Week 10- Geriatrics 1 Flashcards by Amber Zimmer

Up to ____% of grandparents live in a household with and provide for a grandchild

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Age range for geriatrics

65 and older

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In 2020, people 65 and over compromised ____% of the population in the US

20%

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True or false: Women continue to have a longer life expectancy than men

True

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True or false: The majority of older adults age 65+ do not live in the community with their spouse

False

(they do)

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____% of people age 85+ live in long term care facilities

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-Cells have limited lifespan
-Biological clock in each cell controls the aging process
-At some point, cells lose functional capacities which creates aging

Hayflick Limit Theory

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-Hypothalamus controls release many hormones that regulate body functions via chain reactions
-Aging decreases the production of hormones, which decreases ability to repair and regulate body functions

Neuroendocrine and hormonal theory

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-Caloric restriction extends lifespan and slows aging process
-Caloric restriction reduces metabolic rate and oxidative stress, improves insulin sensitivity, alters endocrine and neuro function
-Mechanism unknown

Caloric restriction theory

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-Free radicals damage cells via oxidation, eventually killing cells
-Free radicals attach to cells and interfere with normal processes
-Free radical damage begins at birth and continues until death

Free radical theory

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-Errors in molecules made by DNA accumulate and eventually kill the cell

Error/catastrophe theory

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-Genetic damage or mutation results from radiation, accumulates with age

Somatic mutation theory

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-Aging results from cross linking of proteins
-Cross links interfere with/slow down normal processes, eventually killing organism

Cross linking theory

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Type of aging that is inevitable and affects all systems

Primary aging

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Type of aging based on lifestyle, environment, and disease

Secondary aging

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Factors that contribute to healthy aging

-Physical activity
-Lifestyle
-Sense of purpose
-Stress management
-Social networks
-Family support
-Quality sleep

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Aging that includes gradual decline in functioning of body systems

Typical aging

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Body systems affected by typical aging

-Musculoskeletal
-Cardiopulmonary
-Integumentary
-Cognitive
-Visual
-Auditory
-Vestibular
-Genitourinary

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Aging that may look like normal aging but is due to underlying disease processes (especially refers to declines in cognition)

Atypical aging

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Dementia, Alzheimer’s, and Mild Cognitive Impairment are part of this aging

Atypical aging

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____% muscle loss between 20-50

5-10

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Peak bone density occurs at age ____

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True or false: After age 30, there is more bone resorption than deposition

True

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Increase in bone resorption leads to…

Osteoporosis
Osteopenia
Fractures

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True or false: There is no loss in weight/change in body composition as people get older

False

Neuromuscular changes

-Decrease in brain weight and volume -Decrease in vascular supply and metabolism -Decrease in nerve conduction and velocity -Risk for neurological diseases increases with age (stroke, dementia, epilepsy, ALS, Parkinson's)

Neuro red flags

-LOC -Confusion -Seizures -Sudden bowel/bladder incontinence -Sudden gait abnormalities

This is the #1 cause of death in the US

Heart disease

VO2 max declines ____% per decade after 20

Cardiopulmonary changes

-Decreased cardiac output -Decreased blood vessel elasticity -Heart cells thicken/become more fibrotic -Decrease in pacemaker cells -Decreased chest wall compliance -Decreased lung capacity

Oral changes

-Decreased saliva production -Increased risk of swallowing difficulty

Gut changes

-Altered digestive hormones -Decreased stomach motility -Decreased peristalsis

True or false: Older people have earlier satiety and impaired olfaction

True

Presbyopia may occur around age ____

35-40

Visual acuity _________ and there is a hardening and yellowing of ________

Decreases Lens

Clouding of lens due to protein buildup

Cataracts

Loss of peripheral vision

Glaucoma

Loss of clarity at center of visual field

Macular degeneration

Damaged blood vessels in eye

Retinopathy

Largest organ in the body that accounts 15% of body weight

Skin

Integumentary changes

-Decreased dermis and epidermis thickness -Fewer blood vessels, oil, and sweat gland (less thermoregulation, less hydration) -Decreased cell turnover (increased healing time, decreased barrier function) -Fewer mast cells (increased risk of infection) -Less collagen and elastin (thinner skin, wrinkles)

True or false: The skin is never overlooked

False (it is lol)

These can occur if you do not check the skin on every patient

Skin tears Pressure injuries

Normal changes in cognition due to aging

-Slower cognitive speed -Decreased word finding ability (verbal retrieval) -Decreased selective or divided attention -Difficulty with learning new things -Decreased executive cognitive function

True or false: Long term memory and procedural memory are not stable

False (they are)

True or false: Retention of newly learned information is generally stable, but may require more cueing to recall

True

True or false: Visual recognition of objects remains stable

True

-Withdrawal from hobbies, social activities, family/friends -Easily confused, suspicious, depressed

Mood changes

-Getting lost while driving to a familiar location -Bumping into things -Decreased peripheral vision

Visuospatial changes

-Inability to recognize people -Decreased long term memory

Memory changes

True or false: Geriatric patients may have communication difficulties

True

True or false: Mild Cognitive Impairment (MCI) interferes with ADLs

False

True or false: Mild Cognitive Impairment (MCI) reduces capabilities of a person compared to their respective age and education level

True

There is a gradual cognitive decline over ____ months

MCI has an inverse relationship with...

