Chronologic age, the number of years a person HEALTH CARE PROVISIONS

has lived, is most often used when we speak of aging

Everyone wants the best and most comprehensive
because it is the easiest to identify and measure.
medical care for themselves and their family
Categorizing the Aging Population:
Medicare is the government program that provides
AGE (YEARS) CATEGORY health care funding for older adults and disabled
55 to 64 Older persons. Medicare has four distinct programs, none of
65 to 74 Elderly which pays all of the health care costs.
75 to 84 Aged
Medicare Part A is hospital insurance
85 and older Extremely Aged
Or - It covers inpatient hospital care; skilled nursing
60 to 74 Young-Old care following hospitalization; some home
75 to 84 Middle-Old health services, such as visiting nurses and
85 and older Old-old occupational, speech, or physical therapists; and
hospice services, but only after the patient pays
Others are chronologically young but physically or an initial deductible and any co-payments.
functionally old. Thus, chronologic age is not the most - Medicare instituted the diagnosis-related group
meaningful measurement of aging (DRG) system in an attempt to contain hospital
costs. Under this system, a hospital is paid a set
GERONTOPHOBIA amount based on the patient’s admitting
- The fear of aging and the refusal to accept older diagnosis.
adults into the mainstream of society Medicare Part B is medical insurance
Extreme Forms - It is optional, but most people choose this
1. Ageism coverage. This plan covers 80% of the
-is the disliking of aging and older adults based “customary and usual” rates charged by
on the belief that aging makes people physicians after deductibles are met.
unattractive, unintelligent, and unproductive. - In addition to physicians’ fees, Medicare Part B
-It is an emotional prejudice or discrimination covers medically necessary ambulance
against people based solely on age. transport; physical, speech, and occupational
-Ageism allows the young to separate therapy; home health services when medically
themselves physically and emotionally from the necessary; medical supplies and equipment;
old and to view older adults as somehow having and outpatient surgery or blood transfusions.
less human value. - The patient is responsible for the remaining 20%
2. Age Discrimination of the costs plus the difference between the
-reaches beyond emotions and leads to actions; actual fee and the government’s “customary
older adults are treated differently simply and usual” rate.
because of their age Medicare Part C is Medicare Advantage Plans
-Example: refusing to hire older people, not
approving them for home loans, and limiting the - are optional plans offered by private companies
types or amount of health care they receive. approved by Medicare to individuals who are
eligible for Part A and enrolled in Part B.
DEMOGRAPHICS - These plans allow beneficiaries to receive their
Medicare benefits through private insurance
companies

