B230 Older Adult Physical Changes

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By: Ciara Pino
Created: 2011-12-07
Size: 90 flashcards
Views: 108

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Thymus Gland atrophy

most prominent morphological change
begins to atrophy around puberty
causes increased autoimmunity due to changes in T cell production

Immunosenescence

aging of the immune system

thought to involve primarily innate immunity and the T cells of acquired immunity

Glucose counterregulation

difficulty recovering from hypoglycemia due to impairment, no longer able to regulate quickly, makes more than enough insulin causing increased insulin resistance

Aldosterone

saves sodium and water = increased risk of postural hypotension, affects B/P

Myelin degradation

difficulty w/ neurological processing

Conductive Hearing Loss

issues with sounds getting to inner ear, related to issues outside the ear and in outer ear, e.g. cerumen build-up

Sensorineural Hearing Loss

issues with nerve communication between brain and ear, most common reason for hearing loss

Renal function

decreases, making it difficult to decrease potassium levels
choose Mr. Dash over salt substitute (has potassium chloride in it)

Hypoguesia

decrease in taste

usually noticeable around age 60, more severe decline around age 70
decline in taste of salt changes the most (maybe due to decrease in number of taste buds or change in taste receptors)

Most common concerns w/ taste issues

food poisoning and malnutrition

Dry eye syndrome

dry eyes and/or feeling of irritation (as if something is in the eye)

experienced by many
may be explained by decline in the amount of tears produced by lacrimal glands

Pupil constriction and dilation

reduced ability of the pupil and iris to work together to constrict and dilate

eye is unable to appropriately adapt to changing light intensities
collagen fibers in the eye begin to thicken and muscle cell numbers decrease

Glare

bright areas in the field of view

cornea decreases in transparency causing a reduction in the amount of light entering the eye as well as an increase in light scattering

Presbyopia

farsightedness

inability to focus on nearby objects
most common visual concern (most notable around age 40)
generally corrected with corrective lenses
decline in visual acuity

Sensitivity to contrast (light)

declines as a result of changes in the optics of the eye

further declines under conditions of low light
complaints of driving because they have difficulties seeing at night
change in retinal rods (that affect low-light visibility)

Color vision changes

impaired color discrimination, especially blue-yellow continuum

Cataracts

decrease in the transparency of the lens in the eye

fairly common, everyone who lives long enough will experience some degree of cataracts
more instances in women than men

Glaucoma

increased ocular pressure causing loss in peripheral visual field

genetic, also subject to environmental influences
higher prevalence in African Americans

Macular degeneration

major cause of irreversible impairment and blindness

Diabetic retinopathy

relates directly to the presence of diabetes
not a usual part of aging

Presbycusis

age related hearing loss

most common sensory deficit in older population
correlated with the deterioration in physiological function of cochlea

Intrinsic and extrinsic factors that affect hearing

occupation, loud noise, nutrition, cholesterol, arteriosclerosis, loss of inner ear hair cells, cerumen blockage, cochlear neuron degeneration

Chronological (intrinsic) skin aging

changes due only to the passage of time

characterized by thinness and reduction in elasticity
wrinkles are very fine and skin appears relatively smooth
primarily affects skin's function over appearance

Extrinsic skin aging

result of chronic exposure of the skin to external factors such as smoking, poor nutrition, and especially UV light

Photoaging: deep wrinkles, sagging, leathery appearance (most visible changes)

Changes in skin lead to...

increased risk of infection, contributes to slower wound repair, increases risk of cancer, weakens body's protective barrier

Skin and Vitamin D3

Due to decrease in epidermal D3 precursor and reduction in skin exposure, older adults are at risk for poor bone health, osteoporosis, and numerous other diseases

Greatest changes seen in what layer of skin?

dermis

Changes of the dermis

loss of collagen- thins & decreases in flexibility
elastin becomes brittle & less resilient
declines in vascularity, blood flow (decrease in skin temperature/impaired thermoregulation)
change in nerve endings (decreased sensation)

Hair

thinning and loss of scalp hair occurs in both men and women

may also be thinning of facial hair in men
ear and eyebrow hair longer & coarser in men
women may develop unwanted facial hair (hormone changes)
graying due to loss of melanocytes

Sweat Glands

decrease in number, efficiency declines, less sweat produced

impaired thermoregulation and difficulty staying cool
at risk for heat exhaustion, heat stroke, and hyperthermia

Sebaceous glands (oil glands)

decrease in size NOT number = increased dryness, roughness, and itchiness of skin

Replicative Senescence

result of repeated cell division

cells can only divide so many times,
decline in overall number of immune cells available to ward off invading antigens
weakened immune reponse

Autoimmunity

overall increase in percentage of T cells and B cells as well as memory T cells against many of the body's own cells

related to decrease in thymus function

Vaccinations

can strengthen immune defenses by stimulating the production of antibody-producing B cells as well as memory T cells against the antigen

