Academic Geriatric Resource Center
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AT A GLANCE

Glossary

0. Introduction
1. Demography And Epidemiology
1.1 The Changing Face of Aging: Objectives
1.2 Local and Regional Variations Among Older Adults in the United States
1.3 Implications of an Aging Society for Health Care Needs and Resources
1.4 Common Chronic Conditions Associated with Advanced Age
1.5 Post Test
2. Biology and Physiology of Aging
2.1 Introduction and Background
2.2 Theories of Aging
2.3 Physiological Changes with Aging
2.3.1 Loss of Homeostatic Reserve--Hyperthermia
2.3.2 Loss of Homeostatic Reserve--Hypothermia
2.3.3 Vulnerability of Older Adults to Hypothermia
2.3.4 Clinical Importance of Vulnerability to Hypothermia
2.3.5 Loss of Homeostatic Reserve--Other Examples and Clinical Implications
2.3.6 Clinically Important Age-Related Changes in Organ Systems
2.3.7 Clinically Important Age-Related Changes in the Renal System
2.3.8 Clinical Significance of Age-Related Changes in Renal System
2.3.9 Clinically Important Age-Related Changes in the Cardiovascular System
2.3.10 Clinical Significance of Age-Related Changes in the Cardiovascular System
2.3.11 Clinically Important Age-Related Changes in the Pulmonary System
2.3.12 Clinical Significance of Age-Related Changes in the Pulmonary System
2.3.13 Age-Related Changes in the Neurologic System
2.3.14 Clinical Significance of Age-Related Changes in the Neurologic System (I)
2.3.15 Clinical Significance of Age-Related Changes in the Neurologic System (II)
2.3.16 Clinically Important Age-Related Changes in the Gastrointestinal System
2.3.17 Clinical Significance of Age-Related Changes in the Gastrointestinal System (I)
2.3.18 Clinical Significance of Age-Related Changes in the Gastrointestinal System (II)
2.3.19 Clinically Important Age-Related Changes in the Immune System
2.3.20 Clinical Significance of Age-Related Changes in the Immune System
2.3.21 Clinically Important Age-Related Changes in the Endocrine System (I)
2.3.22 Clinically Important Age-Related Changes in the Endocrine System (II)
2.3.23 Clinical Significance of Age-Related Changes in the Endocrine System
2.3.24 Clinically Important Age-Related Changes in the Musculoskeletal System
2.3.25 Clinical Significance of Age-Related Changes in the Musculoskeletal System (I)
2.3.26 Clinical Significance of Age-Related Changes in the Musculoskeletal System (II)
2.3.27 Clinically Important Age-Related Changes in the Genitourinary System (I)
2.3.28 Clinically Important Age-Related Changes in the Genitourinary System (II)
2.3.29 Clinical Significance of Age-Related Changes in the Genitourinary System
2.3.30 Clinically Important Age-Related Changes in the Sensory Systems
2.3.31 Clinical Significance of Age-Related Changes in the Sensory Systems (I)
2.3.32 Clinical Significance of Age-Related Changes in the Sensory Systems (II)
2.3.33 Clinically Important Age-Related Changes in the Integument
2.3.34 Clinical Significance of Age-Related Changes in the Integument
2.4 Pharmacologic Considerations
2.5 Post Test
3. Socio-cultural And Psychologicial…
3.1 Module Objectives
3.2 Social Theories of Aging
3.3 Psychological Development In Late Life
3.4 Ethno-Cultural Issues And Age-Stratified Societies
3.5 Late-Life Transitions
3.6 Dependent Elders: Special Concerns
3.7 Cultural Views of Death
3.8 References
3.9 Post Test
4. Assessment Of The Geriatric…
4.1 Module Objectives
4.2 Domains of Assessment: Functional Assessment
4.2.1 How to Use Information from a Functional Assessment
4.2.2 Vision Impairment
4.2.3 Hearing Impairment (I)
4.2.4 Hearing Impairment (II)
4.2.5 Oral and Dental Health
4.2.6 Introduction to Oral Health Assessment
4.2.7 Oral Health Assessment
4.2.8 Common Oral Conditions in Older Adults: Tooth Loss (I)
4.2.9 Common Oral Conditions in Older Adults: Tooth Loss (II)
4.2.10 Common Oral Conditions in Older Adults: Care of Dentures
4.2.11 Common Oral Conditions in Older Adults: Dental Decay
4.2.12 Common Oral Conditions in Older Adults: Periodontal Disease
4.2.13 Common Oral Conditions in Older Adults: Candidiasis Infection
4.2.14 Common Oral Conditions in Older Adults: Leukoplakia and the Risk for Oral Cancer
4.2.15 Guidelines for a Dental Referral
4.2.16 Falls and Gait Assessment
4.2.17 Assessing for Falls
4.2.18 Techniques for Gait Assessment
4.2.19 Gait Assessments and Falls Interventions
4.2.20 Risk Factors for Falls and Targeted Interventions
4.2.21 Modification of Risk Factors: Ability to Get Up After a Fall
4.2.22 Modification of Risk Factors: Fracture Risk
4.2.23 Modification of Risk Factors: Anticoagulation
4.2.24 Incontinence
4.2.25 Skin Breakdown: Pressure Ulcers
4.2.26 Cognition/Dementia
4.2.27 Benefits of Early Detection of Dementia
4.2.28 Screening Techniques for Dementia
4.2.29 Decision-Making about Dementia Screening
4.2.30 Nutrition
4.2.31 Alcohol Use and Alcoholism
4.2.32 Medication and Complementary Therapies
4.2.33 Case Example: Mr. Singh
4.2.34 Mr. Singh--Use of Herbal Medicines
4.2.35 Mr. Singh--Possible Interventions
4.2.36 Mr. Singh--Concerns about Marathon Running at 92?
4.2.37 Mr. Singh--Considerations for Patient/Family Well-Being
4.2.38 Assessing for Polypharmacy (I)
4.2.39 Assessing for Polypharmacy (II)
4.3 Domains Of Assessment: Psychosocial Health And Functioning
4.4 Special Considerations In Assessment
4.5 Post Test
5. Health Care Policies
5.1 Module Objectives
5.2 The Policy-Making Process
5.3 Financing Health & Long Term Care
5.4 Quality Of Care Issues In Long Term Care
5.5 Need And Access Across The Spectrum Of Care
5.6 References
5.7 Post Test
6. Exploring Age-Related Body…
6.1 Cardiovascular System
6.2 Endocrine System
6.3 Immune System
6.4 Musculo-Skeletal System
6.5 Neurological System
6.6 Renal System
6.7 Post Test

