Normal AGING

elders.uaa.alaska.edu

Normal AGING

Normal AGING

Presented by

Ronald Lucchino,PhD

Director of Communications and Legislative Advocacy, Alzheimer’s Association, NM

rvluc@pop.net


PURPOSE OF PRESENTATION

TO INCREASE AWARENESS BETWEEN:

• AGE RELATED BIOLOGICAL CHANGES THAT

ARE PART OF AGING FROM;

• AGE ASSOCIATED BIOLOGICAL CHANGES NOT

PART OF THE AGING PROCESS


OUTCOME

TO UNDERSTAND THAT AGE RELATED

BIOLOGICAL CHANGES DO NOT CAUSE

DISEASES OF DYSFUNCTION


What is Aging?


Aging-

• the random driven, systemic loss of molecular fidelity

due to increase in entropy that, after reproductive

maturation,

• exceeds repair capacity resulting in

• a loss of physiological capacity in some major organs.

• which accumulates resulting in senescence,

• the last stage of life, increasing the susceptibility to

disease and vulnerability to death


Analogy

A new car runs smoothly with minimum

maintenance or repair. As time goes on,

repairs are made to maintain function. A

time comes when the wearing out of the

parts greatly exceeds the repairs and

different parts of the car have a reduced

ability to function properly


ASPECTS OF AGING

1. Life long process from conception to death

2. Two aspects of aging

g

A. Increase in vitality- birth to 30 years old

B. Decrease in vitality - 30 to death.

3. Last stage - senescence


1. inevitable

2. irreversible

3. variable

4. linear - we are continuously age year after year

5. plasticity i (compensatory) -the body has the

ability to compensate for loss


OVERLAPPING CHANGES AFFECTING AGING


Aging


Developmental

Disabilities

Aging

Changes


Developmental

Disabilities

Aging

Changes

Medications


Developmental

Disabilities

Age

associated

changes

Aging

Changes

Medications


Developmental

Disabilities

Age

associated

changes

Aging

Age related

Changes

Medications


Aging Curve

• Increase in vitality - growth

• Decrease in vitality - decline


AGING CURVE

Maximum vitality

100

% vitality

vitality

vitality

minimum

vitality

death

conception

birth

age

30

senescence


\What is Vitality

• The ability to respond to stress, the amount of

reserve capacity

• The greater number of functioning i cells per

organ the greater the ability to respond to

stress

• Maximum vitality is 100%.

• Loss of vitality is 0.8% per year after age 30


GENERAL AGING


DETERMINANTS OF AGING

INTERACTION BETWEEN THE FOLLOWING:

1. GENETICS - AT BIRTH 100% OF FUNCTION IS

DETERMINED BY GENETICS, REDUCING IN IMPORTANCE

WITH AGING

Positive gene few to none early lifelong or

• Positive gene - few to none early, lifelong or

late-onset genetic diseases


• Neutral to negative genes- increase vulnerability to

early, lifelong or late-onset genetic diseases

• possible cardiovascular dysfunction

• possible mild osteoporosis

• possible rheumatoid disease

• sensory impairment

• possible diabetes dibt


• Negative genes- early, lifelong or late-onset genetic

diseases

• inherited diseases

• developmental disabilities

• Alzheimer’s disease

• dementia

• severe cardiovascular disease

• severe osteoporosis

• cancer

• neuro-muscular (Parkinson)

• Rheumatoid diseases


2. LIFESTYLE - INCREASES IN IMPORTANCE TO 7O%

BY AGE 60

• Diet

• Physical exercise

• Mental exercise

• Attitude


3. ENVIRONMENT

• Air and water

• Home

• Society

• Physical barriers


DESCRIPTORS OF AGING

SUCCESSFUL AGING

USUAL AGING

PATHOLOGICAL AGING


SUCCESSFUL AGING

Low risk of disease and disease-associated disability,

high mental and physical function; and active

engagement g in life

• Positive i genes

• Positive lifestyle

• good diet

• physical exercise

• mental exercise

• positive attitude


USUAL AGING

Physical or mental functional decline from the interaction of

neutral or negative genes and poor lifestyle from birth to

about age 70 causing a loss of some independence

• Neutral to negative genes

• Poor life style

• poor diet

• little physical exercise

• little mental exercise

• neutral to negative attitude


PATHOLOGICAL AGING

Serious functional limitations from the interaction of

either genetically inherited or developmental traits

with poor lifestyle causing a substantial reduction in

daily activities

• Negative gene

• Negative lifestyle

• poor diet

• no physical exercise

• no mental exercise

• very poor attitude


TERMS TO DESCRIBE AGING

Age related changes

Age associated changes

Disease associated changes


Age Related Changes

Changes that are part of the normal aging

process (successful aging -good genes and

lifestyle) and experienced by everyone


Examples

• sensory changes

• 15% loss of muscle mass

• smaller bladder

• some bone loss

• some cardiovascular changes

• some memory change

• slowing of reflexes


Age Associated Changes

Changes that occur at a higher incidence in older

individuals and are caused by interaction of neutral

or negative genes and/or a poor lifestyle - increasing

vulnerability for loss of independence. d Not

experienced by everyone


Examples

• 33% loss of muscle mass

• vision/hearing impairment

• some confusion

• arthritis

• noticeable memory loss

• high blood pressure


Age Associated Diseases

Changes caused by interaction of negative

genes and a poor lifestyle leading to diseases

that reduce independence resulting in

possible dependent care


Examples

• heart disease

• osteoporosis

• severe hearing/vision impairment

• neuromuscular degeneration

(Parkinson/Huntington)

