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Physiologic Changes with Aging

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Musculoskeletal Neural
  • ↓ Muscle mass (↓ type II = FT) & strength

  • ↓ Motor unit recruitment

  • ↓ Speed of mov't

  • ↓ Joint flexibility

  • ↓ Bone mass & strength

  • Cartilage degeneration

  • ↓ Conduction = altered pain

  • ↓ Enzymatic activity

  • ↓ Reflexes

  • ↑ Postural sway

  • ↓ Responsiveness

  • Change in sleep patterns

Cardiovascular Pulmonary
  • ↓ Cardiac output

  • ↑ Vascular resistance

  • ↓ Lipid catabolism

  • ↓ Vascular elasticity = ↑ DBP

  • ↓ Response to postural stress

  • ↓ Recoil within the lung

  • Calcification of soft tissue in the chest wall

  • ↓ PO2 from 20–70 years

  • ↓ VO2 max

  • ↓ Pulmonary blood flow = ↓ O2 Sat

  • ↑ RV

Integumentary GI
  • ↓ Thickness with ↑ risk of breakdown

  • Uneven pigmentation

  • ↓ Vascularity = altered thermoregulation

  • ↓ Sub-q tissue ↑ risk for

  • Hypothermia

  • ↓ Peristalsis

  • ↓ Enzymatic activity

  • ↓ Motility

Urogenital/Renal Special Senses
  • ↓ Bladder capacity

  • ↓ Bladder elasticity

  • Prostate hyperplasia

  • ↓ Kidney mass

  • ↓ Glomerular filtration rate

  • ↓ Creatinine clearance

  • ↓ Visual acuity

  • ↓ Hearing

  • ↓ Smell & taste

  • ↓ Thymus function

  • ↓ Ca++ control

  • ↓ Sweating

Immune Psychosocial
  • ↓ Function/resistance

  • ↓ T-cells

  • ↓ Temperature regulation

  • ↑ Incidence of depression

  • ↑ Fatigue

  • Cognitive deficits

Influence of Aging on Laboratory Values

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  Test Aging Influence
Chemistry AST, ALT No change
Alkaline phosphatase ↑ 20% males; ↑ 37% females
GGTP, serum bilirubiin No change
Serum albumin Slight ↓
Serum magnesium ↓ 15% from 30–80 yrs
Uric acid Slight ↑
Lipids Total cholesterol 30–40mg/dL ↑ by 55 yrs in females & 60 yrs in males
HDL cholesterol 30% ↑ in males; 30% in females from 30–80 yrs
Triglycerides 30% ↑ in males; 50% in females from 30–80 yrs
Gases pH No change
PaCO2 No change
PaO2 25% ↓ from 30–80 yrs
Renal Creatinine clearance 10 mL/min/1.73m3/decade
Serum creatinine No change
Thyroid T3 Slight ↓
T4 No change
Thyrotropin Slight ↓
Blood Fasting blood glucose 2 mg/dL ↑ per decade > 30 yrs
ESR (sed rate) ↑ to 40 mm/hr in males & 45 mm/hr in females
Hematocrit/hemoglobin No change
Leukocyte count Slight ↓
RBC/platelet count No change

Source: Brigden ML & Heathcote JC (2000).

Assessment of Falling Risk(s)

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...
Risk Factors for Falling Yes No
Have you suffered previous falls?    
Do you have problems with your balance or walking?    

Do you take > 4 of the following medications?

  • Antipsychotics–Thorazine, Haldol

  • Tricyclic antidepressants–Elavil, Prozac

  • Antianxiety–Valium, Xanax

  • Hypnotics–Seconal, Butulan, Doral

  • Antihypertensives

   
Do you have problems with your vision?    
Do you get dizzy when you change positions?    
Do you ever experience light-headedness?    
Are you afraid of falling?    
Do you have problems with your feet?    

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