Annisa7 TUMBANG - Docxa

2010
AGING PROCESS
Annisa Rahim-012106082
LBM 5_ SGD7-TUMBANG im not pretty anymore STEP 1 Saggy/slacker: artinya kendor STEP 2 1. Why her skin looked more saggy/slacker,especially around the eyes? 2. Why weight decreased and her body shape got thinner? 3. What the physiology of aging process? 4. Why she hasnt menstruation anymore since 5 years ago? 5. Why her vision was getting blulrred and her hearing began to decline? 6. Why she was so easy to fall off? 7. Why she felt so dizzy and got balance disorders? 8. What is healthy life style? 9. What are changes occurred in elderly? 10. What usually disease occurred in elderly?
STEP 3 1. Why her skin looked more saggy/slacker,especially around the eyes? Pada usia lansia (>50 thn) fungsi sel berkurang, ada penurunan kemampuan untuk beregenerasi.jadi jika sel rusak tidak akan terjadi perbaruan dan sel mudah rusak. Produksi kolagen turun elastisitas kulit turunkendor Turgor kulit juga turun pada lansia 2. Why weight decreased and her body shape got thinner? Pada lansia masa otot berkurang secara bermakna tampak kurus Bb turun masa otot berkurang & kulit kendorberat badan berkurang - Pengaruh pada menopause shg lemak tubuh berkurang - Ukuran gaster berkurangdaya tampung berkurang,sekresi asam lambung berkurang,rangsang lapar juga berkurang,mukosa usus halus jg atrofi shg penyerapan juga berkurang. 3. What the physiology of aging process? There many teory : a. T.Radikal bebas adanya radikal bebas dlm tubuhakumulasimenempel pada jaringan lemak tak jenuhmerubah struktur mitikondriamengganggu repair DNAberpengaruh pada kolagenkendor b. T.Glikolisis c. T.Dna repair
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d. T.Genetic e. T.metabolic 4. Why she hasnt menstruation anymore since 5 years ago? Decrease of hormonal(testosterone,estrogen,androgen) not reproduce fertile egg not menstruationdecrease libido 5. Why her vision was getting blurred and her hearing began to decline? - Endogen factor change anatomic organphysiology fungtion the organ decrease Eksogenic factor life style and environment In elderly usually presbiophichange the lensemore thickernot elasticblurred eyes
6. Why she was so easy to fall off? - Disorder hormonal (estrogen) influent of bone mass its more weaker than before to support her body weight In elderlyperubahan di sirkulasi otakinsufisiensi di sirkulai otakkrn a.vertebralis berkelokkurang pasokangampang pusing mudah jatuh
- Banyak factor : Rabun mata Mudah jatuh Neuromuskular gerakan mendadak aliran darah bg otak serebelum terganggumenghilangkan reflek mempertahankan postur tubuh Menurunnya masa otot dan tulang Vertigo
7. Why she felt so dizzy and got balance disorders? - Banyak factor : o Rabun mata Mudah jatuh o Neuromuskular gerakan mendadak aliran darah bg otak serebelum terganggumenghilangkan reflek mempertahankan postur tubuh o Menurunnya masa otot dan tulang o Vertigo 8. What is healthy life style? Sel jarang digunakansel mudah rusakjadi harusnya dijaga dgn tetap menggunakan selnya itu misal dengan berolahraga,tetap aktivias, bersosialisasi dengan sesama Definisi? Apa saja yg biasa dilakukan untuk hidup sehat?
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Mengurangi asupan kalorimemperpanjang umur Menambah suplemen vitamin a,d,e,k 9. What are changes occurred in elderly?(physic and psychology) Physic - The vascular system have 3 membran :intima,muscular,serosa. In muscular membranedecrease elasticity of vascular because change the structure of muscular membrane to soft tissue .it can cause hypertention disease - Respiratory system decreaseelastisitas lung decrease pengembangan paru menurun Psychology bored, lonely, utk wanita biasanya iri pada yg lebih muda, merasa ingin diperhatikan,mudah lupa - Bagaimana perubahan sistem reproduksi antara pria dan wanita pada lansia? 10. What usually disease occurred in elderly? - Hypertension - Osteoporosis - Skin disease - Cancer - Katarak - DM (dikasih definisi)
STEP 4 Maping
STEP 5 1. Why her skin looked more saggy/slacker,especially around the eyes? 2. 3. 4. 5. Why weight decreased and her body shape got thinner? What the physiology of aging process? Why she hasnt menstruation anymore since 5 years ago? Why her vision was getting blurred and her hearing began to decline?
6. Why she was so easy to fall off? 7. Why she felt so dizzy and got balance disorders? 8. What is healthy life style? Definisi? Apa saja yg biasa dilakukan untuk hidup sehat? 9. What are changes occurred in elderly?(physic and psychology) - Bagaimana perubahan sistem reproduksi antara pria dan wanita pada lansia? 10. What usually disease occurred in elderly? - Hypertension - Osteoporosis - Skin disease - Cancer - Katarak - DM (dikasih definisi)
STEP 6 Independent learning
STEP 7
1. Why her skin looked more saggy/slacker,especially around the eyes? Cari proses regenerasi sel? Yg berperan apa aja? - Elastisitas: dipengaruhi oleh? - Massa otot? - Hubungan dg hormone?
With aging, the outer skin layer (epidermis) thins even though the number of cell layers remains unchanged. The number of pigment-containing cells (melanocytes) decreases, but the remaining melanocytes increase in size. Aging skin thus appears thinner, more translucent. Age spots or liver spots may appear in sun-exposed areas. Changes in the connective tissue reduce the skin's strength and elasticity. This is known as elastosis and is especially pronounced in sun-exposed areas. http://adam.about.net/encyclopedia/Changes-in-face-with-age_1.htm http://seniorliving.about.com/od/healthnutrition/a/aging101part1.htm wajah kulit di palpebra perubahan? Aging changes in skin Definition Aging changes in the skin are a group of common conditions and developments that occur as people grow older. Alternative Names Wrinkles - aging changes; Thinning of skin Information
Skin changes are among the most visible signs of aging. Evidence of increasing age includes wrinkles and sagging skin. Whitening or graying of the hair is another obvious sign of aging. Your skin does many things. It protects you from the environment, helps control your body temperature and fluid and electrolyte balance, and contains nerve receptors that allow you to feel sensations such as touch, pain, and pressure. Although skin has many layers, it can be generally divided into three main parts:

The outer part (epidermis) contains skin cells, pigment, and proteins. The middle part (dermis) contains blood vessels, nerves, hair follicles, and oil glands. The dermis provides nutrients to the epidermis. The inner layer under the dermis (the subcutaneous layer) contains sweat glands, some hair follicles, blood vessels, and fat. Each layer also contains connective tissue with collagen fibers to give support and elastin fibers to provide flexibility and strength. Skin changes are related to environmental factors, genetic makeup, nutrition, and other factors. The greatest single factor, though, is sun exposure. This can be seen by comparing areas of your body that have regular sun exposure with areas that are protected from sunlight. Natural pigments seem to provide some protection against sun-induced skin damage. Blueeyed, fair-skinned people show more aging skin changes than people with darker, more heavily pigmented skin. AGING CHANGES With aging, the outer skin layer (epidermis) thins, even though the number of cell layers remains unchanged. The number of pigment-containing cells (melanocytes) decreases, but the remaining melanocytes increase in size. Aging skin thus appears thinner, more pale, and clear (translucent). Large pigmented spots (called age spots, liver spots, or lentigos) may appear in sun-exposed areas. Changes in the connective tissue reduce the skin's strength and elasticity. This is known as elastosis and is especially pronounced in sun-exposed areas (solar elastosis). Elastosis produces the leathery, weather-beaten appearance common to farmers, sailors, and others who spend a large amount of time outdoors. The blood vessels of the dermis become more fragile. This leads to bruising, bleeding under the skin (often called senile purpura), cherry angiomas, and similar conditions.
Sebaceous glands produce less oil as you age. Men experience a minimal decrease, usually after the age of 80. Women gradually produce less oil beginning after menopause. This can make it harder to keep the skin moist, resulting in dryness and itchiness. The subcutaneous fat layer thins, reducing its normal insulation and padding. This increases your risk of skin injury and reduces your ability to maintain body temperature. Because you have less natural insulation, you can get hypothermia in cold weather. Some medications are absorbed by the fat layer, and loss of this layer changes the way that these medications work. The sweat glands produce less sweat. This makes it harder to keep cool, and you are at increased risk for becoming overheated or developing heat stroke. Growths such as skin tags, warts, and other blemishes are more common in older people. EFFECT OF CHANGES As you age, you are at increased risk for skin injury. Your skin is thinner, more fragile, and the protective subcutaneous fat layer is lost. In addition, your ability to sense touch, pressure, vibration, heat and cold may be reduced. Thus, your skin is at higher risk for injury. Rubbing or pulling on the skin can cause skin tears. Fragile blood vessels are easily broken. Bruises, flat collections of blood (purpura), and raised collections of blood (hematomas) may form after even a minor injury. This is most easily seen on the outside surface of the forearms, but can occur anywhere on the body. Skin changes and loss of subcutaneous fat, combined with a tendency to be less active, as well as some nutritional deficiencies and other illnesses contribute to pressure ulcers. Aging skin repairs itself more slowly than younger skin. Wound healing may be up to 4 times slower. This contributes to pressure ulcers and infections. Diabetes, blood vessel changes, lowered immunity, and similar factors also affect healing. COMMON PROBLEMS Skin disorders are so common among older people that it is often difficult to tell normal changes from those related to a disorder. More than 90% of all older people have some type of skin disorder. Skin disorders can be caused by many conditions, including:

