1. Cardiovascular System
1.1. Heart valves thicken and become more rigid
1.1.1. Due to sclerosis and fibrosis
1.2. Reduction in cardiac output when demands increase
1.2.1. Myocardial muscle becomes less efficient with less contractile strength
1.3. Dilated aorta
1.3.1. Causes slight ventricular hypertrophy and thickening of the left ventricular wall
1.4. Calcification and reduced elasticity of vessels
2. Genitourinary System
2.1. Urinary Frequnecy
2.1.1. Cause by hypertrophy of the bladder muscle, thickening of the bladder
2.1.1.1. Decreases ability of bladder to expand thus reducing capacity
2.2. Nocturia
2.2.1. Night time urinary frequency
2.3. Urinary Retention
2.3.1. Could be caused by fecal impaction in women or prostatic hypertrophy in men
2.3.1.1. Could lead to urinary tract infections
2.4. Kidney filtration efficiency decreases
2.4.1. Affects ability to eliminate drugs
2.4.1.1. Could lead to toxicity
2.5. Decreased tubular function
2.6. Reduced ability to concentrate and dilute urine
2.6.1. Decreased reabsorption from the filtrate
3. Reproductive System
3.1. Female
3.1.1. Atrophy of vulva, cervix, uterus, fallopian tubes and ovaries
3.1.2. Thinning of vaginal epithelium
3.1.3. Dryer/more alkaline vaginal environment
3.1.4. Mammary glands are replaced by fat tissue
3.1.4.1. Causes breasts sag and be less firm
3.2. Male
3.2.1. Reduction of sperm count
3.2.1.1. Thinning seminal vesicles, muscle tissues turns to connective tissue and decreased fluid retainment
3.2.2. Increased fibrosis, thickening of the basement membrane and narrowing of the lumen in seminiferous tubules
3.2.3. Atrophy of testes and decreased testicular mass
3.2.3.1. Benign Prostatic Hyperplasia
3.2.3.1.1. Some prostate tissue is replaced with fibrotic tissue
4. Nervous System
4.1. Atrophy of the brain and spinal cord
4.1.1. Loss of nerve cell mass
4.2. Brain weight decreases
4.3. Number of nerve cells decline
4.3.1. They have fewer dendrites and some demyelination
4.3.1.1. Causes slower nerve conduction
4.4. Slower response, reaction times and weaker reflexes
4.5. Plaques, tangles and atrophy of the brain
4.6. Decreased cerebral blood flow
4.7. Verbal skills are maintained until about age 70
4.7.1. Unless underlying disease
4.8. Intellectual performance is maintained until about age 80
4.8.1. Unless underlying disease
5. Endocrine System
5.1. Thyroid gland atrophies and decreases in activity
5.1.1. Lower basal metabolic rate
5.1.2. Reduced radioactive iodine uptake
5.1.3. Less secretion and release of thyrotropin
5.2. Diminished adrenal function
5.2.1. Adrenocorticotropic hormone secretion decreases which decreases adrenal secretory activity
5.2.1.1. Decreases secretions of estrogen, progesterone, androgen, 17-ketosteroids and glucocorticoids
5.3. Insufficient release of insulin by beta cells and reduced tissue sensitivity to circulating insulin
5.4. Reduced ability to metabolize glucose
6. Mental Health
6.1. Cognitive health is highly individualized based on personal resources, health status and experiences of life
6.2. Higher incidence of mental illness
6.3. Depression increases prevalence and intensity with age
7. Sleep and Rest
7.1. Insomnia
7.1.1. Difficulty falling asleep or staying asleep and/or premature waking
7.1.1.1. Transient
7.1.1.1.1. Short term, problem associated with a changed environment, illness, added stress or anxiety
7.1.1.2. Chronic
7.1.1.2.1. Physical or mental illness, environmental factors, substance abuse, or medications
7.2. Daytime sleepiness
7.3. Napping
8. Respiratory System
