Abstract The elderly are an important part of any society and ought to be cared for in the best possible ways. The internal body systems undergo a variety of changes as age advances. These changes affect organ integration and cause certain homeostatic imbalances in the body. Proper care can only be advanced if care providers understand, and know how to respond to these changes. This text explores these changes and examines the actual mechanisms behind them.
Physiological Changes Associated With Aging
Aging is the complex and inevitable process of tissue and organ system degeneration. Though largely influenced by genetics, aging is also dependent upon a number of environmental factors including exercise, diet, childhood personality, and exposure to ionizing radiation, pollutants, or microorganisms. The physiological changes that occur as an individual's age advances can be grouped into three, with the first category encompassing changes in such homeostatic mechanisms as extracellular fluid volumes, blood, and temperature; the second encompassing changes related to decreasing organ mass; and the third, changes in the body's functional reserve systems. Promoting the health of an aging population is crucial not only because it ensures the well-being of ageing individuals, but also because it significantly reduces the burden imposed upon a country's medical system. It is with this in mind that this text collates knowledge and research to examine, in a deeper sense, the physiological changes associated with aging.
Summary
Bherer, Erickson and Liu-Ambrose (2013); Saber, 2013
Bherer et al. (2013) express that the physiological changes associated with aging are more pronounced among individuals aged above 85, although this basically depends upon one's lifestyle and genetic factors. Saber (2013) posits that these changes may affect an individual's response to illness and functional reserve stressors. Both articles outline a variety of physiological changes associated with aging. These, together with their etiologies, implications, and assessment parameters have, for purposes of simplicity, been put together, organized, and summarized in the tabular representation below.
Associated Changes
Etiology
Implications
Cardiovascular changes
-stiffening and thickening of arterial walls, reduced compliance
-mitral and atrial valve sclerosis brought about by atrial and left ventricular hypertrophy
-cool extremities brought about by decreasing peripheral and increasing arterial pulses
-Low cardiac reserve;
a) No change in cardiac output or heart rate when individual is at rest
b) Diminished cardiac output, giving rise to slow tachycardia recovery, shortness of breath and fatigue when individual is under stress
-Inflamed varicosities, increasing the risk of hypertension, or diuretic-induced hypotension
Pulmonary system
-Stiff chest wall and diminished muscle strength
-reduced cough reflex, macrophage and ciliary activity
-reduced hypercapnia and hypoxia responses
-Low pulmonary reserve;
a) No change at rest
b) Diminished exercise tolerance, and dyspnea, while under stress
-decreased clearance of foreign matter through mucus and cough
-diminishing respiratory excursion, at times as low as 12-24 breaths per minute
Genitourinary and renal systems
GFR (renal function) determination / calculation of the rate at which creatinine clears)
-Diminishing drug clearance, kidney mass, and reduced blood flow
- Decreased muscle tone and bladder elasticity
-Increased nocturnal urine production
-enlargement of the prostrate in males, with a high BPH risk
-Low renal function reserve
-adverse reaction to drugs
-urine incontinence
Gastrointestinal and oropharyngeal systems
The mass index of a relatively healthy body essentially falls between 18.5 and 24.9kg/m2; 25-29.9 represents overweight, and 30 plus represents obesity
-decreased drug metabolism due to diminishing hepatic activity
-Impaired defecation sensation
-Protective mucosa atrophy
-Delayed emptying of the stomach
-chewing impairment, leading to electrolyte imbalance and eventually, poor nutrition
-high risk of acid-induced ulcers and GERD maldigestion due to altered absorption of drugs
-Fecal incontinence
Musculoskeletal system
Reduction in muscle strength and mass
-diminished exercise tolerance
-Fat redistribution, resulting in lean body mass
-Bone fractures
-height reduction, erosion of articular cartilage, and reduced tendon strength
-unstable gait, increasing the risk of disability
-high osteoporosis and osteopenia risks
-osteoarthritis risk
Cognition and nervous system
-reduction in transmitters and neurons
-cerebral dendrites modification
-impaired thermoregulation
- neurodegenerative diseases and sleep disorders
-slow cognitive processing speed
-absent or blunted fever response
-reduced coordination and balance
(Own-generated table)
Heckman, Gray and Hirdes (2013)
The authors make use of "a common scenario, in which an older community-dwelling person with underlying frailty develops an acute medical condition complicated by geriatric symptoms" (p. 10). The study results indicate that frail older adults are more likely to suffer from low systolic blood pressure. This, the authors opine, can be associated with the impairment of the cognitive system and increased mortality among frail individuals. This low systolic blood pressure impacts negatively on the individual's overall health and can be a major cause of cardiovascular disorders (Heckman et al., 2013; Bherer et al., 2013). In summary, this article dwells specifically on the change to the cognitive system associated with aging and reports that the reduction in transmitters and neurons, and the subsequent impairment of the thermoregulation system inhibit the effective functioning of the cognitive system and lead to the worsening of the associated cardiovascular changes.
Moreover, the associated change gives rise to "new concerns, including behavioral and communication problems (likely related to delirium), incontinence, pain, mobility problems, acute decline in basic activities of daily living," and higher risks of functional decline (Heckman, Gray & Hirdes, 2013, pp. 11-12).
Glassock (2009)
This article dwells on GFR decline as a change associated with senescence. The author points out that "the decline in GFR is a normal and expected phenomenon that does not in, and of itself confer any selective disadvantage upon the individual, unless other diseases are superimposed" (Glassock, 2009). The article points out that the kidney's excretory function and the strength of bladder contraction diminish with aging, creating incontinence and voiding problems in women, and prostate enlargement in males, and increasing vulnerability to genitor-urinary system cancers. The author's main point, however, is that this particular associated change is an inevitable, integral, and predictable part of aging, and not a disease as some have argued.
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