ACTIVITIES IN AGING

Guided by: Mrs. Monalisa

Pattanaik (PT)
Asst Prof, DPT, SVNIRTAR, Olatpur

Presented by: Priyabrata

Kalikinkar Ojha
MPT (1 st Year)
13th Batch

Aging

According to Wikipedia
Ageing(British English)
oraging(American English) is the
process of becoming older. It
represents the accumulation of
changes in a person over time.
In humans, ageing refers to a
multidimensional process of Physical,
Psychological and social change.

According to Britannica
Encyclopedia
Aging,progressive physiological
changes in an organism that lead to
senescence (to grow old), or a
decline of biological functions and of
the organisms ability to adapt to
metabolic stress.

CLASSIFICATION OF
AGING
Three groups have been identified.
Young-Old:
Populations between 65 and 75 years
of age, some what similar to middleaged people.
Associated with minimum level of
disability.
Average life expectancy of about 1520 years.

Middle-Old
The populations between 75 and 85
years of age.
They exhibit the occurrence of
chronic diseases.
Problems associated with
osteoporosis, diabetic neuropathy,
falls etc.
There is decline in additional years of
expectancy.

Old-old
Populations older than 85 years of
age.
With the average additional life
expectancy of 5-6 years.
They have a limited survival benefits
from screening tests or therapeutic
interventions.
In this state achieving the human
comfort is the main matter of
concern.

Theories of Aging
The link between genes and lifespan
is unquestioned. The simple
observation that some species live
longer than others- humans longer
than dogs, tortoises longer than
mice-is one convincing piece of
evidence.

Theories of Aging
All aging begins with genetics.
Aging changes the biochemical and
physiological process in the body.
Cell and molecular biologists
examine and propose theories to
explain the aging process.
(What causes aging? How can you
influence aging.prolong life?)

Categories of aging theory

We have two kinds of Aging theories.
1. Programmed theory
Aging has a biological timetable or internal
biological clock.
2.Error theory
Aging is a result of internal or external
assaults that damage cells or organs they
can no longer function properly.
Many theories are a combination of
programmed and error theories.

Programmed vs. Error Theories

Programmed
theories
Programmed
Senescence Theory
Telomere theory
Endocrine Theory
Immunology
Theory

Error Theories
Wear and Tear
Theory
Rate-of-Living
Theory
Cross-linking
Theory
Free radical Theory
Error Catastrophic
Theory
Somatic Mutation
Theory

Programmed Senescence
Theory
Senescere is a Latin word which means to grow
old or Biological Aging. It is the gradual
deterioration of function characteristic of most
complex life forms, arguably found in all biological
kingdoms, that on the level of the organism
increases mortality after maturation.
Senescence can refer either to cellular senescence
or the whole organism.
Commonly believed that cellular senescence
underlies organismal senescence.
Senescence is the inevitable fate of all organisms.

Continued.
Organisms of some taxonomic groups, including
some animals , even experience chronological
decrease in mortality, for all or art of their life
cycle. On the other extreme are accelerated aging
diseases, rare in humans.
There is also the extremely rare and poorly
understood Syndrome X, whereby a person
remains physically and mentally an infant or child
throughout ones life.
Even if environmental factors do not cause aging,
they may affect it, e.g. ultraviolet radiation
accelerates skin aging

Telomere Theory
Telomeres are the bits of junk DNA at the
end of chromosomes that protect the real
DNA every time a cell divides. During each
cell division, the very last bit of a
chromosome cant be copied 100%- a little
bit gets cut off. It was thought that, as cell
divide, the telomeres get shorter each time,
until they are gone. At that point , the real
DNA cannot be copied anymore and the cell
simply ages and no longer replicates.

ENDOCRINE THEORY OF
AGING
The endocrine theory states that, as we age, the
endocrine system becomes less efficient and eventually
leads to the effects of aging.
First, the endocrine system secretes hormones from
glands that deliver messages to cells containing
information and instructions. The cells are programmed to
receive specific messages from the many hormones that
circulate through the body.
Hormone levels are affected by factors such as stress
and infection (KidsHealth, "Endocrine System").

