Age Related Changes
Cognition includes:
- Attention span, concentration, intelligence, judgement, learning ability, memory, orientation, perception, problem solving, psychomotor ability, reaction time and social intactness
Some functions remain *STABLE* and some may decline
- Attention span, language skills, communication skills, comprehension and visual perception
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
Universal Aging
- Changes are expected for all people, even though they happen at different rates
Intrinsic Aging
- Changes are not modifiable. Due to the causes or elements within the body
Changes
- Changes of aging highly individualized - Changes different in various body systems of individuals
Changes in the Body: CELLS
- Changes start at basic cellular level - Number of cells is reduced - Reduction in lean body mass - Total body fat increases - Decrease in intracellular fluid
Use it or lose it - applies to:
- Cognitive function as well as physical function
Use it or lose it!
- Cognitive functions may remain stable or may decline with increasing age - Early research was cross-sectional rather than longitudinal and often conducted with older adults with illness or institutionalized - Often measured against younger people which may not be appropriate to the distinctive characteristics of older adults - Many tests were designed for young children and most do not address cultural or ethnic differences - Tests often have little relevance to the daily function of older people
Cognition in old age is:
- Dynamic and may even improve eg vocabulary score increase into the 70's
Functional capacity
- Ex. Ventilatory capacity, muscular strength, and cardiovascular output - Increases in childhood and peaks in early adulthood, eventually followed by a decline - Rate of decline largely determined by factors related to adult lifestyle - such as smoking, alcohol consumption, levels of physical activity and diet & external / environmental factors - Gradient of decline may become so steep as to result in premature disability - Acceleration in decline influenced/may be reversible at any age through individual/public policy measures
Cognition in old age . . . is:
- Fraught with myths - Dynamic and may even improve - Stable in some functions; while other functions may decline - Moderated by education - Enhanced by physical activity and cognitive exercise
Changes Influenced by:
- Genetic factors - Long term lifestyle factors: physical activity, diet, alcohol consumption, tobacco use
What is Aging?
- Normal developmental event - Aging is normal and relates to the maturing organism - Results eventually in a person's death - Some will argue that development begins at conception, and aging begins at 30 - Great diversity among individuals as they age, mostly related to lifestyle habits and disease - It begins with conception and continues throughout life until we die
Progressive Aging
- Not reversible
What do these changes mean? (Neurological)
- Reduction in nerve cells, cerebral blood flow, and metabolism - Slower reflexes, delayed responses, and changes in balance - Changes in sleep patterns - Health of the nervous system affected by all other body systems
NEUROLOGIC SYSTEM
- Reduction in nerve cells, cerebral blood flow, and metabolism - Slower reflexes, delayed responses, and changes in balance - may perceive things differently - Health of the nervous system affected by all other body systems - Changes in sleep patterns - Loss of nerve cell mass - Atrophy of the brain and spinal cord - Number of nerve cells declines - Slower nerve conduction - Response and reaction times are slower - Reflexes become weaker - Plaques, tangles, and atrophy of the brain - Free radicals accumulate - Decrease in cerebral blood flow - Intellectual performance unchanged until at least 80 years of age - Slowing in central processing - Delay in time required to perform tasks - Verbal skills maintained until age 70 - Number and sensitivity of sensory receptors, dermatomes, and neurons decrease - Dulling of tactile sensation - Decline in function of cranial nerves affecting taste and smell - SLOWER PROCESSING SPEED!
Decremental Aging
- System/organ/tissue function is effected in ways which impair adaptation
Working memory
- Temporary storage and active manipulation of information (backwards list) may show some decline - May have more difficult remembering newly presented information - word lists, details of events, or context in which something occurred; word finding "tip of the tongue" experiences - May report more everyday memory problems (remembering names)
Physiological Aging
- Universal - Progressive - Decremental - Intrinsic
Some functions remain stable and some may *DECLINE*
- Verbal fluency, logical analysis, selective attention, object naming, complex visual spatial skills - Processing speed or the rate at which perception and execution of decision occurs declines with age Ex. Slowing of response time somewhat slower
Why are the age relating changes (ARC's) important in nursing assessment and care of the older adult?
1. Changes associated with normal aging need to be differentiated from pathological processes in order to develop appropriate interventions 2. Manifestations of aging can adversely impact the health and functional capability of older adults and require therapeutic strategies to correct 3. Age Related Changes predispose older persons to selected diseases 4. Aging and illness may interact reciprocally, resulting in altered presentation of illness, response to treatment and outcomes
Cerebral blood flow decreases by 50% in older adults?
FALSE - Decreases by 20%
What about cognition?
The process of acquiring, storing, sharing, and using information
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 1 and 2 sleep are interrupted d) Higher nerve conduction velocity