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Common Health Problems Associated With Aging
Common Health Problems Associated With Aging
Geriatric Syndromes
Geriatric syndromes refer to a number of problems commonly experienced by the elderly that
do not fit into discrete disease categories.
Frailty
The term “frail” is used to describe elderly people who are at higher risk for adverse health
outcomes.
The most widely used criteria include weight loss, weakness, exhaustion, or poor endurance,
slowness and low activity
Impaired Mobility
Common causes include strokes, Parkinson’s disease, diabetic neuropathy, cardiovascular
compromise, osteoarthritis, osteoporosis, and sensory deficits.
To avoid the downward spiral of immobility:
o Encouraged to stay as active as possible
o Bed rest should be kept to a minimum
o When bed rest cannot be avoided, patients should perform active range of motion
exercises and strengthening exercises
o Caregivers should perform passive ROM for affected extremities
o Frequent position changes
Dizziness
Dizziness (a sensation of disorientation in relation to position), vertigo (a spinning sensation),
near syncope and disequilibrium are common in the elderly.
Causes may include build up of earwax or ear wax impaction, dysfunction of the cerebral cortex,
cerebellum, brain stem, proprioreceptors, or vestibular system.
These can result to loss of balance and subsequent fall and injury.
Urinary Incontinence
Transient causes are:
o D – delirium and dehydration
o R – restricted mobility and restraints
o I – inflammation, infection, and impaction
o P – pharmaceuticals and polyuria
Other causes include neurologic or structural abnormalities like weakened pelvic floor
Detrusor hyperactivity with impaired contractility is a type of urge incontinence that is seen
predominantly in aging population wherein they have no warning that they are about to urinate.
They often void only small amounts of urine or none at all and then experience a large volume of
incontinence after leaving the bathroom.
Urinary incontinence has been associated with depression and low self-esteem and may reduce
the patient’s quality of life by causing restriction in social activities.
Nursing Interventions:
o Kegel’s exercises
o Having quick access to toilet facilities
o Wearing clothing that can be unfastened easily
o Anticholinergics may be inappropriate for elderly due to adverse effects of dry mouth,
slowed GI motility and confusion.
o For detrusor instability, prompted timed voiding and clean intermittent catheterization
Altered Pharmacokinetics
Alteration in absorption, metabolism, distribution, and excretion occur as a result of normal
aging and may also result from drug and food interactions
Absorption
Reduced gastric acid; increased pH Absorption is delayed but the extent of
Reduced gastrointestinal motility absorption is not affected
Prolonged gastric emptying
Distribution
Decreased albumin sites Highly protein bound medications have
fewer binding sites leading to increased
effects and accelerated metabolism and
excretion
Reduced cardiac output Decreased distribution due to decreased
Impaired peripheral blood flow perfusion
Increased percentage of boy fat Increased ability to store fat soluble
medications that may cause accumulation,
prolonged storage and delayed excretion
Decreased lean body mass Higher peak level of medication
Metabolism
Decreased perfusion of the liver due to Decreased metabolism and delay
decreased cardiac output breakdown of medications resulting in
prolonged duration of action,
accumulation and drug toxicity
Excretion
Decreased renal blood flow Decreased rates of elimination
Reduced functioning nephrons Increased duration of action
Decreased renal efficiency Danger of accumulation of drug and
toxicity
Nursing Implications:
A thorough medication history should be comprehensively assessed
Explain the purpose, adverse effects, and dosage of each medication
Provide the schedule of medication in writing
Encourage the use of standard containers without the safety lids
Use of multiple-day, multiple-dose medication dispenser
Destroy or remove old, unused medications
Encourage the patient to inform the health care provider about the use of over-the-counter
medications and herbal agents, alcohol and recreational drugs
Depression
Depression is the most common affective or mood disorder of old age
Among the elderly, depression can follow a major precipitating event or loss and is often related
to chronic illness or pain. It may also be secondary to medication interaction or an undiagnosed
physical condition
Signs of depression include feelings of sadness, fatigue, diminished memory and concentration,
feelings of guilt and worthlessness, sleep disturbances, appetite disturbances with excessive
weight loss or gain, restlessness, impaired attention span and suicidal ideation.