Reference:https://sites.google.com/site/aginginhumans/theories-onaging/endocrine-theory

IMMUNOLOGICAL THEORY OF AGING

This is stating that, as we age, the number of
cells start to decrease becoming less
functional.
Immune responses decrease with aging,
contributing to the increased incidence of
different chronic diseases with an inflammatory
component (sometimes referred to as 'inflammaging'). It is clear from many studies that
human longevity may be influenced by these
changes in the immune system, but how they
proceed is not clearly determined.

Continued

Leukocytes are of two types.

Phagocytes
Lymphocytes
Phagocytes such as neutrophil fight
bacteria and other foreign organisms
that attack the body.
Lymphocytes are broken down into two
catagories namely (i)B-lymphocytes &
(ii) T-lymphocytes.

Continued.
The lymphocytes are produced in the bone
marrow and stay there until they become Blymphocytes and they leave to the Thymus
gland become T-lymphocytes.
The B lymphocyte targets the invading
organisms and sends messages to the T
lymphocytes, which destroy the invading
organisms.
References:
http://www.ncbi.nlm.nih.gov/pubmed/24862019
https://sites.google.com/site/aginginhumans/theories-on- aging/immunologicaltheory

WEAR & TEAR THEORY OF

AGING
According t this theory The aging of human
being and other animals is simply the result
of universal deteriorative processes that
operate in an any organized system.
According to these theories, humans age for
the same reasons and because of the same
processes that cause aging in automobiles
and exterior paints.
Reference:
www.programmed-aging.org/theories/wear_and_tear.html

RATE OF LIVING THEORY

This theory is based on the relationship between
the metabolic rate, body size and longevity.
According to this theory, All living organisms
possess a certain amount of a vital substance
and when all of that substance is used up, we
die.
This theory was initially developed to explain
why the larger animals live longer than the
smaller.
REFERENCE: https://courses.cit.cornell.edu/psych527_nbb420720/student2005/nrb26/Page-2.htm

CROSS-LINKING THEORIES OF
AGING
It is also known as Glycosylation theory of aging.
In this theory it is the binding of glucose (simple
sugars) to protein, (a process that occurs under
the presence of oxygen) that causes various
problems.
The consequences of this cross linking are senile
cataract and the appearance of tough, leathery
and yellow skin, cardiac enlargement and
hardening of collagen fibers.
REFERENCE:http://www.anti-aging-today.org/research/aging/theory/crosslinking.htm

FREE RADICAL THEORY OF

AGING
This theory says, the aging of the organism is due to
the accumulation of free radicals in the cells over
time.
The free radical theory is only concerned with free
radicals such as superoxide ( O 2), but it has since
been expanded to encompass oxidative damage
from otherreactive oxygen speciessuch as hydrogen
peroxide (H2O2), or peroxynitrate(OONO ).
The reducing agents as antioxidants can slow the
process of damage by the free radicals.
REFERENCE: http://en.wikipedia.org/wiki/Free-radical_theory_of_aging

ERROR CATASTROPHIC THEORY OF AGING

The error catastrophe theory of aging

states that aging is the result of the
accumulation of errors in cellular
molecules that are essential for cellular
function and reproduction that eventually
reaches a catastrophic level that is
incompatible with cellular survival.
REFERENCE: http://link.springer.com/10.1007%2F978-0-387-33754-8_162

SOMATIC MUTATION THEORY OF AGING

This theory states that an important part of aging is
determined by what happens to our genes after we inherit
them. From the time of conception, our body's cells are
continually reproducing. Each time a cell divides, there is a
chance that some of the genes will be copied incorrectly,
this is called a mutation. Additionally, exposures to toxins,
radiation or ultraviolet light can causes mutations in your
body's genes.
The body can correct or destroy most of the mutations, but
not all of them. Eventually the mutated cells accumulate,
copy themselves and cause problems in the body's
functioning related to aging.
REFERENCE:
http://longevity.about.com/od/researchandmedicine/p/age_
mutations.htm

DISEASE, DISABILITY &

DEATH
Aging

A gradual diminution in physiological capacity of various systems like musculoskeletal,

cardiovascular, neuropsychiatry and immune
An increase in prevalence of diseases like arthritis, hypertension, stroke, dementia and
infectious diseases

A reduction in functional capacity

Obesity, falls, social isolation and depression

Chronic disability

Death
REFERENCE: Principles of Geriatric Physiotherapy, Narinder Kaur Multani, Satish Kumar Verma

NORMAL AGING
It is an artificial concept describes
physiologic changes that occur with
advancing age.
Normally physiological capacity of
various system attains its optimum
level in 3rd decade of life.

