Foundations of Geriatric Physical Therapy

Foundations and Theories of Geriatric Physical Therapy

• Geriatric physical therapy focuses on older adults and their unique needs.
• Aging is a complex process with physiological changes varying among individuals.
• Aging is common to all members of a species, and progressive with time.
• Gerontology is the study of the social, psychological, and biological aspects of aging.
• Geriatrics is a branch of medicine dealing with diseases and care of the elderly, often defined by age 65 or over.
• The subspecialty encompasses aspects of internal medicine and family medicine.
• Global aging trends show increasing percentages of people over 65, with projections indicating further increases.
• The percentage of people over 65 varies significantly across different countries.
• Life span refers to the maximum survival potential of a species (in humans, 110-120 years).
• Life expectancy represents the expected number of years a person will live from birth.
• Increased life expectancy is linked to better prenatal care, delivery techniques, medical advancements, better nutrition, higher living standards, and more leisure time.
• Physical therapy in geriatrics aims to facilitate the understanding of older adults' needs, promote successful aging principles, which are used in evaluation and intervention.
• Older adults are categorized into several groups, including young elderly (65-74), old elderly (75-84), and old-old or frail elderly (over 85).

Mortality in Geriatrics

• Coronary heart disease (CHD), cancers, cerebrovascular disease (strokes), chronic obstructive pulmonary disease (COPD), and pneumonia/flu are leading causes of death in older adults.

Morbidity in Geriatrics

• Leading causes of disability/chronic conditions in those over 65 include arthritis, hypertension, hearing impairments, heart impairments, cataracts/sinusitis, orthopedic impairments, and diabetes/visual impairments.

The Outward Signs of Aging

• Skin loses underlying fat and oil glands, leading to wrinkles and reduced elasticity.
• Increased susceptibility to cold and bedsores.
• Age spots (melanin deposits) appear on the skin.
• Hair loses pigmentation and turns gray.
• Nails become thicker due to reduced blood flow to connective tissues.

Theories of Aging

• Aging is explained through various theories, including sociological, biological and environmental.
• Sociological theories describe how social interaction and roles change with age

Social Theories of Aging

• Disengagement theory: Withdrawal from society, potentially leading to decreased satisfaction.
• Activity theory: Staying active correlates to higher personal satisfaction.
• Continuity theory proposes adapting to later life for a sense of continuity with the past.

Biological Theories of Aging

• Genetic theory highlights intrinsic aging mechanisms with programmed gene expression variations affecting aging processes.
• Free radical theory explains that highly reactive oxygen molecules damage cellular components, accelerating aging.
• Cell mutation theory describes aging as a result of errors in protein synthesis (DNA/RNA).
• Hormonal theory notes that reduced or altered hormone levels affect aging processes, primarily related to hypothalamic, pituitary, and adrenal gland functions. Protective hormones decrease while stress hormones increase.
• Immunity theory suggests that immune system decline leads to decreased ability to fight foreign organisms. Thymic activity declines, bone marrow decreases, and autoimmune dysfunction increases.