Week 10- Geriatrics 1 Flashcards
Up to ____% of grandparents live in a household with and provide for a grandchild
30
Age range for geriatrics
65 and older
In 2020, people 65 and over compromised ____% of the population in the US
20%
True or false: Women continue to have a longer life expectancy than men
True
True or false: The majority of older adults age 65+ do not live in the community with their spouse
False
(they do)
____% of people age 85+ live in long term care facilities
15
-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
-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
-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
-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
-Errors in molecules made by DNA accumulate and eventually kill the cell
Error/catastrophe theory
-Genetic damage or mutation results from radiation, accumulates with age
Somatic mutation theory
-Aging results from cross linking of proteins
-Cross links interfere with/slow down normal processes, eventually killing organism
Cross linking theory
Type of aging that is inevitable and affects all systems
Primary aging
Type of aging based on lifestyle, environment, and disease
Secondary aging
Factors that contribute to healthy aging
-Physical activity
-Lifestyle
-Sense of purpose
-Stress management
-Social networks
-Family support
-Quality sleep
Aging that includes gradual decline in functioning of body systems
Typical aging
Body systems affected by typical aging
-Musculoskeletal
-Cardiopulmonary
-Integumentary
-Cognitive
-Visual
-Auditory
-Vestibular
-Genitourinary
Aging that may look like normal aging but is due to underlying disease processes (especially refers to declines in cognition)
Atypical aging
Dementia, Alzheimer’s, and Mild Cognitive Impairment are part of this aging
Atypical aging
____% muscle loss between 20-50
5-10
Peak bone density occurs at age ____
30
True or false: After age 30, there is more bone resorption than deposition
True
Increase in bone resorption leads to…
Osteoporosis
Osteopenia
Fractures
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
10
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
6+
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
11
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
50
Pneumonia results in a ___% mortality rate
33
Stereotyping, prejudice, and discrimination based on age
Ageism
Ageism is associated with…
-Earlier death
-Poorer physical and mental health
-Poor health behaviors
