Title: Gerontological
1Gerontological Community Based Nursing
Physiologic Changes of Aging
2Physiologic Changes of Aging
- Physical Changes
- Normal Aging
- Pathologic conditions
3Aging
- Aging starts at birth
- Continues throughoutlife span
- It is universal, progressive, intrinsic, and
unavoidable
4Biologic Theories of Aging
- Stochastic theories
- Nonstochastic theories
5Stochastic Theories
- Stochastic- Aging occurs randomly and progresses
over time. - Error- DNA/RNA Cell replication errors causes
failure of cellular activity and thus the changes
we see with aging. - Free Radical- Oxidation of fats, proteins and
carbohydrates creates free radicals that attach
to other molecules/cells and damage them. Random
damage accumulates, aging results, and eventually
death of the damaged person. - Wear Tear- Repeated and random overuse and
injury of the human body cells, tissues, organs
or body systems.
6Nonstochastic Theories
- Nonstochastic- Cell aging in the body is
genetically programmed for the life span of an
organism. Includes the following - Programmed- Biological clock in each cell
determines number of replications and eventual
death of cell and organism. - Immunological- Alteration in cell is recognized
as a foreign body and antibody are produced to
fight them just as in autoimmune diseases. - Neuroendocrine- Over time, the ability of a cell
to auto regulate itself becomes altered or lost
resulting in aging and death.
7Normal Changes of Aging Integument
8Normal Changes of Aging Integument
- The largest most visible organ of the body think
protection, personal identity, security, temp.
regulation - Integumentary- Skin Changes due to intrinsic and
extrinsic factors such as - _____________
- _____________
- _____________
- _____________
9Normal changes of Aging Hair and Nails
- Hair (head)
- Thinner
- Coarser
- Dryer
- Facial hair
- Nails
- Harder, thicker, more brittle, dull and opaque
10(No Transcript)
11Normal changes of Aging Musculoskeletal
- Influencing Factors
- Age
- Gender
- Race
- Environment
- Average loss
- 2 inches between ages 40-80
12Normal changes of Aging Musculoskeletal
- Bone strength/Bone mineral density
This graph shows how the bone density of the
total hip decreases with age. The units are
standardized bone density in (mg/cm2). The lines
show the average values, and for each age, race
and gender a range of values occurs in the
ordinary population.
13Osteoporosis
14Osteoporosis
- Affects women 4x more often than men
- ? Estrogen loss after menopause
- ? Long term steroid use
15Normal Changes of Aging
- Ligaments, Tendons, Joints
- gtrigid, hardened, stiff
- Arthritis is the 1 cause of disability in
elderly
16- Did you know?During the course of your lifetime,
your heart will typically beat 2.5 billion
times--about once a second, every minute of your
life. The heart pumps about five or more quarts
of blood a minute, nearly 2,000 gallons of blood
throughout your body. A healthy heart is strong
enough to drive a single drop of blood throughout
your entire body in about 24 seconds
17Normal Changes of Aging Cardiovascular System
- Presbycardianormal changes in the healthy heart
- ? stroke volume
- ? cardiac output
- Left ventricle wall thickens
- As much as 50 by age 80
- Left atrium enlarges (to compensate)
- Possible development of a fourth heart sound (S4)
18Normal Changes of Aging Cardiovascular System
- The maximum heart rate decreases and it takes
longer for heart rate and blood pressure to
return to normal resting levels after exertion. - The aorta and other arteries becomes thicker and
stiffer which may bring a moderate increase in
systolic blood pressure with aging. In some
individuals, this may result in hypertension. - The valves between the chambers of the heart
thicken and become stiffer. As a result heart
murmurs are fairly common among older adults. - The pacemaker of the heart loses cells and
develops fibrous tissue and fat deposits. These
changes may cause a slightly slower heart rate
and even heart block. Aberrant heart rhythms and
extra heart beats become more common. - The baroreceptors which monitor blood pressure
become less sensitive. Quick changes in position
may cause dizziness from orthostatic hypotension.
19Peripheral Vascular Changes
- Arteries become less elastic and more brittle
- Calcium leaving the bones is deposited in the
blood vessels - Lumen size of the vessels is ?d
- May lead to increased blood pressure
20Normal Changes of Aging in the Respiratory System
- The lungs become stiffer, muscle strength and
endurance diminish, and the chest wall becomes
more rigid. - Total lung capacity remains constant but vital
capacity decreases and residual volume increases.
- The alveolar surface area decreases by up to 20
percent. - Alveoli tend to collapse sooner on expiration.
- There is an increase in mucus production and a
decrease in the activity and number of cilia. - The body becomes less efficient in monitoring and
controlling breathing.
21Urinary System Changes with Aging
- Kidney mass decreases by 25-30 percent and the
number of glomeruli decrease by 30 to 40 percent.
