1. Normal Aging Changes
1.1. Systems
1.1.1. Respiratory
1.1.1.1. PO2 reduced
1.1.1.2. Loss of elasticity
1.1.1.3. Increased rigidity (trachea and rib cage)
1.1.1.4. Forced expiratory volume reduced
1.1.1.5. Blunting of cough and laryngeal reflexes
1.1.1.6. Increase in residual capacity
1.1.1.7. Fewer alveoli
1.1.1.8. Thoracic muscles increase rigidity
1.1.1.9. Reduced basilar inflation
1.1.1.10. Decreased ciliary action
1.1.2. Reproductive
1.1.2.1. Men
1.1.2.1.1. Fluid retaining capacity of seminal vesicles reduces
1.1.2.1.2. Possible reduction in sperm count
1.1.2.1.3. Venous and arterial sclerosis of penis
1.1.2.1.4. Prostate enlarges (most men experience this)
1.1.2.2. Women
1.1.2.2.1. Fallopian tubes atrophy and shorten
1.1.2.2.2. Ovaries become thicker and smaller
1.1.2.2.3. Cervix becomes smaller
1.1.2.2.4. Drier/less elastic vaginal canal
1.1.2.2.5. Flattening of labia
1.1.2.2.6. Endocervical epithelium atrophies
1.1.2.2.7. Uterus becomes smaller in size
1.1.2.2.8. Endometrium atrophies
1.1.2.2.9. Alkaline vaginal environment
1.1.2.2.10. Loss of vulvar subcutaneous fat/hair
1.1.3. Urinary
1.1.3.1. Decreased size of renal mass
1.1.3.1.1. Due to decreased renal tissue growth
1.1.3.2. Decreased tubular function
1.1.3.2.1. Also causes decreased reabsorption of glucose from filtrate
1.1.3.3. Decreased bladder capacity
1.1.3.4. Decrease in nephrons
1.1.3.5. Renal blood flow decreases
1.1.3.6. Glomerular filtration rate decreases
1.1.3.7. Weak bladder muscles
1.1.4. Cardiovascular
1.1.4.1. More prominent arteries in head, neck, and extremities
1.1.4.2. Valves become thicker and more rigid
1.1.4.3. Stroke volume decreases
1.1.4.4. Heart pigmented with lipofuscin granules
1.1.4.5. Less efficient O2 utilization
1.1.4.6. Aorta becomes dilated and elongated
1.1.4.7. Cardiac output decreases
1.1.4.7.1. Due to heart muscle losing efficiency and contractile strength
1.1.4.8. Resistance to peripheral blood flow increases
1.1.4.9. Blood pressure increases
1.1.4.9.1. To compensate for increased peripheral resistance and decreased cardiac output
1.1.4.10. Less elasticity of vessels
1.1.4.11. Slight left ventricular hypertrophy
1.1.5. Gastrointestinal
1.1.5.1. Decreased taste sensation
1.1.5.1.1. Because tongue atrophies and affects taste buds
1.1.5.2. Esophagus more dilated
1.1.5.3. Reduced saliva and salivary ptyalin
1.1.5.4. Liver smaller in size
1.1.5.5. Reduced intestinal blood flow
1.1.5.6. Decreased esophageal motility
1.1.5.7. Atrophy of gastric mucosa
1.1.5.8. Decreased stomach motility
1.1.5.9. Decreased hunger contractions
1.1.5.10. Decreased stomach emptying time
1.1.5.11. Decreased production of HCL
1.1.5.12. Decreased production of Pepsin
1.1.5.13. Decreased production of lipase
1.1.5.14. Decreased production of pancreatic enzymes
1.1.5.15. Slower peristalsis
1.1.5.16. Fewer cells on absorbing surfaces of intestines
1.1.6. Musculoskeletal
1.1.6.1. Shortening of vertebrae
1.1.6.2. Height decreases approximately 2 inches
1.1.6.2.1. Slight Kyphosis
1.1.6.3. Bones more brittle
1.1.6.4. Slight knee flexion
1.1.6.5. Decrease in bone mass/bone mineral
1.1.6.6. Slight hip flexion
