PHT509: PHYSIOTHERAPY IN GERIATRICS

MATRIC NO: 18/46PT033

CLASS: 500LEVEL PHYSIOTHERAPY
ASSIGNMENT
Question: Write on the age related changes to the endocrine system and special
senses.

A) AGE RELATED CHANGES IN ENDOCRINE SYSTEM.

The human body functions like a wonderful orchestra, with incalculable parts
playing in agreeable harmony. And the conductor of this amazing execution is The
endocrine system which is composed of specialized glands scattered all through the
body, the endocrine system acts as the body's inner chemical courier service. It
utilizes chemical signals called hormones to regulate and facilitate every
physiological process, from the seemly ordinary (breathing, digestion, etc) to the
pivotal (growth, reproduction).

Each hormone functions distinctively by transmitting specific directives to

various body parts. Insulin instructs muscle and adipose cells to assimilate glucose for
energy production, while thyroid hormone governs metabolism and growth.
Conversely, adrenaline regulates bodily responses during instances of stress,
augmenting heart rate and respiration.

Maintaining the appropriate balance of these hormones is paramount for

optimal well-being. An excess or insufficiency of any individual hormone has the
potential to disrupt the entire physiological function, resulting in a myriad of health
complications. Diabetes, thyroid dysfunctions, and imbalances in growth hormone
exemplify a mere fraction of the consequences that may arise when the endocrine
system's harmonious composition falters.

Key Functions of the Endocrine:

1. Metabolism and Energy: Hormones like insulin, glucagon, and leptin regulate
how the body processes and utilizes food for energy.
2. Growth and Development: Growth hormone, thyroid hormone, and sex
hormones play a pivotal role in regulating growth, bone development, and
puberty.
3. Reproduction: Sex hormones (estrogen, progesterone, testosterone) orchestrate
the reproductive system's functions and sexual development.
4. Mood and Stress: Hormones like cortisol and adrenaline modulate stress
responses, mood, and sleep patterns.
5. Fluid and Electrolyte Balance: Antidiuretic hormone (ADH) and aldosterone
regulate the body's fluid and electrolyte levels, ensuring proper blood pressure
and cellular function.

As we age, a the endocrine system, experiences inevitable changes which

might result in an elevation or decline in hormone levels, reduced sensitivity and
impaired receptor function and a drop in the overall function of the endocrine system.
These changes include:
1. HORMONE LEVELS
a) Declines:-
i. Sex hormones: Estrogen, progesterone, and testosterone decline in both men and
women, leading to menopause/andropause and impacting reproductive function.
ii. Growth hormone: it’s production decreases, contributing to decreased muscle
mass and strength, and possibly increased fat deposition.
iii. Thyroid hormones: there may be slight age-related decline, potentially
impacting metabolism and energy levels.
iv. Dehydroepiandrosterone [DHEA]: This is a precursor to other hormones and it
also decreases, potentially influencing immune function and overall well-being.

b) Increases:-
i. Parathyroid hormone: there may be a rise in the production of this hormone to
compensate for reduced calcium absorption, potentially contributing to
osteoporosis risk.
ii. Cortisol: this can remain elevated in chronically stressed individuals, possibly
impacting immunity and metabolism.
2. REDUCED SENSITIVITY AND IMPAIRED RECEPTOR FUNCTION.
i. Reduced sensitivity: Some target organs become less responsive to
hormones, even if levels remain constant. This can affect insulin sensitivity and
glucose regulation.
ii. Impaired in receptor activity: Hormone receptors within cells may undergo
structural changes, further impacting cellular responsiveness to hormonal signals.

