Aging, Age-Related, Degenerative Disorders

Week 6

Macular Degeneration

Central portion of your retina (macula) becomes worn

Cataracts

Clouding of the eye

Osteoporosis

• Bone disease that changes bone structure and strength through decreasing mineral density

• Oestrogen: bone protection

• More women affected by this due to menopause

Hyperkyphosis

• Aka Dowager’s Hump caused by prolonged forward leaning posture (cane or walker)

• Can be a result of advanced osteoporosis (vertebral collapse)

Osteoarthritis

• Degenerations and breakdown of joints

• Common in knees, hips and hands

Rheumatoid Arthritis

• Autoimmune and inflammatory disease

• Common in hands, wrists and knees

Affects of Aging on Skin

• Becomes thin, translucent and has less elasticity

• More fragile, susceptible to bruising and tears

• Loss of subcutaneous tissues (no padding or anchoring of veins)

• Longer wound healing time

Diabetes (Type II)

• Insulin resistance or impaired B-cell function

• Can be not diagnosed, irritation in lining of blood vessels and damages peripheral nerves

Atherosclerosis

• Fatty deposits causing damage, hardening and narrowing of blood vessels

Affects of Aging on Brain

• Shrinks 5% per decade after 40yrs (frontal lobe)

• More space to bleed and gain speed when hit head

• Likely to bleed rather than bruise (ICP without symptoms)

• Should be scanned at hospitals if they hit their head

Demyelination

• Loss of myelin sheath (protective layer) around nerve cells

• Causes delays, slower reactions, memory issues and struggle to learn new things

Brain Injuries

• Traumatic Brain Injury (TBI) or Cerebrovascular Accident (CVA)

• Ischemic Stroke: Blocked blood vessel

• Hemorrhagic Stroke: Ruptured blood vessel

Urinary Retention

• Benign Prostatic Hyperplasia (BPH) 

• Enlarged prostate (need to go to hospital)

• Compresses urethra blocking urine from being removed

Alzheimer’s Disease

• Amyloid plaques in the brain, brain degeneration

• Wandering: Getting lost or losing track of time due to increased confusion and disorientation

Vascular Dementia

• Caused by impaired blood flow to parts of the brain

• Abrupt Onset: Following a stroke

Lewy Body Dementia

• Protein deposits (Lewy bodies) in the brain

• Fluctuations between normal and abnormal behaviour

• Parkinsonism: Motor/movement tremors or rigidity

• Vivid visual hallucinations, may act out dreams in sleep

Frontotemporal Dementia

• Damage to frontal and temporal areas, more significant

• Mood/personality shifts (why is your belly big?)

• Lack of social inhibition, apathy

• Loses speech and language (nod and smile when they don’t understand what you’re saying)

Behaviour Variant FTD (BvFTD)

• Frontal lobe affected first

• Changes in behaviour and personality

Primary Progressive Aphasia (PPA)

• Temporal lobes affected first

• Loss of language skills

• Progressive Non-Fluent Aphasia and Semantic Dementia

Progressive Non-Fluent Aphasia

Speech becomes hesitant and lacks grammatical accuracy

Semantic Dementia

Lose ability to understand or formulate words in a spoken sentence

Wernicke’s Encephalopathy

• Loss of mental activity

• Vision change (twitching/ticking)

• Similar to alcohol withdrawal

• Muscle coordination loss

• Feelings of apathy, confusion and unmotivated (don’t look after themselves)

Korsakoff’s Syndrome

• Can’t form new memories

• Confabulation (know enough to make up info to fill gaps)

• Severe memory loss

• Hallucinations (later stages)

• Feelings of apathy, confusion and unmotivated (don’t look after themselves)

7 Stages of Progressive Dementia

1. Appears normal and can cover up lapses

2. Forgets certain things but can otherwise function normally

3. Difficulties at work, becomes anxious and family notices

4. Reduced ability to count, finds travel difficult, and can’t manage affairs

5. Needs help getting dressed

6. Help eating, using toilet, incontinent, disoriented, forgets who they are

7. Speech loss, motor stiffness, needs feeding, incontinence, total disorientation

Sundowning

• Increased agitation in late afternoon/evening

• Refusal to obey those trying to help

Delirium

• Sudden change from their baseline (on and off switch)

• PINCH ME (Pain, Infection, Constipation/Urinary Retention, Hydration, Medications/Substances and Environmental Triggers)

• Reversible

Parkinson’s Disease

• Loss of dopamine

• Early stages retain good brain function, may develop dementia later

• Masked face, stooped posture, parkinson’s shuffle, lots of tremors

Locked-In Syndrome

• Rare neurological disorder, brainstem damage (pons)

• Full consciousness and normal cognitive abilities

• Paralysis of all voluntary muscles EXCEPT vertical movements of the eyes (up and down) and blinking

• Causes: Stroke, TBI, Tumours, Demyelination, ALS, Guillain-Barré Syndrome

Amyotrophic Lateral Sclerosis (ALS)

• Progressive neurodegenerative disease affecting nerve cells in the brain and spinal cord

• Muscle weakness/twitches and slurred speech

• Unknown cause and cure but therapy and medications to manage symptoms

• Life expectancy of 3-5 years

Motor Neurone Disease

• Group of neurological disorders that affect cells that control voluntary muscle movement

• Muscle weakness/wasting, difficulty speaking, breathing and swallowing

• Unknown cause and cure but therapy and medications to manage symptoms

• Affects men and women equally at any age

Myaesthenia Gravis

• Immune system attacks nicotinic acetylcholine receptors in muscles, blocking nerve signals

• Weakness in voluntary muscles (face, eyes, throat)

• No cure but Rituxan can help manage symptoms

• More common in women under 40 and men over 60

Huntington’s Chorea

• Inherited condition that causes brain cells to lose function (voluntary muscles and memory)

• Uncontrolled movement (chorea), ataxia (loss of coordination), dysphagia (difficulty swallowing)

• Causes can be genetic or TBI, new cure known as AMT-130, slows progression

Muscular Dystrophy

• Duchene muscular dystrophy causes progressive muscle weakness

• Muscle weakness, scoliosis, developmental delay

• Genetic disorder with no cure, just managing symptoms

• Affects younger men

Multiple Sclerosis (MS)

• Immune systems attacks myelin causing inflammation, disrupts and damages nerves that control body functions

• Vision, motor, sensory, cognitive, and bowel issues

• Genetic disorder with no cure, just managing symptoms

Guillain-Barré Syndrome

• Immune system attacks nerves causing weakness and paralysis

• Tingling, loss of reflexes, abnormal hr and bp

• Not curable but ability to recover with minor symptoms 

• Treatment includes plasma exchange and IV immunoglobulin