Blood vessel diseases such as arteriosclerosis Diabetes

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Heart disease Liver disease Nutritional deficiencies Obesity Reactions to medications Stress Other causes of skin changes:
Allergies to plants and other substances Climate Clothing Exposures to industrial and household chemicals Indoor heating Sunlight can cause:
Loss of elasticity (elastosis) Noncancerous skin growths (keratoacanthomas) Pigment changes such as liver spots Thickening of the skin Sun exposure has also been directly linked to skin cancers, including basal cell epithelioma, squamous cell carcinoma, and melanoma. PREVENTION Because most skin changes are related to sun exposure, prevention is a lifelong process.
Prevent sunburn if at all possible. Use a good quality sunscreen when outdoors, even in the winter. Wear protective clothing and hats as necessary. Good nutrition and adequate fluids are also helpful. Dehydration increases the risk of skin injury. Sometimes minor nutritional deficiencies can cause rashes, skin lesions, and other skin changes, even if you have no other symptoms. Keep skin moist with lotions and other moisturizers. Do not use soaps that are heavily perfumed. Bath oils are not recommended because they can cause you to slip and fall. Moist skin is more comfortable and will heal more quickly. http://adam.about.net/encyclopedia/Aging-changes-in-skin.htm
Within the basal layer (stratum basale) of elderly skin the ability to produce new and robust skin cells is slowed down. This reduces the skins thickness. The cells of elderly skin are less robust and produce less cell-binding lipids. The upper layer (stratum corneum) of elderly skin becomes porous, fragile and dry. This results in a weakened barrier function. The skin is prone to outer influences and loss of moisture from the inside. The skins acid protection mantle is an invisible barrier against bacteria and fungi. Elderly skin becomes porous and doesnt regenerate half as quickly as young skin.
http://www.aktiverhautschutz.ch/en/skin-incontinence/healthy-skin-andelderly-skin.html
References Minaker KL. Common clinical sequelae of aging. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 23.
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2. Why weight decreased and her body shape got thinner? Hubungan dg hormone estrogen dll? Massa tubuh? cairan dalam tubuh? massa otot? Lemak? Metabolisme? Penyerapan? Pencernaan? Bagaimana perubahan anatomi, fisiologi, biokimia?
Aging changes in body shape Information Many people are concerned with changes in their body shape as they age. Although some changes inevitably occur with aging, your lifestyle choices may slow or speed up these changes. The human body is made up of fat, lean tissue (muscles and organs), bones, water, and other substances. As we age, the amount and distribution of these materials will change. Fat tissue may increase toward the center of the body, including around the abdominal organs. The amount of body fat may increase by as much as 30%. As fat increases, lean body mass decreases. Your muscles, liver, kidney, and other organs may lose some of their cells. This process of muscle loss is called atrophy. Bones may lose
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some of their minerals and become less dense (a condition called osteopenia, or at its later stage, osteoporosis). Tissue loss reduces the amount of water in your body. You may become shorter. The tendency to become shorter occurs among all races and both sexes. Height loss is related to aging changes in the bones, muscles, and joints. People typically lose about 1 cm (0.4 inches) every 10 years after age 40. Height loss is even greater after 70 years old. In total, you may lose 1 to 3 inches in height as you age. This varies, however. Physical activity, a proper diet, and treating osteoporosis can help reduce height loss. Men often gain weight until about age 55, then begin to lose weight. This may be related to a drop in the male sex hormone testosterone. Women usually gain weight until age 65, then begin to lose weight. Weight loss is, in part, caused by a loss of muscle tissue. Of course, weight loss or gain varies from person to person, too. Diet and exercise play a large role in these changes. A change in total body water may make older people more likely to get dehydrated. Pay attention to how much fluid you drink. Body changes also play an important role in how your body uses drugs. Medication doses may need to be adjusted as you age. The loss of muscle mass in the legs and changes in body shape can affect your balance, leading to falls. Although many age-related changes cannot be prevented, you can take certain steps to help slow or reduce them. These steps include exercise, avoiding smoking, and following a healthy diet. Drinking too much alcohol and using illicit drugs can speed up age-related changes. The picture of a hunched over, frail man or woman with pot belly and skinny arms and legs does not happen to everyone. Lifestyle plays a large role in how fast these age-related changes take place. http://adam.about.net/encyclopedia/Aging-changes-in-body-shape.htm
Regulation of food intake changes with increasing age, leading to what has been called a physiological anorexia of aging. The amount of circulating cholecystokinin, a satiating hormone, increases in the circulation. Other substances are also thought to cause satiety. The interplay between the brain and the gut is gaining increasing attention as a mechanism of anorexia and subsequent weight loss. A highly complex process involving taste sensation,
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neural and humoral signals from the gastrointestinal tract, and neurotransmitters and peptides in the hypothalamus or other brain regions regulates food intake and, consequently, energy homeostasis. Psychosocial and spiritual distress can also influence the sensation of hunger, appetite, or satiety. Loss of lean body mass is common in older people. Advancing age is also associated with a decrease in the basal metabolic rate as well as with changes in the senses of taste and smell. Overly restricted diets, such as those that are low in fat and salt, may cause decreased intake; therefore, a special or restricted diet (low in cholesterol, salt, or concentrated sweets) often reduces food intake without significantly improving the clinical status. The role of inflammatory cytokines, including tumor necrosis factor (TNF, formerly cachectin), interleukin-1 (IL-1), and interleukin-6, has also been postulated. Physiological changes in the regulation of food intake take place, even in the presence of the increased body fat and the increased rates of obesity that occur with age, some of which can be explained by altered patterns of physical activity. Generally speaking, individuals aged 65 years and older experience a mild loss of weight, a near doubling of adiposity, and a significant non-fat mass loss of 5% to 15%. Sarcopenia, the loss of skeletal muscle massand thus leading to a loss of proteinmay play an important role in IWL. Muscle loss can be the result of negative nitrogen balance that occurs with normal aging and with inadequate protein intake, which is commonly observed among the elderly. Agerelated changes in anabolic hormones may contribute to nonfat mass loss. Low testosterone levels in men correlate with the loss of lean body mass, and loss of estrogen during menopause is associated with non-fat mass loss in women. Growth hormone appears to play an important role in body composition; growth hormone levels may decrease by 14% per decade. It has been found that replacement of growth hormone in older people results in increased lean body mass and reduced fat mass. 3. What the physiology of aging process? Ini tentang teori2 proses penuaan!
Biological theories At present, the biological basis of ageing is unknown. Most scientists agree that substantial variability exists in the rates of ageing across different species, and that this to a large extent is genetically based. In model organisms and laboratory settings, researchers have been able to demonstrate that selected alterations in specific genes can extend lifespan (quite substantially in nematodes, less so in fruit flies, and less again in mice) [citation
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needed]
. Even in the relatively simple and short-lived organisms, the mechanism of ageing remain to be elucidated. Less is known about mammalian ageing, in part due to the much longer lives in even small mammals such as the mouse (around 3 years). The US National Institute on Aging currently funds an intervention testing program, whereby investigators nominate compounds (based on specific molecular ageing theories) to have evaluated with respect to their effects on lifespan and age-related biomarkers in outbred mice.[36] Previous age-related testing in mammals has proved largely irreproducible, because of small numbers of animals, and lax mouse husbandry conditions. The intervention testing program aims to address this by conducting parallel experiments at three internationally recognised mouse ageing-centres, theBarshop Institute at UTHSCSA, the University of Michigan at Ann Arbor and the Jackson Laboratory. Many have argued that life-span, like other phenotypes, is selected.
Evolutionary Theories: Enquiry into the evolution of ageing aims to explain why almost all living things weaken and die with age. Exceptions such as rockfish, turtles, and naked molerat are highly informative.[citation needed] Telomere Theory: Telomeres (structures at the ends of chromosomes) have experimentally been shown to shorten with each successive cell division.[37] Shortened telomeres activate a mechanism that prevents further cell multiplication [citation needed]. This may be particularly limit in tissues such as bone marrow and the arterial lining where cell division occurs repeatedly throughout life[citation needed]. Importantly though, mice lacking telomerase enzyme do not show a dramatically reduced lifespan[citation needed] , invalidating at least simple versions of the telomere theory of ageing. Mice may be an exception for the theory, as they have long hypervariable telomeres,[38] prolonging the period after which telomere shortening would affect lifespan. But wild mouse strains do not, and telomere length in these breeds is unrelated to lifespan [39]
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Reproductive-Cell Cycle Theory: The idea that ageing is regulated by reproductive hormones that act in an antagonistic pleiotropic manner via cell cycle signalling, promoting growth and development early in life in order to achieve reproduction, but later in life, in a futile attempt to maintain reproduction, become dysregulated and drive senescence (dyosis).[1][40]
Some theories suggest that ageing is a disease. Two examples are
DNA Damage Theory of Ageing: Known causes of cancer (radiation, chemical and viral) account for about 30% of the total cancer burden and for about 30% of the total DNA damage. DNA damage causes the cells to stop dividing or induce apoptosis, often affecting stem cell pools and hence hindering regeneration. DNA damage is thought to be the common pathway causing both cancer and ageing. It seems unlikely that the estimates of the DNA damage due to radiation and chemical causes has been significantly underestimated. Viral infection would appear to be the most likely cause of the other 70% of DNA damage especially in cells that are not exposed to smoking and sun light. It has been argued, too, that intrinsic causes of DNA damage are more important drivers of ageing.[41][42] Autoimmune Theory: The idea that ageing results from an increase in autoantibodies that attack the body's tissues. A number of diseases associated with ageing, such as atrophic gastritis andHashimoto's thyroiditis, are probably autoimmune in this way. While inflammation is very much evident in old mammals, even SCID mice in SPF colonies still experience senescence.
Genetic theories Many theories suggest that ageing results from the accumulation of damage to DNA in the cell, or organ. Since DNA is the formative basis of cell structure and function, damage to the DNA molecule, or genes, can lead to its loss of integrity and early cell death. Examples include:

Accumulative-Waste Theory: The biological theory of ageing that points to a buildup of cells of waste products that presumably interferes with metabolism. Wear-and-Tear Theory: The very general idea that changes associated with ageing are the result of chance damage that accumulates over time. Somatic Mutation Theory: The biological theory that ageing results from damage to the genetic integrity of the bodys cells. Error Accumulation Theory: The idea that ageing results from chance events that escape proof reading mechanisms, which gradually damages the genetic code.
Some have argued that ageing is programmed: that an internal clock detects a time to end investing in the organism, leading to death. This ageing-Clock Theory suggests, as in a clock, an ageing sequence is built into the operation of the nervous or endocrine system of the body. In rapidly dividing cells the shortening of the telomeres would provide such a clock. This idea is in contradiction with the evolutionary based theory of ageing. [citation needed]
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Cross-Linkage Theory: The idea that ageing results from accumulation of crosslinked compounds that interfere with normal cell function.[citation needed] Free-Radical Theory: The idea that free radicals (unstable and highly reactive organic molecules), or more generally reactive oxygen species or oxidative stress create damage that gives rise to symptoms we recognise as ageing.[citation needed] Reliability theory of ageing and longevity: A general theory about systems failure. It allows researchers to predict the age-related failure kinetics for a system of given architecture (reliability structure) and given reliability of its components. Reliability theory predicts that even those systems that are entirely composed of non-ageing elements (with a constant failure rate) will nevertheless deteriorate (fail more often) with age, if these systems are redundant in irreplaceable elements. Ageing, therefore, is a direct consequence of systems redundancy. Reliability theory also predicts the late-life mortality deceleration with subsequent levelling-off, as well as the late-life mortality plateaus, as an inevitable consequence of redundancy exhaustion at extreme old ages. The theory explains why mortality rates increase exponentially with age (the Gompertz law) in many species, by taking into account the initial flaws (defects) in newly formed systems. It also explains why organisms "prefer" to die according to the Gompertz law, while technical devices usually fail according to the Weibull (power) law. Reliability theory allows to specify conditions when organisms die according to the Weibull distribution: organisms should be relatively free of initial flaws and defects. The theory makes it possible to find a general failure law applicable to all adult and extreme old ages, where the Gompertz and the Weibull laws are just special cases of this more general failure law. The theory explains why relative differences in mortality rates of compared populations (within a given species) vanish with age (compensation law of mortality), and mortality convergence is observed due to the exhaustion of initial differences in redundancy levels. Mitohormesis: It has been known since the 1930s that restricting calories while maintaining adequate amounts of other nutrients can extend lifespan in laboratory animals. Recently, Michael Ristow's group has provided evidence for the theory that this effect is due to increased formation of free radicals within the mitochondria causing a secondary induction of increasedantioxidant defence capacity.[43] Misrepair-Accumulation Theory: Wang et al.[44] suggest that ageing is the result of the accumulation of "Misrepair". Important in this theory is to distinguish among "damage" which means a newly emerging defect BEFORE any reparation has taken place, and "Misrepair" which describes the remaining defective structure AFTER (incorrect) repair. The key points in this theory are: 1. There is no original damage left unrepaired in a living being. If damage was left unrepaired a life threatening condition (such as bleeding, infection, or organ failure) would develop. 2. Misrepair, the repair with less accuracy, does not happen accidentally. It is a necessary measure of the reparation system to achieve sufficiently quick reparation in situations of serious or repeated damage, to maintain the integrity and basic function of a structure, which is important for the survival of the living being. 3. Hence the appearance of Misrepair increases the chance for the survival of individual, by which the individual can live at least up to the reproduction age, which
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is critically important for the survival of species. Therefore the Misrepair mechanism was selected by nature due to its evolutionary advantage. 4. However, since Misrepair as a defective structure is invisible for the reparation system, it accumulates with time and causes gradually the disorganisation of a structure (tissue, cell, or molecule); this is the actual source of ageing. 5. Ageing hence is the side-effect for survival, but important for species survival. Thus Misrepair might represent the mechanism by which organisms are not programmed to die but to survive (as long as possible), and ageing is just the price to be paid. 4. Why she hasnt menstruation anymore since 5 years ago? - Menopause? - Kapan? - Mekanime? - Perubahan organ repro? Anat, faal,BK (hormone) - Faktor2 yg berperan?
Menopause Definition Menopause is the transition period in a woman's life when her ovaries stop producing eggs, her body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether. Alternative Names Perimenopause; Postmenopause Causes Menopause is a natural event that normally occurs between the ages of 45 and 55. Once menopause is complete (called postmenopause) and you have not had a period for 1 year, you are no longer at risk of becoming pregnant. The symptoms of menopause are caused by changes in estrogen and progesterone levels. The ovaries make less of these hormones over time. The specific symptoms and how significant (mild, moderate, or severe) they are varies from woman to woman. A gradual decrease of estrogen generally allows your body to slowly adjust to the hormonal changes. Hot flashes and sweats are at their worst for the first 1 - 2 years. Menopause may last 5 or more years.
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Estrogen levels may drop suddenly after some medical treatments, as is seen when the ovaries are removed surgically (called surgical menopause). Chemotherapy and antiestrogen treatment for breast cancer are other examples. Symptoms can be more severe and start more suddenly in these circumstances. As a result of the fall in hormone levels, changes occur in the entire female reproductive system. The vaginal walls become less elastic and thinner. The vagina becomes shorter. Lubricating secretions from the vagina become watery. The outside genital tissue thins. This is called atrophy of the labia. Symptoms In some women, menstrual flow comes to a sudden halt. More commonly, it slowly stops over time. During this time, the menstrual periods generally become either more closely or more widely spaced. This irregularity may last for 1 - 3 years before menstruation finally ends completely. Before this the cycle length may shorten to as little as every 3 weeks. Common symptoms of menopause include:

Heart pounding or racing Hot flashes Night sweats Skin flushing Sleeping problems (insomnia) Other symptoms of menopause may include:
Decreased interest in sex, possibly decreased response to sexual stimulation Forgetfulness (in some women) Irregular menstrual periods Mood swings including irritability, depression, and anxiety Urine leakage Vaginal dryness and painful sexual intercourse Vaginal infections Joint aches and pains Irregular heartbeat (palpitations) Exams and Tests Blood and urine tests can be used to measure changes in hormone levels that may signal when a woman is close to menopause or has already gone through menopause. Examples of these tests include:
Estradiol FSH
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LH A pelvic exam may indicate changes in the vaginal lining caused by declining estrogen levels. The doctor may perform a bone density test to screen for low bone density levels that occur with osteoporosis. Treatment Treatment with hormones may be helpful if you have severe symptoms such as hot flashes, night sweats, mood issues, or vaginal dryness. Discuss the decision to take hormones thoroughly with your doctor, weighing your risks against any possible benefits. Pay careful attention to the many options currently available to you that do not involve taking hormones. Every woman is different. Your doctor should be aware of your entire medical history when considering prescribing hormone therapy. If you have a uterus and decide to take estrogen, you must also take progesterone to prevent endometrial cancer (cancer of the lining of the uterus). If you do not have a uterus, progesterone is not necessary. HORMONE THERAPY Several major studies have questioned the health benefits and risks of hormone replacement therapy, including the risk of developing breast cancer, heart attacks, strokes, and blood clots. Current guidelines support the use of HT for the treatment of hot flashes. Specific recommendations:
T may be started in women who have recently entered menopause. HRT should not be used in women who started menopause many years ago. The medicine should not be used for longer than 5 years. Women taking HT should have a baseline low risk for stroke, heart disease, blood clots, or breast cancer. To reduce the risks of estrogen therapy and still gain the benefits of the treatment, your doctor may recommend:
Using estrogen or progesterone regimens that do not contain the form of progesterone used in the study Using a lower dose of estrogen or a different estrogen preparation (for instance, a vaginal cream rather than a pill) Having frequent and regular pelvic exams and Pap smears to detect problems as early as possible Having frequent and regular physical exams, including breast exams and mammograms See also: Hormone therapy for more information about taking hormone therapy.
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ALTERNATIVES TO HT There are some medications available to help with mood swings, hot flashes, and other symptoms. These include low doses of antidepressants such as paroxetine (Paxil), venlafaxine (Effexor), bupropion (Wellbutrin), and fluoxetine (Prozac), or clonidine, which is normally used to control high blood pressure. Gabapentin is also effective for reducing hot flashes. LIFESTYLE CHANGES The good news is that you can take many steps to reduce your symptoms without taking hormones:

Avoid caffeine, alcohol, and spicy foods Dress lightly and in layers Eat soy foods Get adequate calcium and vitamin D in food and/or supplements Get plenty of exercise Perform Kegel exercises daily to strengthen the muscles of your vagina and pelvis Practice slow, deep breathing whenever a hot flash starts to come on (try taking six breaths per minute) Remain sexually active See an acupuncture specialist Try relaxation techniques such as yoga, tai chi, or meditation Use water-based lubricants during sexual intercourse Possible Complications Postmenopausal bleeding may occur. This bleeding is often nothing to worry about. However, your health care provider should always check any postmenopausal bleeding, because it may be an early sign of other problems, including cancer. Decreased estrogen levels are also associated with the following long-term effects:
Bone loss and eventual osteoporosis in some women Changes in cholesterol levels and greater risk of heart disease When to Contact a Medical Professional Call your health care provider if:
You are spotting blood between periods You have had 12 consecutive months with no period and suddenly vaginal bleeding or spotting begins again
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Prevention Menopause is a natural and expected part of a woman's development and does not need to be prevented. However, there are ways to reduce or eliminate some of the symptoms of menopause. You can reduce your risk of long-term problems such as osteoporosis and heart disease by taking the following steps:

