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Chapter 5 Common Aging Changes

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Introduction
Changes of aging are highly individualized Changes are also different in various body systems of the individual Changes influenced by: Genetic factors, environment, diet, health, stress, and lifestyle choices

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Cells


Changes start at the basic cellular level Number of cells is reduced

Reduction in lean body mass


Total body fat increases

Decrease in intracellular fluid

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Physical Appearance


Begins in the fourth decade of life Hair loss, gray hair, and wrinkles

Atrophy of body fat


Loss of tissue elasticity

Reduction in skin-fold thickness


Decrease in stature
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Respiratory System


Reduction in respiratory activity
Less lung expansion Increased residual capacity and reduced vital capacity High risk for respiratory infection

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question
Which of the normal age-related changes in the respiratory system can increase the risk of infection in the older adult population? a. Decrease in the anterior-posterior diameter of the chest b. Increased strength of the thoracic musculature c. Increase in residual volume and reduction in vital capacity d. Decreased calcification of costal cartilage
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
c. Increase in residual volume and reduction in vital capacity

As residual volume increases, the vital capacity is reduced, and maximum breathing capacity decreases placing older adults at high risk for developing respiratory infections

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Cardiovascular System


Heart size unchanged in absence of pathology Valves become thick and rigid

Heart muscle loses efficiency


Reduced cardiac output under physiologic stress Reduced elasticity of blood vessels Increased peripheral resistance
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Gastrointestinal System


Tooth loss is not a normal part of aging Less acute taste sensations Increased risk of aspiration, indigestion, and constipation

Effect on esophageal motility


Atrophy of the small and large intestines
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question
Is the following statement true or false?

Atrophy of the small and large intestine, with fewer cells present on the absorbing surface of the intestinal wall, causes certain vitamins and minerals to have a decreased rate of absorption.

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
True.

Absorption of vitamin B, vitamin B12, vitamin D, calcium, and iron is decreased in the intestine of the older adult.

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Urinary System


Reduction in renal blood flow and filtration

Reduced bladder capacity


Urinary frequency, urgency, and nocturia are common in the older adult population Incontinence is not a normal part of aging

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Reproductive System


Male:

Reduction in sperm count in some men


Prostatic enlargement Female: Atrophy Estrogen depletion
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Musculoskeletal System


Atrophy and reduction in the number of muscle fibers
Tendons shrink and harden

Reduction in bone mineral and mass


Increased risk of fractures

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Nervous System


Reduction in nerve cells, cerebral blood flow, and metabolism Slower reflexes, delayed responses, and changes in balance Health of the nervous system affected by all other body systems Changes in sleep patterns
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question
Which of the following is a normal age-related change of the nervous system? a. Decline in the weight of the brain b. Increase in cerebral blood flow c. Stage I and II sleep are interrupted d. Higher nerve conduction velocity
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
a. Decline in the weight of the brain

There is a decline in brain weight and a reduction in blood flow to the brain. Stages III and IV sleep become less prominent. Nerve conduction velocity is lower which causes slower reflexes and delayed response to multiple stimuli.
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Sensory Organs Vision


Presbyopia Narrowing of the visual field; decreased peripheral vision Pupil less responsive to light Potential for macular degeneration
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Sensory Organs Vision (contd)


Opacification of the lens: potential for cataracts

Distortion in depth perception


Arcus senilis

Decline in visual acuity

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Sensory Organs Hearing


Presbycusis

Distortion of high-pitched sounds


Accumulation of cerumen Alteration in equilibrium

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Sensory Organs


Loss of ability to smell
Altered sense of taste Reduction in tactile sensation These changes all result in a potential risk related to safety issues
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Endocrine System


Decreased thyroid gland activity Altered release of insulin

ACTH secretion decreases with age


Delayed and insufficient release of insulin

Decreased tissue sensitivity to circulating insulin


Reduced ability to metabolize glucose
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Integumentary System


Skin is less elastic, more dry, and more fragile Thinning and graying of hair Reduced sweat gland activity

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Immune System


Depressed immune response:
T-cell activity declines Decline in cell-mediated immunity

Potential for infection


Potential for reactivation of dormant varicella-zoster and Mycobacterium tuberculosis
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Body: Thermoregulation


Lower normal body temperatures Reduced ability to respond to cold temperatures

Differences in response to heat

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question
Is the following statement true or false?

Mean body temperatures of the older adult range from 96.9F to 98.3F orally.

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
True.

Normal body temperatures are lower later in life than in younger years.

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes in the Mind


Causes of psychological changes

Personality remains consistent with that of the earlier years in the absence of disease
Changes in memory

Intelligence and aging


Learning ability and aging

Attention span
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nursing Implications of Age-Related Changes


Understanding of aging changes is essential for competent gerontological nursing practice Health promotion Acknowledgment of factors that can alter function with aging Emphasis on capabilities and assets possessed by the older adult
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

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