Older Adult: Age Related Changes

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Older Adult: Age Related Changes by Mind Map: Older Adult: Age Related Changes

1. Respiratory

1.1. Age Related Changes

1.1.1. Respiratory problems develop easily; difficult to manage

1.1.2. Reduced cough

1.1.3. Lungs reduce in size and weight

1.1.4. Decreased elastic recoil

1.1.5. Alveoli less elastic

1.1.6. Reduction in vital capacity; increase residual volume

1.2. Disease

1.2.1. COPD

1.2.1.1. Represents a group of disease including asthma, chronic bronchitis, and emphysema.

1.2.1.2. S&S: on going cough, shortness of breath, wheezing

1.2.1.3. Treatment: rescue inhalers, inhaled or oral steroids can help minimize symptoms and prevent further damage.

1.2.2. Pneumonia

1.2.2.1. One of the leading causes of death in the older adult age group

1.2.2.2. S&S: Pleuritic pain, differences in body temperature, slight cough, fatigue, and rapid respiration.

1.2.2.3. Vaccination: Recommended for persons over 65 years of age

2. Nutrition

2.1. Reduce need for calories

2.2. Less lean body mass

2.3. Basal metabolic rate declines

2.4. Activity level lowered

3. Cardiovascular

3.1. Age Related Changes

3.1.1. Heart valves become thicker and rigid

3.1.2. Aorta becomes dilated; slight ventricular hypertrophy; thickening of left ventricular wall.

3.1.3. Myocardial muscle less efficient; decreased contractile strength; decreased cardiac output when demands increased.

3.1.4. Calcification reduced elasticity of vessels

3.1.5. Less sensitive to baroreceptor regulation of blood pressure.

3.2. Disease

3.2.1. Hypertension

3.2.1.1. Incidence increases with advancing age and is the most prevalent cardiovascular disease of older adults.

3.2.1.2. Arises from vasoconstriction which produces peripheral resistance

3.2.1.3. Systolic pressure > 140 and diastolic > 90

3.2.1.4. S&S: dull headache, impaired memory, disorientation, confusion, epistaxis and a slow tremor

3.2.1.5. Treatment: Rest, reduce sodium intake, and if necessary reduce their weight.

3.2.2. Atrial Fibrilation

3.2.2.1. It commonly occurs in persons with structural defects and comorbidites.

3.2.2.2. S&S: Palpitations, irregular pulse, shortness of breath, chest pain, fatigue, dizziness, and delirium

3.2.2.3. Control and prevention of A fib: antiarrhythmics, electrical cardioversion, and catheter ablation and maze procedure

4. Gastrointestinal

4.1. Age Related Changes

4.1.1. Atrophy of tongue affects taste buds and decreases taste sensation.

4.1.2. Saliva production decreases

4.1.3. Weaker esophageal contractions and weakened sphincter

4.1.4. Esophageal and stomach motility decreases

4.1.5. Decreased elasticity of stomach

4.1.6. Decline in hydrochloric acid

4.1.7. Decline in pepsin

4.1.8. Slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low-fiber diet

4.2. Disease

4.2.1. Peptic Ulcer

4.2.1.1. Can be a complication of COPD

4.2.1.2. Drugs prescribed that can increase gastric secretions: aspirin, reserpine, tolbutamide, phenylbutazone, colchicine, and adrenal corticosteroids.

4.2.1.3. S&S: pain, bleeding, obstruction, and perforation.

4.2.2. Flatulence

4.2.2.1. Caused by constipation, irregular bowel movements, certain foods, and poor neuromuscular control of the anal sphincter.

4.2.2.2. Treatment: avoiding certain foods, administer specific medications. Sitting upright after meals and increasesd activity

5. Reproductive Health

5.1. Female:

5.1.1. Hormonal Changes: Vulva atrophies, Flattening of the labia, loss of subcutaneous fat and hair

5.1.2. Vaginal epithelium thins

5.1.3. Cervix, uterus, and fallopian tubes atrophy

5.1.4. Vaginal Canal Changes: reduction in collagen and adipose tissue, shortening and narrowing of the canal, less lubrication, more alkaline vaginal pH as a result of lower estrogen changes.

5.1.5. Uterus and ovaries decrease in size

5.1.6. Fallopian tubes become shorter and straighter.

5.1.7. Breast sag and become less firm

5.1.8. Some retraction of nipples related to shrinkage and fibrotic changes.

5.2. Male

5.2.1. Seminal vesicles develop thinner epithelium

5.2.2. Muscle tissue replaced with connective tissue

5.2.3. Decreased capacity to retain fluids

5.2.4. Seminiferous tubule changes

5.2.5. Atrophy of the testes and reduction in testicular mass.

5.2.6. Ejaculation fluid contains less live sperm

5.2.7. Testosterone stays the same or decreases slightly

5.2.8. More time required to achieve an erection

5.2.9. Enlargement of the prostate gland

6. Sleep

6.1. Phase advance is common among older adults

6.2. Less sound sleep, delaying onset of sleep

6.3. More time in stages I and II

7. Urinary

7.1. Age Related Changes

7.1.1. Hypertrophy and thickening of the bladder muscle

7.1.2. Changes in cortical control of micturition

7.1.3. Insufficient neurological control of bladder emptying and weaker bladder muscle.

7.1.4. Kidney filtration ability decreases

7.1.5. Reduced renal function

7.1.6. Decreased tubular function

7.1.7. Increase in renal threshold for glucose

7.2. Disease

7.2.1. Bladder Cancer

7.2.1.1. S&S: Chronic irritation of the bladder, exposure to dyes, and cigarette smoking. Frequency, urgency and dysuria. A painless hematuria.

