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Older Adult - Coggle Diagram
Older Adult
Digestive
Common Changes of Aging
As an adult ages there are many changes that occur in the digestive tract
- the tongue atrophies causing reduced taste sensation
- Weakening of the muscles of mastication
- decreased saliva production
- Smooth muscle of the esophageal lining weakens causing weaker contractions which can result in aspiration
- Decreased pepsin production which results in decreased protein absorption
- Peristalsis slows
- Pancreas secretions decrease resulting in decreased breakdown of food
- Decreased sensory perception may result in constipation
Pathologies
- Hiatal hernia is a condition in which the stomach and esophageal junction protrude into the diaphragm
- It is thought that this may develop due to the low fiber diet that many Americans have
- Surgical intervention is typically required
Musculoskeletal
Common Changes of Aging
- Decline in number and size of the muscle cells which decreases overall body strength creating a risk for falling
- Connective tissue changes result in decreased flexibility of muscles and joints limiting overall mobility
- Grip strength decreases
- Endurance and walking speed decrease with age
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Urinary
Common Changes of Aging
- hypertrophy of the bladder which decreases the stretch ability and decreases the volume of the bladder
- Kidney filtration efficiency declines with age
- Blood flow to the kidneys improves in a recumbent position meaning an older adult is more likely to urinate after laying for an extended period of time. This increases the rate of nocturia.
- Decreased kidney function decreases ability to metabolize drugs and increases risk for toxicity
Pathologies
Incontinence is not a normal change of aging, it can be an acute or chronic process
Transient incontinence is the ability to control voiding of bladder related to infection, delirium, fecal impaction, excessive urine production and medications
Established incontinence is a chronic form of incontinence that may have a slow onset.
There are many different types of established incontinence
- Stress: caused by weak pelvic muscles
- Urgency: caused by spasms of the bladder
- Neurogenic: caused by decreased nervous system control on the bladder
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Endocrine
Common Changes of Aging
- The thyroid gland atrophies which results in decreased metabolism
- Thyroid function remains adequate
- adrenocorticotropic hormone levels decreases with age which reduces the secretions of the adrenal gland which reduces androgen secretions
- Pituitary gland decreases with age
- Insulin secretion by the pancreas is insufficient
- Increased insulin resistance of body cells
Pathologies
Type II Diabetes Mellitus is an overall resistance to insulin. The pancreas is able to produce insulin however the body cells do not respond to the insulin resulting in hyperglycemia and decreased energy. There are many complications related to diabetes such as retinopathy and neuropathy. Diabetes is typically caused by inadequate diet and exercise, genetics and obesity.
Integumentary
Common Changes of Aging
- Wrinkles form due to decrease collagen in the skin
- Increased fragility of the skin due to decreased subcutaneous tissue which increases risk for infection
- Changes in aging such as wrinkles, greying hair and thick nails may cause a disturbed body image for the aging adult
Pathologies
Pressure injuries are a serous problem for older adults. They occur on bony prominences such as the sacrum and heels. The intense pressure over long periods of time in immobile patients causes the breakdown of skin and tissue
This creates immense pain for the patients and greatly increases the risk for infection
Respiratory
Common Changes of Aging
- Connective tissue is lost in the nose causes septal deviation which interferes with breathing
- The mucus from the nasopharynx thickens which creates increased difficulty to expel secretions
- The nasal hairs thicken causing more dust to be trapped in the airway
- The lungs decrease in size
- Elasticity decreases in the lungs which decreases strength of respirations
- Gas exchange is diminished due to fibrosis of the alveoli
- Overall reduction in vital capacity in the lungs
- Decrease in sphincter control which increases the risk of aspiration
- Reduction in overall body fluids dries out mucous membranes which decreases coughing and increases risk for infection
Pathologies
Pneumonia is very common among older adults and is one of the leading causes of death among older adults.
Pneumonia is the result of a bacterial infection in the lungs that results in fluid buildup causing poor oxygenation
Chronic Obstructive Pulmonary Disease consists of asthma, bronchitis and emphysema.
This condition is most common in smokers and develops after periods of obstruction in the lungs
Cardiovascular
Common Changes of Aging
- Sclerosis and fibrosis of the heart valves occur
- The aorta diameter increases
- Right ventricular hypertrophy may occur
- The contractility of the heart decreases causing decreased cardiac output
- The heart becomes less responsive to baroreceptor control of blood pressure
- Adults typically have other comorbities that reduce tissue perfusion
Pathologies
Congestive Heart Failure is the result of a combination of risk factors including coronary artery disease, diabetes and hyperlipidemia. Congestive Heart Failure symptoms include shortness of breath on exertion, edema in the lower extremities, impaired tissue perfusion and agitation. Congestive Heart Failure is complicated by any condition that may cause blockages in the blood vessels such as Diabetes.
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Neurological
Common Changes of Aging
- Loss of nerve cell mass causes atrophy of the brain and spinal cord
- Nerve cell numbers declines
- Nerve cells lose dendrites causing decreases stimulation
- Demyelination of the nerves occur which slow nerve impulses
- Reflexes become weaker and responses to stimuli are slower
- Free radical accumulate with age and are toxic to the nerve cells
- Cerebral blood flow decreases by about 20% and can decrease more if the individual has hypertension or diabetes
- After age 70 there is a slow decline of the individual's vocabulary
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