5-Foundations Theories of Geriatric.pdf

Foundations and Theories of Geriatric Physical Therapy By Dr. Mona Abdel Khalek Dr. Mina Atef Dr. Ahmed Abdel Haleem Aging • Aging: the process of growing old; describes a wide array of physiological changes in the body systems; complex and variable. • a. Common to all members of a given species....

Foundations and Theories of Geriatric Physical Therapy By Dr. Mona Abdel Khalek Dr. Mina Atef Dr. Ahmed Abdel Haleem Aging • Aging: the process of growing old; describes a wide array of physiological changes in the body systems; complex and variable. • a. Common to all members of a given species. • b. Progressive with time. • c. Varies among and within individuals. Gerontology • Gerontology : is the study of the social, psychological and biological aspects of aging. Geriatrics • Geriatrics is a branch of medicine that deals with diseases of the elderly and their care.” • Some simply use the age of 65 and over to define when a person is considered to be “geriatric” or “elderly” which is how this lecture will use the term. • It is a sub-specialty of internal medicine and family medicine Percentage of Population Over 65 in 2000 Projected Percentage of Population Over 65 in 2030 Life span &expectancy • Life span: maximum survival potential, the inherent natural life of the species; in humans 110-120 years. • Life expectancy: the number of years of life expectation from year of birth. Major reasons of increased life EXPECTANCY • Better prenatal care • Better delivery techniques • Better medical care • Better nutrition • A generally higher standard of living • More leisure time • Research in many areas that contributes toward making life more comfortable and healthier (Murray 1980) Physical Therapy in Geriatrics • Physical Therapy in Geriatrics . Designed to facilitate understanding of older adults and their special needs and to promote concepts of successful aging based on physical therapy evaluation and intervention. Categories of elderly • a. Young elderly: ages 65-74 (60% of elderly population). • b. Old elderly: ages 75-84. • c. Old, old elderly or old & frail elderly: ages> 85. Mortality in Geriatrics • Leading causes of death (mortality) in persons over 65, in order of frequency: • a. Coronary heart disease (CHD). • b. Cancer. • c. Cerebrovascular disease (stroke). • d. Chronic obstructive pulmonary disease (COPD). • e. Pneumonia/flu. Morbidity in Geriatrics • Leading causes of disability/chronic conditions • (morbidity) in persons over 65, in order of frequency. • a. Arthritis. • b. Hypertension. • c. Hearing impairments. • d. Heart impairments. • e. Cataracts and chronic sinusitis. • f. Orthopedic impairments. • g. Diabetes and visual impairments. The Outward Signs of Aging • The Outward Signs of Aging • The skin loses underlying fat layers and oil glands, causing wrinkles and reduced elasticity. • increased susceptibility to cold(hypothermia) and bedsores. The Outward Signs of Aging • The skin develops "age spots" due to deposits of melanin pigment. • The hair gradually loses its pigmentation and turns gray. • The nails become thicker due to reduced blood flow to the connective tissues. Theories of Aging Theories of Aging • Sociological theories • Biological theories. • Environmental theories. Social Theories of Aging • Disengagement theory • Activity theory • Continuity theory Disengagement theory • Disengagement, withdrawal of individual from society; reduction in social roles leads to further isolation and life dissatisfaction. Activity theory • In contrast to disengagement theory, this theory implies that the more active elderly people are, the more likely they are to be satisfied with life. Continuity theory • Continuity theory is Atchley's theory that individuals, in later life, make adaptations to enable them to gain a sense of continuity between the past and the present. Theories of Geriatrics Biological theories • Genetic • Free radical theory • Cell mutation • Hormonal theory • Immunity theory Genetic • Aging is intrinsic to the organism • genes are programmed to modulate aging changes, overall rate of progression. • (1) Individuals vary in the expression of aging changes, e.g., graying of hair, wrinkles, etc. • (2) Polygenic controls exist (multiple genes are involved): no one gene can modulate rate of development in all aspects of aging. Genetic • This theory brings in the concept of internal biological clock to explain the process of ageing from childhood. Free radical theory • Free radical theory: free radicals are highly reactive and toxic forms of oxygen produced by cell mitochondria; the released radicals. • (1) Cause damage to cell membranes and DNA cell replication. • (2) Interfere with cell diffusion and transport, resulting in decreased 02 delivery and tissue death. • (3) Decrease cellular enzyme activities. Free radical theory • (4) Result in accumulation of aging pigments ( lipofuscins). • (5) Can trigger pathologic changes: atherosclerosis in blood vessel wall; and cancer Cell mutation • Cell mutation : errors in the synthesis of proteins (DNA, RNA) leads to abnormal proteins and aging changes. Hormonal theory • Hormonal theory: functional decrements in neurons and their associated hormones lead to aging changes. • (1) Hypothalamus, pituitary gland, adrenal gland are the primary regulators, timekeepers of aging. • Thyroxine is the master hormone of the body; controls rate of protein synthesis and metabolism. Hormonal theory • (2) Decreases in protective hormones: estrogen and growth hormone. • (3) Increases in stress hormones (cortisol): can damage brain's memory center,and destroy immune cells. Immunity theory • Immunity theory: thymus size decreases, shrivels by puberty, becomes less functional; bone marrow cell efficiency decreases; results in steady decrease in immune responses during adulthood. • (1) Immune cells, T-cells, become less able to fight foreign organisms; B-cells become less able to make antibodies. • (2) Autoimmune diseases increase with age. Thank you