Please enable JavaScript.
Coggle requires JavaScript to display documents.
Age-Related Changes in the Older Adult - Coggle Diagram
Age-Related Changes in the Older Adult
Respiratory System
Age-Related Changes
Upper airway paths, nose, and trachea experience changes as an individual ages
Lungs reduce in size and weight
Decreased elastic coil, alveoli are less elastic. This leads to a reduction in vital capacity and an increased residual volume.
Alveoli are less elastic
Loose or brittle teeth can be aspired
COPD
Emphysema
Increased risk in older adults
Symptoms develop slowly; can delay diagnosis and treatment; tenacious, white, cloudy sputum
Smoking is a major risk factor
Causes-> chronic bronchitis, chronic irritation, and morphologic changes in the lung/secondhand smoke
"Pink Puffer"
Chronic bronchitis
Causes-> persistent, productive cough; wheezing; recurrent respiratory infections; shortness of breath
Signs and symptoms-> Chronic sputum with persistent cough; wheezing; shortness of breath; general cyanosis
"Blue Bloater"
Endocrine System
Age-Related Changes
Thyroid gland atrophies and activity decreases
Leads to weight gain, slower basal metabolic rate
Diminished adrenal function
Adrenocorticotropic hormone (ACTH) secretion decreases
Diabetes Mellitus
Type 1
Autoimmune
Type 2
Decreased sensitivity in tissues to insullin
Hemoglobin A1c test
Monitors effectiveness of disease control (3 months)
Triglyceride levels below 150 mg/dL is ideal
Regular exercise and good nutrition can improve glucose and triglyceride levels
CONNECTION: Since older adults have decreased pressure or discomfort sensation, older adults with diabetes should check their feet daily for bruising or sores
Hypothyroidism
Sings and symptoms-> Fatigue, weakness, lethargy, anorexia, weight gain, impaired hearing, dry skin/hair, and periorbital/peripheral edema
Hyperthyroidism
Signs and symptoms-> Enlarged thyroid, exophthalmos, weight loss, diarrhea, goiter, tachycardia
Sleep Cycle
Age-Related Changes
Altered Circadian sleep-wake cycles
Phase advance can occur in older adults
Phase advance is the change in circadian rhythm to fall asleep earlier than normal and to wake up earlier than normal
Sleep latency or delay in the onset of sleep
Sleep is less sound
CONNECTION: can be due to nocturia; this can put older adults at a higher risk for falls
More time in stages 1 and 2; Less time in stages 3 and 4, which means there is less time in REM
Insomnia
Difficulty falling or staying asleep or prematurely waking
Short-term
Causes: change in environment, illness, stress, or anxiety
Chronic (3 weeks or more)
Causes: Physical or mental illness, environmental factors, substance abuse, or medications
Neurological System
Age-Related Changes
Sensory Nerves
Vision
Depth perception becomes distorted
Decreased peripheral vision can occur
Touch
Reduced ability to sense pressure and discomfort; watch for pressure ulcers!!!
