J.H.

CERILLES STATE COLLEGE

In consortium with
Western Mindanao State University
Balangasan, Pagadian City Zamboanga del Sur 7016

DATE : 09/28/2021
NAME : Vanessa B. Paloma
LESSON Normal Age-related Changes and Assessment of Older People
:
SUBJECT : NCM 114 A - Care of the Older Adult

System/ Area Age-related Changes Normal Assessment

Findings and Implication
Sensory - Hearing Loses ability to hear high frequency Older people can expect some
sounds. Hearing loss can lead to social decline in their five senses. While
isolation and should be the sense of smell, taste and touch
addressed. Hearing aids cannot
all change with age, often the most
address all types of hearing loss.
noticeable changes affect our vision
Sensory - Vision Loss of ability to see items that are and hearing. As senses change,
close up begins in the 40’s. Size of older people may find it more
pupil grows smaller with age: focusing difficult to socialize and participate
becomes less accurate. Lens of eye
in activities.
yellows making it more difficult to see
red and green colors .Sensitivity to
glare increases. Night vision not as
acute. The lens of the eye loses fluid
and becomes less flexible, making it
more difficult to focus at the near
range. Dry eyes are quite common.

Sensory - Taste & Some loss in taste and smell as one

Smell ages, but loss is usually minor and not
until after age 70. Many older people
often complain of food being tasteless.
Possible causes: Loneliness at meals,
Unwilling/unable to cook. Dental
problems. Financial barriers.

Sensory - Pain and Loss of elasticity. Loss of

Touch pigment. Reduced fat layer.
Safety Implications: Lessened ability
to recognize dangerous levels of
heat. Lessened ability of body to
maintain temperature. Tendency to
 System/ Area Age-related Changes Normal Assessment
Findings and Implication
develop bruises, skin tears more
easily.

Brain and CNS Slowed neuronal Unfamiliar or high stress activities

transmission. Changes in sleep cycle: cause an older person to perform
increase in frequency of daytime more slowly.
naps. Sense of smell markedly
decreases.
Intellectual functioning defined as
“Stored” memory increases with
age. Problem solving skills increase
with age. Older people are able to
learn very well.

Cardiovascular Deposits of the "aging Normal changes in the heart

System pigment," lipofuscin, accumulate. The
valves of the heart thicken and become
stiffer. The number of pacemaker cells
decrease and fatty & fibrous tissues
increase about the SA node. A slight
increase in the size of the heart,
especially the left ventricle, is
common. The heart wall thickens.
Lowered blood oxygen levels. The
limits of the heart to exert itself are
reduced with age. Medications
processed and eliminated differently
than in young adults.
include deposits of the "aging
pigment," lipofuscin. The heart
muscle cells degenerate slightly.
The valves inside the heart, which
control the direction of blood
flow, thicken and become stiffer.
A heart murmur caused by valve
stiffness is fairly common in older
people.

Circulatory System Arteries lose mainly due to: thickening This may explain why many older
& stiffening in the media of large people have orthostatic
arteries. Smaller arteries may hypotension, a condition in which
thicken/stiffen minimally; their ability
the blood pressure falls when a
to dilate & constrict diminishes
significantly. person goes from lying or sitting
The aorta becomes thicker, stiffer, and to standing. This causes dizziness
less flexible. Increased large artery because there is less blood flow to
stiffness causes a fall in DBP, the brain.
associated with a continual rise in
SBP. Baroreceptors become less
sensitive that may contribute to the
relatively common finding of
orthostatic hypotension.

