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Effects of Aging on Mobility and Independence. Anthony Poggio, DPM,MS Cal ‘ 79. Muscle Tendon Bone Skin Neurology Vascular Psych. Affects of Aging . Support Skeletal system; Posture Facilitate motion Heat Production. Weakness Contracture Gait changes

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Effects of Aging on Mobility and Independence

Anthony Poggio, DPM,MS

Cal ‘79


Affects of aging l.jpg

Muscle

Tendon

Bone

Skin

Neurology

Vascular

Psych

Affects of Aging


Muscle tendon l.jpg

Support Skeletal system; Posture

Facilitate motion

Heat Production

Weakness

Contracture

Gait changes

decrease in energy supply (ATP, creatine phosphate and glycogen

decreased circulation to bring in O2 and clear lactic acid

Changes at the motor end plate, therefore decrease in stimulation potential

Muscle/Tendon


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Changes at the motor end plate, Sarcolemma are fewer, shorter, become smoother

decrease in surface area therefore decrease in stimulation potential

Muscle/Tendon


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Muscle/Tendon shorter, become smoother

  • reduction in size and number of mitochondria hence decrease in available energy

  • decrease in substances to supply energy (ATP, creatine phosphate and glycogen)


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Decreased circulation to bring in O2 and nutrients shorter, become smoother

breakdown of other substances creating build up of lactic acid

Muscle/Tendon


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Muscle/tendon shorter, become smoother

  • Increase in fat/fibrinous tissue within muscle

  • decreased ability or muscle repair

  • increased scar tissue

  • therefore there is slower, weaker, irregular contraction with longer recovery period


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skeletal structure shorter, become smoother

Attachment for muscle, tendons. ligaments, etc

Blood cell production

Osteoporosis

Osteopenia

fracture, hip

delayed healing

Bone


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Cortical bone: shorter, become smoother

Dense packed bone, very compact and hard

forms outer shell of bone

Trabecular bone:

loosely packed matrix, “spongy”

head and base of long bones

majority of irregular bones

Bone


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Joint shorter, become smoother

  • Arthritis

    • Joint Stiffness

    • loss of cartilage

    • loss of joint contour

    • angular deformities

  • Synovial membrane less elastic as are adjacent ligament structure

  • with less movement-joint (ligaments) contract to position

  • Hyaline vs fibrocartilage


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Joints shorter, become smoother

  • Loss of hyaline cartilage

  • decreased water content with increased calcium salts, crosslinking of fibers therefore more stiff and less elastic

  • can reform fibrocartilage


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Joints shorter, become smoother

  • Synovial fluid decreased in volume secondary to decreased blood flow,

  • Synovial membrane less elastic as are adjacent ligament structure

  • with less movement-joint (ligaments) contract to position


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Provides barrier shorter, become smoother

organisms,

chemicals,

water,

light,

trauma

Skin


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E shorter, become smootherEpidermisPIDERMIS

ROLE:

Provides Protective Covering & Generates New Cell Growth

With aging less able to keep out substances; chemicals, microorganisms

athletes foot, fissures


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D shorter, become smootherDermisERMIS

ROLE:

Provide the Skin with Strength & Elasticity

  • Major Structures: Blood Vessels, Nerve Endings, Hair Follicles, & Sebaceous Glands that secrete sebum to prevent skin from drying out

  • With aging less h20 more crosslinking of collagen therefore thinner and less elastic- fissures


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    Subcutaneous tissue shorter, become smoother

    UTANEOUS TISSUE

    ROLE:

    Provides protection & insulation for the underlying tissue

    • With aging

      • decreased fat: decreased cushion, callous/corns

      • less skin support: increased sheer force

    • ***Typically the subcutaneous tissue is poorly vascularized.


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    Skin shorter, become smoother

    • Decubitus ulcers-bed sore

      • weaker skin

      • thinner skin

      • decreased blood supply

      • skin hygiene

      • poor nutrition

      • decreased ability to repair


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    COMMON LOCATIONS shorter, become smoother

    • Bony Prominences

    • Occiput

    • Scapulae

    • Elbows

    • Sacrum

    • Trochanter

    • Ischium

    • Knees

    • Ankles

    • Heels


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    COSTS OF PRESSURE ULCERS shorter, become smoother

    • Annual US healthcare costs are over $1.3 billion

    • Average cost per ulcer = $27,000

    • Quality of life issues

    • Increased length of stay

    • Tissue and bone infections


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    PRESSURE ULCERS shorter, become smoother

    • Pressure ulcers occur in 11% of all hospital admissions

    • Pressure ulcers occur in over 25% of long term care residents

    • Certain patient groups have even higher groups have even higher incidences - 66% of femoral fracture patients, 60% of quadriplegic patients


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    DEFINITION OF A PRESSURE ULCER shorter, become smoother

    • Localized area of tissue breakdown resulting from compression of soft tissue between a bony prominence and an external surface


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    SKIN BREAKDOWN: DIABETIC ULCERS shorter, become smoother

    Skin breakdown due to loss of sensation coupled with repetitive pressure and shear


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    Peripheral arterial disease shorter, become smoother

    venous disease

    diminished healing ability, defense

    micro-circulation to muscle, nerves, etc

    amputation

    Vascular

    Function:

    Transportation


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    Venous disease shorter, become smoother

    • Return blood to heart

    • slower blood flow-clot formation

    • venous stasis dermatitis- skin damage


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    CAPILLARY HYPERTENSION shorter, become smoother

    • Capillaries have thin, single-cell thickness walls

    • Venous hypertension causes capillary walls to stretch, creating gaps between cells


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    Neurology shorter, become smoother

    • Function

      • monitoring,

      • communicating

      • stimulation

      • coordination


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    Nerve Loss shorter, become smoother

    sensory

    motor

    Coordination

    reflexes

    Neurologic


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    Sensory shorter, become smoother

    requires more stimuli to elicit response

    awareness of position

    reflexes

    Somatic

    decreased transmission speed down axon resulting in slower and weaker contraction ability

    prolonged refractory period before next contraction

    less coordinated motion

    Neurology


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    Misc shorter, become smoother

    • Vision

      • obstacle

    • cardiac

    • pulmonary

      • stamina


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    Putting it all together shorter, become smoother


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    Loss of independence shorter, become smoother

    fear of losing independence

    rely on family/friends for simply tasks

    must be done at their convenience

    isolation

    Psychological Factors


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    Psychological Factors shorter, become smoother

    • Assistive devices

      • realization they are old

      • embarrassment in public

      • limitation in activities


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    Psychological Factors shorter, become smoother

    • Self Care

      • inability to bend to reach items

      • open bottles, apply dressing


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    Fear of Falling shorter, become smoother

    Decreased stamina

    Cycle of decreased activity

    more stiffness

    decreased vasc supply and overall health

    less coordination

    increased isolation

    depression

    Psychological Factors


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    Prevention/Treatment shorter, become smoother

    • In home support vs nursing home

    • improvement in function

      • physical therapy, medication

    • Age related or not??

    • Social agencies

      • paratransit, special equipment (scooters)


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    Prevention/Treatment shorter, become smoother

    • Put in perspective

    • Enlist family support

    • active participation-feel in control

    • speak to them, not down to them

    • patience


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    THANK YOU! shorter, become smootherGood Luck in Your Future Careers

    GO BEARS!!!


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