Describe expected and uncommon physical changes associated with the aging neuro system.

 How do
these impact the patient?

Physiologic Changes Implications

More permeable blood-brain barrier
Less neurons and nerve fibers
Reaction time is slower and lower limbs
have decreased proprioception
Neurotransmitter system decrease
(receptors, enzymes, neurotransmitter)
Possible memory changes or loss
Perception of pain change; possible loss
of vibration sense (ankles or feet)
Decrease in pupil size.
Sleep pattern changes (reduced sleep,
daytime naps, circadian rhythm changes)
Decreased coordination and balance
alteration
Risk for infection
There will be an increased medication and toxin sensitivity
Changes in pain sensation and not as able to localize pain
There is an increased risk of falls and accidents.
Encourage patient to wear sensible shoes and look where
at feet when walking.
Change patient position at least every 2 hours if unable to
move.
Slower processing speed
Older adults need time to respond to directions and/or
questions. This time for processing will differentiate
normal form neurologic deterioration.
White matter in frontal lobe has the greatest loss.
Intellect not impaired but there is a slow learning process.
Memory loss in older adults needs reinforced teaching and
repetition.
May lead to falls or accidents.
Ask patient about quality and characteristic of pain.
Amount of light entering eye is restricted and vision
adaption is slow.
Make sure patient has safe environment to avoid falls and
injury
Older adults need less sleep.
Assess sleep habits and bedtime routines.
Calming, relaxing environment with noise reduction could
help older adults have better sleep.
Coordination and reflex decrease in older adults.
Can cause falls if patient moves too quickly.
Older adults would need ambulatory aids and adaptive aids
for support.
There is a structural deterioration of microglia (responsible
for cell-mediated response of CNS)
Older adult patients need to be periodically monitored for
infection and also there is a need to stop infection from
happening.

Real life scenario:

Most patients I have seen in the hospital are older adults and they come in with all kinds of
disorders or illness. Especially in the SNF, I noticed older adults have most of the physiologic changes
mentioned above. For example, they have decreased need for sleep and are usually up very early in the
morning. They have a slower pain reception even when you would expect them in so much pain after
surgery or experiencing chronic illness. They have unsteady gait and have an increased risk for falls.
Short term memory loss is also common, as well as an increased risk for infection.