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Changes of Aging - Coggle Diagram
Changes of Aging
Neuro
Normal Changes of Aging
Decline in function of cranial nerves affecting taste and smell
Intelligence remains constant until 80
Slowing in central processing
Delay in time required to perform tasks
Verbal skills maintained until 70
Number of sensory receptors, dermatomes, and neurons decrease
Dulling of tactile sensation
Plaques, tangles, atrophy of the brain
Free radicals accumulate
Decrease in cerebral blood flow
Atherosclerosis
Pathologies
Parkinson's Disease
A disorder of the CNS that affects movement
Result of impaired function of basal ganglia in the midbrain
Neurons that produce
dopamine
die
S/S appear after 80% of dopamine neurons have been lost
Etiology
Unknown cause
Thought to be associated with
Hx of exposure to toxins
Encephalitis
CV disease
Atherosclerosis
Signs & Symptoms
Faint tremor in hands & feet that progresses
May be first clue
Reduced with
intentional
movement
Muscle rigidity & weakness
Drooling
Dysphagia
Slow speech
Monotone voice
Mask-like facial expression
Bradykinesia
Slow movement
Poor balance
Postural instability
Shuffling gait
Secondary S/S
Depression & anxiety
Sleep distubrances
Dementia
Forced eyelid closure
Decreased blinking
Constipation
Urinary hesitancy & urgency
Treatment
Sinemet
Carbidopa/levodopa
Converts to dopamine & reduces adverse effects
Dopamine agonists
Deep brain stimulation
PT & OT
Dementia
.
Respiratory
Normal Changes of Aging
Loss of elastic recoil
Trachea hardens
Declining muscle strength
Reduced cough reflex
Decrease in lung size & weight
Cilia solidify
Less effective filter
sufrace area alveoli- NEED
Decreased reaction of chemoreceptors to hypoxia and hypercapnia
CT changes in nose.. NEED
Pathologies
COPD
Pneumonia
Cardiovascular
Normal Changes of Aging
Heart valves become thicker & more rigid
Diastolic murmurs in 50% of older adults
Aorta becomes dilated
Slight left ventricular hypertrophy
Myocardial muscle becomes less efficient
Prolonged cardiac cycle
Baroreceptors become less sensitive to hypoxia and hypercapnia????
Pathologies
Gastrointestinal
Normal Changes of Aging
Decline in hydrochloric acid
Decline in pepsin
Slower peristalsis
Weakening of esophageal sphincter
Presbyeophagus
Esophageal & stomach motility decreases
Risk for aspiration & indigestion
Decreased stomach elasticity
Less food can be ingested in one sitting
Higher pH of stomach acid
Due to decrease in hydrochloric acid & pepsin
Fewer cells on absorbing surface of intestinal wall
Impaired absorption of dextrose, xylose, vitamins B & D
Affect neuro function
Liver
Size decreases
Decreased enzyme production
Prolonged drug metabolism (increased half-life)
Bile salt synthesis decreases
Risk of gallstones, impaired digestion of fats
Mouth
Atrophy of tongue
Less taste buds
Decreased taste
Decreased saliva production
Impaired swallowing
Pathologies
Colorectal Cancer
Reproductive
Normal Changes of Aging
Male
Seminal vesicles develop thinner epithelium
Muscle tissue replaced with connective tissue
Decreased capacity to retain fluids
Seminiferous tubule changes
Increased fibrosis, epithelium thinning, thickening of the basement membrane, and narrowing of the lumen
Atrophy of testes and reduction in testicular mass
Ejaculation fluid contains less live sperm
Testosterone remains the same or decreases slightly
More time required to achieve an erection
Female
Vulva atrophies
Flattening of the labia
Loss of sub-q fat & hair
Vaginal epithelium thins
Cervis, uterus, and fallopian tubes atrophy
Vaginal canal changes
Reduction in collagen & adipose tissue
Shortening & narrowing of canal
