Ageism y Ageism, also called age discrimination is stereotyping of and discrimination against individuals or groups because of their age.

It is a set of beliefs, attitudes, norms, and values used to justify age based prejudice, discrimination, and subordination Ageism in common parlance and age studies usually refers to negative discriminatory practices against old people, people in their middle years, teenagers and children. There are several forms of age-related bias. Geriatric nursing y Geriatric Nursing is a comprehensive source for clinical information and management advice relating to the care of older adults.

Physical changes

Normal Physical Changes Associated with Aging Rationale

Integumentary system y Increased skin dryness y y y Increased skin pallor Increased skin fragility Progressive wrinkling and sagging of the skin Brown age spots on body parts Decreased perspiration Thinning and graying of scalp, pubic, and axillary hair Slower nail growth and increased thickening with ridges

y y y y

Decrease in sebaceous gland activity and tissue fluid Decrease vascularity Reduced thickness and vascularity of dermis; loss of subcutaneous fats Loss of skin elasticity; increased dryness, and decreased subcutaneous fat Clustering of melanocytes Reduced number and function of sweat glands Progressive loss of pigment cells from hair bulbs Increase calcium deposition

y y y

y y y

Neuromuscular y Decreased speed and power of skeletal muscle contractions y Slowed time reaction

Decrease in muscle fibers

Diminished conduction speed of nerve fibers and decreased muscle tone Atrophy of intervertebral disc, increased flexion at hips and knees Bone reabsorption outspaces bone reformation Drying and loss of elasticity in joint cartilage Decreased muscle strength, reaction time, and coordination, change in center of gravity Fewer cells in cerebral cortex

Loss of height

y y y

Loss of bone mass Joint stiffness Impaired balance

y y y

Greater difficulty in complex learning and abstraction

Sensory

y y

Loss of visual acuity Increased sensitivity to glare and decreased ability to adjust to darkness Partial or complete glossy white circle around the periphery of cornea Progressive loss of hearing Decreased sense of taste, especially the sweet sensations at the tip of the tongue Decreased sense of smell Increased threshold for sensations of pain, touch, and temperature

y y

Degeneration leading to lens opacity, thickening, and inelasticity Changes in ciliary muscles; rigid pupil sphincter; decrease in pupilary size Fatty deposits

y y

y y

Changes in the structures and nerve tissues in inner ear; thickening of eardrum Decreased number of taste buds in tongue because of tongue atrophy Atrophy olfactory bulb at the base of the brain Possible nerve conduction and neuron changes

y y

y y

Pulmonary y Decreased ability to expel foreign or accumulated matter y Decreased lung expansion, less effective exhalation, reduced vital capacity, and increased residual volume y Difficult, short, heavy, rapid breathing following intense exercise

y y

Decreased elasticity and ciliary activity Weakened thoracic muscles; calcification of costal cartilage, making the rib cage more rigid with increased anterior-posterior diameter; dilation from inelasticity of alveoli Diminished delivery and diffusion of oxygen to the tissues to repay the normal oxygen debt because of exertion or changes in both respiratory and vascular tissues Increased rigidity and thickness of heart valves; decreased contractile strength

Pulmonary y Reduced cardiac output and stroke volume, particularly during increased activity or unusual demands; may result in shortness of breath on exertion and pooling of blood in extremities y Reduced elasticity and increased rigidity of arteries y Increase in diastolic and systolic blood pressure y Orthostatic hypertension Gastrointestinal y Delayed swallowing time y Increased tendency for indigestion Increased tendency for constipation

y y y

Increased calcium deposits in muscular layer Inelasticity of systemic arteries and increased peripheral resistance Reduced sensitivity of the blood pressureregulating baroreceptors Alterations in the swallowing mechanism Gradual decrease in digestive enzymes, reduction in gastric pH, and slower absorption rate Decreased muscle tone of the intestines; decreased peristalsis; decreased free body fluid Decreased number of functioning nephrons and arteriosclerotic changes in blood flow Decreased tubular function Enlarged prostate gland in men; weakened muscles supporting the bladder or weakness of urinary sphincter in women Decreased bladder capacity and tone

y y

Urinary y Reduced filtering ability of the kidney and impaired renal function y y Less effective concentration of urine Urinary urgency and urinary frequency

y y

Tendency for nocturnal frequency and retention of residual urine

Genitals y Prostate enlargement in men y y y Multiple changes in women Increased time to sexual arousal Decreased firmness of erection, increased refractory period Decreased elasticity vaginal lubrication and

y y y y

Exact mechanism is unclear; possible endocrine changes Diminished secretion of female hormones and more alkaline vaginal pH Changes in blood supply to penis and clitoris Changes in blood supply

Loss of estrogen effects

Immunological y Decreased immune response; lowered resistance to infections y Poor response to immunization y Decreased stress response

y y

T cells less responsive to antigens; B cells produce fewer antibodies Immune system changes may precipitate insulin resistance

Endocrine y Increased insulin resistance y Decreased thyroid function

Unclear mechanism

Theories of Aging Theory type Wear and tear theory Hypotheses y Proposes that humans, like automobiles, have vital parts that run down with time, leading to aging and death y Proposes that the faster an organism lives, the quicker it dies y Proposes that cells wear out through exposure to internal and external stressors, including trauma, chemicals, and buildup of natural wastes y Proposes that events occurring in the hypothalamus and pituitary are responsible for changes in hormone production and response that result in the organisms decline Proposes that unstable free radicals result from the oxidation of organic materials, such as carbohydrates and proteins. These radicals cause biochemical changes in the cells, and the cells cannot regenerate themselves Proposes that the organism is genetically programmed for a predetermined number of cells division, after which the cells/organism dies Proposes that when damage to the protein synthesis occurs, faulty proteins will be synthesized and will gradually accumulate, causing a progressive decline in the organism

Endocrine theory

Free radical theory

Genetic Theory

Cross-linking Theory

y Immunological Theory

Proposes that the irreversible aging of proteins such as collagen is responsible for the ultimate failure of tissues and organs Proposes that are cells age, chemical reactions create strong bonds or crosslinkages, between proteins These bonds cause loss of elasticity, stiffness, and eventual loss of function Proposes that the immune system becomes less effective with age, resulting in reduced resistance to infectious diseases and viruses Proposes that a decrease in immune function may result in an increase in autoimmune responses, causing the body to produce antibodies that attack itself