Copy of Older Adult

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Copy of Older Adult by Mind Map: Copy of Older Adult

1. Cardiovascular changes

1.1. Isolated systolic hypertension

1.1.1. Systolic- > 140 mmHg

1.1.2. Diastolic- < 90 mmHg

1.2. Heart dimensions stay the same

1.3. Heart muscle loses efficiency and contractile strength

1.4. Reduced cardiac output

1.5. Valves become thick and rigid especially atrioventricular valve

1.5.1. Left ventricular hypertrophy Prolonged relaxation phase increases the amount of blood in the chamber

1.6. Blood vessels reduce elasticity

1.6.1. Calcification of elastin fibers

1.6.2. Increase in collagen

1.7. Oxygen used less efficiently

1.8. Aorta becomes dilated and enlarged

1.9. Resistance increases

1.10. Stroke volume decreases by 1% per year

1.11. More prominent arteries in head and necklace

1.12. Prolonged filling and emptying of heart

1.13. Incomplete valve closure

1.14. Pacemaker cells become irregular

1.15. Sinus node thickens

1.16. Disease prevalence

1.16.1. Atherosclerosis

1.16.2. Arteriosclerosis

1.16.3. Cardiac disease

1.16.4. Hypertension

1.16.5. CHF

1.16.6. Tachycardia or bradycardia

1.16.7. Murmurs

1.16.8. Stroke

2. Respiratory changes

2.1. Decreased respiratory muscle strength

2.2. Decreased response to hypoxia and hypercapnia

2.3. Stiff chest wall

2.4. Calcification of costal cartilage

2.5. Reduction of cough and laryngeal reflexes

2.6. Thoracic muscles become more rigid

2.7. Reduced basilar inflation

2.8. Loss of elasticity

2.9. Decreased ciliary action

2.10. Hypertrophy of bronchial mucous gland

2.11. Breathing changes

2.11.1. Reduced PO2

2.11.2. Reduced amount of oxygen that can be consumed

2.11.3. Forced expiration volume decreases

2.11.4. Delayed oxygen perfusion

2.11.5. Reduced vital capacity

2.11.6. Increased residual capacity

2.12. Nasal changes

2.12.1. Thicker secretions

2.12.2. Rotation downwards Septal deviations

2.12.3. Obstructive apnea Trouble sleeping

2.13. Disease prevalence

2.13.1. Pneumonia

2.13.2. Flu/influenza

2.13.3. COPD

2.13.4. Common cold

3. Genitourinary changes

3.1. Kidney

3.1.1. Renal mass becomes smaller

3.1.2. Renal tissue growth declines

3.1.3. Atrophy of the kidney

3.1.4. Pharmacokinetic decrease in excretion of drugs

3.1.5. Decrease in nephrons

3.1.6. Reducing renal blood flow Renal toxicity risk

3.1.7. Decreased GFR Reduces by 1/2 between the ages of 20-90

3.2. Bladder

3.2.1. Decreased bladder capacity

3.2.2. Reduced bladder elasticity Urinary frequency Urgency Retention Urinary incontinence Not a normal aging change Nocturia

3.2.3. Weaker bladder muscles

3.3. Ureters

3.3.1. Decrease in tubular function Less efficient exchange of water and sodium Hyponatremia risk Suppression of ADH Decrease reabsorption of glucose Risk for proteinuria and glycosurias

3.3.2. More difficult to empty bladder

3.3.3. Micturition reflex delayed

3.3.4. Weakened pelvic diaphragm

4. Gastrointestinal changes

4.1. Mouth, tongue, teeth

4.1.1. Decreased saliva production

4.1.2. Increased risk for aspiration and indigestion

4.1.3. Flattened chewing cusps

4.1.4. Gingival retraction and decreased dentin production

4.1.5. Loss of tongue papillae

4.1.6. Brittle tooth enamel

4.1.7. Cavities increase

4.1.8. Poor hygiene due to weakness and confusion

4.1.9. Disease prevalence Periodontal disease Aspiration

4.2. Atrophy of the small and large intestine

4.3. Increased risk for aspiration, indigestion, and constipation

4.4. Decreased gastric motility

4.5. Impaired sensation to defecate

4.6. Esophagus

4.6.1. Dilation

4.6.2. Slower esophageal emptying because of decreased propulsion

4.6.3. Weakened gag reflex

4.6.4. Relaxation of lower esophageal sphincter Presbyesophagus risk Decreased propulsion waves

4.6.5. Disease prevalence Hiatal hernia Stomach pushes up through the diaphragm muscle Esophageal cancer Aspiration GERD Acid or bile irritates the esophagus

