Gerontology: Changes in Aging

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Gerontology: Changes in Aging by Mind Map: Gerontology: Changes in Aging

1. Respiratory

1.1. Oxygen requirements do not change

1.1.1. Sedentary lifestyle = risk for respiratory depression Increased risk for pneumonia Penicillins

1.1.2. Increased residual capacity & reduced vital capacity High risk for infection

1.2. Calcification of costal cartilage and trachea

1.2.1. rib cage more rigid

1.3. Reduction of cough and laryngeal reflexes

2. Lydia Miller

3. Demographics

3.1. Gender

3.1.1. Male Typically shorter life expectancy Decline in testosterone

3.1.2. Female Typically longer life expectancy Effects of Aging Menopause beginning in 50s

3.2. Education

3.2.1. US Census 2010 Majority (36.4%) High school graduate 20.6% Some college/Assoc. Degree 22.5% Bachelor's or Higher Degree 20.5% Incomplete High school (no diploma) or less education

3.2.2. Adapt education planning based on geriatric patient's baseline

3.3. Socialization

3.3.1. Isolation Rapid decline in health Depression Loss of sense of well-being Sedentary/inactive Maybe be involuntary Ageism Loss of spouse, family & friends Uneducated or unadapted on modern technology or ways of living Hearing or vision declination Risk for developing delirium

3.3.2. Strong family & friend circle Thrive in environments Increased sense of well-being

3.3.3. Role Changes Grandparenting Adapt to active lifestyles Loss of spouse Performing ADLs alone Single income Loss of intimacy Retirement Role in society Sense of identity

3.4. Interests

3.4.1. Active lifestyle Frequent exercise/activity Weekly social groups Frequent visits with friends and family Maintain mental acuity

3.4.2. Inactive 2 hrs complete bedrest = decline in body Risk for impaired skin integrity

4. Cardiac & Circulatory

4.1. Decreased proficient circulation

4.1.1. Heart muscle loses efficiency & contractile strength Reduced cardiac output w/ physiologic stress Harder to maintain BP Valves become thick and rigid Blood vessels reduce elasticity O2 used less efficiently Baroreceptors less responsive Reduced compensation during activity

4.2. Heart dimensions = unchanged

5. Cellular

5.1. Body composition

5.1.1. Less lean muscle mass

5.1.2. Increased subcutaneous fat

5.1.3. Loss of tissue elasticity

5.2. Immunosenescence

5.2.1. Presbycusis

5.2.2. Presbyesophagus

5.2.3. Presbyopia

5.3. Functional cell number decreases

5.4. Fluid Composition

5.4.1. Extracellular fluid remains constant

5.4.2. Intracellular fluid reduces Easily dehydrated Increased risk for Delirium Create electrolyte imbalances

5.5. Lose ability for cell mediated defense

5.5.1. Increased risk for infection

6. Gastrointestinal

6.1. Decreased proper processing of food

6.1.1. Decreased pepsin

6.1.2. Decreased peristalsis

6.1.3. Presbyesophagus Increased risk for aspiration

6.1.4. Atrophy of small and large intestines Decreased proper nutrient uptake Need for diet changes to include lacking nutrients Take oral supplements Indigestion & constipation

7. Sleep

7.1. Pattern

7.1.1. Circadian Rhythem Cycle changes Early to bed & early to rise Less time in REM

8. Nero

8.1. Changes

8.1.1. Demylenization

8.1.2. Lacking exercise = increased free radicals

8.1.3. Slowing of central processing

8.1.4. Reduction in neurons, nerve fibers and cerebral blood flow Slower response to change in balance

8.1.5. Hypothalamus less effective in temperature regulation

8.1.6. Changes in sleep pattern w/ waking often

8.2. Decline in weight and blood flow to brain

8.2.1. Maintain mental acuity Until around 80s Verbal skills intact Intelligence Crystallized Fluid

9. Endocrine

9.1. Decreased parathyroid secretions

9.1.1. Reduced calcium production

9.2. Decreased ACTH

9.2.1. Decreased BP

9.3. Thyroid gland atrophies

9.3.1. Basal Metabolic Rate lowers Gain weight easier Cannot thermoregulate as well Tend to be colder Cannot withstand drastic temperature changes

9.4. Beta cells in pancreas become less effective in secreting insulin

9.4.1. Decrease sensitivity to insulin & glucose Cannot deliver glucose successfully to cells Possibly lead to Type 2 Diabetes Inability to sustain homeostasis of glucose

10. Musculoskeletal

10.1. Loss of lean body mass (Sarcopenia)

10.1.1. Increased risk for fragility Combat with regular aerobic and resistance/low weight workouts

10.2. Increase in subcutaneous fat

10.3. Shift in distribution of weight

10.3.1. Become more top-heavy Increased instability Increased risk of falls

10.4. Decrease flexibility

10.5. Thinning disks & shortened vertebrae

10.6. Decreased bone and mineral mass

10.6.1. Diminished calcium absorption Increased risk of fractures Increase diet or supplementation of calcium

11. Safety

11.1. Pharmaceutical

11.1.1. Manage Drugs & Interactions Polypharmacy Try to prevent w/ adaptations to lifestyle

11.2. Mobility

11.2.1. Limited activity Decreased lean muscle Limited mobility Struggle with rapid movements & reactions Increased fall risk Increased risk for fractures Common sites: Hips, Pelvis, Wrist, Radius Increase calcium intake

12. Reproductive

12.1. Male

12.1.1. BPH develops in about half of aging men Harms sexual activity with vasoconstriction of vessels

12.1.2. Rate of sperm cell productive slows

12.2. Female

12.2.1. Decreased vaginal lubrication

12.2.2. pH of vagina becomes alkalotic Increase risk of UTI

12.2.3. Vulva atrophies & labia flatten

13. Pharmaceutics

13.1. Polypharmacy

13.1.1. Patient taking more than 6 drugs at once Increased risk for interactions & contraindications

13.2. Common drugs

13.2.1. Anti hypertensives Beta blockers Diuretics ACE inhibitors

13.2.2. Antiinfectives Penecillins Vancomycin

13.2.3. Glucose control Insulins Oral glucose regulators

13.2.4. Supplements Calcium, Potassium, Iron

14. Renal

14.1. Reduced renal blood flow & GFR

14.2. Reduced bladder capacity

14.2.1. Increased urgency & frequency BPH compression increases urgency to urinate

14.2.2. Nocturia