Ethical Consideration In Care of The Elderly

In this article, we are going to be showing you all you need to know about the effect of aging on the body system.

Many physiological functions decline at a rate of one percent after the age of 30. A decline in one major system is not always significant as the deterioration of several organs  that typically affect functional ability of older adults. As age related changes occur, most people develop chronic problems and therefore become more vulnerable to illness.

Effect of Aging on the Integumentary System

The most obvious reflection of age appears on the integumentary system. The hair, skin, body composition and teeth all undergo changes. Integumentary changes are related to internal(genetic) and external causes such as exposure to sunlight and environmental chemicals.

Skin

Below are the changes that occurs in the skin due to aging;

The skin composes of three  layer;

Epidermis

This is the outer layer of the skin that prevents foreign substances from entering the body and also prevents loss of body fluids. Melanocytes   which is the pigmentation of the skin,  decreases in the elderly. Also there is flattening out of the barrier within the  epidermis and  the dermal junction, causing the retraction of papillae in elderly people. These changes causes the skin to appear pale and translucent

Dermis

The dermis contains the blood vessels that provide nutrients to the epidermis and assist in thermoregulation, it also contains nerve fibres that serve as sensory perceptual purpose in the perception of pain, touch and other sensation. In elderly, collagen which makes up the major portion of the dermis is decreased, leading to decreased elasticity and strength. There is also decreased vascularity and increased fragility which makes the older adults less resistant to sharing force and more prone to skin ulcers.

Subcutaneous

This inner layer composes of fat tissue and serves as a storage area for calories and also an insulator and regulator for temperature change. It also protects the body from trauma. Subcutaneous glands and sweat glands are contained in this layer also. With advancing age, these glands reduces their function due to the loss of hair follicles and impairment in the ability of the body to maintain body temperature.

Nails

As a result of aging, the nail growth slows down around the third decade, with a decrease in lunula size and a decrease in peripheral circulation. The nail plate turns yellow and there is also reduction in thickness, causing the nail to become soft and brittle and can splint easily.

Hair

Graying of the hair is the result of decline in melanin production. The hair becomes thinner on the head and the body, while there is increased density of nasal and ear hair particularly in male. Increase facial hair is seen in women as a result of decreased oestrogen.

 

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Effect of Aging on Musculoskeletal System

The primary changes in musculoskeletal system includes change in stature and posture. There a decrease in height mainly due to compression of the spinal column. There is lengthening and broadening  of ear and nose. The long bones of the body are not affected due to aging.

 

There is also change in the body tissue as a result of stress, vitamin D intake, decrease in parathyroid hormones and calcium, thereby leading to changes in bone mass and metabolism.

There is also increase in bone absorption within the vertebral bodies, wrist and hip due to decrease in calcium level. There is also decrease in lean body mass with increase in body fat. There is also slowing of muscle tissue regeneration, make the muscle to become atrophied with more fibrous  changes. All these changes leads to slower movement and decrease in strength and endurance.

 

Effect of Aging on The Cardiovascular System

With the increase in age , the heart gets an increase in lipofuscin deposits in the myocardial fibres. The number of pacemaker cells in the sinoatrial node decreases, which causes a change in the normal sinus rhythm. An accumulation of lipids combined   with a degeneration of collagen and calcification of the valve causes the valve to become thick and stiff.

The increase in thickness produces cardiac murmurs which are common in  older adults. There is increase in the number of calcium deposits on the walls of the aorta and large vessels, leading increased systolic blood pressure. In addition the baroreceptors which regulates blood pressure are less sensitive in the older adults.

There is also reduced blood volume due to the drop in plasma volume, there is also slight drop in red blood cells, hemoglobin and hematocrit level also drops.

 

Effect of Aging on Respiratory System

Aging produces changes both within the respiratory system and other related systems. In addition, changes in other system affects the respiratory system.

Musculoskeletal changes such as shortening of the thorax, with an anterior-posterior diameter increase, osteoporosis of the ribs  and vertebrae as well as calcification of the coastal cartilages occur.

There is a decrease in rigidity of the chest wall, weakening of the diaphragm, intercoastal muscles and accessing muscles. There is also atrophy of the pharynx and larynx.