4.7. Liver

4.7.1. Reduced volume and weight

4.7.2. Decreased ability to regenerate cells

4.7.3. Pharmacokinetics decreased in absorption of drugs

4.7.4. Less absorption of cholesterol

4.7.5. Disease prevalence Liver failure Gallstones Cirrhosis Scarring of the liver

4.8. Stomach and intestines

4.8.1. Small intestine decreases in size and weight

4.8.2. Less absorption of nutrients and vitamins Fat Vitamin B12 Iron Calcium

4.8.3. Higher pH in stomach

4.8.4. Decreased hunger urges

4.8.5. Reduced motility

4.8.6. Constipation

4.8.7. Slower peristalsis

4.8.8. Gastric mucosa shrinks

4.8.9. Decrease pepsin, lipase, pancreatic enzymes, and hydrochloric acid

4.8.10. Gastric irritation

4.8.11. Slower peristalsis

4.8.12. Intestinal blood flow decreases

4.8.13. Loss of internal sphincter tone

4.8.14. Decreased elasticity of stomach

4.8.15. Less secretions to stomach and intestines

4.8.16. Nerve impulses slow down to bowel

4.8.17. Disease prevalence Constipation C.difficile Incotinence Colon cancer Electrolyte imbalance

5. Musculoskeletal changes

5.1. Bone

5.1.1. Decrease in height Shortening of vertebrae Thinning discs

5.1.2. Bones become brittle

5.1.3. Decreased calcium absorption

5.1.4. Slower production of new bone

5.1.5. Disease prevalence Kyphosis Osteoporosis Especially women due to lack of calcium consumption Broken bones

5.2. Joint

5.2.1. Enlargement of joints

5.2.2. Deterioration of cartilage

5.2.3. Increase in calcification

5.2.4. Loss of flexibility

5.2.5. Inflammation Spurs Occur due to formation of new bone Arthritis Stiffness Deformities Pain

5.3. Muscle

5.3.1. Decreased bone mass and mineralization

5.3.2. Muscle fiber atrophy

5.3.3. Decrease in muscle strength and movement

5.3.4. Fibrous tissue replaces muscle mass

5.3.5. Disease prevalence Muscle cramping and tremors Fall risk Sarcopenia Loss of muscle tissue

6. Immune changes

6.1. Thymus mass decreases

6.2. Decline in cell mediated immunity

6.3. T cell production and activity decreases

6.4. IGM decreases

6.5. IGA and IGG increase

6.6. Inflammation defense decreases

6.7. Cytokines increase

6.8. Disease prevalence

6.8.1. Infections Bacterial Viral

6.8.2. Nosocomial infections

6.8.3. Tuberculosis

6.8.4. Herpes Zoster

6.8.5. Cancer

6.8.6. Flu

7. Reproductive changes

7.1. Male

7.1.1. Sperm count decreased

7.1.2. Prostate enlargement

7.1.3. Testosterone decreases

7.1.4. Sclerosis of the penis

7.1.5. Testes shrink

7.1.6. Increase in luteinizing hormone and follicle stimulating hormone

7.1.7. Disease prevalence BPH Prostate cancer Bladder cancer UTI

7.2. Female

7.2.1. Loss of subcutaneous fat

7.2.2. Thinner and less vascular epithelium

7.2.3. Smaller ovaries

7.2.4. Cervix shrinks in size

7.2.5. Uterus shrinks

7.2.6. Ovaries become smaller and thicken

7.2.7. Labia flattens

7.2.8. Shrinkage and shortening of the Fallopian tubes

7.2.9. Menopause

7.2.10. Decrease in estrogen

7.2.11. Less secretory fluid

7.2.12. Disease prevalence Ovarian cancer UTI Cancer of the endometrium Breast cancer

8. Nervous system changes

8.1. Decline in weight and blood flow to the brain

8.2. Reduction in neurons, nerve fibers, and cerebral blood flow

8.3. Slow responses to change in balance

8.4. Decreased temperature regulation

8.5. Changes in sleep patterns with frequent awakening

8.6. Disease prevalence

8.6.1. Delirium Reversible, acute confusion

8.6.2. Dementia Irreversible, progressive impairment in cognitive function

8.7. CNS

8.7.1. Decline in weight

8.7.2. Lower nerve conduction

8.7.3. Hypothalamus temperature malfunction

8.7.4. Brain cells decline

8.7.5. Neurofibrillary tangles Increased risk for Alzheimer's

8.7.6. Memory loss

8.7.7. Blood flow decreases

8.7.8. Decrease in nerve conduction, neurons, and nerve fibers

8.8. PNS

