211: Geriatric Considerations
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| ___ and ___ of aging vary among individuals | rate, effect
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| aging may not match ____ age | chronological
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| rate of change from aging depends on 4 things | genetic makeup., lifestyle, health status, cardiovascular fitness
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| how does aging affect size of brain | No change in size of brain except with pathology (Alzheimer's), increased size of ventricles
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| how does aging affect weight of brain | decrease weight
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| loss of ____ through lifespan | nuerons
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| how does aging affect neurotransmitters | decrease (decrease synthesis and release of ACh)
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| neurotransmitter examples | dopamine, epinephrine, norepinephrine, ACh
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| ACh function | a main factor in memory and muscles contraction
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| decreased speed of conduction of neurotransmitter results in what? | slower movements
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| decrease in dopamine results in | tremors 'Parkinson like syndrome'
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| how does aging affect NM system? | decrease in responsiveness, coordination speed of transmission, increase reaction time, decrease cognitive processing speed, attention span, decrease acuity of sensory systems, increase postural instability and gait changes, decrease nerve cells in brain
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| VO2 max | the standard for defining exercise ability/efficiency (aerobic capacity)
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| how does aging affect vo2 max? | decrease, decreases with deconditioning
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| does resting oxygen consumption change with age? | does not change with age - unless a Hx of pneumonia or asthma
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| how does age affect resting HR | decreases - unless a Hx of cardiac or medicinal use
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| how much does resting HR decrease per decade | decreases 5-7BPM/decade
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| why does BP increase with age | due to atherosclerosis and arteriosclerosis
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| atherosclerosis | thickening (fat accumulation)
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| arteriosclerosis | decreased resilience of vessel walls (hardening)
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| HR max formula for elderly | 208 - [0.7 x age]
(208 instead of 220)
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| age related vs. age dependent | age related: time/age related but are not necessarily caused by aging processes
age dependent: related to normal aging, almost everyone will experience
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| most prevalent disease in those over 60 | CAD/ischemic heart disease - Common but not 'normal' change with age
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| what is most common cause of CAD | •90% due to atherosclerosis
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| what does CAD result in | decrease blood flow --> angina -->MI --> tissue death
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| how does age affect maximum heart rate, cardiac output, stroke volume, and VO2max | decrease
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| how does age affect thickness and stiffness of L ventricular wall & valves | increase
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| how does age affect peripheral vascular resistance | increase
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| how does age affect total and LDL cholesterol, ↓ HDL cholesterol | increase
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| aging causes delayed response of ____ | baroreceptors
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| decrease response of ____ cells with age | pacemaker
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| how does age affect residual volume | increases, causes decrease in amount of oxygen exchange
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| how does age affect vital capacity? | decrease = decrease o2 sats and increased risk of pneumonia
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| vital capacity | max you can breathe out
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| how does aging affect lung tissue and chest wall | decrease elasticity
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| how does aging affect cough reflex and cilia | decreased activity
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| how much does residual volume increase with aging? | 30-50%
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| how is alveolar surface area and vascularity affected by aging? | decrease
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| how much does the work of respiratory muscles increase with aging? | 20%
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| tidal volume | the lung volume representing the normal volume of air displaced between normal inhalation and exhalation when extra effort is not applied.
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| max ventilatory capacity | the volume of air that can be moved with maximum inhalation followed by maximum exhalation.
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| collagen | basic protein which increases tensile strength
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| how does aging affect collagen | increase diameter, increase cross linkages (tighter and less flexibility), increase strength of collagen fibers
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| elastin | allow for return to original length following stretch
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| how does aging affect elastin | decrease recoil, increase ability to overstretch and tear
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| ground substance (glycoproteins) | lubrication, helps maintain fluid content in tissue: Turgor test
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| how does aging affect ground substance | decrease (can also decrease from dehydration), if hydration decreases then more wrinkling
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| overall affect of aging on connective tissue | •increase cross - linkages of collagen lead to in tensile strength
decreased elasticity in skin, arteries and bronchial tree
•decrease fluid in tissues
•Net result = rigidity, tendency for adhesions
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| soft tissue work for the elderly | gentle stretches, massage works well in the elderly
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| how does aging affect the epidermis | increase turnover time with age, decrease moisture = brittle skin, epidermis separates from dermis easier so skin tear occur easily
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| ____ are very easy to tear | liverspots
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| how to prevent bruising in elderly | Bruises easily with a circumferential grip, use a lumbrical grip, wear long sleeve, use stockinet, elbow/ ankle pads
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| how does age affect the dermis | decrease blood flow, increase inflammatory reactions, bruises slowly, takes a long time to heal
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| things to be careful with in elderly | Gait belts, transfers, structural damage at shoulders, taping, wrapping, splinting, orthotics
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| how does aging affect temperature regulation? | •Cold intolerance - due to decreased shivering and vasoconstriction
•Heat intolerance - decreased ability to perspire and lower body temp
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| elderly need increased ___ time with exercise | cooling, Do not exercise them in a warm/hot room - need a cool room/ not cold either
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| factors that can affect temperature regulation | Medications, atherosclerosis, anemia, hyperthyroidism, diabetes
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| what type of mm fibers decrease with age? | type 2 (more in the LE than UE
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| how is the motor unit affected by aging? | reduction in the number of mm fibers per motor unit, decreased speed of contraction
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| how does aging affect muscle | decrease Muscle mass, endurance, strength, speed of contraction, tissue compliance
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| BED REST acronym | •Bladder/bowel incontinence and retention, Bed sore
•Emotional trauma, Electrolyte imbalance
•Deconditioning, Depression, Demineralize bone
•ROM - contractures, Renal dysfunction
• Energy depletion
•Sleep disorders, Sensory deprivation
•Trouble
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