1. Musculoskeletal
1.1. Loss of bone mass
1.2. Thinking of vertebral disks
1.2.1. Shortening of trunk
1.3. Decreased bone calcium
1.4. Loss of cartilage
1.5. Decreased muscle mass
1.6. Bone mineral density decreases
1.7. Decreased ROM
1.8. Increased body fat
1.9. Pathophysiology
1.9.1. Fractures
1.9.1.1. Trauma
1.9.1.2. Bone cancer
1.9.1.3. Often due to falls
1.9.1.4. PREVENTION
1.9.2. Osteoarthritis
1.9.2.1. Progression of deterioration of joint cartilage
1.9.2.2. Affects most persons over 55
1.9.2.3. Women are affected more after menopause
1.9.2.4. Joint injury, genetics, obesity
1.9.3. Rheumatoid arthritis
1.9.3.1. Projection of synovial tissue
1.9.3.2. Painful, stiff, red, swollen, warm to touch
1.9.4. Osteoporosis
1.9.4.1. Most prevalent metabolic disease of the bone
1.9.4.2. Demineralization of the bone
1.9.4.3. D/t: inactivity, other diseases, decreased hormone production, diet, medication
2. Cardiovascular
2.1. Dysrhythmias
2.1.1. Increased systolic BP
2.1.2. Increased size of atria
2.2. Cardiac output decreases
2.3. Increased peripheral resistance
2.4. Decreased heart rate
2.5. Decreased stroke volume
2.6. Loss of elasticity of vessels
2.7. Mitral and aortic valves become thick and rigid
2.8. Contractility decreases in response to increase demand
2.9. Pathophysiology
2.9.1. Hypertension
2.9.1.1. Most prevalent cardiovascular disease
2.9.1.2. Vasoconstriction with age
2.9.1.3. Peripheral resistance
2.9.2. Congestive heart failure
2.9.2.1. Edema and poor nutrition of tissues
2.9.3. Pulmonary embolism
2.9.3.1. Increased incidence with fractured hip
2.9.3.2. Often challenging to diagnosis with increased age
2.9.3.3. Shortness of breath, chest pain, cough
2.9.4. Myocardial infarction
2.9.4.1. Increased risk in men with hypertension
2.9.4.2. Tightness or pain in chest, abnormal heart beat, anxiety
3. Genitourinary
3.1. Size and weight of kidney decrease
3.2. GFR decreases d/t decrease in renal blood flow
3.3. Drug metabolism decreased
3.4. Tubular function diminishes
3.5. Risk for reflux of urine into the ureters
3.6. Bladder capacity decreases
3.6.1. Increased urinary frequency
3.6.2. Nocturia
3.7. Increase frequency and dribbling
3.7.1. Weakened bladder
3.7.2. Enlarged prostate in men
3.8. Prostatic enlargement
3.8.1. Urinary retention
3.8.2. Bladder infection
3.9. Women experience stress incontinence
3.10. Pathophysiology
3.10.1. Urinary Incontinence
3.10.1.1. Stress, urgency, overflow, neurological, functional, mixed
3.10.2. Renal calculi
3.10.2.1. Stones resulting from immobilization, infection, changes in pH of urine
3.10.3. Glomerulonephritis
3.10.3.1. Older adult w/ acute condition
3.10.3.2. Inflammation of kidney due to immune response
4. Neurologic
4.1. Decrease in neurons and neurotransmitters — do not regenerate
4.2. Decrease in CNS and PNS function
4.3. Intelligence remains consistent
4.4. Performance of tasks is slower
4.5. Decrease in tactile sensitivity
4.6. Loss of connection in nerve ending in the skin
4.7. Loss of proprioception— affects balance
4.8. Pathophysiology
4.8.1. Parkinson’s disease
4.8.1.1. Central nervous system can no longer control body movements
4.8.1.2. Decreased dopamine production
4.8.1.3. More common in men
4.8.2. TIA
4.8.2.1. reduction in cerebral blood flow
4.8.2.2. Increased risk for CVA
4.8.3. CVA
4.8.3.1. Risk factors: hypertension, arteriosclerosis, diabetes, gout, anemia, hypothyroidism, silent MI, TIA, dehydration, smoking
5. Endocrine
5.1. Glands atrophy
5.2. Decreased rate of secretion of hormones
5.3. Thyroid activity decreases
5.4. Metabolic rate slows
5.5. Cessation of estrogen with menopause
5.6. Reproductive organs atrophy in women
5.7. Gonadal secretion of progesterone and testosterone decrease
5.8. T4 and T3 metabolic clearance rates decreases
5.9. Pathophysiology
5.9.1. Diabetes
5.9.1.1. Insulin production decreases or insulin resistance increases
5.9.2. Hypothyroidism
5.9.2.1. Decrease tissue use of hormones
5.9.2.2. More common in women
5.9.3. Hyperthyroidism
5.9.3.1. Thyroid excretes excess amount
5.9.3.2. Weight loss, irregular heart beat
6. Integumentary
6.1. Thinning of skin
6.2. Loss of subcutaneous tissue
6.3. Drying of skin
6.4. Loss of elastin
6.5. Decrease in ability to regulate temperature
6.5.1. Decreased overall body temperature
6.6. Decrease in lean body mass and water
6.6.1. Increased risk for dehydration
6.7. Delayed wound healing d/t increased vascular fragility
6.8. Hair loss
6.9. Nails become brittle and thick
6.10. Regeneration slows
6.11. Keratinocytes become smaller
6.12. Women have increased facial hair
6.13. Increased age spots
6.14. Pathophysiology
6.14.1. Pressure ulcers
6.14.1.1. No blood supply
6.14.1.2. Increased pressure over bony prominences