Pneumonia and influenza

sometimes less effective due to slower and weaker immune systems

Anemia and Aging

deficiency in the number of RBcs or the amount of hemoglobin

common condition among older persons, but NOT an age-related disease
most forms of anemia due to causes other than aging

Older adult MOST affected by....

health behaviors, genetics, and the availability of resources

Cardiac aging

enlargement of the heart chambers and coronary cells
increased thickening of heart wall (especially left ventricle)
decline in ventricle flexibility
increase in heart weight
ventricles begin to thicken/stiffen
decreased # of myocardial cells

Vascular Aging

arterial walls thicken
arteries become extended and twisted
large arteries dilate and stiffen (HTN)
arterial walls lose muscle attachments
atrophy or arterioles
dilation of aorta decrease
decreased vascular tone
calcium deposits in valves (stenosis)

Most prevalent respiratory diseases

pneumonia and COPD

Respiratory Aging

blood volume to lungs decrease, chest wall stiffens, flattening of the diaphragm, decrease elasticity, decreased surface area of alveoli, decreased air flow through lungs

Changes in the mouth

change in taste, ability to chew, dental decay and tooth loss, atrophy in the muscles and bones of jaw

Esophageal changes

Presbyesophagus

decrease in upper esophageal pressure
stiffening wall
less sensitivity to discomfort & pain
gag reflex decrease or absence
lots of dysphagia, reflux, heartburn, angina

Gastric defenses...

decrease in gastric defense mechanism

Small Intestine changes

bacterial overgrowth leading to malabsorption and malnutrition

increase in Vitamin A absorption (toxicity)
Vitamin D, zinc, and calcium decrease in absorption (necessary for wound healing and bone growth/strength)

Changes in the colon

loss of nerve connections to smooth muscle
longer transit time
increased fibrosis
colonic pressure
rectum has increased fibrous tissue that decreases its ability to stretch
decreased sphincter control

Liver changes

decrease in size, blood flow, and perfusion
decreased drug clearance (risk for toxicity)

Gallbladder changes

decreased emptying rates
gall stones
bile ducts widen

Pancreatic changes

decrease in weight
fibrosis and cell atrophy

Renal changes

majority of functional change in the kidneys w/age
decrease in length and weight
decrease in drug clearance- polypharmacy (dosage- start low and go slow)

Urinary Bladder changes

decrease detrusor muscle contraction
filling capacity declines
walls become thicker and stronger to compensate for decreased function

Urination changes

amount of expelled urine decreases
nocturia can disturb sleep patterns
enlarged prostate affecting urinary function
incontinence (not a part of aging) - decreased tone in urinary musculature

Homeostasis changes (kidneys)

structural changes in kidneys lead to functional declines

deterioration in ability to regulate Na concentration under usual conditions
" " maintain Na & K homeostasis, due to low K secretion
" " to conserve water in times of stress

Calcium-Parathormone (Vitamin D3 axis)

decrease in vitamin D metabolism, decrease in calcium serum levels, need Vitamin D supplementation

Female changes associated with....

onset of menopause and decline in estrogen levels

Decreases in estrogen and progesterone...

affects the brain, resulting in cognitive changes, insomnia, and possible depression

also affects skin, sweat and sebaceous glands, hair follicles, bone loss, loss of CT, decreased bladder function, CV function and BP change, changes in metabolism

Ovaries...

atrophy so much that they become impalpable during exam

leads to infertility
decline begins in 30's/40's, rapidly declining after 35

Uterus...

decrease in uterine endometrial thickening during menses due to decreased estrogen and progesterone levels, leading to decrease in menstrual flow, then missed cycles, then cessation of ovulation and menses

supporting ligaments are weakened

Vagina...

becomes shorter and narrower and walls get thin and weak

loss of elasticity, loss of mucosal layers (becomes very dry causing intercourse to be painful)

vaginal pH shifts from acidic to alkaline ( pH>8)

vaginal infections tend to increase

Menopause

occurs ~ age 51, ALL Females
begins 12 months after final menstrual period

symptoms: hot flashes, mood disturbances, weight gain, hair loss, vaginal dryness, bladder infections, loss of sex drive, backaches, fatigue, insomnia, cognitive loss, joint pain

Testes...

decrease in size and weight, decrease in testosterone
decreased sperm production, but never ceases (older males remain fertile)

Prostate glands

lining and muscle layer thin and blood flow to area decreases
Benign Prostate Hyperplasia (BPH) causes the prostate to grow very large, blocking the urethra

increased urinary frequency and discomfort
bladder and kidney infections (increase)
ED

Penis...

fibrous changes in erectile issues, causes problems for intimacy = takes longer, doesn't last as long

Andropause

decrease in testosterone levels and eventually a deficiency
does not occur in ALL males
symptoms of Androgen Deficiency in Adult Males (ADAM): decreased libido, decreased energy, strength, and stamina, increased irritability, cognitive changes