Continued..
Rate of decline varies from individuals to
individual and from one physiologic
system to other.
Examples
Nerve conduction velocity declines only
10 to 15 % from 30-80 years of age.
Resting cardiac index declines 20-30%.
Maximum breathing capacity at age 80
is about 40% that of a 30-year-old.

Continued
The rate of decline in function also
varies from individual to individual.
Example
An individual may be active and
independent at the age of 80 years,
whereas some persons may be
inactive in the age of 65 years
because of disease and disability.

FEATURES OF NORMAL
AGING

MUSCULOSKELETAL CHANGES IN AGING

BONE become more
thinner and porous making
it more prone for fracture.

MUSCLES declining blood

supply, dead nerve cells
and waning testosterone
result in decreased muscle
mass and strength.

Musclo-skeletal structures
1. Increased adipose tissue.
2. Reduced lean body mass, bone mineral
contents.
3. Reduced height-kyphoscoliosis.
4. Narrowing of inter-vertebral spaces.
5. Reduced collagen formation, muscle
mass.
6. More fibrotic synovial membrane.
7. Osteopenia, osteomalacia, osteoporosis.

Age associated Axial Skeletal

Changes
Head forward: Shifts center of mass
forward; may increase dizziness due to
compromising the basilar artery
(vertebrobasilar system).
Dorsal kyphosis: Reduces trunk motion for
breathing and motor responses;
encourages scapular protraction; may
provoke shoulder pathologies.
Flat lumbar spine: Reduces trunk/hip
extension for gait strides.

 Occasional kyphosis of lumbar spine:

Results from compression of
vertebral bodies; not reversible.
Least commonly increased in lumbar
lordosis: Tightness of lumbar and hip
extensors.
Posterior pelvic tilt: Results from
prolonged sitting; reduces trunk/hip
extension for gait strides.
Scoliosis: May alter balance,
breathing, and extremity motion.

CARDIOVASCULAR CHANGES IN AGING

ARTERIES build up of calcium

and fatty tissue raises blood
pressure and decreases oxygen
and nutrients reaching to the
bodys cells.

HEART grows less efficient as

its valves become thicker and
less elastic.

1. Accumulation of intracellular lipofuschin.

2. Extra cellular amyloid.
3. Increased intracellular collagen,
reduction in left ventricle diastolic
compliance.
4. Patchy fibrosis of conduction system,
reduction in pacemaker cells in SA node.
5. Variable decline in stroke volume. COP,
max HR.
6. Reduced Max O2 consumption.
7. Lateral displacement of apex beat.
8. Aortic rigidity leads to increase in
systolic BP and wide pulse pressure.

9. Calcification of aortic valve cups and mitral ring.

10.Dilated, elongated aorta and stiff vessel walls
due to fragmentation of elastin: after load on
ventricle rises.
11.Smaller heart size.
12.Loss of contractile strength and efficiency.
13.30-35% decrease in cardiac output after the age
of 70 years. Heart valve thickening leads to
incomplete closure gives rise to systolic murmur
14.25% increase in left ventricular wall thickness
between 30-80 years.
15.Fibrous changes in SA node, inter nodal atrial
tracts leads to atrial flutter, atrial fibrillation.
16.35% decrease in coronary artery blood flow
between ages20-60.

17.Reduced strength, elasticity of

blood vessels leads to arterial,
venous insufficiency.
18.Reduced ability to respond to
physical and emotional stress.

CENTRAL NERVOUS SYSTEM

1. Reflex difficult to elicit.
2. Vibration sense lost.
3. Degenerative changes in neurons of
central and peripheral nervous system.
4. Slower nerve transmission.
5. Decrease in number of brain cells by
about 1% per year after 50.
6. Hypothalamus less effective at
regulating body temperature.

7. 20% neuron loss in cerebral cortex.

8. Decreased in stage 3 and 4 of sleep
causing frequent awakenings.
Repeated Eye Movement sleep also
decreased.

RESPIRATORY SYSTEM
1. Reduction of the lung elasticity and chest wall
compliance.
2. Air trapping-rise in residual volume, fall in VC.
3. Reduced area for gas exchange.
4. Poor ventilation of basal areas.
5. Arterial O2 tension (PaO2) falls from 95mm Hg
(12.7kPa) at age 30, to 75mm Hg (10k Pa) at 60.
6. O2 saturation reduced by 5%..
7. Maximum breathing capacity per minute
reduced.