Control your blood pressure, cholesterol, and other risk factors for heart disease. Do NOT smoke. Cigarette use can cause early menopause. Eat a low-fat diet. Get regular exercise. Resistance exercises help strengthen your bones and improve your balance. If you show early signs of bone loss, talk to your doctor about medications that can help stop further weakening. Take calcium and vitamin D. References Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society. Menopause. July/August 2008;15(4)584-602. Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, Dolor RJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation. 2007 Mar 20;115(11):1481-501. Nelson HD. Menopause. Lancet. 2008 Mar 1;371(9614):760-70. North American Menopause Society. Estrogen and progestogen use in peri- and postmenopausal women: March 2007 position statement of The North American Menopause Society. Menopause. 2007;14:168-182. National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Feb. 2008. Accessed July 23, 2008. Rossouw JE, Prentice RL, Manson JE, Wu L, Barad D, Barnabei VM, et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA. 2007 Apr 4;297(13):1465-77. U.S. Preventive Services Task Force. Hormone therapy for the prevention of chronic conditions in postmenopausal women: recommendations from the U.S. Preventive Services Task Force.Ann Intern Med. 2005;142:855-860 5. Why her vision was getting blurred and her hearing began to decline? - Perubahan penglihatan? - Mekanisme melihat normal? Penglihatan kabur,maksudnya? Organ apa aja yg terganggu? Akibatnya? - Perubahan pendengaran? - Mekanisme mendengar normal dipengaruhi oleh apa aja? Pendengaran menurun berarti apa aja yg terganggu? Akibatnya?
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Aging changes in the senses Definition Aging changes in the senses are perceptual changes related to growing older. Information When you age, the way your senses (taste, smell, touch, vision, and hearing) are able to give you information about the world changes. Your senses become less acute, and you may have trouble distinguishing details. Sensory changes can have a tremendous impact on your lifestyle. You may have problems with communication, enjoyment of activities, and social interactions. Sensory changes can contribute to a sense of isolation. All of the senses receive information of some type from the environment (light, sound vibrations, and so on). This is converted to a nerve impulse and carried to the brain, where it is interpreted into a meaningful sensation. Everyone requires a certain minimum amount of stimulation before a sensation is perceived. This minimum level is called the threshold. Aging increases this threshold, so the amount of sensory input needed to be aware of the sensation becomes greater. Changes in the body part related to the sensation account for most of the other sensation changes. Hearing and vision changes are the most dramatic, but all senses can be affected by aging. Fortunately, many of the aging changes in the senses can be compensated for with equipment such as glasses and hearing aids or by minor changes in lifestyle. HEARING
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With aging, ear structures deteriorate. The eardrum often thickens and the inner ear bones and other structures are affected. Your ears have two jobs. One is hearing and the other is maintaining balance. Hearing occurs after vibrations cross the eardrum to the inner ear. They are changed into nerve impulses and carried to the brain by the auditory nerve. Balance (equilibrium) is controlled in a portion of the inner ear. Fluid and small hairs in the semicircular canal (labyrinth) stimulate the nerve that helps the brain maintain balance. As you age, your ear structures deteriorate. The eardrum often thickens and the bones of the middle ear and other structures are affected. It often becomes increasingly difficult to maintain balance. Hearing may decline slightly, especially that of high-frequency sounds, particularly in people who have been exposed to a lot of noise when younger. This age-related hearing loss is called presbycusis. Some hearing loss is almost inevitable. It is estimated that 30% of all people over 65 have significant hearing impairment. The sharpness (acuity) of hearing may decline slightly beginning about age 50, possibly caused by changes in the auditory nerve. In addition, the brain may have a slightly decreased ability to process or translate sounds into meaningful information. Impacted ear wax is another cause of trouble hearing and is more common with increasing age. Impacted ear wax may be removed in your doctor's office. Sensorineural hearing loss involves damage to the inner ear, auditory nerve, or the brain. This type of hearing loss may or may not respond to treatment, but function can be helped by hearing aids. Conductive hearing loss occurs when sound has problems getting through the outer and middle ear to the inner ear. Surgery or a hearing aid may be helpful for this type of hearing loss, depending on the specific cause.
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Persistent, abnormal ear noise (tinnitus) is another fairly common hearing problem, especially for older adults. It is usually a result of mild hearing loss. VISION
Vision occurs when light is processed by the eye and interpreted by the brain. Light passes through the transparent eye surface (cornea). The pupil (the black opening in the front of the eye) is an opening to the eye interior. It can get larger or smaller to regulate the amount of light entering the eye. The colored portion (iris) is really a muscle controlling the pupil size. The inside of the eye is filled with a gel-like fluid. There is a flexible, transparent lens that focuses light so it hits on the back of the eye (the retina). The retina converts light energy into a nerve impulse that is carried to the brain and then interpreted.
With age, the lens may become misshaped and the corneal tissue may become clouded. Vision occurs when light is processed by your eye and interpreted by your brain. Light passes through the transparent eye surface (cornea).
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Your pupil is an opening to the inside of the eye. It becomes larger or smaller to control the amount of light that enters your eye. The colored portion (iris) is a muscle that controls the pupil size. After light passes through your pupil, it reaches the lens. The lens focuses light on your retina(the back of the eye). Your retina converts light energy into a nerve impulse that is carried to the brain and interpreted. Some age-related eye changes may begin as early as your 30s. Aging eyes produce less tears. Dry eyes can be quite uncomfortable. Many people find relief by using eyedrops or artificial tears solutions. All of the eye structures change with aging. The cornea becomes less sensitive, so injuries may not be noticed. By the time you turn 60, your pupils decrease to about one-third of the size they were when you were 20. The pupil may also react more slowly in response to darkness or bright light. The lens becomes yellowed, less flexible, and slightly cloudy. The fat pads supporting the eye decrease and the eye sinks back into the socket. The eye muscles become less able to fully rotate the eye. As you age, the sharpness of your vision (visual acuity) may gradually decline. Glasses or contact lenses may help correct age-related vision changes. You may eventually need bifocals. Almost everyone older than 55 needs glasses at least part of the time. However, the amount of change is not universal. Only 15% to 20% of older people have bad enough vision to impair driving ability, and only 5% become unable to read. The most common problem is difficulty focusing the eyes (a condition called presbyopia). You may be less able to tolerate glare, and you may find that you have more trouble adapting to darkness or bright light. Many older people find that although their vision is good enough to drive during the day, they must give up night driving because of problems with glare, brightness, and darkness. Significant difficulty with night driving may be the first sign of acataract (a clouding of the eye lens). Indoor glare, such as glare from a shiny floor in a sunlit room, can also make it difficult to get around inside. For people of all ages, it is harder to distinguish blues and greens than it is to distinguish reds and yellows. This becomes even more pronounced with aging. As your age increases, using warm contrasting colors (yellow, orange, and red) in your home can improve your ability to tell where things are and makes it easier to perform daily activities. Many older people find that keeping a red light on in darkened rooms (such as the hallway or bathroom) makes it easier to see than using a "regular" night light. Red light produces less glare than a regular incandescent bulb.
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With aging, the fluid inside your eye may change. Small particles can create "floaters" in your vision. Although annoying, floaters usually do not indicate a dangerous condition and usually do not reduce vision. If you suddenly develop floaters or have a rapid increase in the number of them, you should have your eyes checked by a professional. When your eyes are examined, you may not be able to move your eye in all directions. Your upward gaze may be limited. The area in which objects can be seen (visual field) gets smaller. Reduced peripheral vision is common and can limit social interaction and activity. Older people may not communicate with people sitting next to them because they cannot see them well -- or perhaps at all. Food and drinks may be spilled. Driving can become dangerous. Common eye disorders in the elderly (changes that are NOT normal) include cataracts,glaucoma, senile macular degeneration, and diabetic and hypertensive retinopathy. TASTE AND SMELL The senses of taste and smell interact closely, helping you appreciate food. Most taste really comes from odors. The sense of smell begins at nerve receptors high in the membranes of the nose. You have approximately 9,000 taste buds. Your taste buds are primarily responsible for sensing sweet, salty, sour, and bitter tastes. Smell (and to a lesser extent, taste) also play a role in both safety and enjoyment. We detect certain dangers, such as spoiled food, noxious gases, and smoke with taste and smell. A delicious meal or pleasant aroma can improve social interaction and enjoyment of life. The number of taste buds decreases beginning at about age 40 to 50 in women and at 50 to 60 in men. Each remaining taste bud also begins to atrophy (lose mass). The sensitivity to the four taste sensations does not seem to decrease until after age 60, if at all. If taste sensation is lost, usually salty and sweet tastes are lost first, with bitter and sour tastes lasting slightly longer. Additionally, your mouth produces less saliva as you age. This causes dry mouth, which can make swallowing more difficult. It also makes digestion slightly less efficient and can increase dental problems. The sense of smell may diminish, especially after age 70. This may be related to loss of nerve endings in the nose. Studies about the cause of decreased sense of taste and smell with aging have conflicting results. Some studies have indicated that normal aging by itself produces very little change
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in taste and smell. Rather, changes may be related to diseases, smoking, and environmental exposures over a lifetime. Regardless of the cause, decreased taste and smell can lessen your interest and enjoyment in eating. Some people become less aware of personal hygiene when the sense of smell is decreased. Enjoyment of your environment may be diminished. Sometimes changes in the way food is prepared, such as a change in the spices used, may help. For some people, there is an increased risk of asphyxia because they cannot detect the odor of natural gas from the stove, furnace or other appliance. A visual gas detector that changes appearance when natural gas is present may be helpful. TOUCH, VIBRATION, AND PAIN The sense of touch also includes awareness of vibrations, pain, and your body position. The skin, muscles, tendons, joints, and internal organs have receptors that detect touch, temperature, or pain. Your brain interprets the type and amount of touch sensation. It also interprets the sensation as pleasant (such as being comfortably warm), unpleasant (such as being very hot) or neutral (such as being aware that you are touching something). Medications, brain surgery, problems in the brain, confusion, and nerve damage from trauma or chronic diseases such as diabetes can change this interpretation without changing awareness of the sensation. For example, you may feel and recognize a painful sensation, but it does not bother you. Some of the receptors give the brain information about the position and condition of internal organs. Even though you may not be consciously aware of this information, it helps to identify changes (for example, the pain of appendicitis). Many studies have shown that with aging, you may have reduced or changed sensations of pain, vibration, cold, heat, pressure, and touch. It is hard to tell whether these changes are related to aging itself or to the disorders that occur more often in the elderly. It may be that some of the normal changes of aging are caused by decreased blood flow to the touch receptors or to the brain and spinal cord. Minor dietary deficiencies, such as decreased B1 levels, may also be a cause of changes. Regardless of the cause, many people experience changes in the touch-related sensations as they age. You may find it harder, for example, to tell the difference between cool and cold. Decreased temperature sensitivity increases the risk of injuries such as frostbite,hypothermia, and burns.
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Reduced ability to detect vibration, touch, and pressure increases the risk of injuries, including pressure ulcers. After age 50, many people have reduced sensitivity to pain. You may develop problems with walking because of reduced ability to perceive where your body is in relation to the floor. This increase your risk of falling, a common problem for older people. Fine touch may decrease. However, some people develop an increased sensitivity to light touch because of thinner skin (especially people older than 70). To increase safety, make allowances for changes in touch-related sensations:

