Copy of Changes of the Older Adult

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1. Sexuality

1.1. Andropause

1.1.1. Does not happen to all men

1.1.2. Breast enlargement

1.1.3. Osteopenia

1.1.4. Osteoporosis

1.1.5. Shrinkage of testes

1.2. Dyspareunia

1.2.1. Result of less lubrication in women

1.3. Erectile dysfunction

1.3.1. Common but not normal

1.4. Menopause

2. Respiratory

2.1. Problems develop easily and are hard to handle

2.2. Changes in upper airway paths, nose, and trachea

2.3. Reduced cough

2.4. Lungs

2.4.1. Reduced in size

2.4.2. Reduced in weight

2.5. Decrease elastic recoil

2.6. Alveoli less elastic

2.7. Vital capacity reduced

2.8. Residual volume increased

2.9. Loose or brittle teeth can be aspired

2.10. COPD

2.10.1. Group of diseases including asthma, chronic bronchitis, emphysema, lung cancer, and lung abscess

2.10.1.1. Higher risk in women and smokers

3. Circulatory

3.1. Heart valves

3.1.1. Thicker

3.1.2. Rigid

3.2. Aorta dilated

3.2.1. Slight ventricular hypertrophy

3.2.2. Left ventricular wall thickened

3.3. Myocardial muscle less efficient

3.3.1. Decreased strength

3.3.2. Decreased CO when demand increases

3.4. Calcification

3.4.1. Reduced elasticity

3.5. Less sensitive to baroreceptor regulation

3.5.1. Blood pressure

3.6. Congestive Heart Failure

3.6.1. Complication of heart disease

3.6.2. Coronary artery disease is responsible for most cases

3.6.3. SOB, confusion, dyspnea, weight gain, edema

4. Reproductive

4.1. Women

4.1.1. Hormonal changes

4.1.2. Vaginal epithelium thins

4.1.3. Atrophy of cervix, uterus, and Fallopian tubes

4.1.4. Vaginal canal changes

4.1.5. Uterus and ovaries decrease in size

4.1.6. Breasts sag

4.1.7. Fallopian tubes become shorter and straighter

4.1.8. Cancers of the Ovaries

4.1.8.1. Leading cause of death from gynecological malignancies

4.1.8.2. S/s: bleeding, masses, ascites

4.2. Men

4.2.1. Seminal vesicles

4.2.1.1. Thinner epithelium

4.2.2. Muscle tissues becomes connective tissue

4.2.3. Decreased capacity to retain fluids

4.2.4. Seminiferous tubule changes

4.2.4.1. Increased fibrosis, epithelium thinning, thickening of the basement membrane, and narrowing of the lumen

4.2.5. Atrophy of testes

4.2.5.1. Slower central processing

4.2.6. Enlargement of prostate gland

5. Musculoskeletal

5.1. Decline in size and number of muscle fibers

5.1.1. Decrease strength and endurance

5.2. Reduction in muscle mass

5.3. Connective tissue changes

5.3.1. Reduced flexibility

5.4. Sarcopenia

5.4.1. Age-related reduction of muscle mass or function resulting from a reduction in protein synthesis and an increase in muscle protein degeneration

6. Endocrine

6.1. Thyroid gland atrophy

6.2. Diminished adrenal function

6.3. ACTH secretion decrease

6.4. Pituitary gland volume decreases

6.5. Insufficient insulin

6.5.1. Reduced tissue sensitivity to insulin

6.6. Diabetes Mellitus

6.6.1. “A chronic condition that affects the way your body metabolizes glucose”

