Adulthood & Aging

Question 1

Objectives

1. Discuss health factors related to the aging population and the elderly
2. Discuss functional implications of age-related changes in skeletal muscles
3. Relate age-related changes to the cardiovascular, pulmonary and nervous systems to physical functioning and differences in cognition and motivation
4. Explain how changes associated with aging can be challenging for patients and patient’s families or caregivers

Answer 1

fyi

Question 2

Rate of physiologic function decline is highly variable

Answer 2

Aging

Question 3

1. In 2000, median age rose to highest level ever. 35.3 y/o
2. Fastest growing segment of population is those over age 85. In 1995 it was 3.6 million and projected for 2050 at 18.2 million. Those over 100 (1995) were 54,000 and by 2020 it is projected to be 214,000.
   
   • That’s a lot of people to assist out of bed!!

Answer 3

STATS

Question 4

1. The incidence of chronic disease INCREASES with age.
2. Disability & need for assistance also INCREASES with age.
3. There is a high coorelation between increasing age, decreasing physical activity and increasing disability.
4. Inactivity & disuse mimic the physiologic changes observed w/aging. Gilligan et al reported that “disuse accounts for about ½ the functional decline that occurs between 30 & 70, and aging causes the other ½.”

Answer 4

Maladies

Question 5

Aging study

Rowe & Kahn (researchers) found that successful aging was determined by an?

Answer 5

1. active engagement with life
2. high cognitive & physical function
3. avoiding disease & disability

Question 6

what increases with age?

Answer 6

1. Increased systolic BP
2. Increased stiffness
3. Increased fat mass
4. Increased risk of CVA, HTN, & AMI
5. Increase of 30-50% residual capacity
6. Increased risk for hypercholesterolemia & atherosclerosis

Question 7

what decreases with age?

Answer 7

1. 2-4 bpm of resting HR
2. cardiac heart muscle & volume
3. elasticity of blood vessels
4. capillary/muscle ratio
5. 40-50% vital capacity
6. size & # of mitochondria
7. bone mineral content
8. cartilage water content
9. 25-40% muscle mass
10. 10-15% NCV
11. 15% BMR
12. 30-50% renal function

Question 8

Decreased cardiac output, stroke volume, and max heart rate together w/increased systolic & diastolic BP represent age-related _________ _________changes.

Answer 8

CARDIOVASCULAR CHANGES

OR

CV

Question 9

Aerobic or functional capacity is greatly affected by age & disease-related processes. The measure of functional capacity is often measured in

Answer 9

METS

(metabolic equivalent units)
1 MET = utilization of 3.5 ml O2 per kilogram of body weight per minute
Example- walking 2 miles per hour requires 2.5 METs

Question 10

lungs

In the absence of disease, declines in the___________system are not noticeable until the individual reaches 60, 70 or even 80 y/o.

Answer 10

pulmonary

Question 11

Decreased mobility of the bony thorax can change the resting position of _________ __ _________, therefore influencing function of the lungs

Answer 11

muscles of respiration

Question 12

Loss of the _______- _______ ________ & increased alveolar size secondary to destruction of the walls of individual alveoli are the major forms of lung deterioration found w/aging.

Answer 12

alveoli-capillary interface

&

increased alveolar size

Question 13

Lung compliance or ability of lungs to expand, increases w/age & @ same time elastic recoil ?

Answer 13

decreases

Question 14

1. Dehydration, especially during exercise, is common in the elderly
2. Electrolyte imbalance associated w/dehydration are also common w/aging
3. Less lean body mass & less metabolically active tissue contribute to a decline in metabolic rate & energy requirements of the body.

Answer 14

Body composition

Question 15

OSTEO JT problems

Answer 15

Osteopenia, osteoporosis, osteoarthritis.

Question 16

Cross-linking collagen fibers increases w/loss of motion. If loss of motion, then nutritional exchange of articular cartilage are reduced adding to degenerative changes in _________ _________joints.

Answer 16

weight bearing

Question 17

• Strengthening the muscles around the joint help resist decrease the risk of injury to the joint by supporting it.
• name 3 forces acting on the bone during normal activity:

Answer 17

Gravity
Weight bearing
Pulling forces of the muscle on the bone

Question 18

recurring anterior vertebral compression fractures of t-spine lead to wedging & kyphosis

Answer 18

Kyphosis-

Question 19

flattens w/age in L-spine

Answer 19

Lordosis

Question 20

narrowing of the central canal

Answer 20

Central stenosis

Question 21

Water content of nucleus pulposus decreases or increases?