Limit the maximum water temperature in your house (there is an adjustment on the water heater) to reduce the risk of burns. Look at the thermometer to decide how to dress rather than waiting until you feel overheated or chilled. Inspect your skin (especially your feet) for injuries, and if you find an injury, treat it. Don't assume that just because an area is not painful, the injury is not significant.
References Minaker KL. Common clinical sequelae of aging. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007:chap 23. http://adam.about.net/encyclopedia/Aging-changes-in-the-senses.htm 6. Why she was so easy to fall off? - Hubungan dg musculoskeletal, hormone yg berperan? - Keseimbangan? - Cari siapa yg mengatur - Pencegahan
Aging changes in the bones - muscles - joints Alternative Names Osteoporosis and aging; Muscle weakness associated with aging Information Changes in posture and gait (walking pattern) are as universally associated with aging as changes in the skin and hair.
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The skeleton provides support and structure to the body. Joints are the areas where bones come together. They allow the skeleton to be flexible for movement. In a joint, bones do not directly contact each other. Instead, they are cushioned by cartilage in the joint, synovial membranes around the joint, and fluid. Muscles provide the force and strength to move the body. Coordination is directed by the brain but is affected by changes in the muscles and joints. Changes in the muscles, joints, and bones affect the posture and gait, and lead to weakness and slowed movement. AGING CHANGES Bone mass or density is lost as people age, especially in women after menopause. The bones lose calcium and other minerals. The spine is made up of bones called vertebrae. Between each bone is a gel-like cushion (intervertebral disk). The trunk becomes shorter as the disks gradually lose fluid and become thinner. In addition, vertebrae lose some of their mineral content, making each bone thinner. The spinal column becomes curved and compressed (packed together). Bone spurs, caused by aging and overall use of the spine, may also form on the vertebrae. The foot arches become less pronounced, contributing to a slight loss of height. The long bones of the arms and legs, although more brittle because of mineral loss, do not change length. This makes the arms and legs look longer when compared with the shortened trunk. The joints become stiffer and less flexible. Fluid in the joints may decrease, and the cartilage may begin to rub together and erode. Minerals may deposit in and around some joints (calcification). This is common in the shoulder. Hip and knee joints may begin to lose joint cartilage (degenerative changes). The finger joints lose cartilage and the bones thicken slightly. Finger joint changes are more common in women and may be hereditary. Some joints, such as the ankle, typically change very little with aging. Lean body mass decreases, caused in part by loss of muscle tissue (atrophy). The rate and extent of muscle changes seem to be genetically determined. Muscle changes often begin in the 20s in men and the 40s in women. Lipofuscin (an age-related pigment) and fat are deposited in muscle tissue. The muscle fibers shrink. Muscle tissue is replaced more slowly, and lost muscle tissue may be replaced
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with a tough fibrous tissue. This is most noticeable in the hands, which may appear thin and bony. Changes in the muscle tissue, combined with normal aging changes in the nervous system, cause muscles to have less tone and ability to contract. Muscles may become rigid with age and may lose tone, even with regular exercise. EFFECT OF CHANGES Bones become more brittle and may break more easily. Overall height decreases, mainly because of shortening of the trunk and spine. Inflammation, pain, stiffness, and deformity may result from breakdown of the joint structures. Almost all elderly people are affected by joint changes, ranging from minor stiffness to severearthritis. The posture may become more stooped (bent) and the knees and hips more flexed. The neck may become tilted, and the shoulders may narrow while the pelvis becomes wider. Movement slows and may become limited. The walking pattern (gait) becomes slower and shorter. Walking may become unsteady, and there is less arm swinging. Older people become tired more easily, and have less energy. Strength and endurance change. Loss of muscle mass reduces strength. However, endurance may be enhanced somewhat by changes in the muscle fibers. Aging athletes with healthy hearts and lungs may find that performance improves in events that require endurance, and decreases in events that require short bursts of high-speed performance. COMMON PROBLEMS Osteoporosis is a common problem, especially for older women. Bones break more easily, and compression fractures of the vertebrae can cause pain and reduce mobility. Muscle weakness contributes to fatigue, weakness, and reduced activity tolerance. Joint problems are extremely common. This may be anything from mild stiffness to debilitating arthritis (see osteoarthritis). The risk of injury increases because gait changes, instability, and loss of balance may lead to falls. Some elderly people have reduced reflexes. This is most often caused by changes in the muscles and tendons, rather than changes in the nerves. Decreased knee jerk or ankle jerk can occur. Some changes, such as a positive Babinski's reflex, are not a normal part of aging. Involuntary movements (muscle tremors and fine movements called fasciculations) are more common in the elderly. Inactive or immobile elderly people may experience weakness or abnormal sensations (paresthesias).
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Muscle contractures may occur in people who are unable to move on their own or have their muscles stretched through exercise. PREVENTION Exercise is one of the best ways to slow or prevent problems with the muscles, joints, and bones. A moderate exercise program can help you maintain strength and flexibility. Exercise helps the bones stay strong. Consult with your health care provider before beginning a new exercise program. A well-balanced diet with adequate amounts of calcium is important. Women need to be especially careful to get enough calcium and vitamin D as they age. Postmenopausal women, and men over age 65, need 1,200 - 1,500 mg of calcium and 400 - 800 international units of vitamin D per day. If you have osteoporosis, talk to your doctor about prescription treatments. References Minaker KL. Common clinical sequelae of aging. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 23.
Aging changes in the nervous system
The nervous system controls the many complicated and interconnected functions of the body and mind. Motor, sensory cognitive and autonomic function are all coordinated and driven by the brain and nerves. As people age, nerve cells deteriorated in number and facility, causing some lessening in function.
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Aged nervous tissue is less able to rapidly communicate with other neural tissues. Information As people age, their brain and nervous system go through natural changes. The brain and spinal cord lose nerve cells and weight. Nerve cells may begin to transmit messages more slowly than in the past. Waste products can collect in the brain tissue as nerve cells break down, causing abnormal structures called plaques and tangles to form. A fatty brown pigment (lipofuscin) can also build up in nerve tissue. The breakdown of nerves can affect the senses. You might have reduced or lost reflexes or sensation, leading to problems with movement and safety. Some slight slowing of thought, memory, and thinking seems to be a normal part of aging. Although these changes are natural, many people have misconceptions about the type and extent of these changes. A common myth is that all elderly people become senile. Or, many people blame increased confusion on "getting old" when it may really be caused by an illness. These changes are not the same in everyone. Some people have many physical changes in their nerves and brain tissue, others have few changes. Some people will have atrophy and plaques, some will have plaques and tangles, and some will have other changes. Furthermore, these changes are not always clearly related to their effects on your ability to think. For example, plaques and tangles are associated with Alzheimer's disease, but some people with the most severe symptoms have fewer plaques and tangles than those who have mild or moderate symptoms. NERVOUS SYSTEM PROBLEMS IN THE ELDERLY
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Dementia and severe memory loss are NOT normal processes of aging. They can be caused by degenerative brain disorders such as Alzheimer's disease. Delirium can complicate dementia, but is often due to illnesses that are not related to the brain, which can also cause changes in thinking and behavior. For example, almost any infection can cause an older person to become severely confused. Poorly controlled blood sugar (glucose) levels in people with diabetes is another common cause of temporary difficulties with thinking and behavior. Rising and falling glucose levels can interfere with thought. Discuss any significant changes in memory, thought, or ability to perform a task with your health care provider, especially if these symptoms occur suddenly or along with other symptoms. A change in thinking, memory, or behavior is important if it is different from your normal patterns or it affects your lifestyle. PREVENTION There is some evidence that both physical and mental exercise can help maintain thinking abilities. Reading, doing crossword puzzles, and engaging in stimulating conversations -- as well as ordinary physical exercise -- may all help keep your brain as sharp as possible. Such strategies have not been proven, however. See also:

Aging changes in organs, tissues, and cells Aging changes in the senses
References Knopman DS. Alzheimers disease and other dementias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007:chap 425. Minaker KL. Common clinical sequelae of aging. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007:chap 23.
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Osteoarthritis is a chronic disease of the joint cartilage and bone, often thought to result from "wear and tear" on a joint, although there are other causes such as congenital defects, trauma and metabolic disorders. Joints appear larger, are stiff and painful and usually feel worse the more they are used throughout the day. 7. Why she felt so dizzy and got balance disorders? The semicircular canals, found within the vestibular apparatus, let us know when we are in a rotary (circular) motion. The semicircular canals are fluid-filled. Motion of the fluid tells us if we are moving. The vestibule is the region of the inner ear where the semicircular canals converge, close to the cochlea (the hearing organ). The vestibular system works with the visual system to keep objects in focus when the head is moving. This is called the vestibuloocular reflex (VOR). Movement of fluid in the semicircular canals signals the brain about the direction and speed of rotation of the head - for example, whether we are nodding our head up and down or looking from right to left. Each semicircular canal has a bulbed end, or enlarged portion, that contains hair cells. Rotation of the head causes a flow of fluid, which in turn causes displacement of the top portion of the hair cells that are embedded in the jelly-like cupula. Two other organs that are part of the vestibular system are the utricle and saccule. These are called the otolithic organs and are responsible for detecting linear acceleration, or movement in a straight line. The hair cells of the otolithic organs are blanketed with a jellylike layer studded with tiny calcium stones called otoconia. When the head is tilted or the body position is changed with respect to gravity, the displacement of the stones causes the hair cells to bend. The balance system works with the visual and skeletal systems (the muscles and joints and their sensors) to maintain orientation or balance. For example, visual signals are sent to the brain about the body's position in relation to its surroundings. These signals are processed by the brain, and compared to information from the vestibular, visual and the skeletal systems. When balance is impaired, an individual has difficulty maintaining upright orientation. For example, an individual may not be able to walk without staggering, or may not even be able to stand. They may have falls or near-falls. When symptoms exist, they may include:

A sensation of dizziness or vertigo. Lightheadedness or feeling woozy.

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Problems reading and difficulty seeing. Disorientation.
Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic. Some reactions to the symptoms are fatigue, depression, and decreased concentration. The symptoms may appear and disappear over short time periods or may last for a longer period. Cognitive dysfunction (disorientation) may occur with vestibular disorders. Cognitive deficits are not just spatial in nature, but also include non-spatial functions such as object recognition memory. Vestibular dysfunction has been shown to adversely affect processes of attention and increased demands of attention can worsen the postural sway associated with vestibular disorders. Recent MRI studies also show that humans with bilateral vestibular damage undergo atrophy of the hippocampus which correlates with their degree of impairment on spatial memory tasks. 8. What is healthy life style? Definisi? Apa saja yg biasa dilakukan untuk hidup sehat? A healthy lifestyle is a valuable resource for reducing the incidence and impact of health problems, for recovery, for coping with life stressors, and for improving quality of life. http://www.phac-aspc.gc.ca/ph-sp/docs/healthy-sain/pdf/lifestyle.pdf
Healthy lifestyle tips

