MODULE 2

Physiologic Changes in Aging Affecting Various Systems

 LESSON 4 CARDIOVASCULAR SYSTEM
 The Cardiovascular system consist of the heart, associated vasculature, and the blood.
 The heart contains four chambers, consisting of the two upper atria and the two lower
ventricles.
 The main function of the is to maintain homeostasis by transferring oxygen, nutrients
and hormones to the other organ system.
 Cardiac Aging

 Enlargement of the heart chambers and coronary cells result to increased

thickening of heart walls especially in left ventricle.
 This enlargement & thickening causes a decline in ventricle flexibility &
overall increase heart weight for about 1.5grams/yr in women & 1.0gram/yr
in men, from age to 30 to age 90yrs.
 Ventricles in the heart also begin to thicken and stiffen in correlation w/
continued steady production of collagen.

Vascular Aging

 Aged arteries stiffen, dilate, become extend become and twisted. This leads to
hypertension characterized by increased blood variety from the aorta to the
systemic arterial system.
Cardiovascular Aging Mechanism

 Potential mechanisms includes radicals, inflammatory process, advanced

glycation end products, and gene expression.
 The presence of lipofuscin, a brown pigment found in aging cells, relates to
oxidative mechanisms.
 Increased levels of free radicals can foster apoptosis, or cell death. It is due to
very limited regenerative properties of cardiomyocytes or heart cells.
Lifestyle Intervention to Maintain or Improve Physiological Functioning
in Cardiovascular Aging
Physical activities 1. Do some type of exercise at least 30 minutes
per day and more involved exercise 3-5 days
per week.
2. Include cardiovascular training, weight-
bearing exercise, resistanc balance training,
and flexibility exercise.

Nutrition 1. Low-calorie diet

2. Low-fat diet
3. Low-sodium diet
4. Low-cholesterol diet
5. At least five fruits and vegtable per day
6. Plenty of whole grains
7. Eight glasses of water a dayy

Vitamins and Minerals 1. Vitamins; B6, B12,D,K,A,C,E, beta-

carotene, and folic acids
2. Minerals; selenium, calcium, and iron.
 LESSON 5 HEMATOPOETIC SYSTEM

 Hematopoietic system is responsible for the production, differentiation, and proliferation

of mature blood cells from stem cells.
 The site of blood cell production or HEMATOPOIESIS, changes with the developmental
stage of an organism.
 In the fetus, blood cells are produced in liver, spleen, and yolk sac.
 In children and adults, blood cells are produced in bone marrow.
 Hematopoietic system is responsible also for a variety of function including oxygen
delivery to cells, the immune response, and hemostasis.
 Aging of Hematopoietic System

 Reduced proliferation and self-replicative capacity of stem cells and changes

in cytokine network

Stem Cells and Aging

 Stem cells’ proliferative capacity is limited (because of telomeres shortening)

and may decrease with age---exhaustion----cell proliferation ceases---inability
to supply mature hematopoietic cells----poor oxygen delivery and immune
response
 LESSON 6 Gastrointestinal System
 The two GI areas most affected by age are the upper tract and the colon, also
referred to as the large intestine.
 Changes in the GI system can have multiple and varied effects, including effects
upon consumption and absorption of nutrients and waste secretion.

MOUTH

• The mouth is utilized for mastication, or chewing and for moistening food with saliva.
• Age related changes in teeth cause them to be less sensitive and more brittle causing
tooth decay and loss. This may improve by increased health awareness, improved
dentistry practices, and higher availability of fluoride toothpaste and floss.
 With age, there is atrophy of those muscles and bones of the jaw and mouth that
control mastication. Along with changes in the ability of the nerves and muscles to
coordinate functioning.

ESOPHAGUS
 Impaired esophageal motility function in older individuals results to
presbyesophagus, where esophagus appears wavier than typically straight causing
changes of food motility in the esophagus.
 Older adults demonstrated stiffening of the esophageal wall and less sensitivity to
discomfort and pain in the esophagus.
 The gag reflex also appears to be absent in around 40% of healthy older adults.
Dysphagia (difficulty of swallowing), reflux, heartburn and chest pain are common
complaints that relate to changes in the pharynx and esophagus approximately 35%
of older individuals report such complaints.
LARGE INTESTINE
 In aging, a loss of enteric or intestinal neurons and nerve connections to
the smooth muscle in the colon occurs; causing older adults to experience
longer colonic transit time (the amount of time needed for fluid and
excrement to travel the length of the colon).
 Increased colonic transit time also correlates with increased fibrosis in the
colon resulting to constipation which but can be lowered with fiber
supplementation.
 Absorption of nutrients generally does not change with age, though
changes in vitamin absorption are seen with particular vitamins but not
others.
 Vitamin A absorption increases in older adults whereas vitamin D, zinc,
and calcium absorption decreases. Absorption of vitamin B1, B12, and C
and iron does not change with age.
 LESSON 7 URINARY SYSTEM
 Contains kidneys, renal associated structures, urethra, ureter and urinary bladder
 One of the vital functions is to remove toxic substances from the body

Urinary Structural Changes

 With age, kidneys shrink in length and weight. The size and number of nephrons and other
nearby structures also decrease with age. Glomerular function rate is therefore compromised.
 A decline in GFR becomes significant as people age because elimination of waste and toxin also
declines, causing an accumulation of harmful substances like uric acid and medications in the
body.
 Despite age related structural changes, kidneys contain a large reserve capacity and functional
abilities remain relatively stable unless stressed.
 With age, bladder decreases in size and develops fibrous muscle in bladder wall,
changing its stretching capacity and contractibility.---filling capacity and ability to
withhold voiding declines
 Ureters do not demonstrate any age-specific changes.
 Urethra and its sphincter also thins and weakens with aging; prostate in men enlarges
thereby causing urinary dysfunction (BPH, Benign Prostatic Hyperplasia)
Urinary Functional Changes with Age
 The amount of urine decreases with age, correlating with increases of around 50-100
ml in post void residual----Nocturia (Increased night voiding)which disturb sleep
patterns also happen during aging.
 Renal changes affect the ability to concentrate and dilute the urine, causing
electrolyte imbalance.
 BPH can lead to prostatic changes that influence lower tract urinary functional and
erectile and ejaculatory disorders----urinary retention, dysuria, UTI then renal failure.
 Older adults also experience changes in their ability to reabsorb water and in
conjunction with decreased thirst, the body can become dehydrated more quickly