1. Reproductive
1.1. Females
1.1.1. Decreased Production of Secretions
1.1.2. Increased risk of Uterine Cancer
1.1.3. Hormonal changes
1.1.3.1. Vulva atrophied
1.1.3.1.1. More susceptible to infection
1.1.3.2. Flattening of the labia
1.1.3.3. Loss of SubQ Fat
1.1.4. Thinning of vaginal epithelium
1.1.5. Cervix, uterus, Fallopian tubes atrophy
1.1.6. Vaginal canal changes
1.1.6.1. Reduction in collagen and adipose tissue
1.1.6.2. Shortens and narrows
1.1.6.3. Less lubricaiton
1.1.6.4. More alkaline pH
1.2. Males
1.2.1. Reduced Sperm Count
1.2.2. Benign Prostatic Hypertrophy
1.2.3. Seminal vesicles develop thinner epithelium
1.2.4. Muscle tissue replaces with connective tissue
1.2.5. Decreased capacity to retain fluids
1.2.6. Seminiferous tubule changes
1.2.6.1. Increased fibrosis, epithelium thinning, thickening of the basement membrane, and narrowing of the lumen
1.2.7. Atrophy of testes
2. Neurological
2.1. Sleep
2.1.1. Disturbance
2.2. Pain
2.2.1. Neuropathic
2.2.2. Nociceptic
2.2.3. Acute/Chronic
2.3. Delirium
2.3.1. Rapid change in mental status
2.3.2. Can be reversible
2.3.3. Treatment depends on cause
2.3.3.1. Hypoxia
2.3.3.2. Infection
2.3.3.2.1. UTI
2.3.3.2.2. Cellulitis
2.3.3.2.3. Respiratory
2.3.3.3. Dehydration
2.3.3.4. Hypernatremia/ hyponatremia
2.3.3.5. Medications
2.3.3.6. Cognitive impairment
2.4. Dementia
2.4.1. Irreversible/ progressive
2.4.2. Impairment of cognitive function
2.4.2.1. Memory
2.4.2.2. Orientationr
2.4.2.3. Reasoning
2.4.2.4. Attention
2.4.2.5. Language
2.4.2.6. Problem solving
2.4.3. Caused by damage or injury to brain
2.4.4. Alzheimer’s
2.4.4.1. Most common form
2.4.4.2. Changes in brain
2.4.4.2.1. Neuritic plaques containing beta-amyloid proteins
2.4.4.2.2. Neurofibrillary tangles in cortex
2.4.4.2.3. Loss or degeneration of neurons or synapses
2.4.4.2.4. Changes in neurotransmitter system
2.4.4.3. Possible causes
2.4.4.3.1. Genetics
2.4.4.3.2. Environment
2.4.4.3.3. Chromosomal abnormalities
2.4.4.3.4. Free radicals
2.4.4.3.5. Aluminum and Mercury in the brain
2.4.4.3.6. Slow-acting virus
3. Respiratory
3.1. Reduction of cough and laryngeal reflexes
3.2. Increased residual capacity
3.3. Calcification of costal cartilage
3.3.1. Trachea and rib cage more rigid
3.4. Reduced vital capacity
3.5. High risk for respiratory infection
3.5.1. May not have chest pain/ low body temperature
3.6. COPD
3.6.1. Asthma
3.6.1.1. Can develop in older years
3.6.1.2. High risk of complications from bronchiolectasis/ cardiac problems
3.6.1.3. High rates of mortality
3.6.2. Chronic bronchitis
3.6.2.1. persistent, productive cough
3.6.2.2. Wheezing
3.6.2.3. Recurrent respiratory infections
3.6.2.4. Shortness of breath
3.6.3. Emphysema
3.6.3.1. Increasing incidence in older adults
3.6.3.2. Causes: chronic bronchitis, chronic irritation, and morphologic changes in the lung
3.6.3.3. Cigarette smoking major role in development
3.6.3.4. Symptoms develop slowly; can delay diagnosis, treatment
3.6.4. Lung cancer
3.6.4.1. Increasing incidence in 65 years and older
3.6.4.2. Higher incidence in men than in women
3.6.4.3. Incidence and mortality rate varies in ethnic groups
3.6.4.4. Incidence in smokers twice as nonsmokers
3.6.4.5. Symptoms: dyspnea, coughing, chest pain, fatigue, anorexia, wheezing, and respiratory infections
3.6.4.6. Treatment: surgery, chemotherapy, and radiotherapy
3.6.5. Lung abcess
3.6.5.1. Causes: pneumonia, tuberculosis, malignancy, trauma, and aspiration
3.6.5.2. Symptoms: anorexia, weight loss, elevated temperature, and chronic cough
3.6.5.3. Diagnosis: same as other age groups
3.6.5.4. Treatment: postural drainage; high-protein, high-calorie diet
4. Cardiovascular
4.1. Heart muscle loses efficiency and contractile strength
4.1.1. Reduced cardiac output with physiologic stress
4.2. Valves become thick and rigid
4.3. Blood vessels reduce elasticity
4.4. Oxygen used less efficiently
4.5. Prevalent diseases
4.5.1. Cardiovascular diseases
4.5.1.1. Women
4.5.1.1.1. Prevalence increases with age
4.5.1.1.2. Signs differ with women
4.5.1.1.3. Education regarding cardiovascular disease and promotion of cardiovascular health
4.5.1.1.4. Guide women about not ignoring symptoms
