Geriatric presentation

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  1. 1. The Health of The Elderly inThe Health of The Elderly in Rehabilitation For Health PromotionRehabilitation For Health Promotion and Preventive Medicineand Preventive Medicine Assoc. Prof. S.Ufuk Yurdalan, Ph.D. ,PTAssoc. Prof. S.Ufuk Yurdalan, Ph.D. ,PT 9 Eylul University,9 Eylul University, School of Physical Therapy and RehabilitationSchool of Physical Therapy and Rehabilitation zmir-TRzmir-TR
  2. 2. TerminologyTerminology older , elderly , geriatric , gerontologyolder , elderly , geriatric , gerontology adult , individuals , people ..men &womenadult , individuals , people ..men &women aged over 65 & octogenariansaged over 65 & octogenarians
  3. 3. What is geriatric ???What is geriatric ??? Geriatric is the medical branchGeriatric is the medical branch dealing with the care of the aged.dealing with the care of the aged.
  4. 4. WhenWhen dodo we old ???we old ??? Forty is the old age of youth; fifty is the youth ofForty is the old age of youth; fifty is the youth of old age.old age. young oldsyoung olds 65 -7465 -74 old oldsold olds 7575 -- 8484 oldest oldsoldest olds 85 +85 +
  5. 5. DemographyDemography During the first 50 yrs of the 21st century, theDuring the first 50 yrs of the 21st century, the world population 65 and over is expectedworld population 65 and over is expected to triple.to triple. The number of people 80 yrs and older grew at anThe number of people 80 yrs and older grew at an average rate at 159% between 1960-90, and is expectedaverage rate at 159% between 1960-90, and is expected to continue growing at 70% until 2020 among countriesto continue growing at 70% until 2020 among countries belong to OECD.belong to OECD. Family Community HealthFamily Community Health Vol.26,No:4,pp.338-349,Aug 2003Vol.26,No:4,pp.338-349,Aug 2003
  6. 6. Survival curves in humanSurvival curves in human
  7. 7. How big is the increase in years ofHow big is the increase in years of active life?active life?
  8. 8. WHAT IS THEWHAT IS THE ELDERLYELDERLY POPULATION IN EUROPE ???POPULATION IN EUROPE ???
  9. 9. Population PyramidsPopulation Pyramids Asia (1995 and 2025) Latin America (1995 and 2025) Europe (1995 and 2025)
  10. 10. WhereWhere do we meet the elderly ???do we meet the elderly ??? familyfamily elderly communitieselderly communities hospitalshospitals dispensarydispensary hospices hospices
  11. 11. Who are interested in the elderly ???Who are interested in the elderly ??? Multi-professional teamMulti-professional team geriatrics, PTs & OTs, nursesgeriatrics, PTs & OTs, nurses psychologists, social workerspsychologists, social workers families, friends, neighbors, etc.families, friends, neighbors, etc.
  12. 12. PT - Elderly InteractionPT - Elderly Interaction GERIATRIC REHABILITATIONGERIATRIC REHABILITATION
  13. 13. What does geriatric rehabilitation do ???What does geriatric rehabilitation do ??? . Focuses on restoring functional independence to older adults, in terms of. Focuses on restoring functional independence to older adults, in terms of mobility,mobility, activity of daily livingactivity of daily living (ADLs), and quality of life (QoL).(ADLs), and quality of life (QoL). J of Gerontological Nur.J of Gerontological Nur. Vol.27, Iss.10, pp.7,Oct 2001Vol.27, Iss.10, pp.7,Oct 2001
  14. 14. What are the expectations ???What are the expectations ??? Small gains in function can mean large gainsSmall gains in function can mean large gains in elder patients QoL.in elder patients QoL. Disease Management and Health OutcomesDisease Management and Health Outcomes 11(6): 363-374, 200311(6): 363-374, 2003
  15. 15. The Seneca study dietary, QoL, lifestyle, and healthydietary, QoL, lifestyle, and healthy ageing in Europe ???ageing in Europe ??? 1,091men / 1,109 women1,091men / 1,109 women aged 70 75 yrsaged 70 75 yrs Be., Fr., It., NL, Port., Sp., Switz., Pl.Be., Fr., It., NL, Port., Sp., Switz., Pl. 1988 - 19991988 - 1999
  16. 16. Mortality riskMortality risk smokingsmoking having a low-quality diethaving a low-quality diet being physically inactivebeing physically inactive The net effect of a healthy lifestyle on the process ofThe net effect of a healthy lifestyle on the process of healthyhealthy ageingageing is likely to go together withis likely to go together with decreaseddecreased morbidity.morbidity.