1.1.6.7. Slight wrist flexion
1.1.6.8. Impaired flexion and extension movements
1.1.6.9. Muscle strength decreased
1.1.6.10. Limited joint activity and movement
1.1.7. Nervous
1.1.7.1. Decreased conduction velocity
1.1.7.1.1. Manifested by slower reflexes and delayed responses to stimuli
1.1.7.2. Slower response and reaction time
1.1.7.2.1. Associated with a decrease in new axon growth and never reinnervation of injured peripheral nerves
1.1.7.3. Decreased brain weight
1.1.7.4. Reduced blood flow to brain
1.1.7.4.1. Accompanied by a reduction in glucose utilization and metabolic rate of oxygen in brain
1.1.7.5. Changes in sleep pattern
1.1.7.5.1. Brain affects sleep wake cycle and circadian rhythm. Less prominent time spent in stages III and IV of sleep
1.1.7.6. Declined nervous system
1.1.7.7. Hypothalamus regulates temperature less effectively
1.1.7.7.1. Leads to poor thermoregulation
1.1.7.8. Brain cells slowly decline
1.1.7.8.1. Cerebral cortex loses some neurons
1.1.8. Sensory
1.1.8.1. Sight
1.1.8.1.1. More opaque lens
1.1.8.1.2. Decreased pupil size
1.1.8.1.3. More spherical cornea
1.1.8.1.4. Presbyopia
1.1.8.1.5. Reduced lacrimal secretions
1.1.8.2. Smell
1.1.8.2.1. Impaired ability to identify odors
1.1.8.3. Taste
1.1.8.3.1. Taste impairment
1.1.8.4. Touch
1.1.8.4.1. Reduction in tactile sensation
1.1.8.5. Hearing
1.1.8.5.1. Atrophy of hair cells of organ of Corti
1.1.8.5.2. Tympanic membrane sclerosis and atrophy
1.1.8.5.3. Increased cerumen
1.1.8.5.4. Increased concentration of keratin
1.1.8.5.5. Presbycusis
1.1.8.5.6. Decreased blood supply
1.1.8.5.7. Reduced flexibility of basilar membrane
1.1.8.5.8. Degeneration of vestibular structures and atrophy of cochlea
1.1.9. Endocrine
1.1.9.1. Thyroid gland atrophies
1.1.9.1.1. Decreased thyroid activity
1.1.9.2. Diminished renal function
1.1.9.3. ACTH, glucocorticoids, progesterone, androgens, and estrogen hormone secretion decreases
1.1.9.3.1. Decreased secretion of adrenal gland
1.1.9.4. Volume of pituitary gland decreases
1.1.9.4.1. Causes decrease in secretion of ACTH, TSH, follicle stimulating hormone, luteinizing hormone, and luteotropic hormone
1.1.9.5. Insufficient release of insulin
1.1.9.6. Reduced tissue sensitivity to circulating insulin
1.1.9.7. Decreased gonadal secretion
1.1.9.7.1. Decrease in testosterone, estrogen, and progesterone
1.1.10. Integumentary
1.1.10.1. Flattening of the dermal-epidermal junction
1.1.10.2. Subcutaneous fat loss
1.1.10.3. Degeneration of elastin fibers
1.1.10.4. Skin infections and malignant neoplasms
1.1.10.4.1. Due to skin immune response declining
1.1.10.5. Reduction of melanocytes
1.1.10.6. Fragile fingernails and decreased growth
1.1.10.7. Scalp, pubic, and axillary hair thins/grays
1.1.10.8. Females may grow facial hair
1.1.10.9. Reduction in perspiration
1.1.10.10. Males increase growth in ear hair, eyebrow hair, and nostril hair
1.1.11. Immune
1.1.11.1. Immunosenescence
1.1.11.1.1. Depressed immune response
1.1.11.2. T cell activity decreases
1.1.11.3. Decrease in cell mediated immunity
1.1.11.4. Inflammatory defense declines
1.1.11.5. Increase in pro inflammatory cytokines