6.6.2. S/S: increased thirst, frequent urination, unintended weight loss, fatigue, blurred vision

6.6.3. Need an increased amount of protein in diet to control glucose

6.6.4. Kidney damage common complication

6.6.5. Neuropathy common

7. Nutrition and Hydration

7.1. Reduced need for calories

7.1.1. Less lean body mass

7.1.2. Decline in BMR

7.1.3. Activity level declines

7.2. Intercellular fluid lost causes decreased total body fluid

7.3. 1,500 mLs of fluid a day minimum

7.4. Change in nutrient absorption

8. Rest and Sleep

8.1. Phase advance

8.2. More time in stages I and II

8.3. Less sound sleep

8.4. Delay in onset of sleep

8.5. Possible sleep disturbances

8.5.1. Insomnia, nocturnal myoclonus, restless leg syndrome, sleep apnea, GERD, dementia, musculoskeletal disorders

8.6. Restless leg syndrome

8.6.1. Neurological condition of urge to move legs

8.6.1.1. Causes: anemia, uremia, Parkinson’s, rheumatoid arthritis, diabetes

9. Urinary Elimination

9.1. Hypertrophy and thickening of bladder muscles

9.1.1. Decreased ability to to expand

9.1.2. Reduced storage capacity

9.1.2.1. Daytime urinary frequency and nocturia

9.2. Changes in cortical control of of micturition

9.2.1. Nocturia

9.3. Inefficient neurological control

9.3.1. Retention of large volumes of urine

9.3.1.1. Females: fecal impaction

9.3.1.2. Males: prostatic hypertrophy

9.4. Kidney filtration ability decreased

9.4.1. Affects drug elimination and could cause adverse effects or toxicity

9.5. Reduced renal function

9.5.1. High BUN and creatinine

9.6. Decreased tubular function

9.6.1. Concentration of urine changes

9.7. Increase renal threshold for glucose

9.8. Incontinence

9.8.1. Not normal aging

10. Gastrointestinal

10.1. Atrophy of tongue

10.1.1. Affects taste buds and taste sensation

10.2. Saliva production decreased

10.2.1. Difficulty swallowing

10.3. Presbyesophogus

10.3.1. Weaker esophageal contractions

10.4. Esophageal and stomach motility decreases

10.4.1. Risk for aspiration and indigestion

10.5. Decrease elasticity of stomach

10.6. High pH in stomach

10.6.1. Decline in Hydrochloric acid and pepsin

10.7. Fewer cells on absorbing surface of intestinal wall

10.8. Sensory perception decreases

10.8.1. Constipation or incomplete elimination

10.9. Decreased bile salt synthesis

10.9.1. Increased gallstone development

10.10. Pancreatic changes

10.10.1. Digestion of fats is affected

10.11. Slower peristalsis

10.11.1. Increase risk of constipation

10.12. Dysphasia

10.12.1. Difficulty swallowing

10.12.1.1. Causes: GERD, stroke, and structural disorders

10.12.2. Incidence increases with age

11. Neurological

11.1. Loss of nerve cell mass

11.1.1. Brain weight decreases

11.1.2. Brain and spinal cord atrophy

11.2. Number of dendrites decreases

11.3. Demyelination

11.3.1. Slower nerve conduction

11.3.2. Weaker reflexes

11.4. Number and sensitivity of sensory receptors, dermatomes, and neurons decrease

11.4.1. Dulling of tactile sensation

11.5. Decline in function of cranial nerves

11.5.1. Affects taste and smell

11.6. Brain changes

11.6.1. Plaques

11.6.2. Tangles

11.6.3. Atrophy

11.7. Accumulation of free radicals

11.8. Parkinson’s Disease

11.8.1. Affects ability of the central nervous system (CNS) to control body movements

11.8.2. Dopamine

11.8.3. S/S: tremors, face mask, shuffling gait

12. Integumentary

12.1. Dermis changes

12.1.1. Reduced thickness

12.1.2. Reduced vascularity

12.2. Degeneration of elastic fibers

12.3. Reduction of epidermal turnover

12.4. Increased coarseness of collagen

12.5. Skin becomes more fragile

12.6. Reduction of melanocytes

12.7. Decline in hair and nail growth

12.8. Skin cancer

12.8.1. Basal cell carcinoma

12.8.1.1. Most common but rarely metastasized

12.8.2. Squamous cell carcinoma

12.8.2.1. Contributions: sun exposure and factors that facilitate growth

12.8.3. Melanoma

12.8.3.1. More easily metastasized