5. SELECTED PHYSIOLOGIC AGE-RELATED CHANGES Changes in drug levels Strength Tendency toward dehydration Lean body mass Muscular mass Creatinine production Skeletal mass Total body water Percentage adipose tissue (until age 60, then .until death) Body composition Clinical Manifestations Physiologic Change Affected Organ or System
6. Cancer risk DNA damage and DNA repair capacity Oxidative capacity Accelerated cell senescence Fibrosis Lipofuscin accumulation Cells Clinical Manifestations Physiologic Change Affected Organ or System
7. Ability to recognize speech Loss of high-frequency hearing EARS Tendency to parkinsonian symptoms (eg, muscle tone, arm swing) Number of dopamine receptors alpha-Adrenergic responses Muscarinic parasympathetic responses CNS Clinical Manifestations Physiologic Change Affected Organ or System
8. Muscle mass Bone mass Fracture risk Vaginal dryness Changes in skin Water intoxication Menopause, estrogen and progesterone secretion Testosterone secretion Growth hormone secretion Vitamin D absorption and activation Incidence of thyroid abnormalities Incidence of diabetes ( insulin sensitivity or insulin resistance) Bone mineral loss Secretion of ADH in response to osmolar stimuli Endocrine system Clinical Manifestations Physiologic Change Affected Organ or System
9. Tendency toward constipation and diarrhea Splanchnic blood flow Transit time GI TRACT Presbyopia Glare and difficulty adjusting to changes in lighting Visual acuity Lens flexibility Time for pupillary reflexes (constriction, dilation) Incidence of cataracts EYES Clinical Manifestations Physiologic Change Affected Organ or System
10. Tendency toward syncope Ejection fraction Intrinsic heart rate and maximal heart rate Blunted baroreflex Cardiac acceleration Diastolic relaxation Atrioventricular conduction time Atrial and ventricular ectopy HEART Clinical Manifestations Physiologic Change Affected Organ or System
11. Tendency toward some infections and possibly cancer Antibody response to immunization or infection but Autoantibodies T-cell function B-cell function IMMUNE SYSTEM Clinical Manifestations Physiologic Change Affected Organ or System
12. Changes in drug levels with risk of adverse drug effects Tendency toward dehydration Renal blood flow Renal mass Glomerular filtration Renal tubular secretion and reabsorption Ability to excrete a free-water load KIDNEYS Tightening of joints Tendency toward osteoarthritis Degeneration of cartilaginous tissues Fibrosis Elasticity JOINTS Clinical Manifestations Physiologic Change Affected Organ or System
13. Taste and consequent appetite Likelihood (slightly) of Nosebleeds Smell NOSE Changes in drug levels Hepatic mass Hepatic blood flow Activity of P-450 enzyme system LIVER Clinical Manifestations Physiologic Change Affected Organ or System
14. Tendency toward syncope Response to beta-blockers Exaggerated response to anticholinergic drugs Baroreflex responses beta-Adrenergic responsiveness and number of receptors Signal transduction Muscarinic parasympathetic responses Preserved alpha-adrenergic responses PERIPHERAL NERVOUS SYSTEM Clinical Manifestations Physiologic Change Affected Organ or System
15. Likelihood of shortness of breath during vigorous exercise if people are normally sedentary or if exercise is done at high altitudes Risk of death due to pneumonia Risk of serious complications for patients with a pulmonary disorder Vital capacity Lung elasticity (compliance) Residual volume FEV1 V/Q mismatch PULMONARY SYSTEM Clinical Manifestations Physiologic Change Affected Organ or System
16. Tendency toward hypertension Endothelin-dependent vasodilation Peripheral resistance VASCULATURE Clinical Manifestations Physiologic Change Affected Organ or System
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