1.1.11.5.1. Linked to cause pathologic diseases
1.1.12. Thermoregulation
1.1.12.1. Reduced ability to respond to cold temperatures
1.1.12.1.1. Due to inefficient vasoconstriction, reduced peripheral circulation, decreased cardiac output, reduced muscle mass and diminished shivering
1.1.12.2. Reduced ability to respond to hot temperatures
1.1.12.2.1. Due to impaired sweating mechanisms and decreased cardiac output
1.1.12.2.2. Can cause older adults to be more susceptible to heat stress
1.2. Physical appearance
1.2.1. Gray/thin hair
1.2.2. Ectropion of eyelids
1.2.3. Elongated ears
1.2.4. Arcus senilis
1.2.5. Growth of facial hair (women)
1.2.6. Diminished muscle mass
1.2.7. Diminished skin fold thickness
1.2.8. Thick hair in ears/nose
1.2.9. Darkening/wrinkling of skin around orbits
1.2.10. Narrow gait in women
1.2.11. Wider gait in men
1.2.12. Deepening of hollows of axillae, intercostal, and supraclavicular spaces
2. Pathologic Changes
2.1. Systems
2.1.1. Respiratory
2.1.1.1. Chronic Obstructive Pulmonary Disease
2.1.1.1.1. Asthma
2.1.1.1.2. Emphysema
2.1.1.1.3. Chronic Bronchitis
2.1.1.2. Pneumonia
2.1.1.3. Influenza
2.1.1.4. Lung Cancer
2.1.1.5. NURSING DIAGNOSES
2.1.1.5.1. Risk for infection related to pooling of secretions in the lungs
2.1.1.5.2. Intolerance to activity related to chronic hypoxia
2.1.1.5.3. Disruption of gas exchange related to chronic tissue hypoxia
2.1.2. Reproductive
2.1.2.1. Men
2.1.2.1.1. Erectile Dysfunction
2.1.2.1.2. Benign Prostatic Hyperplasia
2.1.2.1.3. Cancer of the Prostate
2.1.2.1.4. Tumors of the penis, testes, and scrotum
2.1.2.1.5. NURSING DIAGNOSES
2.1.2.2. Women
2.1.2.2.1. Infections and tumors of the Vulva
2.1.2.2.2. Vaginitis
2.1.2.2.3. Cancer of the vagina
2.1.2.2.4. Problems of the cervix
2.1.2.2.5. Cancer of the cervix
2.1.2.2.6. Cancer of the endometrium
2.1.2.2.7. Cancer of the ovaries
2.1.2.2.8. Perineal herniation
2.1.2.2.9. Dysparenuia
2.1.2.2.10. Cancer of the breast
2.1.2.2.11. NURSING DIAGNOSES
2.1.3. Urinary
2.1.3.1. Urinary tract infection
2.1.3.2. Urinary incontinence
2.1.3.3. Bladder cancer
2.1.3.4. Renal calculi
2.1.3.5. Glomerulonephritis
2.1.3.6. NURSING DIAGNOSES
2.1.3.6.1. Ineffective health maintenance related to ineffective filtration of drugs
2.1.3.6.2. Impaired urinary elimination related to decreased bladder capacity
2.1.3.6.3. Disturbed body image related to incontinence
2.1.4. Cardiovascular
2.1.4.1. Hypertension
2.1.4.2. Hypotension
2.1.4.3. Congestive Heart Failure
2.1.4.4. Pulmonary Emboli
2.1.4.5. Coronary Artery Disease
2.1.4.5.1. Angina
2.1.4.5.2. Myocardial Infarction
2.1.4.6. Hyperlipdemia
2.1.4.7. Arrhythmias
2.1.4.7.1. Atrial Fibrillation
2.1.4.8. Peripheral Vascular Disease
2.1.4.8.1. Arteriosclerosis
2.1.4.8.2. Aneurysms
2.1.4.8.3. Varicose Veins
2.1.4.8.4. Venous Thromboembolism
2.1.4.9. NURSING DIAGNOSES
2.1.4.9.1. Intolerance to activity related to insufficient oxygen and poor circulation
2.1.4.9.2. Decreased cardiac tissue perfusion related to decreased cardiac output
2.1.4.9.3. Acute pain related to occlusion and vasospasms
2.1.5. Gastrointestinal
2.1.5.1. Xerostomia
