1. Geriatric Health Nursing Course|520410 Chapter Four Physiological Changes Due to Ageism Assembled by: Miss. Ala’ Obeyat 2024

2. Integumentary System • As individuals age, their bodies undergo a multitude of changes, including significant alterations to the integumentary system, which comprises the skin, hair, nails, and sweat glands. • These changes not only affect the appearance but also the functionality and overall health of the skin.

3. Changes of integumentary system • Skin Thinning: Fragile and prone to injury. • Decreased Elasticity: Wrinkles and sagging skin. • Dryness: Itching and discomfort. • Decreased Melanocyte Function: Lighter skin; increased sun damage and skin cancer risk. • Slower Wound Healing: Impaired healing of wounds. • Loss of Subcutaneous Fat: Less insulation; increased vulnerability to cold and pressure sores. • Changes in Hair: Thinning, graying, slower growth. • Nail Changes: Thicker, more brittle • Increased Risk of Skin Lesions: More benign and malignant growths. • Decreased Sweat Gland Activity: Impaired temperature regulation.

4. Integumentary System • Notable changes due to aging • Graying of hair • Wrinkling of skin • Reduced skin turgor • Dry scaly skin • Thinning epidermis • Thicker nails • Age spots

5. Actinic Keratosis • Pronounced • (ak-TIN-ickair-ah-TOH-sis) • Defined • Premalignant warty lesion, occurring on the sun-exposed skin of the face or hands in aged light-skinned persons • Raised areas appear scaly and may bleed at the edges • (also called solar keratoses)

6. Seborrheic Keratosis • Pronounced • (seb-oh-REE-ikkair-ah-TOH-sis) • Defined • Brown or waxy yellow wart-like lesions that are loosely attached to the skin • Senile warts

7. Carcinoma, Basal Cell • Pronounced • (car-sih-NOH-mahBAY-sal sell) • Defined • Most common malignant tumor of epithelial tissue, occurring most often on areas of skin that are exposed to the sun • Presents as a slightly elevated nodule with a depression or ulceration in the center that becomes more obvious as the tumor grows

8. Eczema • Pronounced • (EK-zeh-mah) • Defined • Acute or chronic inflammatory skin condition characterized by erythema (reddening), edema (swelling), papules (bumps), and crusting of the skin followed, finally, by (thickening) and scaling of the skin.

9. Skeletal System

10. Skeletal System • Notable changes due to aging • Normal age-related changes affect mobility • After age 50, musculoskeletal system gradually loses bone mass • Increase in bone fragiliaty • Decrease in bone strength

11. Fracture of the Hip • Pronounced • (Fracture of the hip) • Defined • Break in continuity of bone involving upper third of femur • Location of most hip fractures is in upper 1/3 of the femur • Occurs most often in the elderly due to diminished sense of equilibrium, coordination and body position

12. Fracture of the Hip • Causes • Falls • Cause of most hip fractures, impactions, or dislocations • Women more susceptible • Due to osteoporosis • Treatment • Surgery • May involve open reduction and internal fixation

13. Fracture of the Hip Internal Fixation Devices

14. Osteomalacia • Pronounced • (oss-tee-oh-mah-LAY-she-ah) • Defined • Abnormal softening of bones due to a deficiency of calcium and phosphorus in blood • Which is necessary for bone mineralization

15. Osteoporosis • Pronounced • (oss-tee-oh-poh-ROW-sis) • Defined • Porous bones • Bones that were once strong become fragile due to loss of bone density • Occurs more frequently in postmenopausal women, in sedentary or immobilized individuals, and in patients on long-term steroid treatment

16. Osteoporosis

17. Muscles and Joints • Notable changes due to aging • Loss of muscle mass • Decline in muscle strength • Cartilage in joints eventually erodes • Increasing stress on underlying bone • Joint mobility is hampered • Elastic synovial tissue is replaced with collagen fibers • Synovial fluid within joint increases in viscosity

18. Nervous System • Notable changes due to aging • Slower nerve transmission • Slower voluntary movements • Stooped forward-flexed posture • Slowed gait • Dry eyes • Impaired ability to hear high-pitched sounds • Decreased ability to maintain balance and correct imbalance

19. Cardiovascular

20. Cardiovascular System • Notable changes due to aging • Workload of heart may be compromised due to accumulation of excess fat surrounding the heart • May be due to poor dietary and exercise habits • Risk for cardiovascular disease increases significantly in women after menopause • Risk is about equal in men and women after the age of 65

21. Arteriosclerosis • Pronounced • (ar-tee-ree-oh-skleh-ROH-sis) • Defined • Arterial condition in which there is thickening, hardening and loss of elasticity of the walls of arteries (hardening of the arteries) • Results in decreased blood supply, especially to lower extremities and cerebrum

22. Congestive Heart Failure • Pronounced • (con-JESS-tiv heart failure) • Defined • Condition in which pumping ability of heart is progressively impaired to the point that it no longer meets bodily needs

