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Older Adults - Coggle Diagram
Older Adults
Nervous System
Reduced number of neurons and nerve fibers
Demyelination occurs to neurons
Weight of the brain and blood supply to brain is reduced
Slower response to changes in balance
Crystalized intelligence stays the same, fluid intelligence can decline
Long term memory stays the same, short term memory declines
Longer time needed to perform tasks: slower central processing
Number of sensory receptors and dermatomes decrease
Free radicals accumulate
Intellectual performance maintained until at least 80 years of age
Pathologies
Parkinsons
symptoms: tremor at rest, bradykinesia, mask like expression, shuffling gait
Affects ability of the CNS to control body movement
Caused by the loss of never cells in the substantial Nigra which produce dopamine
Alzheimer’s
Pathology is still relatively unknown but changes such as neural plaques, neurofibrillary changes, and degeneration of neuron synapses can be seen in the brain
S+S: memory loss, confusion with time or place, wandering, misplacing items, aphasia, apraxia, agnosia
CONNECTION
Regulation of hormones is performed by many structures within the nervous system
Urinary System
Glomerular filtration declines by 50% by age 90
Decreased number of functioning glomeruli
Bladder has reduced capacity
Blood flow to the kidneys declines
Size and weight of kindeys decrease
Hypertrophy and thickening of the bladder wall
Decreases the bladder's ability to expand
Increased risk for reflux of urine into the ureters
Prostatic hypertrophy
Higher blood urea nitrogen levels
Pathologies
Renal calculi
A stone forms inside the kidneys made out of calcium, Uris acid, or struvie
S+S: severe flank pain, Dysuria ,cloudy urine, hematuria
Respiratory System
Decrease in alveolar surface area
Reduced cough reflex
Calcification of costal cartilage
Lungs lose elastic recoil
Decreased vital capacity
Increased residual capacity
Decreased reaction form chemoreceptors to hypoxia and hypercapnia
Decrease in cillia
Decreased ability to clear mucus
Pathologies
Lung Cancer
Caused by exposure to environmental carcinogens, 80-90% are smokers
Malignant tumor grows in the lung tissue disrupting the function
S+S: dyspnea, cough, chest pain, fatigue, anorexia, wheezing, respiratory infections
Chronic bronchitis
S+S: cough, mucus, wheezing, chest discomfort,dyspnea
Part of the pathology of COPD
Caused by over production of mucus in the airway in response to irritants
Emphysema
Alveoli inside the lungs are damaged causing them to rupture which reduces the area available for gas exchange
S+S: shortness of breath, wheezing,cough, wheezing, mucus production
Cardiovascular System
Peripheral resistance increases
Valves become thick and rigid
Blood vessels calcify and lose elasticity
Myocardial muscle has decreased contractile strength
Dysrhythmias become more common
Hypertension
Risk Factors: smoking, obesity, sedentary lifestyle, improper diet
Signs and Symptoms: headache, disorientation, fatigue, chest pain
Often no symptoms are present
Systolic blood pressure > 140 mmHg Diastolic blood pressure > 90 mmHg
Heart Failure
The inability of the heart to pump enough blood to meet O2 demands of the body
Left sided
Left ventricle fails to pump blood out blood to the peripheral vascular system, causes blood congestion in the lungs
Symptoms: dyspnea, crackles in lungs, cough, tachycardia, fatigue, anxiety, confusion
Right sided:
Right ventricle fails to pump blood out to the lungs causing congestion in the peripheral vascular system
Symptoms: peripheral edema, weight gain, distended neck veins, anorexia, weakness, hepatomegaly, ascites
CONNECTION
The respiratory and cardiac systems work closely together to deliver oxygen throughout the body, a disruption in one system will affect the other
Gastrointestinal System
Esophageal motility decreased
Dysphagia
Caused by GERD, strokem and structural disorders
Less peristalsis in the intestines
can lead to indigestion and constipation
Taste sensations become less acute
Saliva production decreseases
less enzymes in the mouth to begin breaking down food
Swallowing may be more difficult
Decreased motility and elasticity in the stomach
Higher risk for indigestion, food isn't broken down as well
Higher pH as a result of less HCL and pepsin
Decline in pepsin interferes with the absorption of protein
Less HCL causes an increase in gastric irritation, interferes with absorption fo calcium, iron, folic acid, vitamin b-12
Less surface area in the intestines, nutrients aren't absorbed as easily
Pathologies
Hiatal hernia
Occurs when the upper part of the stomach protrudes up through the diaphragm
S+S: heartburn, regurgitation, acid reflux, difficulty swallowing, feeling full soon after eating
Requires surgery to fix
Fecal impaction
Hardened fecal matter is retained in the bowel which cannot be evacuated by normal means
Prevention of constipation Is the first step to preventing fecal impaction
S+S: watery diarrhea, nausea or vomiting, back or stomach pain, dehydration, swollen belly
Endocrine System
Diminished adrenal function
Insufficient release of insulin as well as tissue is less sensitive to insulin
Leads to type 2 diabetes
Thyroid gland atrophies
Causes weight gain
ACTH secretion decreases
Pathologies
Diabetes Mellitus
Diagnosis- random blood glucose >200, fasting blood glucose > 126
Pancreatic cells stop secreting insulin, insulin sensitive cells stop responding to insulin
Glucose homeostasis cannot be maintained
Diabetes is controlled by medication (insulin)
Hyperthyroidism
S+S: sensitivity to heat, weight loss, tachycardia, irritability, fatigue, insomnia, brittle hair
T3 > 220 ng/dL T4> 12 mcg/dL
Hypothyroidism
T3 < 70 T4 < 5
S+S: Fatigue, sensitivity to col, dry skin, weight gain, moon face, weakness, thin hair, bradycardia, goiter
Medication Use
Large use of medications due to prevalence of health conditions
Multiple drug use increases risk of drug-food interaction
Distribution of drugs are difficult to determine in older adults
Changes in membrane structure
Changes in circulation
Dehydration and hypoalbuminemia
Changes in tissue make up
Biological half-life is extended
Decline in detoxification and excretion of drugs
Decline in liver function changes how drugs are detoxifies and excreted
Decline in kidney filtration affects excretion of drugs through the renal system
Sensitivity to drugs
Increased CNS sensitivity to narcotics, alcohol, and bromides
Increased myocardial sensitivity to drugs such as anesthesia
Senses
Decline in taste
Decline in smell
Decline in hearing
Decline in vision
Decline in touch
Cellular Chages
Lean body mass decreases
Total body fat increases, subcutaneous fat decreases
Functional cell number decreases
Intracellular fluid decreases, less body fluid overall
Mental Health
Pts above 85 are at the highest risk for suicide
Decline could be due to a specific event
CONNECTION
Changes in the nervous system particularly the brain can have affects on mental health
Musculoskeletal System
Bone mass decreases
Muscle mass is reduced, leading to reduced strength and mobility
Immune System
Inflammatory defenses decline, inflammation can present atypically
Cell mediated immunity declines
Physical Appearance
Diminished stature
Appearance of wrinkles, tissue loses elasticity