Here are a few ways of ensuring a healthy old age:
Stop smoking Moderate alcohol consumption Take exercise Healthy diet Stay mentally active Socialise with others Get out in the fresh air Make sure that your home is safe Positive thinking
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http://www.medic8.com/healthguide/elderly-care/healthy-lifestyle.html
9. What are changes occurred in elderly?(physic and psychology) Semua organ? Perubahan anatomi fisiologi? Awal bagaimana? Berubahnya kenapa? Akibatnya apa? Kalo bisa bikin tabel , Bagaimana perubahan sistem reproduksi antara pria dan wanita pada lansia?
Aging changes in organs - tissue - cells Information All vital organs begin to lose some function as you age. Aging changes have been found in all of the body's cells, tissues and organs, and these changes affect the functioning of all body systems.
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Living tissue is made up of cells. There are many different types of cells, but all have the same basic structure. Tissues are layers of similar cells that perform a specific function. The various kinds of tissues group together to form organs. There are four basic types of tissue:
Connective tissue supports other tissues and binds them together. This includes bone, blood, and lymph tissues in addition to the tissues that give support and structure to the skin and internal organs. Epithelial tissue provides a covering for deeper body layers. The skin and the linings of the various passages inside the body are made of epithelial tissue. Muscle tissue includes three types of tissue: Striated muscles, such as those that that move the skeleton (also called voluntary muscle) Smooth muscles (also called involuntary muscle), such as the muscles that surround the stomach and other internal organs Cardiac muscle, which makes up most of the heart wall (also involuntary muscle) Nerve tissue is made up of nerve cells (neurons) and is used to carry messages to and from various parts of the body. The brain is made of nerve tissue. AGING CHANGES Cells are the basic building blocks of tissues. All cells experience changes with aging. They become larger and are less able to divide and reproduce. Among other changes, there is an increase in pigments and fatty substances inside the cell (lipids). Many cells lose their ability to function, or they begin to function abnormally. Waste products accumulate in tissue with aging. A fatty brown pigment called lipofuscincollects in many tissues, as do other fatty substances. Connective tissue changes, becoming increasingly stiff. This makes the organs, blood vessels, and airways more rigid. Cell membranes change, so many tissues have more trouble receiving oxygen and nutrients and getting rid of carbon dioxide and wastes. Many tissues lose mass. This process is called atrophy. Some tissues become lumpy (nodular) or more rigid. Because of cell and tissue changes, your organs also change as you age. Aging organs gradually but progressively lose function, and there is a decrease in the maximum functioning capacity. Most people do not notice this loss, because you seldom need to use your organs to their fullest capability. Organs have a reserve ability to function beyond the usual needs. For example, the heart of a 20-year-old is capable of pumping about 10 times the amount that is actually needed to preserve life. After age 30, an average of 1% of this reserve is lost each year.
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The most significant changes in organ reserve occur in the heart, lungs, and kidneys. The amount of reserve lost varies between people and between different organs in a single person. These changes appear slowly and over a long period of time. Even so, when an organ is worked harder than usual it may not be able to increase function. Sudden heart failure or other problems can develop when the body is worked harder than usual. Things that produce an extra workload (body stressors) include the following: Certain medications Illness Significant life changes Suddenly increased physical demands on the body, for example: A sudden change in activity Exposure to a higher altitude Loss of reserve also makes it harder to restore equilibrium in the body. Drugs are detoxified at a slower rate. Lower doses of medications may be needed, and side effects become more common. Medication side effects can mimic the symptoms of many diseases, so it is easy to mistake a drug reaction for an illness. Some medications have entirely different side effects in the elderly than in younger people. AGING THEORY No one really knows how and why people change as they get older. Some theories claim that aging is caused by accumulated injuries from ultraviolet light, wear and tear on the body, by-products of metabolism, and so on. Other theories view aging as a predetermined, genetically-controlled process. However, no theory sufficiently explains all the changes of the aging process. Aging is a complex and varied process that varies in how it affects different people and even different organs. Most gerontologists (people who study aging) feel that aging is the cumulative effect of the interaction of many lifelong influences. These influences include heredity, environment, cultural influences, diet, exercise and leisure, past illnesses, and many other factors. Unlike the changes of adolescence, which are predictable to within a few years, each person ages at a unique rate. Some systems begin aging as early as age 30. Other aging processes are not common until much later. Although some changes typically occur with aging, they occur at different rates and to different extents. There is no reliable way to predict specifically how you will age. TERMS
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ATROPHY Cells shrink. If enough cells decrease in size, the entire organ atrophies. This is often a normal aging change and can occur in any tissue. It is most common in skeletal muscle, the heart, the brain, and the secondary sex organs (such as the breasts). The cause of atrophy is unknown, but may include reduced use, decreased workload, decreased blood supply or nutrition to the cells, and reduced stimulation by nerves or hormones. HYPERTROPHY Cells enlarge. This size increase is caused by an increase in cellular proteins, such as the cell wall and internal cell structures, not an increase in the cell's fluid. When some cells atrophy, others may hypertrophy in an attempt to compensate for loss of cell mass. HYPERPLASIA The number of cells increases. There is an increased rate of cell division. Hyperplasia usually occurs in an attempt to compensate for loss of cells. It allows some organs and tissues to regenerate, including the skin, the lining of the intestines, the liver and the bone marrow. The liver is especially good at regeneration. It can replace up to 70% of its structure within 2 weeks after an injury. Tissues that have limited ability to regenerate include bone, cartilage, and smooth muscle (such as the muscles around the intestines). Tissues that seldom or never regenerate include nerves, skeletal muscle, heart muscle, and the lens of the eye. When injured, these tissues are replaced with scar tissue. DYSPLASIA The size, shape, or organization of mature cells becomes abnormal. This is also called atypical hyperplasia. Dysplasia is fairly common in the cells of the cervix and the lining of the respiratory tract. NEOPLASIA The formation of tumors, either cancerous (malignant) or noncancerous (benign). Neoplastic cells often reproduce rapidly. They may have unusual shapes and abnormal function.
References Martin GM. Biology of aging. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 22. Aging changes in hormone production Information The endocrine system is made up of organs and tissues that produce hormones. Hormones are natural chemicals produced in one location, released into the bloodstream, then used by other target organs and systems.
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The hormones control the target organs. Some organ systems have their own internal control systems along with, or instead of, hormones. As we age, changes naturally occur in the way that body systems are controlled. Some target tissues become less sensitive to their controlling hormone. The amount of hormones produced may also change. Blood levels of some hormones increase, some decrease, and some are unchanged. Hormones are also broken down (metabolized) more slowly. Many of the organs that produce hormones are, in turn, controlled by other hormones. Aging also changes this process. For example, an endocrine tissue may produce less of its hormone than it did at a younger age, or it may produce the same amount at a slower rate. AGING CHANGES The hypothalamus is located in the brain. It produces hormones that control the other structures in the endocrine system. The amount of these regulating hormones stays about the same, but the response by the endocrine organs can change as we age. The pituitary gland is also located in the brain. This gland reaches its maximum size in middle age and then gradually becomes smaller. It has two parts:

The back (posterior) portion stores hormones produced in the hypothalamus. The front (anterior) portion produces hormones that affect the thyroid gland (TSH), adrenal cortex, ovaries, testes, and breasts. The thyroid gland is located in the neck and produces hormones that help control metabolism. With aging, the thyroid often becomes lumpy (nodular). Metabolism gradually declines, beginning around age 20. Less thyroid hormone may be produced, but there is also less body mass (because of loss of muscle and bone tissue). This means that thyroid function testsusually show results within the normal range. The parathyroids are four tiny glands located around the thyroid. Parathyroid hormone affects calcium and phosphate levels. This, in turn, affects the strength of the bones. Changes in the level of parathyroid hormones may contribute to osteoporosis. Insulin is produced by the pancreas. A molecule of insulin fits into a place on the cell wall called an insulin receptor site. It acts like a lock and key to help sugar (glucose) go from the blood to the inside of cells, where it can be used for energy.
The average fasting glucose level rises 6 to 14 mg/dL (milligrams per deciliter) for each 10 years after age 50. This is because the cells become less sensitive to the effects of insulin, probably because of a loss in the number of insulin receptor sites in the cell wall. The adrenal glands are located just above the kidneys. The adrenal cortex, the surface layer, produces the hormones aldosterone and cortisol. Aldosterone regulates fluid and electrolyte balance.
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Cortisol is the "stress response" hormone. It affects the breakdown of glucose, protein, and fat, and has anti-inflammatory and anti-allergy effects. Aldosterone secretion decreases with age, which can contribute to light-headedness and a drop in blood pressure with sudden position changes (orthostatic hypotension). Cortisol secretion decreases with aging, but the blood level stays about the same. Dehydroepiandrosterone levels also drop, although the effects of this drop on the body are not clear. The ovaries and testes have two functions. They produce the reproductive cells (ova and sperm). They also produce the sex hormones that control secondary sex characteristics, such as breasts and facial hair.
With aging, men sometimes experience a slightly decreased level of testosterone. Women have decreased levels of estradiol and other estrogen hormones after menopause. EFFECT OF CHANGES Overall, some hormones are decreased, some unchanged, and some increased with age. Hormones that are usually decreased include:
Aldosterone Calcitonin Growth hormone Renin In women, estrogen and prolactin levels usually decrease significantly. Hormones that remain unchanged or only slightly decreased include:
Cortisol Epinephrine Insulin Thyroid hormones T3 and T4 Testosterone levels usually decrease slightly as men age. Hormones that may increase include:
Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) Norepinephrine Parathyroid hormone
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References Minaker KL. Common clinical sequelae of aging. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 23.
Aging changes in the male reproductive system Definition Aging changes in the male reproductive system may include changes in testicular tissue, sperm production, and erectile function. These changes usually occur gradually. Alternative Names Andropause; Male reproductive changes Information Unlike women, men do not experience a major, rapid (over several months) change in fertility as they age (like menopause). Instead, changes occur gradually during a process that some people call andropause. Aging changes in the male reproductive system occur primarily in the testes. Testicular tissue mass decreases and the level of the male sex hormone testosterone stays the same or decreases very slightly. There may be problems with erectile function. However, this is a general slowing, rather than a complete lack of function. Fertility: The tubes that carry sperm may become less elastic (a process called sclerosis). The testes continue to produce sperm, but the rate of sperm cell production slows. The epididymis, seminal vesicles, and prostate gland lose some of their surface cells but continue to produce the fluid that helps carry sperm. Urinary function: The prostate gland enlarges with age as some of the prostate tissue is replaced with a scarlike tissue. This condition, called benign prostatic hypertrophy (BPH), affects about 50% of men. This may cause problems with slowed urination, as well as with ejaculation. In both men and women, reproductive system changes are closely related to changes in the urinary system.
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EFFECT OF CHANGES Fertility varies from man to man, and age is not a good predictor of male fertility. Prostate function is not closely related to fertility, and a man can father children even if his prostate gland has been removed. Some fairly old men can (and do) father children. The volume of fluid ejaculated usually remains the same, but there are fewer living sperm in the fluid. Decreases in the sex drive (libido) may occur in some men. Sexual responses may become slower and less intense. This may be related to decreased testosterone level, but it may also result from psychological or social changes related to aging (such as the lack of a willing partner), illness, chronic conditions, or medications. Aging by itself does not prevent a man from being able to enjoy sexual relationships. COMMON PROBLEMS Erectile dysfunction (ED) may be a concern for aging men. It is normal for erections to occur less frequently than when a man was younger, and aging men often have less ability to experience repeated ejaculation. However, ED is most often the result of a medical or psychological problem rather than simple aging, and 90% of ED is believed to be of medical rather than psychological origin. Medications (especially those used to treat hypertension and certain other conditions) can cause some men to be unable to develop or maintain enough of an erection for intercourse. Disorders such as diabetes can also cause ED. Erectile dysfunction that is caused by medications or illness is often successfully treated. Talk to your primary health care provider or a urologist if you are concerned about this condition. BPH may eventually interfere with urination. The enlarged prostate partially blocks the tube that drains the urinary bladder (urethra). Changes in the prostate gland make elderly men more likely to have urinary tract infections. Backup of urine into the kidneys (vesicoureteral reflux) may develop if the bladder is not fully drained. If this is not treated, it can eventually lead to kidney failure. Prostate gland infections or inflammation ( prostatitis) may also occur. Prostate cancer becomes more common as men age. It is one of the most frequent causes of cancer death in men. Bladder cancer is also a common cancer in older men. Testicular cancersare possible, but these occur more often in younger men. PREVENTION
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Many physical age-related changes, such as prostate enlargement or testicular atrophy, are not preventable. Getting treatment for health disorders (such as high blood pressure and diabetes) that lead to changes in urinary and sexual health may prevent later problems with urinary and sexual function. Changes in sexual response are most often related to factors other than simple aging. Older men are more likely to have good sex if they have continued to have sexual activity during middle age.
The main function of the male reproductive system is the production of viable sperm in sufficient quantities to increase the likelihood of fertilization of the female egg.
The aged male reproductive system may not be as effective in producing viable sperm. References Minaker KL. Common clinical sequelae of aging. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 23. Aging changes in the female reproductive system Definition
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As a woman ages, a number of changes take place in the female reproductive system. For women, the cessation of menses (menopause) is an obvious sign of aging. But, it is by no means the only change. A transition period, called the climacteric, lasts for many years before and after a woman's last menstrual period. See also: Menopause Information For a woman, aging changes involve hormone levels, physical changes in the woman's entire reproductive tract, and psychological changes. Changes occur in the intricate relationship between the ovarian hormones and those produced by the pituitary gland (in the brain). AGING CHANGES Menopause is a normal part of a woman's aging process. The ovaries stop releasing eggs (ova), and menstrual periods stop. Most women experience menopause around age 50, although it occurs before age 40 in about 8% of women. Prior to menopause, menstrual cycles often become irregular. The ovaries become less responsive to stimulation by follicle-stimulating hormone (FSH) and luteinizing hormone (LH). To try to compensate for the decreased response, the body produces more of these ovary-stimulating hormones for a time. The level of these hormones will eventually decrease. The hormones produced by the ovaries include the different forms of estrogen (including estradiol), progesterone, and androgens (including testosterone). These hormones also decrease around menopause. The ovaries continue to produce small amounts of testosteroneand some estrogen. The hormones produced by the pituitary gland are also decreased. Because hormone levels fall, changes occur in the entire reproductive system. The vaginal walls become less elastic, thinner, and less rigid. The vagina becomes shorter. Secretions become scant and watery. The external genital tissue decreases and thins (atrophy of the labia). In both men and women, reproductive system changes are closely related to changes in the urinary system. EFFECT OF CHANGES Prior to menopause, fertility varies depending on hormone levels. Menopause is said to have occurred when there has been one year without a menstrual period. With menopause, reproductive capacity is lost (the woman can no longer become pregnant).
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Symptoms that accompany menopause vary in severity. Many of the symptoms are triggered by the hormone changes. Only about 20% to 30% of all women have symptoms that are severe enough that they seek medical attention. Changes occur in the woman's breast tissue at the same time as other reproductive changes. A woman may experience changes in her sex drive (libido) and her sexual response may change, but aging does not prevent a woman from being able to have or enjoy sexual relationships. Most often, things such as availability of a partner, symptoms from vaginal dryness and thinning vaginal walls, and psychological and social factors affect a woman's sexual response more than direct aging changes. COMMON PROBLEMS The pubic muscles lose tone, and the vagina, uterus, or urinary bladder can fall out of position. This is called vaginal prolapse, bladder prolapse, or uterine prolapse, depending on which structure collapses. A prolapse of any of these structures increases the risk of problems such as stress incontinence (urine leakage). Most prolapses can be treated. Irritation of the external genitals can occur (pruritus vulvae). The vaginal walls become thinner and dryer and may become irritated (atrophic vaginitis). Sexual intercourse may become uncomfortable for some women (dyspareunia). There are changes in the levels of normal microorganisms in the vagina, and there is an increased risk of vaginal yeast infections. Similar changes to the bladder and urethra may increase symptoms such as frequency and urgency of urination, and there is an increased risk of urinary tract infection after menopause. Hot flashes, mood disturbances, headaches, and sleep disturbances are also common symptoms that occur during menopause. The causes of these changes are not well understood, but they are also related to the decreasing amount of estrogen produced by the ovaries. Osteoporosis risk is greater in older women. This is caused, in part, by decreased estrogen levels. PREVENTION and TREATMENT Adequate lubrication (with a water-soluble lubricant) can help prevent painful sexual intercourse. A topical estrogen (applied inside the vagina) is sometimes recommended to help maintain the structure of the vaginal tissues. Sexual changes are most frequently related to factors other than simple aging. Estrogen replacement (such as pills or patches) can prevent or reduce many of the symptoms associated with menopause, including vaginal atrophy and hot flashes. It also decreases the risk of complications such as osteoporosis. However, hormone therapy (HT)
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may have side effects such as vaginal bleeding, and it has been associated with a somewhat increased risk of breast cancer, stroke, and, under some circumstances, heart disease. Each woman should discuss the pros and cons of estrogen replacement with her own health care provider.
Menopause is the transition in a woman's life when the ovaries stop releasing eggs, menstrual activity decreases and eventually ceases, and the body decreases the production of the female hormones estrogen and progesterone. References Lobo RA. Menopause: endocrinology, consequences of estrogen deficiency, effects of hormone replacement therapy, treatment regimens. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 42.
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10. What usually disease occurred in elderly?
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HYPERTENSION
OSTEOPOROSIS http://adam.about.net/encyclopedia/infectiousdiseases/Osteoporosis.htm
Osteoporosis
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Definition Osteoporosis is the thinning of bone tissue and loss of bone density over time. Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency or advanced age. Regular exercise and vitamin and mineral supplements can reduce and even reverse loss of bone density.
Alternative Names Thin bones Causes Osteoporosis is the most common type of bone disease. Researchers estimate that about 1 out of 5 American women over the age of 50 have osteoporosis. About half of all women over the age of 50 will have a fracture of the hip, wrist, or vertebra (bones of the spine).
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Osteoporosis occurs when the body fails to form enough new bone, when too much old bone is reabsorbed by the body, or both. Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, your body uses these minerals to produce bones. If you do not get enough calcium, or if your body does not absorb enough calcium from the diet, bone production and bone tissues may suffer. As you age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. This can result in brittle, fragile bones that are more prone to fractures, even without injury. Usually, the loss occurs gradually over years. Many times, a person will have a fracture before becoming aware that the disease is present. By the time a fracture occurs, the disease is in its advanced stages and damage is severe. The leading causes of osteoporosis are a drop in estrogen in women at the time of menopause and a drop in testosterone in men. Women over age 50 and men over age 70 have a higher risk for osteoporosis. Other causes include:

Being confined to a bed Chronic rheumatoid arthritis, chronic kidney disease, eating disorders Taking corticosteroid medications (prednisone, methylprednisolone) every day for more than 3 months, or taking some antiseizure drugs Hyperparathyroidism
White women, especially those with a family history of osteoporosis, have a greater than average risk of developing osteoporosis. Other risk factors include:

Absence of menstrual periods (amenorrhea) for long periods of time Drinking a large amount of alcohol Family history of osteoporosis History of hormone treatment for prostate cancer or breast cancer Low body weight Smoking Too little calcium in the diet
Symptoms There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include:
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Bone pain or tenderness Fractures with little or no trauma Loss of height (as much as 6 inches) over time Low back pain due to fractures of the spinal bones Neck pain due to fractures of the spinal bones Stooped posture or kyphosis, also called a "dowager's hump"
Exams and Tests Bone mineral density testing (specifically a densitometry or DEXA scan) measures how much bone you have. Your health care provider uses this test to predict your risk for bone fractures in the future. For information about when testing should be done, see bone density test. A special type of spine CT that can show loss of bone mineral density, quantitative computed tomography (QCT), may be used in rare cases. In severe cases, a spine or hip x-ray may show fracture or collapse of the spinal bones. However, simple x-rays of bones are not very accurate in predicting whether someone is likely to have osteoporosis. You may need other blood and urine tests if your osteoporosis is thought to be due to a medical condition, rather than simply the usual bone loss seen with older age. Treatment The goals of osteoporosis treatment are to:

Control pain from the disease Slow down or stop bone loss Prevent bone fractures with medicines that strengthen bone Minimize the risk of falls that might cause fractures
There are several different treatments for osteoporosis, including lifestyle changes and a variety of medications. Medications are used to strengthen bones when:

Osteoporosis has been diagnosed by a bone density study. Osteopenia (thin bones, but not osteoporosis) has been diagnosed by a bone density study, if a bone fracture has occurred.
Bone density scan
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A bone density scan measures the density of bone in a person. The lower the density of a bone the higher the risk of fractures. A bone scan, along with a patient's medical history, is a useful aid in evaluating the probability of a fracture and whether any preventative treatment is needed. A bone density scan has the advantage of being painless and exposing the patient to only a small amount of radiation. http://adam.about.net/encyclopedia/Bone-density-scan.htm
BISPHOSPHONATES Bisphosphonates are the primary drugs used to both prevent and treat osteoporosis in postmenopausal women.
Bisphosphonates taken by mouth include alendronate (Fosamax), ibandronate (Boniva), and risedronate (Actonel). Most are taken by mouth, usually once a week or once a month. Bisphosphonates given through a vein (intravenously) are taken less often.
CALCITONIN Calcitonin is a medicine that slows the rate of bone loss and relieves bone pain. It comes as a nasal spray or injection. The main side effects are nasal irritation from the spray form and nausea from the injectable form. Calcitonin appears to be less effective than bisphosphonates. HORMONE REPLACEMENT THERAPY Estrogens or hormone replacement therapy (HRT) is rarely used anymore to prevent osteoporosis and are not approved to treat a woman who has already been diagnosed with the condition.
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Sometimes, if estrogen has helped a woman, and she cannot take other options for preventing or treating osteoporosis, the doctor may recommend that she continue using hormone therapy. If you are considering taking hormone therapy to prevent osteoporosis, discuss the risks with your doctor. PARATHYROID HORMONE Teriparatide (Forteo) is approved for the treatment of postmenopausal women who have severe osteoporosis and are considered at high risk for fractures. The medicine is given through daily shots underneath the skin. You can give yourself the shots at home. RALOXIFENE Raloxifene (Evista) is used for the prevention and treatment of osteoporosis. Raloxifene is similar to the breast cancer drug tamoxifen. Raloxifene can reduce the risk of spinal fractures by almost 50%. However, it does not appear to prevent other fractures, including those in the hip. It may have protective effects against heart disease and breast cancer, though more studies are needed. The most serious side effect of raloxifene is a very small risk of blood clots in the leg veins (deep venous thrombosis) or in the lungs (pulmonary embolus). EXERCISE Regular exercise can reduce the likelihood of bone fractures in people with osteoporosis. Some of the recommended exercises include:

