Within these notes, "incr." means "increases", "higher" or "more"; "decr." means "decreases", lower", or "less".

 Page index

1. Describe the overall effects of most age changes on maintaining homeostasis and explain why these effects occur.  Page index
1. most aging -> reduced abilities to prevent or limit deviations and to correct them by negative feedback
2. adverse effects on all three steps in negative feedback
   
2. Describe the distinctions between aging and disease, and explain why many abnormal and disease conditions accompany aging. Page index
1. aging =/= disease, aging not necessarily accompanied by disease, no disease unique to elderly
2. reasons for incr. disease with incr. age
1. decreased ability to maintain homeostasis (barriers, insulators, negative feedback)
2. decreased reserve capacity to "hide" new disease
3. increased time for chronic disease to eliminate reserve capacity
4. increased time for "slow" disease to develop
5. increased time for exposure to "causes" (number and duration of exposures)
 
3. Explain how abnormal and disease changes can be reduced and why doing so is important (1) prevent occurrence, (2) slow progress, (3) compensate for or cure.  Page index
1. avoid risk factors
2. early detection and treatment
3. "prevention" and cure -> increased longevity and improved quality of life
 
4. Name main risk factors that promote abnormal and disease conditions that often accompany aging.  Page index
1. smoking
2. stress
3. poor nutrition
4. inadequate exercise
5. exposure to environmental hazards (biological, chemical, physical, sunlight)
6. high blood pressure
7. high blood cholesterol
8. genes
 
5. Name non-modifiable and modifiable factors that influence mean longevity and explain their relationships to quality of life. Page index
1. none-modifiable = genes (?), race, gender, family history, intelligence, personality
2. modifiable = education, social relationships, nutrition, exercise, housing, health care, employment, marital state, stress, quality of physical environment, diseases, accidents
3. improving factors -> increased longevity and increased quality of life
 
6. Explain concepts of quality of life and their importance. Page index
1. concepts vary
1. external quantitative measures by others of health, performance of tasks, psychological status, economic status, social abilities
2. internal self-evaluation including personal sense of identity, independence, efficacy, control of environment, satisfaction
2. important for establishing and evaluating programs, policies, and individual choices involving life style for optimizing conditions for elders and for society

1. Parts  Page index
1. Epidermis
1. Keratin -> barrier to microbes, chemicals, water, trauma
2. Melanin -> barrier to light
3. Langerhans cells -> barrier (start immune responses against microbes, chemicals), fights skin cancer
2. Dermis
1. Barrier
2. Information
3. Temperature regulation
4. Vitamin D production
5. Cosmetic effects
3. Boundary between the epidermis and the dermis
4. Subcutaneous layer
 
2. Effects from sunlight  Page index
1. increased production of and damage from free radicals
2. incr. production of irregular keratinocytes -> incr. skin cancer
3. incr. patchy distribution of melanocytes -> incr. "age spots"
4. decr. Langerhans cells -> incr. infection, incr. skin cancer, decr. warning from inflammation
5. incr. irregularities in elastin -> incr. sagging and wrinkling
6. decr. blood vessels -> decr. inflammation for warning, decr. temp. regulation, decr. vit. D production and removal
7. thicker capillary walls -> decr. exchange for epidermis, dermis, Vit. D production and removal
8. enlarged sebaceous glands -> adverse cosmetic effects (i.e., blackheads)
9. Prevention  Page index
1. avoid exposure
2. wear protective clothing
3. use sun screen lotions
4. use anti-oxidant lotions
10. Treatment
1. Tretinoin
1. reduce sun damage
2. reverse cosmetic effects from sun damage
3. reverse sun damage to collagen, vessels, and the junction between the epidermis and dermis
2. Skin peals and abrasion
3. Laser treatment
4. Moisturizers
3. Effects from Heat  Page index
1. incr. production of irregular keratinocytes -> incr. skin cancer
2. incr. patchy distribution of melanocytes -> incr. "age spots"
3. decr. Langerhans cells -> incr. infection, incr. skin cancer, decr. warning from inflammation
4. decr. blood vessels -> decr. inflammation for warning, decr. temp. regulation, decr. vit. D production and removal
5. thicker capillary walls -> decr. exchange for epidermis, dermis, Vit. D production and removal
6. enlarged sebaceous glands -> adverse cosmetic effects (i.e., blackheads)
4. Causes of Decubitus ulcers  Page index
1. decr. immobility
2. age changes weaken skin
3. thinner fat layer
4. circulatory diseases (e.g., atherosclerosis)
5. decr. nutrition
6. decr. skin hygiene
7. decr. exercise
8. incr. diseases (e.g., atherosclerosis, diabetes)
9. effects = infection, pain, adverse cosmetic effect
5. Neoplasia  Page index
1. benign
1. cosmetic, incr. risk of skin injury, discomfort, incr. risk of infection
2. malignant
1. cosmetic, infection, damage other organs
6. Prevention of skin diesases  Page index
1. good skin care
2. decr. sunlight
3. remain active
4. good nutrition
5. regular evaluation and corrective measures
6. decr. exposure to harmful factors (microbes, trauma, burns, chemicals)
7. avoid or treat other diseases (e.g., atherosclerosis, diabetes)

