Al – Noor University College

Department of anesthesiology

Geriatric Anatomical and Physiological changes

The term ‘Elderly’ is applied to those individuals belonging to age
60 years and above, who represent the fastest growing segment of
populations throughout the world.

All cells experience changes with aging. They become larger and are
less able to divide and multiply. Among other changes, there is an
increase in pigments and fatty substances inside the cell (lipids). Many
cells lose their ability to function, or they begin to function abnormally.

common signs and symptoms of aging include:

1-Increased susceptibility to infection.

2-Greater risk of heat stroke or hypothermia.

3-Slight decrease in height as the bones of our spines get thinner and
lose some height.

3-Bones break more easily.

4-Joint changes, ranging from minor stiffness to severe arthritis.

5-Stooped posture

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Physiological changes:
A number of physiological changes occur as we grow older. Some of the
common changes are the result of diseases.

Height

The height falls after the age of 50. The primary factors contributing to
this reduction in height include : compression of vertebrae ,changes in
posture, and increased curvature of the hips and knees.

By the time of age 80, most of loose an average height of about 2 inches

Nose and ears continue to grow in length.

Male and female shapes become more similar with aging.

Male weight tend to increase till late 50 and then decline. ,

Female weight tend to increase till 60 and then decline.

Total body water in male: young 60% to elderly 54%.

Total body water in female: young 52% to elderly 46%.

Cardiovascular system:

Heart disease is the leading cause of death in elderly. The size of

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heart increases in old age. But the amount of blood in the chamber
decreases because the heart wall thickening. The maximum heart rate
decreases. The cardiac output decreases. The aorta and other arteries
become thicker and stiffer which may lead to increase in systolic blood
pressure with aging. In some individuals, this may result in hypertension.

Blood flow to the kidneys may decrease by 50 percent and to the brain
by 15 to 20 percent.

The baroreceptors which monitor and adjust the blood pressure when we
change position become less sensitive with aging. This can cause
orthostatic hypotension.

Respiratory system:

Lungs become more rigid and stiffer. Muscles of the chest wall
becomes weak. Pulmonary function decreases. increase in the amount
of anatomic dead space. Vital capacity declines.

Gastrointestinal system:

Reduced GI secretions. Reduced GI motility. Fall of teeth is an obvius

sign of aging. Delayed gastric emptying.

Liver: Reduced blood flow. Altered clearance of some drugs.

Decreased weight of liver, Liver metabolizes less efficiently

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As we grow old, the small intestines absorb less calcium and vitamin D.
Therefore, we need more calcium to prevent bone mineral loss and
osteoporosis in later life.

Reduced peristalsis of the colon can increase risk for constipation.

There is decreased salivation, so there is difficulty in swallowing food.

Skin:

One of the most common physical changes that people associate with

The skin becomes less able to retain fluids and is more easily dry and

However, hair growth actually accelerates and thickens in places like

have an increase in facial hair as their estrogen levels decrease.

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Urinary system

With aging, there is a reduced hormonal response (vasopressin) and an

impaired ability to conserve salt which may increase risk for dehydration.

incontinence, and urinary obstruction.

females, perineal muscles relax, there is urge incontinence and stress

urinary incontinence.

weight change is more likely the result of reductions in activity and

diminished.

As age increases, muscles generally decrease in strength,

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Nervous system:

are reduced

Nerve transmission slows so, older people take longer to respond and

neurons each year.

Vision:

Visual impairment is the most common sensory problem of older

see items that are close up begins in the 40’s, results in cataracts.

Quantity of tears decreases..

Smell: By age 80, the sense of smell is reduced by about half.

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Immune system:

As we grow older, our bodies are less able to produce antibodies which

greater risk for infections and the mortality rate from infection is much
higher than in the young.

Hormones:

E
testosterone, aldosterone, cortisol, progesterone.