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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