NURS 306: Week 4 - What Happens to Our Bodies as we Grow Older? Part 3

Where does systemic aging begin?

Gonads.

Which organ is the first to be impacted by hormonal decline?

Brain.

What is menopause?

A sudden drop of estrogen and progesterone in women, causing the cessation of menstruation.

What is required for a diagnosis of menopause?

12 consecutive months without a period.

What is perimenopause?

The transitional phase before menopause, during which the ovaries still function, but menstruation becomes unpredictable

What is andropause?

The gradual decline of testosterone in men.

What does a decrease in estrogen cause in women?

- Memory lapses

- Mood swings

- Disrupted sleep

- Anxiety

- Irritablity

- Depression

What does a decrease in testosterone cause in men?

- Reduced motivation

- Fatigue

- Cognitive dulling

- Low mood

- Emotional flatness

The regulation of which 4 main hormones is affected by hormonal imbalance?

- Insulin

- Cortisol

- Thyroid

- Adrenal

What is the hypothalmic-pituitary-gonadal (HPG) axis?

The primary endocrine system regulating reproduction and sexual development.

How do the adrenal glands compensate for decreased estrogen and testosterone levels?

By producing more cortisol.

What does elevated cortisol cause in women?

- Fatigue

- Sleep issues

- Increased belly fat

- Insulin resistance

What do elevated cortisol cause in men?

- Amplified inflammation and catabolic wear

- Fatigue

- Low mood

- Emotional flatness

How does decreasing estrogen affect thyroid hormones in women?

They alter how thyroid hormones are bound, metabolized, and are received.

How does a decrease in estrogen and testosterone affect glucose meabolism?

They increase insulin resistance.

Hormonal changes causes psychological changes first before physical ones (True/False).

True

1 multiple choice option

Which specific thyroid hormone does low testosterone especially affect?

T3.

How does a decrease in estrogen affect the circadian rhythm of women?

- Insomnia

- Night sweats

- Fatigue

- Fragmented sleep

- Worsening mood and focus

How does a decrease in testosterone affect the circadian rhythm of men?

- Lighter sleep

- Decreased REM sleep

- Shift in metabolic rhythm

How do changes in key hormones like serotonin and dopamine affect women?

- Mood swings

- Anxiety

- Irritability

- Trouble sleeping

How do changes in key hormones like serotonin and dopamine affect men?

- Apathy

- Low motivation

- Mild depression

- Poor memory

What is serotonin responsible for?

Mood, sleep, emotional stability.

What is dopamine responsible for?

Motivation, focus, and reward.

What is adrenaline responsible for?

Energy, attention, and stress response.

Both estrogen and testosterone have anti-inflammatory effects (True/False).

True

1 multiple choice option

What is immunosenescence?

The gradual decline of the immune system as we grow older.

What is inflammaging?

A state of low level chronic inflammation that slowly builds over time.

How does estrogen help the immune system?

- Boosts regulatory T cells

- Helps B cells make antibodies

How does low estrogen affect the immune system in women?

It increases their risk of developing autoimmune conditions (Ex. Rehumatoid arthritis, MS).

How does testosterone help the immune system?

- Suppresses pro-inflammatory cytokines

- Supports the activity of macrophages

- Boosts NK and cytotoxic T cells

How does low testosterone affect the immune system in men?

It increases their risk for acquiring chronic diseases and serious infections.

What does chronic inflammation contribute to?

- Atherosclerosis

- Type II DM

- Sarcopenia

What does chronic stress do to cortisol levels?

Increases cortisol.

What does dysregulated cortisol control lead to?

- Immune suppression

- Paradoxical pro-inflammatory cytokine surge

What are some key biomarkers for chronic stress and decreased hormone secretion?

- Increased IL-6, TNF, and CRP

- Decreased T-cell activity

- Blunted cortisol awakening response

What are 3 main protective social factors?

- Emotional support

- Cultural validation

- Community belonging

What cardioprotective roles does estrogen play before menopause?

- Increased nitric oxide

- Decreased LDL and increased HDL

- Antioxidant/anti-inflammatory properties

- Inhibits vascular smooth muscle proliferations

What are some rapid biological shifts that occur as estrogen decreases after menopause?

- Increased BP

- Increased LDL

- Accelerated arterial stiffening

What cardioprotective roles does testosterone play before andropause?

- Modulation of vascular tone via nitric oxide

- Regulation of lipid and glucose metabolism

- Enhancement of insulin sensitivity

- Reduction of inflammatory cytokines

What are some rapid biological shifts that occur as testosterone decreases with andropause?

- Increased visceral adiposity

- Increased insulin resistance

- Increased triglycerides and LDL

- Decreased endothelial function

What are some psychological contributors to CVD in older adults?