1. Describe the characteristics of exercise programs that improve cardiac functioning in older people.
1. programs must have vigorous, extended, and frequent exercise. Page index
   
2. Describe the trends in heart disease (incidence, severity) as age increases and describe the reasons for these trends.  Page index
1. incidence and severity increase with age due to
1. increased chances and duration of exposure to risk factors,
2. provision of adequate time for development of significant disease,
3. decrease cardiac efficiency -> incr. O2 use
   
3. Explain why following preventative measures for coronary atherosclerosis and the resulting coronary disease is important in biological as well as other ways in a person's life.  Page index
1. prevent impacts for victim and others
1. threat to health and life
2. disruption of life of victim and others
3. disability
4. social
5. psychological
6. economic
2. reduce risk of death
 
4. Name the three most important risk factors for coronary atherosclerosis and describe ways by which these risk factors can be reduced or eliminated. Page index
1. high blood pressure
2. smoking
3. high blood lipoprotein (cholesterol and LDL)
   
5. Name risk factors for coronary atherosclerosis. Page index
1. smoking
2. high blood pressure
3. high blood lipoprotein
4. diabetes mellitus
5. family history
6. increasing age
7. high blood homocysteine levels
8. low exercise
9. obesity
10. stress
11. menopause
12. being male
13. type A personality
14. high blood iron levels
15. periodontal disease
 
6. Explain the interrelatedness among risk factors for coronary atherosclerosis.  Page index
1. geometric synergism
   
7. Name and describe the effects from the four changes in arterial properties caused by atherosclerosis.  Page index
1. narrowness -> decr. flow = decr. service for cells
2. roughness -> clot formation -> decr. flow -> decr. service for cells
3. stiffness -> decr. ability to dilate -> decr. adaptability with incr. demand by cells
4. weakness -> aneurysms -> (1) pressure on structures, (2) clot formation, (3) bleeding
 
8. Describe varicose veins, indicate that they are a disease, explain how they develop, name and describe three effects they produce, and name and describe three ways to reduce their occurrence. Page index
1. expanded veins
2. do not develop in all people
3. cause by chronic passive congestion
4. cause cosmetic effects, pain, infection, edema, ischemia, bleeding (G.I. tract), pulmonary embolism
5. avoid long standing, constrictive posture or clothing, inactivity, chronic cough, alcoholism: wear support hosiery, get exercise
 
9. Describe what hemorrhoids are and name ways to reduce their occurrence.  Page index
1. varicose veins at the anus
2. avoid constipation, forced bowel movements, chronic cough, alcoholism: get adequate fiber, water, exercise, accessible toilet facilities

1. Describe the effects of amounts of exercise and levels of health on age changes affecting ventilation.  Page index
1. exercise and good health minimizes rate and degree of age changes
2. lack of exercise and poor health increase rate and degree of age changes
 
2. Describe non-biological effects from age changes in the respiratory system related to biological age changes in respiration. Page index
1. select examples of social, psychological, and economic effects and interactions with biological and the other types of effects
 
3. Name types of air pollution and explain why reducing exposure to air pollution is important. Page index
1. smoking,
2. occupational air pollution (fibers, coal, sawdust, asbestos, exhaust fumes, solvent fumes),
3. urban air pollution,
4. farm air pollution
5. air pollution increases the adverse effects of aging on respiration, leading to decreased maximum speed and endurance, disability, disease, and death
 
4. Name reasons for the increased incidence and severity of respiratory system diseases as age increases. Page index
1. increased risk and incidences of exposure to factors
2. increased duration of exposure to factors
3. lowered body defenses

