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7/29/2019 Pryhhh
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Penuaan/ Aging
Dalam buku ajar geriatri, Prof.Dr. R.Boedi Darmojo dan H. Hadi Martono
mengatakan:
Menua (aging) adalah prosesmenghilangnya secara perlahan-lahan
kemampuan jaringan untuk memperbaiki
diri/ mengganti diri dan mempertahankan
struktur dan fungsi normalnya sehingga
tidak dapat bertahan terhadap jejas
(termasuk infeksi) dan memperbaiki
kerusakan yang diderita
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3 PERSPEKTIF PENUAAN
1. Usia biologis kapasitas fungsi sistem organ
2. Usia psikologis
kapasitas perilaku adaptasi3. Usia sosial
perubahan peran & perilaku sesuai usiamanusia
Teori saling melengkapi
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PERAN TEORI DLM
MEMAHAMI PENUAAN pemahaman tentang fenomena Landasan & sudut pandang untuk melihat fakta Menjawab pertanyaan filosofi
pijakan dan arah untuk diskusi dan penelitian Perawat relevansi
Pertanyaan evaluasi terhadap teori :◦ Konsisten secara internal & logis?◦ Dukungan empiris?◦ Menghadirkan konsep & kondisi yg dapat dimodifikasi?◦ Mampu membuat perubahan besar, yang baik?
DISIKAPI
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BIOLOGIC THEORIES
OF AGING
Stochastic theories
aging as event that occur
randomly & accumulate over time Nonstochastic theories
aging as certain predetermined,
timed phenomena
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The change in the biology of an organism asit ages after its maturity.
Such changes range from those affecting itscells and their function to those affecting the
whole organism. There are a number of theories as to why
senescence
Gene expression changes
Damage caused by biological processes.
Cold blooded
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JANIN/fetus
Kulit
Bulan ke 4: kulit terbentuk dengan
baik, papila dermal nampak jelas,
struktur tambahan mulai terbentuk. Rambut
Bulan ke 5 dan 6: tumbuh lanugo yang
kemudian hilang saat janin berumur 7bulan berganti dgn rambut vellus.
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BAYI BARU LAHIR (newborn)
Kulit:
sangat tipis
Kelenjar
kel. sebasea sangat aktif vernix
caseosa.
akumulasi kel. sebasea milia (bintik
putih di dahi dan hidung hilang padausia 3 minggu.
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ANAK
Kulit
tekstur lembut, lembab, tidak berminyak,
simpanan lemak subkutan banyak.
Rambutrambut kepala bersinar, lembut, kuat, dan
elastis.
Kuku
pink, cembung, halus, keras tapi fleksibel.
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REMAJA/puber
Kulit
lebih berminyak, muncul acne.
Rambut
Tumbuh rambut di aksila, pubis,
kumis/jenggot, dll. (ciri seks sekunder).
Rambut lebih berminyak.
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DEWASA
Penampakan kulit optimal di usia 20-30 tahun.
Paparan lingkungan (angin, sinar
matahari, dll.) terakumulasi bersisik, radang kulit (dermatitis).
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USIA LANJUT
(usila/lansia)
PERUBAHAN
KULIT
AKIBAT
Stratumgerminativum
menipis
Kulit menipis, kurangtahan gesekan (mudah
luka)
Kolagen dan elastinberkurang Kulit berkerut/keriput
Pergantian sel
epidermal melambat
Penyembuhan luka
lambat
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PERUBAHAN
KULIT
AKIBAT
Lemak
subkutanberkurang
Bantalan bony prominence
berkurang, termoregulasiterganggu
Sel Langerhan
berkurang
Respon imun berkurang
kulit mudah rusak dan infeksi Aliran darah ke
kulit berkurang
Kulit dingin shg mudah
kedinginan, absorbsi
transdermal berkurang
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PERUBAHAN KULIT AKIBAT
Jumlah dan
keaktivan melanosit
berkurang
Perlindungan terhadap
UV berkurang kanker
kulitJumlah dan
kepekaan reseptor
sensori berkurang
Kurang peka rangsang
risiko cedera/injuri
Produksi vit. D
berkurang
Penyerapan kalsium dan
fosfat berkurang
kelemahan otot dan tulang
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PERUBAHAN
RAMBUT
AKIBAT
Folikel rambut
berkurang
Rambut tipis,
pertumbuhan lambat
Melanin berkurang Rambut beruban
Wanita: kadangmuncul rambut di
wajah (hirsutisme)
Penampilan terganggu
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Premature Aging Syndromes
Also known as progeria, include two very rareinherited conditions,
Hutchinson-Gilford syndrome and Werner syndrome.
In both conditions, skin changes that indicate
premature aging include: atrophy (skin thinning and loss of elasticity)
loss of cutaneous fat
wrinkling
greying hair
loss of hair
nail dystrophy
defective pigmentation
ulceration
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Hutchinson-Gilford Syndrome Werner Syndrome
Occurs in about 1 in 8 million childrenOccurs in about 1 in 1 million
individuals
Signs of progeria begin to show
around 6-12 months when the baby
fails to gain weight and skin changes
occur
First sign of syndrome is around
puberty when the child fails to have a
normal growth spurt, or may be
delayed until an individual is as old as
30 years
•Characteristic features include:
Baldness, prominent scalp, veins and
eyes, small jaw, delayed tooth
formation
•Thin limbs with prominent joints,
short stature, joint stiffness, hipdislocations
•Thickened, tight and shiny skin over
joints
•Characteristic features include:Striking difference between person's
appearance and his/her real age
•Greying hair and/or balding, wrinkling
and aging of the face, sunken cheeks,
small jaw
•Small stature (usually less than 1.6mtall), muscle weakness
•Thickened, tight and shiny skin over
joints, leading to ulcers
•High-pitched voice
Average life expectancy is 13 years,
with approximately 75% dying from
Death usually occurs in patients
between 30-50 years, with most dying
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Cause Of Prematur Aging
Both Hutchinson-Gilford syndrome and Werner syndrome are
autosomal recessive disorders, which means an individual
has inherited a mutated gene from both parents.
1 in 4 offspring would be expected to have the disorder and
others may be carriers of the gene. Werner syndrome appears to be caused by a defect at the
WS gene (WRN) locus, which provides instructions to a
protein called helicase.
Werner syndrome is caused by a helicase defect, which
affects the way DNA and RNA are replicated and repaired in
the body.
Mutation in the gene LMNA that produces the protein Lamin
A, which is the structural scaffolding that holds the nucleus of
a cell together.
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Complications Of Progeria
In addition to skin changes, patients with
Werner syndrome often develop the following
conditions:
Cataracts – rapidly progressing cataractsdevelop between the ages of 20-40 years
in most cases
Osteoporosis (loss of bone density) –
particularly in the legs, caused bydisturbances in the parathyroid glands
Diabetes mellitus – this occurs in at least
30% of patients, and there is abnormal
glucose tolerance in many others
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Cardiovascular disease – particularly
arteriosclerotic disease, which may lead tofatal heart attack
Pituitary gland underactivity ,
Hypogonadism or agonadism (absent or
underactive ovaries or testes) andpremature menopause
Soft tissue calcification , Cancer – the
incidence of malignancy is high, especially
fibrosarcomas which occur in 10% of patients (carcinomas of the thyroid and
other organs, blood disorders,
meningiomas and skin cancers)