6.14.1.3. 4 stages
6.14.2. Keratosis
6.14.2.1. Can be precancerous
6.14.2.2. Treated with freezing agents and acids
6.14.2.3. Small gray or brown lesions on area of exposure
6.14.3. Seborrheic keratosis
6.14.3.1. Dark, wart like
6.14.3.2. Increase in size and number w/ age
6.14.3.3. Benign
6.14.4. Pruritus
6.14.4.1. Caused by excessive bathing/ dry heat
6.14.4.2. Possible cause: atrophy
6.14.4.3. Most common dermatological problem
7. Respiratory
7.1. Decreased immune response
7.2. Imbalanced perfusion
7.3. Lungs loose elasticity
7.4. Increased demands for oxygen
7.5. Increased breaths
7.6. Decreased alveolar surface area
7.7. Decreased ability to clear mucus secretion
7.8. Decreased cilia
7.9. Decreased ability to cough and deep breathe
7.10. Pathophysiology
7.10.1. Asthma
7.10.1.1. Wheezing, chest pain,shortness of breath
7.10.2. Chronic bronchitis
7.10.2.1. Persistent productive cough, shortness of breath, often takes years to be diagnosed
7.10.3. Emphysema
7.10.3.1. Cigarette smoking
7.10.3.2. Air sacs are damaged / enlarged
7.10.3.3. Air is abnormally present in body tissues
8. Gastrointestinal
8.1. Decreased saliva and dry mouth
8.2. Dental caries, loss of teeth
8.3. Decreased ability to chew food
8.4. Decreased hunger sensations
8.5. Loss of taste buds
8.6. Increased risk of GERD and aspiration
8.6.1. Relaxation of lower esophageal sphincter
8.6.2. Sliding hiatal hernia
8.7. Delayed gastric emptying
8.8. Weigh loss
8.9. Decreased peristalsis
8.10. Decreased absorption in small intestine
8.11. Decreased enzyme production in liver
8.11.1. Affects drug metabolism
8.11.2. Affects detoxification process
8.12. Pathophysiology
8.12.1. Production of Pepsin and hydrochloride acid decreases
8.12.2. Dysphagia
8.12.2.1. Difficulty swallowing
8.12.2.2. Changes in diet
8.12.3. Hiatal hernia
8.12.3.1. May be caused by high fiber diet
8.12.3.2. Surgically fixed
8.12.4. Peptic ulcer
8.12.4.1. D/t stress and diet
8.12.4.2. Complication of chronic diseases
8.12.5. Diverticular disease
8.12.5.1. Multiple pouches of mucosa
8.12.5.2. Avoid seeds and acidity in diet
9. Reproductive
9.1. Ovarian function decreases
9.2. Breast tissue decreases
9.3. Ovaries and uterus atrophy
9.4. Perineal muscle weakness
9.5. Atrophy of vulvla
9.6. Vaginal mucus membrane: becomes dry, decreases in elasticity, reduced secretions which may lead to painful intercourse
9.7. Testes atrophy and soften
9.8. Prostate enlargement due to changes in testosterone
9.9. Erection can be less firm and shorter
9.10. Decreased force with ejaculation
9.11. Pathophysiology
9.11.1. Benign prostatic hyperplasia
9.11.1.1. In men, often have dysuria and dribbling
9.11.2. Atrophic vaginitis
9.11.2.1. Reduction in collagen and adipose tissue
9.11.2.2. Shortening and narrowing of vaginal canal
9.11.2.3. Easily irritated
9.11.3. New Topic
9.12. Women experience menopause
10. Sensory
10.1. Loss off cells in olfactory bulb
10.2. Decrease in sensory cells
10.3. Sensitivity to smell declines
10.4. Taste perception decreases
10.5. Tear production decreases
10.6. Cataracts can form
10.6.1. Abnormal progressive clouding or opacity of the lens in the eye
10.7. Marcus senilis
10.7.1. Partial or co,Pete white ring encircles the periphery of the cornea
10.8. Hearing of high pitch sounds decrease
10.9. Discrimination of times diminishes
10.10. Pathophysiology
10.10.1. Detached retina
10.10.1.1. Forward displacement of retina
10.10.1.2. Causes spots or floaters
10.10.2. Hearing deficits
10.10.2.1. Hearing aids
10.10.3. Glaucoma
10.10.3.1. Optic nerve damage
10.10.4. Macular degeneration
10.10.5. Corneal ulcer
10.10.5.1. Inflammation of cornea
11. Needs
11.1. Nutrition
11.1.1. Less lean body mass
11.1.2. Do not burn calories as quickly
11.1.3. Activity level usually slower
11.1.4. Calories needs decrease
11.1.5. Fiber is important for bowel function
11.1.6. Nutritional supplements may be needed
11.1.7. Pathophysiology
11.1.7.1. Anoxeria
11.1.7.1.1. Familial losses, stress
11.1.7.2. Dysphagia
11.1.7.3. Constipation
11.1.7.3.1. Slowed peristalsis, inactivity, drug metabolism , less fiber and fluid in diet
11.2. Sleep
11.2.1. Stages 3 and 4 less prominent
11.2.2. Nocturia
11.2.3. Insomnia
11.2.4. Napping
11.2.5. Sleep apnea
11.2.6. Restless leg syndrome
11.2.7. Nocturnal myoclonus
11.3. Sexuality
11.3.1. More interest in religion
11.3.2. Older women experience painful intercourses
11.3.3. Age spots
11.3.4. Arthritic joints
11.3.5. Loss of muscle tone
11.3.6. Graying and loss of hair
11.3.7. More women than men with increased age
11.4. Spirituality
11.4.1. Need to feel they are cared for
11.4.2. Hope, forgiveness of past relationships, expression of faith
11.4.3. New involvement in community or group home