Module 6: Exploring Age-Related Body Systems Changes

6.4: Musculo-Skeletal System



6.4.21: References

Bassey, E. J., Fiatarone, M.A., O’Neill, E. F., Kelly, M., Evans, W. J., Lipsitz, L. A. (1992). Leg extensor power and functional performance in very old men and women. Clinical Science (Lond). 1992 Mar;82(3):321-7.

Baumgartner, R. N., Koehler, K. M., Gallagher, D., Romero, L., Heymsfield, S.B., Ross, R. R., Bean, J. F., Kiely, D. K., Herman, S., Leveille, S. G., Mizer, K., Frontera, W. R., & Fielding, R. A. (2002) . The relationship between leg power and physical performance in mobility-limited older people. Journal of the American Geriatric Society. Mar;50(3):461-7.

Baylink, D. J., Jennings, J. C., & Mohan, S. (1999). Calcium and bone homeostasis and changes with aging. In W. R. Hazzard, J. P. Blass, W. H. Ettinger, J. B. Halter, & J. G. Ouslander (eds). Principles of geriatric medicine and gerontology, 4th ed (pp. 1041-1056). New York: McGraw-Hill.

Bean, J.F., Kiely, D.K., Herman, S., Leveille, S.G., Mizer, K., Frontera, W.R., & Fielding,R.A. (2002). The relationship between leg power and physical performance in mobility-limited older people. Journal of the American Geriatric Society. 50(3): 461-467.

Bohannon, R. W., et al., (1984). Decrease in timed balance scores with aging. Physical Therapy, 64: 1067-10

Carmeli, E., Coleman, R., Reznick, A. Z. (2002). The biochemistry of aging muscle. Experimental Gerontology, 37: 477-489.

Evans, W. J. (2000). Exercise strategies should be designed to increase muscle power. Journal of Gerontology A Biological Science Medical Science. Jun;55(6):M309-10.

Evans, W. J. (2002) Effects of exercise on senescent muscle. Clinical Orthopedics. Oct;(403 Suppl): S211-20.

Evans, W. J. Exercise as the standard of care for elderly people. J Gerontol A Biol Sci Med Sci. 2002 May;57(5): M260-1

Fielding, R. A., LeBrasseur, N. K., Cuoco, A., Bean, J., Mizer, K., Fiatarone Singh, M. A. (2002) High-velocity resistance training increases skeletal muscle peak power in older women. Journal of the American Geriatric Society. Apr;50(4):655-62.

Frontera, W. R., Hughes, V. A., Fielding, R. A., Fiatarone, M. A., Evans, W. J., Roubenoff (2000) Aging of skeletal muscle: a 12-yr longitudinal study. Journal of Applied Physiology. Apr;88(4):1321-6

Frontera, W. R., Hughes, V. A., Krivickas, L. S., Roubenoff, R. (2001). Contractile properties of aging skeletal muscle. International Journal of Sports Nutrition & Exercercise Metabolism. Dec;11 Suppl:S16-20.

