GERIATRICS

GERIATRICS


Geriatrics is the medical specialty that deals with the
physiology of aging and with the diagnosis and
treatment of diseases affecting older adults.
GERONTOLOGY
 Gerontology is the study of all aspects of the aging
process, including the clinical, psychologic, economic,
and sociologic problems of older adults and the
consequences of these problems for older adults and
society.
 AGING
 Ageing or aging is the process of becoming older or we
can say that it is the process in which structural and
functional changes accumulate in an organism as a
result of the passage of time.
 Aging: a continual process of biologic, cognitive, and
psychosocial change that begins at conception.
 It can be described chronologically, physiologically,and
functionally.
 Chronologic age, the number of years a person has lived
 Many people who have lived a long time –
 remain functionally and physiologically young,
 remain physically fit and stay mentally active,
 productive members of society.
 Others are chronologically young but physically or functionally
old.
 According to chronologic age, Categorizing the Aging Population
–
 AGE
(YEARS) CATEGORY
Young-
55 to 64 Older Or
old*

65 to 74 Elderly Or Young-old

75 to 84 Aged Or Middle-old

85 and Extremely
Or Old-old
older aged
Ageing Process
 It is a normal, universal, progressive, irreversible process.
 Factors Influence Ageing Process - hereditary & environmental factors
 Hereditary Factors
 Some families live longer than others, given the same environmental circumstances.
 This is related with genetic factors. This gene is not only the ageing gene but could be
also a cancer gene.
 Environmental Factors
Bourlier (1973), has given three categories of environmental factors
that can influence the rate of ageing in man.
 Abiotic Factors - These are the physical and chemical components
of the environment such as:
 Climatic influences,
 Pollutants and
 Radiation.
 Biotic Factors - thousands of living organisms which presents in man's environment
such as:
 pathogens,
 parasites
 the quality and availability of food products.
 Socio-Economic Factors -
 Stress factors are more prevalent in a modern industrialized society.
 Income and poverty
 Chronic health problems also affect ageing.
MYTHS AND REALITIES
S.NO MYTHS REALITY
1 Old age is a disease. It is a normal physiological
process.
2 Senility is a Normal Part Senility, or dementia is not normal.
of Aging There are a variety of causes of
dementia.
3 Most old people are alone This is not true at all! Friends and
and lonely. family are very important in the
lives of older adults.
4 Most old people are in More than 2/3 of people over 65
poor Health. years of age told researchers that
they are in good, very good, or
excellent health.

5 Most older adults live in Only about 5% of older adults live

nursing homes. in nursing homes.
S.NO MYTHS REALITY
6 Most old people have Although sexual activity may be less
no interest in or frequent the ability to perform but not
capacity for sexual depends on the ageing.
relations.
7 Older adults don't care They want to be attractive to others.
how they look
8 Old people cannot Are capable of learning new things,
learn complex new but the speed with which they process
skills information slows with age
9 Old people have ‘old Every individual either young or old
ways’ of thinking.” has their own unique thoughts and
feelings about society.
10 Elderly people are less May be a bit slower to adapt, they are
adaptable to change. certainly capable of change.
DEMOGRAPHY OF
AGING
INTRODUCTION
 Over the past few years, we have seen the remarkable
growth in the number and proportion of old age persons
worldwide. Such a rapid, large, and ubiquitous growth
has never been seen in the history of civilization. The
major reason behind this is that in the last few decades,
the world’s population has continued on its remarkable
transition path from a state of high birth and death rates
to low birth and death rates coupled with improvement
in health services & standard of living.
Aging Demography of India

 The world of the 21st century is reeling under the

pressure of an ageing population.
 Proportion of elderly people in population of the
countries across the world is increasing and same is true
for India also.
 The growth in elderly population is due to the longevity
of life achieved because of economic well-being, better
medicines and medical facilities and reduction in
fertility rates.
 The total population of the aged people in India was
 104 million (As per census of 2011)
 53 million females and 51 million males.
 which is estimated to rise to
 177 million by the year 2025 (estimated)
 324 million by the year 2050(estimated)
CONCEPT OF
AGING
CONCEPT OF AGING
 There is no single universally accepted definition of aging.
Aging is best looked at as a series of changes that occur over
time, contribute to loss of function, and ultimately result in the
death of a living organism. The maximal life expectancy for
humans today appears to be 120 years.
 Aging is classified as
 biological aging,
 psychological aging,
 social aging,
 chronological aging,
 functional aging.
Chronological Aging

 Chronological Aging is the number of years a person

has lived so far.
 For example, the 85-year-old woman may be an active
volunteer, while the 75-year-old man could be
homebound. Sometimes we say, “he looks younger than
his age,” or “she does not act her age.” In these cases,
the biological, psychological, and social age do not
match the chronological age.
Biological Aging