Taste
Taste acuity is dependent on smell
CONNECTION: Due to decreased taste sensation, older adults may over salt their foods. This can lead to hypertension and other cardiac/circulatory problems. Education on the DASH diet is significant for older adults
Atrophy of the tongue
Memory
Short-term memory may decline
Long-term memory stays the same
Intelligence
Basic intelligence stays the same
Crystallized intelligence is maintained
Delirium vs. Dementia
Delirium
Generally reversible
Signs and Symptoms-> rapid, altered level of consciousness
Causes include infection (most common), hypoxia, dehydration, hypernatremia, hyponatremia, new medications, pain, and cognitive impairment
Dementia
Irreversible, progressive
Caused by damage or injury to the brain
Impairment in cognitive function affects memory, orientation, reasoning, attention, language, and problem solving
Alzheimer's Disease
Most common form of dementia
No current treatment to prevent or cure
Changes to the brain
Neural plaques containing beta-amyloid protein
Nerofibrillary tangles in the cortex
Loss of degeneration of neurons and synapses
Changes in neurotransmitter systems
Reproductive System
Age-Related Changes
Female Reproductive System
Hormonal Changes
Vulva atrophies
Flattening of the labia
Loss of subcutaneous fat and hair
Vaginal Canal Changes
Reduction in collagen and adipose tissue
Shortening and narrowing of the canal
Less lubrication
May lead to discomfort with intercourse
More alkaline vaginal pH as a result of lower estrogen changes
Uterus and ovaries decrease in size
Cervix becomes smaller; endocervical epithelium atrophies
Male Reproductive System
Seminal vesicles evelop thinner epithelium
Muscle tissue replaced with connective tissue
Decreased capacity to retain fluids
Atrophy of the testes and reduction in testicular mass
Seminiferous tubule changes
Increased fibrosis, epithelium thinning, thickening of the basement membrane, and narrowing of the lumen
Ejaculation contains less live sperm
Testosterone stays the same or decreases slightly
More time required to achieve an erection
Enlargement of the prostate gland
Breast Cancer
Second leading cause of cancer deaths
Risk increases with age
Can be present in male patients
Diagnosis can be determined by a 3-D ultrasound
Treatment includes chemotherapy or radiation
Benign Prostatic Hyperplasia (BPH)
All men will have some degree
Symptoms progress slowly but continuously
Signs and Symptoms
Hesitancy on urination
Decreased force of urinary stream
Nocturia
CONNECTION: Assess male patients for BPH if nocturia is present to determine if it is a prostate, urinary or neural cause
Cardiac/ Circulatory System
Age-Related Changes
Heart valves become thick and more rigid
Diastolic murmurs occur in 50%of older adults
Aorta becomes dilated
Slight ventricular hypertrophy and thickening of the left ventricular wall
Myocardial muscle less efficient
Decreased contractile strength and prolonged cardiac cycle
Unable to meet the demands of increased activity
Calcification & reduced elasticity of vessels
Less sensitive to baroreceptor regulation of blood pressure
Dysrhythmias become more common with age!!!
Increased peripheral resistance
Increased risk for hypertension
Increased risk for cardiovascular disease
CONNECTION: Along with educating older adults about DASH diet for decreased taste sensation, the DASH diet is an essential part of education for patients with cardiac and circulatory diseases. Decreasing a patient's sodium intake plays a key role in lowering hypertension.
Hypertension
Incidence and prevalence increases with age
Evaluation of blood pressure must be noted on at least two occassions
Systolic blood pressure that is greater than or equal to 140 mmHg
Diastolic pressure that is greater than of equal to 90 mmHg
Factors to consider when monitoring blood pressure: anxiety, stress, and activity before assessment
Symptoms
Dull headache, impaired memory, disorientation, confusion, epistaxis, and slow tremor
Linkage: Although hypertension is its own circulatory disorder, but it is a common symptom for other circulatory or cardiovascular disorders
Coronary Artery Disease/Atherosclerosis
Prevalence increases with age; some forms are present 70 years of age
Angina
Atypical presentation: vague discomfort under the sternum, indigestion, coughing, syncope, sweating, and confusion
Nitroglycerin may be used
Educate the patient about chest pain unrelieved by 3 doses of nitroglycerin within 5 minutes
Myocardial Infarction
Atypical presentation: confusion, decreased blood pressure, shortness of breath, elevated temperature, and sedimentation rate
Left-sided heart failure
Causes pulmonary edema- results in pulmonary congestion due to the inability of the left ventricle to pump blood to the periphery
Symptoms
dyspnea
crackles
cough
fatigue
tachycardia
anxiety
restlessness
confusion
CONNECTION: due to the anatomy of blood flow through the lungs and the heart, heart damage and lung damage directly influence the function of the other. For example, with left sided heart failure, pulmonary edema can occur leading to decreased oxygen perfusion from the lungs to the bloodstream
Right-sided heart failure
causes peripheral edema- results in pulmonary congestion due to the inability of the right ventricle to pump blood out to the lungs this may occur because of left sided failure or pulmonary disease
Symptoms
peripheral edema
weight gain
distended neck veins
anorexia
weakness
hepatomegaly
ascites
Immune System
Age-Related Changes
Inflammation presents atypically
temperature will be low with infection!!