23. Coronary Artery Disease • Pronounced • (KOR-oh-nah-ree AR-ter-ee dih-ZEEZ) • Defined • Narrowing of coronary arteries to the extent that adequate blood supply to the myocardium is prevented

24. Coronary Artery Disease • Treatments for occluded coronary arteries • Medications • Percutaneous Transluminal Coronary Angioplasty (PTCA) • Directional Coronary Atherectomy • Coronary Bypass Surgery = Coronary Artery Bypass Graft (CABG)

25. Respiratory System

26. Respiratory System • Notable changes due to aging • Decreased volume during inspiration and expiration • Loss of elasticity in pulmonary tissue • Decreased action of cilia within respiratory tract • Respiratory muscle strength and endurance decreases • Decreased strength for breathing and/or coughing

27. Influenza • Pronounced • (in-flew-EN-zah) • Defined • Highly contagious viral infection of the respiratory tract • Transmitted by airborne droplet infection • Flu

28. Pneumonia • Pronounced • (noo-MOH-nee-ah) • Defined • Acute inflammation of lungs caused mainly by inhaled pneumococci of the species Streptococcus pneumoniae • May also be caused by other bacteria, as well as viruses

29. Pulmonary Edema • Pronounced • (PULL-mon-air-ree eh-DEE-mah) • Defined • Swelling of lungs caused by an abnormal accumulation of fluid in the lungs • Either in alveoli or the interstitial spaces

30. Digestive System

31. Digestive System • Notable changes due to aging • Loss of teeth related to dental or periodontal problems • Decrease in quality and quantity of saliva • Some decrease in normal peristalsis in esophagus • Weakness in musculature of large intestine • Results in decreased forcefulness of contractions and slowing of peristaltic activity

32. Diverticular Disease • Pronounced • (dye-ver-TIK-yoo-lar dih-ZEEZ) • Defined • Expression used to characterize both diverticulosis and diverticulitis • Diverticulosis = noninflamed outpouchings or herniations of the muscular layer of the intestines • Diverticulitis = inflammation of these outpouchings • Increasingly common occurrence in persons over 45

33. Urinary System

34. Urinary System • Notable changes due to aging • Aging kidney is more susceptible to trauma or disease • Number of nephron units of the kidney decrease during the aging process • 50 percent decrease in glomerular filtration rate by age 70 to 80 • Drugs may not be excreted as rapidly as possible

35. Urinary Incontinence • Pronounced • (YOO-rih-nair-ree in-CON-tin-ens) • Defined • Inability to retain urine in bladder • Loss of urine from bladder due to loss of sphincter control • Urine loss is severe enough to cause social or hygienic problems

36. Urinary Incontinence • Urinary incontinence • Affects mostly older adults • Not necessarily a normal consequence of aging • Possible causes • Abnormalities of bladder contraction • Abnormalities of urethral relaxation • Dementia (in some elderly persons)

37. Urinary Incontinence • Stress incontinence • Inability to hold urine when bladder isstressed by sneezing, coughing, laughing, or lifting • Functional incontinence • Individual experiences an involuntary unpredictable passage of urine • Characterized by urge to void, or bladder contractions strong enough to result in loss of urine before reaching an appropriate receptacle

38. Urinary Incontinence • Urge incontinence • Urge to empty bladder is sudden and uncontrollable • Individual experiences involuntary passage of urine soon after the strong sense of urgency to void • Overflow incontinence • Involuntary loss of urine is associated with overdistention of bladder, when bladder’s capacity has reached its maximum

39. Male Reproductive System • Notable changes due to aging • Decrease in testosterone level • Decrease in sperm production • Decrease in muscle tone of scrotum • Decrease in size and firmness of testicles • Enlargement of prostate gland

40. Benign Prostatic Hypertrophy • Pronounced • (bee-NYEN pross-TAT-ik high-PER-troh-fee) • Defined • Benign enlargement of prostate gland, creating pressure on upper part of the urethra or neck of bladder, causing obstruction to flow of urine • Common condition occurring in men over 50

41. Carcinoma of the Prostate • Pronounced • (car-sin-OH-mah of the PROSS-tayt) • Defined • Malignant growth within prostate gland, creating pressure on upper part of urethra • Most common cause of cancer among men, and most common cause of cancer death due to cancer in men over age 55

42. Female Reproductive System • Notable changes due to aging • Physical changes occur after menopause • Ovaries cease to produce ova • Less estrogen hormone secreted • General atrophy of genitalia • Includes less fat, external hair loss, flattening of the labia • Vaginal dryness • Breast sagging due to changes

43. Atrophic Vaginitis • Pronounced • (ay-TROH-fikvaj-in-EYE-tis) • Defined • Degeneration of vaginal mucous membrane after menopause • Also known as senile vaginitisrefers to the thinning, drying, and inflammation of the vaginal walls that can occur due to a decrease in estrogen levels • Common in estrogen-deprived older women

44. Ovarian Carcinoma • Pronounced • (oh-VAY-ree-an car-sin-OH-mah) • Defined • Malignant tumor of ovaries, most commonly occurring in women in their 50s • Rarely detected in early stage