The process of becoming older, a
process that is genetically determined
and environmentally modulated.
Aging is a sequential or progressive
change in an organism that leads to
increase risk of debility, disease and
death. Senescence consist of these
manifestations of the aging process.
Who Are Elderly? Aging in Society?
Gerontology is a field of science that seeks to
understand the process of aging and the
challenges encountered as seniors grow older.
Gerontologist investigate age, aging, and the
aged. Gerontologists study what it is like to be
an older adult in a society and the ways that
aging affects members of a society.
This refers to a specialized field of gerontology
that examines the social aspects of aging.
Researchers focus on developing a board
understanding of the experiences of people at
specific ages, such as mental and physical
wellbeing, plus age specific concerns such as
the process of dying.
Social gerontologists work as social
researchers, counselors, community
organizers, and service providers for older
Phases of Aging:
The United states older adult population
can be divided into three life-stage
The young-old (approximately 65-74)
The middle-old (ages 75-85)
The old-old (over age 85)
Frail elder is described in literature as the older
adults with problems in multiple domains or who
is vulnerable , fragile , and lacking resilience.
The FRIED definition of frail elderly includes the
Unintentional weight loss
Slow walking speed
Low physical activity
Frail elders are generally older than 65 years and
present with deficiencies in at least 2 of the major
Following are the major domains :
The process of developing and maintaining the
functional ability that enables well-being in
People age in different ways and at different rates ,
although there is some consensus of opinion as to
normal aging and what may be termed as
Exercise tolerance , strength , and balance
frequently experience a decline with age , yet
regular exercise has been shown to preserve
these functions overtime and , in some cases,
reverse the usual decline.
Aging Around The World:
■Aging in the population is moderate in outside
of East Asia and Europe such as Indonesia
■But aging is rapidly increase in China , Japan ,
South Korea , Germany , United states of
America and many others.
■Research held by the University of Washington
according to get research in 2100 2.4 billion
are going to be over the age of 65 compared
with 1.7 billion under the age of 20.
■PEW research centre:
They surveyed and got a result that at a time
when the global population of people ages 65
and older is expected to triple to 1.5 billion by
mid century , public opinion on whether the
growing number of older people is a problem
varies dramatically around the world .
■Aging in Pakistan: Pakistan is one of the
country that potentially stands to benefit from
future demographic trends because Pakistan
centrally has large shares of children in their
Age Related Changes:
Change in appearance : such as reduction in
height, loss of weight ,muscle loss ,loss of bone
Changes in audience ,olfaction ,vision ,
pulmonary and immune functions
Some aged-related changes also called
Farsightedness which may caused by the
continuous growth of eyes ,lenses and appears to
be universal of human aging.
Number of pathologies increases with age
included 2 types of diabetes ,heart diseases
,cancer ,arthritis and kidney disease.
loss of ability to hear the high frequency
Hearing can lead to social isolation
Hearing aids can't address all types of hearing
loss of ability to see items
Size of pupil grows smaller with age
Lens of eyes yellow making it more difficult to see
red and green colors
Dry eyes are common
Taste & Smell :
Many older people often complain of food
Sense of smell decreases
4. Pain & Touch :
With age skin is not sensitive as in youth
Loss of elasticity
Reducer of layer
_ Number of gastric cell decreased products of
_ Constipation is more common in older adults
due to slowed circulation , reduced the thirst and
decrease tone in stomach & intestine
_ Emotions play a significant role in appetite and
_ loss of elasticity of connective tissues can
_ Maintain bone health through diet exercise
&getting adequate rest
Changes in Skin
To most people ; condition of skin ,hair and connective
tissues represent the indicator of age_
Muscles of face capable of movement , smile
,laughter, frown and surprise are all recorded .
By age of 40; most people bear typical lines of their
In the absence of diseases ; the heart tends to
maintain its size
Heart valves tend to increase in thickness with age
Bp increase with age
Airway and tissue become less elastic and
more rigid with age
Power of respiratory & abdominal muscles
_ At the age of 65 :
arthritis and allied bones ,muscles
conditions are most common disorders
Inflammation and degenerative change in joint
gradual wearing away of joint cartilage that results in
exposure of rough underlying bone ends
Can damage internal ligament
Weight bearing joint
A chronic , systematic and inflammatory disease of
2-3 times more common among women May occur at
age most common onset between 20 & 50
Bladder of elderly person has a capacity of
less than young person and contain more
Micturation reflex is delayed; usually activated
when bladder is half full.
Common Health Problems Of
Following are the common health problems that
older adults usually face:
•Chronic obstructive pulmonary disease
Is also known as degenerative disease.
Commonly occur in older person and is
characterized by chronic degeneration of
cartilage of joints.
