1

Late adulthoodyears after 65

2

• Late adulthood can be divided into:– Young old 65 – 74 years– Middle old 75 – 84 years– Old old over 85 years

• Geriatrics: is the term for medical speciality that addresses the diagnosis and treatment of the physical problems of elderly person

• Gerontology: is a science that study all aspects of the aging process including biologic, psychologic and sociologic factors

3

Biologic theories of aging

• Wear and tear theories: – Dr. August Weismann, a German biologist, first introduced

this theory in 1882. – He believed that the body and its cells were damaged by

overuse and abuse. – The organs, liver, stomach, kidneys, skin and so on are

worn down by toxins in our diet and in the environment; by the excessive consumption of fat, sugar, caffeine, alcohol and nicotine; by the ultra-violet rays of the sun and by the many other physical and emotional stresses to which we subject our bodies.

4

Biologic theories of aging

– Wear and tear is not confined to our organs, however; it also takes place on the cellular level.

– When we are young the body's own maintenance and repair systems keep compensating for the effects of both normal and excessive wear and tear

– With age the body loses its ability to repair damage caused by diet, environmental toxins, bacteria or a virus

5

Biologic theories of aging

• The Neuroendocrine Theory– Proposes that changes in hormone production result in

organism’s decline– When we are young, our hormones work together to

regulate many bodily functions, including our responses to heat and cold, our life experiences and our sexual activity

– Hormones are vital for repairing and regulating our bodily functions, and when aging causes a drop in hormone production, it causes a decline in our body's ability to repair and regulate itself

6

• The Genetic Control Theory :– We are born with a unique genetic code, a predetermined

tendency to certain types of physical and mental functioning, and that genetic inheritance has a great deal to say about how quickly we age and how long we live

• Cross – linking theory:– Proposes that chemical reactions create strong bonds

between proteins these bonds cause loss of elasticity, stiffness and loss of function

7

• Autoimmune Theory – Proposes that immune system becomes less

effective that incubated viruses in the body damage the body organs.

– Also a reduction in immune function will increase autoimmune responses causing the body to produce antibodies that attack itself

8

Integumentary system • Skin:

– dry, fragile and pale– Wrinkling and sagging in skin, eyelids, ear lobs,

breast due to decrease elasticity and subcutaneous fat

– Appearance of Lentigo Senilis (brown age spots) due to clustering of melanocytes (pigment cells)

– Women may start to have facial hair• Hair loses color• Fingernails and toenails become thickened and

brittle• Losses of subcutaneous fat decreases elderly

tolerance of cold (hypothermia is a major health problem)

9

Neuromuscloskeletal

• Steady decrease in muscle fibers and muscle tones• Reduction of speed and power of muscle contractions• Elderly may experience impaired balance (due to

slower reaction time)• Loss of overall stature (due to atrophy of

intervertebral discs)• Stooping posture due to muscle weakness and

kyphosis: curved posture, the head down, the back and knees bent, and a forward pitch with small, shuffling steps when walking.

10

• The loss of bone density and mass causes a compression of the bones especially in the vertebral area creating a slight decrease in height

• Osteoporosis due to bone demineralization causing bones break more easily

• A loss of cartilage makes painful joint complaints more common and contribute to a decrease range of movement and mobility

11

12

Osteoporosis is a weakening of bones due to loss of bone density.

Osteoporosis is preventable to a very large extent by calcium intake and regular load-bearing exercise, such as weight training.

13

14

Sensory/ perceptual

• Eyes: – Shrunken appearance due to loss of orbital

fat. – Slow blinking reflex – Looseness of the eyelids particularly the

lower lid due to poorer muscle tone. – Continue loss of visual acuity, less power to

adapt to sudden changes to more or less light or near to far objects (temporary blindness): hazard of night driving.

15

–Difficulty in discriminating similar colors.–May have • Cataract• Glaucoma• Reduce peripheral vision • And arcus senilis (white circle around the iris: it

is a peripheral corneal opacity caused by a deposition of phospholipid and cholesterol granules in the corneal stroma )

16

• Hearing: after age 75, 50% or more have hearing deficits: higher tones are more difficult to hear than low ones

• Smell and taste: older people, especially men, experience losses in both taste and smell, which may result in decreased appetite.

• Touch: loss of skin receptors causing decrease sensation of pain, touch and temperature places the elderly at risk for burn or injuries.

17

Pulmonary

• Decreases inhalation of air due to musculoskeletal changes and calcification of costal cartilage which decreases lung expansion thus decreasing respiratory rate

• Residual air will be greater (weaker expiratory muscle)

• Decreased cough efficiency with age thus mucous secretions tend to collect more often causing infection

• Dyspnoea with exercises

18

Cardiovascular

• Heart working capacity will decrease especially during exercises

• Heart rate slow in responding and slow to return to normal after physical activity

• Decreased the arterial elasticity will reduce the blood supply to legs causing calf pain and to the brain causing dizziness.

19

Gastrointestinal

• Delayed in swallowing time• Increase tendency of indigestion due to

decrease digestive enzymes and decrease muscle tone of GI system

• Low absorption rate of nutrients and drugs due to decrease number of absorbing cells in GI

• Decreased peristalsis movements causing constipation.

20

Urinary

• Decreased numbers of functioning nephrons lead to diminished kidney function

• Urinary urgency and frequency are common in elderly due to enlarged prostate in men and weakness in muscles that support the bladder in women

21

Cognitive development

• An old adult maintains cognitive skills however, this will be affected with disease processes

• Memory: age related problems occur in short-term memory

• Old person needs more time to learn due to problem with retrieving information

22

Health problems in late adulthood:

23

Health problems

• Dementia: – is a permanent or progressive organic mental

disorder– It is a declining of cognitive abilities, characterized

by personality changes, confusion, disorientation and deterioration of intellectual functioning and memory.

– The most common type of irreversible dementia is Alzheimer’s disease (AD)

24

• Most prominent symptoms of AD are steady decline in memory, learning, attention, judgment, orientation and language skills as well as decline in physical abilities.

25

Health problems in late adulthood:

Alois Alzheimer

Alzheimer’s disease affects a growing number of older persons—especially those over 80 year.

Cause is not known, but involves deterioration of the brain’s abilities to maintain itself.

26

27

• Parkinson’s disease: – Parkinson's disease is a chronic, progressive

neurodegenerative movement disorder. Tremors, rigidity, slow movement (bradykinesia), poor balance, and difficulty walking (called parkinsonian gait) are characteristic of Parkinson's disease.

– The cause is unknown (idiopathic)

28

– Parkinson's results from the degeneration of dopamine-producing nerve cells in the brain

– Dopamine is a neurotransmitter that stimulates motor neurons, those nerve cells that control the muscles. When dopamine production is depleted, the motor system nerves are unable to control movement and coordination.

– Parkinson's disease patients have lost 80% or more of their dopamine-producing cells by the time symptoms appear.

29