geriatrics week 1 summary.pdf

1.1 intro to aging global aging population world health organization significant increase in worlds population age greater than 60 yrs from 2015 to 2050-from 12 to 22% 2050 projecting 80% of old...

1.1 intro to aging global aging population world health organization significant increase in worlds population age greater than 60 yrs from 2015 to 2050-from 12 to 22% 2050 projecting 80% of older population will be living in low and middle income countries growth happening faster than in the past (brazil, china, india (1/3)) will impact available resources, public health, economic growth and welfare & the prevalence of chronic disease and disability impacted SDOH & pop specific needs aging in the US more than 46 mil adults over 65 in the US 2050- expected to double to about 90 bw 2020 - 2030 alone time last of baby boon cohorts reach 65; projected increase by ~18 mil 2030: 1 in 5 americans projected to be 65 yo or older important- rural: older vs urban: younger since 1980s lifespan has decreased exponentially despite having highest health expenditures US: 77yo vs other countries: 82.1 yrs (canada, australia, germany, switzerland, japan and france) women (by 5.1) > men -life expectancy blacks: lowest lifespan @ 71.8 yrs impact of growing aged population aging= adaptions to policies, structures, systems and programs increased demand on HC system altered municipality resources declining economic capacity and workforce declining sustainability of the public pension system increased pressure on families and society to provide assistance or care -require careful thought of effective use of current resources using evidence based info -QOL= interventions to address all levels ^hc, social care transportation housing urban planning government policies advocacy for change PT -understand SDOH -factors that impact mobility and exercise capacity reflect and check our own biases healthspan age expectancy has increased due to hc advances increased # of yrs DOES NOT equate to increased QOL or health w/in those yrs healthspan defined by: period of life spent in good health, free from chronic diseases and disabilities of aging -can be faulty bc it implies that healthspan is length of chronological time from birth and that a condition arises and demarcates the end of healthspan -also assumes theres no reversing healthspan but in reality there are gray area for when healthspan ends bc conditions affect ppl differently ↓ ↓  aging and activity limitation look at fxnal limitations and activity more considered by rehab professionals ~85% of lifespan is free from activity limitations pts w higher disabilities= multimorbidity (presence of 3 or more chronic diseased, institutionalization, or decreased QOL) common chronic conditions arthritis (or msk conditions) heart or circulatory diseases CHD stroke heart failure hypertension aging and fxnal limitation interdisciplinary team- help pts w difficulty performing ADLs, community, improve cognition or social participation w/in the community WHO response to aging population WHO 2017 proposed areas for countries to address to improve healthy aging proposed programs and policies to increase knowledge and improve perceptions on aging, foster abilities of older ppl, provide person centered integrative care and health services and increase availability of long term care aims to promote collaboration bw countries, support well being of older pts and caregivers thru adequate and equitable services, support research and innovation in healthy aging and diversity advocate for healthy aging thru out life course while combating age discrimination  aging standouts *read pics* aging standouts promote age friendly world and healthy aging hc of adults needs to improve increased prevalence of elderly abuse rising rates of mental health conditions these factors are driving the global plan to address the needs of the increasing aging population Summary Changing demographics in the United States drives the need to focus on health span PTs play a significant role in prevention, management, and compensation of activity and functional limitations  1.2 theories of aging biological theories of aging 1. Categories of Biological Aging Theories - Programmed Theories - Aging follows a programmed schedule. - Cells are programmed to stop functioning after a certain period. -depends on gene expression; may affect body maintance, ability to self repair and immunity overtime -Error/Damage-based Theories - Aging is caused by cumulative damage from exposure to hazards. - Damage starts from birth and leads to system failure. -exposure is immediate and damage is slow hallmarks of aging (2013, Lopez-Otin et al) - Altered Intercellular Communication - Disturbances in communication between body systems -altered neuro hormonal fxn, impact of inflammation and impaired intra-organ coordination - Stem Cell Exhaustion - Decline in tissue regeneration ability as we age - Cellular Senescence - Cells stop dividing and growing, accumulating with age. - Mitochondrial Dysfunction - Decreased ATP production capacity due to various physiological factors - Genomic Instability - Accumulation of genetic damage as cells proliferate and DNA is exposed to internal and external stressors - Loss of Proteostasis - Loss of protein stability/ homeostasis and function.impacting their structure and cell viability - Epigenetic Alteration - Changes in DNA methylation and gene expression impacted by age and is related to telomere attrition