Age : OA rise after age 50 in men & age 40 in
Obesity : Is a common cause of OA
Injury : Injuries develop osteoarthritis.
Stiffness of joint
Loss of flexibility
Group of disorder of heart and blood vessels including
hypertension (high BP) coronary heart disorder (heart attack)
Coronary heart disease
Peripheral arterial disorder
Family history of CVD
Chronic disease by elevated levels of blood glucose.
(chronic obstructive pulmonary disorders)
Chronic inflammatory lung disease that causes
obstructed airflow from lungs.
Occupational exposure to dust and chemicals
Mistreatment and Abuse:
Mistreatment :Treating a person badly , cruelty
and unfairly , Improper treatment.
Abuse :Treat with cruelty or violence , regularly
CAUSES OF ABUSE:
Poverty and unemployment
Lack of social safety
TYPES OF ABUSE:
EFFECTS OF ABUSE:
Long lasting depression and anxiety
Fall Prevention in Elderly
Decreased sensory control
Causes Of Fall:
Location of fall
Activity prior to fall
Loss of consciousness
Use of walking aid like cane
Environmental factors like slippery floor, rug
● What a PT does in this regard??
He/ she determines if the risk factors are modifiable or
If yes, Those factors causing fall in elderly must b altered
according to need
Hindrance in between walk must be eliminated
Reduced distance between bed room and rest room
Room arrangements are also considered in this regard
National Institute Of Aging:
Offers advices for preventing fall and fractures
on its Web site
And a list of number of suggestions for
Identification of individual risk factors contributing
Identification of environmental factors
Use of proper medications and supplements like
osteoporosis is the most common issue among
Improving physical mobility through exercise
programs, gait training,.
Use of walking aids
Educating the patient's family about risk
factors and continence promotion and toilet
Assessment Of Physical
Physical activity refers to all movement
including during leisure time, for transport to
get to and from places, or as part of a person's
work. Both moderate- and vigorous-
intensity physical activity improve health.
Current Techniques to Measure Physical
Before initiating an exercise program , older
adults should be screened for possible signs
and symptoms that need medical attention.
The fitness levels of older adults vary
considerably based on the physical activity
and general health of older adults , one needs
to assess cardio respiratory functions ,
muscular strength ,
Endurance ,flexibility and body composition.
The physical capacity of a the individual to
meet ordinary and unexpected demands of
daily life safely and effectively.
Following are the functional test that are
performed to measure functional fitness.
Continuous scale physical functional
Performance Test (CS-PFP)
Physical Performance test (PPT)
The Senior Fitness test
Social Implications of Aging:
A pattern of life changes that occur as one grows
Refers to a persons habits & roles relative to
Increase population of older people means that
there is an increased demand of health & social
Social implication & Social issues affecting
Old age accompanied by role change or often role
Many people can expect transformation in
occupation, family or community roles &
sometimes number of many different roles
Social and psychological problems
New York Times , 25th March 2009 quoted , Loneliness leads to poorer
physical & mental health.
Negative & unpleasant feeling
( Tiwari Indian psychiatric)
Loneliness is reported to be more dangerous than smoking.
Factors cause loneliness
discrepancy b/w level of his/her needs & social contacts
Migration of people.
Low self esteem
poor coping strategies
Keeping self busy
Joining of groups of self interest
Collecting good thought
Staying in contact with family & friends
Aging basically a state in which individual lacks
a sense of,
Engagement with others
Quality & Fulfilling of relationship
Make groups or friends ,meet regularly
Educational & Social activities
Retirement and Mental Health:
There are many studies in 1995,2002 & 2003 to
support the indication that
Retirement and mental health are positively
associated with social implications of aging
Retirement cause mental & physical health
Increase difficulties associated with mobility &
Increase illness conditions declines mental health
Increase probability of suffering financial
Frustration with ongoing medical problems &
Increase numbers of medication
Increased probability of having at least one
diagnosed condition & Taking a drug for such
Increased probability of suffering from clinical
Inability to manage DLA independently
Difficulty in coping And accepting physical
change of aging
Feeling inadequate from inability to
continues to work
Medical Implications of Aging
The good news is that with the age comes dignity &
Greater understanding of life and human conditions
But some health care or medical issues are also
Inter-Relate with the procedure of aging.
Heart disease & many more
Strategies to promote successful
• Don't smoke
• Get enough sleep
• Avoid chronic stress
• Maintain healthy weight
• Eat healthy diet
On the Basis of SOCIOLOGY following
are the strategies to promote Successful
Refers various sources of help
Resources to obtained social relationship with
family , friends and other care providers
Types of social support:
Instrumental support , helps with activities of daily
Appraisal support , help with decision making
Helping elderly to identify meaningful ways to
stay involved in different activities to stay healthy
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