1. Describe the overall effects of nervous system aging on conscious sensation, and explain how these changes affect homeostasis and quality of life.  Page index
1. decr. detection of stimulus
2. decr. identification of stimulus
3. decr. evaluation of strength of stimulus
4. effects =
1. decr. learning,
2. decr. pleasure,
3. decr. control of movement
5. compensation by strengthening stimulus, allowing more time
 
2. Describe the overall effects of nervous system aging on voluntary movement, and explain how these changes affect homeostasis and quality of life.  Page index
1. weaker
2. slower
3. prolonged movement
4. less accurate movement
5. less coordinated movement- affects all strength, fast, and skilled activities
6. compensation by choosing other activities, use of more efficient motion strategies, "youth vs. experience", use of assistance devices (e.g., canes)
 
3. For strokes, indicate that strokes are diseases (not age changes), and give the following information.  Page index
1. rank as cause of death among elderly (3rd)
2. effects other than death (disability, social, psychological, economic)
3. trend in incidence (incr. especially after age 65)
4. two main causes (atherosclerosis, heart failure)
5. reasons that the two main causes produce stroke (block vessel, brain hemorrhage)
6. three main types of stroke based on time factors (TIA with recovery within 24 hours, RIND with partial gradual recovery, completed with little or no recovery)
7. methods of preventing strokes (prevent atherosclerosis)
 
4. Explain how multi-infarct dementia develops.  Page index
1. continuous accumulation of small dead spots in the brain from inadequate blood flow causes gradual decline in many brain functions, finally resulting in dementia.
   
5. List adverse effects from smoking including three from outside the respiratory system.  Page index
1. free radical formation
2. decreasing antioxidants
3. amplifies age changes and incidences of diseases in skin
4. increases risks of high blood pressure, blood clots, and atherosclerosis
5. increases incidence of cataracts
6. increases risks of osteoporosis
7. increases risk of diabetes mellitus
8. decreases immune system functioning
9. increases risk of many cancers.

1. List and describe ways by which good vision is beneficial.  Page index
1. negative feedback,
2. warning,
3. "finding and getting 'goodies'",
4. communication with others,
5. learning,
6. pleasure
 
2. Name the three main reasons for poor vision.  Page index
1. poor focusing (scattering or improper refraction).
2. improper amount of light
3. poor processing of impulses (in the eye, visual pathways, or the brain)
 
3. List ways by which vision among the elderly can be assisted or improved.  Page index
1. increase lighting
2. decrease glare
3. enlarge items
4. increase contrast
5. avoid close vision
6. slow motions and objects
7. use eyeglasses and contacts
 
4. Describe the main reasons why the following eye diseases decrease vision: cataracts, age- related macular degeneration, glaucoma, diabetic retinopathy. Page index
1. cataracts = lens opacities (especially in the center) -> decr. transparency and incr. scattering -> cloudy and foggy vision, blindness
2. age-related macular degeneration = separation of macular region of the sensory retina from other layers (made worse by choroid hemorrhaging) -> decr. nutrition for the macula -> macular degeneration -> decr. central vision (including color vision)
1. bleeding -> rapid macular blindness
3. glaucoma = incr. intraocular pressure -> injury to retina and optic nerve -> limited field of view (tunnel vision), blindness
4. diabetic retinopathy = damaged retinal capillaries -> retinal damage
1. NOTE: bleeding into the vitreous -> blindness
2. (sorbitol in mural cells -> mural cell swelling and injury -> capillary weakness) -> capillary hemorrhaging and narrowed capillaries (ischemia) -> damaged retina (with vessel proliferation into vitreous -> vitreous hemorrhaging -> retinal detachment &/or secondary glaucoma -> blindness)Name the four types of stimuli monitored by the ears and name two benefits from monitoring these stimuli.- stimuli = (1) sound, (2) gravity, (3) change in speed, (4) rotation of head
5. benefits = homeostasis, learning, communication, pleasure
 
5. Describe age changes in cerumen and describe effects from these changes. Page index
1. cerumen - becomes more viscous -> accumulation -> blockage of ear canal -> decr. hearing
 
6. Describe age changes in ability to hear, ability to hear different frequencies of sound, ability to localize sound, and ability to interpret sound, and give one effect from each change including biological, social, psychological, and economic examples. Page index
 
1. hearing - decr. hearing (from (1) decr. endolymph and (2) decr. # of cells in and around the organ of Corti)
2. frequencies - decr. in hearing higher frequencies (from (1) deterioration of the beginning area of the organ of Corti)
3. localization - decr. ability to localize sound (from (1) unequal age changes between the two ears and (2) decr. processing and interpretation by the brain)
4. interpretation - decr. interpretation (from decr. brain functioning)
5. effects = decr. defense, decr. learning, decr. communication, decr. pleasure
 
