Age-related Physiologic Changes

Over time, the body gradually goes through normal age related physiologic changes. As the nurse, you'll recognize how these changes impact the body systems in older adults and consider conditions that can develop as a result.

Starting with age related changes of the cardiovascular system. The heart's muscle loses tone and becomes stiffer to compensate, muscle mass increases but is a less effective pump.

This decreases cardiac output and increases the risk of heart failure. The heart valves become thicker and calcified which can lead to valve disease and murmurs.

Additionally, the conduction system including the sinoatrial node, known as the pacemaker of the heart loses cells, decreasing heart rate and increasing risk for arrhythmias.

Also, blood vessels become stiffer, decreasing venous, return from the periphery and contributing to dependent edema and varicosities.

And the build up of atherosclerotic plaque within the vessels can lead to coronary artery disease, peripheral artery disease and hypertension.

Lastly, an impaired barrow reflex which helps maintain BP by adjusting heart rate, cardiac output and peripheral vascular resistance during position changes can result in orthostatic hypotension and an increased risk of falls.

Ok. Moving on to changes to the respiratory system.

There are certain age related changes that increase the risk of respiratory infections, like pneumonia and influenza. These include fewer cilia that trap and remove inhaled microbes and debris.

Fewer pulmonary macrophages, which are the first line of defense against inhaled pathogens and a decreased cough reflex, which is needed to help expel inhaled pathogens and clear secretions.

Other changes include thoracic muscle weakness and calcifications of rib cartilage which can limit lung expansion, increase the work of breathing and decrease the ability to take deep breaths.

Lastly, loss of alveolar elasticity, decreased alveolar surface area and fewer pulmonary capillaries result in reduced gas exchange which impairs oxygenation.

Next up in the gastrointestinal system, receding gums and loose or missing teeth can decrease the ability to bite and chew.

Potentially impairing nutrition. Nutrition can also be affected by dysphasia or difficulty swallowing due to reduced esophageal motility, decreased gastric secretions needed for digestion and increased gastric ph that can alter the absorption of nutrients.

Additionally, aging leads to decreased liver size and enzyme production, which can impair drug metabolism, increasing the risk of medication toxicity.

Older adults also typically have diminished thirst perception, which can result in dehydration and constipation and is further compounded by slowed gastric motility.

Lastly, the lower esophageal sphincter loses tone over time, increasing the incidence of gastroesophageal reflux disease or GERD.

Now, in the urinary system, fewer functional nephrons and decreased renal blood supply, reduce the kidney's ability to remove body wastes and clear medications from the bloodstream which can allow a buildup of toxins.

Also decreased tissue elasticity limits bladder capacity or the amount of urine the bladder can hold before needing to void and impaired voluntary control of the external sphincter muscle can result in urinary urgency and frequency.

These factors along with an impaired perception of the need to void can also lead to incontinence or accidental loss of urine.

Moreover, reduced bladder tone makes incomplete bladder emptying and urinary retention. More likely increasing the risk of developing a urinary tract infection or uti also keep in mind that even though biological females are typically more prone to UTIs due to factors such as a relatively shorter urethra and its close proximity to the anus in biological males.

The prostate enlarges with age which can compress the urethra causing incomplete bladder emptying and urine retention, thereby increasing the risk of developing a uti switching gears in the musculoskeletal system.

There is a gradual loss of calcium from the bones over time causing decreased bone mineral density, also known as osteopenia, which often leads to osteoporosis, meaning bones become brittle and break easier.

This can also cause some individuals to develop a hunched appearance called kyphosis, which is a more pronounced thoracic curvature.

Additionally, the space between each intervertebral disc decreases, causing overall loss in height. Also, both tendons and ligaments lose elasticity over time resulting in decreased flexibility and mobility.

Concerning older adults are also at increased risk for developing osteoarthritis or joint inflammation, which can further limit physical mobility and cause chronic pain.

There's also decreased muscle mass and blood supply to the muscles resulting in weakness and higher fall risk. Lastly, there are certain age related changes to the integumentary system.

Starting with skin, the top layer called the epidermis thins over time, increasing susceptibility to trauma and increasing the time needed for healing in the dermis or middle layer.

Fewer elastin fibers lead to the appearance of wrinkles. Similarly, in the hypodermis or bottom skin layer, there's a loss of subcutaneous fat resulting in a heightened risk of cold related illness, like hypothermia, as well as the development of pressure injuries for immobilized individuals.

Other changes include less active sebaceous and sweat glands, resulting in dry skin and decreased sweating, decreased sweating can make older adults more prone to heat related illness like hyperthermia.

Finally, body hair gradually thins and fades in color. And the growth of nails slows and they become more brittle and thicker.

All right. It's a quick recap.

Age related physiologic changes normally occur in the body over time. As the nurse caring for older adults, you'll recognize these body system changes and consider conditions that can develop as a result.