9. Mucocilliary protection of airway reduced.

10.Reduced inspiratory /expiratory muscle
strength.
11.Increased AP diameter BARREL CHEST.
12.Calcification of costal cartilage.
13.Nose enlargement from continued cartilage
growth.
14.Tracheal deviation due to degenerative
changes in spine. i.e. kyphoscoliosis.
15.Reduced diffusing capacity- vital capacity.

 30% reduction in surfectant leads to

respiratory infection and mucus
plugs.

GASTRO INTESTINAL TRACT

Impairment of sense of smell and taste.
Loss of teeth.
Impaired coordination of swallowing and
esophageal peristalsis.
Reduced gastric-acid secretion.
Structural changes-hiatus hernia,
diverticualr disease and gallstones.
Reduced pancreatic function due to duct
& parenchymal changes.

Increased development of diverticula.

Reduced surface area in small bowel.
Reduced large bowel motility.
Decreased mucosal elasticity.
Liver: decrease in weight, regenerative
capacity, blood flow, less efficient metabolism
of drugs & detoxification of drugs.
Diminished mucosal capacity.
Reduced GI secretions, affecting digestion &
absorption.

 Decline in hepatic enzymes involved

in oxidation & reduction, causing less
efficient metabolism of drugs and
detoxification of substances.
Decreased motility, bowel wall &
sphincter tone and abdominal wall
strength.

IMMUNE SYSTEM
Decline beginning at sexual maturity and
continues with age.
Loss of ability to distinguish self/non-self.
Loss of ability to recognise/destroy mutant
cells increase of cancer incidence.
Reduced antibody response-increased
susceptibility to infection, tonsillar
atrophy, lymphadenopathy.
Lymph node, spleen reduced slightly.

 Increased fatty bone marrow-reduced

RBC production.
Reduced B12 absorption, RBC, Hb%,
hematocrit value.

MALE REPRODUCTIVE SYSTEM

Reduced testosterone productionreduced libido.
Atrophy, softening of testis.
48-69% of sperm production reduced
by 60-80 years.
Reduced volume, viscosity of seminal
fluid.
Slower, weaker physiologic reaction
(erection) during intercourse.

FEMALE REPRODUCTIVE
SYSTEM

Atrophy of glandular, supporting, fatty tissue.

More pronounced inflammatory ridges.
Reduced estrogen /progesterone (50 years).
Cessation of ovulation, atrophy, thickening,
reduced size of ovaries.
Loss of pubic hair, flattening of labia majora.
Shrinking of vulval tissue, atrophy, loss of
elasticity.
Thin dry mucus lining, more PH of vaginal
environment.

 Cervical atrophy , failure to produce

mucus for lubrication, thinner
endomyometrium.
Shrinking uterus.

GENITO-URINARY SYSTEM
GFR reduced by 30%-at that age of
65 years.
Blood urea in elderly remain normal.
Impaired ability to concentrate urine
and to process an extra water load
quickly.
This results in increased nocturia in
old.
Renal scarring-46% of normal elderly.
Reduced number of functioning

ENDOCRINE SYSTEM
Low levels of growth hormones cause
global muscle wasting.
Increased insulin due to insulin
resistance-carbohydrate tolerance
diminishes-blood glucose
concentration remains longer.
Artrial natriuretic peptide increases
causing nocturia.

 Secretion of testosterone decreases

in men.

FUNCTIONAL VISION CHANGES IN

AGING EYE
Static visual acuity declines with age due to
miosis or the increased density of the lens.
Dynamic Visual Acuity decreases as the target
velocity is increased.
Contrast senstivity also changes due to neuron
loss within the visual pathway. (no lenticular
changes)
Ability to see colour (colour vision) declines with
age because of the changes in absorption of
light by the occular media such as the lens and
reduction in pupil size.

 Often take longer time to recover

when exposed to a source of glare.
Ability of adaptation to darkness
decline as the age progresses due to
changes in Media (cornea, lens,
vitreous) and Nerve.