Medicare Part D is Prescription drug coverage

- It is a voluntary plan available to anyone

enrolled in Part A or B of Medicare. It cannot be
 used if someone chooses a Medicare Advantage
Plan (Part C) that has prescription drug
coverage.
- Prescription drugs are distributed through local
pharmacies and administered by a wide variety
of private insurance plans
COSTS AND END-OF-LIFE CARE
Not all older people use the available health care
resources equally. Most health care services are
consumed by the very ill or terminally ill minority, many
of whom happen to be older adults.
“tiguwang na ill nagani tiguwang pa tas ginaatiman pa”
ADVANCED DIRECTIVES
legally recognized documents that specify the types of
care and treatment the individual desires when that
individual cannot speak for himself or herself.
Addressed in AD:
1. do not attempt to resuscitate (DNAR) or allow
natural death (AND)
2. directives related to mechanical ventilation
3. directives related to artificial nutrition and
hydration
Formal types of AD
1. the durable power of attorney for health care
⮚ transfers the authority to make health
care decisions to another person,
called the health care agent.
2. the living will
⮚ informs the physician that the
individual wishes to die naturally if he
or she develops an illness or receives
an injury that cannot be cured.
⮚ prohibit the use of life-prolonging
measures and equipment when the
individual is near death or in a
persistent vegetative state.
⮚ go into effect only when two
physicians agree in writing that the
necessary criteria are met.
POLST, or physician orders for life-sustaining treatment
- legal document, takes the person’s wishes
further by creating actual doctor’s orders to be
carried out by emergency personnel.
- POLST contains 4 sections
1. specifics about CPR (whether to attempt
resuscitation or allow natural death)
2. medical interventions (comfort care, limited
interventions, or full treatment including
when to transfer to hospital)
3. antibiotics (use freely, use for comfort, or
don’t use at all)
4. artificial nutrition (no tube feeding, trial of
tube feeding, or long-term tube feeding)
Demographic Changes Affecting the Family
● Extended life spans are leading to more older
family members.
● More people are living with chronic conditions
and need some degree of care or assistance
● The number of people in the younger
generations is decreasing in proportion to the
number of older members.
● There is an increasing number of widows who
may be unprepared to provide for their own
needs and will need assistance
● The role of women is changing. As women
increasingly must work outside the home, many
are attempting to meet the demands of their
parents, home, children, and workplace
Family Crisis: Wanay mapuy- an ang tiguwang/ or
longer able to love alone
2 common solutions or options:
1. bringing the aging parent into the home of one
of the children.
2. placing the parent in a long-term care facility
AGE(YEARS) GENERATION
80+ Parents
60+ Children
40+ Grandchildren
20+ Great-grandchildren
Less than 20+ Great-great-grandchildren
THE NURSE AND FAMILY INTERACTIONS
When we as nurses care for older adults, particularly in
hospital or nursing home settings, we see the person
only as he or she is now. We often forget that these
people have not always been old. They lived, loved,
worked, argued, and wept as each of us does. Often, the
older adults we care for are very ill or infirm, and, as
nurses, we tend to focus on their physical needs, cares,
and treatments.
In our preoccupation with our duties, we can easily lose
our perspective of the older patient as both a person
and a member of a family
SELF-NEGLECT
Self-neglect is defined as the failure to provide for the
self because of a lack of ability or lack of awareness.
Self-neglect is often connected with some form of
mental illness or dementia. Once the problem is
recognized, legal action through the courts may be
needed to place the person in the custody of a family
member or adult protective services.
Indicators:
1. The inability to maintain activities of daily living
such as personal care, shopping, meal
preparation, or other household tasks
2. The inability to obtain adequate food and fluid
as indicated by malnutrition or dehydration
3. Poor hygiene practices as indicated by body
odor, sores, rashes, or inadequate or soiled
clothing
4. Changes in mental function, such as confusion,
inappropriate responses, disorientation, or
incoherence
5. The inability to manage personal finances as
indicated by the failure to pay bills or by
hoarding, squandering, or giving away money
inappropriately
6. Failure to keep important business or medical
appointments
7. Life-threatening or suicidal acts, such as
wandering, isolation, or substance abuse
Intentional abuse occurs when any person deliberately
plans to mistreat or harm another person. Intentional
abuse is most likely to occur in families with preexisting
behavioral or social problems.
Unintentional abuse or neglect is most likely to occur
when the caregiver lacks the necessary knowledge,
stamina, or resources needed to care for an older loved
one.
Neglect and abandonment also constitute forms of
abuse
Physical Abuse
- Physical abuse is any action that causes physical
pain or injury.
- Abuse may involve a physical attack upon a frail
older adult who is unable to defend himself or
herself from younger, stronger family members.
- Some older people are starved by family
members or given food that is unsuitable or
unfit for human consumption. Failure to provide
adequate food or fluids also constitutes physical
abuse.
- Warning signs of physical abuse include
bruising, lacerations, broken teeth, broken
glasses, sprains, fractures, burn marks, wounds
in various stages of healing, unexplained
injuries, torn or bloody underwear, signs of
vaginal trauma, delay in seeking medical
treatment or history of “doctor shopping,” and
refusal by the caregiver to let visitors see the
older adult.
Neglect
- is a passive form of abuse in which caregivers
fail to provide for the needs of the older person
under their care.
- This includes safety needs hygiene, failure to
provide medical care
- However, it is not considered neglect if the
mentally competent older person refuses
treatment.
Emotional Abuse
- is the most subtle and difficult-to-recognize type
of abuse. It often includes behaviors such as
isolating, ignoring or depersonalizing older
adults
- comes from verbal or non-verbal such as voice
threats, door slamming, and negative
communication.
- Signs of emotional abuse may include the lack
of eye contact, trembling, agitation,
evasiveness, or hypervigilance
Financial Abuse
- exists when the resources of an older person
are stolen or misused by a person whom the
older adult trusts
Abandonment
- occurs when dependent older persons are
deserted by the person or persons responsible
for their custody or care under circumstances in
which a reasonable person would continue to
provide care.
Responses to Abuse
- Fear of being treated even worse or fear of
being institutionalized or abandoned may
prevent the victim from seeking help
Signs the Older Person May Be Experiencing Abuse
▪ Excessive agreement or compliance with
the caregiver
▪ Signs of poor hygiene such as body odor,
uncleanliness, or soiled clothing or
undergarments
▪ Malnutrition or dehydration
▪ Burns or pressure sores
▪ Bruises, particularly clustered on trunk or
upper arms
▪ Bruises in various stages of healing that may
indicate repeated injury
▪ Inadequate clothing or footwear
▪ Inadequate medical attention
▪ Lack of food, medication, or care
▪ Verbalization of being left alone or isolated
▪ Verbalization of fear of the caregiver
▪ Verbalization of a lack of control in personal
activities or finances
SUPPORT GROUPS
A wide variety of services to reduce abuse and to
meet the emotional and physical needs of older
adults and their caregivers are available
Caregivers who want or need to share their
experiences and frustrations have started forming
support groups to help one another cope with
stress.
Support groups allow caregivers to share their
feelings and to learn new strategies to improve
coping skills
Respite care allows the primary caregiver to have
time away from the demands of caregiving, thereby
decreasing stress and the risk of abuse. Respite care
gives the primary caregiver the opportunity to
attend church, go shopping, conduct personal
business, obtain medical care, or simply participate
in leisure activities.
THEORIES OF AGING
Aging is best looked at as a series of changes that
occur over time, contribute to loss of function, and
ultimately result in the death of a living organism.
The maximal life expectancy for humans today
appears to be 120 years.
Theories of aging have been considered throughout
