Aging Process

Cardiorespiratory System

Dibuat oleh : dr. Merie Octavia

Pembimbing : dr. Melinda Harini, Sp.KFR
Aging in not a disease
• Aging itself does not result in disease; however, it does lower the
threshold for the development of disease and can intensify and
accelerate the effects of disease once initiated
• Awareness of the principles of aging biology, in general, will help
clinicians tailor intelligent treatments to the older patient.
• Age-related declines in cardiovascular and exercise performance have
been shown to be partially preventable and reversible with exercise
training
• Exercise is a strategy to mitigate the adverse effects of aging on
cardiovascular function
Theory of Aging
• Free radical theory of aging
• Mitochondrial theory of aging
• Gene regulation theory of aging
• Telomere theory of aging
• Inflammation hypothesis of aging
• Immune theory of aging
Risk Factors Aging Become a Disease
• Less active
• Poor life-style ,ex : obesity
• Poor environment
Cardiovascular System
Changes in Structure and Function
1. Irregularities in size and shape of
endothelial cells
2. Old arteries are contracted by an
age-related increase in receptors to
endothelin-1.Decreased response to
endhothelin-1
Compensation
1. Inhibit telomere shortening. In
endothelial cells with persistently
long telomeres, age-associated
abnormalities may be
significantly reduced.
2. Exercise training appears to
decrease basal endothelin-1
levels and restore its
responsiveness.
Changes in Structure and Function
3. Slowing left ventricular filling
4. Slowed early filling
5. Left ventricular wall thickness
Compensation
3. End diastolic volume normal
4. More filling occurs later in
diastole to compensate
5. Increase sufficiently to
normalize wall stress, thus
maintaining normal cavity and
ejection fraction
Changes in Structure and Function Compensation
6. Arterial Stiffness, increase 6. increasing the pressure in the
workload and induce hypertrophy proximal aorta.

7. cardiomyocytes may be 7. cardiac myocytes that remain

reduced across the lifespan by are increased in size and are much
50% more variable in size
• The age-related alterations in the anatomy and physiology of the
heart and vasculature likely have varying degrees of significance.
Some may not have functional significance
• Aortic sclerosis, ventricular septal thickening, and attenuated cardiac
function response during exercise, may simulate disease
• Age-related declines in cardiovascular and exercise performance are
modifiable and have been shown to be partially preventable and
reversible with exercise training, maintaining regularly scheduled
physical activity and conditioning is a potentially important strategy to
mitigate the potential adverse effects of aging on cardiovascular
function.
Respiratory System
• The effects of aging on the respiratory system are many, diverse,
complex and often interactive.
• There is considerable variability in what might be defined as
normal respiratory function in the elderly and it can sometimes be
difficult to distinguish it from age-related comorbidity.
Changes in Structure and Function
1. Reduce the respiratory
efficiency of the chest wall and
diaphragm
2. The elastic recoil of lung tissue
decreases with aging 
increasing TLC
Compensation
1. No change in the thickness of the
diaphragm with age, although
structural changes in the chest wall
reduce the curvature of the
diaphragm
2. the increased stiffness of the chest
wall and the loss of motor power
together decrease TLC, thus this two
conditions result in unchanged TLC
Changes in Structure and Function
3. Decreased FEV1/FVC, increased
FRC, increased CV and increased
RV.  reduces the ventilation at
the bases of the lungs in
comparison to perfusion.
Compensation
3. Lungs still capable of a large
physiologic reserve and therefore
these changes are not evident in
older adults unless they are
affected by a pathologic process.
Changes in Structure and Function
4. Mean arterial oxygen tension
(PaO2 [partial pressure arterial
oxygen]) declines during middle
life even in healthy never-smokers
Compensation
4. Mean PaO2 remains relatively
constant at about 80 mm Hg from
age 65 to 90 years in healthy older
persons. This is because
hemoglobin/ oxygen (HbO2)
dissociation curve levels off at
PaO2 values greater than 60 mm
Hg. Reduction in PO2 which
becomes significant only when it
falls below 60 mm Hg
Daftar Pustaka
1. Halter JB, Ouslander JG. Hazzard’s Geriatric Medicine and
Gerontology, Seventh Edition;2017
2. Downey, Darling;Physiological Basis of Rehabilitation Medicine,3rd
ed.New York;2001
3. P.M.Lalley. Respiratory Physiology and Neurobiology. 187 (2013)
199–210
4. Tosato M, Zamboni V, Ferrini A, et al. The Aging Process and Potential
Interventions to Extend lLife ExpectancyClinical Interventions in Aging
2007:2(3) 401–412