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Changes With Aging - Coggle Diagram
Changes With Aging
NEUROLOGICAL CHANGES OF AGING
slowed central processing
recalling certain memories may take longer
certain tasks will take longer to acomplish
does not affect intelligence
intelligence remains constant throughout lifespan
verbal skills maintained until about age 70, then become slower
dulling of tactile sensation
pain receptors are not firing as fast as they do when an individual is younger
older adult pt will experience less pain than the younger adult
number and sensitivity of receptors decrease as we age
cranial nerve function declines
decrease in taste and smell receptors
pt should be taught to season with different spices instead of adding additional salt
increase in salt consumption will increase BP
loss of nerve cell mass
atrophy of brain and spinal cord
lose a lot of brain mass
number of dendrites declines with age
demyelination
slower nerve conduction
reaction times will be slower
reflexes are slower and will be weaker
Multiple sclerosis is not a normal change of aging but is a condition that occurs due to the demyelination of nerves
neurofibrillary tangles and plaque formation
can lead to Alzheimer' s disease
not a normal change of aging but can result in a decline in memory with intermittent periods of lucidity
free radicals accumulate in brain
DIGESTIVE CHANGES WITH AGING
atrophy of tongue and taste receptors
teach pt to use more seasoning that does not include salt
pt at risk for HTN if they are using more salt
saliva production decreases
xerostomia
swallowing is more difficult
at risk for aspiration/choking
presbyesophagus
weaker esophageal contractions
stomach motility decreases
reduced elasticity of stomach
older adult will not be able to eat as much as they did prior
increased risk of constipation
also d/t sensory perception of needing to use the bathroom is decreased
decrease in Pepsin and Hcl production
stomach has a higher Ph
interferes with absorption of calcium, iron, folic acid, and vitamin B12
Interferes with absorption of protein
decreased enzyme production in liver
alters metabolism of certain drugs
increased risk of gallstone
bile salt production decreases
altered digestion of fats
PAIN
Low back pain is the most common in the older adult
severe joint pain increases with age
chronic pain is prevalent in 3/5 of the older adult lasting at least a year.
diabetes contributes to neuropathic pain:
pain is sharp, tingling, burning, or stabbing that has a quick onset with high intensity
visceral pain: deep and aching
somatic pain: throbbing and aching
nociceptive pain: could be described on "bone on bone" grinding pain
could also be from thermal or chemical problems
role of age in the pain experience is still unclear
if unrelieved, pts can become constiated, infected with pneumonia, depressed, develop pressure ulcers, and have limited mobility
get a detailed pain assessment, use open ended questions compared to simply recording on the NPS
numeric pain scale, visual analog scale, and McGill pain Questionnaire
sarcopenia: weakening of musculoskeletal structure in older adult
SKIN CHANGES WITH AGING
Development of skin cancers
Basal cell carcinoma
most commonly found on the face and neck (areas where sun exposure is the highest)
can be red with a glossy raised border
squamous cell carcinoma
abnormal growth of squamous cells
melanoma
melanocytes start to grow uncontrollably
typically a dark brown/black pigment will appear
typically the most malignant
Skin loses elasticity and starts to wrinkle
skin becomes thin and frail
Skin becomes dry due to decreased endocrine function
loss of subcutaneous fat
decreased body temperaure
older individual at risk for hypothermia
room needs to be above 75 degrees
RESPIRATORY CHANGES WITH AGING
cartilage in ribs, and trachea become more rigid
less room to expand with inspiration causes less airflow into the lungs
decrease in elastic recoil making it harder to get the residual air out of the lungs
reduction in cough reflex
at risk for aspiration
could lead to pneumonia
increase in residual capacity
decrease in vital capacity
use spirometer to help strengthen respiratory muscles
respiratory infections
Pneumonia: due to aspiration, ventilation, or viral transmission
pt will present with confusion and productive cough with sputum
most infections of the older adult will display signs of confusion