7. List the effects on a person's life style or quality of life that result from the age changes mentioned in objectives above.  Page index
 
8. Define presbycusis, describe trends with aging in its incidence and severity, describe methods to prevent its occurrence, name methods to compensate when it occurs, and name effects from presbycusis including biological, social, psychological, and economic examples.  Page index
1. presbycusis = serious decrease in hearing
2. incr. incidence and incr. severity with incr. age
3. prevention = avoid loud noise (music, occupational, recreational, entertainment)
4. compensation = reduce background noise, speak slower and more clearly, use visual cues, repeat messages, ask for confirmation of information or message sent
5. effects = decr. defense, decr. learning, decr. communication, decr. pleasure, social, psychological, economic effects
 
9. List and briefly explain factors that increase the risk of falling and of being injured by a fall as age increases.  Page index
1. decr. ear functioning
2. decr. vision
3. decr. skin sensations
4. decr. proprioceptor sensations
5. decr. muscle strength
6. incr. joint stiffness
7. decr. reflexes
8. decr. coordination
9. thinner fat
10. weaker bones
11. weaker soft tissues (e.g., skin)
12. slower healing
 
10. List ways of reducing the risk of falling for the elderly and explain why preventing falls is especially important for the elderly including biological, social, psychological, and economic examples.  Page index
1. prevent falls, (e.g., remove hazards, improve lighting, provide rails and grab bars)
2. falls -> injury (e.g., fractures) and slower recovery (e.g., slower healing) -> increased and longer adverse effects and disability (e.g., immobility) -> increased number and severity of outcomes and complications from injuries from falls as age increases

1. Describe the effects of aging on muscle mass and name six effects from these changes. Page index
1. effects of aging
1. gradual decr. in mass, especially after age 50, and especially with decr. exercise (from decr. # of muscle cells and decr. thickness of muscle cells)
2. effects =
1. decr. strength
2. decr. speed
3. decr. coordination
4. altered posture
5. altered appearance and body proportions
6. need for decr. calories and diet modification,
7. need to adjust medications due to altered % body fat vs % lean body mass
3. NOTE: great variability among people and among different muscles in a person because of variable decr. in exercise
 
2. Describe the effects of aging on the four aspects of stamina, i.e., performing extended vigorous activity.  Page index
1. decr. maximum rate of extended work -> must "pace" slower
2. decr. endurance for extended hard work -> must "quit" sooner incr. recovery time (e.g., removal of lactic acid)
3. incr. stiffness and soreness after exercise (from incr. lactic acid build-up)
 
3. Describe some effects on the muscle system and three other systems circulatory system, skeletal system, endocrine system, on quality of life, on diseases, and on life expectancy from staying physically active - i.e., maintaining high level of exercise. Page index

1. muscle system

1. slows decline in muscle mass

2. slows decline in strength

3. slows decline in insulin sensitivity

2. circulatory system

   1. decr. risk of atherosclerosis- decr. LDLs, decr. cholesterol, incr. HDLs - decr. BP or slower rise in BP

3. skeletal system

1. slows decline in minerals, maintains joint mobility

4. endocrine system

1. slows decline in insulin sensitivity, maintains GH levels

5. quality of life

1. retain physical ability plus non-biological benefits derived therefrom

6. diseases- decr. risk of developing some diseases - e.g., atherosclerosis, heart disease, strokes, diabetes, osteoporosis

1. decr. severity of diseases

7. life expectancy

1. little increase in life expectancy currently demonstrated, though increase is expected

 
4. Describe the effects from reducing levels of physical activity.  Page index
1. no "bank account" from exercise.
2. "use it or lose it"
 
5. Describe some effects on the muscle system and three other systems - circulatory system, respiratory, nervous, skeletal, endocrine system, on quality of life, on diseases, and on life expectancy from increasing activity when older (The answer is essentially the same as for objective above.)  Page index
 