3. A DROP IN OVERALL FUNCTION OF ENDOCRINE SYSTEM.

i. Slower response time: The endocrine system may take longer to adjust to
changes in internal or external stimuli, impacting adaptation and resilience.
ii. Increased risk of imbalances: The delicate balance of hormone production and
signaling becomes more fragile with age, increasing the risk of endocrine
disorders.
B) AGE RELATED CHANGES IN SPECIAL SENSES.
The special senses – vision, hearing, smell, taste, and touch – are like a
masterfully woven thread, shaping our perception of the world and enriching every
aspect of our lives. These five senses are far from mere receptors, they function as a
harmonious unit, each playing a distinct yet interconnected role in the enriching of
human existence. T
1. Vision: Vision can be likened to the frontman of our sensory ensemble,
translating light into a mesmerizing exhibition of colors, shapes, and movement. Our
eyes seize light and transmit it to the brain in the form of electrical impulses.
Subsequently, the brain deciphers these impulses, yielding the extraordinary visual
images that grace our perception. The faculty of vision facilitates our secure
navigation, enables us to relish the world and facilitates interpersonal connections
through shared visual experience
As we age, our eyes, like other parts of our body, experience changes that can
affect our vision. Some common age-related vision changes include:-
i. Blurred vision: The lens can become cloudy, leading to cataracts, causing
blurry, hazy vision, especially at night.
ii. Glare sensitivity: Loss of light-filtering ability in the lens can increase
sensitivity to bright lights and glare.
iii. Age-related macular degeneration (AMD): Damage to the central macular area
of the retina can cause blind spots and impaired central vision
iv. Presbyopia: Around 40, the lens loses flexibility, making it harder to focus on
near objects (reading, sewing). This requires reading glasses or bifocals.
v. Decreased accommodation: The ability of the eye to adjust focus between near
and far objects diminishes, contributing to difficulty switching focus, especially
in changing light conditions.
vi. Decreased contrast sensitivity: Difficulty distinguishing between objects with
similar colors or brightness levels.
vii. Changes in color perception: Colors may appear less vibrant or more difficult to
differentiate, especially blues and greens.
viii. Increased floaters: Tiny clumps of gel in the vitreous humor become more
noticeable, although usually harmless.
ix. Dry eyes: Decreased tear production can cause discomfort, irritation, and blurred
vision.
x. Increased risk of eye diseases: Glaucoma, diabetic eye disease, and other eye
conditions become more prevalent with age.

2. Hearing: This provides the soundtrack to our lives. Sound waves, are like
dancers on the air currents, they enter the ear canal, their vibrations amplified by the
delicate ossicles of the middle ear. These amplified vibrations reach the inner ear,
where specialized hair cells within the cochlea transform them into electrical signals.
Carried to the brain's auditory cortex. These signals are then interpreted, allowing us
to discern the nuances of speech, the melodies of music, and the symphony of
environmental sounds. Hearing fosters communication, emotional connection, and a
heightened awareness of the dynamic soundscape that surrounds us. As we age, the
following changes might occur in our hearing:
i. Presbycusis: This is the most common age-related hearing loss, and it affects
people over 65. It is caused by damage to the hair cells in the inner ear, which are
responsible for converting sound waves into electrical signals. Presbycusis
usually causes a gradual loss of high-frequency sounds, making it difficult to hear
consonants and understand speech in noisy environments.
ii. Tinnitus: This is a ringing, buzzing, or hissing sound in the ears that is not
caused by an external sound. It is a common symptom of presbycusis and other
hearing problems
iii. Otosclerosis: This is a condition that causes the bone around the inner ear to
harden, making it difficult for sound waves to reach the hair cells. Otosclerosis
can cause hearing loss at any age, but it is most common in people between the
ages of 30 and 50.
iv. Meniere's disease: This is a disorder of the inner ear that causes episodes of
vertigo, tinnitus, and hearing loss. The exact cause of Meniere's disease is
unknown, but it is thought to be caused by a buildup of fluid in the inner ear.
v. Age-related hearing loss can also be caused by exposure to loud noise. Over
time, loud noise can damage the hair cells in the inner ear, leading to hearing loss.