teach pt to get the pneumoccal vaccine and the influenza vaccine
decrease in sensitivity to hypoxia and hypercapnia
decrease ability to clear mucus secretions or to cough and deep breath leading to risk for further infections
SENSORY CHANGES WITH AGING
vision
decreased acuity due to opacification of lens and vitreous
presbyopia occurs as a result of decreased elasticity of lens
retina loses photoreceptor cells causing difficulty with night vision
importance of having a red nightlight in bathroom to prevent falls and other injuries
white ring or halo can develop in the peripheral vision as well as generalized reduced peripheral vision
cataracts: clouding of lens disrupting a pt's vision
hearing
presbycusis
sensorineural hearing loss
ability to hear high pitched sounds is lost
lose the ability to discriminate between tones
otosclerosis: stiffening of bones inside the ear making it difficult to hear
taste
taste buds decrease so food does not taste as good without extra seasoning
decreased tactile sensation
decreased ability to sense temperature changes
olfactory sensor decreases due to loss of cells in olfactory bulb
URINARY CHANGES OF AGING
size and weight of kidney decrease
decrease in glomerular filtration rate
this is due to the decrease in blood flow to kidneys with age
This affects the bodies ability to eliminate drugs (dosage will have to be lower or alternatives to certain medications need to be used)
toxic levels of drugs can accumulate
The bladder's ability to expand decreases
can lead to incontinence (urgency, functional, stress, neurogenic) and nocturia
retention of urine
most common cause in women is fecal impatction
most common cause in men is prostatic hypertrophy
release of urine will become more difficult due to bladder muscle changes or an enlarged prostate
BUN levels will be increased in older adult
also common to see proteinuria
CARDIOVASCULAR CHANGES WITH AGING
Heart valves begin to hypertrophy leading to increased thickness and rigidity
diastolic murmurs are heard in half the older population
This is caused by the valves either not closing all the way and causing regurgitation or from stenosis of the valve itself
aorta becomes dilated
This results in improper closure of the aortic valve causes blood to flow back into the heart instead of flowing to the rest of the body
This results in circulatory problem such as
DVT
,
PE
, or
TIAs
The ventricles take on a lot more pressure when this happens causing ventricular hypertrophy
decreased contractile strength of heart muscles
decreased cardiac output
all changes in the heart of the older individual is going to affect vascular and circulatory systems
if the damage is on the left side of the heart, the respiratory system will be affected
left sided HF is caused by right sided HF
Heart disease is preventable
teach pts to quit smoking, be active, and eat a heart healthy diet to promote cardiovascular health
ENDOCRINE CHANGES WITH AGING
insufficient release of insulin or decreased tissue sensitivity to the insulin
causing a higher risk for diabetes in older adult population
typical diabetes symptoms are not present in older adult
hyperglycemia with glycosuria is not present
older adult may appear confused or act out of character
most likely will not present with polyuria, polydipsia, or polyphagia
to diagnose diabetes do a fasting blood glucose test
if the reading is >126, the pt is diabetic
random blood glucose > 200 is also indicative of diabetes
can be managed with insulin and frequent blood glucose testing
monitor pt for difficulty reading the syringe numbers, filling up a vial of insulin, or not understanding proper finger prick assessmetn
diabetes can cause renal issues
(kidney disease)
due to the increased demand to excrete the extra glucose in the blood stream
REPRODUCTIVE SYSTEM CHANGES WITH AGING
Intimacy is not lost due to aging
Important to teach pt about protection from STIs
some interventions to help with intimacy include more lubrication, medications for ED (which is not a normal change of aging), and counseling
Hormone changes
women have increased estrogen and progestin as they age
men have a decrease in testosterone production as they age
reduced muscle mass, strength, and endurance
sexual behavior can be disrupted
this is either from losing a partner, having a certain disease process (dementia), or feeling embarrassed