Garry, P. J., Lindeman, R. D. (1998). Epidemiology of sarcopenia among the elderly in New Mexico. American Journal of Epidemiology. Apr 15;147(8):755-63.

Gunta, K. E. (2002). Alterations in Skeletal Function: Congenital Disorders, Metabolic bone disease, and neoplasms. In C. M. Porth & M. P. Kunert, Pathophysiology: Concepts of altered health states (pp. 1341-1366). Phil: Lippincott Williams & Wilkins.

Hamerman, D. (1989). The biology of osteoarthritis. New England Journal of Medicine. 1989 May 18;320(20):1322-30.

Holloszy, J. O. (2000). The biology of aging. Mayo Clinic Proceedings, 75(Suppl): S3-S9.

Hughes, V.A., Frontera, W. R., Wood, M., Evans, W. J., Dallal, G. E., Roubenoff, R., Fiatarone Singh, M. A. (2001). Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health. Journal of Gerontology A Biological Science Medical Science. May;56(5):B209-17.

Lieber, R. (2002) Skeletal Muscle Structure, Function and Plasticity: The Physiological Basis of Rehabilitation. Phil: Lippincott Williams & Wilkins

Lindle, R. S., Metter, E. J., Lynch, N. A., Fleg, J.L., Fozard, J. L., Tobin, J., Roy, T. A., Hurley, B. F. Age and gender comparisons of muscle strength in 654 women and men aged 20-93 yr. Journal of Applied Physiology. 1997 Nov;83(5):1581-7.

Loeser, R. F. & Delbono, O. (1999), Aging & the Musculoskeletal System, In W. R. Hazzard et al., eds. Principles of geriatric medicine and gerontology, 4th ed. p. 1108, McGraw Hill.

McArdle, A., Vasilaki, A., & Jackson, M. (2002). Exercise and skeletal muscle ageing: Cellular and molecular mechanisms. Ageing Research Reviews, 1: 79-93.

Melton, L. J. 3rd, Khosla, S., & Riggs, B. L. (2000). Epidemiology of sarcopenia. Mayo Clinic Proceedings. Jan;75 Suppl:S10-2; discussion S12-3.

Miszko, T. A., Cress, M. E., Slade, J. M., Covey, C. J., Agrawal, S. K., & Doerr, C. E. (2003). Effect of strength and power training on physical function in community-dwelling older adults. Journal of Gerontology A Biological Science Medical Science. 2003 Feb;58(2):171-5.

Nair, K. S. (2000). Age related changes in muscle. Mayo Clinic Proceedings, 75(Suppl): S14-S18.

Raisz, L. G. (1988). Hormonal regulation of bone growth and remodelling. Ciba Found Symposium. 136:226-38.

Recker, R. R., Davies, K. M., Hinders, S. M., Heaney, R. P., Stegman, M. R., Kimmel, D. B. (1992). Bone gain in young adult women. JAMA. 1992 Nov 4;268(17):2403-8.

Recker, R. R., Lappe, J. M., Davies, K. M., Kimmel, D. B. (1992). Change in bone mass immediately before menopause. J Bone Miner Res. 1992 Aug;7(8):857-62.

Roubenoff, R. & Hughes, V. A. (2000). Sarcopenia: current concepts. Journal of Gerontology A Biological Science Medical Science. Dec;55(12):M716-24.

Roubenoff, R., Castaneda, C. (2001). Sarcopenia-understanding the dynamics of aging muscle. JAMA. 2001 Sep 12;286(10):1230-1.

Skelton, D. A., Greig, C. A., Davies, J. M., Young, A., (1994). Strength, power and related functional ability of healthy people aged 65-89 years. Age and Ageing. 23, 371-377.

Suzuki, T., Bean, J. F., Fielding, R. A. (2001) Muscle power of the ankle flexors predicts functional performance in community-dwelling older women. Journal of the American Geriatric Society, Sep;49(9):1161-7.

Taaffe, D. R. & Marcus, R. (2000). Musculoskeletal health and the older adult. Journal of Rehabilitation Research and Development. 37(2), 245-254.

Turner, C. H., & Robling, A. G. (2003) Designing exercise regimens to increase bone strength. Exercise and Sports Science Reviews. 2003 Jan;31(1):45-50.

Vandervoort, A. A. (2002). Aging of the human neuromuscular system. Muscle & Nerve, 25: 17-25.

Williams, G. N., Higgins, M. J., & Lewek, M. D. (2002). Aging skeletal muscle: Physiologic changes and the effects of training. Physical Therapy. 82: 62-68.


Module 6: Exploring Age-Related Body Systems Changes
6.4.20 Summary Case
6.5 Neurological System