3. Smell: Smell unveils a hidden dimension of our environment. Odorant

molecules, carried by the air, bind to olfactory receptor cells in the nasal cavity. These
receptors discern these chemical signals and send electrical signals to the brain's
olfactory bulb, where the scent is identified. This identification triggers a cascade of
responses, evoking memories, influencing emotions, and shaping our behavior. Smell
allows us to savor the aroma of a freshly baked cake, detect potential dangers, and
experience the unique olfactory nuances of each place we visit.
As we age, the array of scents we perceive can shift subtly, these changes,
while natural, can impact our quality of life and enjoyment of the world around us.
Some common age-related changes in smell:
i. Fewer olfactory receptors: With age, the number of olfactory receptors in the
nose gradually declines. This translates to a weaker ability to detect odors overall.
ii. Loss of nerve cells: Nerve cells responsible for transmitting scent information to
the brain also decrease, further diminishing sensitivity.
iii. Difficulty distinguishing smells: Fine-tuning the nuances of different scents
becomes more challenging, potentially leading to confusion or misidentification
of odors.
iv. Changes in odor preference: Certain scents that were once pleasant may
become less appealing, while others might take on a different character.
v. Phantosmia: This condition causes the perception of phantom smells, even when
no actual odor is present. It can be a symptom of neurological issues or
medication side effects.
vi. Parosmia: Distorted perception of real smells, making them unpleasant or
unrecognizable. This can be due to respiratory infections, head injuries, or
neurological conditions.

4. Taste: A variety of flavors are conducted on the tongue, taste provides the
gustatory counterpoint to smell. Tiny taste buds, scattered across the tongue's surface,
are equipped with specialized receptor cells that detect the five basic tastes: sweet,
salty, sour, bitter, and umami. These receptors, act as discerning gourmets, sending
electrical signals to the brain's gustatory cortex, where the taste is interpreted. Taste
allows us to appreciate the diverse culinary landscape, identify harmful substances,
and experience the joy of a shared meal. Some common age-related changes in taste
are:
i. Fewer taste buds: Like other sensory organs, the number of taste buds on the
tongue naturally decreases with age. This decline can start as early as the 40s and
reach 50% reduction by the age of 80.
ii. Diminished cell function: Even surviving taste bud cells become less efficient in
detecting taste stimuli over time. This reduced sensitivity weakens the overall
intensity of sweetness, saltiness, sourness, and bitterness.
iii. Changes in sweetness preference: While individual preferences vary, older
adults often show a reduced perception of sweetness and may crave sugary foods
more to compensate for the weaker taste.
iv. Shifting perception of bitterness: Bitterness often becomes more prominent
with age, making some foods like coffee or dark chocolate seem unappealing.
v. Difficulty distinguishing flavors: The ability to discern subtle differences
between ingredients and complex flavors diminishes, potentially leading to
blandness or a muted taste experience.
vi. Reduced enjoyment of food: As the pleasure derived from taste wanes, some
older adults may experience decreased appetite and lose interest in cooking or
trying new foods.

5. Touch: This is the foundation upon which all other senses are built, touch
grounds us in the physical reality of our existence. A multitude of receptors,
embedded in the skin, respond to pressure, temperature, pain, and vibration. These
receptors send electrical signals to the brain's somatosensory cortex, where the tactile
experience is interpreted. Touch allows us to navigate our environment with
precision, feel the warmth of a loved one's embrace, and experience the intricate
textures of the world around us. It is the primal sense, forging connections with others
and anchoring us in the present moment. Some age realeted changes in touch
perception include:
i. Decreased sensitivity: The number of sensory receptors in the skin, responsible
for detecting touch, pressure, temperature, and pain, gradually decreases with
age. This can lead to a general dulling of touch perception, making it harder to
feel light touches, temperature changes, and subtle textures.
ii. Reduced ability to discriminate touch: With fewer receptors, it becomes more
challenging to distinguish between different types of touch, such as light stroking
versus tapping, or sharp versus dull pain.
iii. Slower response time: The speed at which the nervous system transmits touch
signals to the brain slows down with age. This can make it harder to react quickly
to touch-based stimuli, like avoiding hot objects or maintaining balance.
iv. Changes in skin thickness and elasticity: As skin ages, it becomes thinner and
loses its elasticity. This can affect the overall sensitivity to touch and make it
more susceptible to injury.
v. Increased risk of nerve damage: Certain medical conditions, like diabetes or
peripheral neuropathy, can damage nerves responsible for touch
sensation, leading to numbness, tingling, or burning pain.