Physical Changes

vision - primary aging characteristics

• decrease in amount of light passing through (cornea, lens thickening, less flexible)

• increased sensitivity to glare

• light/dark adaptation declines (Miosis)

• lens adaptation declines (presbyopia)

Miosis (primary vision aging)

abnormally constricted pupils, limiting light that comes in too much

Presbyopia (primary vision aging)

decline in ability to focus on nearby objects, time to change focuses increases

→ age-related farsightedness

secondary aging vision changes

• cataracts

• age-related macular degeneration (AMD) 

• glaucoma

Cataracts (secondary vision aging)

• opaque spots covering/clouding the lens

• caused by protein (in lens) breakdown, prolonged UV exposure 

• leading cause of blindness worldwide 

Age-related macular degeneration (AMD) (secondary vision aging)

• progressive loss of central vision

• caused by accumulation of protein deposit or blood/fluid leak in macula 

• affects central vision, fovea location (responsible for visual acuity, vivid colour processing) 

wet vs dry AMD

dry AMD → protein deposits

wet AMD → protein deposits w/ blood/fluid leak in macula (extension of the disorder) 

Glaucoma (secondary vision aging)

• damage to optic nerve

• high pressure in eyes

• loss of peripheral vision

• subtle changes to vision, not initially apparent and not noticed until it becomes quite bad

inner ear damage leads to

balance issues

→ fluid in semicircular canals moves around as body/head move

primary aging hearing changes

• presbycusis

  • hearing in noise 

Presbycusis (primary hearing aging) 

• gradual age-related hearing loss

• caused by damage/wear to inner ear over time 

• hearing in noise also affected 

  • functional hearing (hearing sentences/words in noisy environ)

• pure tone audiometry 

what is Hearing in noise

functional hearing (hearing sentences/words in noisy environ)

typical audiogram

louder volume needed to hear higher frequencies

secondary aging - hearing

as pure tone hearing decreases, so does functional hearing

primary balance aging

• vestibular system

• proprioception

primary balance aging - vestibular system 

it declines with age, semicircular canals process movement in 6 degrees of freedom 

• vest. syst. helps us orient in space & maintain balance 

primary aging balance - proprioception 

declines with age, perception of joint/body movement in 3D space 

• vestibular system works with this

secondary balance aging

vertigo/dizziness

secondary balance aging (vertigo/dizziness)

sensation of movement that makes one uneasy

→ multi-factoral causes, puts balance in jeopardy, increase in risk of falls 

primary/secondary muscle aging

sarcopenia

primary/secondary muscle aging - sarcopenia

progressive age-related loss of muscle tissue, strength 

• multi-fact causes (genetic, lifestyle, hormonal) - increased risk of falls, physical disability

• prevention → exercise, strength/resistance training 

primary joint aging (ligaments)

become less elastic overtime → thick, short, flexible, fibrous connective tissue that connects bones/cartilage, holds joints tgt 

• prone to damage/tearing 

secondary joint aging

• osteoarthritis 

• rheumatoid arthritis

secondary joint aging - osteoarthritis

• degeneration of cartilage (cushion for bones) → bone-on-bone contact 

• inc risk with age, injury, genetics 

• symp: pain, tender, stiff, swell, loss flexibility 

secondary joint aging - rheumatoid arthritis

• autoimmune condition 

• degeneration of cartilage, inflammation around joints 

• diff pathology/causes than osteo

secondary aging bones - osteoporosis 

• change in amount of bones, decr quality of tissue 

• low bone mass (quantity) 

• deterioration of bone tissue (quality) 

• low bone mineral density 

osteoporosis in women 

• 50% will devel, 1/3 will break a bone bc of it 

• causes: 

  • less bone mass

  • low levels of estrogen

  • greater rate of bone density decreases

  • insufficient dietary calcium

  • less weight-bearing activities in devel

what hormone directly impacts intracellular processes that regulate bone/muscle health (and deficiency incr risk for osteoporosis and sarcopenia) 

estrogen 

osteoporosis in men

• 1/5 will break a bone 

• 37% who suffer hip fracture will die within 1 yr 

general risk factors for osteoporosis

• genetic 

• previous falls and broken bones 

• smoking 

• drinking alc >3/day 

• certain medication 

• where you live 

  • LBMD in developed countries w/higher pop 

prevention of osteoporosis

• weight bearing and muscle strengthening exercise 

• avoid smoking/alc 

• at 50+ yrs → get assessed 

• at 65+ yrs → regularly assessed 

• calcium and vitamin D supplements/intake levels 

4 imp (individual) risk factors that can lead to falls

weakness, balance deficit, gait deficit, visual deficit 

fear of falling is associated with ___ activity

decreased/less

fear of falling is a ___ problem, why

cyclical problem

→ ppl fear falling, don’t do activities they could fall, not exercising increases risk of falls 

fear of falling & sensory impairment/difficulties

• FOF higher proportion of sensory difficulties 

• ppl with FOF report difficulties walking 2km, 3 yrs later 

• FOF decreased likelihood of exercise, which increases chance of falling