- These changes reduce the ability to filter and
concentrate urine and to clear drugs. - With aging, there is a reduced hormonal response
(vasopressin) and an impaired ability to conserve
salt which may increase risk for dehydration. - Bladder capacity decreases and there is an
increase in residual urine and frequency. - These changes increase the chances of fluid
electrolyte imbalances, urinary infections,
incontinence, and urinary obstruction.
22Age-related Changes in the Endocrine System
- Insulin resistance may prevent efficient
conversion of glucose into energy. - A decrease in aldosterone and cortisol may affect
immune and cardiovascular function
23Major Gastrointestinal Changes with Aging
- Decreased peristalsisgtreflux and hiatal hernias
- Increased stomach pH gt increase susceptibility
to gastric irritation ulcers. - The liver is less efficient in metabolizing drugs
and repairing damaged liver cells. - Diverticuli from weakened intestinal walls in the
colon may cause pain. - Reduced peristalsis of the colon can increase
risk for constipation.
24Age-related Changes in the Female Reproductive
System
- Ovulation ceases and estrogen levels drop by 95.
- Vaginal walls become thinner and lose elasticity
- Most women experience a decrease in the
production of vaginal lubrication.
25Age-related Changes in the Male Reproductive
System
- In some men, testosterone levels drop by up to
35. - The size of the testes decreases.
- There is a decline in the rate of sperm
production although the extent varies among
individuals. - Erectile dysfunction (impotence), in which an
erection cannot be achieved is experienced by 15
of men by the age of 65 and increases to 50 by
age 80
26Normal Age-related Changes in the Neurological
System
- Delayed neurological function
- NOT the loss of cognitive function
- Intellectual performance remains intact
- Performing tasks may take longer
27Normal Age-related Changes in the Central Nervous
System
- The brain and spinal cord lose nerve cells and
weight - Nerve cell transmission may slow
- Waste products may collect in the brain tissue
causing plaques and tangles - Reflexes may be reduced or lost
- Slight slowing of thought, memory and thinking
are part of normal aging
28Normal Age-related Changes in the Peripheral
Nervous System
- ? in tactile sensitivity
- Loss of nerve endings in skin
- ?risk for injuries and burns
- Altered kinesthetic sense (ones position in
space) - ?risk for falling
29Normal Age-related Changes in the Eyes
- Drooping eyelids (senile ptosis)
- ? orbicular muscle strength
- Arcus senilis
- Gray/white/silver ringinside the outer edge of
iris - Decrease in number of goblet cells producing eye
lubrication
30Normal Age-related Changes in the Eyes contd
- Presbyopia-the crystalline lens begins to have so
many layers of accumulated tissue built up that
it becomes stiff and the iris muscles must work
harder to bring near objects into focus - Increased time to accommodate to changes in light
- ? sensitivity to glare
- Pupils decrease in size
- Require increased lighting
31Cataracts
- A cataract is a clouding of the normally clear
lens of the eye. It can be compared to a window
that is frosted or "fogged" with steam. - Common symptoms of cataract include
- Painless blurring of vision
- Glare, or light sensitivity
- Frequent eyeglass prescription changes
- Double vision in one eye
- Needing brighter light to read
- Poor night vision
- Fading or yellowing of colors
32Intraocular Changes of Eye
33Intraocular Changes of Eye
- Sclera may become yellowish (imitating jaundice)
- Floatersbits of vitreous that have broken off
the retina - Retina becomes dull
- Glaucoma is an abnormal condition resulting when
intraocular pressure becomes higher than what is
healthy for the optic nerve
34Aging Changes in Ears Hearing
- Function of Ears
- Hearing
- Maintenance of balance
35Aging Changes in Ears Hearing
- Presbycusis
- age-related hearing loss
- ? hearing acuity
- ? speech intelligibility
- ? auditory threshold
- ? discrimination of pitch
36Classroom activity
- Changes of Aging Activity
- This activity is intended to simulate the feeling
of some of the physical changes of aging and the
potential difficulties they can produce. - Stand with feet apart at least 14 inches (to
provide a wide base) and do the following - Round the shoulders and upper back
- Tuck the buttocks and relax the abdominal
musculature, making the umbilicus point toward
the ceiling - Remaining in this position, take a deep breath
(simulating the change in respiratory function
that accompanies change in stature) - Still remaining in this position, bend the knee
while keeping the foot of that leg on the ground - Take a few steps forward (simulation of slowed
mobility with aging) - Have students discuss what they were feeling,
physically and emotionally, and thinking during
various steps of this exercise. Ask them to
consider and share with the rest of the class how
they might feel if these physical changes were
permanent. What challenges can they anticipate
these physical limitations will cause?
37 NURSING DIAGNOSIS OF THE ELDER ADULT IN THE
COMMUNITY