8.1. Thicker and harder to expel mucus in the nasopharynx
8.1.1. Reduced secretions from the submucosal gland
8.1.1.1. Could cause a chronic tickle and cough
8.2. Hair in nostrils become thicker
8.2.1. Could interfere with normal inspiration of air if dust and debris get caught in the thicker hair
8.3. Trachea stiffens from calcification of cartilage
8.4. Reduced vital capacity and increase in residual volume
8.4.1. Lungs become smaller in size and weight
8.4.2. Respiration and ventilation weakens
8.4.2.1. Connective tissue weakens
8.4.3. Decreased elastic recoil during expiration
8.4.3.1. Less elastic collage and elastin
8.4.4. Less elastic alveoli with fewer functioning capillaries
8.4.5. Kyphosis and barrel chest
8.4.5.1. R/t loss of skeletal muscle strength in thorax and diaphragm
9. Gastrointestinal System
9.1. Tongue atrophy
9.1.1. Leading to decreased taste sensation
9.1.1.1. Xerostomia (dry mouth)
9.2. Decreased production of saliva
9.2.1. Could lead to dysphagia
9.3. Thinning of mucosa and weakening of the muscles for mastication
9.4. Presbyesophagus
9.4.1. Degenerative smooth muscle lining of the lower esophagus
9.4.1.1. Weaker esophageal contractions and sphincter
9.5. Decreased motility
9.5.1. Risk for indigestion and aspiration
9.6. Decreased stomach elasticity
9.6.1. Shows the need for nutrient rich calories rather than the need to increase calories
9.7. Increased risk of gastric irritation
9.7.1. Due to increased stomach pH from the decrease in HCl and Pepsin
9.7.1.1. Reduces absorption of protein
9.8. Less absorption of nutrients
9.8.1. Due to fewer cells on absorbing surface of intestinal walls
9.9. Constipation
9.9.1. From slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low fiber diet
10. Musculoskeltal System
10.1. Decline in the number and size of muscle fibers
10.2. Reduced flexibility of joints and muscles
10.2.1. Due to connective tissue changes
10.3. Reduction of muscle mass and body strenght
10.4. Sarcopenia – decline in walking speed or grip strength
10.4.1. Due to disease, immobility, decreased caloric intake, poor blood flow to muscle, mitochondrial dysfunction, decrease in anabolic hormones and increased in proinflammatory cytokines
10.5. Impaired muscle regeneration
10.5.1. ould lead to disability – esp. in those with diseases or organ impairment
10.6. Decreased bone mineral mass
10.7. diminished calcium absorption
10.8. Increased risk of fractures
11. Vision and Hearing
11.1. Eyes
11.1.1. Presbyopia
11.1.1.1. Reduced elasticity and stiffening of muscle fibers of the lens of the eye
11.1.2. Visual acuity progressively declines
11.1.2.1. Due to decreased pupil size and loss of photoreceptor cells in the retina
11.1.3. Light perception threshold decreases
11.1.3.1. Dark and light adaptation take longs
11.1.4. Eyes produce fewer tears and are dryer
11.2. Ears
11.2.1. Presbycusis
11.2.1.1. Reduces the ability to hear s, sh, f, ph, and w sounds and may distort speech
12. Integumentary System
12.1. Reduced thickness and vascularity of the dermis
12.1.1. Increased risk for tears, bruising, pressure injury and skin infections
12.2. Reduced rate of epidermal turnover
12.3. degeneration of elastic fibers
12.4. Reduction in melanocytes
13. Physical Changes
13.1. Graying and thinning hair
13.2. Elongated ears
13.3. Wrinkles
13.4. Loss of subcutaneous fat
13.4.1. bony appearance
13.4.2. thinning skin
13.4.3. decline in natural insulation
13.5. Decrease in stature (approx. 2 in.)
13.5.1. Due to reduced hydration, loss of cartilage, thinning of vertebrae, curvature of spine - if present