1
Q
why do we age?
A
aging causes functional changes at the cellular level
2
Q
why use the term older adult?
A
- senior is too limited
- elderly connotes frailty
3
Q
general physical changes with aging
A
- increased risk of chronic disease
- activity level declines (geriatric syndromes)
- decline in lean body mass and bone density
- increased risk of falls and fractures
- impaired oral/eye/ear health
- changes in skin, taste, smell
4
Q
geriatric syndromes
A
the emergence of multiple isolated health conditions, including frailty, urinary incontinence, falls, and pressure ulcers, each with a distinct cause
5
Q
changes during aging
A
- skeletal system
- musculature
- vision
- hearing
- vestibular
- joint perception
- balance
6
Q
at what age do skeletal system issues arise?
A
30 years old
- happens to women after menopause
7
Q
importance of the skeletal system
A
- calcium storage
- movement
- reduce frailty
8
Q
what issues progress with the skeletal system when you’re ~30?
A
- density or mass of bones diminish
- bones are more fragile and likely to break
- development of osteoporosis or osteoarthritis
- stiff joints (cartilage decrease)
- limited ROM (fluid decreases)
- collapse of vertebrae (changes in posture)
9
Q
what age is peak muscle strength?
A
age 20-30
10
Q
importance of musculature
A
- preventing weakness and fatigue
- improve ability to perform daily activities
- reduce risk of falls and injury
11
Q
what occurs to the musculature after 30?
A
- muscle atrophy
- sarcopenia
- muscle fibres not able to contract as quickly due to changes in NS
- presence of lipofuscin (muscle fibres shrink and replaced by bone)
12
Q
muscle atrophy
A
thinning/loss of muscle tissues
13
Q
sarcopenia
A
loss of muscle
14
Q
at what age do visual changes start to occur?
A
age 50 due to environment, genes, illness/diseases, and socioeconomic factors
15
Q
common diseases of the eye
A
- glaucoma (damages optic nerve)
- dry eyes (occurs due to aging)
- macular degeneration (macula damaged)
- cataracts (clouding of lens)
- diabetic retinopathy (vision loss due to diabetes)
16
Q
age related changes to the eye
A
- pupil: decreased diameter
- vitreous humor: changes from gel to liquid and may detach from retina
- macula: loss of central vision
- lens: protein precipitate = cataracts
17
Q
hearing changes
A
- presbysusis
- sensorineural hearing loss (fixed with a hearing aid)
- conductive hearing loss
- mixed hearing loss
*can impact one or both ears
18
Q
presbycusis
A
progressive, multifaceted, age-related hearing loss
- influenced by genetics, environment, trauma and ototoxic medicines
19
Q
ear changes - inner ear
A
hair cells lost and otoliths degenerate causing loss of balance
20
Q
ear changes - Eustachian tube
A
muscle atrophy
21
Q
ear changes - tympanic membrane
A
- becomes less vascular
- decreased elasticity
22
Q
ear changes- cochlea
A
hair cells degenerate causing presbycusis
23
Q
ear changes- ossicles
A
joints between bones become thinner
24
Q
ear changes- ear canal
A
- may collapse
- earwax accumulates
25
ear changes- pinna
enlarges with age
26
vestibular system age related changes
1. decrease in balance
2. frailty
27
important of vestibular system
1. allows equilibrium and balance
2. keeps you upright
3. shows where you are in space
28
Joint proprioception and aging
1. mechanoreceptors (neural input) change (located in joints, capsules, ligaments, muscles, tendons, skin)
- causes impaired/deterioration of proprioception leading to less accurate detection of body position
2. increased risk of falls and degenerative joint disease
29
the properties of balance
1. steadiness
2. symmetry
3. dynamic stability
30
what do balance disorders result from
steady reduction of several systems functions, including musculoskeletal, central NS and sensory system
31
good balance meaning
require reliable sensory input from an individuals vision, vestibular system and proprioceptors
- as we AGE these systems deteriorate
32
top 10 chronic diseases
1. hypertension
2. periodontal disease
3. osteoarthritis
4. ischemic heart disease
5. diabetes
6. osteoporosis
7. cancer
8. COPD
9. asthma
10. mood and anxiety disorders
33
aging risk factors
1. alcohol and tobacco use
- more likely men
2. nutrition
- women have a harder time at older age
3. PA (60.6% don't meet guidelines)
4. sleep (46.8% struggle to fall asleep)
34
multi morbidity
co-occurrence in the same individual of two of more of the ten common chronic diseases
- 1/3 seniors have it
- risk increases as you age
35
negative effects of multi morbidity
1. impaired quality of life
2. increased use of health care resources
3. institutionalization
4. disability
5. premature death
36
diabetes and age risk factors
1. risk increases as we age (mostly type II)
2. management of diabetes becomes more difficult as we age
37
why does management of diabetes become more difficult as we age?
1. coexisting medical conditions
2. cognitive issues (forgetting to take meds)
3. lack of knowledge and access to resources
38
why is diabetes placed on the back-burner for older adults?
older adults suffering from multimorbidity disease focus on the more prominent disease even though diabetes is perpetuating their negative health
39
cardiovascular disease and aging
risk of cardiovascular disease increases with age regardless of risk factors
40
high blood pressure (hypertension) and aging
reduction of elastic tissues due to age-related vascular changes, resulting in stiff arteries (BP increases)
- occurs regardless of PA level and alcohol consumption as you age
41
cancer and aging
1. risk of cancer increases as you age
2. however, the incidence of cancer decreases after age 85
- possibly due to a decline in the physiological processes that lead to cancer (cells)
42
what is the most common injury and one of the leading causes of death in older adults?
falling
43
where are falls more likely?
in the community rather than a long term care home as they are set up for preventing falls
44
what percentage of falls cause a life-threatening injury?