- Depression

- Anxiety disorders

- Sleep disorders

- Social isolation

What are some validated tools used to assess stress in older adults?

- PHQ-9

- GAD-7

- Perceived Stress Scale (PSS)

What are some key social factors that interact with hormonal aging?

- Socioeconomics status

- Healthcare access

- Social isolation

- Cultural attitudes

According to WHO and the Heart and Stroke Foundation of Canada, what are the key SDHs that affect heart health?

- Low income

- Low education

- Racial status

- Neighbourhoods

What is the normal role of estrogen in the musculoskeletal system?

- Regulation of osteoclast activity

- Promotion of osteoblast survival

- Maintenance of calcium balance via PTH and vitamin D

How does menopause affect the musculoskeletal system?

There is increased osteoclast activity, causing increased bone resorption and bone loss.

What is the normal role of testosterone in the musculoskeletal system?

- Promotion of muscle protein synthesis

- Enhancement of neuromuscular signalling

- Inhibition of myostatin

What is myostatin?

A protein that inhibits muscle growth.

How does andropause affect the musculoskeletal system?

- Decreased anabolic drive

- Decreased muscle mass

- Decreased strength

- Decreased mobility

What is anabolism?

The building of molecules.

What is catabolism?

The breakdown of molecules.

What is sarcopenia?

The age-related loss of muscle mass and strength.

What is the normal role of estrogen in the genitourinary system?

- Maintenance of the vaginal mucosa thickness and elasticity

- Supports uroepithelial integrity

- Preservation of lactobacillia colonization

- Modulation of urethral sphincter tone

How does menopause affect the genitourinary system?

- Vaginal atrophy

- Increased risk of UTIs

- Stress urinary incontinence

What is genitourinary syndrome of menopause (GSM)?

A collection of symptoms related to changes in the genitourinary system caused by menopause.

What is the normal role of testosterone in the genitourinary system?

- Maintenance of prostatic tissue homeostasis

- Modulation of pelvic floor and bladder function

- Support of ejaculatory reflex and force

How does andropause affect the genitourinary system?

- Prostate enlargement

- Decreased ejaculatory volume and force

- Urinary hesitancy, frequency, and nocturia

- Bladder obstruction

- Decreased renal function

Libido and need for intimacy and companionship deceases in older males (True/False).

False

1 multiple choice option

What does estrogen modulate in the GI system?

- Gut permeability

- Microbiota composition

- Serotonin signaling

What does testosterone affect in the GI system?

- Gut motility

- Immune function

- Metabolic signaling

The GI tract produces most of the body's serotonin (True/False).

True

1 multiple choice option

Disruption in the microbiota related to hormonal decline increases risk for what?

- Neuroinflammation

- Parkinson's disease

- Alzheimer's

- Mood disorders

A decrease in estrogen decreases intestinal motility, causing bloating and constipation in older women (True/False).

True

1 multiple choice option

Gut feelings are false signs of emotional distress for aging women (True/False).

False

1 multiple choice option

A loss of gut rhythm can trigger mood changes (True/False).

True

1 multiple choice option

What does estrogen maintain in the integumentary system?

- Skin moisture

- Barrier function

- Elastic fibers

- Collagen density

How does menopause affect the integumentary system?

- Decreased collagen

- Decreased skin thickness

- Increased water loss

- Dry, itchy skin

- Hair thinning

- Nail brittling

- Slower wound healing

What does testosterone maintain in the integumentary system?

- Sebum production

- Muscle tone

- Skin regeneration

- Hair growth

What are the effects of andropause in the integumentary system?

- Drier skin

- Thinning of the dermis

- Hair loss

- Slower wound healing

What can pruritus without rash be worsened by?

- Anxiety

- Depression

- Loneliness

What can wound pickling, nail biting, and skin picking be manifestations of in older adults?

- Stress

- Cognitive decline

- Body-focused repetitive behaviours

What does estrogen help with in the sensory system?

- Lacrimal glands

- Occular blood flow

- Auditory processing

What does testosterone help with in the sensory system?

- Inner ear

- Neuroprotection

- Support of skin and mucosal tissues

What is neuroplasticity?

The brain's ability to adapt and change.

What are some s/s of age-related sensory decline?

- Decreased tear production causing dry eyes

- Presbyopia

- Increased risk of macular degeneration

- Presbycusis

- Decreased sound localization accuracy

- Hyposmia

- Decreased function of the olfactory bulb

- Hypogeusia

- Decreased tactile sensitivity

What are some risks with sensory decline?

- Falls

- Burns

- Malnutrition

- Depression

- Occular disease

- Hearing-related isolation

Sensory decline is a strong risk factor for dementia due to reduced cognitive stimulation (Ture/False).

True

1 multiple choice option