2. CONTENTS
Definition of elderly…
Epidemiology of aging
Changes during process of aging and how does it occur
What is geriatrics? Giant of Geriatric?
3. Definition
WHO: People who are 65 years old or more.
MALAYSIA : Elderly those with the age of 60
and above
“elderly” a chronological age of 65 years old or older,
65 ->74 years old “early elderly” and those over
75 years old “late elderly.
Geriatrics & Gerontology International, Volume 6, Issue 3,pages
149–158, September 2006
4. Epidemiology
In 2006, almost 500 million people worldwide were 65
and older. By 2030 1 billion (1 in every 8 of the earth’s
inhabitants.)
5. MALAYSIA
Population of Malaysian >60 years in
1995 5.9%,
2000 6.6%
2009 7.1% (2.03M)
Projected percentage of elderly in 2020 9.8%
Department of Statistics Malaysia. 2010
6. THE AGING PROCESS
A process of gradual and spontaneous
change, resulting in maturation through
childhood, puberty, and young adulthood
and then decline through middle and late
age
7. CHANGES OCCURING DURING
AGING
Overview
Alter the older person’s response to illness
show great variability among individuals
often impacted by genetic and long-term
lifestyle factors
commonly involve a decline in functional
reserve with reduced response to stressors.
8. General
Increase body fat
Prone to get obesity
Prone to get weight bearing disease(arthritis)
Higher chances to get chronic diseases
eg: Diabetes and Hypertension
Reduce total body water
Risk of dehydration
10. Age-Associated Cardiovascular
Changes
CHANGES IMPLICATIONS
Decreased exercise tolerance-
Arterial wall thickening and > fatigue, SOB
stiffening, decreased
compliance.
Risk of arrhythmias
Left ventricular and atrial
hypertrophy.
Sclerosis of atrial and mitral Diminished peripheral
valves. pulses, cold extremities.
Reduced arterial compliance
Reduced β-adrenergic response Increased blood pressure
Reduced baroreceptor sensitivity
Reduced SA node automaticity postural hypotension
11. Age-Associated Gastrointestinal
changes
CHANGES IMPLICATIONS
Decreases in strength of muscles of
Risk of malabsorption,
fluid/electrolyte imbalances, poor
mastication, taste, and thirst nutrition.
perception.
Gastric changes: Increased risk
Decreased gastric motility with (GERD), maldigestion, NSAID-
delayed emptying. Atrophy of induced ulcers.
protective mucosa.
Constipation. Risk of fecal
incontinence.
Colonic contraction less effective &
impaired sensation to defecate. Decreased metabolism of drugs.
Risk of adverse drug reactions.
Liver size and blood flow are
reduced -> hepatic reserve
decrease.
12. Age Associated Changes in Musculoskeletal
System
CHANGES IMPLICATIONS
Decreased muscle mass Sarcopenia: increased risk of
disability, falls, unstable gait.
Decreased myosin adenosine
Risk of osteopenia and
triphosphatase activity osteoporosis.
Deterioration and drying of Limited range of motion, joint
joint cartilage. instability, risk of osteoarthritis.
Muscle weakness/ muscle
Decreased bone mass and
fatigue
osteoblastic activity
13. Age associated changes in CNS
CHANGES IMPLICATIONS
Impairments general muscle
strength; reflexes; nerve
Decrease in neurons, conduction velocity, slowed motor
neurotransmitters, dendrites skills and deficits in balance and
and synapses brain atrophy coordination.
Changes in autonomic Decreased temperature sensitivity.
hypo/hyperthermia
regulation -> Compromised
thermoregulation.
Slowed speed of cognitive
processing.
Reduced :
Brain catecholamine synthesis Increased risk of sleep disorders,
delirium, neurodegenerative
Brain dopamine synthesis diseases.
14. Age associated changes in
endocrine function
CHANGES IMPLICATIONS
Impaired glucose DM
homeostasis Thyroid dysfunction
Reduced thyroxine clearance Metabolic abnormalities
Increase ADH, reduce renin (Low Na+, high K+)
and aldosterone impotence
Reduce testosterone fracture
production
Reduce vitamin D absorption
and activation osteopenia
15. Age associated changes in urinary
system
CHANGES IMPLICATIONS
Decreases in kidney mass, blood Reduced renal functional
flow, GFR reserve; risk of renal
complications in illness.
Reduced bladder elasticity,
muscle tone, capacity. Risk of nephrotoxic injury
and adverse reactions from
Increased post-void residual, drugs.
nocturnal urine production.
Increased risk of urinary
In males, prostate enlargement urgency, incontinence, UTI,
with risk of (BPH). nocturnal polyuria.
16. References:
Geriatrics & Gerontology International, Volume 6
Primary Care Geriatrics 5th Edition. Ham, Sloane, Warshaw, Bernard,
Flaherty. 2007. Mosby
Encyclopedia of Aging And Public Health By Sana Loue, Martha
Sajatovic
Thank you
Notes de l'éditeur
We are aging—not just as individuals or communities butas a worldRefine last point
? Source of Malaysian data State latest % elderly Mlaysian pop. & projected % of elderly in 2POPULATION 2010-28M2020-33.3m
Many physiologic fns deteriorate..
Respiratory rate 12 to 24 bpm.A. Assess respiration rate, rhythm, regularity, volume, depth, exercise capacity. Ascultate breath sounds throughout lung fields. B. Inspect thorax, symmetry of chest expansion. Obtain smoking history. C. Monitor secretions, breathing rate during sedation, positioning, , arterial blood gases, pulse oximetry. D. Assess cough, need for suctioning.
CPY3A ( component in cytochrome P450) activity reduced up to 50 %
Sarcopenia (from the Greek meaning "poverty of flesh") is the degenerative loss of skeletal muscle mass and strength associated with aging (0.5-1% loss per year after the age of 25). Sarcopenia is a component of the frailty syndrome.The frailty syndrome is a collection of symptoms or markers, primarily due to the aging-related loss and dysfunction of skeletal muscle and bone, that place (mostly) older adults at increased risk of adverse events such as death, disability, and institutionalization.Degenerative loss of msk muscle mass and strength a/w aging.1% loss per year after 25 y/oSarcopeniaOsteoporosisMuscle weakness
POSTprandial glucose tolerence is impaired w age (inc 10 mg/dL per decade)
CSS-creatinine clearance decline rate 10ml per decade.