat mass, and prevent declines in metabolic rate
Special considerations when creating a WL plan
- > obese/overweight ppl are more likely to be unfit therefore many will benefit from low to moderate intensity PA at the start
- > consider non-weight bearing activity’ pool or bike (consider an obese person and how they feel about going to pool)
- > if client is reconditioned consider multiple bouts of aerobic activity (intensity comes after, they need some initial progress to that they’re motivated)
- > WEIGHT IS A SENSITIVE ISSUE, BE SUPPORTIVE
health improvements can be observed with small weight losses of ____________
2-3% of body weight
- > recommendation of WL is to aim for 5-10% of eight
_____% of weight loss in biggest loser competition was regained after ___ years
70% after 6 years
- > 12% less than their original weight (consider RMR setpoint)
*in extreme WL, for every 1kg lost there is a 19kcal reduction in energy expenditure
Arthritis
group of joint and bone disorders (most common is osteo; wear and tear of bone, and rheumatoid arthritis; inflammation of the joint)
- > 1/6 ppl 15+ have it (61 500 kids)
Safety
- > non weight bearing exercises
- > some soreness after exercise (referral if more than 2hrs of swelling)
- > early morning exercise is difficult for them
Cancer
cells that don’t do their job; function is compromised
- > affects most ppl 50+, 1/3 cancer are related to lifestyle
- > energy varies throughout the day (consider making them workout when they’re exhausted)
- > swimming is not appropriate for those with cathedral, radiation therapy (skin sensitization)
- > getting them to workout in a public space if they’re sick and immunocompromised
dementia
dementia is a category of cognitive impairments/diseases
- > 7% of people live with dementia
- > depression and anxiety are common amongst dementia patients so consider how this may affect their PA
- > medications for dementia increase HR
- > at high risk of falls; give caretakers a break when they come see you, MOODSWINGS
mental health
consider their motivation
- > MH is only disclosed in more private settings or if it affects PA
Respiratory disease
Asthma (prevalent in kids) and COPD (caused by smoking)
- > have an inhaler at all times
- > ensure proper warmup
- > avoid asthma triggers (cold air, smog, pollen)
- > rescue inhaler ready
osteoporosis
- > does not hurt; you can’t feel your symptoms
- > typically diagnosed after a random break
- > lower rates of OP in ppl with higher body weight as bones an joints naturally receive a greater load and bone density increases accordingly
- > 1,5 million (10%) will be diagnosed; women at greater risk
Safety - > no front bending
- > no jumps w/frail individuals
- > no twisting of spine
