Week 2: Physical Healthy Aging

Question 1

Why do our bodies age (2)

Answer 1

-Cellular regeneration declines as we age
-Functional changes at cellular level, replication slows down

Question 2

General Physical Changes with Aging

Answer 2

-Increased risk of chronic disease
-Decline in lean body mass & bone density
-Increased risk of fractures
-Increased risks of falls
-Impaired oral, eye, ear health
-Changes in skin, taste, smell
-Geriatric Syndromes (common health conditions in older adults)

Question 3

Changes during aging (7 Categories)

Answer 3

1. Skeletal
2. Musculature
3. Vision
4. Hearing
5. Vestibular
6. Joint Proprioception
7. Balance

Question 4

What is the skeletal system essential for?

Answer 4

Skeletal system is essential for: calcium storage, movement, reduce frailty

Question 5

Skeletal System and Healthy Aging Issues

Answer 5

Starting at ~30, progression of various issues such as:

-Density or mass of bones begin to diminish
-Bones more fragile and more likely to break
-Development of Osteoporosis or Osteoarthritis
-Stiffer / less flexible joints (thinner cartilage, fluidity, etc.)
-Limited range of motion
-Collapse of vertebrae (middle of body becomes shorter as discs lose fluid and vertebrae collapse)

Question 6

What is the musculature system essential for?

Answer 6

-Musculature is essential for: prevent weakness, fatigue, improve ability to perform activities of daily living, reduce risk of falls and injury

Question 7

Musculature and Healthy Aging (Issues)

Answer 7

-Peak muscle strength occurs at age 20-30
-After 30 into old age:
-Muscle Atrophy = the thinning or loss of muscle tissues (muscle “wastes away”)- harder to produce lean muscle
-Sarcopenia = loss of muscle.
-Muscles fibers not able to contract as quickly- due to changes in nervous system
-Presence of Lipofuscin- muscle fibres begin to shrink, muscle tissue replaces more slowly and replaced by more tough fibrous tissue instead of softer

Question 8

Visual Changes (5 common diseases, age changes begin)

Answer 8

By age 50 changes occur due to environment, genes, illness/diseases, and socioeconomic factors
-1 in 9 Canadians experience irreversible vision loss by the age of 65

Common diseases include:
1. Glaucoma- group of diseases that can cause vision loss and blindness due to damage to optic nerve
2. Dry eyes
3. Macular degeneration
4. Cataracts- clouding of lens (one of the most well-known/common)
5. Diabetic retinopathy- vision loss due to changes when diagnosed with diabetes

Question 9

Hearing Changes

Answer 9

Presbycusis – progressive, multifaceted, age-related hearing loss
-Influenced by factors like genetics, environment, trauma, ototoxic medicines
-Multiple forms of hearing loss including sensorineural, conductive, and mixed hearing loss
-Can impact one or both ears

Question 10

Vestibular Changes

Answer 10

-Lot of issues understanding speech when there is background noise
-Decrease in balance
-Lot of these changes interact to influence each other

Question 11

Joint Proprioception and Aging

Answer 11

-Mechanoreceptors changes, which are in the joints, capsules, ligaments,
muscles, tendons and skin
-Impaired/Deterioration of proprioception leading to less accurate detection of body
position
-Can result in increased risk for falls and degenerative joint disease

Question 12

Balance and Aging (definition, 3 properties)

Answer 12

-Balance is the ability to maintain the projected center of mass of the body within the stability limits of support

-Three fundamental properties: steadiness, symmetry, & dynamic stability

-Balance disorders result from steady reduction of several systems’ functions, including musculoskeletal system, central nervous system & sensory system
-Good balance also requires reliable sensory input from an individual’s vision, vestibular system, & proprioceptors
-As you age, these systems can deteriorate
-Many falls are related to balance issues - Falling is one of the leading health concerns for older adults

Question 13

Aging Risk Factors found in study on older adults (4)

Answer 13

1. Alcohol and Tobacco Use: 9.5% of sample report daily or occasional tobacco use and 8.3% exceed low risk drinking guidelines
2. Nutrition: 77.3% of sample consume fruits and vegetables less than 5x a day
3. Physical Activity: 60.6% of sample don’t meet physical activity guidelines
4. Sleep: 46.8% of sample report trouble falling asleep