Brain changes

decrease in size and weight
less gray matter, more white matter (myelinated)
breakdown in myelin sheath

Cholinergic neurotransmitter

releases acetycholine (plays a big role in learning and memory)
decrease in acetylcholine synthesis and release
more pronounced in Alzheimer's patients

Dopaminergic neurotransmitter (Dopamine)

dopamine levels decrease ~10% with every decade

Hypothalamic-pituitary-adrenal axis (HPA)

regulates glucocorticoid; allows body to respond to stressful situations

neuroendocrine change that causes glucocorticoid to circulate longer possibly causing damage to hippocampus

Vascular changes (brain)

cerebral blood flow decreases
blood brain barrier shows degradation of capillary walls, affects ability of nutrients to nourish brain, can prevent waste by-products from exiting the BBB

Plaques and tangles show signs of what?

beta amyloid plaques and neurofibrillary tangles -> (signs of Alzheimer's, but doesn't guarantee it)

Free Radicals

O2 radicals increase with age causing oxidative damage to lipids, proteins, and DNA
O2 is the major generator of free radicals in humans

Nerve conduction changes

aging spine narrows due to pressure on spinal cord, spinal cord axons decrease and can cause changes in sensation

conduction speed slows due to degradation of myelin sheath

Changes in sensory neurons (touch, smell, taste)

Touch: decrease in touch receptors (Meissner's corpuscles) and pressure receptors (Pacinian corpuscles)
Smell: olfactory neurons decrease w/ age, decrease in ability to detect and identify smells
Taste: affects salty most, then bitter

What is the cause of older adult HTN?

hardening of the peripheral arteries

Pituitary gland role

master gland that regulates other endocrine glands

releases growth hormone, vasopressin, thyrotropin, and corticotropin

Growth hormone & aging

stimulates the uptake of amino acids into cells and creates protein, resulting in bone, muscle, and other tissue growth

works antagonistically against insulin & increases blood sugar levels
levels decrease causing bone, muscle, & tissue loss

Vasopressin & aging

antidiuretic hormone that regulates homeostatic levels of osmotic pressure and blood pressure

promotes water reabsorption to maintain a substantial blood flow (prevents BP from becoming to low)
decreases with age, causing loss of H20 in urine, ↓ BP

Thyroid role in aging

secretes TSH to maintain growth and structural integrity of thyroid gland

regulates the body's metabolic rate, regulate body temp
decrease causes slower metabolism, lethargy, poor resistance to cold

Calcitonin & aging

inhibits bone reapsorption, lowering blood calcium levels

decreased calcitonin levels with age, puts one at risk for osteoporosis

Parathyroid & aging

antagonist to calcitonin, increases bone reabsorption and mobilizes calcium

removes Ca from bone, activates vit D by kidney stimulating SI to absorb Ca
decreased ability to activated Vit. D & decrease in Ca serum levels

Melatonin & aging

secretion influenced by light properties to put us to sleep, shifts in response to seasonal changes

decline in melatonin levels as we age, may be linked to poor sleep quality and insomnia

Aldosterone & aging

main function to maintain BP through effects of water retention and increased fluid, also reabsorbs potassium and sodium to aid in the fluid-electrolyte balance

declines w/ age, more likely to experience Na loss & possible hyponatremia

Norepinephrine, epinephrine, stress, & aging

critical role in body's stress response, release is greatly increased under stressful situations

decrease in epinephrine = impairment of stress response

Oral Glucose Tolerance Test

check for diabetes

drink glucose drink after 10 hrs of fasting
levels measures in beginning and q3hr
normal tolerance- rise in glucose levels, then returns to normal w/in 2 hours
impaired tolerance- levels remain high for longer than 2 hours

Insulin resistance

primary effect on aging process of glucose homeostasis

resistance leads to impaired ability to suppress glucose release from liver as well as an impaired glucose uptake

Counterregulation

delayed recovery from hypoglycemic state and elevated fasting glucose levels

elderly less aware if warning signs of hypoglycemia and less likely to take action to return levels to normal
place elderly at risk for insulin and glucose intolerance

Anorexia & aging

decline of food intake with age, may be associated with decrease in sense of smell and taste, loss of appetite

Risks for malnutrition

Eating alone
Involuntary weight loss
Economic hardship
Age >80

Arthritis

inflammation of the joints accompanied by joint pain and injury

osteoarthritis & rheumatoid arthritis

affects weight bearing joints
break down and weakening of cartilage, decrease in cushioning, cartilage loss, then bones start to rub together

Decline in proprioception leads to...

leads to more susceptibility to imbalances and falls

Osteoporosis

results from the reductions in bone quantity and strength, very porous bone, thin and fragile, prone to fracture

About this deck

By: Ciara Pino
Created: 2011-12-07
Size: 90 flashcards
Views: 108

About StudyBlue

“Simply amazing. The flash cards are smooth, there are many different types of studying tools, and there is a great search engine. I praise you on the awesomeness.”
Dennis