Adult Ax and Tx: Normal Age Effects on the mind and body

Sarcopenia shows

decreased muscle mass, elasticity, flexibility, and total body water. Increased fat tissue.

What kind of effects do changes in body composition cause?

Effects of medication processing especially with the liver and kidney where it takes longer to excrete medications. Dosage also needs to be modified as we age.

What kind of changes in diet should you consider when body composition changes?

Decrease in sodium intake, reduced calorie intake, increase intake of protein, calcium, and vitamin D.

Age related changes in the cardiovascular system

Heart muscles thicken, valves enlarge and stiffen, muscular contraction force decreases.

The aging person utilizes oxygen less efficiently due to changes in the

cardiovascular system

With lower oxygen efficiency, people will have

a lower ability to maintain physical activity for long periods of time. Thus low intensity exercise is better.

Age related respiratory system

• Decreased maximum capacity

• decreased lung elasticity

• vital capacity declines

• cilia reduced

• decreased cough

Considerations for changes in the respiratory system:

Older persons should remain active, pace tasks, avoid activities that re overly strenuous.

Gastrointestinal system

• Decreased contraction of esophageal muscles

• diminished secretion of digestive juices

• diminished efficiency of small intestine

• decreased contraction of colon

• decreased mass of liver, gallbladder, and pancreas.

Considerations for gastrointestinal changes

• Diet changes (reduction in fat and sugar)

• Remain upright during/after meals

• avoid eating late in the evening.

Changes in the endocrine (chemical processes) system

• Females experience decreased hormone production

• Males and females experience decreased production of hormones such as testosterone, thyroid hormones, growth hormones, and insulin.

Considerations for changes in the endocrine system

• Hormone replacement therapies. Can be beneficial but there are also some risks.

• Research aimed at reversing/delaying aging using hormone replacements.

Renal: Kidneys

Decrease in volume and weight. Function decreases by up to 50%.

Urinary: Bladder

Reduced capacity, delayed sensation of needing to empty.

Urinary system considerations

Higher sensitivity to alcohol, caffeine, medications. Incontinence leading to dehydration. Avoiding social situations due to fear of limited bathroom access.

Age-related sexual changes: Women

Decreased secretions, slower response to stimulous.

Age related sexual changes: Men

Decreased force of ejaculation, sperm, loss of erection.

Sexual changes considerations

Adults still need privacy for such purposes. Interest/capacity has not decreased. Avoid teasing older adults for being “inappropriate”

Sleep changes

Sleep stages decrease in duration

cycles are fewer and shorter

circadian rhythms change

Sleep considerations

Sleep medications may have the opposite effect. Improve sleep hygiene. Remember older persons may take naps.

Musculoskeletal and proprioceptive system changes

Bone loss, joint stiffness, loss of strength and stamina, decreased ability to orient body in space.

Musculoskeletal and proprioceptive system considerations

Take cautious, shuffling steps. Seek external spatial cues and supports. Need to improve balance and strength with general and aerobic exercise. have difficulty climbing stairs.

Integumentary system: Skin

Photo aging or extrinsic aging, decreased shedding//replacement of epidermis, deermis thins and loses elasticity, slower healing, changes in subcutaneous layers.

Integumentary system: Hair

Gray, fine, and thin. Decreased body hair. Increased facial hair in women, Nose and ear hair for men.

Integumentary system: Nails

Thick, brittle, fungus.

Considerations for changes in the Integumentary system:

susceptible to freezing to death and overheating. Skin tears/bruises easily. Ear wax accumulation may cause hearing loss.

Vision

Blurred vision, decreased acuity, decreased contrast sensitivity, poor adaptation to illumination changes, changes in color perception, poor depth perception.V

Vision Considerations

Reduce glare, increase levels of yellow light, increase light levels, large print, avoid blues, consider psychological impact.

hearing

Poor hearing sensitivity/detection, poor speech understanding, difficulty understanding speech in noise.Cons

iderations for hearing

Reduce competing noises, use sound-absorbing materials when possible, speak slowly, clearly, with a lower pitch.

Vestibular system

Loss of sensory cells, response to linear movement, poor balance.

Vestibular system changes

May feel sensation of spinning/dizziness, fall risk, experience negative psychological effects, need to use compensatory strategies.

Somatosensory

Loss of sensitivity with touch, lack of response to extreme temperatures, decreased discrimination of pain levels.

Taste and smell

Taste sensitivity is usually decreased in adults over 60. More olfactory receptors degenerate than can be replaced.

Considerations for taste and smell

May be unable to detect gas leaks, smoke, body odor, or even pleasant smells. Changes in social patterns during meals and meal prep. Flavor additives are successful in helping adapt.

Swallowing

Decreased cough, increased risk of aspiration, changes in the oral-pharyngeal mechanism.

Swallowing considerations

Take smaller bites, cut up food well, sitting upright, alternative seasonings over salt.

Cognition: Attention

Does not decrease but is negatively affected by several factors. May not duel process/multitask well.

Cognition: Intelligence

Liquid IQ is effected but not crystalized IQ.

Cognition: memory

Working memory is affected but storage capacity remains.

Cognitions considerations

Personalize environments.

balance of stimulating/relaxing activities.

Encourage reminiscing, reduce fatigue and stress, use memory aids, remain mentally active.

Communication Increases in…

Disfluencies, pauses, topic shifts, and amendments in conversational speech (hard to follow convos), use indefinite terms (stuff, thingamajig), naming errors, sentence fragments, vocabulary, verbosity, voice tremor, hoarseness, weakness.

Communication decreases in

cohesion, conciseness, rate, and organization in conversational speech. Use of proper nouns and specific referents. Naming skills. Sentence complexity. Comprehension. Sentence production (males only.)

Considerations for communication.

No elder speak. Prepare to repeat, rephrase, or write messages. Do not correct. maintain eye contact. Speak clearly, slowly, with appropriate intonation. Use familiar vocabulary. Supplement words with gestures. Pause frequently. Leave topic if it is causing frustration.