Question 14

10 Most Common Chronic Diseases (in order)

Answer 14

1. Hypertension 65%
2. Periodontal disease (teeth) 52%
3. Osteoarthritis 38%
   *top 3
4. Osteoporosis
5. Diabetes
6. Ischemic Heart Disease
7. COPD
8. Asthma
9. Cancer
10. Mood and Anxiety Disorders

Question 15

Graph of Diseases Trend

Answer 15

Aging is one of the most important risk factors for chronic disease
(most increase risk with age)

Question 16

Multimorbidity

Answer 16

co-occurrence in the same individual of two or more of ten common chronic diseases

-Associated with impaired quality of life, increased use of health care resources, institutionalization, adverse health effects, disability and premature death

*The proportion of seniors with multimorbidity increases with age, regardless of sex

Question 17

Diabetes and Risk Factors

Answer 17

-Diabetes is a growing public health burden in older adults
-Aging increases the risk of diabetes
-Management of diabetes for older adults is more complicated
-Coexisting medical conditions
-Cognitive issues
-Diabetes self-management is more difficult due to lack of knowledge and access to resources

Question 18

CVD and aging

Answer 18

Lifetime risk of cardiovascular disease increases with age with or without risk factors. Risk factors increase rate of lifetime risk %

Question 19

High blood pressure

Answer 19

-Most common in older adults
-Due to changes in the vascular system as one ages
-Reduction of elastic tissues, resulting in stiff arteries
-Age a factor even in heart-healthy people (who exercise and have good nutrition)

Question 20

Cancer and aging

Answer 20

-Aging is a major risk factor for cancer
-Over 85 incidences decreases- age related physiological changes (changes in rates of cell proliferation and regeneration)- extreme aging can result in age related declines in age related physiological changes that lead to cancer- decrease in cell growth

Question 21

Falls

Answer 21

-Most common cause of injury in older adults
-One of the leading causes of death in older adults
-1/5 falls cause a serious or life-threatening injury
-Large costs to healthcare systems result from falls in older adults

Question 22

Post-Fall Syndrome

Answer 22

-Creates a cycle of increasing weakness and instability through joint mobility reductions, physical deconditioning, and poor balance
-Dependence, loss of autonomy, loss of self-confidence, depression, confusion, immobilization, restriction to daily activities

*Important to help increase confidence through physical activity, improve balance

Question 23

Fall Cycle in Seniors

Answer 23

Fall -> Loss of balance confidence -> fear of falling again *cautious gait -> self-restriction of physical activities -> reduced muscle strength and impaired balance -> abnormal gait, more unstable on feet *frozen gait -> increased risk of falling -> fall again

Question 24

Compensatory Mechanisms (2 types of gait)

Answer 24

1. Cautious Gait
   -Excessive degree of age-related changes in walking and fear of falling
   -Usually right after falling (fear of falling again)
   -Slow, wide base, arms slow
2. Frozen Gait
   -Abnormal gait pattern in which there are sudden, short and temporary
   episodes of an inability to move the feet forward despite the intention to
   walk
   -Feet do quick shuffling movements and then stop
   -Typically occurs later after falls, but result in additional falls and more serious injury

Question 25

Frailty

Answer 25

-Earlier you detect frailty the easier it is to correct and live a higher quality life
-Not all older adults are frail but have increased risk
*Increased vulnerability to things like disease, disability, dependability, death
-Increases burden on health care system

Question 26

AVOID acronym for reducing development of frailty

Answer 26

1. Activity- exercise can slow or reverse frailty (focus on strength and balance at least 2x per week, and activities that get your heart rate up daily)
2. Vaccinate- vaccines for flu, shingles, pneumonia, up to date booster shots
3. Optimize medications
4. Interact- maintain strong social relationships to avoid frailty, advanced aging and depression/dementia/high BP
5. Diet and Nutrition- food is medicine, need lots of protein to keep muscles and bones strong, vitamin D and calcium support bone and muscle strength