 With biological aging, tissues and organs are less likely to

function efficiently, the body’s ability to repair itself slows
down, and the immune functions decline, making the body
more prone to infection. It is to measure by the Abilities and
Performances of a person.
 Biological aging is sometimes referred to as Physical Aging. A
person who keeps fit and gets regular check-ups can appear
biologically younger than someone who is the same age but
does not keep fit. For example, the 70 yrs. (suffered from
disease) older than 80 yrs. (healthy).
Psychological Aging

 Psychological Aging involves changes in memory,

learning, intelligence, personality, and coping. An older
person who is mentally active and is able to deal with
new situations can be said to be psychologically young.
 The psychological changes that occur as a person
getting older. It is measured by mental capacity -
intelligence, memory, power, cognitive function etc.
Social Age

 Itrefers to changes in roles and relationships as

we age, both within their networks of relatives
and friends and in formal organizations such as
the workplace and houses of worship. For
example, Husband/wife, Parents/Grandparents,
employee/retiree. It shapes the meaning of aging
for the person, and this can make aging a
positive or negative experience.
Functional aging

 It refers to a combination of the chronological,

physiological and psychologically ages.” It is related to
how people compare psychologically to others to similar
age. It is describing how that person functions in daily
life. An important issue related to functional ageing is
the relationship between length of life and the amount of
time spent in the disabled state.
 Active life expectancy - average number of years an
individual at a given age will survive and remain in the
active, or non‐disabled, state.
THEORIES OF AGING
 THEORIES

Psychosoci Biological Nursing

al theories theories theories
PSYCHOSOCIAL THEORIES

 that does not explain the physical changes of aging.

 They attempt to explain -The changes in behaviour, personality,
attitude, roles, and relationship that occur as individual ag
 Psychosocial
Theories

Activity Disengagem Continuity

Theory ent Theory Theory
Activity Theory

 Given by Havighurst and Albrecht in 1953 and published in 1963.

 Activity is necessary to maintain a person’s life satisfaction and a
positive self-concept”.
 Activity is necessary for successful aging.
 Active participation in physical and mental activities helps maintain
functioning well into old age.
 Purposeful activities and interactions that promote self-esteem
improve overall satisfaction with life, even at the older age.
 The continuation of activities performed during middle age is
necessary for successful aging
Disengagement Theory

 The highly controversial theory given by Cummings and Henry in

1961.
 Aging is characterized by gradual disengagement from society and
relationships.
 This separation is desired by society and older adults that serves to
maintain social equilibrium and promote internal reflection.
 While the transition of responsibility from old to young maintains a
continuously functioning society unaffected.
 The outcome of disengagement is a new equilibrium that is ideally
satisfying to both the individual and society.
 This theory is no longer supported.
Continuity Theory

 Proposed by Robert C. Atchley, 1989

 Continuity Theory suggests that personality is well developed by the
time we reach old age and tends to remain consistent throughout our
lives.
 Old age is not a separate phase of life,
 Personality influences roles and life satisfaction and remains
consistent throughout life
 Past coping patterns recur as older adults adjust to physical, financial,
and social decline
BIOLOGIC THEORIES

 Two types:
 Non-stochastic Theories
 stochastic Theories
 Programmed theory

 Everyone has a biologic clock

 Each individual has a genetic program specifying with predetermined
number of cell divisions.
 As the program plays out, the person experiences predictable
changes
Run-out-of-program theory

 Every person has a limited amount of genetic material

 Will run out eventually
 Rate of living theory

 Individuals have a finite number of breaths or heartbeats that are

used up over time.
Gene theory

 Proposes the existence of one or more harmful genes that activate

over time, resulting in the typical changes seen with aging and
limiting the life span of the individual.
Immunity Theory

 Lower rate of T-lymphocyte (“killer cells”) proliferation in response to

a stimulus & therefore a decrease in the body’s defense against
foreign pathogens.
 Molecular Theories - aging is controlled by genetic materials that
are encoded to predetermine growth and decline.
Error Theory

 Errors can occur in the transcription in any step of the protein

synthesis of DNA
 As transcription errors to occur, the end product would not even
resemble the original cell, thereby compromising its functional ability.
 Cellular Theories - aging is a process that occurs because of cell
damage
Free Radical Theory

 Free radicals are by-products of metabolism-can increase as a result

of environmental pollutants
 When they accumulate, they damage cell membrane, DNA, and the
immune system, decreasing its efficiency
 Wear & Tear Theory

 Cells simply wear out over time because of continued use-rather like
a machine
 As people age, their cells, tissues, and organs are damaged by
internal or external stressors.
 Result: overall functioning decreases
Cross-Linkage Theory

 Some proteins in the body become cross-linked, thereby not allowing

for normal metabolic activities
 Result: tissues do not function at optimal efficiency
 For e.g., skin changes typically attributed to aging such as dryness,
wrinkles, and loss of elasticity.