• neurological degeneration (dementia)


BIOLOGICAL SYSTEM: Age related

changes


• Little to no change

Nervous System

• IQ remains the same or increases

• no change in personality

• little change in ability to learn new skills

• no major loss of short term memory

• no loss of long term memory

• slowing of recall


Changes in the Senses

Age Related Changes in Vision

• Reduced ability to tolerate glare

• Reduced dark adaptation

• Reduced depth perception

• Need more light

• Reduced ability to distinguish shades of

green -blue

• Presbyopia- farsighted


Age Related Changes in Hearing

• Increased sound threshold

• Presbycusis - decreased ability to hear

high frequencies

• Buzzing

• Reduced ability to maintain balance


Combined Affects due to Vision and

Hearing Changes

• Slowing of recall

• Interference with short term memory

•.Slowing of cognitive function

• Reduced ability to process multi- sensory input


Age Related Change in Temperature

Regulation

• Increase threshold to feel external temp.

Effects

• May feel cold at room temperaturet

• May not feel hot - possible heat stroke

Possible Associated Effects

• Possible dehydration

• Possible acute dementia


Age Related Changes in Thirst

• Increased thirst threshold

• Reduced fluid intake

Possible Associated Effects

• Reduced fluid intake

• Increased possible dehydration

• Increased acute dementia


Age Related Changes in Taste/Smell

• Reduced smell

• Reduced taste

Possible Related Effects

• Reduced appetite

Possible Associated Effects

• Acute dementia


Age Related Change in Pain

• Increased threshold

• Reduced pain (may not feel symptoms of

diseases)

Possible Associated Effects

• Mimics or masks diseases

• May affect behavior


Possible effects

• Slow in response to environment

Sensory Deprivation i - Age Associated Changes

Resulting in Interaction of a Significant Loss of the Senses

Sensory • Possible Deprivation increase in falls - Age Associated Changes

Resulting in Interaction of a Significant Loss of the Senses

• Behavior or personality changes


• Reduced socialization

• Acute dementia

• Depression

• Inappropriate social response


Cardiovascular

• Little change - blood pressure remains in

normal range

• Some arteriosclerosis (smoking and alcohol

increases arteriosclerosis

• Slowing of blood pressure reflex - longer to

regain blood pressure when suddenly standing


Risk Factors for Cardiovascular

Diseases (stroke/heart attack)

• Family history

• high blood pressure,

• high cholesterol,

• diabetes 2

• Obesity


Aging g and Cross -Culture

• Native Americans male and females have similar

risk factors as African-Americans and Hispanic,

higher then whites

• Native Americans males and females have a higher

incidents of stroke and heart attack than whites

• Older females from all cultural groups have a

higher incidents of cardiovascular problems

than males


Age Related Changes in Skin

Changes

• Reduced oil glands

Possible Associated Effects

• dry skin, itching, increased

water loss, skin infections

• Reduced sweat glands

• Reduced fat under skin

• Hyperthermia - coma,

dehydration, d hyperactivity

i

• Hypothermia - tired, sleepy,

confused, acute dementia

• Bed sores


Changes

Possible Associated Effects

• Reduced skin pigment

• Increased chance of

sunburn

• Skin becomes thinner

• Increased splitting and

infection


Muscular

Related Aging Change

• Moderate (15%) loss of muscle

mass

Intervention

• Moderate exercise will

strengthen th upper and

lower body

Associated Aging Change

• Severe (33%) loss of muscle

No interventioni

• Significant loss of muscles

• Weak upper body

• Increased falls

• Reduced activities


Bone Loss

Age related changes

• Some loss in jaw bone

• Moderate loss in other bones

Effects

• Dentures may not fit

• Little effect on bones

Age associated/disease

• Osteoporosis

• Kyphosis

Effects

• Increased fractures/breaks

• Low back pain

• Reduced height

• Bent over - possible fainting


Osteoporosis - types

Type 1 - pre-senile osteoporosis

• Menopause (prior to age of 70)

• Female (white - fair skin/ Asian)

• HRT/medications

Type 2- senile osteoporosis

• Diet (live long poor diet/lack of exercise)

• Male - 12% of bone mass/female - up to 25% of bone mass

• Reduced Vitamin D production by skin

• Diet therapy (vitamin D/Calcium/P/Fl)