history as mankind has sought to find ways to avoid
aging.
No one has identified a single unified rationale for
why we age and why different people live lives of
different lengths. Theories abound to help explain
and give some logical order to our observations.
Observations, including physical and behavioral
data, are collected and studied to scientifically
prove or disprove their effects on aging
Fact: Observations about the world around us.
Example: “It’s bright outside.”
Theory: A well-substantiated explanation acquired
through the scientific method and repeatedly tested
and confirmed through observation and
experimentation.
Example: “When the sun is out, it tends to make it
bright outside.”
BIOLOGIC THEORIES
Biologic theories of an aging attempt to explain the
physical changes of aging. Researchers try to
identify which biological factors have the greatest
influence on longevity. It is known that all members
of a species suffer a gradual, progressive loss of
function over time because of their biologic
structure.
1. Programmed Theory
- proposes that everyone has a “biologic clock”
that starts ticking at conception.
- In this theory, each individual has a genetic
“program” specifying an unknown but
predetermined number of cell divisions
- As the program plays out, the person
experiences predictable changes such as
atrophy of the thymus, menopause, skin
changes, and graying of the hair.
2. Run-out-of-program theory
- which proposes that every person has a limited
amount of genetic material that will run out
eventually.
3. Rate of living theory
- which proposes that individuals have a finite
number of breaths or heartbeats that are used
up over time.
4. Gene theory
- proposes the existence of one or more harmful
genes that activate over time, resulting in the
typical changes seen with aging and limiting the
life span of the individual
The molecular theories propose that aging is
controlled by genetic materials that are encoded to
predetermine growth and decline.
Cellular theories propose that aging is a process that
occurs because of cell damage. When enough cells
are damaged, overall functioning of the body is
decreased.
5. Error theory
- proposes that errors in ribonucleic acid protein
synthesis cause errors to occur in cells in the
body, resulting in a progressive decline in
biologic function.
6. Somatic mutation theory
- is similar but proposes that aging results from
deoxyribonucleic acid (DNA) damage caused by
exposure to chemicals or radiation and that this
damage causes chromosomal abnormalities
that lead to disease or loss of function later in
life
7. Free radical theory
- provides one explanation for cell damage.
- Free radicals are unstable molecules produced
by the body during the normal processes of
respiration and metabolism or following
exposure to radiation and pollution.
- These free radicals are suspected to cause
damage to the cells, DNA, and the immune
system
- Excessive free radical accumulation in the body
is purported to contribute to the physiologic
changes of aging and a variety of diseases, such
as arthritis, circulatory diseases, diabetes, and
atherosclerosis
- One free radical, named lipofuscin, has been
identified to cause a buildup of fatty pigment
granules that cause age spots in older adults
- Individuals who support this theory propose
that the number of free radicals can be reduced
by the use of antioxidants, such as vitamins A, C,
and E, carotenoids, zinc, selenium, and
phytochemicals.
8. Crosslink or connective tissue theory
- which proposes that cell molecules from DNA
and connective tissue interact with free radicals
to cause bonds that decrease the ability of
tissue to replace itself
- This results in the skin changes typically
attributed to aging such as dryness, wrinkles,
and loss of elasticity
9. Clinker theory
- combines the somatic mutation, free radical,
and crosslink theories to suggest that chemicals
produced by metabolism accumulate in normal
cells and cause damage to body organs, such as
the muscles, heart, nerves, and brain.
10. Wear-and-tear theory
- presumes that the body is similar to a machine,
which loses function when its parts wear out
- As people age, their cells, tissues, and organs
are damaged by internal or external stressors.
When enough damage occurs to the body’s
parts, overall functioning decreases.
- This theory also proposes that good health
maintenance practices will reduce the rate of
wear and tear, resulting in longer and better
body function
11. Reliability theory of aging and longevity
- Is a complex mathematical model of system
failures first used to describe failure of complex
electronic equipment. It is used as a model to
describe degradation (disease) and failure
(death) of human body systems.
12. Neurondocrine theory
- focuses on the complicated chemical
interactions set off by the hypothalamus of the
brain.
 COMPLEMENTARY AND ALTERNATIVE THERAPIES
to slow or reverse aging.
ANTIOXIDANT THERAPY
● Proposed as a method of neutralizing free
radicals, which may contribute to aging and
disease processes.
● Includes a number of vitamins and minerals,
such as vitamins A, B6, B12, C, and E; beta
carotene; folic acid; and selenium
● Generally safe when consumed as fruits and
vegetables as part of the overall diet
● High doses of some antioxidants may cause
more harm than benefits
● No proof that antioxidants are effective
● Discuss with physician before starting use.
HORMONE THERAPY
● Proposed to replace a reduction in hormones,
which naturally decrease with aging
● Includes hormones, such as
dehydroepiandrosterone (DHEA), estrogen,
testosterone, melatonin, and human growth
hormone (HGH)
● Little evidence to support claims made by
advocates
● May actually cause more harm than provide
benefits
● Usually requires prescription or supervised
medical administration
SUPPLEMENTS
● Proposed to replace or enhance nutritional
status; often marketed as “natural” remedies
● Include substances such as ginseng, coral
calcium, Echinacea, and other herbal
preparations
● No proof of effectiveness
● Not regulated by the Food and Drug
Administration, so there is no control regarding
the amount of active ingredients, purity, and
quality
● High risk for interaction with prescription
medications; physician must be notified if these
products are used
CALORIE-RESTRICTED DIET
● Proposes that significant calorie reduction can
extend life; based on studies in rats, mice, fish,
and worms; not proven in humans
● Severe calorie restriction can result in
inadequate consumption of necessary nutrients
● Studies show that severely underweight persons
have a higher risk for some diseases and even
death
● Dietary changes should be discussed with a
physician or nutritionist to ensure that adequate
nutrition is maintained
13. Immunologic theory
- proposes that aging is a function of changes in
the immune system.
- According to this theory, the immune system—
an important defense mechanism of the body—
weakens over time, making an aging person
more susceptible to disease
- also proposes that the increase in autoimmune
diseases and allergies seen with aging is caused
by changes in the immune system
PSYCHOSOCIAL THEORIES
Psychosocial theories of aging do not explain the
physical changes of aging; rather they attempt to
explain why older adults have different responses to the
aging process.
Some of the most prominent psychosocial theories of
aging are the disengagement theory, the activity theory,
life-course or developmental theories, and a variety of
other personality theories
1. Disengagement theory
- was developed to explain why aging persons
separate from the mainstream of society
- This theory proposes that older people are
systematically separated, excluded, or
disengaged from society because they are not
perceived to be of benefit to the society. This
theory further proposes that older adults desire
to withdraw from society as they age
2. Activity theory
- Proposes that activity is necessary for successful
aging. Active participation in physical and
mental activities helps maintain functioning well
into old age.
- Purposeful activities and interactions that
promote self-esteem improve overall
satisfaction with life, even at an older age.
3. Life-course theories
- These theories trace personality and personal
adjustment throughout a person’s life.
1. Erikson’s theory
- Identifies eight stages of developmental tasks
that an individual must confront throughout the
life span:
lifestyle changes or to the acceptance of the self
as is.
- Jung proposes that the individual is likely to
shift from an outward focus (with concerns
about success and social position) to a more
inward focus. Successful aging, according to
Jung, includes acceptance and valuing of the
self without regard to the view of others.

