Overview of Problems in Elderly


Dr Manigreeva Krishnatreya Medical Officer



• Aging is a gradual and continuous process of natural change that begins in early adulthood.

• During early middle age, many bodily functions begin to gradually decline

• People do not become old or elderly at any specific age

Chronologic age: Chronologic age is based solely on

the passage of time. It is a person’s age in years

Biologic age: Biologic age refers to changes in the body that commonly occur as people age. Some people may be biologicaly 50, but chronologically 35 only

Psychologic age: Psychologic age is based on how people act and feel. For example, an 80-year-old who works, plans, looks forward to future events, and participates in many activities is considered psychologically young


People often wonder whether what they are experiencing as they age is normal or


Answer: Every individuals ageing is different, some changes result from internal

processes (“pure aging”)


Healthy (successful) aging

• Healthy aging refers to postponement of or reduction in the undesired effects of aging

1. Maintainingphysicalandmentalhealth 2. Avoidingdisorders
3. Activeandindependent

Tips for Healthy (successful) aging ??

• Following a nutritious diet • Exercising regularly
• Staying mentally active


• Gerontology is the study of the aging process,

including physical, mental, and social changes.

• Geriatrics is the branch of medicine that specializes in the care of older people, which often involves managing many disorders and problems at the same time

Most people do not need the expertise of a geriatrician (a doctor who specializes in the care of the elderly) until they are 70 to 75 years old

Life Expectancy

• In India, life expectancy at birth in 1947 was 32 years

• In 2015, Life expectancy at birth In India was 69.9 years for women and 66.9 years for men

• In the US, 81 years for women and 76 years for men


Did You Know… Average life expectancy has increased a lot, but maximum life span has increased little if at all

Factors of Life Expectancy

• Heredity: Heredity influences whether a person will develop a disorder. For example, a person who inherits genes that increase the risk of developing high cholesterol levels is likely to have a shorter life. A person who inherits genes that protect against coronary artery disease and cancer is likely to have a longer life. There is good evidence that living to a very old age—to 100 or older—runs in families.

• Lifestyle: Avoiding smoking, not abusing drugs and alcohol, maintaining a healthy weight and diet, and exercising help people function well and avoid disorders.

• Exposure to toxins in the environment: Such exposure can shorten life expectancy even among people with the best genetic makeup.

• Health care: Preventing disorders or treating disorders after they are contracted, especially when the disorder can be cured (as with infections and sometimes cancer), helps increase life expectancy



Did You Know… Disorders, not aging, usually account for most loss of bodily functions


Aging Organs

• How well organs function depends on how well the cells within them function (Older cells function less well)

• When the number of cells becomes too low, an organ cannot function normally

• Often, the first signs of aging involve the musculoskeletal system. The eyes, followed by the ears, begin to change early in mid-life

Bones and Joints

Bones tend to become less dense. Loss of Damage to the cartilage due to lifelong bone density is osteoporosis use of joints often leads to osteoarthritis




Muscles and Body Fat

Aging’s effects reduce muscle mass and strength by no more than about 10% to 15% during an adult’s lifetime


Muscles and Body Fat

By age 75, the percentage of body fat typically doubles compared with what it was during

young adulthood.

Too much body fat can increase the risk of health problems, such as diabetes



Did You Know…
To make up for the muscle mass lost during each day during strict bed rest period by an elderly, it may need up to 2 weeks of exercise
(Bed rest not always good unless indicated)

As people age, the following occur:

1.The lens stiffens, making focusing on close objects harder.

2.The lens becomes denser, making seeing in dim light harder.

3.The pupil reacts more slowly to changes in light.

4.The lens yellows, changing the way colors are perceived.

5.The number of nerve cells decrease, impairing depth perception.

6.The eyes produce less fluid, making them feel dry.

Loss of near vision: This change in vision, called presbyopia,

occurs because the lens in the eye stiffens.

Need for brighter light: So for reading, brighter light is needed.

Changes in color perception: Colors are perceived differently, partly because the lens tends to yellow with aging. Colors may look less bright and contrasts between different colors may be more difficult to see. Blues may look grayer, and blue print or background may look washed out.

Floaters: Older people may see more tiny black specks moving across their field of vision. These specks are bits of normal fluid in the eye that have solidified.


Did You Know…
Most 60-year-olds need 3 times more light to read than 20- year-olds


• Most changes in hearing are probably due as much to noise exposure as to aging

• This change is considered age-associated hearing loss (Presbycusis). For example, violin music may sound less bright


Did You Know… High-pitched sounds are particularly hard for older people to hear

Mouth and Nose

• Taste and smell starts to gradually diminish

• Many foods tend to taste bitter, and foods
with subtle smells may taste bland

• With aging, the nose tends to lengthen and enlarge, and the tip tends to droop


• The skin tends to become thinner, less elastic, drier, and finely wrinkled

• The skin changes because the aging body produces less collagen (a tough, fibrous tissue that makes skin strong) and elastin (which makes skin flexible)

• The fat layer under the skin thins (Cushion and preserves body heat)

Brain and Nervous System

The number of nerve cells in the brain typically decreases

 New nerve cells may form in some areas of the brain, even during old age (Contrary to popular belief)

 The brain has more cells than it needs to do most activities—a characteristic called “redundancy”




Did You Know…
The brain has ways to compensate for the loss of nerve cells that occurs with aging

Heart and Blood Vessels

 The heart and blood vessels become stiffer

 The heart fills with blood more slowly

 The stiffer arteries are less able to expand when more blood is pumped through them. Thus, blood pressure tends to increase

Muscles of Breathing and the Lungs

The muscles used in breathing, such as the diaphragm, tend to weaken

The number of air sacs (alveoli) and capillaries in the lungs decreases. Thus, slightly less

oxygen is absorbed from air that is breathed in

The lungs ability to fight infection


Digestive System

Digestive system is less affected by aging than most other parts of the body

In the large intestine, materials move through a little more slowly. In some people, this slowing contributes to constipation

Liver function declines

Kidneys and Urinary Tract

Certain changes in the urinary tract may make controlling urination

more difficult

The maximum volume of urine that the bladder can hold decreases. Thus, older people may need to urinate more often.

The bladder muscles may contract unpredictably (become overactive),

The muscle that controls the passage of urine out of the body (urinary sphincter) is less able to close tightly and prevent leakage



Endocrine System

• Growth hormone levels decrease, leading to decreased muscle mass.

• Aldosterone levels decrease, making dehydration more likely This hormone signals the body to retain salt and therefore water.

• Insulin, which helps control the sugar level in blood, is less effective, and less insulin may be produced Diabetes

Blood & Immune System

• The amount of active bone marrow, where blood cells are produced, decreases

• The cells of the immune system act more slowly

Anemia Easy Infections Easy Bleedings

CANCERS IN ELDERLY >65 years (2016)

Hypoph… Oesoph…

289 283

Oesophag… Gall bladder

Uterine… Mouth Lung Breast

Hypophar… Stomach Ovary


132 102

Lung 200 Tongue 138

Mouth 112 Stomach 109






56 48

33 31

26 24 22



Gallblad… 88 Larynx 62 Liver 60

Tonsil 57 0






PSYCHOLOGICAL SUPPORT • CognitionandPerceptionSupport

Cognitive function is defined as the intellectual process by which an individual becomes aware of surroundings

• Inter-generationalRelations
• Show regards for Values and Beliefs

Values are standards, principles or qualities that a person upholds

Beliefs come from real life experiences

• ProvidingEmotionalSupport

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