CHRONIC ILLNESS AND

AGING
 CHRONIC ILLNESS:

• A long-lasting illness (in contrast to

ACUTE illness, which is temporary)

• Most common in older adults

– Heart disease
– Cancer
– Cerebrovascular disease (stroke)
HEART DISEASE:

• Principal cause of death among o.a.’s

• Accounts for significant morbidity,

disablement & inactivity among o.a.’s

• Dominant factor--atherosclerosis
(build-up of fatty deposits within
arterial walls)
Mechanism:

• Atherosclerotic buildup------>
• Narrowing of arteries supplying blood
to the heart----->
• ISCHEMIA (denial of adequate blood
supply)
• Ischemic heart disease also known as:
– coronary heart disease (CHD)
– coronary artery disease

– A common form: myocardial infarction

(heart attack)
– persistence of deficient blood supply,
tissue dies. Dead area: an infarct
Heart attack may also result
from:
• Cardiac arrest-- some interruption of
normal pattern of cardiac contraction
• Coronary thrombosis--sudden
blockage of coronary artery with a
blood clot
• Strenuous exercise resulting in
suddenly increased need for O2
Mortality associated with MI:

• Over 70--2x that under age 70

• Symptoms of MI may differ in older

people than in younger ones
• “…while complete absence of chest
pain is very rare in acute myocardial
infarction up to middle age, it is a
‘mundane occurrence’ in old people”

• “…only about 1/3 of elderly patients

present with a classical prolonged
episode of chest pain”. (Kart & Kinney,
p. 111)
Heart Disease: Modifiable Risk
Factors:
• Cigarette smokers 2x MI rate of non-
smokers
• High BP
• High serum cholesterol levels
• Diabetes
• Obesity
• Sedentary lifestyle
Healthy People 2000 goals:

• 1. Increase prop. Of people whose

high BP is under control
• 2. Reduce mean-serum cholesterol
levels
• 3. Reduce dietary fat intake &
average unsaturated fat intake
• 4. Reduce prevalence rates of
obese/oveweight adults
• 5. Increase proportion of children &
adults engaging in regular, daily
physical activity at least 30 min/day
• 6. Reduce cigarette smoking among
people age 20 and older

• http://www.health.gov/healthypeople
 CANCER

• 2nd leading cause of death in U.S.

• Incidence increases with age--Why?
– Most forms of cancer have a long latent
period; initiating factors start during
youth
– increasing age and accompanying
physiological changes make one more
susceptible to actions of carcinogens
CA, cont’d

• …onset and management of many

cancers do not vary greatly in the old
and young. Prevention is still the
order of the day regarding cancer.” p.
113.

• This includes:
• 1. Avoiding unnecessary exposure to
ionizing & ultraviolet radiation
• 2. Implementing hygienic measures in
occupations involving exposure to CA-
producing chemicals & dusts
• 3. Avoiding exposure to tobacco &
cigarette smoke
• 4. Have periodic preventive medical
exams.
CEREBROVASCULAR DISEASE

• Results from:
– changes in blood vessels that serve the
brain tissue
– cerebral infarction
– cerebral hemorrhage
• When a portion of the brain is
completely denied blood, a
cerebrovascular accident (CVA), or
stroke results

• Severity is determined by location

and total amount of brain tissue
involved
• After diseases of the heart,
malignant neoplasms, & accidents,
cerebrovascular disease is the
fourth-leading cause of death in the
U.S.
Cerbral Thrombosis

• Main cause of stroke in o.a.’s

• Occurs when a formed clot becomes

lodges in an already narrowed artery.
• Stroke in evolution:

– May develop over hours or even days

– Symptoms can appear within minutes or
hours after onset
Transient ischemic attacks
(TIA’S)--”mini-strokes”
• Warning signs of an impending stroke
• Transitory symptoms:
– sudden motor weakness
– speech dysfunction
– dizziness
– sudden changes in vision (especially in
one eye)
– sudden falls
Cerbral Embolism: Another
cause of strokes
• Thrombus forms elsewhere in the
body and travels to obstruct a vessel
supplying the brain

• The onset of the stroke and its

damage is immediate
Damage from Strokes

• One-sided weakness or paralysis

• Sensory disturbances
• Aphasia (speech disorders)
• Mental symptoms

• Rehab should begin immediately

APHASIA

• Impaired ability to comprehend or

express verbal language
• Receptive aphasia:
– difficulty in processing external stimuli;
– may not understand other’s speech or
what is read
– familiar objects may become
unrecognizable
• Expressive aphasia
– A person understands what is said but
cannot form the words or gestures to
respond to stimuli

– May be incorrectly associated with

mental deterioration