2. Havighurst’s theory
- details the process of aging and defines specific
tasks for late life
2.1 adjusting to decreased physical strength
and health
2.2 adjusting to retirement and decreased
income
2.3 adjusting to the loss of a spouse
2.4 establishing a relationship with one’s
age group
2.5 adapting to social roles in a flexible way
2.6 establishing satisfactory living
arrangements
3. Newman’s theory
- identifies the tasks of aging as:
(1) coping with the physical changes of aging
(2) redirecting energy to new activities and
roles, including retirement, grandparenting,
and widowhood.
(3) accepting one’s own life
(4) developing a point of view about death
4. Jung’s theory
- proposes that development continues
throughout life by a process of searching,
questioning, and setting goals that are
consistent with the individual’s personality
- At this stage, they begin to question whether
the decisions and choices they have made were
the right choices for them. This is the so-called
midlife crisis, which can lead to radical career or
 PHYSIOLOGIC CHANGES
The peak years of physiologic function last from the late
teens through the thirties—the so-called prime of life.
Physiologic changes are still occurring during this time,
but they are subtle and not easily recognized. Because
these changes do not happen as rapidly or as
dramatically as those earlier in life, they may be ignored
pale, making older individuals more susceptible to the
effects of the sun.
Melanocyte clusters can form areas of deepened
pigmentation, a condition called senile lentigo; these
areas are often referred to as age spots or liver spots
and are most often seen on body areas that are most
exposed to sunlight.

As a person moves into his or her fifth and sixth decades

of life, these physiologic changes become more
apparent. In the seventh and eighth decades and
beyond, they are significant and no longer deniable

INTEGUMENTARY SYSTEM

Epidermis

- the outermost layer of the skin, is an important

structure that provides protection for internal
structures, keeps out dangerous chemicals and
microorganisms
- functions as part of the body’s fluid regulation
system, and helps regulate body temperature
and eliminate waste products. In a condition called seborrheic keratosis, slightly
- It also contains melanocytes that produce the raised, wartlike macules with distinct edges appear.
pigment melanin, which provides protection (ABOVE PIC) Seborrheic keratoses usually appear at
from ultraviolet radiation approximately the fifth decade of life and gradually
increase in number with age.
Dermis

- contains collagen and elastin fibers, which give

strength and elasticity to the tissues.

Sebaceous (oil-producing) and eccrine

(sweat-producing) glands

- located in the subcutaneous tissue, as are the

hair and nail follicles and the sensory nerve
receptors

EXPECTED AGE-RELATED CHANGES Skin tags, or cutaneous papilloma (ABOVE), are small,
brown or flesh-colored projections of skin that are most
With aging, the epidermis becomes more fragile, often observed on the necks of older adults
increasing the risk for skin damage such as tears,
maceration, and infection. Rashes caused by contact
with chemicals, such as detergents or cosmetics, are
increasingly common in older individuals. Skin repairs
more slowly in older individuals, increasing the risk for
infection.

Melanocyte activity declines with age, and in

light-skinned individuals, the skin may become very
A decrease in the function of sebaceous and sweat Capillary walls become increasingly fragile with age and
gland secretion increases the likelihood of dry skin, or may
xerosis. Dry skin is probably the most common
skin-related complaint among older adults, particularly
when accompanied by pruritus (itching). This problem is
often more severe on the lower extremities because of
diminished circulation.

hemorrhage, leading to senile purpura: red, purple, or

brown areas commonly seen on the legs and arms.