7.2.1.2. Treatment: surgery, radiation, immunotherapy, or chemotherapy, depending ont eh extent and location of the lesion.

7.2.2. Glomerulonephritis

7.2.2.1. S&S: fever, fatigue, nausea, vomiting, anorexia, abdominal pain, anemia, edema, arthralgias,, elevated blood pressure, and an increased sedimentation rate.

7.2.2.2. Treatment: antibiotics, a restricted sodium and protein diet, and close attention to fluid intake and output are basic parts of the treatment plan.

8. Musculoskeletal

8.1. Age Related Changes

8.1.1. Decline in size and number of muscle fibers, and reduction in muscle mass

8.1.2. Connective tissue changes: reduced flexibility of joints and muscles

8.1.3. Sarcopenia: age-related reduction of muscle mass or function resulting from a reduction in protein synthesis and an increase in muscle protein degeneration.

8.1.4. Psychosocial factors impacting activity

8.2. Disease

8.2.1. Osteoarthritis

8.2.1.1. Progressive deterioration and abrasion of joint cartilage, with the formation of new bone at the joint surface.

8.2.1.2. Weight - bearing joints are most affected, common sites being the knees, hips, vertebrae, and fingers.

8.2.1.3. S&S: crepitation on joint motion, distal joints may develop bony nodules.

8.2.1.4. Treatment: acetaminophen, analgesics for pain, rest, heat or ice, aquatherapy, and gentle massage.

8.2.2. Osteoporosis

8.2.2.1. Demineralization of the bone occurs, evidenced by a decrease in the mass and density of the skeleton.

8.2.2.2. Inadequate calcium intake, excessive calcium loss, or poor calcium absorption can cause osteoporosis.

8.2.2.3. Treatment may include calcium supplements, vitamin D supplements, SERMs, and hormone therapy.

9. Neurological Function

9.1. Age Related Changes

9.1.1. Loss of nerve cell mass

9.1.2. Number of dendrites declines

9.1.3. Demyelinization

9.1.4. Plaques, tangles, atrophy of the brain

9.1.5. Decrease in cerebral blood flow

9.1.6. Fatty deposits accumulate in blood vessels

9.1.7. Slowing in central processing

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

9.2. Disease:

9.2.1. Parkinson's Disease

9.2.1.1. Affects the ability of the CNS to control body movements

9.2.1.2. Impaired function of basal ganglia in the midbrain. Neurons that produce dopamine in the substantia nigra die or become impaired.

9.2.1.3. S&S: tremor in hands or feet, muscle rigidity and weakness, drooling, dysphagia, slow speech, and monotone voice.

9.2.2. Transient Ischemic Attacks (TIA)

9.2.2.1. Temporary or intermittent neurological events that can result from any situation that reduces cerebral circulation.

9.2.2.2. Reduced blood pressure resulting from anemia and certain drugs and cigarette smoking, due to its vasoconstrictive effect.

9.2.2.3. S&S: hemiparesis, hemianesthesia, aphasia, unilateral loss of vision, diplopia, vertigo, N/V, and dysphagia.

10. Integumentary

10.1. Age Related Changes

10.1.1. Flattening of the dermal - epidermal junction

10.1.2. Reduced thickness and vascularity of the dermis

10.1.3. Degeneration of elastic fibers

10.1.4. Reduction in melanocytes

10.1.5. Atrophy of hair bulbs and decline in the rate of hair and nail growth

10.1.6. Increased fragility of the skin

10.2. Disease

10.2.1. Skin Cancer

10.2.1.1. Basal cell carcinoma, squamous cell carcinoma, and melanoma.

10.2.1.2. Basal Cell carcinoma: grows slow and rarely metastasizes.

10.2.1.3. Risk factors: advanced age, exposure to the sun, ultraviolet radiation, and therapeutic radiation.

10.2.1.4. Commonly occurs on the face, growth tends to be small, dome-shaped elevations, covered with small blood vessels.

10.2.1.5. Typically treated by removal of some of the surrounding tissue and subcutaneous fat.

11. Endocrine

11.1. Age Related Changes

11.1.1. Thyroid gland atrophies and activity decreases

11.1.2. Diminished adrenal function

11.1.3. Adrenocorticotropic hormone (ACTH) secretion decreases

11.1.4. Volume of pituitary gland decreases

11.1.5. Insufficient release of insulin and reduced tissue sensitivity to circulating insulin.

11.2. Disease:

11.2.1. Hyperthyroidism

11.2.1.1. Thyroid gland secretes excess amounts of theyroid hormones.

11.2.1.2. Potential cause is use of amiodarone, a cardiac drug containing iodine that deposits in tissue and delivers iodine to the circulation over very long periods of time.

11.2.1.3. S&S: diaphoresis, tachycardia, palpitations, hypertension, tremor, diarrhea, stare, lid lag, insomnia, nervousness, confusion, heat intolerance, increased hunger, proximal muscle weakness, and hyperreflexia.

11.2.1.4. Treatment: depends on the cause but antithyroid medications or radioactive iodine are methods, or surgery.

12. Immune System

12.1. Age Related Changes

12.1.1. Thymus gland declines in size

12.1.2. Increased number of immature T cells

12.1.3. T-cell function declines

12.1.4. Reduced antibody response

12.1.5. Decreased number of Langerhans cells in the skin

12.1.6. Reduced thickness of the skin

12.2. Disease

12.2.1. As adults age the immune system becomes weaker and is slower to respond. The body may not heal as fast. The immune systems ability to detect and correct cell defects declines.

13. Sources:

13.1. Eliopoulos, C. (2018). Gerontological Nursing 9th Edition. Wolters Kluwer, Philadelphia

14. By: Olivia Williams