Subhanjan Das

What is GeriatricsGeriatrics is the branch of medicine that

focuses on health care of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults.

Geriatrics was separated from internal medicine as a distinct entity in the same way that pediatrics is separated from adult internal medicine and neonatology is separated from pediatrics.

Gerontology Gerontology is the branch of biomedical

sciences that studies aging. The term "geriatrics“ is used to refer specifically to the medical study of diseases and problems of the elderly.

Changes with ageingSKIN:Epidermis thinner and fragileDermis less elastin and flexibleHypodermis thinner and less paddingUV light accelerates skin ageingSenile purpura

Changes with ageingEYEPtosisDry eyeTearing Flatten & uneven cornea with light scatteringHyperopia (farsightedness)Smaller pupil requiring brighter light to readSlower dark adaptationReduced contrast sensitivity

Changes with ageingEARReduced sweat glands with increased ear

wax affecting hearingCochlea degeneration causing high tone loss

Changes with ageingKIDNEYSReduced ability to excrete water, waste

products and drugsLess tolerate water depletionLoss of circadian rhythm with nocturiaSmaller and less expansible bladder with

frequency of urineLess contractable bladder with hesitancyBigger prostate with fair urine stream

Changes with ageingBONEContinual loss of bone mass from the 4th

decadeHormonal change with more bone resorption

than formationLess Ca absorptionShorter and stoopBrittle with easy fractureNew bone formation at the verge of jointsCartilage thinner

Changes with ageingNERVOUS SYSTEM30,000-50,000 neurons die each day with

diminishing reserveIQ slowly decline after the age of 25Reduced short term memoryDecreased retrieval abilityInterrupted and less deep sleepReduced pain, touch, temperature, and vibration

sensationsReduced postural control and balance

Changes with ageingHEARTHeart becomes more rigid with decreased outputHeart beat less responsive to stressHeart beat less variable with each breathingIrregular heart beat more common with ageingSystolic blood pressure increases with agePulse pressure widened with hardened vesselsLess efficient venous return prone to postural

hypotension

Changes with ageingLUNGSLungs become more rigid with early closure of small

airwaysLess efficient blood gas exchangeChest wall becomes more rigid tooReduced Lung Volume and Vital CapacityBronchial villi thinner and cough reflex less effectiveReduced ability to cope with challenges like climbing

stairs, runningReduced immunity prone to chest infection

Changes with ageingGITSaliva glands secret less with dry mouthTaste and smell senses declineLess heathy teeth affecting chewing/nutritionStomach muscle weakened and less hungrySmall intestine villi absorb less calcium, vitamin B12, folic

acidLarge intestine muscle weakened and secrets less mucus

prone to constipationLess liver blood flow and function with fall in toxic

substance/drug clearanceBile thicker with cholesterol prone to gallstones

Diseases in old age

Diseases in old age

Geriatric physiotherapyGeriatric physiotherapy became a specialty of

physical therapy study in 1989. Since then, physiotherapists have worked to understand the problems of the aging. There is a long list of problems dealt with in geriatric physiotherapy.

Alzheimer's arthritis balance disorders cancercardiovascular disease incontinencejoint replacement pulmonary diseasestroke

3 major groups1. deconditioning2. cardiovascular diseases3. musculoskeletal problems

3 major groups1. deconditioning:

problems that happen because the patient simply does not use their limbs. These problems can be addressed by reconditioning through range-of-motion and other exercises

2. cardiovascular diseases: like heart disease and stroke. Exercise, aqua therapy, electrical stimulation and more can be used.

3. musculoskeletal problems: such as osteoporosis and osteoarthritis. These problems require special attention as osteoporosis makes patients frailer, and osteoarthritis is very painful.

Because falls are such a problem, the osteoporosis therapy is crucial. Along with that, geriatric physiotherapy is responsible for preventing many falls because of work with balance and gait. Some clinics focus entirely on balance issues for the elderly.

Qualities of geriatric physiotherapistProfound knowledgeCaring attitudeGood

communication skillAbility to think out

of the box