1. Nutrition and Hydration
1.1. Reduced need for calories
1.1.1. Less lean body mass
1.1.2. Decline in BMR
1.1.3. Activity level declines
1.2. Intercellular fluid lost causes decreased total body fluid
1.3. 1,500 mLs of fluid a day minimum
1.4. Change in nutrient absorption
2. Rest and Sleep
2.1. Phase advance
2.2. More time in stages I and II
2.3. Less sound sleep
2.4. Delay in onset of sleep
2.5. Possible sleep disturbances
2.5.1. Insomnia, nocturnal myoclonus, restless leg syndrome, sleep apnea, GERD, dementia, musculoskeletal disorders
2.6. Restless leg syndrome
2.6.1. Neurological condition of urge to move legs
2.6.1.1. Causes: anemia, uremia, Parkinson’s, rheumatoid arthritis, diabetes
3. Sexuality
3.1. Andropause
3.1.1. Does not happen to all men
3.1.2. Breast enlargement
3.1.3. Osteopenia
3.1.4. Osteoporosis
3.1.5. Shrinkage of testes
3.2. Dyspareunia
3.2.1. Result of less lubrication in women
3.3. Erectile dysfunction
3.3.1. Common but not normal
3.4. Menopause
4. Respiratory
4.1. Problems develop easily and are hard to handle
4.2. Changes in upper airway paths, nose, and trachea
4.3. Reduced cough
4.4. Lungs
4.4.1. Reduced in size
4.4.2. Reduced in weight
4.5. Decrease elastic recoil
4.6. Alveoli less elastic
4.7. Vital capacity reduced
4.8. Residual volume increased
4.9. Loose or brittle teeth can be aspired
4.10. COPD
4.10.1. Group of diseases including asthma, chronic bronchitis, emphysema, lung cancer, and lung abscess
4.10.1.1. Higher risk in women and smokers
5. Circulatory
5.1. Heart valves
5.1.1. Thicker
5.1.2. Rigid
5.2. Aorta dilated
5.2.1. Slight ventricular hypertrophy
5.2.2. Left ventricular wall thickened
5.3. Myocardial muscle less efficient
5.3.1. Decreased strength
5.3.2. Decreased CO when demand increases
5.4. Calcification
5.4.1. Reduced elasticity
5.5. Less sensitive to baroreceptor regulation
5.5.1. Blood pressure
5.6. Congestive Heart Failure
5.6.1. Complication of heart disease
5.6.2. Coronary artery disease is responsible for most cases
5.6.3. SOB, confusion, dyspnea, weight gain, edema
6. Urinary Elimination
6.1. Hypertrophy and thickening of bladder muscles
6.1.1. Decreased ability to to expand
6.1.2. Reduced storage capacity
6.1.2.1. Daytime urinary frequency and nocturia
6.2. Changes in cortical control of of micturition
6.2.1. Nocturia
6.3. Inefficient neurological control
6.3.1. Retention of large volumes of urine
6.3.1.1. Females: fecal impaction
6.3.1.2. Males: prostatic hypertrophy
6.4. Kidney filtration ability decreased
6.4.1. Affects drug elimination and could cause adverse effects or toxicity
6.5. Reduced renal function
6.5.1. High BUN and creatinine
6.6. Decreased tubular function
6.6.1. Concentration of urine changes
6.7. Increase renal threshold for glucose
6.8. Incontinence
6.8.1. Not normal aging
7. Reproductive
7.1. Women
7.1.1. Hormonal changes
7.1.2. Vaginal epithelium thins
7.1.3. Atrophy of cervix, uterus, and Fallopian tubes
7.1.4. Vaginal canal changes
7.1.5. Uterus and ovaries decrease in size
7.1.6. Breasts sag
7.1.7. Fallopian tubes become shorter and straighter
7.1.8. Cancers of the Ovaries
7.1.8.1. Leading cause of death from gynecological malignancies
7.1.8.2. S/s: bleeding, masses, ascites
7.2. Men
7.2.1. Seminal vesicles
7.2.1.1. Thinner epithelium
7.2.2. Muscle tissues becomes connective tissue
7.2.3. Decreased capacity to retain fluids
7.2.4. Seminiferous tubule changes
7.2.4.1. Increased fibrosis, epithelium thinning, thickening of the basement membrane, and narrowing of the lumen
7.2.5. Atrophy of testes
7.2.5.1. Slower central processing
7.2.6. Enlargement of prostate gland
8. Gastrointestinal
8.1. Atrophy of tongue
8.1.1. Affects taste buds and taste sensation
8.2. Saliva production decreased
8.2.1. Difficulty swallowing
8.3. Presbyesophogus
8.3.1. Weaker esophageal contractions
8.4. Esophageal and stomach motility decreases
8.4.1. Risk for aspiration and indigestion
8.5. Decrease elasticity of stomach
8.6. High pH in stomach
8.6.1. Decline in Hydrochloric acid and pepsin
8.7. Fewer cells on absorbing surface of intestinal wall
8.8. Sensory perception decreases
8.8.1. Constipation or incomplete elimination
8.9. Decreased bile salt synthesis
8.9.1. Increased gallstone development
8.10. Pancreatic changes
8.10.1. Digestion of fats is affected
8.11. Slower peristalsis
8.11.1. Increase risk of constipation
8.12. Dysphasia
8.12.1. Difficulty swallowing
8.12.1.1. Causes: GERD, stroke, and structural disorders
8.12.2. Incidence increases with age
9. Musculoskeletal
9.1. Decline in size and number of muscle fibers
9.1.1. Decrease strength and endurance
9.2. Reduction in muscle mass
9.3. Connective tissue changes
9.3.1. Reduced flexibility
9.4. Sarcopenia
9.4.1. Age-related reduction of muscle mass or function resulting from a reduction in protein synthesis and an increase in muscle protein degeneration
10. Neurological
10.1. Loss of nerve cell mass
10.1.1. Brain weight decreases
10.1.2. Brain and spinal cord atrophy
10.2. Number of dendrites decreases
10.3. Demyelination
10.3.1. Slower nerve conduction
10.3.2. Weaker reflexes
10.4. Number and sensitivity of sensory receptors, dermatomes, and neurons decrease
10.4.1. Dulling of tactile sensation
10.5. Decline in function of cranial nerves
10.5.1. Affects taste and smell
10.6. Brain changes
10.6.1. Plaques
10.6.2. Tangles
10.6.3. Atrophy
10.7. Accumulation of free radicals
10.8. Parkinson’s Disease
10.8.1. Affects ability of the central nervous system (CNS) to control body movements
10.8.2. Dopamine
10.8.3. S/S: tremors, face mask, shuffling gait
11. Endocrine
11.1. Thyroid gland atrophy
11.2. Diminished adrenal function
11.3. ACTH secretion decrease
11.4. Pituitary gland volume decreases
11.5. Insufficient insulin
11.5.1. Reduced tissue sensitivity to insulin
11.6. Diabetes Mellitus
11.6.1. “A chronic condition that affects the way your body metabolizes glucose”
11.6.2. S/S: increased thirst, frequent urination, unintended weight loss, fatigue, blurred vision
11.6.3. Need an increased amount of protein in diet to control glucose
11.6.4. Kidney damage common complication
11.6.5. Neuropathy common
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