Less lubrication
May lead to discomfort with intercourse
More alkaline vaginal pH
A result of
less estrogen
More prone to yeast infections & vaginitis
Endometrium continues to respond to hormonal stimulation
Breasts sag & are less firm
Pathologies
Musculoskeletal
Normal Changes of Aging
Decline in # & size of muscle fibers
Reduced muscle mass
Loss of grip strength endurance
CT changes: reduce flexibility of joints and muscles
Sarcopenia: decline in walking speed or grip strength
Can be caused by disease, immobility, decreased caloric intake, poor blood flow to muscle, decline in anabolic hormones, increase in pro-inflammatory cytokines
Decreased activity level
Psychosocial factors
The loss of a spouse or friend can limit participation in social & recreational activities
Retirement
Relocation to smaller living space
Pathologies
Rheumatoid Arthritis
ENDOCRINE
Normal Changes of Aging
THYROID GLAND
Undergoes fibrosis, cellular infiltration, increased nodularity
Lower basal metabolic rate
Reduced radioactive iodine uptake
Total serum iodine is reduced
Less thyrotropin secretion and release
Progressively atrophies
Significant reduction in T3 as a result of reduced conversion of T4 to T3
Overall, thyroid function remains adequate
ADRENAL GLAND
Diminished Function
PITUITARY GLAND
Decrease in volume
Decrease in ACTH, TSH, FSH, LH
Gonadal secretion declines
Decrease in testosterone, estrogen, progesterone
PANCREAS
Delayed and insufficient release of insulin by beta cells
Reduced tissue sensitivity to circulating insulin
Pathologies
T2 Diabetes Mellitus
7th leading COD in older adults; affects 20% of older adults
Risk factors
Obesity, sedentary lifestyle, high levels of glucose consumption, reduced ability to metabolize glucose
Complications
Hypoglycemia: behavior disorders, convulsions, somnolence, confusion, disorientation, poor sleep patterns, nocturnal headache, slurred speech, unconsciousness
PVD: influenced by poorer circulation and atherosclerosis due to normal aging
Retinopathy: greater risk with HTN and unmanaged DM
Drugs that increase the risk of hyperglycemia
Sulfonylureas increase risk of hypoglycemia
Symptoms
Orthostatic hypotension, periodontal disease, stroke, gastric hypotony, impotence, neuropathy, confusion, Dupuytren's contracture, infection
Diagnosis
Renal threshold for glucose increases with age-> Older adults can be hyperglycemic without glucosuria
Glucose tolerance test is most effective
1) S/S of DM & random BG >200 mg/dL 2) HbA1c >6.5% 3) Fasting BG >126 mg/dL 4) BG >200 mg/dL after oral glucose intake
Hypothyroidism
Subnormal concentration of thyroid hormone
Primary results from destruction of thyroid gland: low free T4 & elevated TSH
Secondary caused by insufficient TSH from pituitary: low free T4 & low TSH
Diagnosis
Low T3 (<70), low T4 (,5), presence of T4 antibody
Signs & Symptoms
Fatigue, weakness, lethargy, anorexia, weight gain, puffy face, impaired hearing, periorbital/peripheral edema, myalgia, paresthesia, ataxia, dry skin/hair, husky voice, slow speech
Treatment
Levothyroxine (Synthyroid)
Sleep and Rest
Normal Changes of Aging
Sleep latency or delay in onset of sleep
Sleep is less sound
More time spent in stages I & II, less time in stage III & IV
Less time spent in REM
Decline in restorative effects of sleep
Pathologies
Urinary
.
Nervous System
Normal Changes of Aging
Loss of nerve cell mass
Atrophy of brain & spinal cord
Brain weight decreases
Number of dendrites declines
Demyelination
Slower nerve conduction
Response & reaction times are slower
Reflexes become weaker
Thermoregulation
lower body temp
Sensory Organs
Integumentary
Immune