PHYSIOLOGIC CHANGES IN ELDERLY
Introduction
 A number of physiological changes
occur as we grow older.
 Some of the common changes are
the result of diseases.
Body conformation
 The height falls after the age of 50.
 Nose and ears continue to grow in
length.
 Male and female shapes become
more similar with aging.
Body content
 Male weight tend to increase till
late 50 and then decline.
 Female weight tend to increase till
60 and then decline.
 Total body water male: young 60%
to elderly 54%.
 Total body water female: young 52%
to elderly 46%.
Integumentary System
 One of the most common physical
changes that people associate with
aging is
 Wrinkling
 Pigment alteration
 Thinning of the skin
 The most common changes in the
skin include:
 Thinning of the area between the
dermis and epidermis (due to
decrease in epidermal proliferation)
 Elastic fibers are reduced in
number.
 Collagen become stiffer.
 Subcutaneous fat diminishes.
 The decrease in number of
capillaries in the skin results in
diminished blood supply.
 The skin becomes less able to retain
fluids and is more easily dry and
cracked.
 As a result, both the thickness and
elasticity of skin decrease.
 Therefore, sunscreens and
moisturizing creams play an
important part in protecting aging
skin.
Hair
 Hair becomes gray because of
gradual decrease in production of
melanin, the pigment cells in the hair
bulbs.
 The graying of hair is also
influenced by heredity and
hormones.
 There are also fewer hair follicles
on the scalp and the growth rate of
hair decreases in the scalp, armpits,
and pubic areas. However, hair
growth actually accelerates and
thickens in places like nostrils, ear,
and eyebrows, especially in men.
 Older women often have an increase
in facial hair as their estrogen levels
decrease.
Health promotion strategies
 Avoid solar exposure(clothing,
sunscreen, stay indoors).
 Dress appropriately for
temperature.
 Maintain a safe indoor temperature.
 Lubricate skin.
Musculoskeletal System
 By the time of age 80, most of loose
an average height of about 2 inches.
 The primary factors contributing to
this reduction in height include
 compression of vertebrae
 changes in posture,
 and increased curvature of the hips
and knees.
 Weight increases until about age 60
and then declines
 This pattern of weight change is
more likely the result of reductions
 in activity and changes in eating
rather than aging itself.
 Bone mineral content diminished.
 As age increases, muscles generally
decrease in strength, endurance,
size, and weight.
 Typically, 23 percent of muscle mass
is decreased, by age 80, both the
number and size of muscle fibers
decrease.
 Body fat mass can double; lean
muscle mass is lost
Health promotion strategies
 Exercise regularly.
 Eat a high calcium diet, limit
phosphorus intake.
 Take calcium and vitamin D
supplements.
 Encourage use of assistive devices if
indicated
 Modify environment to reduce fall
risk
 Encourage activity- take walks etc.
Respiratory System
 Lungs become more rigid and
stiffer.
 Muscles of the chest wall becomes
weak.
 Pulmonary function decreases. The
alveoli within the lungs enlarge and
becomes thinner, increasing the
amount of anatomic dead space.
 The number of cilia decline in
number as age grows.
 Vital capacity declines.
 Reduction in respiratory fluid.
 cough efficiency decreases.
Cardiovascular System
 Heart disease is the leading cause
of death in elderly.
 The size of heart increases in old
age.
 Despite slight increase in heart size,
the amount of blood the chamber
can hold actually decreases because
the heart wall thickening.
 The maximum heart rate decreases.
 The cardiac output decreases.
 The aorta and other arteries
becomes thicker and stiffer which
may bring a moderate increase in
systolic blood pressure with aging.
In some individuals, this may result
in hypertension.
 The valves between the chambers of
heart thicken and become stiffer
due to the deposition of calcium and
collagen.
 Blood flow to the kidneys may
decrease by 50 percent and to the
brain by 15 to 20 percent.
 The baroreceptors which monitor
and adjust the blood pressure when
we change position become less
sensitive with aging.
 This can cause orthostatic
hypotension.
Health promotion strategies
 Regular exercise and activities
 Eat low fat diet, low salt diet
 Participate in stress reduction
activities
 Check blood pressure regularly
Gastrointestinal System
 Reduced GI secretions.
 Reduced GI motility.
 Fall of teeth is an obvious sign of
aging.
