Age Related Changes in Health

Age Related Changes

• Cardiovascular Changes:
  • Lungs: Diaphragm flattens, thorax less flexible, decreased gas exchange efficiency.
  • Heart: Irregular heart conduction, less efficient pumping, decreased elasticity in blood vessels, decreased contractile ability of the venous system.
• Functional Performance Threshold:
  • Definition: The ability to complete Activities of Daily Living (ADLs) to maintain self-care and independent living. It's the maximum sustained activity level before exertion becomes unsustainable.
  • Functional Capacity: An individual's maximum ability to perform daily tasks.
  • Threshold: When physical decline reduces functional capacity below the performance threshold, self-care and independent living become difficult. This may be due to age-related changes or other health conditions and a decline in minimal reserves.

Sensory Function

• Low Vision:
  • Definition: Severe vision loss not correctable by medical or surgical intervention or glasses.
  • Prevalence: Affects 18% of older adults, 30% of those over 85.
  • Types: Age-related changes in eyes and visual pathways.

Nervous System Changes

• Slower processing of visual stimuli
• Requires longer time to process and identify visual stimuli
• Pathological changes in the eyes and visual pathways
• Cataracts -Lens degeneration -Decreased visual acuity -Blurred vision -Altered color perception -Sensitivity to glare -Distorted image
• Age related macular degeneration (AMD) -Affects people over 50 -Loss of central vision, commonly in industrialized countries -Risk factors: Caucasian, smoking, family history
• Glaucoma -Progressive optic nerve damage in stages -Treated medically or surgically, depending on the stage -Peripheral vision loss
• Diabetic retinopathy -Results from damage to retinal blood vessels -Scotoma (blind spots) can be a result of this
• Presbyopia Deficits (vision issues) -Difficulty focusing on objects close up -The ability to accommodate (adjust focus) on nearby objects is reduced -Affects occupations that require close-up work.

Hearing Loss

• Hearing loss begins in the 30s
• Types:
  • Conductive hearing loss (Not the primary cause)
  • Sensorineural hearing loss
    • Tinnitus
    • Presbycusis (age-related hearing loss)
• Changes in Behavior:
  • Repeated requests to speak louder
  • Non responsiveness to questions/conversations -Inappropriate responses
    -Leans to side, tilts head. -Distress or irritation -Disoriented/confused in conversations -Avoids social interaction

Taste and Smell Loss

• Declines as age increases; noticeable around 65-70 years old
• Factors: Less saliva, fewer taste buds, and fewer odor receptors.

Neuromusculoskeletal

• Muscle strength and power decrease.
• Skeletal muscle mass loss.
• Reduced functional motor units.
• Changes in posture
• Changes in balance and gait
• Reduced maximal speed of movement
• Reduced sensitivity to vibration
• Reduced proprioception

Bone Changes

• Calcium loss is a major primary aging bone change
• Peak bone mass around 30, declines gradually thereafter.
• Osteoporosis: Significant bone mass loss
• Osteoarthritis: Most common form of joint disease.

Active Aging

• Self-care
  • Definition: Personal care and chores that range from personal care to personal business.
  • Includes individual, family, and community self-care, participation.
  • Importance of personal self-care in maintaining quality of life and societal participation. Models for understanding performance for self-care (EHP)

Leisure

• Definition: Discretionary time not obligated to work, self-care, or instrumental activities.
• Culturally recognized.
• A state of being relaxed, contented; usually experience-based.
• Importance of leisure in maintaining well-being and quality of life.

Work and Retirement

• Career Identity: Formation of stages and developmental tasks, including career selection.
• Effects: Gender, family influence, and educational attainment.
• Retirement: Phases and types, including phased retirement, and bridged retirement.

Resilience in Aging

• Definition: Capacity to maintain or regain well-being despite adversity. Includes adapting to physical, emotional and social changes, retaining a sense of purpose.
• Factors:
  • Individual resources (optimism, self-efficacy)
  • Social support
  • Physical/mental health
  • Meaningful engagement
• Resilience pathways: Recovery, and sustainability
• Strategies/suggestions: Promoting resilience in aging by enhancing individual resources, building support, and creating opportunities for meaningful engagement.

Community Mobility and Public Transportation

• Importance: Critical for community participation, especially for vulnerable groups (older adults, disabilities, low-income).
• Impact: Access to essential services, employment, and social activities, maintaining independence, improving quality of life.
• Barriers and opportunities for improvement:
  • Limited routes, schedules, physical accessibility.
  • Safety concerns, funding issues.
• Implications: Public policy and urban planning to prioritize accessible, affordable public transit for a more inclusive community and positive outcomes.

Transportation Transitions

• Key to independence: Ability to travel safely and efficiently is vital for older adults, enabling access to essential services and participation.
• Challenges:
  • Physical/cognitive decline.
  • Limited alternative transportation options.
  • Emotional impact of losing driving ability.
• Role of OT:
  • Driving assessments
  • Education/counseling
  • Skill training (Transit use/ride-sharing apps)
  • Future-proofing:
    • Early discussion on alternatives
    • Age-friendly transportation
    • Community-based investment
• Policy recommendations:
  • Advocate for inclusive transportation systems.
  • Develop policies that promote sustainable practices

100 Days of Confinement

• Context: Study of older adults experiencing COVID-19 restrictions
• Key Themes/Findings:
  • Adapting daily routines and hobbies to confinement.
  • Internal reflection on values, roles, and identities.
  • Strategies for becoming more adaptable and resilient.
  • Maintaining social connections (using digital tools/socially distanced activities.)