1. muscle
1. incr. muscle mass
2. incr. strength
3. incr. speed of motion
4. incr. stamina
5. all four parts including VO₂ max
2. circulatory
1. incr. cardiac output
2. incr. cardiac efficiency
3. incr. HDL/LDL ratio
4. incr. vessel diameter
5. decr. BP
6. decr. arrhythmias
7. incr. organ perfusion
8. probably decr. risk of atherosclerosis
3. respiratory
1. slows decline in respiratory functioning
2. helps reduce effects from COPD (incr. mucous clearance, incr. respiratory muscle function, decr. airway collapse, decr. smoking)
4. nervous
1. incr. speed of CNS impulse processing
2. incr. short term memory
3. improves sleep
4. improves motor neuron functioning -> incr. speed and strength
5. skeletal
1. slows bone demineralization
2. reduces risk of osteoporosis
3. improves joint function = easier movement, incr. ROM
6. endocrine
1. incr. insulin sensitivity
1. incr. glucose tolerance
2. decr. risk and severity of NIDDM
3. slows decline in growth hormone
2. slows decline in organ size and function
7. quality of life,
8. diseases
9. life expectancy (as above)
10. miscellaneous
1. weight regulation
2. incr. nutrition by incr. amount and variety of foods eaten
3. incr. independence
4. improves
1. psychology - e.g., incr. mood, incr. well-being, decr. boredom, decr. anxiety, decr. stress
2. incr. social contacts
3. improves economic status
 
6. Name important steps or considerations in planning an exercise program for elders.. Page index
1. set goals
2. evaluate participants before beginning and after participation in the program for a while (e.g., several weeks)
3. individualize the program for each participant
4. adjust the program according to the progress of the participants
5. include modifications in nutrition in the program to accommodate for the increase in physical activity and altered metabolism
6. take steps to minimize injuries and risks from possible abnormalities or diseases present in the participants
7. alter the nature of the exercises to avoid boredom and maintain interest
8. provide positive feedback to maintain interest and motivation
9. consider implementing "alternative practical" exercises such as activities of daily living (ADLs), hobbies, etc

1. Describe the effects of menopause on bone matrix loss including the reason for the effects, the different effects on trabecular and cortical bone, common fractures that result, and the results from those fractures.  Page index
1. decr.decr.decr. trabecular bone from decr.decr.decr. estrogen
2. greater decr. in trabecular bone than in cortical bone -> incr. vertebral and hip fractures
3. results = pain, disability, infection, expense, immobility (clots, bed sores, pneumonia, faster matrix loss, muscle deterioration, etc. from lack of exercise)
 
2. Name methods for minimizing bone loss.  Page index
1. maintain ample exercise, calcium, vitamin D, & estrogen
2. avoid smoking and stomach antacids that contain aluminum
3. avoid excesses in alcohol, caffeine, phosphates (e.g., carbonated beverages), corticosteroids, dietary fiber, dietary protein
 
3. Define osteoporosis and distinguish between the two types of osteoporosis based on age of onset, main contributing factors, and gender differences.  Page index
1. osteoporosis = bone disease -> hollow, thin, porous bone matrix
2. Type I = post-menopausal osteoporosis from decr.decr. estrogen in late 40s and 50s
1. almost always in women
3. Type II = senile osteoporosis from decr.decr. kidney vitamin D activation after age 60 and from decr. intestinal response to vitamin D
1. 2:1 ratio in :
 
4. Name and describe the effects from vertebral fractures caused by osteoporosis.  Page index
1. pain
2. decr. mobility
3. decr. height
4. altered posture
5. decr. respiration
6. social
7. psychological
8. economic
 
5. Name and describe the effects from hip fractures caused by osteoporosis. Page index
1. decr. mobility
2. disability (decr. ADLs)
3. institutionalization
4. complications (clots, pneumonia, bed sores, infections, faster matrix loss, muscle deterioration, etc. from less exercise)
5. social
6. psychological
7. economic
 
6. Name main ways to reduce the incidence of fractures for those who have weakened bones from osteoporosis.  Page index
1. avoid heavy lifting
2. reduce falls
 
7. Describe the effects of exercise on the effects of aging of joints.  Page index
1. exercise slows rate of stiffening and rate of decr. ROM

1. Name and explain the importance of the six main functions of the digestive system. Page index
1. supply nutrients
2. store blood
3. eliminate wastes
4. regulate blood chemistry
5. vocalization
6. produce hormones
 
2. Describe age changes (not abnormalities) in the following aspects of the oral region and describe consequences from these age changes: teeth, muscles.  Page index
 