4.5.1.2. Coronary artery disease
4.5.1.2.1. Ischemic heart disease
4.5.1.2.2. Prevalence increase with age
4.5.1.2.3. Angina
4.5.1.2.4. Myocardial infarction
4.5.2. Diabetes, cancer, renal failure
4.5.3. Blood dyscrasias
4.5.4. Blood Pressure
4.5.4.1. Hypertension
4.5.4.1.1. Incidence and prevalence increase with age
4.5.4.1.2. Symptoms: dull headache, impaired memory, disorientation, confusion, epistaxis, and slow tremor
4.5.4.2. Hypotension
4.5.4.2.1. Decline in systolic blood pressure of 20 mm Hg or more after changing positions
4.5.4.2.2. Postural and postprandial hypotension due to increased intake of vasoactive medications and baroreceptor sensitivity
4.5.4.2.3. Consequences: falls, stroke, syncope, other coronary complications
4.5.5. Congestive Heart Failure
4.5.5.1. Incidence increases with age
4.5.5.2. Leading cause of hospitalization
4.5.5.3. Complication of arteriosclerotic heart disease
4.5.5.3.1. Pulmonary emboli
4.5.5.4. Coronary artery disease responsible for most cases
4.5.5.5. Symptoms: shortness of breath, dyspnea on exertion, confusion, insomnia, wandering at night, agitation, depression, orthopnea, wheezing, weight gain, and edema
5. Gastrointestinal
5.1. Less acute taste sensations
5.2. Decreased esophageal motility
5.3. Atrophy of the small and large intestines
5.4. Increased risk of aspiration, ingestion, and constipation
5.4.1. Dysphagia
5.5. Decreased secretion of saliva
5.5.1. Dry mouth
5.6. Increased pH
5.6.1. Decreased HCL and pepsin
5.7. Decreased elasticity of the stomach
5.8. Decrease in bile salt synthesis
5.8.1. Increased risk of gall stones
5.9. Diseases
5.9.1. Hiatal Hernia
5.9.2. Esophageal cancer
5.9.3. Peptic ulcer disease
5.9.4. Stomach cancer
5.9.5. Diverticula disease
5.9.6. Colon cancer
5.9.6.1. Second most common malignancy in the US
5.9.7. Chronic constipation
6. Urinary
6.1. Decreased GFR
6.1.1. 50%by 90
6.2. Reduced Bladder capacity
6.2.1. Frequency
6.2.2. Urgency
6.2.3. Nocturna
6.3. Incontinence NOT a normal part of aging
6.4. Hypertrophy and thickening of the bladder muscle
6.4.1. Decreases bladder ability to expand
6.4.2. Reduces storage capacity
6.4.2.1. Daytime urinary frequency
6.4.2.2. Nocturia
6.4.2.2.1. Changes in cortical control of micturition
6.5. Inefficient neurological control of bladder emptying and weaker bladder muscle
6.5.1. Retention of large volumes of urine
6.6. Female: fecal impaction
6.7. Male: prostatic hypertrophy
6.8. Increased risk fo renal calculi and bladder cancer
7. Musculoskeletal
7.1. Frailty Syndrome
7.1.1. Weakness
7.1.2. Weight loss/ muscle wasting
7.1.3. Exercise intolerance/ immobility/ falls
7.1.4. Instability of chronic disease
7.1.5. Occurs in 20-30% of people over 75
7.2. Function
7.2.1. Decrease in size and quantity of muscle fibers
7.2.2. Decreased endurance
7.2.3. Reduced flexibility
7.3. Failure to thrive
7.3.1. May have multiple chronic illnesses
8. Medication metabolism
8.1. Extended half-life of drugs
8.1.1. Decreases liver function.
8.1.2. Decreased renal function
8.2. Altered pharmacodynamics
8.2.1. Increased myocardial sensitivity to anesthesia
8.2.2. Increased CNS receptor to narcotics, alcohol, and bromides
9. Endocrine
9.1. Thyroid gland atrophied and activity decreases
9.1.1. Weight gain
9.2. Volume of pituitary gland decreases
9.2.1. GH
9.3. Insufficient release of insulin and reduced tissue sensitivity to circulation insulin
9.3.1. Type II diabetes
9.3.1.1. Heart attack
9.3.1.2. Stroke
9.3.1.3. Retinopathy
9.3.1.4. Circulation/ amputation
9.3.1.5. Kidney function
9.4. Diminished adrenal function
9.5. Adrenocorticotropic hormone secretion decreases
9.5.1. Glucocorticoids
9.5.2. Mineralocorticoids
9.5.3. Steroids
9.6. Reduction of estrogen in women
10. Immune
10.1. Reduced antibody response
10.1.1. Decreased immunization response
10.2. Decreased number of langerhans cells in skin
10.3. Reduced thickness of the skin
10.4. Decreased circulation of the skin
10.5. Manifestations of the infection
10.5.1. Delirium
10.5.2. Fever
10.5.2.1. Also could have low temperature
10.5.3. Chills
10.5.4. Hypotension
10.5.5. Incresed pulse
10.5.6. Increased respiration’s
10.5.7. Flank pain
10.6. HIV
10.6.1. Often misdiagnosed