Diseases of the Elderly

3rd Quarter 2019 In-Service Training

CHRONIC ILLNESS:

• A long-lasting illness (in contrast to ACUTE illness, which is temporary)

• Most common in older adults– Heart disease

– Cancer

– Cerebrovascular disease (stroke)

HEART DISEASE:

• Principal cause of death among older adults

• Accounts for significant morbidity, disablement & inactivity

• Dominant factor--atherosclerosis (build-up of fatty deposits within arterial walls)

Mechanism:

• Atherosclerotic buildup------>

• Narrowing of arteries supplying blood to the heart----->

• ISCHEMIA (denial of adequate blood supply)

• Ischemic heart disease also known as:– coronary heart disease (CHD)

– coronary artery disease

– A common form: myocardial infarction (heart attack)

– persistence of deficient blood supply, tissue dies. Dead area: an infarct

Heart attack may also result from:

• Cardiac arrest-- some interruption of normal pattern of cardiac contraction

• Coronary thrombosis--sudden blockage of coronary artery with a blood clot

• Strenuous exercise resulting in suddenly increased need for O2

Mortality associated with MI (myocardial infarction ):

• Over 70--2x that under age of 70

• Symptoms of MI may differ in older people than in younger ones

• “…while complete absence of chest pain is very rare in acute myocardial infarction up to middle age, it is a ‘mundane occurrence’ in old people”

• “…only about 1/3 of elderly patients present with a classical prolonged episode of chest pain”. (Kart & Kinney, p. 111)

Heart Disease: Modifiable Risk Factors:

• Cigarette smokers 2x MI rate of non-smokers

• High BP

• High serum cholesterol levels

• Diabetes

• Obesity

• Sedentary lifestyle

Healthy People 2000 goals:

• 1. Increase prop. Of people whose high BP is under control

• 2. Reduce mean-serum cholesterol levels

• 3. Reduce dietary fat intake & average unsaturated fat intake

• 4. Reduce prevalence rates of obese/overweight adults

• 5. Increase proportion of children & adults engaging in regular, daily physical activity at least 30 min/day

• 6. Reduce cigarette smoking among people age 20 and older

• http://www.health.gov/healthypeople

CANCER

• 2nd leading cause of death in U.S.

• Incidence increases with age--Why?– Most forms of cancer have a long latent

period; initiating factors start during youth

– increasing age and accompanying physiological changes make one more susceptible to actions of carcinogens

CA, cont’d

• …onset and management of many cancers do not vary greatly in the old and young. Prevention is still the order of the day regarding cancer.” p. 113.

• This includes:

• 1. Avoiding unnecessary exposure to ionizing & ultraviolet radiation

• 2. Implementing hygienic measures in occupations involving exposure to CA-producing chemicals & dusts

• 3. Avoiding exposure to tobacco & cigarette smoke

• 4. Have periodic preventive medical exams.

CEREBROVASCULAR DISEASE

• Results from:– changes in blood vessels that serve the

brain tissue

– cerebral infarction

– cerebral hemorrhage

• When a portion of the brain is completely denied blood, a cerebrovascular accident (CVA), or stroke results

• Severity is determined by location and total amount of brain tissue involved

• After diseases of the heart, malignant neoplasms, & accidents, cerebrovascular disease is the fourth-leading cause of death in the U.S.

Cerebral Thrombosis

• Main cause of stroke in o.a.’s

• Occurs when a formed clot becomes lodges in an already narrowed artery.

• Stroke in evolution:

– May develop over hours or even days

– Symptoms can appear within minutes or hours after onset

Transient ischemic attacks (TIA’S)--”mini-strokes”

• Warning signs of an impending stroke

• Transitory symptoms:– sudden motor weakness

– speech dysfunction

– dizziness

– sudden changes in vision (especially in one eye)

– sudden falls

Cerebral Embolism: Another cause of strokes

• Thrombus forms elsewhere in the body and travels to obstruct a vessel supplying the brain

• The onset of the stroke and its damage is immediate

Damage from Strokes

• One-sided weakness or paralysis

• Sensory disturbances

• Aphasia (speech disorders)

• Mental symptoms

• Rehab should begin immediately

APHASIA

• Impaired ability to comprehend or express verbal language

• Receptive aphasia:– difficulty in processing external stimuli;

– may not understand other’s speech or what is read

– familiar objects may become unrecognizable

• Expressive aphasia– A person understands what is said but

cannot form the words or gestures to respond to stimuli

– May be incorrectly associated with mental deterioration

5 Signs of Parkinson’s Disease to Watch for in Seniors

Parkinson’s disease (PD) isn’t always easy to spot at first, but it’s important

to be aware of the symptoms early on as thousands of cases go

undetected each year. Whether Mom’s hands are shaking more than

normal or her movements are “delayed,” getting her symptoms checked

out with a neurologist is the first step to getting the treatment she needs.

The Parkinson’s Foundation notes that about one million Americans live with

PD, and approximately 60,000 Americans are diagnosed with it each

year—meaning that approximately 1% of the population over 60-years-old

has PD.

The symptoms of PD may vary from person to person, but the primary symptoms of Parkinson’s disease to watch for are:

1. Slurred words. Words may begin to slur when person speaks, or they may hesitate

before they says something in a quieter tone.

2. Tremors. This is one of the most common symptoms of PD. Tremors may start

in hands and progress up to the arm. Jaw and facial tremors may also be present.

A sign that the person may have early PD is a back-and-forth rubbing of their

forefinger and thumb.

2. 3. Slowed movements. Becoming slower comes with age, but with PD, person may

drag their feet when walks —making simple tasks become more difficult. Look for

signs that they struggling, such as how much time it takes them to do simple tasks

that they used do with ease.

4. Rigidity in the arms, legs, or neck. If an elder person is complaining about

soreness in her muscles, it could be because they are having muscle stiffness

from PD.

5. Loss of balance or postural instability. Actions that previously didn’t take any

thought—anything from blinking to moving their arms when they walks—may

become foreign to them if they developing PD.

If you’ve noticed one or more of

these symptoms on more than

one occasion, consulting a

doctor should be Mom’s next

step. While there is no cure or

standard treatment for PD,

there may be treatment options

that can help alleviate some of

the symptoms she’s

experiencing. Many of these

options, including balance

activities or physical exercise,

can be carried out in a senior

living setting.

Question 1

One reason chronic heart disease progresses over time

is because it causes:

A. ischemia

B. stroke

C. heart attack

D. aneurysm

Question 2

Lifestyle choices that can increase risk of heart disease

include:

A. smoking

B. obesity

C. being sedentary

D. all of the above

Question 3

A stroke can be caused by:

A. Narrowing of a blood vessel in the brain

B. Blockage of a blood vessel in the brain

C. Rupture of a blood vessel in the brain

D. Any of the above

Source

http://ogg.osu.edu/site_documents/sage/course1/ppt/CHR

ONICILLNESSANDAGING_files/CHRONICILLNESSANDA

GING.ppt