BSN Notes: Common Signs And Symptoms: Age Related Problems,Physiological changes of ageing

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AGE RELATED PROBLEMS
 Introduction
·         Ageing has been defined as a universal internally predictable biologic process following maturity.
·         It is characterized by changes accumulated over time that increase susceptibility to disease and ultimately lead to death.
·         Physiologically aging in the absence of disease involves a steady decline in the functional reserve of organ system and homeostatic controls, especially when a person is under stress.
Physiological changes of ageing

System
Changes that occur during ageing
Cardiovascular
·         Decreased vessel elasticity due to calcification.
·         Decreased number of heart muscle fibers with increased size
·         Decreased filling capacity, stroke volume,  sensitivity of baroreceptors
·         Degeneration of vein valves

Respiratory
·         Decreased chest wall compliance due to calcification of the costal cartilage
·         Decreased alveolar ventilation
·         Decreased respiratory muscle strength and air trapping
·         Decreased ventilation due to degeneration of lung tissue.
Renal and urinary
·         Decreased Glomerular filtration rate due to nephron degeneration.
·         Decreased ability to concentrate urine and regulate hydrogen ions.
Gastro-intestinal
·         Decreased muscular contractions
·         Decreased esophageal emptying
·         Decreased bowel mobility
·         Decreased production of hydrochloric acid, enzymes and intrinsic factor.
Neurological and sensory
·         Degeneration and atrophy of nerve cells
·         Decrease of 25% to 45% of neurons.
·         Decrease in neurotransmitters.
·         Decrease rate of conduction of nerve impulses
·         Loss of auditory function.
Musculoskeletal
·         Decreased muscle mass, bone demineralization
·         joint degeneration
·         Erosion and calcification.
Immune system          
·         Decreased inflammatory response.
Integumentary
·         Decreased subcutaneous fat causing altered temperature regulation
Neurological /behavioral
·         Parkinsonism, essential tremor, Alzheimer's disease or dementia, depression, anxiety, psychosis or paranoid state, sleep disturbance.

           
Structural and functional changes and common health problems in older adults
Cardiovascular
·         Hypotension, IHD, heart failure, cardiac dysrhythmia, valvular heart disease, peripheral vascular disease, varicose veins,
·         Dehydration, stroke/Transient ischemic attack.
·         Peripheral vascular disease, stroke, varicose veins.
Respiratory
·         Pneumonia, chronic obstructive pulmonary disease, dyspnea.
Gastrointestinal
·         Constipation, diarrhea, Gastro-esophageal reflux, fecal incontinence, colorectal cancer, rectal prolapse, dysphagia, anorexia, gallbladder disease.
Genitourinary
·         Renal insufficiency, urinary incontinence, UTI, enlarged prostate, sexual dysfunction
Endocrine/metabolic
·         DM, hypo or hyperthyroidism,
·         Thyroid cancer, Hypercalcemia or Hypocalcemia, hyperlipidemia, hypokalemia, hyponatremia, gout.
Musculoskeletal
·         Osteoporosis, Osteomalacia, rheumatoid arthritis, osteoarthritis, spondylosis, fractures, foot pathology, gait disturbance, falls.
Autonomic nervous system
·         Falls, accidental injuries, orthostatic hypotension, impaired body temperature regulation.
Hematologic and immune
·         Iron deficiency anemia, pernicious anemia, autoimmune diseases.
Oral
·         Periodontal disease, problems with speech, chewing and swallowing.
Sensory
·         Visual impairment, hearing impairment, diminished smell or taste.
Dermatologic
·         Pressure sores, basal cell and squamous carcinoma, pruritus, hypothermia or hyperthermia.
Reproductive
·         Female-Cervical cancer, breast cancer.  
·         Male-Prostate cancer, impotence.

Management
·         Regular medical check up
·         Screening for cardiac problems
·         Exercise
·         Diet modification and prompt treatment of the underlying cause
·         Use of seat belt o Smoking cessation programs
·         Diet low in fat, high in fiber
·         Regular weight bearing exercise
·         Weight control.
·         Limiting alcohol intake and promote regular dental care




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