Foundations and Theories of Geriatric Physical Therapy PDF

Foundations and Theories of Geriatric Physical Therapy By Dr. Mona Abdel Khalek  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...

Foundations and Theories of Geriatric Physical Therapy By Dr. Mona Abdel Khalek  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