COMMON DISORDERS SEEN WITH AGING

1. Basal Cell Carcinoma and Melanoma

- is a type of skin cancer that most often develops
on areas of skin exposed to the sun, such as the
face
- Older adults who have spent significant
amounts of time in the sun
- Older men are most at risk for melanoma, a
potentially fatal form of skin cancer because of
its ability to metastasize.
 3. Inflammation and Infection
3.1 Rosacea

- The risk of melanoma doubles if someone has

had more than five sunburns at any age
- The unusual appearance of moles should be
- appears as redness, dilated superficial blood
suspected to be melanoma. Irregular shapes,
vessels, and small “pimples” on the nose and
irregular borders, changes in color, changes in
center of the face.
size or symptoms, such as itchiness or bleeding,
- It may spread to cover the cheeks and chin. Left
are all considered abnormal.
untreated, it can lead to swelling and the
2. Pressure Ulcers
enlargement of the nose or to conjunctivitis.
- Shrinkage in the cushion provided by
- CAUSE: unknown but most common in
subcutaneous tissue along with vascular
postmenopausal women, people who flush
changes places the older adult at increased risk
easily, and individuals taking vasodilating
for pressure ulcers (breakdown of the skin and
medications.
tissues located over bony prominences)
- TREATMENT:
- This is a significant problem for immobilized
people such as those who are bedridden or ⮚ Treatment of vasodilation includes
confined to wheelchairs. lifestyle modification, for example
A. Early-stage pressure ulcers, or stage I avoidance of triggers such as stressful
lesions, are commonly dismissed as minor situations, extreme heat, sun
abrasions because their primary attribute is exposure, spicy foods, and alcoholic
nonblanchable erythema. beverages.
B. Stage II ulcer, which is characterized by
some skin loss, may be difficult to identify ⮚ Oral and topical medications or light
accurately because of its resemblance to a and laser treatments may provide
blister or abrasion some benefits.
3.2 Contact and allergic dermatitis

- appear as rashes or inflammation that is either

localized to certain areas of the body or
generalized
- CAUSE: Identification of the particular irritant
may be difficult because of the number of
 chemicals, drugs, and other substances to
which an individual is exposed.
- TREATMENT: consists of avoiding the offending
substance.
3.3 Seborrheic dermatitis
- is characterized by itching and patches of scales
that exfoliate.
- is an unsightly skin condition characterized by
yellow, waxy crusts that can be either dry or
moist.
- CAUSE: Caused by excessive sebum production,
seborrheic dermatitis can occur on the scalp,
eyebrows, eyelids, ears, axilla, breasts, groin,
and gluteal folds
- TREATMENT: There is no known cure, but
special shampoos and lotions can help.
3.4 Infectious diseases of the skin and nails
commonly seen in older adults include:
1. herpes zoster (shingles);
2. fungal, yeast, and
3. bacterial infections; and infestation with
scabies (mites).
4. Hypothermia
- The decrease in subcutaneous tissue reduces the older
adult’s ability to regulate body temperature.
- Very thin older adults lose the insulation provided by
- subcutaneous and adipose tissue. This loss of
insulation is most likely to result in hypothermia if the
person is exposed to an environment that is too cold.
MUSCULOSKELETAL SYSTEM
The red bone marrow in the cavities of spongy bones
produces red blood cells (RBCs), platelets, and WBCs.
BONES
Bone consists of protein and the minerals calcium and
phosphorus
Calcium is necessary for bone strength, muscle
contraction, myocardial contraction, blood clotting, and
neuronal activity. It is normally obtained by eating dairy
products and dark-green leafy vegetables.
Vitamin D is needed for the absorption of calcium and
phosphate through the small intestine; vitamins A and C
are needed for ossification, or bone matrix formation.
It is also necessary to apply stress to the long bones to
keep the minerals in the bones. This needed stress is
best provided by weight-bearing activities, such as
standing and walking.
HORMONES
Calcitonin- produced by the thyroid gland, slows the
movement of calcium from the bones to the blood,
lowering the blood calcium level.
Parathyroid hormone (PTH)- increases the movement
of calcium from the bones to the blood, increasing the
blood calcium level.
Insulin and thyroxine aid in the protein synthesis and
energy production needed for bone maintenance.
Estrogen and testosterone- produced by the ovaries
and testes, respectively, help retain calcium in the bone
matrix
VERTEBRAE
The spinal column consists of a series of small bones,
called vertebrae, which stack up to form a strong,
flexible structure. ACTUALLY DAGHAN PAG ANATOMY
KAPOY NA.
EXPECTED AGE-RELATED CHANGES
The major bone-associated change related to aging is
the loss of calcium. This change begins between age 30
and 40. With each successive decade, the skeletal bones
become thinner and relatively weaker. Women lose
approximately 8% of skeletal mass each decade,
whereas men lose approximately 3%