Question 27

7 Behaviours of a Healthy Lifestyle

Answer 27

1. Exercising
2. Eating a diet high in fruits and vegetables
3. Not smoking
4. Drinking alcohol in moderation
5. Getting adequate rest
6. Coping with stress
7. Having a positive outlook
   *add social interaction

Question 28

Maintaining performance: Basic Activities of Daily Living (6)

Answer 28

1. Dressing
2. Locomotion
3. Continence
4. Eating
5. Transferring
6. Walking and moving around

*if no longer able to do, need more care through long-term care home

Question 29

Maintaining performance: Instrumental Activities of Daily Living (6)

Answer 29

1. Using a Telephone
2. Traveling
3. Shopping
4. Preparing meals
5. Housework
6. Taking Medicine *one that’s more confusing

*if no longer able to perform these, can get in-home care or retirement home

Question 30

Canadian Physical Activity Guidelines (65+)

Answer 30

-150 mins MVPA per week
-Resistance training at least 2x per week
-Balance activities
-More physical activity provides greater benefits

Question 31

Types of PA (5)

Answer 31

1. Aerobic (or endurance)
   -Supplies O2 to brain
   -Walking, jogging, swimming, etc.
   -20-30 min a day moderate intensity
2. Strength
   -Muscles work more than daily living activities
   -Weight training, resistance bands, body weight
3. Flexibility
   -Flexibility and stretching for increased freedom of movement for everyday activities and other exercise
   -Yoga, leg raises, swimming, tai chi
4. Balance
   -Strengthens muscles that keep you upright
   -Improve stability and prevent falls
5. Functional
   -Trains muscles to work together
   -Prepares for daily tasks by reproducing common movements
   -Various muscles in upper and lower body used at same time

*Have to adjust for different individuals and one person may need to do one thing more than another, hitting all types/multiple types is best

Question 32

Benefits of Physical Activity (9)

Answer 32

-Can make a substantial difference in a person’s life, regardless of age
-Decrease blood pressure
-Increase strength and CV endurance
-Increase balance
-Increase lung and breathing function
-Improve immune function
-Reduce depression and anxiety
-Control obesity
-Add life to one’s years *Quality of Life!

Question 33

Frailty and Exercise

Answer 33

Everyone benefits from exercise
-Adults at risk of frailty or living with frailty
-Individuals in long term care
-Hospitalized individuals
-Can help improve physical function, help minimize and delay age-related declines
-Aerobic, muscle-strengthening, and multi-component physical activity programs all demonstrate benefits

Question 34

Benefits related to Frailty:

Answer 34

-Improves ability to perform tasks- at job, within community + social groups, with family at home
-Prevents weak bones and muscle loss
-Improves joint mobility
-Improves sleep quality
-Reduces risk of chronic conditions
-Extends years of activity and independent living
-Lowers risk of dementia
-Reduces likelihood of falls and injury

Question 35

Barriers to Physical Activity and Healthy Aging (2)

Answer 35

1. Intrinsic barriers
   -Related to the beliefs, motives and experiences of the individual.
   -Such as previous experiences at school, concerns about over- exertion, or perceptions of physical activity.
   -Educated, afraid
2. Extrinsic barriers
   -Related to the broader physical activity environment.
   -Such as the skills and attitudes of others, the types of opportunities available, access and safety.

Question 36

Overcoming Barriers (2)

Answer 36

1. Reassurance in relation to concerns about safety, frequency and intensity
2. Education of individuals as to what is appropriate physical activity

Question 37

Changing up PA as we age: why do each type?

Answer 37

-Strength to lift household objects
-Flexibility to wash hair, tie shoes
-Balance and agility to climb stairs
-Co-ordination and dexterity like opening a door
-Speed to cross the road at pedestrian traffic lights
-Muscular endurance to walk to the shops

Question 38

Master Athletes (are they role models?)

Answer 38

-Starting as early as 25-35+ years, but typically thought of as 50+
-Activity-dependent
-Later-life leisure
-Increasing in popularity and participation
-First World Masters
-Championships (1975) in Toronto
-Most recent in New Zealand

They can be motivating and inspiring for those that are that age and can engage in sports and are physically active, but they do create social comparison with those who can’t physically engage in sport the same way the master athletes can, and therefore they don’t participate in exercise as much.