Lifespan- Sensory Changes Associated with Aging

peripheral sensory system

all provide feedback from the environment in real time and sent information to the CNS so that we can appropriately respond to our environment

visual, proprioceptive, vestibular, auditory, tactile, olfactory

the peripheral sensory system includes

decline in sensory system acuity

what is the normal age related process of aging in the sensory system

variable

the extent of the age related decline in sensory system acuity is

environmental factors

some of the age related decline in sensory system acuity is based on

gradually

how does the most of the sensory system decline occur

severe

most of the sensory system decline goes unnoticed until it is

other systems

when one system begins to fail we rely more heavily on

more difficulty accommodating for the loss

when multiple systems decline, older adults may begin to have

inappropriate physical response

older adults may miss environmental cues, or when they receive the cue, the information may be skewed or too late, resulting in an

vision

allows us to identify environmental cues, distinguish environmental hazards, maintain upright balance and communicate with others

visual field impairments, reduced visual acuity, illumination, glare, dark adaptation, color, contrast, depth perception

what are some areas that may experience vision changes

visual field impairments

reduced peripheral vision, may not see tripping hazards, road signs, or a person standing at their side

reduced visual acuity

decreased ability to discriminate fine details in visual field; may need bifocals/trifocals, can be a hazard on stairs

illuminaiton

vision during the day is least affected, vision under low light becomes impaired, people with cataracts are particularly affrcted

cataracts

people with what vision change are most affected by illumination

glare

unable to weed out the excessive light

dark adaptation

requires increased time to adapt when moving from well lit to low light environments

color

ability to differentiate and distinguish colors declines (blues, greens, greys)

contrast

ability to discriminate degrees of brightness, use warm colors (red/orange/yellow) to highlight important visual targets

red, orange, yellow

what colors should be used to highlight important visual targets

depth perception

reduced ability to discriminate color, impaired visual input from both eyes can effect convergence, effects our ability to accurately construct special relationships (curb, heights, distance between objects)

cataracts, macular degeneration, glaucoma, diabetic retinopathy

what are common pathologic visual conditions

Cataracts

cloudy/blurred vision, difficult to see at night; sensitive to glare/may see halos around light; colors fade

macular degeneration

blind spot in center of visual field; distortions at the center of vision; dulling of colors; difficult with low light to bright light transition

glaucoma

blind spot in visual field; gradual loss of side vision; increased sensitivity to light and glare; poor discrimination between color; reduced night vision

diabetic retinopathy

spots (floaters) in vision; blurred vision; fluctuating vision; impaired color vision

joints, muscles, and tendons

proprioceptive, somatosensory input is gathered from receptors located in

body segment position and movement in space; amount of force; amount of force generated for the movement

Proprioceptive input provides CNS with what information

impaired 2 point discrimination, decreased vibration sense

what are age related proprioceptive declines

vibration sense

what is the main determinant for postural control

increased sway

decreased vibration sense will result in what

vestibular

provides the CNS with information about the angular acceleration of the head; key sensory information related to postural control; regulates head and neck positions and movement via the vestibular ocular reflex and the vestibular spinal reflex

vestibular ocular reflex

stabilizes visual images during head movements

vestibular spinal reflex

reflex control of the neck and LE postural muscles so that the head and trunk can be maintained accurately and correlated with eye movements

loss of peripheral hair cells, changes in vestibular nerve fibers, changes in VOR

what are anatomic./physiologic changes of the vestibular system

benign paroxysmal positional vertigo, unilateral vestibular hypofunction, meniere disease, bilateral vestibular hypofunction

what are health conditions of the vestibular system

increased postural sway, increased LOB, dizziness, motion sensitivoty

what are resulting impairments of the vestibular system

visual, proprioceptive, vestibular

what are the peripheral systems of balance

visual system

tells us where we are in relation to our environment, if the walls are vertical and the desks are horizontal, we must be upright

proprioception system

tell us where we are in relation to the ground; postural muscles also give us a sense of stability and how much to react to a perceived loss of balance

vestibular system

tells us where our head is in space/angular acceleration; if out eyes are closed and we are standing on an uneven or foam surface, do we still know what is upright

sensorineural hearing loss

cochlear damage or 8th cranial nerve damage; presbycusis

conductive hearing loss

dysfunction of the external ear, middle ear, or both; decreased transmission of sound wave vibration into the inner ear

presbycusis

age related hearing loss

decreased sensitivity to sound, decreased ability to discriminate words in a noisy environment, slowing of the processing and interpretation of sounds; difficulty localizing sound

what are changes in the auditory system caused by presbycusis

sound amplifier, flashing lights, vibration, make eye contact and stand in front when communicating, write down what needs to be communicated, speak in low tone frequencies, speak more slowly, annunciate

what are modifications to consider if a patient has hearing impairments

tactile

includes touch and pressure, temperature, pain, limb movement

difficulty differentiating or manipulating small objects, increased reaction time to tactile stimulation

what are implications for tactile impairments

olfactory

smell sense declines gradually with age, can be associated with respiratory disease

neurologic disease

olfactory decline can be an early indication of

risk of injury due to undetected fire or spoiled food

what are considerations of olfactory decline