1. teeth -> (1) (decr. pulp) -> decr. sensitivity -> decr. warning of damage and decay(2) loosening teeth and receding of gums -> incr. periodontal disease
2. muscle -> decr. strength and coordination -> decr. swallowing -> incr. choking
3. NOTE: IMPORTANCE OF PREVENTION (FLUORIDE DURING YOUTH, GOOD DENTAL HYGIENE THROUGHOUT LIFE)
 
3. List main ways for preventing or reducing abnormal changes in teeth.  Page index
1. fluoride during youth,
2. good dental hygiene throughout life (avoid sweets, brush teeth, regular dental check-ups and treatments)
 
4. For the large intestine, describe the effects of age changes on defecation including the incidence of constipation and fecal incontinence.  Page index
1. slowed transit time -> incr. risk of constipation
2. rectal changes (fibrosis, sphincter weakening, decr. voluntary sphincter control) -> incr. fecal incontinence
 
5. Name factors that increase the incidence of constipation with aging and tell effects from constipation.  Page index
1. factors = aging, laxative, delayed defecation, decr. fiber, decr. water, decr. exercise, meds, incr.incr.incr. fiber
2. effects = discomfort, gas, diarrhea, fecal incontinence, hemorrhoids, diverticulosis, etc.
 
6. Name factors that increase the incidence of diarrhea with aging and tell effects from diarrhea.  Page index
1. factors = constipation, laxatives, bacteria, meds, ulcerative colitis, cancer
2. effects = dehydration, salt loss (e.g., heart, brain, BP, muscles), fecal incontinence
 
7. Name factors that increase the incidence of fecal incontinence with aging and tell effects from fecal incontinence.  Page index
1. factors = constipation, diarrhea, hemorrhoid surgery, nervous disorders (e.g., stroke, dementias, cord injury), diabetes, immobility
2. effects = skin inflammation, infection, bed sores, social, psychological, institutionalization
 
8. Name factors that increase the incidence of diverticulosis and diverticulitis with aging and tell effects from diverticulitis.  Page index
1. factors = constipation, decr. fiber, decr. water,
2. effects = pain, constipation, diarrhea, bleeding, infection, perforation
 
9. Name factors that increase the incidence of hemorrhoids with aging and tell effects from hemorrhoids.  Page index
1. factors = constipation, cirrhosis, coughing, childbirth
2. effects = pain, bleeding, infection, surgery
 
10. Name factors that increase the incidence of colon cancer with aging and tell effects from colon cancer.  Page index
1. factors = incr. animal fats, incr. sugars, decr. fiber, genetics
2. effects = obstruction, intestinal destruction, metastasis, bleeding
 
11. For cirrhosis of the liver, name common causes and effects from cirrhosis including malnutrition, jaundice, and hemorrhoids, and ways to reduce the risk of developing cirrhosis.  Page index
1. causes = gall stones, alcohol, toxins, malnutrition, hepatitis
2. effects = malnutrition, jaundice, hemorrhoids, NH₃ toxicity, ascites, edema, bleeding, anemia, weak bones, altered sexual functioning
3. prevention = treat gall stones, avoid alcoholism, avoid toxins, avoid hepatitis
 
12. Name ways to reduce the risk of developing pancreatic cancer.  Page index
1. avoid smoking, excess fats, nitrates and nitrites, excess coffee
 
13. Understand and explain that most age-related changes in the digestive system, including abnormalities and diseases, result not form age changes but from abuse, misuse, and disuse of the digestive system or from abnormalities or diseases in other body systems. Therefore, most age-related problems in the digestive system are preventable to some degree.  Page index

1. Name the four main uses of nutrients in the body.  Page index
1. energy for activities
2. raw materials (e.g., growth, repair, and replacement)
3. cofactors to assist reactions (e.g., vitamins, minerals)
4. fluid/electrolyte balance (e.g., osmotic pressure, blood pressure)
 
2. Describe the correlations between proper diet and proper nutrition (nutritional homeostasis).  Page index
1. normally, proper diet -> proper nutrition
2. sometimes proper diet does not -> proper nutrition
1. e.g., digestive malfunction, disease, smoking, alcohol, medications
 
3. Explain why malnutrition can have diverse effects.  Page index
1. many possible types of malnutrition
1. diversity in severity and duration of malnutrition
2. diversity from direct and indirect effects from malnutrition
 
4. Describe overall effects from malnutrition.  Page index
1. decr. homeostasis
2. decr. quality of life
3. incr. diseases (e.g., atherosclerosis, osteoporosis)
 
