Week 1 Geriatrics

What is the slippery slope of aging?

Fun to function to frailty to failure

What is the fun portion of the slippery slope of aging?

unrestricted participation in work, leisure, and home activities

What is the function portion of the slippery slope of aging?

may need to modify work and home, restricts or adapts leisure activities

What is the frailty portion of the slippery slope of aging?

Managing basic ADLs is challenging, substantial limitations in community activities

What is the failure portion of the slippery slope of injury?

requires assist with BADLs and IADLs, may be bedridden

5 factors that interact to produce successful aging

life satisfaction, social support system, good physical and mental health, financial security, control over ones life

Common chronic conditions for adults 65+

hypertension, high cholesterol, obesity, arthritis, coronary artery disease,diabetes, chronic kidney disease, depression

True or false: most older adults are reaching the recommended activity levels

false: only 12% meet overall recommended guidelines

What are the 5 areas of physical function activities?

mobility, BADLs, IADLs, work, recreation

What is optimal aging?

the capacity to function across many domains — physical, functional, cognitive, emotional, social, and spiritual — to ones satisfaction and in spite of one’s medical conditions

Why is exercise and an active lifestyle so important for older adults?

Because it helps older adults avoid the slippery slope of aging, particularly after sustaining a fall or sickness.

What defines moving from function to frailty?

when managing basic ADLs consumes a significant portion of physiological capacity

Cachexia

inexorable decline in muscle wasting that cannot be arrested nutritionally, frequently occurs before death, rapid decline

Sarcopenia

muscle wasting of old age, two or more standard deviations below young adult values

What is the difference between sarcopenia and cachexia

sarcopenia responses to progressive loading, cachexia does not and often does not warrant PT

When is peak bone mass achieved? When is loss greatest?

age 20-30, post menopausal women

What are major age related changes in skin/collagenous tissues?

loss of water from matrix (vertebral discs, shrinkage of articular cartilage), increase in number of collagen cross links (stiffer tissues, greater passive tension in tissues, loss of end range of motion), loss of elastic fibers (sagging skin and organs, less give with fascia and tendons)

What is an important clinical change in older adults that we need to be aware of when prescribing aerobic exercise?

decline in maximum HR and aerobic capacity

How might we enhance adaptation to aerobic exercise?

adding muscle mass via strength training

How does aging affect the nervous sytem?

slowed conduction, loss of motor units, denervation and innervation of muscle fibers which then impacts fine motor controlW

What are the 5 M’s of geriatrics

mind, mobility, medications, multi-complexity, matters most

How do sensory systems change with age?

they become impaired, regardless of the presence of comorbidities, visual function and hearing are common

How is the hormonal axis affected in the geriatric population?

altered function of endocrine glands, decrease in hormone production, and a loss of responsiveness in those tissues that hormones target

How does aging affect the hypothalamic-pituitary -gonadal complex

reduction in sex hormones negatively affects muscle and bone mass, visceral adipose tissue, insulin sensitivity, LDL metabolism, libido