Aging Changes

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Aging Changes

• Overview of Various Body Systems Age-related
  Changes
• Highlights of Some of the Major Disorders
  Diseases

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Skin Age-related Changes

• Functions of the skin
• Thermoregulation
• Excretion of metabolic wastes
• Protection of underlying structures
• Maintenance of fluid electrolyte balance
• Sensation of pain

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Integumentary System

• Age-related changes
• Flattening of epidermal-dermal junction
• Decrease in of melanocytes Langerhans cells
• Increase in quantity quality of elastin
• Decrease in of sweat and sebaceous glands

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Integumentary Age related changes contd

• Decrease in subcutaneous fat and dermal blood
  supply
• Thinner dermis
• Slowed nail growth
• Changes in hair color, quantity, distribution

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Integumentary (contd)

• Negative Functional Consequences

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Integumentary (contd)

• Risk Factors
• Heredity
• Pathologic conditions
• ADRs
• Lifestyle
• Environmental

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Vision

• Age-Related Changes
• Yellowing opacity of cornea
• Increase in size density of lens
• Decrease in pupillary size

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Vision (contd)

• Atrophy of ciliary muscle
• Decrease in blood supply neurons in the retina
• Decreased tears
• Shrinkage of vitreous

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Vision (contd)

• Negative Functional Consequences

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Vision (contd)

• Negative Functional Consequences

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Visual Deficits -- Cataracts

• Most common disorder found in the aging eye
• Incidence increases with age
• A clouding of the normally clear transparent
  lens of the eye

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Cataracts -- symptoms

• Symptoms
• Causes

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Cataracts

• Treatment
• Prognosis

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Age-related Macular Degeneration (AMD)

• Macula located in centre of retina
• Leading cause of blindness in older adults
• Risk factors

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AMD (contd)

• Symptoms
• Difficulty performing tasks that require close
  central vision
• Dark or empty area in the centre of vision
• Decreased color vision
• A kink in telephone poles or a bend in lines
  on road
• Words on a page blurred

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AMD (contd)

• Diagnosis
• Treatment

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Hearing

• Age-related changes
• Outer ear
• Middle ear
• Inner ear

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Hearing (contd)

• Presbycusis
• A slowly progressive bilaterally symmetric
  disease in hearing that primarily affects high
  tones and is associated with aging.
• Causes

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Smell

• Taste

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Musculoskeletal

• Age-related changes
• Decreased muscle mass (decrease in size and of
  muscle fibers)
• Changes to bone remodelling
• Bone loss

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Musculoskeletal (contd)

• Age-related changes (contd)
• Deterioration of muscle fibrils with replacement
  by connective tissue fat
• Deterioration of muscle cell membranes
• Degenerative changes in arterial cartilage

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Musculoskeletal (contd)

• Negative Functional Consequences

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Musculoskeletal Diseases

• Osteoporosis
• Gradual loss of bone mass
• Affects all individuals to some degree
• Women experience greater bone loss than men

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Osteoporosis

• Primary Osteoporosis
• Associated with age- and menopause-related
  changes
• Occurs more often in women
• age of onset is menopause
• Consequences can occur 10 to 20 years
  post-menopause

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Osteoporosis (contd)

• Risk factors
• Female
• Increased age
• White or Asian
• Estrogen deficiency
• Low calcium intake
• Prolonged immobility

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Osteoporosis (contd)

• Risk factors (contd)
• Small bones
• Excessive alcohol intake
• Genetics
• Excessive use of antacids, particularly those
  that contain aluminum
• Inadequate Vit. D. intake
• Cigarette smoking
• Long-term use of certain medications

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Osteoarthritis

• A nearly universal, slowly progressive
  degenerative condition affecting men women
• Also known as degenerative joint disease
• Degeneration of the cartilage

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Osteoarthritis (contd)

• Symptoms
• Joint pain
• Stiffness
• Loss of motion
• Decreased function
• Deformity

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Falls

• Age-related functional consequence
• Considered predictable events of which many can
  be prevented
• Caused by a number of environmental and intrinsic
  factors
• Usually a result of a combination of factors

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Falls -- Intrinsic Factors

• -- increased age
• -- functional impairment
• -- dizziness
• -- postural hypotension
• -- poor balance
• -- gait disorders

• -- weakness
• -- impaired proprioception
• -- cognitive impairment
• -- chronic illness
• -- depression
• -- risk-taking

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Falls -- Extrinsic Factors

• -- outdoor areas
• -- transition areas
• -- poor footwear

• -- lack of supervision
• -- medications
• -- restraints

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Cardiovascular

• Age-related changes
• Stiffening of vasculature

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Restraints
One method used to prevent falls since time
began has been to restrain the person or their
limbs.

