Ageing and Changes in Other Systems

Introduction[edit | edit source]

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Aging refers to the physiological changes that occur in the human body from the attainment of adulthood, and ending in death.

  • These changes involve a decline of biological functions, and are accompanied by psychological, behavioural, and other changes.[1]
  • Some of these changes are quite obvious, while others are subtle.[2]

Gastrointestinal System[edit | edit source]

Changes Include:

  • Loss of teeth, dental caries (tooth decay), gingival recession with problems adapting to dentures and altered bite – any of these can affect appetite.
  • Atrophic changes in jaw, mucosae, intestinal glands and muscular (the thin layer of smooth muscle that forms part of a mucous membrane, as in the esophagus) with asymptomatic alterations in secretion, motility and absorption, and reduced surface area in the small bowel.
  • Liver impairments suspected in the older people. Can lead to anorexia and malnutrition, defective absorption of iron and vitamins eg B12, and to pernicious anaemia or iron deficient anaemia through chronic blood loss.
  • Oesophageal reflux, ulcerations and conditions such as diverticulosis - can be issues.
  • Constipation often due to a combination of dehydration, immobility and poor dietary roughage intake as compared to serious pathology.
  • Gastrointestinal problems may lead to an altered nutritional status, so you will need to be aware of how much energy your treatment is using.

Homeostasis[edit | edit source]

Particularly vulnerable in old age to: plasma or blood loss; dehydration; potassium depletion; and metabolic acidosis.

At rest, a person can maintain a constant internal environment, but capacity to react to stress. In the elderly the response to the demands of daily living (a stress)is markedly lessened owing to two key characteristics of ageing:

1. Poverty of reserve which impairs the ability to restore systemic equilibrium quickly when it is upset.

2. Breakdown in co-ordination because different organs age at different rates hence functions dependent on the performance of several systems are therefore impaired. eg Temperature intolerance is an issue eg eg undress in a gym, may consider to be too cold; use of heat or ice as treatment modalities. If a patient ‘overheats’ and is unaware of the rising temperature, you may have a fainter on your hands.

Endocrine System[edit | edit source]

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Failure in the endocrine system is not a consequence of normal ageing, but as in other systems, poverty of reserves may precipitate evidence of deficiency.

  • Secretory capacity of pancreatic beta cells diminishes and abnormality of glucose tolerance increases with age.
  • The efficiency of insulin in dealing with excess glucose declines.
  • Functional thyroid activity declines with age.
  • Basal metabolic rate and radioactive iodine uptake fall.
  • Pituitary activity appears to be retained at normal levels with age, but adrenal activity is impaired.

Clinical disorders will include diabetes, myxoedema (severe hypothyroidism) and thyrotoxicosis (the condition caused by excessive quantities of thyroid hormones).

Central autonomic dysfunction[edit | edit source]

May contribute to: postural hypotension; impaired temperature control and the risk of hypothermia; loss of appreciation of visceral pain; and defective alimentary motility.

Immune system[edit | edit source]

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The immune system has the enormous task of recognizing self from non-self.

  • Not all components of the immune system may be equally affected by aging, but dysfunction known to accompany ageing increases susceptibility to a number of disabling diseases having different aetiologies.
  • Increasing incidence of tumourigenesis occurs with age.
  • Levels of circulating antibodies begin to decline, therefore infectious diseases occur more frequently and with greater consequences in older people, e.g. pneumonia, influenza, urinary tract infections.

Aging and Cardio Respiratory system[edit | edit source]

Aging has a direct effect on the cardiorespiratory system. It affects the structure and function of the cardiovascular system.

Gradually there occurs hypertrophy of the heart and it becomes less responsive to sympathetic stimuli due to this reason, exercise induced heart rate rise and myocardial contractility gets blunted.[3]

The physiologic changes that happen due to aging are increased stiffness of the arterial system. This leads to left ventricle hypertrophy, increased after load on the left ventricle, and an increase in systolic blood pressure. All the age related changes set a stage for isolated systemic hypertension, diastolic dysfunction and heart failure.[4]

Changes in the respiratory system mainly involved a decrease in chest wall compliance, respiratory muscle strength, the ventilatory response to hypoxia and hypercapnia, and the sensation of dyspnea while an increase in air trapping and alveolar dead space.[5]

Aging and Locomotor System[edit | edit source]

Research has proven that locomotion is affected as the person advances his age. The muscles, bone and joints are affected as the person ages. The force production of lower limb muscles diminishes especially the calf muscles hence in compensation the proximal muscles such as that of the hip joint have to work more. There is a so-called distal to proximal shift in the joint power in old people while walking.[6]Studies have shown reduced long extensor muscle strength and tendon stiffness in aged individuals.

There are various postural changes that occur as a person advances his age. The angle of thoracic kyphosis increases with age and it results in a hyperkyphotic curve. In compensation, the forward head posture is developed. It results in impaired cervical proprioception, vestibular deficits, and increased fall risk.[7]

Balance is also affected as a person ages. the sensorimotor function gets declined. The vision, cognition, strength, somatosensation and vestibular functions worsen.[8]

Resources[edit | edit source]

Ageing and Changes in Other SystemsReferences

  1. Khan SS, Singer BD, Vaughan DE. Molecular and physiological manifestations and measurement of aging in humans. Aging cell. 2017 Aug;16(4):624-33.
  3. Ferrari AU, Radaelli A, Centola M. Invited review: aging and the cardiovascular system. Journal of Applied Physiology. 2003 Dec;95(6):2591-7.
  4. Cheitlin MD. Cardiovascular physiology—changes with aging. The American journal of geriatric cardiology. 2003 Jan;12(1):9-13.
  5. Sharma G, Goodwin J. Effect of aging on respiratory system physiology and immunology. Clinical interventions in aging. 2006 Sep;1(3):253.
  6. Kulmala JP, Korhonen MT, Kuitunen S, Suominen H, Heinonen A, Mikkola A, Avela J. Which muscles compromise human locomotor performance with age?. Journal of the Royal Society interface. 2014 Nov 6;11(100):20140858.
  7. Migliarese S, White E. Review of forward-head posture and vestibular deficits in older adults. Current Geriatrics Reports. 2019 Sep;8(3):194-201.
  8. Wagner AR, Akinsola O, Chaudhari AM, Bigelow KE, Merfeld DM. Measuring vestibular contributions to age-related balance impairment: a review. Frontiers in neurology. 2021 Feb 9;12:635305.