Geriatric Patient (Condensed Version)

Chronologic entry for old age?

65 years

Young-old, old-old, oldest-old, centenarians, supercentenarians?

65–74,

75–84,

85+,

100+,

110+

Difference between biological and chronological age?

Biological = physical/functional state

What is functional age?

Based on health and ability to perform activities

Functional age categories?

Independent, frail, dependent

Primary aging?

Normal, intrinsic changes (e.g., wrinkles)

Secondary aging?

Disease or trauma-related changes (e.g., heart disease)

Optimal aging?

Slowed aging via prevention (diet, exercise)

Skin changes?

Thin, wrinkled, dry, pigmented

Musculoskeletal?

Bone loss, muscle weakness, stiff joints, spinal curvature

Cardiovascular?

Lower cardiac output, less elastic vessels, atherosclerosis risk

Respiratory?

Decreased vital capacity, weaker cough

Gastrointestinal?

Slower peristalsis, lower secretions

Nervous system?

Slower cognition, short-term memory decline, reduced tactile sensitivity

Sensory changes?

Presbyopia, presbycusis, reduced salt taste, smell declines

Endocrine?

Lower thyroid/metabolism, thermoregulation changes

Immune?

Decline in defense, higher infection risk

How does cognition affect function?

Lower attention and concentration

Environmental distractions?

Excess light, noise

Oral health link?

Tooth loss/gingivitis → lower cognition

Factors influencing longevity?

Genetics, lifestyle, diet, exercise

Lifestyle risks?

Tobacco, alcohol, obesity

Periodontitis links?

Atherosclerosis, diabetes, respiratory infections, RA

Common in older adults?

Alzheimer’s, osteoarthritis, alcoholism, osteoporosis, STDs, respiratory/cardiovascular disease

Definition?

Nonreversible dementia

Types?

Early (30s–40s), Late (65+)

Treatment goals?

Support, preserve function, prevent complications

Medications?

Antidepressants, antianxiety, antipsychotics, anticonvulsants

Oral health link?

Periodontal disease → brain inflammation

Symptoms?

Pain, stiffness, crepitation

Treatment?

PT, exercise, rest, diet, drugs

Dental care adaptations?

Short/afternoon appointments, jaw breaks

Why higher risk in older adults?

Less tolerance, worse health effects, drug interactions, depression

Causes?

Hormonal changes, low calcium/Vit D, sedentary lifestyle

Prevention?

Calcium/Vit D, load-bearing exercise, lifestyle changes

Medications?

Bisphosphonates, SERMs, calcitonin, parathyroid hormone

Oral health link?

Bone loss → periodontal/mandibular bone issues

Dental care adaptations?

Prevent falls, extra time, avoid surgery if on bisphosphonates

Most common in older adults?

HIV/AIDS

Risk factors?

Thinning epithelium, reduced immunity, generational knowledge gaps

Dental care?

Physician referral, nonjudgmental communication, patient education

Respiratory?

Pneumonia, COPD, asthma

Cardiovascular?

Hypertension, angina, MI, CHF, valve disease, stroke

Dental adaptations?

Monitor vitals, adjust seating, relaxation techniques

Lips/mucosa/tongue?

Dry lips, thin mucosa, smooth tongue

Xerostomia causes?

Medications, autoimmune disease, diabetes, radiation

Oral candidiasis causes?

Dentures, xerostomia, immunocompromised

Teeth changes?

Darkening, pulp changes, attrition, abrasion, root caries

Bone/gingiva changes?

Bone loss, decreased healing, gingival recession

Periodontal disease risk?

Chronic disease, medications, similar to younger adults

Care focus?

Comprehensive, preventive, long-term maintenance

Barriers?

Lack of perceived need, financial, access, mobility, physical barriers

Precautions?

Eliminate hazards, adjust seating, short appointments, raise chair slowly