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Cardiovascular

• Age-related changes
• Stiffening of vasculature
• Thicker, less elastic, more dilated veins
• Altered baroreflex mechanisms
• Changes in conduction mechanism
• Increase in heart weight
• Increased peripheral resistance

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Cardiovascular (contd)

• Negative functional consequences

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CV disease

• Modifiable risk factors
• Hypertension
• Lifestyle
• Smoking
• Body weight

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CV disease

• Non-modifiable risk factors
• Age
• Gender
• Family history

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Cardiovascular Diseases

• Arteriosclerosis
• Atherosclerosis
• Coronary artery disease (CAD)
• Cerebrovascular accident (CVA)

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Arteriosclerosis general term meaning hardening
of the arteriesAtherosclerosis accumulation
of fatty deposits and fibrous tissue in the walls
of the arteries.
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CAD

• A pathologic condition of the coronary arteries
  in which abnormal lipids and fibrous tissue
  accumulate in the arterial wall
• These changes lead to alterations in the blood
  flow to the heart muscle

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Coronary Artery Disease

• Incidence increases with age
• Risk factors
• Hypertension, smoking, diabetes mellitus,
  elevated cholesterol

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CAD

• Arterial wall consists of 3 layers
• Intima
• Media
• Adventitia

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Cerebrovascular Accident (CVA)

• A rapidly developing vascular deficit in the
  brain, which causes a focal disturbance of brain
  function for more than 24 hours
• A Transient Ischemic Attack (TIA) lasts less than
  24 hours

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Cerebrovascular Accident (CVA) (contd)

• CVAs (Strokes) are the 3rd most common cause of
  death in industrialized countries
• 70 of strokes occur in people 65

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Cerebrovascular Accident (CVA) (contd)

• Risk factors
• Hypertension
• Diabetes mellitus
• Cardiac disease
• Oral contraceptives
• Hypotension

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Cerebrovascular Accident (CVA) (contd)

• 2 main causes of CVAs
• 1. Hemorrhages due to hematomas and aneurysms
  that bleed into the brain

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Cerebrovascular Accident (CVA) (contd)

• Ischemia due to thrombosis and embolism

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Cerebrovascular Accident (CVA) (contd)

• Signs Symptoms
• Light-headedness
• Dizziness
• Headache
• Drop attack

• Hemiplegia
• Behavioral Memory changes
• Aphasia
• Hemianopsia

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Respiratory

• Age-Related changes
• Decreased elasticity of lung tissue
• Increased anteroposterior diameter of chest wall
• Weakened respiratory muscles
• Decreased vital capacity
• Increased residual lung volume

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Respiratory (contd)

• Negative Functional Consequences
• Increased use of accessory muscles
• Increased energy expenditure for breathing
• Decreased gas exchange
• Diminished cough reflex
• Increased susceptibility to respiratory
  infections

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Respiratory Diseases (contd)

• Lower Respiratory Infections
• Do not display the typical symptoms!

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EliminationAge- related changes

• Decreased of nephrons
• Decreased renal blood flow
• Decreased bladder capacity
• Relaxation of pelvic floor muscles

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Elimination (contd)

• Decreased bladder capacity
• Incomplete bladder emptying
• Urinary urgency and frequency
• Nocturia

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Elimination (contd)

• Risk factors leading to elimination problems,
  such as infection or incontinence
• Enlargement of the prostate
• Systemic diseases (dementia, dehydration, CVA)
• Medications
• Impaired mobility
• Unfamiliar environment
• Indwelling catheter

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