1/5
45
what can falls result in?
1. chronic pain
2. reduced mobility
3. loss of independence
4. death
46
post-fall syndrome
cycle increasing weakness and instability through joint mobility reductions, physical deconditioning and poor balance
47
post-fall syndrome symptoms
1. dependence
2. loss of autonomy
3. loss of self-confidence
4. depression
5. confusion
6. immobilization
7. restriction to the daily activities
48
fall cycle
1. fall
2. loss of balance confidence
3. fear of falling again
4. self restriction of physical activities
5. reduced muscle strength, impaired balance
6. abnormal gait, more unstable on feet
7. increased risk of falling
8. fall
- and the cycle begins again
48
compensatory mechanisms for balance
actually increases the risk of falling
1. cautious gait
2. frozen gait
49
cautious gait
excessive degree of age-related changes in walking and fear of falling
ex. slow, wider base, stooped, reduced arm movement
- occurs right after the fall
50
frozen gait
short, sudden, temporary episodes of an inability to move the feet forward despite the intention to walk
ex. quick shuffling, momentum of upper body causes falls
- occurs later after a fall - results in more
51
frailty
state of increased vulnerability to disease, dependence, disability and death
- age increases the risk of frailty
52
Canadian Frailty Framework (AVOID)
1. Activity
2. Vaccinate
3. Optimize medications
4. Interact w others
5. Diet and nutrition
53
physical activity programs and aging
PA programs must be individualized to a person and their social, functional and cognitive abilities
54
what percentage of older adult age 65+ have at least 1 of the 10 common chronic diseases?
73%
55
prevalence of falls in older adults
20-30% of seniors experience 1+ falls each year
56
how many seniors are admitted to LTC post fall?
1/3
57
Percentage of senior’s injury related hospitalizations
85%
58
percentage of hip fractures cased by falls
95%
59
how much do falls cost in healthcare costs each year
$2 billion
60
7 behaviours of a healthy lifestyle
1. exercising
2. eating a diet high in fruits and veggies
3. not smoking
4. drinking alcohol in moderation
5. getting adequate rest
6. coping with stress
7. having a positive outlook
61
what is missing from the 7 behaviours?
social interactions and social relationships
62
basic activities of daily living to maintain "performance"
1. dressing
2. locomotion
3. continence
4. eating
5. transferring
6. walking and moving around
*good ways to monitor ones independence
**basic needs
63
instrumental activities of daily living to maintain "performance"
1. using a telephone
2. traveling
3. shopping
4. preparing meals
5. housework
6. taking medicine
**taking CARE of yourself
64
PA guidelines for older adults (65+)
1. 150 minutes MVPA
2. add muscle and bone strengthening activities 2 days/week
3. PA to enhance balance and prevent falls
65
types of PA
1. aerobic (endurance)
2. strength
3. flexibility
4. balance
5. functional
66
aerobic exercise
- supplies O2 to brain
- walking, jogging, swimming, etc.
- 20-30 min/day
67
strength exercise
- muscle work MORE than daily living activities
- weight training, resistance bands, body weight
68
flexibility exercise
- increases freedom of movement for everyday activities
- yoga, leg raises, swimming
69
balance exercise
- strengthens muscles that keep you upright
- improve stability and prevent falls
70
functional exercise
- trains muscles to work together
- prepares for daily tasks by reproducing common movements
- gardening, mopping, mimicking daily activities
71
benefits of PA
1. decrease BP
2. increase strength and CV endurance
3. increase balance
4. increase lung and breathing function
5. improve immune function
6. reduce depression and anxiety
7. control obesity
**ADD LIFE TO ONE'S YEARS (QUALITY)
72
frailty and exercise
helps improve physical function, minimizes and delays age-related declines
73
best targeted exercise for frailty
1. aerobic
2. muscle-strengthening
3. multi-component PA
74
PA benefits related to frailty
1. improves ability to perform tasks
2. prevents weak bones and muscle loss
3. improves joint mobility and sleep quality
4. reduces risk of chronic conditions
5. extends years of activity and independent living
6. lowers risk of dementia
7. reduces likelihood of falls and injury
75
barriers to activity
1. intrinsic
2. extrinsic
76
intrinsic barriers to activity
related to beliefs, motives and experiences of the individual
ex. previous experiences at school, concerns about over-exertion, perceptions of PA
77
extrinsic barriers of activity
related to broader PA environment
ex. skills and attitudes of others, types of opportunities available, access and safety
78
two main avenues of overcoming barriers
1. reassurance in relation to concerns about safety, frequency and intensity
2. education of individuals as to what is appropriate PA
79
changing up what PA means for older adults
1. strength to lift objects
2. flexibility to wash hair, tie shoes
3. balance to climb stairs
4. coordination and dexterity to open a door
5. speed to cross the road
6. muscular endurance to walk to the shops
80
master athletes
- 25-35+ years old
- later-life leisure
81
are master athletes role models?
they can be motivating for those who can be like them but can cause social comparison for those who cannot engage in exercise like master athletes can