Weight-bearing exercises -- walking, jogging, playing tennis, dancing Resistance exercises -- free weights, weight machines, stretch bands Balance exercises -- tai chi, yoga Riding a stationary bicycle Using rowing machines
Avoid any exercise that presents a risk of falling, or high-impact exercises that may cause fractures. DIET Get at least 1,200 milligrams per day of calcium and 800 - 1,000 international units of vitamin D3. Vitamin D helps your body absorb calcium.Your doctor may recommend a supplement to give you the calcium and vitamin D you need.
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Follow a diet that provides the proper amount of calcium, vitamin D, and protein. While this will not completely stop bone loss, it will guarantee that a supply of the materials the body uses to form and maintain bones is available. High-calcium foods include:

Cheese Ice cream Leafy green vegetables, such as spinach and collard greens Low-fat milk Salmon Sardines (with the bones) Tofu Yogurt
STOP UNHEALTHY HABITS Quit smoking, if you smoke. Also limit alcohol intake. Too much alcohol can damage your bones, as well as put you at risk for falling and breaking a bone. PREVENT FALLS It is critical to prevent falls. Avoid sedating medications and remove household hazards to reduce the risk of fractures. Make sure your vision is good. Other ways to prevent falling include:

Avoiding walking alone on icy days Using bars in the bathtub, when needed Wearing well-fitting shoes
MONITORING Your response to treatment can be monitored with a series of bone mineral density measurements taken every 1 - 2 years. Women taking estrogen should have routine mammograms, pelvic exams, and Pap smears. RELATED SURGERIES There are no surgeries for treating osteoporosis itself. However, a procedure called vertebroplasty can be used to treat any small fractures in your spinal column due to osteoporosis. It can also help prevent weak vertebrae from becoming fractured by strengthening the bones in your spinal column.
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The procedure involves injecting a fast-hardening glue into the areas that are fractured or weak. A similar procedure, called kyphoplasty, uses balloons to widen the spaces that need the glue. (The balloons are removed during the procedure.) Outlook (Prognosis) Medications to treat osteoporosis can help prevent fractures, but vertebrae that have already collapsed cannot be reversed. Some persons with osteoporosis become severely disabled as a result of weakened bones. Hip fractures leave about half of patients unable to walk independently. This is one of the major reasons people are admitted to nursing homes. Although osteoporosis is debilitating, it does not affect life expectancy. Possible Complications

Compression fractures of the spine Disability caused by severely weakened bones Hip and wrist fractures Loss of ability to walk due to hip fractures
When to Contact a Medical Professional Call your health care provider if you have symptoms of osteoporosis or if you wish to be screened for the condition. Prevention Calcium is essential for building and maintaining healthy bone. Vitamin D is also needed because it helps your body absorb calcium. Following a healthy, well-balanced diet can help you get these and other important nutrients throughout life. Other tips for prevention:

Avoid drinking excess alcohol Don't smoke Get regular exercise
A number of medications are approved for the prevention of osteoporosis. References
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Cranney A, Papaioannou A, Zytaruk N, et al., Clinical Guidelines Committee of Osteoporosis Canada. Parathyroid hormone for the treatment of osteoporosis: a systematic review. CMAJ. 2006 4;175(1):52-59. Gass M, Dawson-Hughes B. Preventing osteoporosis-related fractures: an overview. Am J Med. 2006;119:S3-S11. Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society. Menopause. 2008;15(4):584-602. Management of osteoporosis in postmenopausal women: 2006 position statement of The North American Menopause Society. Menopause. 2006;13(3):340-367. National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Accessed July 23, 2008. Available online athttp://www.nof.org/professionals/Clinicians_Guide.htm SKIN DISEASE CANCER
KATARAK DM
(dikasih definisi,patofis singkat)
1. Vision changes/Cataracts, glaucoma and macular degeneration
Before an individual turns 50, his eyes have begun to change. As they age, the eyes become less able to produce tears, the retinas thin, and the lenses gradually turn yellow and become less clear. As aging progresses, the iris (the colored portion of the eye) stiffens, turns less responsive and it is more difficult to adapt to different light levels. The three most common ailments related to aging eyes are cataracts, glaucoma and macular degeneration. A cataract is a clouding of the lens that affects vision. Most cataracts are related to aging. In a patient with the eye disease glaucoma the normal fluid pressure inside the eyes slowly rises, which can lead to vision loss or blindness if not treated. Age-related macular degeneration causes no pain but gradually robs an individual of his/her clear, central vision. AMD is the leading cause of vision loss in people over 60.
2. Hearing loss
One in three people older than 60, and half of those older than 85 have hearing loss, according to the National Institute on Deafness and Other Communication Disorders. Gradual hearing loss that occurs from aging is called presbycusis and is thought to run in families. NIDCD reports that hearing loss can also be caused by a virus or bacteria, heart condition or stroke, head injury, tumors and certain medications. Hearing loss hinders or
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prevents vital communication with family, friends and caregivers, banishing an individual to virtual isolation. This can cause frustration, anger and depression.
3. Arthritis
This chronic disease is an inflammation of the joints. The most common type is osteoarthritis, and although it can occur in any joint, it most often affects the hands, knees, hips or spine. The exact cause is not known. Although it occurs after considerable wear and tear on the joints (in older people and athletes, for instance), heavy "wear and tear" alone cannot cause it to occur. It is believed the disease runs in families.
4. Sleep changes/disorders
By the time an adult is 65 or older, their sleep-wake cycle does not work as well. Typical changes an older person experiences include getting sleepy earlier than usual, trouble falling asleep, not sleeping soundly and waking early. Alcohol, caffeine and smoking can wreak havoc on the sleep cycle, as can illness, pain or certain medications. The elderly are especially vulnerable to insomnia, a disorder that prevents sleep, sometimes night after night, which can lead to sleep deprivation. Sleep disorders such as sleep apnea (can cause daytime sleepiness and worsen high blood pressure and heart disease), restless leg syndrome (may prevent falling asleep) and periodic limb movement disorder (can interrupt sleep and result in daytime sleepiness), affect older people and are treatable.
5. Osteoporosis
This silent disease is more common in women than in men, because they have less bone mass to begin with, tend to live longer and take less calcium and need estrogen to keep their bones strong. However, if men live long enough, they too are at risk. As many as half of all women and a quarter of men older than 50 will break a bone due to osteoporosis, according to the National Institutes of Health. Risk factors for the disease include aging, a thin body and small bone frame, a family history of osteoporosis, taking certain medications, being a Caucasian or Asian woman and low bone mass. An individual with osteoporosis is often unaware she has the disease until she suffers a broken bone, low back pain or develops a hunched back. The disease can cause the vertebrae to collapse, so the person may also get shorter over time. There is no cure, so those afflicted must learn to manage the disease with nutrition, exercise and medication.
6. Cardiovascular disease and stroke
With age the heart becomes less efficient and must work harder to circulate blood throughout the body. Blood vessels lose their elasticity. The loss of elasticity, along with atherosclerosis (caused by hardened fatty deposits on the arterial walls), makes the arteries inflexible, which forces the heart to work harder. This process leads to high blood pressure.
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High blood pressure, along with atherosclerosis and uncontrolled diabetes (see below) are two major risk factors for stroke. A stroke can occur without warning and cause temporary or permanent brain damage and related loss of bodily function(s), depending on the area of the brain where the blockage occurs. "One in three people older than 60, and half of those older than 85 have hearing loss. " National Institute on Deafness and Other Communication Disorders Thought at one time to be part of the normal aging process, cardiovascular disease and stroke are two disease processes that are now known to be influenced by lifestyle. Smokers, those who eat a lot of meat and fat and have high cholesterol levels are at high risk for this condition.
7. Diabetes
Nearly 17 million people have diabetes in the U.S. today, according to the American Academy of Family Physicians (AAFP). The blood sugar levels of a person with diabetes are too high. The disease prevents the body from producing any insulin (Type 1); or, the body does not produce enough insulin or the cells ignore the insulin (Type 2). As a result, the glucose/sugar builds up and stays in the blood instead of being distributed to the cells. Nearly 95% of people with diabetes have Type 2, according to AAFP. There is no cure, but people with diabetes can live a healthy life by controlling their glucose levels. This can be accomplished with good nutrition, exercise, maintaining a healthy weight and taking oral medications or insulin. Untreated, diabetes can lead to blindness, heart disease, nerve and blood vessel damage and kidney damage.
8. Cancer
This disease evokes universal fear when mentioned, and while it strikes people of all ages, adults are more likely to get cancer as they age (even if no one in your family has had it). According to the National Institute on Aging, cancer begins when cells in one part of the body become abnormal and begin multiplying. These extra cells form a mass of tissue called a tumor; as it gets larger it can harm nearby tissue and organs. The cancer can break away and spread to other parts of the body. People over 50 should have tests on a regular basis to screen for specific cancers: breast cancer (clinical breast exam and mammogram); cervical and other cancers (pap test and pelvic exam); colorectal cancer (fecal occult blood test, sigmoidoscopy and colonoscopy); mouth and throat cancers (oral exams); prostate cancer (digital rectal exam and Prostate Specific Antigen (PSA)); and skin cancer (skin exams)
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STEP 6 Independent learning

Blood vessel diseases such as arteriosclerosis Diabetes

Some theories suggest that ageing is a disease. Two examples are

Aging changes in the nervous system

A sensation of dizziness or vertigo. Lightheadedness or feeling woozy.

Problems reading and difficulty seeing. Disorientation.

Healthy lifestyle tips

Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) Norepinephrine Parathyroid hormone

10. What usually disease occurred in elderly?

Bone density scan

Avoid drinking excess alcohol Don't smoke Get regular exercise

A number of medications are approved for the prevention of osteoporosis. References

(dikasih definisi,patofis singkat)

1. Vision changes/Cataracts, glaucoma and macular degeneration

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