Education

MCI increases risk of...

Alzheimer's

An umbrella term that describes a collection of symptoms that are caused by disorders affecting the brain. Not one specific disease.

Dementia

Dementia affects...

-Thinking -Behavior -Ability to perform everyday tasks

True or false: Brain function in dementia is affected enough to interfere with a person's normal social or working life

True

Most common type of dementia

Alzheimer's

Diagnostic criteria for dementia (2 or more must be significantly impaired)

-Memory -Communication and language -Ability to focus and pay attention -Reasoning and judgement -Visual perception

Conditions that may present as dementia

-Depression -UTI -Delirium -Medication side effects -Vitamin deficiency -Alcohol/drug abuse

Sudden change in mental function

Delirium

Delirium is often accompanied by...

-Decreased level of consciousness -Slurred speech -Agitation -Hallucinations -Emotional lability

Causes of delirium

-UTI or infection -Dehydration -Hospitalization (11-42% of hospitalized older adults) -Drug interactions

Most common mental health condition in people age 65+

Depression

Depression occurs in ____% of the overall older adult population

11-16

True or false: The rate of depression decreases among lower socioeconomic status patients

False (increases)

Biggest contributors to depression in geriatrics

-Loneliness -Life events -Transitions

Depression presentations

-Sadness, anxiety, irritability, hopelessness -Cognitive problems (concentration, memory, indecisiveness) -Low self esteem, apathy -Withdrawal from family/friends, hobbies -Difficulties sleeping -Weight changes -Slowed movement

Most common types of cancer

-Breast -Lung -Prostate -Colorectal

There is a ___x increased chance of developing cancer as an older adult than as a younger person

Signs and symptoms of cancer

-Constant pain that occurs at night -Weight loss -Fever -Extreme fatigue -Back pain

Often juvenile onset, pancreas does not produce insulin

Type 1 diabetes

Generally middle age onset, pancreas decreases insulin production

Type 2 diabetes

Risk factors for Type 2 diabetes

-Obesity -Family history -High blood pressure -Lack of exercise -Age over 45 -African American, American Indian, or Pacific Islander

Complications of diabetes

-Diabetic neuropathy -Diabetic retinopathy -Poor wound healing -Increased risk of stroke -Increased risk of some cancers

Key hallmark of frailty

Decreased physiologic reserve across multiple organ systems leading to identifiable alterations in physical function

BMI < 18.5

Underweight

Aspects of being underweight

-Weakness -Slow gait speed -Low energy -Shrinking -Inactivity

True or false: Frailness does not affect physical, cognitive, and psychological domains

False (it does)

Frailness is predictive of...

-Falls -Hospitalization -Death -Disability

_________ are a leading cause of long term disability

Strokes

Strokes reduce _________ in over half of stroke survivors over age _____

Mobility 65

Stroke risk factors

-AGE -HIGH BLOOD PRESSURE -DIABETES -Smoking -High cholesterol -Heart disease

Acronym used for Stroke

F- face A- arms S- speech T- time

Primary infection acquired in hospitals or long term care facilities

UTI's

UTI's are the most common cause of hospitalization for a __________ infection

Bacterial

True or false: UTI's are more common in women

True

____% of women 65+ have had a UTI within the last 12 months

10%

Signs and symptoms of UTI's

-Fever -Flank pain -Hematuria -CHANGE IN MENTAL AND FUNCTION STATUS (often mimics dementia) -Report falling or LoB

Primary older adults are ___x more likely to have pneumonia, and ___x more likely to be hospitalized

4 5

Effects of pneumonia

-Increased risk of aspiration with age -Decreased immune response -Decreased ability to clear the airway (weaker supportive muscles such as diaphragm and intercostals)

Second leading cause of hospital acquired infection

Pneumonia

Pneumonia occurs in ___% of all hospital admissions

8-10

Pneumonia leads to roughly ___% of all diagnoses of sepsis

Pneumonia results in a ___% mortality rate

Stereotyping, prejudice, and discrimination based on age

Ageism

Ageism is associated with...

-Earlier death -Poorer physical and mental health -Poor health behaviors