2.1.5.2. Periodontal Disease
2.1.5.3. Dysphagia
2.1.5.4. Hiatal hernia
2.1.5.5. Esophageal cancer
2.1.5.6. Peptic ulcer
2.1.5.7. Cancer of the stomach
2.1.5.8. Diverticular Disease
2.1.5.9. Colorectal cancer
2.1.5.10. Chronic constipation
2.1.5.11. Flatulence
2.1.5.12. Intestinal obstruction
2.1.5.13. Fecal impaction
2.1.5.14. Fecal incontinence
2.1.5.15. Acute appendicitis
2.1.5.16. Cancer of the pancrea
2.1.5.17. Biliary tract disease
2.1.5.18. NURSING DIAGNOSES
2.1.5.18.1. Activity intolerance related to constipation
2.1.5.18.2. Deficient fluid volume related to malnutrition
2.1.5.18.3. Imbalance nutrition less than body requirements related to altered taste sensations
2.1.6. Musculoskeletal
2.1.6.1. Fractures
2.1.6.2. Osteoporosis
2.1.6.3. Osteoarthritis
2.1.6.4. Rheumatoid Arthritis
2.1.6.5. Gout
2.1.6.6. Podiatric conditions
2.1.6.7. NURSING DIAGNOSES
2.1.6.7.1. Risk for injury related to unsteadiness
2.1.6.7.2. Disturbed body image related to change in body structure or function
2.1.6.7.3. Activity intolerance related to pain
2.1.7. Nervous
2.1.7.1. Parkinson’s disease
2.1.7.2. Transient Ischemic Attack
2.1.7.3. Stroke
2.1.7.4. NURSING DIAGNOSES
2.1.7.4.1. Risk for injury related to altered mental status
2.1.7.4.2. Impaired physical mobility related to poor coordination
2.1.7.4.3. Altered thought processes related to cerebrovascular accident
2.1.7.5. Dementia
2.1.8. Sensory
2.1.8.1. Sight
2.1.8.1.1. Cataracts
2.1.8.1.2. Glaucoma
2.1.8.1.3. Macular degeneration
2.1.8.1.4. Detached retina
2.1.8.1.5. Corneal ulcer
2.1.8.1.6. NURSING DIAGNOSIS
2.1.8.2. Smell
2.1.8.2.1. Defect in olfactory nerve or difficulty smelling
2.1.8.2.2. NURSING DIAGNOSIS
2.1.8.3. Taste
2.1.8.3.1. Xerostomia
2.1.8.3.2. Cancer of the mouth
2.1.8.3.3. NURSING DIAGNOSIS
2.1.8.4. Touch
2.1.8.4.1. Dyskinesia
2.1.8.4.2. Circulatory problems
2.1.8.4.3. NURSING DIAGNOSIS
2.1.8.5. Hearing
2.1.8.5.1. Hearing loss
2.1.9. Endocrine
2.1.9.1. Diabetes Mellitus
2.1.9.2. Hypothyroidism
2.1.9.3. Hyperthyroidism
2.1.9.4. NURSING DIAGNOSES
2.1.9.4.1. Risk for infection related to diabetes Mellitus complications
2.1.9.4.2. Anxiety related to fear of disease impact
2.1.9.4.3. Noncompliance related to lack of knowledge of endocrine disease
2.1.10. Integumentary/physical appearance
2.1.10.1. Pruritus
2.1.10.2. Keratosis
2.1.10.3. Seborrheic Keratosis
2.1.10.4. Skin cancer
2.1.10.5. Vascular lesions
2.1.10.6. Pressure injury
2.1.10.7. NURSING DIAGNOSES
2.1.10.7.1. Impaired skin integrity related to immobility
2.1.10.7.2. Risk for infection related to fragile skin
2.1.10.7.3. Altered tissue perfusion related to pressure injury
2.1.11. Immune
2.1.11.1. Autoimmune disorders
2.1.11.2. Cancer
2.1.11.2.1. Lymphoma
2.1.11.3. Chrons disease
2.1.11.4. Diabetes type 1
2.1.11.5. Lupus
2.1.11.6. Leukemia
2.1.11.7. Inflammatory bowel disease
2.1.11.8. Rheumatoid Arthritis
2.1.11.9. Multiple Sclerosis
2.1.11.10. NURSING DIAGNOSES
2.1.11.10.1. Risk for infection related to immunosuppression
2.1.11.10.2. Risk for impaired mobility related to multiple sclerosis
2.1.11.10.3. Risk for infection related to type 1 diabetes complications