The intervertebral disks shrink as the thoracic vertebrae
slowly change with aging. The result is a condition called
kyphosis, which gives the older adult a stooped or
hunchback appearance, with the head dropping forward
toward the chest.
The combination of disk shrinkage and kyphosis results
in loss of overall height. A person can lose as much as 2
inches of height by age 70.
COMMON DISORDERS SEEN WITH AGING
1. Osteoporosis
- ibandronate (Boniva), raloxifene (Evista), and
Excessive loss of calcium from bone combined with
insufficient replacement results in osteoporosis.
- is characterized by porous, brittle, fragile bones that
are susceptible to breakage
RISK FOR OSTEOPOROSIS
• Female gender • Caucasian or Asian race • Small body
frame • Family history of osteoporosis • Poor nutrition
(diet low in calcium and vitamin D) • Malabsorption
disorders, such as celiac disease • Menopause (low
estrogen levels) • Chemotherapy • Lack of
exercise/immobility • Excessive alcohol consumption •
Cigarette smoking • Hormonal imbalances
(hyperthyroidism and hyperparathyroidism) • Long-term
use of medications, including phenytoin (Dilantin),
heparin, and oral corticosteroids
Bone mineral density (BMD) may be assessed in
someone at risk for osteoporosis. Measurement of bone
density generally reflects its strength and ability to bear
weight.
Osteoporosis is best prevented and treated by lifestyle
modifications and medications. Lifestyle modifications
include a well-balanced diet with adequate amounts of
calcium and vitamin D, regular weight-bearing exercise,
smoking cessation, and restriction of alcohol intake.
Medications for osteoporosis generally fall into two
categories:
(a) medications that increase bone strength and
density (anabolic drugs)
- Teriparatide, a form of parathyroid hormone, is
currently the only anabolic osteoporosis
medicine approved by the Food and Drug
Administration (FDA).
(b) medications that inhibit bone loss
(antiresorptive medications)
- alendronate (Fosamax), risedronate (Actonel),
calcitonin (Calcimar)
2. Degenerative Joint Disease
2.1 Osteoarthritis
- Some people call
it degenerative
joint disease or
“wear and tear”
arthritis.
- the tissues in the joint break down over time
- The exact cause of osteoarthritis is unknown;
however, risk factors have been identified, including
age, obesity, joint injury or overuse, genetic
predisposition, and muscle weakness.
- Osteoarthritis is treated with a combination of
exercise, weight control, joint protection, physical or
occupational therapy, and medications.
- Medication therapy may include nonsteroidal
antiinflammatory drugs (NSAIDs) or by injecting
corticosteroids into the joints.
2.2 Rheumatoid arthritis
-
is an autoimmune and inflammatory disease, which
means that your immune system attacks healthy
cells in your body by mistake, causing inflammation
(painful swelling) in the affected parts of the body.
RA mainly attacks the joints, usually many joints at
once.
- is a collagen disease that results from an
autoimmune process, affecting more women than
men.
- RA is characterized by periods of exacerbation
(sometimes called flares), during which the
symptoms are severe and cause further damage,
and remission, during which the progress of the
disease—and the damage it causes—halts.
- Symptoms of RA include: • Pain and stiffness,
particularly after rest • Warm, tender, painful joints
• Fatigue • Sense of feeling unwell • Occasional
fevers
- Treatments for RA include lifestyle changes such as
stress reduction, balanced rest and exercise, and
joint care using splints to support joints
- Medications:
• NSAIDs, such as aspirin, acetaminophen,
ibuprofen, and naproxen
• Corticosteroids, such as methylprednisone
• Disease-modifying antirheumatic drugs
(DMARDs), such as cyclosporine, azathioprine,
sulfasalazine, and methotrexate
• Tumor necrosis factor inhibitors, such as
etanercept and infliximab
• Interleukin-1 inhibitor, such as anakinra
- Surgical interventions, including synovectomy,
tendon reconstruction, and joint replacement,
may be performed to reduce pain, to improve
joint function, and to allow the individual to
maintain the highest possible level of
independent function
2.3 Bursitis
- inflammation of the bursa and the surrounding
fibrous tissue, can result from excessive stress
on a joint or from a localized infection
- The most common causes of bursitis are
repetitive motions or positions that put
pressure on the bursae around a joint. Examples
include: Throwing a baseball or lifting
something over your head repeatedly. Leaning
on your elbows for long periods
- Treatment includes resting the joint and
administering NSAIDs. Corticosteroid
preparations are occasionally injected into the
painful areas to reduce inflammation. Mild
range-of-motion exercise is encouraged to
prevent permanent reduction or the loss of joint
function.
2.4 Gouty Athritis

- It usually affects one joint at a time (often the
big toe joint).
- is caused by an inborn error of metabolism that
results in elevated levels of uric acid in the body
- It is observed more often in men but is also
common in postmenopausal women.
- Recommendations may include reduction of
body weight and decreased intake of alcohol
and foods rich in purines, such as liver or dried
beans or peas
RESPIRATORY SYSTEM
COMMON DISORDERS SEEN WITH AGING
1. Chronic Obstructive Pulmonary Disease
- is an umbrella term for the commonly occurring
respiratory disorders of emphysema and chronic
bronchitis.
- Emphysema is characterized by changes in
alveolar structure. The alveoli lose elasticity,
become overinflated, and are ineffective in gas
exchange.
- Chronic bronchitis involves inflammation of the
trachea and bronchioles. Chronic irritation leads
to excessive mucus secretion and a productive
cough.
2. Influenza
- often referred to as the flu, is a highly
contagious respiratory infection caused by a
variety of influenza viruses.
- The incubation period is brief, often only 1 to 3
days from the time of exposure.
- Cause: influenza virus: airborne
- The onset of symptoms is sudden; symptoms
include chills, fever, cough, sore throat, and
general malaise and may be dramatic and leave
the victim feeling severely ill.
- Yearly flu shots are recommended for all
persons older than 65 years of age to reduce
the chance of contracting influenza.
- Immunization should be obtained yearly,
because the vaccine is different from the
previous year.
3. Pneumonia
- is acute inflammation of the lungs caused by
bacterial, viral, fungal, chemical, or mechanical
agents.
- Viral pneumonia, sometimes called walking
pneumonia, is most commonly seen following
influenza or another viral disease.
- Bacterial pneumonia can be caused by a
number of organisms, most commonly
Staphylococcus, Streptococcus, Klebsiella, and
Legionella.
- Aspiration pneumonia is an inflammatory
process of the bronchi and lungs caused by
inhalation of foreign substances, such as food or
acidic gastric contents.
4. Tuberculosis
- is an infectious disease caused by the bacillus
Mycobacterium tuberculosis, which spreads by
means of airborne droplets.
- Treatment today consists of drug therapy using
a variety of antimicrobial agents, such as
isoniazid, rifampin, ethambutol, and
streptomycin.
5. Lung Cancer
- or bronchogenic cancer, is cancer that forms in
tissues of the lung, usually in the cells that line
the air passages.
- Smoking, secondsmoke, radon gas Causes
- The treatment of choice is surgical resection of
the lungs. This procedure is associated with a
high mortality rate in older adults. Radiation
and chemotherapy are used in some patients,
with varying amounts of success.
CARDIOVASCULAR SYSTEM
Older persons enhance cardiac output by increasing
stroke volume, whereas younger persons increase
output by increasing heart rate (Cardiac output =
stroke volume × heart rate).

