Degenerative joint changes dehydration of

Degenerative joint changes
 Dehydration of intervertebral disk
 Fat tissue increase
 Neurological
 Degeneration of nerve cells
 Decrease in neurotransmitters
 Decrease in rate of conduction of impulses
 Sensory
 Eyes: Decrease accommodations to near/far vision, smaller pupils
 Ears: Loss of acuity for high frequency tones, build-up of earwax
 Taste: Often diminished, often fewer taste buds
 Smell: Often diminished
 Touch: Decreased skin receptors
 Proprioception: Decreased awareness of body positioning in space
 Genitourinary
 Fewer nephrons, 50% decrease in renal blood flow by age 80, decreased bladder
capacity
 Male: enlargement of prostate
 Female: Reduced sphincter tone
 Reproductive
 Male: Sperm count diminished, smaller testes, erections less firm and slow to
develop
 Female: Decreased estrogen production, degeneration of ovaries, atrophy of
vagina, uterus, breasts
 Endocrine
 General- alterations in hormone production with decreased ability to respond to
stress
 Thyroid- diminished secretions
 Cortisol, Glucocorticoids- increased anti-inflammatory hormone
 Pancreas- increased fibrosis, decreased secretion of enzyme and hormones,
decreased sensitivity to insulin
 Immune System
 Thymus decreases in size and volume
 T-cell function decreases
 Core temperature elevation is lowered.
 Functional Changes
 Functional status includes day to day ADLs within physical, psychological,
cognitive and social domains
 May be difficult for patient to accept loss of independence/functionality
with aging
 Capacity for and safe performance of ADLs is a sensitive indicator of
health or illness
 Comprehensive assessment may include Occupational and Physical
Therapists
 A sudden change in function is often a sign of onset of acute illness:
 Such as pneumonia, electrolyte imbalance, urinary tract infection
 or worsening (exacerbation) of a chronic problem:
 such as diabetes, CV disease, COPD
 ADLs (bathing, dressing, toileting)
 IADLs: instrumental ADLs (ability to write a check, shop, prepare meals, make
phone calls)
 Patient Education : promotes understanding of age-related changes, appropriate
lifestyle adjustments, effective coping
 Factors that promote highest functioning : healthy well-balanced diet, paced
and appropriate activity, regular visits with healthcare provider, participation in

Unit 4 Objectives
meaningful activities, use of stress management techniques, and avoidance of
alcohol, tobacco and illicit drugs
 Cognitive Changes
 Symptoms of cognitive impairment: Disorientation, loss of language skills,
loss of ability to calculate, exhibiting poor judgment ARE NOT normal changes due
to aging
 Delirium
 Sudden onset
 Causative factors: Fever, hypoglycemia, electrolyte imbalance
 Impaired memory, judgment, disorganized thinking, incoherent
 Altered LOC
 Increased or decreased activity
 Rapid mood swings
 Rapid inappropriate speech
 REVERSIBLE
 Dementia (5 A’s of dementia: Aphasia, Amnesia, Apraxia, Agnosia,
Anomia)
 Slow duration
 Causative factors: Alzheimer’s, Vascular ds
 Memory loss, aphasia, ataxia, impaired judgment