Risk of infection becomes significant
T-cell activity declines
Cell-mediated immunity declines
Inflammatory defense declines
Gastrointestinal System
Age-Related Changes
Slower esophageal motility
Atrophy of small & large intestine
Increased risk of aspiration, indigestion & constipation
Decreased peristalsis
Atrophy of the tonuge
Affects taste buds and decreases taste sensation
Saliva production decreases
Swallowing may be difficult
Risk for aspiration
Presbyesophagus results in weaker esophageal contractions and weakness of the sphincter
Stomach has higher pH as a result of decline in hydrochloric acid and pepsin
Dysphagia
Incidence of swallowing difficulties increases with age
Causes
Gastroesophageal reflux disease (GERD), stroke and structural disorders
Raise the head of the bed above 30 degrees when eating and an hour after eating
CONNECTION: Dysphagia is health problem that connects the precautions taken for
Diverticular Disease
Causes
Chronic constipation
Obesity
Atrophy of the intestinal wall muscles
Signs and Symptoms
Diverticulitis: left lower quadrant pain, increased flatus, and rectal bleeding
Obstruction: fever, anorexia, abdominal distention, constipation alternating with diarrhea
Urinary/Renal System
Age-Related Changes
Hypertrophy of the bladder muscle and thickening of the bladder
Decreases the bladder's ability to expand & reduces storage capacity
Daytime urinary frequency and nocturia
Nocturia
Night-time urinary frequency
CONNECTION: nocturia can be due to neurological problems such as neurogenic incontinence. With decreased sensory function and nocturia, older adults are at an increased risk for falls.
Age-related changes to the cortical control of the micturition contributes to nocturia
Weakness of bladder muscle
Increased retention
Development of UTI's
Decreased glomerular filtration rate
Ineffective filtration of drugs
Increased risk for drug toxicity
Increased BUN level
Leading to lethargy, confusion, headaches, and dizziness
Incontinence is NOT a normal age-related change, but age-related changes can increase the risk for incontinence
Size and weight of kidney decreases
Lose 50% of kidney function by age 80
Inefficient neurological control of bladder emptying and weaker bladder muscle
Retention of large volumes of urine
Female: fecal impaction
Male: prostatic hypertrophy
Urine refluxes into the ureters and becomes stagnant
Puts a patient at risk for pyelonephritis
Types of Urinary Incontinence
Stress: Occurs with physical activity such as running, laughing or coughing
Urgency: The sudden need to use the restroom
Overflow: Involuntary release of an overfilled bladder
Neurogenic (reflex): The nervous system does not have control to hold or release bladder
Functional: An individual is unaware of when they need to use the restroom or they physically cannot reach the restroom
Mixed: Combination of stress and urge incontinence
Musculoskeletal System
Age-Related Changes
Shortening of vertebrae
Between ages 20-70, height decreases approximately 2 inches
Bones more brittle
Slight knee flexion
Decrease in bone mass and bone mineral
Slight kyphosis
Slight hip flexion
Impaired flexion and extension movements
Sarcopenia
Loss of muscle mass, strength and function
Osteoarthiritis
Degenerative joint disease in which there is progressive deterioration and abrasion of joint cartilage, with the formation of new bone at the joint surfaces
Signs and Symptoms
Does not develop inflammation, deformity, and crippling like rheumatoid arthritis
Leading cause of physical disability in older people
Joint pain
Osteoporosis
Demineralization of the bone
Signs and Symptoms
Kyphosis and reduction of height
Bones fracture more easily
Pain in the lumbar region of the spine
CONNECTION: Estrogen deficiency can be a significant risk factor for women
Linkage: weakened muscles lead to decreased activity which can increase a patient's risk for falls and bone fractures.
Mental Health
One in five older adults presents with some type of mental health issue
DSICLAIMER: None of the categories in this section are common age-related changes, but their prevalence is so significant that I felt it should be included in this concept map.
20% of all suicides occur in individuals over the age of 65
The most common conditions include anxiety, mood disorders (depression or bipolar disorder), and severe cognitive impairment
CONNECTION: A diminishing mental health is just as significant as any other disease or disorder. A decrease in mental health can heavily influence other body systems as it affects physical health.