Chapter 5

Theories of Aging and Physical

Changes

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc.
 Changes with Aging

 Changes are:
 Intrinsic, which comes from within
 Extrinsic, which comes from environmental factors
(e.g., exposure to smoke or pollutants)
 Triggers of aging are influenced by genetics or
by injury or abuse to the body.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 2
 Biological Theories of Aging

 Theories indicate that:

 Cells in the body become disorganized or chaotic.
 Cells no long replicate.
 Cellular death occurs.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 3
 Error (Stochastic) Theories

 Errors are accumulated in the synthesis of

cellular DNA and RNA.
 With the accumulation of replication errors, cells
are no longer able to function.
 Most common theories are:
 Wear and tear
 Cross link
 Oxidation stress (free-radical)

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 4
 Programmed Aging
(Nonstochastic) Theories
 Attributes aging to be predetermined or
“programmed” at the cellular level.
 As more cells cease to replicate, signs of aging
occur.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 5
Neuroendocrine-Immunological Theory

 Cells of the immune system become more

diversified with age.
 T-lymphocytes show more signs of aging than B-
lymphocytes.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 6
 Physical Changes of Aging: Skin
 Changes occur as a result of genetic (intrinsic) and environmental
(extrinsic) factors.
 Changes occur as a result of genetic (intrinsic) and environmental
(extrinsic) factors.
 Dryness, thinning, and a decrease in elasticity occur.
 As a result of a decrease in the epidermis, blood vessels and bruises
are more visible.
 Fewer melanocytes result in a lighter appearance of the skin.
 Age spots or liver spots (lentigines) appear on the backs of hands and
wrists and on the face.
 Seborrheic keratoses and thick, brown, and raised lesions appear.
 Thinning of the dermis causes a decrease in the stretching ability of the
skin.
 Areas of the hypodermis atrophy, which causes the person to be more
sensitive to cold.
Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 7
 Physical Changes of Aging:
Hair and Nails
 Hair thins on the head.
 Hair increases in the ears, nose, and eyebrows.
 Pigmentation is lost (graying occurs).
 Older woman develop chin hair, and leg, axillary,
and pubic hair decrease.
 Nails are hard and thick.
 Vertical ridges appear.
 Nails are slower growing.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 8
 Physical Changes of Aging:
Musculoskeletal
 Aging affects the ligaments, tendons, and joints,
which causes the older person to be more rigid
and stiff in his or her movements.
 Muscle mass decreases.
 Posture changes as a result of the intervertebral
disks that dehydrate.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 9
 Physical Changes of Aging:
Cardiovascular
 Myocardial and blood vessels become stiff.
 The left ventricle wall thickens, and the size of the
left atrium slightly increases.
 Maximum coronary artery blood flow, stroke
volume, and cardiac output decrease.
 The heart takes longer to accelerate and then to
return to normal.
 Elasticity decreases, and blood vessels recoil.
 Veins become stretched, and the valves become
less efficient.
Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 10
Physical Changes of Aging: Respiratory

 Recoil is lost.
 The chest wall stiffens.
 Gas exchange is less efficient.
 Resistance to air flow increases.
 Effectiveness of cough response is reduced.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 11
 Physical Changes of Aging: Renal

 Kidney blood flow decreases.

 Size and function of the kidneys decrease.
 Urine creatinine clearance decreases.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 12
Physical Changes of Aging: Endocrine

 Glands atrophy, and the rate of secretion

decrease.
 The rate of type II diabetes is high in older adults.
 The rate of hypothyroidism increases as a result
of changes in the structure and function of the
thyroid in the older person.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 13
 Physical Changes of Aging:
Reproductive
 Women are unable to procreate after the cessation of
ovulation.
 Female breasts appear smaller, are more pendulous,
and are less firm.
 Ovaries, uterus, and cervix atrophy.
 Estrogen levels decrease.
 Vaginal wall loses its ability to lubricate.
 Testes atrophy and soften.
 Ejaculation is slower and less forceful.
 Testosterone level reduces.
 Men may experience urinary retention.
Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 14
 Physical Changes of Aging:
Gastrointestinal
 Teeth lose enamel and dentin, making them vulnerable to
decay.
 Teeth lose enamel and dentin, making them vulnerable to
decay.
 Taste buds decline in number.
 Salivary secretion lessens; consequently, a dry mouth exists.
 Pleasure in eating decreases, and weight loss occurs.
 Esophagus and stomach sluggishly empty.
 Villi in the intestines are less functioning, which affects
absorption.
 Peristalsis slows.
 Constipation is common.
Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 15
Physical Changes of Aging: Accessory
Organs
 Liver function tests are unaltered.
 Incidence of gallstones increase.
 Serum cholesterol level increases.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 16
 Physical Changes of Aging:
Neurological Cognition
 Brain size and weight decrease.
 Sleep disturbances occur.
 Mild memory disturbances are evident.
 Balance difficulties develop.
 Injuries increase as a result of a decrease in
tactile sensations in the fingers and palms.
 Reaction time is delayed.
 Risk for falls increases.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 17
 Physical Changes of Aging:
Eyes and Ears
 Senses of smell, sight, and touch decrease.
 Near vision decreases, and the lenses thicken.
 Eyelids lose elasticity and droops, and color
perception decreases.
 Lower eye lids turn out, and dry eye syndrome is
common.
 Ear lobes sag, elongate, and wrinkle; hearing
loss occurs; and ear hair is more stiff and
course.
 Ear wax is more thick and dry.
Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 18
 Physical Changes of Aging: Immune

 Immunity is reduced at the cellular level.

 Oral temperature is lower.
 Decreased response to foreign antigens
 Immunoglobulins increase.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 19
 Maslow’s Hierarchy and Physical
Changes
 Physical changes affect all levels of Maslow’s
hierarchy
 Level 1 - Physiologic needs in every body
system affected by aging
 Upper level needs can be affected by inability to
adequately meet physiologic needs.

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 20
 Question

Stan arrives at your clinic. His daughter reports a

decrease in cognitive function. Which of the
following could be causes for this event?

A. Urinary tract infection*

B. Eye infection
C. Change of residence*
D. Muscle atrophy

Mosby items and derived items © 2014, 2010, 2005 by Mosby, Inc., an imprint of Elsevier Inc. 21