  17. 17. Healthy ageingHealthy ageing is provided by health promotionis provided by health promotion Age & AgeingAge & Ageing 32(4): 427 - 434, July.200332(4): 427 - 434, July.2003
  18. 18. Public health policies are designed to create anPublic health policies are designed to create an infrastructure toinfrastructure to promote healthy ageingpromote healthy ageing andand offer support to the growing elderlyoffer support to the growing elderly population.population. Disease and Management & Health OutcomesDisease and Management & Health Outcomes 11( 5 ): 299 309, 200311( 5 ): 299 309, 2003
  19. 19. DEFINITION OFDEFINITION OF HEALTHY / SUCCESSFULHEALTHY / SUCCESSFUL AGEINGAGEING
  20. 20. Definition of healthy / successful ageingDefinition of healthy / successful ageing includes the maintenance of physical andincludes the maintenance of physical and mental function, as well as continued socialmental function, as well as continued social engagement.engagement. Health Screening and Health Promotion for ElderlyHealth Screening and Health Promotion for Elderly
  21. 21. Succesful ageing factorsSuccesful ageing factors racerace ethnicityethnicity educationeducation economic & social resourceseconomic & social resources Disease and Management & Health OutcomesDisease and Management & Health Outcomes 11 ( 5 ) : 299 309, 200311 ( 5 ) : 299 309, 2003
  22. 22. AGEING PROCESSAGEING PROCESS
  23. 23. Begins before birth but the effects onlyBegins before birth but the effects only become apparent around the age of 30.become apparent around the age of 30.
  24. 24. With ageing there is aWith ageing there is a lossloss in size andin size and functionalfunctional unitsunits within every bodily system and awithin every bodily system and a decrease in the proficiency of the remainingdecrease in the proficiency of the remaining functionsfunctions
  25. 25. Ageing is characterized by aAgeing is characterized by a decreased abilitydecreased ability to adapt to and recover from physiologicalto adapt to and recover from physiological displacingdisplacing stimuli.stimuli.
  26. 26. ExerciseExercise is a form of physiologicalis a form of physiological stimulationstimulation requiring complexrequiring complex interactioninteraction amongamong systemssystems..
  27. 27. PTsPTs who test and prescribe exercise for middle-who test and prescribe exercise for middle- aged and older persons should be aware of theaged and older persons should be aware of the affects of aging on the various systems and onaffects of aging on the various systems and on thethe abilityability to exercise and train, as well as theto exercise and train, as well as the generalgeneral characteristicscharacteristics and specificand specific needs ofneeds of olderolder people.people.
  28. 28. Effects of ageing on systemsEffects of ageing on systems cardiovascular systemcardiovascular system left ventricular hypertrophyleft ventricular hypertrophy limited left ventricular fillinglimited left ventricular filling decreased beta-adrenoceptor med. CV responsesdecreased beta-adrenoceptor med. CV responses cardiac dysrhytmias with exercisecardiac dysrhytmias with exercise
  29. 29. Pulmonary systemPulmonary system decreased & impaired pulmonary functionsdecreased & impaired pulmonary functions effects of smoking , chronic illnesseseffects of smoking , chronic illnesses
  30. 30. Musculoskeletal system/ bone massMusculoskeletal system/ bone mass gradual loss of bone massgradual loss of bone mass begins at age 30 to 35begins at age 30 to 35 -In women, it accelerates after menopause-In women, it accelerates after menopause -In men, it accelerates at age 50 to 55-In men, it accelerates at age 50 to 55 spontaneous fractures & fractures after mild traumaspontaneous fractures & fractures after mild trauma
  31. 31. OsteoporosisOsteoporosis -Genetic factors-Genetic factors -Nutrition-Nutrition and life style factorsand life style factors -Hormonal and reproductive factors-Hormonal and reproductive factors -Medications-Medications -Comorbid factors-Comorbid factors MJA Vol.180, pp.18-22, March.2004
  32. 32. Musculoskeletal system / muscle massMusculoskeletal system / muscle mass reduces in the number and size of fast-twitchreduces in the number and size of fast-twitch glycolglycolyytic muscle fiberstic muscle fibers diminishes muscle massdiminishes muscle mass stiffening of cartilage, tendons, and ligamentsstiffening of cartilage, tendons, and ligaments
  33. 33. Musculoskeletal systemMusculoskeletal system Distribution of body fatDistribution of body fat More fat is deposited internally and on the torsoMore fat is deposited internally and on the torso
  34. 34. Relation between muscle mass & bodyRelation between muscle mass & body fatfat Diminished muscle mass is masked by anDiminished muscle mass is masked by an increased amount of body fat.increased amount of body fat. LIFESTYLE !!!LIFESTYLE !!!
  35. 35. Neurological systemNeurological system decreases in the number and size of neuronsdecreases in the number and size of neurons decreases nerve conduction velocitydecreases nerve conduction velocity decreased righting reflexesdecreased righting reflexes increased reaction timeincreased reaction time loss of ankle jerks and vibratory senseloss of ankle jerks and vibratory sense
  36. 36. Neurological systemNeurological system