The Aging Neuromuscular System

Question 1

What two factors contribute to decreased brain weight in an aging adult?

Answer 1

Neuron Loss (decreased grey matter)
Myelin Loss (decreased white matter)

Question 2

What happens to impulse conduction rate and conduction velocity as we age?

Answer 2

It becomes more delayed

Question 3

As we age how does the vestibular system change?

Answer 3

the number of hair cells and receptor ganglion cells decreases

Question 4

How does blood flow and glucose metabolism in the brain change as we age?

Answer 4

They both decrease

Question 5

What functional deficits are commonly effected with CNS aging?

Answer 5

• delayed memory recall
• rote memory decreases (memorization and ability to recite information)
• altered gait, balance, and fine motor control
• diminished motor learning
• decreasing activity level

Question 6

What are common CNS pathologies with an aging adult?

Answer 6

• cerebral vascular accident (CVA)
• TBI
• Parkinson’s
• Dementia

Question 7

What happens to the level of sympathetic activity as we age?

Answer 7

Increases

Question 8

What happens with fiber grouping in a muscle as we age?

Answer 8

decreased number of neuron’s per muscle fiber

Question 9

How does the internodal length change as we age?

Answer 9

It increases

Question 10

As the PNS changes with age how does the level of motor unit recruitment for normal tasks change?

Answer 10

Increased recruitment due to more work required to do a task

Question 11

What happens with resting blood pressure as we age?

Answer 11

Increases

Question 12

What is the H-reflex latency and how does it change as we age?

Answer 12

The closer a muscle is to the spinal cord the faster it can respond to stimulus (e.g the pectoral muscles can respond faster than the finger flexors)

As we age the latency of our muscles increases

Question 13

What happens to nerve fibers in the PNS as we age?

Answer 13

decrease number and density of myelinated peripheral nerve fibers as well as the thickness of the remaining fibers. Overall this leads to decreased nerve conduction velocity and action potentials.

Question 14

When does normal aging vision loss begin to occur?

Answer 14

after the 3rd decade of life

Question 15

What is presbyopia?

Answer 15

decreased flexibility of the lens to accommodate from far to near

Question 16

In what ways is it normal for an eye to deteriorate as we age?

Answer 16

• decrease elasticity of the lens
• decrease recovery from glare
• decrease tear production
• decrease acuity
• decrease visual fields

Question 17

What is the most common disease of the eye in patients over 80 years old?

Answer 17

Cataracts

Question 18

What type of home environmental modification can be made for a patient who has developed a decreased ability to see contrasts?

Answer 18

highlights obstacles or changes in floor surface levels

Question 19

What compensatory measures can be made for patients with decreased visual acuity?

Answer 19

• corrective lenses
• using larger print
• tactile cues for phone, oven, or microwave dials

Question 20

True or false: Errors in visual acuity have the largest impact on balance for aging adults.

Answer 20

False, proprioception errors have a bigger effect on balance than vision

impairments with proprioception are associated with increased fall risk, which PTs need to address using sensory strategies to improve

Question 21

What is Presbycusis? How does it effect each gender?

Answer 21

the decline of hearing with age

effects both genders but men especially lose hearing for higher frequencies

usually presents as patient having a hard time tuning out background noise

Question 22

When speaking with a patient that has had their hearing impaired what are good strategies to communicate with them?

Answer 22

• Always ask what best works for the individual patient
• use a lower tone
• face the person when possible
• avoid “elderspeak”
• avoid jumping from one topic to another
• slow rate of speech appropriately

Question 23

What is hyposmia and anosmia?

As we age how does our risk for these change?

Answer 23

hyposmia-decreased smell

anosmia-loss of smell

higher prevalence of both as we age

Question 24

What implications are there with loss of smell?

Answer 24

Can create a safety risk (inability to smell a gas leak)

Impairs ability to taste and enjoy food

thirst sensation declines