 Delayed gastric emptying.
Liver:
 Reduced blood flow
 Altered clearance of some drugs
 Decreased weight of liver
 Reduced regenerative capacity of
liver
 Liver metabolizes less efficiently
Intestines:
 As we grow old, the small intestines
absorb less calcium and vitamin D.
  Therefore, we need more calcium to
prevent bone mineral loss and
osteoporosis in later life.
 Some enzymes, such as lactase
which aids the digestion of lactose
(a sugar found in dairy products)
decline with age.
 Reduced peristalsis of the colon can
increase risk for constipation.
 The sensitivity of the taste buds
decrease altering pleasure in eating.
 They may also lose the ability to
differentiate sour, salty, and bitter
tastes.
 There is decreased salivation, so
there is difficulty in swallowing
food.
 Reduced gastrointestinal motility
results in delayed emptying of
stomach contents and early
satisfaction( feeling of fullness).
Health promotion strategies
 Use mouthwash, brush, and receive
regular dental care.
 Sit up and avoid heavy activity after
eating.
 Limit antacids and laxatives.
 Eat small, frequent meals.
 Maintain bowel habit.
Genitourinary System
 After 40 renal function decreases.
 By 90, we lose 50% of function.
 Filtration and reabsorption is
decreased
 Size and number of nephrons
decreases.
 Bladder muscles weaken.
 Kidney mass decreases by 25-30
percent and the number of glomeruli
decrease by 30 to 40 percent.
 These changes reduce the ability to
filter and concentrate urine and to
clear drugs.
 Bladder capacity decreases and
there is an increase in residual urine
and frequency.
 With aging, there is a reduced
hormonal response (vasopressin) and
an impaired ability to conserve salt
which may increase risk for
dehydration.
 These changes increase the chances
of urinary infections, incontinence,
and urinary obstruction.
 In males, Benign Prostatic
Hyperplasia (BPH) is more common.
 In females, perineal muscles relax,
there is urge incontinence and
stress urinary incontinence.
Health promotion strategies
 Seek referral to urology specialist.
 Have ready access to toilet.
 Wear easily manipulated clothing.
 Drink adequate fluids.
 Avoid bladder irritants (caffeinated
beverages, alcohol)
 Pelvic floor exercises.
Reproductive System
Male:
 Reduced testosterone level
 Size of the testis and penis
decreases
 Decrease in sperm production
 Seminal fluid decreases and
becomes more viscous
 Erection dysfunction may occur
Female:
 estrogen and progesterone levels
declines
 Ovulation ceases
 Introitus constricts and loses
elasticity
 Vagina atrophies and becomes dry.
 Uterus shrinks.
 Breasts become pendulous and lose
elasticity.
Health promotion strategies
  Females may require estrogen
replacement therapy.
 To use a lubricant with intercourse.
Nervous System
 Neurons of central and peripheral
nervous system degenerate
 Loss of brain mass
 Synthesis and metabolism of the
major neurotransmitters are
reduced
 Nerve transmission slows so; older
people take longer to respond and
react.
 Hypothalamus becomes less
effective in regulating body
temperature.
 Deep sleep decreases.
 After 50yrs one loses 1% of neurons
each year.
 Allow longer time to respond to
stimulus and move more
deliberately.
 Encourage slow rising from a resting
position.
Sensory System
Vision:
 Visual impairment is the most
common sensory problem of older
people.
 Not all older people have impaired
vision.
 Loss of ability to see items that are
close up begins in the 40’s
 Size of pupil grows smaller with
age: focusing becomes less accurate
 Lens of eye yellows making it more
difficult to see red and green
colors
 Sensitivity to glare increases
 Night and depth vision decreases
 Eyelids become baggy and wrinkled
 Conjunctiva becomes thin and yellow
 Lens enlarges
 Lens becomes less transparent
 Can actually become clouded
 Results in cataracts.
 Quantity of tears decreases.
 About 95% of individuals aged 65
and older report needing glasses to
improve their vision.
Health promotion strategies
 Wear eyeglasses, use sunglasses
outdoors.
 Avoid abrupt changes from dark to
light.
 Use large print books.
 Use magnifier for reading.
 Avoid night driving.
 Use contrasting colors for color
coding.
 Avoid glare of shiny surfaces and
direct sunlight.
Hearing
 Hearing loss is very common with
aging.