5. Compare and contrast nutritional needs for younger and older adults.  Page index
1. same because of same body functions
1. adjust kcals based on activity levels
2. modify based on abnormal or unusual conditions
1. e.g., heat, cold, exercise, disease, medications
 
6. Explain why a diet plan for an elderly person must be more individualized.  Page index
1. increased heterogeneity in
1. lifestyle
2. amount of exercise
3. diseases
4. medications
5. levels of activity
6. disabilities
7. sensory, motor, and mental problems
8. social
9. economic
10. psychological
 
7. Describe the general trends in malnutrition as age increases and explain reasons for these trends. Page index
1. increased incidence and severity as age increases
1. numerous and diverse reasons including biological, social, psychological, economic
 
8. Describe an appropriate sequence of steps to prevent or reduce malnutrition.  Page index
1. evaluate nutritional status
2. identify factors contributing to malnutrition
3. make adjustments in diet and activity to improve nutrition
1. individualize adjustments
1. combine nutrition with other activities
2. use selected supplements, medications
4. reevaluate and adjust as circumstances change (e.g., disease, finances, psychology, social, level of activity)
 
9. Describe strategies to maintain energy balance and nutritional homeostasis.  Page index
1. decr. kcals but incr. nutrient density when decr. energy needs
2. incr. activity to allow incr. eating with no weight gain
 
10. Describe effects from being obese and being underweight.  Page index
1. adverse effects on many body system, increases risk of many diseases, social, psychological, economic impact
2. underweight
1. weakness, fatigue, decr. body temp. regulation in cold, decr. resistance to abnormal and disease conditions, decr. body reserves for use during stress periods (e.g., recovery from illness)
 
11. Describe the general characteristics of a diet that can provide proper nutrition and explain the underlying reasons for these characteristics.  Page index
1. eat a variety of foods in moderation to obtain a complete mixture of the many and varied nutrients needed to support the body's many and varied structures and functions.
 
12. Explain in general terms why obtaining an adequate diet to obtain nutritional homeostasis becomes more difficult as age increases and why dietary planning must be more individualized as people age.  Page index
1. incr. adverse age changes, incr. abnormal conditions, incr. diseases, incr. use of medications in many systems
2. plus adverse
1. social,
2. psychological, and
3. economic changes

- > difficulty selecting, obtaining, preparing, eating, and digesting foods and in absorbing and using nutrients

1. Explain why the incidence and severity of excursions beyond the kidneys' capabilities increase with age.  Page index
1. incr. age change in other systems  (e.g., decr. thirst sensations)
2. incr. diseases (e.g., diabetes, G.I. tract, disabilities)
3. incr. use of medications (e.g., diuretics)
   
2. Name specific factors that increase demands on kidney functioning.  Page index
1. incr. salt intake
2. incr. salt substitute intake
3. decr. water intake
4. incr. perspiration
5. diarrhea
6. incr. diuretics
7. respiratory problems (varying pH)
8. decr. thirst sensitivity
9. incr. meds
10. I.V.s, diabetes mellitus
    
3. Name specific effects when the kidneys are not able to maintain homeostasis.  Page index
1. urea toxicity
2. acidosis
3. edema
4. incr. BP
5. arrhythmias
6. CNS functioning
7. bone demineralization
8. muscle spasms
9. muscle weakness
10. anorexia
11. poor vit. D absorption
12. anemia
13. incr. risk of systemic infection
14. kidney stones
15. medication toxicity from build-up
16. cell swelling (e.g., increased intracranial pressure in brain)
    
4. Name strategies that help balance kidney functioning with body needs. Page index
1. regulate fluid and mineral intake
2. regulate medications that affect kidney functioning
3. prevent and treat abnormal and disease conditions that adversely affect kidney functioning (e.g., atherosclerosis, diabetes, diarrhea)
 
5. Name specific factors that increase the incidence of urinary incontinence.  Page index
1. dementia
2. strokes
3. disability
4. neuroactive meds.
5. diuretics
6. diabetes mellitus
7. decr. bladder sensitivity
8. decr. sphincter strength
9. decr. estrogen
10. bladder spasms
11. lifting
12. coughing
13. laughing
14. alcohol
15. caffeine
16. UTI
17. BPH
18. perineal surgery
 
6. Describe biological and non-biological consequences from urinary incontinence.  Page index
1. skin problems (inflammation, infection),
2. social
3. psychological
4. economic
5. institutionalization

