Grey is Grace

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Grey is Grace by Mind Map: Grey is  Grace

1. Population pyramid

1.1. Describes the make-up of a given population

1.2. Visualize sex and age population composition

1.3. Age categories:

1.3.1. Young population (0-14)

1.3.2. Working Age population (15-60)

1.3.3. Elderly population (60+)

1.4. X-axis : population size

1.5. Y- axis (5 year group intervals) : separates Males (L) from Fmales (R) populations

1.6. Pyramid model

1.6.1. Expanding population

1.6.2. Stable population

1.6.3. Contracting population

2. Active aging

2.1. Optimizing opportunities throughout elderly life

2.1.1. Extended life expectancy

2.1.2. Productivity

2.1.3. Quality

2.2. "Active " refers to continuous contribution to surrounding community

3. Demographic transition

3.1. Population changes over time

3.2. Begun in 1929 to observe changes in birth and death rates in industrialized societies over the past 200 years

3.3. Demographic transition model

3.3.1. High stationary

3.3.2. Early expanding

3.3.3. Late expanding

3.3.4. Low stationary

4. Aging theories

4.1. Programmed theories

4.1.1. Programmed longevity

4.1.2. Endocrine

4.1.3. Hay-flick's limit

4.1.4. Immunological

4.2. Damage/Error theories

4.2.1. Wear & tear

4.2.2. Free radical

4.2.3. Cross link

4.2.4. Somatic mutation

5. Physiological changes

5.1. Primary ( intrinsic aging) VS Secondary ( Extrinsic aging)

5.2. Cardiovascular changes

5.2.1. BP increases ( 1mmHg/ year after the age of 50) meanly because of increase in systolic BP

5.2.2. Arterial walls thicken, harden and loss elasticity ( results in arteriosclerosis)

5.2.3. Barororeceptors decreased sensitivity ( results in postural (orthostatic) hypotension

5.2.4. CO decreases by 1%/ year after the age of 30

5.2.5. Loss in SA node

5.2.6. Reduced response to Beta receptors

5.3. Urological changes

5.3.1. Reduction in renal mass

5.3.2. Decrease of GFR and RPF

5.3.3. Decrease in uinary bladder compliance

5.4. Respiratory changes

5.4.1. Decreased

5.4.1.1. Lung elasticity

5.4.1.2. Vital capacity

5.4.1.3. Inspiratory reserve volume

5.4.1.4. Alveolar surface area

5.4.1.5. Gas exchange

5.4.1.6. Cough reflex

5.4.2. Increased

5.4.2.1. Chest wall rigidity

5.4.2.2. Risk of pneumonia

5.5. Neurological changes

5.5.1. Decreased

5.5.1.1. Neurons

5.5.1.2. Neurotransmitters

5.5.1.3. Brain mass

5.5.1.4. Sensitivity to high frequency sounds

5.5.1.4.1. Hearing problem

5.5.2. Vision problems

5.5.2.1. Presbyopia

5.6. Musculoskeletal changes

5.6.1. Muscles atrophy , lower muscle mass

5.6.2. Bone atrophy, decrease in mass & density leads to fractures & osteoporosis

5.6.3. Compression of intervertebral discs and loss of vertebra, leads to decreased height

5.6.4. Higher liability to osteoarthritis ( 50% of elderly )

5.7. Immunological changes

5.7.1. Decreased Functions of

5.7.1.1. Macrophages

5.7.1.2. B cells

5.7.1.3. T cells

5.7.1.4. Some mediators ex. IL- 1, NO

5.7.2. Increased risk of autoimmunity

5.8. Other common problems

5.8.1. Obesity 75% of elderly

5.8.2. Vision problems

5.8.3. Higher liability to cancer

5.8.4. Dental problems

5.8.5. Problems in maintaining balance ( falling)

6. Metabolic pathways in fed state

6.1. Glycolysis

6.2. Glycogenesis

6.3. Citric acid Cycle

6.4. Fatty acid synthesis (lipogenesis)

6.5. Protein synthesis

7. Metabolic pathways in fasted state

7.1. Glycogenolysis

7.2. Gluconeogenesis

7.3. Fatty acid degradation

7.4. Ketogenesis

7.5. Protein degradation

7.6. Glycolysis

8. Nutritional deficiency in elderly

8.1. Causes

8.1.1. Dental problems

8.1.2. Social & economic barriers

8.1.3. Dementia

8.1.4. Lack of sun exposure

8.1.5. Less nutrients absorption due to medications side effects

8.2. Need of healthy nutritional diet plan

9. Pharmacological changes

9.1. Pharmacokinetics changes

9.1.1. Absorption

9.1.1.1. Generally slower due to

9.1.1.1.1. Slow gastric emptying & esophageal motility

9.1.1.1.2. Increased gastric pH

9.1.2. Distribution

9.1.2.1. Less serum albumin levels which increases the concentration unbounded drug form

9.1.3. Metabolism

9.1.3.1. Decreased

9.1.3.1.1. Hepatic blood flow, slowed phase I reactions

9.1.3.1.2. Drug metabolism through cytochrome p-450 enzyme

9.1.3.1.3. First pass effect by 1 %/ year after 40 years ( higher drug circulation levels)

9.1.4. Elimination

9.1.4.1. Decreased renal functions

9.1.4.1.1. Renal blood flow

9.1.4.1.2. GFR

9.1.4.1.3. Tubular secretions

9.1.4.1.4. Creatinine clearance

9.2. Pharmacodynamics changes

9.2.1. Increased sensitivity to many CNS drugs, sedatives and anesthetic

10. Psychology problems

10.1. Treatments

10.1.1. Pharmacological therapy

10.1.2. Electroconvulsive therapy

10.1.3. Transcranial magnetic stimulation

10.1.4. Psychological therapy

10.2. Most common

10.2.1. Depression

10.2.2. Anxiety

11. Menopause

11.1. Hormonal changes

11.1.1. Lower estrogen

11.1.1.1. Leads to vaginal atrophy

11.1.1.2. Osteoporosis

11.1.1.3. Night sweat

11.1.1.4. Hot flashes

11.1.1.5. Palpitation

11.1.1.6. Fatigue

11.1.1.7. Headaches

11.1.2. No progesterone

11.1.3. Higher ADH

12. Functional abilities

12.1. Activities of daily living

12.1.1. Bathing

12.1.2. Feeding

12.1.3. Using the bathroom independently

12.2. Instrumental activities of daily living

12.2.1. Preparing meals

12.2.2. Managing finances

12.3. Could be assisted by asking elderly individual, caregiver, number of screening tests as timed up and go test ( balance) ,snelled chart ( vision) & , whispered voice test or audioscope (hearing ) .

13. Healthy routine lifestyle

13.1. Decreasing smoking

13.2. Dental care

13.3. Frequent check ups

13.4. Adequate sleep

13.5. Good hygiene

13.6. Social activities

14. Supportive roles

14.1. Family

14.1.1. Frequent visits

14.1.2. Engagement to surrounding life

14.1.3. Being patient and understandable

14.1.4. Encouragement to participate in social activities

14.2. Public services in Qatar

14.2.1. Ehsan

14.2.1.1. Financial support

14.2.1.2. Psychological support