COMMON DISORDERS SEEN WITH AGING
1. Coronary Artery Disease
- is caused by plaque buildup in the wall of the
arteries that supply blood to the heart (called
coronary arteries). Plaque is made up of
cholesterol deposits. Plaque buildup causes the
inside of the arteries to narrow over time.
- Once circulation to the heart muscle decreases
significantly, the amount of oxygen delivered to
the heart decreases and ischemia occurs (is a
condition in which blood flow (and thus oxygen)
is restricted or reduced in a part of the body)
- The pain that may be experienced with ischemia
is referred to as angina pectoris (literally, chest
pain).
- When one or more coronary arteries become
totally obstructed by atherosclerosis or
embolus, the person is said to have a
myocardial infarction (MI), or heart attack.
- Physicians usually prescribe coronary
vasodilators, such as nitroglycerin, or
β-adrenergic blocking agents for people with
ischemic heart disease.
2. Coronary Valve Disease
- In heart valve disease, one or more of the valves
in your heart doesn't work properly. Your heart
has four valves that keep blood flowing in the
correct direction. In some cases, one or more of
the valves don't open or close properly. This can
cause the blood flow through your heart to your
body to be disrupted.
- The heart valves become less pliable over time.
In addition, calcium deposits may develop on
the valves, preventing them from sealing
completely. This can result in mitral valve
prolapse, mitral regurgitation, and, ultimately,
heart failure (HF).
- Symptoms of mitral valve prolapse include chest
pain, palpitations, fatigue, and dyspnea
- Calcium deposits on the valves roughen the
lining and increase the risk for clot formation in
the chambers of the heart and in the blood
vessels.
- Medicines are not a cure for heart valve disease,
but treatment can often relieve symptoms.
These medicines may include: Beta-blockers,
digoxin, and calcium channel blockers to reduce
symptoms of heart valve disease by controlling
the heart rate and helping to prevent abnormal
heart rhythms.
- You might eventually need heart valve surgery
to repair or replace the diseased heart valve
 even if you don't have symptoms. If you need - Chronic HF can become acute HF with increased
surgery for another heart condition, your doctor physical or emotional stress.
might repair or replace the diseased valve at the - Medical management of HF includes dietary
same time. restriction of sodium to decrease fluid
3. Cardiac Arrhythmias retention, administration of diuretics (e.g.,
- is an irregular heartbeat. Heart rhythm furosemide) to reduce fluid overload,
problems (heart arrhythmias) occur when the administration of cardiotonic medications (e.g.,
electrical signals that coordinate the heart's digoxin) to increase the pumping efficiency of
beats don't work properly. The faulty signaling the heart, and planned levels of activity
causes the heart to beat too fast (tachycardia), designed to reduce cardiac workload.
too slow (bradycardia) or irregularly.
- Many factors can affect your heart's rhythm,
such as having had a heart attack, smoking,
congenital heart defects, and stress.
- Heart arrhythmia treatment may include
medications, catheter procedures, implanted
devices or surgery to control or eliminate fast,
slow or irregular heartbeats. A heart-healthy
lifestyle can help prevent heart damage that can
trigger certain heart arrhythmias.
- Sinus node dysfunction, sometimes called sick
- sinus syndrome, is the primary conduction
disorder seen in older adults. 5. Cardiomegaly
4. Heart Failure
- The older term congestive heart failure was
used as it described the disease process: the
patient’s lungs are often congested, and edema
appears because the heart’s pumping action is
ineffective.
- HF is not a single disease but rather a syndrome
that accompanies and results from many other
disorders. A variety of cardiovascular diseases
can contribute to the development of HF.
- Metabolic changes and fluid and electrolyte - Enlargement of the heart
imbalances seen with malnutrition can lead to - As we age, the muscular wall of the left
HF. Excessive sodium intake with fluid retention ventricle thickens. Because arteries and veins
increases the risk for HF. The effects of alcohol, lose elasticity with age, the heart must pump
digoxin, hormones, some antineoplastics, harder to move blood through the vessels. The
corticosteroids, and NSAIDs can directly or muscles of the left ventricle hypertrophy in an
indirectly lead to HF. attempt to improve the output of blood from
- Mild chronic HF tends to have a slow, insidious the heart to meet the body’s tissue demands for
onset. Older adults who experience mild oxygenated blood.
symptoms, such as dyspnea, orthopnea, or - The right side of the heart may also
paroxysmal nocturnal dyspnea, often decrease hypertrophy. Right-sided enlargement is a result
their activity spontaneously of increased resistance in the pulmonary
- Acute HF can result in severe pulmonary circulation. When one side of the heart is
congestion or cardiogenic shock and is often weakened, the other side is soon affected.
fatal in older adults. - can be caused by damage to the heart muscle
or any condition that makes the heart pump
 harder than usual, including pregnancy.
Sometimes the heart gets larger and becomes
weak for unknown reasons.
- Enlarged heart treatment may include
procedures/surgery to: Implant a pacemaker to
help your heart beat a steady rhythm. Place an
implantable cardioverter defibrillator (ICD), a
device that can shock your heart back into
rhythm. Repair or replace a damaged heart
valve.
6. Peripheral Vascular Disease
- is a slow and progressive circulation disorder.
Narrowing, blockage, or spasms in a blood
vessel can cause PVD. PVD may affect any blood
vessel outside of the heart including the
arteries, veins, or lymphatic vessels.
- Vessel changes with aging can lead to mild or
severe problems.
- Excessive plaque is often related to lifestyle
factors or to other disease conditions, most
commonly obesity, high cholesterol intake,
cigarette smoking, and diabetes mellitus (DM).
- It is primarily caused by the buildup of fatty
plaque in the arteries, which is called
atherosclerosis. PAD can happen in any blood
vessel, but it is more common in the legs than
the arms.
- An early symptom of arterial occlusive disease is
pain. Intermittent claudication, which manifests
as a cramping pain in the legs during or after
walking, is common with diminished peripheral
circulation.
- There are 2 main types of revascularisation
treatment for PAD: angioplasty – where a
blocked or narrowed section of artery is
widened by inflating a tiny balloon inside the
vessel. artery bypass graft – where blood
vessels are taken from another part of your
body and used to bypass the blockage in an
artery.
7. Occlusive Peripheral Vascular Problems
7.1 Thrombus
- Thrombus formation (clotting) in the lumen of a
vein is a common problem, particularly in
immobile older adults. These clots can form
quickly because of sluggish blood flow within
the vessels. Increasing the patient’s activity and
using antiembolism stockings help prevent
problems related to venous stasis or pooling.
- Medical Management of thrombophlebitis
typically includes rest, elevation of the affected
leg, application of elastic stockings or wraps,
administration of analgesics, anticoagulant
therapy, and sometimes application of heat.
- If a thrombus breaks loose from the vein and
travels in the circulatory system, it is referred to
as an embolus. Emboli can be life-threatening.
They are particularly dangerous if they reach
small blood vessels in the lungs or brain, where
they can occlude the blood supply to vital
tissues
8. Varicose Veins
- are seen when blood pools in the veins and
dilates or stretches them. The decrease in
vascular muscle tone that occurs with aging
increases the risk for this.
- Older adults who are obese, are inactive, or
spend a great deal of time standing are more
likely to have varicosities. The risk for inflamed
varicosities increases with age
- Patients can reduce or prevent related problems
by avoiding constricting garments, such as
garters or rolled stockings, by refraining from
sitting with crossed legs, by increasing activity,
by resting with the legs elevated, and by
wearing elastic stockings that promote venous
return
9. Aneurysm
- the pouching or ballooning of arteries, is
common in older adults who suffer from
arteriosclerotic blood vessel changes.
 - high blood pressure (hypertension) over many Albumin, the most abundant plasma protein, is
years resulting in damage and weakening of important in the maintenance of osmotic pressure
blood vessels. fatty plaques (atherosclerosis) needed to regulate blood pressure and volume. In the
resulting in a weakness of the blood vessel wall. fibrinogen component are prothrombin, fibrinogen
inherited diseases that may result in weaker itself, and other clotting factors that circulate until they
than normal blood vessel walls. are required by the body. Globulins function as
- If you require emergency treatment because of transport agents for lipids and fat-soluble vitamin
a ruptured brain aneurysm, you'll initially be
given a medication called nimodipine to reduce Erythrocytes, or RBCs, live for approximately 120 days
the risk of the blood supply to the brain When RBCs become old and fragile, they are removed
becoming severely disrupted (cerebral from the circulation by the reticuloendothelial cells of
ischaemia). Either coiling or clipping can then be the spleen, liver, and red bone marrow
used to repair the ruptured brain aneurysm.
Leukocytes, or WBCs, have protective functions: they
10. Hypertensive Disease destroy dead or damaged tissue, detoxify foreign
- Hypertension is categorized as essential proteins, protect from infectious disease, and function
(primary) or secondary. in the immune response.
- Essential hypertension, the more common form,
has no known cause. Many factors, including Platelets, more properly called thrombocytes, are not
heredity, diet, obesity, stress, smoking, whole cells but pieces of cells. They are produced when
increased serum cholesterol levels, and large cells called megakaryocytes fragment and enter
abnormal sodium transport, are known to the circulation. Platelets, which remain in circulation for
contribute to essential hypertension approximately 10 days, play an important role in the
- Essential hypertension cannot be cured, but it blood’s clotting mechanism
can be treated. Treatment includes
nonpharmacologic approaches, such as rest,
smoking cessation, use of stress-reduction
techniques, weight loss, and dietary sodium
restriction.
- Secondary hypertension occurs as a result of a
coexisting disease process or other known
cause. Renal, vascular, and endocrine pathologic
conditions are among the most common causes
of secondary hypertension.
- Treatment of secondary hypertension is
directed at the underlying pathologic condition