8.8.1. Impulse conduction decreases to reinervate nerve fibers

8.8.2. Myelin sheath is degernated

8.8.3. Slower responses

8.8.4. New axons decrease in size

9. Sensory changes

9.1. Decreased vision

9.1.1. Lens elasticity decreases

9.1.2. Pupil size decrease

9.1.3. Decreased ability to adapt to light

9.1.4. Narrowing of visual field causing decrease in peripheral vision

9.1.5. Alterations in blood supply to eye

9.1.6. Rhodopsin rods decreasing causing Decreased night vision

9.1.7. Decreased lacrimal secretions causing dry eyes

9.1.8. Lenses Opicification Increase density Muscle fibers stiffen

9.1.9. Retina Alteration in blood supply Photoreceptor cells lost

9.1.10. Disease prevalence Presbyopia Glaucoma Increase ocular pressure Cataract Clouding of lense Macular degeneration Progressive vision loss

9.2. Decreased hearing

9.2.1. Progressive hearing loss

9.2.2. Distortion of high pitched noises

9.2.3. Cerumen increases

9.2.4. Decreased blood supply

9.2.5. Basilar membrane becomes less flexible

9.2.6. Endolymph production reduced

9.2.7. Tympanic membrane atrophies

9.2.8. Increased keratin production

9.2.9. Alteration in equilibrium

9.2.10. Disease prevalence Ototoxicity Multiple drugs can cause this for example NSAIDS, aspirin, Gentamicin, chemotherapeutic drugs, loop diuretics, and anti malaria drugs Pharmacodynamics of these drugs causes the ototoxicity Presbycusis

9.3. Decreased taste and smell

9.3.1. Taste acuity is dependent on smell

9.3.2. Sense of smell decreases

9.3.3. Atrophy of the tongue

9.3.4. Decrease in number of cells in sensory lining

9.3.5. Reduced taste sensation

9.3.6. Decreased discrimination of odorsf

9.3.7. Less cells in the olfactory bulb

9.3.8. Decreased saliva

9.3.9. Poor oral hygiene

9.4. Decreased touch

9.4.1. Reduction of tactile sensation

9.4.2. Reduced ability to sense pressure, discomfort, and changes in temperatures

9.4.3. Decrease in touch receptors

10. Endocrine system

10.1. Thyroid

10.1.1. Decrease function

10.1.2. Atrophy

10.1.3. Lower metabolic rate

10.1.4. Reduced iodine reuptake

10.1.5. Increased modular activity

10.1.6. Reduced T3 release

10.1.7. Reduced parathyroid hormone

10.1.8. Disease prevalence Hypothyroidism Depression Osteoporosis

10.2. Pituitary gland

10.2.1. ACTH secretion decreases

10.2.2. Volume decreases by 20%

10.2.3. Decrease in secretion of hormones TSH ACTH Follicle stimulating hormone Luteinizing hormone Leutropic hormone

10.2.4. Gonadal secretions decline Estrogen Progesterone Testosterone

10.3. Pancreas

10.3.1. Decreased glucose metabolism Higher blood sugar levels

10.3.2. Delayed insulin release

10.3.3. Disease prevalence Type 2 diabetes Dementia Pancreatic cancer Pancreatitis

10.4. Adrenal cortex

10.4.1. Secretory activity decreases Aldosterone Glucocorticoids 17-ketosteroids Progesterone Androgen Estrogen

10.4.2. Disease prevalence Adrenal insufficiency Addison's disease

11. Integumentary changes

11.1. Flattening of the dermal-epidermal junction

11.2. Reduced thickness and vascularity of the dermis

11.3. Slowing of epidermal proliferation

11.4. Increased quantity of degeneration of elastin fibers

11.5. Collagen fibers become more coarse and random

11.5.1. Reduced skin elasticity

11.6. Dermis becomes thinner and avascular

11.7. Skin becomes more dry and fragile

11.8. Subcutaneous fat is lost

11.9. Lines and wrinkles become apparent

11.10. Skin breakdown is more common

11.11. Age spots

11.12. Scalp, pubic, and auxiliary hair becomes gray and thins or is lost

11.13. Women may grow facial hair

11.14. Fingernails grow more slowly

11.15. Perspiration is reduced

11.15.1. Sweats glands and bulbs decrease in size

11.16. Hair in the nose and ears become thicker

11.17. Disease prevalence

11.17.1. Benign/malignant skin neoplasms

11.17.2. Skin infections