HGD: Intro to Aging

Aging is the process of

growing old

elderly categories: young elderly

65-74

elderly categories: old elderly

75-84

Old, old elderly or old, frail elderly

>85

Geriatrics

the branch of medicine concerned with illness of old age and their care

Gerontology

the scientific studay of the factors impacting the normal aging process and the effects of aging

What is a key point noted about the current population?

rising geriatric / reduced birth rate

Morbidity =

Chronic disease health care management is responsible for over 90% of the $3.3 trillion annual health care costs in the United States (all ages) and account for most of the deaths in the United States

60% of adults have at

least one chronic condition

12% of adults have

5+ chronic conditions

Older persons account for

36% of total health care expenditure

body function

physiological and psychological functions of body systems

body structures

anatomical parts of the body (organs, limbs, and their components)

Impairments

problems in body function/structure such as significant deviation or loss

Activity

execution of task or action by an individual

Participation

involvement in a life situation (going to work, participating in community)

Activity Limitation

difficulty an individual has taking part in live situation

Environmental Factors

physical, social, and attitudinal enviroments in which people live

What are the 5 M’s?

Multi-complexity, Mind, Mobility, Medications, what Matters most

Multi-complexity describes the whole person and is typically an older adult living with

multiple chronic conditions, advanced illness, and/or with complicated biopsychosocial needs

MIND involves

Mentation, Dementia. Delirium, Depression

Movement Framework for Older Adults (MFOA) is a practical lens for

connecting geriatric context to movement, function, and clinical decisions

The central question for the MFOA is

“What movement problem matters most to this person AND what factors are shaping it?”

The MFOA adds a geriatric lens to _______ and ______ but does NOT replace them

ICF

Patient/Client Management Model

Start with What Matters Most

Elicit goals, meaningful roles, and the patient’s definition of success.

Observe a meaningful movement task

Choose a task that represents the patient’s priority.

Use the Geriatric 5Ms

Recognize factors that influence function, safety, learning, and participation.

Choose the next best step

Select an initial screen, safety action, education point, referral, or examination priority

The MFOA uses the Geriatric 5Ms to guide

exam priorities, intervention adaptation, communication, safety planning, and reassessment.

A Simple MFOA Sequence → step 1

What Matters Most?

What does this person want or need to do?

A Simple MFOA Sequence → step 2

Meaningful Task

What task best represents that priority?

A Simple MFOA Sequence → step 3

Observe Movement

Is the task safe, successful, efficient, and adaptable?

A Simple MFOA Sequence → step 4

Focused 5Ms Scan

Mind • Mobility • Medications • Multicomplexity

A Simple MFOA Sequence → step 5

Next Best Step

Screen, educate, improve safety, refer, or examine further

The 5Ms are applied selectively→

only the factors relevant to the individual case should guide the next step.

What are the three aging theories?

evolutionary, molecular, cell

Evolutionary theory states that aging results from

decline in force of natural selection

What are the characteristics of evolutionary theory?

• Harmful late acting mutations accumulate

• Lead to pathology and deterioration of age

Molecular theory states that deteriotation of age results from

changes in gene expression

What are the characteristics of the molecular theory?

• Longevity of life has a genetic component

The cell theory states there are limited number of

cell divisions normal human cells can undergo

What are the characteristics of cell theory?

• Replicative: with each cell division, a small amount of DNA is lost

• Stress induced: DNA damage occurs when cells are stressed

• Damage: accumulation of free -radicals, somatic mutations cause deterioration of age

System-based theory states that aging is related to a decline in

organ system (NS, endocrine, and immune)

Nervous, endocrine, and immune system play a key role in

coordinating repsonsiveness of body sytems to external and internal stimuli

The hypothalamo-pituitary-adrenal axis is key for physiological adjustments neccessary for homeostasis involves which system?

neuro-endocrine

________ may weaken and exhaust the neuro-endocrine system to adapt

Chronic stress

Aging causes reduced

sympathetic responsiveness, feedback control, and hormonal adaptation

Neuroendocrine-immune involves the decline of function in

immune system with aging

Older adults demo decreased resistance to

infection disease and protection against other disease

Environmental theory

Aging is influenced by insults from environment including UV, saturated fats, toxic chemicals, radiation and viruses (Results in errors of protein synthesis and DNA/genetic sequences)

Psychological theory

Integrity vs. despair

Sociological theory

Life experiences influence aging

Activity:

older people who are social active exhibit improved adjusted to aging process •Positive self-image and improved life satisfaction

Disengagement:

Withdrawal from society leads to isolation and life dissatisfaction

Dependency:

reliance on others

Slippery Slope of Aging =

physiological capability; fun → function → frality → failure

EXERCISE is vital for

prevention, reversal, and protection

Multimorbidity: 3 or more chronic conditions are associated with

high rate of death, disability, institutionalization, greater use of healthcare resources, poorer quality of life, and higher rates of adverse effects of treatment or interventions

Multimorbidity Requires

prioritization

What are the goals of multimorbidity?

Do not address every diagnosis on first day / ID next action that supports the person’ s priorities, safety and function

Healthy Aging includes

physical, functional, cognitive, social, and spritiual

Criteria for Health Aging includes all of the following EXCEPT:

Caloric rintake

but also having a diet that contains all essential nutrients and vitamins.