View
214
Download
0
Category
Tags:
Preview:
Citation preview
Recent approaches challenge the inevitability of
function pathology by grouping the aging processes into three categories:
1. Aging with disease and disability2. Usual aging, with absence of overt
pathology but presence of some declines in function
3. Successful or healthy aging, with no pathology and little or no functional loss
Such a grouping of aging processes:1. De-emphasizes the view that aging is
exclusively characterized by declines in functional competence & health
2. Refocuses on the substantial heterogeneity among old persons
3. Underscores the existence of positive trajectories (i.e., without disability, disease, major physiological decline)
4. Highlights the possible avoidance of many, if not all, the diseases and disabilities usually associated with old age
Figure 2.3: Common
causes of death by age in the United States
(also look 3.7)
Pathology: abnormal function leading to disease* COPD:
Chronic Obstructive Pulmonary Disease
** Disease of
Kidney
Tables 3-11 Di seases of the Elderly
Limited to aging
Osteoporosis Osteoarthritis Prostatic adenocarcinoma Polymyalgia rheumatica Temporal arteritis
Associated with aging
Known etiology Septicemia Pneumonia Cirrhosis Nephritis Cerebrovascular disease Myocardial infarction
Unknown etiology Adult-onset, Type 2 diabetes Neoplasm Hypertension Alzheimer's disease Parkinson's disease Emphysema
Disease may be viewed as a process that is :
• Selective (i.e., varies with the species, tissue, organ, cell and molecule)
• Intrinsic and extrinsic (I.e., may depend on environmental and genetic factors)
• Discontinuous (may progress, regress, or be arrested)• Occasionally deleterious (damage is often variable,
reversible)• Often treatable (with known etiopathology, cure may be
available)
Causes of Death According to AgeAll Races, Both Sexes
Ages: 65-84 Ages: 85+2003 2003
1. Heart disease (28.2%) 1. Heart Disease (36.2%)2. Cancer (27.7%) 2. Cancer (11.6%)3. COPD‡ (7.1%) 3. Stroke (9.4%)
4. Stroke (6.6%) 4. Alzheimer’s Disease (5.5%)5. Diabetes Mellitus (3.6%) 5. Pneumonia/Influenza (4.6%)
6. Pneumonia/Influenza (2.4%) 6. COPD‡ (4.4%)7. Alzheimer’s Disease (2.2%) 7. Diabetes Mellitus (2.2%)
8. Nephritis (1.9%) 8. Nephritis (2%)9. Accidents (1.9%) 9. Accidents (1.9%)10.Septicemia (1.5%) 10.Septicemia (1.4%)
- All others (17%) - All others (20.9%)
Causes of Death According to Age and Time PeriodAll Races, Both Sexes (1996 vs 2003)
Ages: 85+
2003 19961. Heart Disease (36.2%) 1. Heart Disease
(41.2%)2. Cancer (11.6%) 2. Cancer (11.7%)3. Stroke (9.4%) 3. Stroke (10.5%)
4. Alzheimer’s Disease (5.5%) 4. Pneumonia/Influenza (6.6%)
5. Pneumonia/Influenza (4.6%) 5. COPD‡ (3.5%)6. COPD‡ (4.4%) 6. Diabetes Mellitus
(1.9%)7. Diabetes Mellitus (2.2%) 7. Alzheimer’s
Disease (1.9%)8. Nephritis (2%) 8. Accidents (1.8%)9. Accidents (1.9%) 9.
Atherosclerosis (1.6%)10.Septicemia (1.4%) 10.Nephritis
(1.4%)- All others (20.9%) - All others
(17.9%)
‡ COPD = Chronic Obstructive Pulmonary Disease
Table 3-12 Common Fatal Diseases in Old Age
GENERAL HOSPITAL GERIATRIC UNIT (% AFFECTED) (% AFFECTED)
AGE AGE
DISEASE 65-69 70-74 75-79 80+ 80-89 90+
Cancer 29 27 27 24 Atherosclerosis 21 30
Cardiovascular 25 25 32 36 Myocardial infarct 19 10
Respiratory 14 12 13 1O Bronchopneumonia 17 25
Digestive 12 9 13 16 Cancer 10 7
Nervous System 11 9 8 6 Cerebral thrombosis 9 --
Renal tract 4 7 5 3 Chronic bronchitis 7 --
Other 5 1 2 5 Other* 16 28
*Senile dementia frequent in old age. Due to chronicity patients are placed in long-term care facilities.
Table 3-10 General Characteristics of Disease in the Elderly
Symptoms
Vague and subtle
Atypical
Unreported
Chronic versus acute
Multisystem disease
Altered response to treatment
Increased danger of iatrogenicity (medically induced morbidity and/or mortality)
Table 3-8 Physiologic Parameters in Aging, Physical Inactivity Weightlessness (In Space)* Reduced Increased
Maximum oxygen consumption (VO2 max) Systolic blood pressure and peripheral resistance
Resting and maximum cardiac output Vestibular sensitivity Stroke volume Serum total cholesterol Sense of balance Urinary nitrogen and creatinine Body water and sodium Bone calcium Blood cell mass Lean body mass Glucose tolerance test Variable Sympathetic activity and neurotransmission Endocrine changes Thermoregulation Altered EEG Immune responses Altered sleep
Changes in specific senses
*po s sibly responsive to physical activity
Diseases as a tool for the study of aging
Syndromes in humans: having multiple characteristics of premature (early onset) of aging, or
accelerated (rapid progression) of aging
Are called: progeria-like
progeroidsegmental syndrome.
Progeria-like: Hutchinson-Gilford syndrome, becomes apparent at early age and Werner’s syndrome becomes apparent at later ages
Slow growth, all body characteristics of old age.Advanced cardiovascular disease (generally thecause of death)
Note: Skin changes, some cardiovascular problems,metabolic disturbances,NO Alzheimer’s Disease, dementia, and hypertensionResponsible for WS is the WRN gene located on chromosome 8.
Recommended