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NYCC Human DD Plez

Human Dev. Diagnosis Dr. Plezbert test 3 Spring 2012

QuestionAnswer
In 2010 an estimated ___% of the population was over 65. In 2030, that number will be ___% 14% 22%
The fastest growing segment of the population? OVER 85 y.o.a.
Geriatrics specialty of medicine focusing on the treatment, management, and PREVENTION OF ILLNESS and disease states in older adults.
Gerontology the study of biological, PSYCHOLOGICAL, AND SOCIAL aspects of human aging
Baby boomer years 1946-1966
What is the average life expectancy of a Boomer today? 80's (in 1900, avg was 47 yo)
pre-geriatric geriatric pre-centurian centurian (ages) 55-64 65+ 85-99 100+
W.H.O. defines ELDERLY, OLD, and VERY OLD as? Elderly 5-70 Old 76-0 Very old >90
Familiarize yourself w/ the top 8 causes of mortality in the US Cardiovascular dz, Malignancy, Stroke (CVA), Respiratory conditions, Accidents/fx, Diabetes, Suicide, Liver dz
How about the top 8 causes of morbidity? Arthritis, Hypertension, Hearing impairment, Heart dz, Visual impairment, Diabetes, Orthopedic deformity, varicose veins
indicates a medical condition existing simultaneously but INDEPENDENTLY with another condition in a patient CO-morbidity
living in an UNHEALTHY state either PHYSICALLY OR MENTALLY -diminished quality of life due to a disease state Morbidity (consequences of chronic disease)
Is the incidence of ADL limitations going up or down in over 65? down
Is the death rate for heart dz going up or down? down *malignancy is steady Cerebrovascular is down Diabetes is up Alzheimer's is up Chronic lower respiratory is down
What country has the highest life expectancy for both men and women? Japan (France is 2nd for women! Move to France - yay!)
Who has higher degree over age 65 of functional limitations (stooping, kneeling, reaching overhead, walking 2-3 blocks, lifting 10 lbs) Women (men at 19%, women at 32% - the price of living longer)
Avg percent of over 65 Medicare who have limitations in ADL's and get personal assistance 65-70%
What is the number one concern of older people? being VICTIMIZED (fear) others: ageism, loss of function/independence, financial issues, transportation
Percentage of US population over 65 visiting chiro college clinics 13% Percentage of chiro patients over 65 is 17% (table difficult to interpret but instructor teaching class published it so...it's in the notes)
What is the majority age of chiropractors, accding to NBCE 31-50 yo is 29% over 65 is 15.4% 51-64 is 22.8%
Chief complaints at chiro offices LBP/pelvic, midback, neck, HA or facial pain (um...everything) = 65.8% Extremity 17.1%, Chest/ab 6.6%, Wellness 8.0%, Other non-MS 2.5%
The majority of patient conditions in chiro offices arise (etiology) from: ADL's (21%) Overuse/repetitive stress MVA's Sports/exercise/recreation Emotional/environ/diet stress Acute/chronic or other illness
According to BJ Palmer (yikes), elderly patients are vulnerable to the 3 main causes of the VSC (yikes, again): Negative thoughts Toxins Trauma
Dr. Charles Brown-Sequard French physiologist: Hormonal manipulations - guinea pig testicle extract to increase mm mass, grip strength, vim and vigor (for anyone under 30 out there, that just means 'mojo').
Quick board review: what is Brown-Sequard syndrome Hemiplegia where on ipsilateral side is loss of motor, vibration, discrimination, proprioreception and on contralateral side side is loss of pain and temperature.
More evidence of male science: Professor Voronoff in the early 1900's grafted ______ to aged persons. testicles
Dr. Ellie Metchinkoff, awarded the Nobel prize for discovering phagocytosis, believed in auto-intoxication from fermentation in the colon caused physical deterioration. Luckily, after the good doctor stopped advocating for 'prophylatic colonectomies,' he switched to clean colon idea of YOGURT cultures.
Most favored current theories of aging: Neuroendocrine Free-radical Genetic expression (hopefully she means telomeric length)
Dr. Vladimir Dilman could have been a vampire, but his last name was Dilman. What was his neuroendocrine theory? Hypothalamus = Master endocrine gland Loses sensitivity to peripheral hormones ergo, doesn't keep up.
Neuroendocrine theory of aging: Dilman hypothalamus = master endocrine gland loss w/ age leads to cannot detect low hormone levels
Free Radical theory of aging: Dr. Denham Harman, MD, PhD is the ___________ Pioneer! ANTIOXIDANT Free radicals create cell damage b/c aging causes decreased production of SOD, Catalase, and Glu Perox that kill free radicals.
Free radical theory of aging: Instances of free radical damage Harman: cell proteins, membranes, DNA, lipofuscin accumulation
Genetic control theory of aging: Telomeres! Death is encoded within DNA at birth via predetermined cell divisions. Longevity runs in family Lifespan constant for many species
Other names for the telomere genetic control theory of pre-programmed DNA replication longevity Pacemaker theory Hayflick phenomenon
Molecular theories of aging: (3) 1. Error & Somatic mutation 2. Error in DNA/RNA synthesis results in abnormal protein synth 3. Gradual accumulation of molecular damage impairs regulation of gene expression
WEAR & TEAR theory Repeated use causes wearing out Inability to continuously repair Overall deterioration & tissue destruction
Age pigments: accumulation of ___________ most predominate age associated change**** LIPOFUSCIN = ***most predominate age-associated change
Where does LIPOFUSCIN go? Neurons Cardiac myocytes liver adrenals testes
Effect of LIPOFUSCIN on cells? LOSS of cytoplasmic mass LOSS of mitochondria LOSS of rough ER
Cross-linking theory Biological macromolecules develop CROSS-LINKAGES with other molecules -alters physical/chemical properties -damages cells and tissues -AGE's [ Advanced Glycosylation End products ]
AGE's Advanced Glycosylation End products that occur due to cross linking (theory of aging)
Lifestyle factors that affect aging (ie, behaviors and attitudes that screw you) Lack of exercise Smoking, alcohol (or smoking alcohol) Inadequate nutrition Obesity Mental health
Lots of tests done to approximate biological age: Near vision, Hearing, Skin turgor (vs. dehydration), Reaction times, Lipid levels, Pulmonary fcn, Blood pressure, Exercise stress tests
Name the BASELINE HORMONES that should be assessed? THYROID - DHEA - TESTOSTERONE/ESTROGEN/PROGESTERONE - GROWTH HORMONE - MELATONIN
Are MANUAL THERAPIES considered anti-aging interventions? YES
Typical anti-aging interventions: Hormone replacement, Low glycemic diets, Anti-oxidant and mineral supplements, Detox regimens, Stem cell therapy, Exercise
Name an anti-aging organization American Academy of Anti-Aging Medicine (A4M)
What is a functional status exam? Measures the ability to function in the world from basic to more complex tasks is predominately correlated with neuromusculoskeletal abilities
Name 2 functional status exams for aging IADL's = instrumental activities of daily living/more complex tasks ADL's = Activities of daily living/ more basic functions
Which one measures more complex tasks: IADL's or ADL's IADL Instrumental...
6 basic ADL items: Bathing, Continence, Dressing, Feeding, Toileting, Transferring
Created by: hecutler