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Physical Changes Integumentary ↑ Skin dryness ↑ Skin pallor ↑ Skin fragility Progressive wrinkling/sagging of the skin Brown “age spots” (lentigo senlist) ↓ Perspiration Thinning/graying of scalp, public, and axillary hair Slower nail growth and ↑ thickening with ridges Neuromuscular ↓ speed/power of skeletal muscle contractions Slowed reaction time Loss of height (stature Loss of bone mass Joint stiffness Impaired balance Greater difficulty in complex learning/abstraction Sensory/Perceptual Loss of visual acuity Rationale ↓ sebaceous gland activity and tissue fluid ↓ vascularity Reduced thickness/vascularity of the dermis, los of SC fat Loss of skin elasticity, ↑ dryness, ↓ SC fat Clustering of melanocytes Reduced number/function of sweat glands Progressive loss of pigment cells from the hair bulbs ↑ calcium deposition ↓ in muscle fibers Diminished conduction speed nerve fibers, ↓ muscle tone Atrophy of Intervertebral disks, ↑ flexion at hips/knees Bone reabsorption outpaces bone reformation Drying and loss of elasticity in joint cartilage ↓ muscle strength, reaction time, coordination, change in center of gravity Fewer cells in cerebral cortex Degeneration leading to lens opacity, thickening , and inelasticity ↑ sensitivity to glare and ↓ ability to adjust to darkness Partial or complete glossy white circle around the periphery of the cornea (arcus senilis) Progressive loss of hearing (presbycusis) Changes in the ciliary muscles; rigid pupil sphincter. ↓ pupil size ↓ sense of taste, esp. sweet sensations at tip of tongue ↓ sense of smell ↑ threshold for sensations of pain, touch, and temperature Pulmonary ↓ ability to expel foreign/accumulated matter ↓ lung expansion, less effective exhalation, reduced vital capacity, and ↑ residual volume ↓ number of taste buds in tongue RT tongue atrophy Atrophy of olfactory bulb at the base of the brain Possible nerve conduction/neuron changes Difficult, short, heavy, rapid breathing (dyspnea) following intense exercise Diminished delivery and diffusion of O2 to the tissues to repay the normal oxygen debit because of exertion or changes in both respiratory/vascular tissues Cardiovascular Reduced cardiac output and stroke volume, particularly during ↑ activity or unusual demands; may result in SOB on exertion and pooling of blood in the extremities Reduced elasticity and ↑ rigidity of arteries ↑ in diastolic and systolic blood pressure Orthostatic hypertension Fatty deposits Changes in the structures/nerve tissue in inner ear; thickening of eardrum ↓ elasticity and ciliary activity Weakened thoracic muscles; calcification of costal cartilage which makes rib cage more rigid with ↑ a/p diameter; dilation from inelasticity of alveoli ↑ rigidity/thickness of heart valves; ↓ contractile strength ↑ calcium deposits in the muscular layer Inelasticity of systemic arteries and ↑ peripheral resistance Reduced sensitivity of the blood pressure-regulating baroreceptors Adapted from Kozier & Erb’s Fundamentals of Nursing (9th Ed.) Physical Changes Gastrointestinal Delayed swallowing time ↑ tendency for indigestion ↑ tendency for constipation Urinary Reduced filtering ability of the kidney and impaired renal function Less effective concentration of urine Urinary urgency and urinary frequency Tendency for nocturnal frequency and retention of residual urine Genitals Prostate enlargement (benign) in men Multiple changes in women (shrinkage/atrophy of the vulva, cervix, uterus, fallopian tubes, and ovaries; reduction in secretions; and changes in vaginal flora) ↑ time to sexual arousal ↓ firmness of erection, ↑ refractory period ↓vaginal lubrication and elasticity Immunologic ↓ immune response; lowered resistance to infections Poor response to immunization ↓ stress response Endocrine ↑ insulin resistance ↓ thyroid function Rationale Alterations in the swallowing mechanism Gradual ↓ in digestive enzymes, reduction in gastric acid production, and slower absorption rate ↓ muscle tone of the intestines; ↓ peristalsis; ↓ free body fluid ↓ number of function nephrons and arteriosclerotic changes in blood flow ↓ tubular function Enlarge prostate gland I men; weakened muscles supporting bladder or weakness of urinary sphincter in women ↓ bladder capacity and tone Exact mechanism is unclear; possible endocrine changes Diminished secretion of female hormones and more alkaline vaginal pH Changes in blood supply to penis, clitoris Changes in blood supply Loss of estrogen effects T cells less responsive to antigens; B cells produce fewer antibodies Immune system changes may precipitate insulin resistance Unclear mechanism Adapted from Kozier & Erb’s Fundamentals of Nursing (9th Ed.)