THE HEMATOPOIETIC AND LYMPHATIC SYSTEMS

Body fluids distribute essential protective factors,
nutrients, oxygen, and electrolytes throughout the body.
The two major fluids of the body are blood and lymph.
These fluids flow through the body within two parallel
circulatory systems.

Blood is 91% to 92% liquid; the remaining 8% to 9% is

solid. The liquid of the blood is called plasma.
Carbon dioxide is carried in the plasma as bicarbonate
ion. Plasma contains a variety of proteins.
 - Folic-acid-deficiency anemia is usually caused by
poor nutrition, chronic alcohol abuse, or
malabsorption syndromes, such as Crohn
disease.
2. Leukemia

- is the result of excessive production of

immature WBCs.
- Chronic lymphocytic leukemia is the form most
often seen in older adults

THE GASTROINTESTINAL SYSTEM

COMMON DISORDERS SEEN WITH AGING

1. Hiatal Hernia
- is the protrusion of the stomach into the
thoracic cavity through the esophageal opening
in the diaphragm

COMMON DISORDERS SEEN WITH AGING

1. Anemia
- is defined as inadequate levels of RBCs or
insufficient hemoglobin. The most commonly
observed anemias in older adults are
iron-deficiency anemia, pernicious anemia, and
folic-acid-deficiency anemia.
- Iron-deficiency anemia results from inadequate
nutritional intake, blood loss, malabsorption, or
increased physiologic demand.
- Pernicious anemia is associated with decreased
intake or absorption of vitamin B12. A, Sliding hernia. B, Paraesophageal hernia.
- Complaints may include heartburn, acid reflux,
or generalized epigastric distress. - Diverticula are small pouches or sacs that
- Causes: Chronic coughing. Lifting heavy objects. develop because of weaknesses in the intestinal
Repetitive vomiting. Straining during a bowel mucosa
movement. - is caused by an infection of one or more of the
- Surgery to repair a hiatal hernia may involve diverticula. It is thought an infection develops
pulling your stomach down into your abdomen when a hard piece of stool or undigested food
and making the opening in your diaphragm gets trapped in one of the pouches. This gives
smaller or reconstructing an esophageal bacteria in the stool the chance to multiply and
sphincter. In some cases, hiatal hernia surgery is spread, triggering an infection.
combined with weight-loss surgery, such as a - Mild diverticulitis can be treated with rest,
sleeve gastrectomy changes in your diet and antibiotics. Severe or
recurring diverticulitis may require surgery.
2. Gastroesophageal reflux disease (GERD) 5. Diverticulitis
-is a major problem that can occur with hiatal - involves inflammation of one or more
hernias. diverticula. This inflammation may result in
- occurs when stomach acid repeatedly flows bowel obstruction, perforation, or abscess
back into the tube connecting your mouth and formation.
stomach (esophagus). This backwash (acid 6. Colon Cancer
reflux) can irritate the lining of your esophagus. - The incidence of colon cancer begins to increase
Many people experience acid reflux from time at 40 years of age and peaks between the ages
to time. of 60 and 75.
- Causes: Eating large meals or eating late at - is a disease in which cells in the colon or
night. Eating certain foods (triggers) such as rectum grow out of control.
fatty or fried foods. Drinking certain beverages, - Lack of regular physical activity. A diet low in
such as alcohol or coffee. Taking certain fruit and vegetables. A low-fiber and high-fat
medications, such as aspirin. diet, or a diet high in processed meats.
- : Prescription-strength proton pump inhibitors. Overweight and obesity.
These include esomeprazole (Nexium),
lansoprazole (Prevacid), omeprazole (Prilosec),
pantoprazole (Protonix), rabeprazole (Aciphex)
and dexlansoprazole (Dexilant).
3. Gastric and Ulcers
3.1 Chronic atrophic gastritis
- is an inflammatory change in the mucous
membranes of the stomach in which the
mucosa becomes thin and abnormally smooth
and may develop hemorrhagic patches. All or
part of the stomach may be involved.
3.2 Peptic Ulcer
- is a term that refers to both gastric and
duodenal ulcers. Either can occur with aging,
but gastric ulcers are more common.
- Helicobacter pylori or H. pylori, has been
implicated as the major cause of gastric ulcers.
- Diet and nutrition do not appear to play a role
in causing or preventing peptic ulcers. Smoking 7. Hemorrhoids
and alcohol do contribute to ulcers, however
4. Diverticulosis and Diverticulitis
 - sometimes called piles by older adults, are
common at all ages but may be particularly
troublesome to older patients.
- can develop from increased pressure in the
lower rectum due to: Straining during bowel
movements. Sitting for long periods of time on
the toilet.
- Most patients with hemorrhoids do not require
surgery. Diet changes, stool softeners, or bulk
laxatives are usually effective in reducing
problems related to constipation and
hemorrhoids.
8. Rectal Prolapse
- occurs when part of the large intestine's lowest
section (rectum) slips outside the muscular
opening at the end of the digestive tract (anus).
- We do not know the exact cause of rectal
prolapse, but risk factors include chronic
constipation, straining to pass bowel motions,
and weakened pelvic floor muscles. Treatment
includes surgery, performed through the
abdomen or via the anus, to tether the rectum
into place.
URINARY SYSTEM
The kidneys decrease in size from approximately 400 g
at age 40 to only 250 g by age 80. By age 70, they lose
approximately one-third of their efficiency and they lack
functional reserve. Despite this, the kidneys are usually
able to remove waste adequately to maintain normal
blood levels.
1. Urinary Incontinence
- the involuntary loss of urine, is not a routine or
normal occurrence with aging.
2. Urinary Tract Infection
- are common infections that happen when
bacteria, often from the skin or rectum, enter
the urethra, and infect the urinary tract. The
infections can affect several parts of the urinary
tract, but the most common type is a bladder
infection (cystitis). Kidney infection
(pyelonephritis) is another type of UTI.
- are usually caused by bacteria from poo
entering the urinary tract. The bacteria enter
through the tube that carries pee out of the
body (urethra). Women have a shorter urethra
than men. This means bacteria are more likely
to reach the bladder or kidneys and cause an
infection.
- Taking antibiotics, prescribed by a healthcare
professional, at home can treat most UTIs.
However, some cases may require treatment in
a hospital.
3. Chronic Renal Failure
 - Chronic kidney disease, also called chronic
kidney failure, involves a gradual loss of kidney
function. Your kidneys filter wastes and excess
fluids from your blood, which are then removed
in your urine.
- caused by certain other medical conditions that
put strain on the kidneys over time, including
diabetes, high blood pressure or hypertension
and long-term inflammation of the kidneys
- The main treatments are: lifestyle changes – to
help you stay as healthy as possible. medicine –
to control associated problems, such as high
blood pressure and high cholesterol. dialysis –
treatment to replicate some of the kidney's
functions, which may be necessary in advanced
(stage 5) CKD.
NERVOUS SYSTEM
Many cellular changes have been observed in the aging
brain, including a reduction in its size and weight
resulting from a decrease in the volume of the cerebral
cortex. Cerebral blood flow decreases with aging
because of the gradual accumulation of fatty deposits
(i.e., arteriosclerosis). Decreased blood flow also results
in a slower rate of cerebral metabolism
1. Parkinson Disease
- is a brain disorder that causes unintended or
uncontrollable movements, such as shaking,
stiffness, and difficulty with balance and
coordination.
- also called paralysis agitans, is a progressive,
degenerative disorder of the central nervous
system
- The cause of Parkinson disease is unknown.
Specific neurons in the brain that produce the
neurotransmitter dopamine are lost. Symptoms
usually begin after age 40 years and appear
gradually. The incidence of Parkinson disease
increases in older age groups.
- The main therapy for Parkinson's is levodopa.
Nerve cells use levodopa to make dopamine to
replenish the brain's dwindling supply. Usually,
people take levodopa along with another
medication called carbidopa
2. Dementia
- is a general term for a permanent or progressive
organic mental disorder. Dementia is
characterized by personality changes;
confusion; disorientation; deterioration of
intellectual functioning; and impaired control of
memory, judgment, and impulses.
- is not a specific disease but is rather a general
term for the impaired ability to remember,
think, or make decisions that interferes with
doing everyday activities. Alzheimer's disease is
the most common type of dementia. Though
dementia mostly affects older adults, it is not a
part of normal aging.
- is caused by damage to or loss of nerve cells
and their connections in the brain.
- No cure, Donepezil (also known as Aricept),
rivastigmine (Exelon) and galantamine
(Reminyl) are used to treat the symptoms of
mild to moderate Alzheimer's disease.
Donepezil is also used to treat more severe
Alzheimer's disease.
1. Vascular Dementia
- previously known as multiinfarct dementia, is
the second most common form of dementia
- Refers to changes to memory, thinking, and
behavior resulting from conditions that affect
the blood vessels in the brain. Cognition and
brain function can be significantly affected by
the size, location, and number of vascular
changes
2. Dementia with Lewy Bodies (DLB)
- is caused by microscopic protein clumps in the
brain (Lewy bodies) that cause damage to nerve
cells
- is a disease associated with abnormal deposits
of a protein called alpha-synuclein in the brain.
These deposits, called Lewy bodies, affect
chemicals in the brain whose changes, in turn,
can lead to problems with thinking, movement,
behavior, and mood.
3. Parkinson Disease Dementia (PDD)
- is a decline in thinking and reasoning skills that
develops in some people living with Parkinson's
at least a year after diagnosis.
4. Mixed Dementia
- Mixed dementia is a condition in which brain
changes of more than one cause of dementia
occur simultaneously.
blood flow to the brain, known as a transient
ischemic attack (TIA), that doesn't cause lasting
symptoms.
- is a medicine called tissue plasminogen
activator (tPA). It breaks up the blood clots that
block blood flow to your brain. A doctor will
inject tPA into a vein in your arm. This type of
medicine must be given within 3 hours after
your symptoms start.
SPECIAL SENSES

3. Alzheimer Disease
- is the most common type of dementia. It is a
progressive disease beginning with mild
memory loss and possibly leading to loss of the
ability to carry on a conversation and respond to
the environment. Alzheimer's disease involves
parts of the brain that control thought, memory,
and language.
- is thought to be caused by the abnormal
build-up of proteins in and around brain cells.
One of the proteins involved is called amyloid,
deposits of which form plaques around brain
cells. The other protein is called tau, deposits of
which form tangles within brain cells.
- Aducanumab is the only disease-modifying
medication currently approved to treat
Alzheimer's.

4. Transient Ischemic Attack

- or "mini stroke" is caused by a temporary
disruption in the blood supply to part of the bra
5. Stroke
- formerly called a cerebrovascular accident,
sometimes called a brain attack, occurs when
something blocks blood supply to part of the
brain or when a blood vessel in the brain
bursts. In either case, parts of the brain become
damaged or die. A stroke can cause lasting brain
damage, long-term disability, or even death
- There are two main causes of stroke: a blocked
artery (ischemic stroke) or leaking or bursting
of a blood vessel (hemorrhagic stroke). Some
people may have only a temporary disruption of

1. Refractive errors
- or errors in focusing ability, occur when the
cornea is misshapen or when the lens cannot
appropriately change shape to focus images.
- 50 years of age experience some degree of
farsightedness, also called hyperopia or
presbyopia, which literally means “aging eye.”
- Astigmatism, a malformation of the cornea,
causes blurring of images at all distances.
People of all ages can have astigmatism, but
younger people compensate for it by quickly
refocusing the blurred and unblurred images.
When this ability decreases with aging,
astigmatism appears to worsen. Corrective
lenses help with this
2. Blepharitis
- is a common eye condition that makes your
eyelids red, swollen, irritated, and itchy. It can
cause crusty dandruff-like flakes on your
eyelashes.
3. Diplopia
- or double vision, is not normal and indicates
some disturbance of the nervous system that
requires further investigation by the primary
care provider
4. Cataracts
- which cause a clouding of the lens of the eye,
are increasingly common with aging.
5. Glaucoma
- is a disease characterized in most cases by
increased fluid pressure (intraocular pressure)
 within the eye that may result in damage to the
retina.
- is a group of eye diseases that can cause vision
loss and blindness by damaging a nerve in the
back of your eye called the optic nerve
EARS