 Auditory changes begin to be
noticed at about 40 years of age.
 Membranes in the middle ear,
including the eardrum, become less
flexible with age.
 In addition, the small bones in the
middle ear, the ossicles, become
stiffer.
 Both these factors somewhat
decrease hearing sensitivity but are
not thought to cause significant
impairment.
 The vestibular apparatus begins to
degenerate with age.
 Equilibrium becomes compromised
and older individuals may complain of
dizziness and lose their balance.
Health promotion strategies
 Recommend a hearing examination.
 Reduce background noises.
 Encourage to face person and use
nonverbal cues.
 Speak with a low-pitched voice.
 Use of hearing aids.
 Response: first line of defense for the
Smell immune system
 The number of functioning smell
Correct answer: helps determine
receptors decreases. hydration status
 After the age of 50 the sense of
smell decreases rapidly. Score: 0 out of 1 No
 By age 80, the sense of smell is
reduced by about half.
Question 3
Epidermal cells become thinner
Taste
making the skin look noticeably thicker
 Taste also diminishes with age
 Some atrophy of the tongue occurs Response: False
with age and this may diminish Correct answer: False
sensitivity to taste.
Score: 1 out of 1 Yes
Immune System
 Decline in immune function
Question 4
Physical changes related to normal
 Fatty marrow replaced red bone
aging are not disease.
marrow
 As we grow older, our bodies are Response: True
less able to produce antibodies Correct answer: True
which are important in fighting
infections.
Score: 1 out of 1 Yes
 As a result older adults are at
Question 5
greater risk for infections and the
The following nursing assessment
mortality rate from infection is
indicates changes in the
much higher than in the young. musculoskeletal system. Which one
Endocrine System does not apply?
 Estrogen levels decrease in women.
 Other hormonal decreases include
Response: D. Decrease in coughing
reflexes.
testosterone, aldosterone, cortisol,
progesterone Correct answer: D. Decrease in
coughing reflexes.
Score: 1 out of 1 Yes
Which topic should student nurse
Elentores include when discussing Question 6
ways to prevent skin disorders? Hair growth on the scalp , armpits and
pubic areas decreases as one the
Response: b.) Effects of long exposure physiologic changes however , in men
to sunlight hair accelerates its growth in the
Correct answer: b.) Effects of long following areas, EXCEPT:
exposure to sunlight Response: Head
Score: 1 out of 1 Yes Correct answer: Head

Question 2 Score: 1 out of 1 Yes

The following are considered
functions of the skin EXCEPT: Question 7
 Which one is the best way to slow or
prevent problems with the muscles ,
joints and bones.
Response: Exercise
Correct answer: Exercise
Score: 1 out of 1 Yes
Question 8
Each layer of the skin contains
connective tissues with fibers to give
support and provide flexibility and
strength. This refers to:
Response: Collagen fibers
Correct answer: Collagen fibers
Score: 1 out of 1 Yes
Question 9
What is the largest organ of the body?
Response: Integumentary system
Correct answer: Integumentary system
Score: 1 out of 1 Yes
Question 10
People who live in an active lifestyle
lose less muscle mass and flexibility
as they age.
Response: False
Correct answer: True
Score: 0 out of 1 No
Question 11
A decreased in the number of cilia is
one of the changes in the lungs. If
increased in number, which one is
correct?
Response: Keep the airways clear of
mucus and dirt allowing to breathe
easily without irritation.
Correct answer: Keep the airways
clear of mucus and dirt allowing to
breathe easily without irritation.
Score: 1 out of 1 Yes
Question 12
It is a progressive decline in muscle
mass due to aging which results in the
decreased functional capacity of
muscle. This condition is known as:
Response: Sarcopenia
Correct answer: Sarcopenia
Score: 1 out of 1 Yes
Question 13
The total amount of air exhaled after
maximal inhalation, this refers to:
Response: Vital capacity
Correct answer: Vital capacity
Score: 1 out of 1 Yes
Question 14
Decrease in the function of sebaceous
and sweat glands contribute to oily
skin.
Response: False
Correct answer: False
Score: 1 out of 1 Yes
Question 15
The following are the physiologic
changes in aging EXCEPT:
Response: Capacity of the bladder
increases.
Correct answer: Capacity of the
bladder increases.
Score: 1 out of 1