Answer 21

decrease

Question 22

Neuromuscular junction changes & nerve conduction slows :

name 6 gait changes:

Answer 22

1. Mild rigidity & less body motion proximally than distally
2. Arm swing decrease in amplitude & speed
3. BOS becomes wider to improve stability
4. Step length becomes smaller
5. More time is spent in double support stance w/decreased swing to stance ratio
6. Decreases in speed of gait

Question 23

In aging nervous systems, neurons get smaller & fewer

true of false

Answer 23

true

Question 24

there is Decrease in what type of fibers

Answer 24

type II fibers

Question 25

Functionally- neuro changes result in generalized

Answer 25

1. weakness, 2. impaired mobility & balance, 3. poor endurance, 4. fractures 5. impaired ability to perform ADL’s.

Question 26

Integumentary system: name some aging relations

Answer 26

1. Epidermis flattens & thins, therefore making it susceptible to shearing forces 2. Dermis also atrophies & has diminished vascularity 3. Loss of collagen & elastin fibers 4. Lentigos—flattened pigmented age spots. Increase with exposure to sun

Question 27

lattened pigmented age spots. Increase with exposure to sun

Answer 27

Lentigos

Question 28

1. Slowing down & deterioration of movement 2. Decline in size & weight of brain 3. Decline in cerebral blood flow, oxygen needs, & glucose utilization by the brain 4. Ventricles become larger. Sulci & gyri become less defined peaks & valleys 5. Neuronal loss from thalamus, forebrain & hippocampus 6. Loss of purkinje fibers from the cerebellum 7. Fibers play a role in control of movement 8. Volume of myelin decreases

Answer 28

CNS

Question 29

1. Presbyopia 2. Size of pupil decreases 3. Photoreceptors in the retina and related projections to the thalamus & visual cortex lose ½ of their cells 4. Color discrimination is harder due to the lens of the eye changes 5. Lens becomes more opaque and yellow 6. Cataracts 7. Glaucoma 8. Macular degeneration

Answer 29

eyes

Question 30

physiologic loss of accommodation or ability to focus on near objects

Answer 30

Presbyopia

Question 31

visual cortex lose

Answer 31

½ of their cells

Question 32

degenerative opacity of the lens causing obstruction & scattering of light to the retina. Images are blurred & acuity is reduced

Answer 32

Cataracts

Question 33

one of the leading causes of blindness in persons over 35. Damage of the optic nerve causes blindness.

Answer 33

Glaucoma

Question 34

3rd major source of visual disability. Sees gray shadows in CENTER of visual field but can see outer borders okay. Makes TV & computer work much more difficult

Answer 34

Macular degeneration

Question 35

Auditory

Answer 35

1. Presbycusis—inner ear age related decline in auditory acuity & most common cause of hearing loss in adults. 2. Incidence of hearing loss is 50-60% in persons 71-80 y/o 3. Hearing loss is the 3rd most prevalent chronic condition in older adults.

Question 36

1. Presbyastasis—disequilibrium. 2. 20% reduction in hair cells in the ear that sense linear acceleration and 40% loss of hair cells in semicircular canals. 3. Fear of falling is reported to be 29-92% in older adults. Results in a decrease in health status & functional decline

Answer 36

1. Presbyastasis—disequilibrium. 2. 20% reduction in hair cells in the ear that sense linear acceleration and 40% loss of hair cells in semicircular canals. 3. Fear of falling is reported to be 29-92% in older adults. Results in a decrease in health status & functional decline

Question 37

1. Hyposmia—decreased sensitivity to smell that occurs in olfactory system 2. Hypogeuia—decreased sensitivity to taste that occurs in the gustatory stystem 3. Both make food taste less appealing and may lead to poor nutrition

Answer 37

Olfactory & gustatory

Question 38

1. Difficulties with orientation to time 2. Capacity for cognitive reserve decreases 3. Ability to learn & improve cognitive performance continues 4. Demonstrate diminished performance in timed learning tasks, in learning that is new, and in understanding new methods or situations.

Answer 38

Cognition

Question 39

the ability to subconsciously screen out extraneous information while focusing on important cues is developed in adolescence. _On divided attention tasks, the performance of the older adult decreases with a more rapid decline after age 70. _

Answer 39

Selective attention

Question 40

Performance on vigilance tasks decreases w/age & does not seem to be changed by practice to support the skill.

Answer 40

Vigilance

Question 41

1. Depression in the elderly tends to manifest related to thoughts, ideas & guilt. 2. A link….? 3. Some studies involving low blood pressure & depression…

Answer 41

Depression

Question 42

this was a slide with questions /see if you can answers 1. Name a health factor related to the aging population and the elderly 2. List a few functional implications of age-related changes in skeletal muscles 3. List two age-related changes to the cardiovascular, pulmonary and nervous systems to physical functioning and differences in cognition and motivation

Answer 42

smile the end