Symptoms

a) back pains (low back)

b) angina like pains

c) abdominal pains


Falls and bone breaks

•The reasons for falls are:

a) environmental such as rugs, loose objects on the floor, curbs, poor lighted areas

b) when a person with kyphosos looks up they could cut off blood flow to brain

causing fainting

c) falling bouts due to hypo tension

d) medications cause many falls due to hypo tension, dizziness, confusion

e) sensory changes that will result in an older individual not seeing an object in

the way

• Results:

a) age (85% of all breaks-65 and over)

1. 30% over 65 will fall in home

2. 50% over 80 will fall in home

b) nursing home admission

1. 40% admitted because of break

2. 25% die in 6 months of break

3. $12 billion dollars cost


Aging g and Cross -Culture

Osteoporosis

Risk factors

Gender - White or Asian females

Smoking

Alcohol

Menopause

Poor diet

Racial - Female African-Americans Americans have

the lowest incidents


Joints - RELATED CHANGES

• Stiffness in joints

• Stiffness in spine

• Reduced range of motion


Joints - associated changes/disease

• Osteoarthritis

• Rheumatoid arthritis


Aging g and Cross -Culture

African-American American females and Native

American males and females have a higher

incidents of Rheumatoid arthritis then whites

Females in general have a higher incidents of

Rheumatoid arthritis than males


Age Related Changes in the Digestive

MOUTH

System

• Poor fitting dentures - jaw shrinks due to bone loss

• Dryness in mouth - reduced secretions of saliva

• Recessed gums - loss of gum tissue


ESOPHAGUS

-

• Weakened muscles - difficulty in swallowing food

• Reflux- increased acid from stomach results in heartburn

• Curling - food slow in reaching stomach - may lodge in

esophagus and feel stuck or reverse movement into throat and

be inhaled resulting in possible choking


INTESTINES

• Mild constipation - bowl movement within three days

• Weakening of anal muscles - possible staining of

undergarments


Age Related Changes in Nutrition

• Reduced ability to absorb:

• iron

• Vitamin B12

• calcium

• Slowing movement of intestine ti -

moderate constipation

• Reduced energy

• Increased water need

• Increased protein in diet

• Reduced carbohydrates

• Increased fiber in diet


Age Associated Effects of Poor

Nutrition

• Anemic- may cause acute dementia

• Acute constipation - no bowl movement more than

three days

• Increased weight (diet high in fats and carbohydrates) -

increased blood pressure, obesity, possible increase in

diabetes two, and heart problems

• Dehydration


Age Related Changes in Sleep

• Need 6-8 hours - similar to when younger

• Less time in deep sleep -easier to arouse

(feel sleep inadequate)

• Less dream sleep - need nap(s) during day


Causes of Disturbed Sleep Patterns

• Noise

• Worry or anxiety

• Pain

• Medication(s)

• Dementia

• Fear of incontinence

• Uncomfortable bed

• Change - address, room, location of bed or room

Change address, room, location of bed or room

mate


Hormones

Age Related Changes

• Decreased thyroid function

• Menopause - (decreased

estrogen)

Associated Affects

• Low body temperature

• Acute dementia

• Possible mood swings

• Depression

• Bone loss

• Possible short-term

memory impairment


Excretory

Age related changes - increased frequency

• Reduced bladder size

• Reduced strength of contraction

• Reduced muscle tone

Age associated change

• Increased frequency of infection

• Decreased control

• Incontinence


Causes of Incontinence

• Depression

• Acute dementia

• Chronic dementia

• Medication(s)

• Disease/dysfunction

• Attention


Age-Related Changes in the Female

Reproductive System

• Thinning of vagina mucosa- irritation/some pain

• Reduction in secretion for lubrication

• Some decline in desire or ability to engage in sexual

activities

• Reduced size in width and length of vaginaintercourse

may be painful if male not gentle

• Reduced lubrication- use lubricant


• Some decline in erotic touch

• Menopausal changes

• possible behavior changes

• possible decrease in activity/energy

• possible short term memory loss

• possible hot flashes

• possible appetite change


Age-Associated Diseases in the Female

Reproductive System

• Breast/uterine cancer

Hispanics and African-Americans have a higher

incidence of breast and cervical cancer then white

females

• Yeast infection

• Severe menopausal symptoms


Possible Age Associated Diseases

Indirectly Related to Menopause

• Osteoporosis

• Increased occurrence of heart disease

• Increased blood cholesterol l levelsl


Age-Related Changes in the Male

Reproductive System

• Some reduction in ability and desire for

sexual activity

• Longer in achieving erection

• Increased time between orgasms

• Reduced psychological stimulation


• Enlarged non-cancerous prostate

(BHP - Benign Hyperplasic Prostate)

• reduced flow of urine

• reduced ability to urinate

• reduced force of urine flow


Age Associated Diseases in the Male

Reproductive System

Types of prostate cancer

• Occult - silent

• Clinical - noticeable signs

• Latent - older age

Symptoms of prostate cancer

• reduced flow of urine

• reduced ability to urinate

• reduced force of urine flow


Aging g and Cross -Culture

African-Americans males have the highest

rate of prostate cancer

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