Urinary System Decreased renal blood flow from As people age, the arteries
about 600ml/min (age 40) to about supplying the kidneys narrow.
 System/ Area Age-related Changes Normal Assessment
Findings and Implication
300ml/min (age 80). Kidney Because the narrowed arteries may
size decreases by 20-30% by age no longer supply enough blood for
90. Renal blood vessels become normal-sized kidneys, kidney size
smaller & thicker reducing renal blood
may decrease. Also, the walls of the
flow. Decreased GFR.
There is a decline in the number of small arteries that flow into the
renal tubular cells, an increase in glomeruli thicken, which decreases
tubular diverticula, & a thickening of the function of the remaining
the tubular walls is decreased ability to glomeruli.
concentrate urine & clear drugs from
the body. The muscular ureters,
urethra, & bladder lose tone &
elasticity. The bladder may retain
urine causes incomplete
emptying. Decline in bladder capacity.
The warning period between the urge
and actual urination is shortened or
lost as one ages
Endocrine System Concomitant morbidities, such as Malfunction in the production line
obesity, diabetes mellitus, reduced of a hormone or on its ability to
nutrition, systemic illness and function correctly.
medication use, alter how aging
affects individual pituitary
hormones.
Reproductive In women the “climacteric” occurs One clear sign of aging occurs
System (defined as the period during with when your menstrual periods stop
reproductive capacity decreases (ie, permanently. This is known as
ovarian failure) then finally stops = menopause. Aging changes in the
loss of estrogen & progesterone;
male reproductive system occur
FSH & LH ↑↑). This is also
described as the transition from peri- primarily in the testes. Testicular
menopause (~age 40s) to tissue mass decreases. The level of
menopause. Thinning & graying of the male sex hormone,
pubic hair. Loss of subQ fat in testosterone decreases gradually.
external genitalia giving them a There may be problems getting an
shrunken appearance. Ovaries &
erection. This is a general slowing,
uterus decreases in size & weight. In
men; Testosterone decreases, testes instead of a complete lack of
become softer & smaller.Erections function.
are less firm & often require
direct stimulation to retain
rigidity. Though fewer viable sperm
are produced & their motility
decreases, men continue to produce
enough viable sperm to fertilize ova
well into older age. Less seminal
fluid may be ejaculated. They may
 System/ Area Age-related Changes Normal Assessment
Findings and Implication
not experience orgasms every time
they have sex. The prostate gland
enlarges; this often results in
compression of the urethra which
may inhibit the flow of urine.
Skin is less elastic + loss of glandular
tissue gives breasts a sagging
appearance. Other physical changes
may include hot flashes (can cause
sleep deprivation if they occur at
night), sweats, irritability, depression,
headaches, myalgias. Sexual desire is
variable. The symptoms are typically
present for about 5 years. Atrophy of
vaginal tissues due to low estrogen
levels = thinning & dryness occurs;
agglutination of
labia majora & minora may occur.
Musculoskeletal Sarcopenia (↓ muscle mass & Muscles are less toned and less able
System - Muscle contractile force) occurs with age. to contract because of changes in
Some of this muscle-wasting is due the muscle tissue and normal aging
to diminished growth hormone
changes in the nervous system.
production, but exactly how much is
due to aging versus disuse is Muscles may become rigid with age
unclear.Sarcopenia is associated and may lose tone, even with
with increased fatigue & risk of regular exercise.
falling (so may compromise
ADLs). Sarcopenia affects all
muscles including, for example, the
respiratory muscles (↓ efficiency of
breathing) & GI tract (constipation).
Fulfillment

Musculoskeletal Gradual loss of bone mass

System - Bones/ (bone resorption > bone formation)
Tendons/ ligaments starting around age 30s. Decreased
water content in cartilage. The
“wear-&-tear” theory regarding
cartilage destruction & activity
doesn’t hold up as osteoarthritis is
also frequently seen in sedentary
elders. Decreased water in the
cartilage of the intervertebral discs
results in a ↓ in compressibility and
flexibility. This may be one reason
for loss of height. There is also
 System/ Area Age-related Changes Normal Assessment
Findings and Implication
some decrease in water content of
tendons & ligaments contributing to
↓ mobility.

Respiratory System The number of cilia & their level of The amount of oxygen delivered to
activity is reduced. Glandular cells the bloodstream and the rate of
in large airways are blood flow declines with age. Even
reduced. Decreased number of with the lung capacity remaining
nerve endings in larynx. The cough
normal, the lung tissues seem to
reflex is blunted thus decreasing the
effectiveness of cough. Decreased lose facility for making the oxygen-
levels of secretory IgA in nose & to-blood transfer to the
lungs results in decreased ability to bloodstream. Since older people
neutralize viruses. cannot breathe as fast, there is less
The number of functional alveoli oxygen entering the blood per
decreases as the alveolar walls
minute. Less oxygen in the system
become thin, the aveoli enlarge, are
less elastic. Decreased elasticity of cuts down the amount of work that
the lungs may be due to collagen can be done.
cross-linking. The loss of elasticity
accounts for "senile hyperinflation";
unlike in smokers, there is little or
no destruction of the alveoli. The
FEV1 drops by 30 mL/year during
your adult life. VC is diminished by
about 20%. RV increases by about
50%.
Hematologic The number of red blood cells (and Age-related hematologic changes
System correspondingly, H&H) are are marked by a decline in marrow
reduced, but not significantly. Most cellularity, increased risk of
of the white blood cells stay at the myeloproliferative disorders and
same levels, but lymphocytes
anemia, and a decline in adaptive
decrease in number and
effectiveness. Overall, cell counts immunity.
and parameters in the peripheral
blood are not significantly different
from in young adult life. However,
the cellularity of the bone marrow
decreases moderately. For example,
30% cellularity on an iliac crest
biopsy (which would be very low
for a young adult) is not unusual in
an older person.
Immune System The thymus gland (which produces The efficiency of the immune
hormones that activate T cells) system declines with age, but this is
atrophies throughout life. variable among persons.
System/ Area Age-related Changes Normal Assessment
Findings and Implication
The peripheral T-cellsproliferate much Nonspecific defenses become less
less exuberantly in old age. Common effective. The ability of the body to
infections are often more severe with make antibodies diminishes.
slower recovery & decreased chances Autoimmune disorders are
of developing adequate immunity.
increased in older adults