1. Name and describe main temporary effects and main permanent effects from hormone changes resulting from menopause. Page index
1. temporary
1. hot flashes
2. altered psychological and mental functions (e.g., depression, anxiety, confusion, decr. memory)
2. permanent
1. altered reproductive and breast structure and functions and hair distribution
2. great decr. bone matrix
3. great incr. LDLS and great decr. HDLs Describe beneficial and harmful effects from estrogen replacement therapy (ERT)- beneficial = decr. hot flashes, incr. psychology and mental activity, incr. vaginal secretion, incr. skin, decr. LDLs and incr. HDLs, slower bone loss
3. harmful = incr. risk from cancer, blood clots, gall bladder problems in some women
 
2. Describe the role of insulin and the effects of aging on its effectiveness.  Page index
1. insulin -> decr. blood sugar and incr. energy supply for cells.
1. age -> no effect on ability
 

3. For diabetes mellitus among the elderly, name contributing factors and harmful effects and describe real life practical consequences from the harmful effects.  Page index

1. contributing factors
1. genetics
2. obesity
3. decr. exercise
2. harmful effects
1. cataracts -> poor vision and blindness ->
2. diabetic retinopathy -> poor vision and blindness ->
3. decr. sensory neuron functions -> loss of sensations ->
4. decr. muscle control -> loss of muscle control, muscle weakness ->
5. decr. autonomic reflexes (e.g., digestion, incontinence, sexual response)
6. great incr. atherosclerosis ->
7. decr. WBC functioning -> decr. defense ->
8. kidney failure ->
9. incr. osmotic pressure -> cell shrinking ->
10. dehydration -> cell shrinking, decr. blood pressure ->
11. salt loss -> nerve and muscle cell malfunction ->
12. incr. infection ->
13. decr. tissue perfusion -> cell weakness ->
14. decr. O2 in blood -> muscle weakness ->
15. decr. diffusion in tissue spaces -> cell weakness and waste build-up ->
16. glaucoma -> poor vision and blindness ->
17. autoimmune activity ->
18. joint stiffness ->Name and describe methods for reducing the incidence and severity of problems from diabetes mellitus among the elderly.- prevention
19. avoid risk factors such as obesity, decr. exercise, incr. CHOs
20. watch for signs and symptoms
3. treatment must be individualized
1. diet control
2. weight control
3. exercise control
4. medications and insulin
5. prevent, recognize, and treat complications

1. Name main benefits from immune system functioning.  Page index
1. causes inflammation to warn of injurious chemical (e.g., rash on the skin)
2. eliminates foreign substances and microbes (e.g., bacteria, viruses)
3. eliminates cancer cells
 
2. Describe the general average effects of aging on immune system functioning.  Page index
1. variable but gradual average decline in immune functioning
1. requires more stimulus to be activated
2. requires more time to become active
3. produces less primary response
4. loses memory faster
5. produces less secondary response, especially from new primary responses
6. NOTE: immune system performance declines but it still performs fairly well throughout life unless other factors (many of which are age-related) overwhelm its capacity
7. autoimmune antibodies increase, which seem to indicate declining regulation of immune response but which have no known adverse effects
 
3. Name specific factors that cause an age-related decrease in the effectiveness of immune system functioning.  Page index
1. excess exposure of skin to sunlight (decr. Langerhans cells)
2. cirrhosis
3. malnutrition
4. diabetes mellitus
5. surgery and implants
6. use of anti-inflammatory steroids
7. stress (biological, social, or psychological)
8. excess exposure to microbes or carcinogens (e.g., hospitals)
9. decreased cough and gag reflexes
10. decreased mucociliary escalator function
11. increased risk of physical injury (e.g., bed sores, fractures) etc.
 
4. Name problems resulting from age changes in immune system functioning.  Page index
1. decreased inflammation and warning of presence of injurious chemicals
2. increased risk of new infection (e.g., pneumonia)
3. increased reactivation of infection such as tuberculosis and shingles
4. increased risk of cancer
5. decreased response to vaccines
 
5. Name ways to minimize consequences from age-related decreases in immune functioning.  Page index
1. avoid excess chronic sun exposure
2. avoid alcoholism
3. get good nutrition
4. exercise
5. minimize use of anti-inflammatory steroids
6. reduce stress
7. avoid exposure to disease-producing microbes, chemicals, and other conditions
8. get vaccinations early and get booster shots as needed
9. augment immune defense functions with other strategies (e.g., antibiotics, chemotherapy)

Page index

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Copyright 2020: Augustine G. DiGiovanna, Ph.D., Salisbury University, Maryland

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