Late adulthood
years after 65
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• Late adulthood can be divided into:
– Young old 65 – 74 years
– Middle old 75 – 84 years
– Old old over 85 years
• Geriatrics: is the term for medical speciality that
addresses the diagnosis and treatment of the
physical problems of elderly person
• Gerontology: is a science that study all aspects of the
aging process including biologic, psychologic and
sociologic factors
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Biologic theories of aging
• Wear and tear theories:
– Dr. August Weismann, a German biologist, first introduced
this theory in 1882.
– He believed that the body and its cells were damaged by
overuse and abuse.
– The organs, liver, stomach, kidneys, skin and so on are
worn down by toxins in our diet and in the environment;
by the excessive consumption of fat, sugar, caffeine,
alcohol and nicotine; by the ultra-violet rays of the sun and
by the many other physical and emotional stresses to
which we subject our bodies.
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Biologic theories of aging
– Wear and tear is not confined to our organs,
however; it also takes place on the cellular level.
– When we are young the body's own maintenance
and repair systems keep compensating for the
effects of both normal and excessive wear and
tear
– With age the body loses its ability to repair
damage caused by diet, environmental toxins,
bacteria or a virus
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Biologic theories of aging
• The Neuroendocrine Theory
– Proposes that changes in hormone production result in
organism’s decline
– When we are young, our hormones work together to
regulate many bodily functions, including our responses to
heat and cold, our life experiences and our sexual activity
– Hormones are vital for repairing and regulating our bodily
functions, and when aging causes a drop in hormone
production, it causes a decline in our body's ability to
repair and regulate itself
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• The Genetic Control Theory :
– We are born with a unique genetic code, a predetermined
tendency to certain types of physical and mental
functioning, and that genetic inheritance has a great deal
to say about how quickly we age and how long we live
• Cross – linking theory:
– Proposes that chemical reactions create strong bonds
between proteins these bonds cause loss of elasticity,
stiffness and loss of function
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• Autoimmune Theory
– Proposes that immune system becomes less
effective that incubated viruses in the body
damage the body organs.
– Also a reduction in immune function will increase
autoimmune responses causing the body to
produce antibodies that attack itself
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Integumentary system
• Skin:
– dry, fragile and pale
– Wrinkling and sagging in skin, eyelids, ear lobs,
breast due to decrease elasticity and subcutaneous
fat
– Appearance of Lentigo Senilis (brown age spots) due
to clustering of melanocytes (pigment cells)
– Women may start to have facial hair
• Hair loses color
• Fingernails and toenails become thickened and
brittle
• Losses of subcutaneous fat decreases elderly
tolerance of cold (hypothermia is a major health
problem)
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Neuromuscloskeletal
• Steady decrease in muscle fibers and muscle tones
• Reduction of speed and power of muscle contractions
• Elderly may experience impaired balance (due to
slower reaction time)
• Loss of overall stature (due to atrophy of
intervertebral discs)
• Stooping posture due to muscle weakness and
kyphosis: curved posture, the head down, the back
and knees bent, and a forward pitch with small,
shuffling steps when walking.
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• The loss of bone density and mass causes a
compression of the bones especially in the vertebral
area creating a slight decrease in height
• Osteoporosis due to bone demineralization causing
bones break more easily
• A loss of cartilage makes painful joint complaints
more common and contribute to a decrease range of
movement and mobility
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Osteoporosis is a weakening of
bones due to loss of bone density.
Osteoporosis is preventable to a
very large extent by calcium
intake and regular load-bearing
exercise, such as weight
training.
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Sensory/ perceptual
• Eyes:
– Shrunken appearance due to loss of orbital
fat.
– Slow blinking reflex
– Looseness of the eyelids particularly the
lower lid due to poorer muscle tone.
– Continue loss of visual acuity, less power to
adapt to sudden changes to more or less light
or near to far objects (temporary blindness):
hazard of night driving.
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– Difficulty in discriminating similar colors.
– May have
• Cataract
• Glaucoma
• Reduce peripheral vision
• And arcus senilis (white circle around the iris: it
is a peripheral corneal opacity caused by a
deposition of phospholipid and cholesterol
granules in the corneal stroma )
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• Hearing: after age 75, 50% or more have hearing
deficits: higher tones are more difficult to hear than
low ones
• Smell and taste: older people, especially men,
experience losses in both taste and smell, which may
result in decreased appetite.
• Touch: loss of skin receptors causing decrease
sensation of pain, touch and temperature places the
elderly at risk for burn or injuries.
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Pulmonary
• Decreases inhalation of air due to musculoskeletal
changes and calcification of costal cartilage which
decreases lung expansion thus decreasing respiratory
rate
• Residual air will be greater (weaker expiratory
muscle)
• Decreased cough efficiency with age thus mucous
secretions tend to collect more often causing
infection
• Dyspnoea with exercises
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Cardiovascular
• Heart working capacity will decrease
especially during exercises
• Heart rate slow in responding and slow
to return to normal after physical
activity
• Decreased the arterial elasticity will
reduce the blood supply to legs
causing calf pain and to the brain
causing dizziness.
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Gastrointestinal
• Delayed in swallowing time
• Increase tendency of indigestion due to
decrease digestive enzymes and decrease
muscle tone of GI system
• Low absorption rate of nutrients and drugs
due to decrease number of absorbing cells in
GI
• Decreased peristalsis movements causing
constipation.
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Urinary
• Decreased numbers of functioning nephrons
lead to diminished kidney function
• Urinary urgency and frequency are common in
elderly due to enlarged prostate in men and
weakness in muscles that support the bladder
in women
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Cognitive development
• An old adult maintains cognitive skills however,
this will be affected with disease processes
• Memory: age related problems occur in shortterm memory
• Old person needs more time to learn due to
problem with retrieving information
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Health problems in late adulthood:
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Health problems
• Dementia:
– is a permanent or progressive organic mental
disorder
– It is a declining of cognitive abilities, characterized
by personality changes, confusion, disorientation
and deterioration of intellectual functioning and
memory.
– The most common type of irreversible dementia is
Alzheimer’s disease (AD)
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• Most prominent symptoms of AD are steady
decline in memory, learning, attention,
judgment, orientation and language skills as well
as decline in physical abilities.
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Health problems in late adulthood:
Alois Alzheimer
Alzheimer’s disease affects a growing number of
older persons—especially those over 80 year.
Cause is not known, but involves deterioration of
the brain’s abilities to maintain itself.
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• Parkinson’s disease:
– Parkinson's disease is a chronic, progressive
neurodegenerative movement disorder. Tremors,
rigidity, slow movement (bradykinesia), poor
balance, and difficulty walking (called
parkinsonian gait) are characteristic of Parkinson's
disease.
– The cause is unknown (idiopathic)
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– Parkinson's results from the degeneration of
dopamine-producing nerve cells in the brain
– Dopamine is a neurotransmitter that stimulates
motor neurons, those nerve cells that control the
muscles. When dopamine production is depleted,
the motor system nerves are unable to control
movement and coordination.
– Parkinson's disease patients have lost 80% or
more of their dopamine-producing cells by the
time symptoms appear.
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