Pulmonary changes that affect the respiratory system include decrease  blood flow to pulmonary circulation, decrease oxygen diffusion and shorten breath with decreased maximum breathing capacity.

There is also increase in airway resistance, less ventilation to the base of the lungs and more of the apex, impaired gas exchange.

All these combined age-related changes results to increase stiffness of the chest wall and diminished muscular strength, leading to reduced efficiency of breathing.

 

Effect Of Aging On Gastrointestinal System

The gastrointestinal system of older adults maybe characterized by decrease  secretion, absorption and motility.

Constipation is a common complaint among older adults, but it most likely caused by decrease fluid intake, insufficient bulk and lack of exercise.

After the age of 50, the liver begins to shrink and enzymes production decreases. Changes in the liver are particularly important when considering drug therapy especially those drugs that are metabolized by the liver. Lower drug dosage in elderly is a common rule.

The elderly may have decreased absorption in iron, vitamin and foliate resulting in anaemia.

Effect of Aging on Urinary System

Age related changes in the urinary system include; a decrease filtration surface area with a progressive loss of renal mass and kidney weight. Renal blood flow progressively decreases 1200ml/minute to 600/minute by age 80.

Glomerular filtration rate decline with age due to nephron loss and decrease in proximal tubular functions.

Changes in the tubules decrease tubular mechanism due to diminished ability to concentrate or dilute urine in response to excess or loss of salt and water.

Creatinine clearance decreases with age and should be carefully monitored before administration of drugs that acts on the renal function.

The diurinal rhythm of urine production is lost with urine production remaining relatively the same over 24 hours with nocturia as the outcome.

In addition, renal disease may cause accumulation of drugs while low serum albumin level provides fewer binding sites, making fewer drugs available for the elderly.

Effect of Aging On Endocrine System

There is little decrease  in hormone secretion in aging with the excretion of oestrogen and testosterone. The most common disorder associated with the endocrine system are thyroid dysfunction and diabetes mellitus.

The thyroid gland is located in the neck anterior to the trachea. The thyroid gland produces thyroxine(T4) and tri-iodothyroxine(T3).  The three common disease condition that affect the thyroid are hypothyroidism, hyperthyroidism, and nodules.

The signs and symptoms of these disorders may not be typical in the older adults and may go undiagnosed and untreated. The most common symptom of hypothyroidism in older adults may be attributed to normal aging changes and thus go undiagnosed.  Among these symptoms are fatigue, loss of initiatives, depression, myolgia, constipation and dry skin.

In addition some fragile older adults may develop mental confusion, anorexia, function incontinence and arthalgia.

Hyperthyroidism in the elderly may go undiagnosed because the symptoms are vastly different than in the younger population. Common atypical presentation in the elderly are weakness and apathy, weight loss, congestive heart failure and atrial fibrillation, bowel disturbance, abdominal distress, mental confusion and depression.

 

Effect of Aging on Sense Organ

Visual

Presbyopia is rigidity and loss of elasticity to the crystalline lens and decrease in cilliary muscle prevent the accommodation for near vision. Diagnosis can be made during eye examination and glasses usually correct the problem

Cataracts

Senile cataracts or opacity of the crystalline lens of adult blindness. Clouding or opacity of the crystalline lens is due to changes in the lens protein which causes swelling within the lens capsule. Clouding of the lens results in blurred vision and also cause light rays to scatter producing a glare.

Cataracts are visible in dark pupil. Diagnosis is made by fundoscopic eye examination and the problem is corrected surgically.

Hearing

Presbycusis is sensorineural loss of hearing, particularly of consonant high -pitches sounds. Hearing loss may be gradual and the older adults adopt by reading lips or cupping the less affected ear. Diagnosis is made from a hearing  examination implants, surgery or assistive hearing devices may correct or improve the problem.

Effect of Aging on  Reproductive System

In older age males  testosterone production decrease, the phases of intercourse are slower and there is a lengthened refractory time. No changes are seen in libido and sexual satisfaction. Testes decreases in size, sperm count decreases and seminal fluid has a diminished viscosity .

Female estrogen production decreases with menopause and breast tissue diminishes. The uterus decreases in size and mucus secretion ceases. Uterine prolapse  many occur as result of muscle weakness..

We hope this information was helpful, feel free to ask your questions in any comment section below

 

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