MAJOR PATHOLOGICAL CHANGES IN

EYE

Cataracts
Senile macular degeneration
Glaucoma
Diabetic retinopathy (Type-II, Adult
onset)
Visual impairments and blindness

AUDITORY CHANGES
(PRESBYCUSIS)
Calcification of the ossicles.
Inability to distinguish high pitched
consonents.
Atrophy of Organ of corti and
Auditory nerve leads to SENSORY
PRESBYCUSIS.

CAUSES OF HEARING LOSS IN OLD

AGE
Exposure to excessive noise.
Bacterial and viral infections of earaltering the hearing and balance
mechanisms.
Intaking of OTOTOXIC drugs.
Cardiovascular disease,
cerebrovascular accidents, transient
ishemic attacks and atherosclerosisdamage to the auditory structures in
the CNS.

OTHER AUDITORY
CONDITIONS
Tinnitus
Difficulty in understanding spoken
language (loss of hearing sensivity).

HAIR (ageing changes)

Rapid pigment, gray, white hair.
Thinning of hair as number of
melanocytes reduced.
Pubic hair loss resulting from
hormonal changes.
Facial hair increase in
postmenopausal women.
Facial hair decrease in men.

SKIN (changes due to ageing)

Thin, atrophied, dry
skin- decrease in
elasticity.
Urticaria.
Hypo, hyper
pigmentation-brown
spots.
Loss of subcutaneous
fat- increase facial
lines.
Reduced blood supply.

 Reduced number, size, active sweat

glands and output. Dry mucous
membrane.
Results in difficulty in regulating body
temperature.
50% reduction in cell replacementdelayed wound healing.

CLASSICAL SIGNS OF AGING

Confusion and amnesia

Dementia
Depression
Insomnia
Falls & gait disorders
Dizziness & vertigo
Osteoporosis
Less calorie intake
Constipation
Loss of vision
Hearing loss
Dehydration
Infections

CONFUSION & AMNESIA

Confusion is mainly associated with
DELIRIUM & DEMENTIA.
Drugs like SEDETIVES, ANALGESICS,
HISTAMINE BLOCKERS, INCONTINENCE
AGENTS, ANTI PSYCHOTIC & ANTI
ARRHYTHMIC DRUGS cause confusion in
elderly people.
Depressive disorders, dementing illness
and effects of drugs and alcohol account
for memory problems in elderly people.

DEMENTIA
It is the clinical syndrome of at least
6 months of chronic and progressive
impairments in 2 or more domains of
cognitive function in the absence of
delirium or a psychiatric or medical
illness that cause cognitive illness.
This syndrome includes impairment
of orientation, memory,
comprehension, calculation, learning
capacity and judgment.

 Senile dementia classified into

1. PRIMARY DEMENTIA (associated with
Alzheimer's disease & Parkinsons
disease)
2. SECONDARY DEMENTIA(Multi infract
dementia, alcohol induced, dementia
due to metabolic disturbances, due to
space occupying lesions, depressive
disorders and pressure hydrocephalus)

DEPRESSION
Depressive disorder in older people, like those
of younger adults, can occur without obvious
causes or precipitants.
Late-life depression occurs in the context of
medical illness, psychological stress, and loss.
It can be disabling, interfering with social,
instrumental or self -care activities.
Depression diagnosed mainly in patients with
Parkinsonism, stroke, cancer, arthritis, COPD &
ischemic heart disease.

INSOMNIA
The sleep of older adults is characterized by
decrease in stage III/IV sleep, possibly the most
restful stage of sleep.
The elderly have more frequent nocturnal arousals
(awakenings) and their sleep efficiency (total time
asleep/total time in bed) is decreased.
Patient with Alzheimers disease have a decrease
in rapid eye movement sleep, a significant
increase in nocturnal awakening, causing an
intellectual decline.
Cause: internal clock at suprachiasmatic nucleus is
phase advanced relative to younger subjects and
may possibly have weaker amplitude.

FALLS
Fall is when a person unintentionally
comes to rest on the floor or at a
lower level than before.
It is common in old age but should
not be viewed as normal.
Causes: (i)intrinsic factors,
(ii)extrinsic factors

GAIT DISORDERS
Gait velocity is usually maintained until the
seventh decade.
Alterations in speed, symmetry, and
smoothness are among the indicators for
gait disorders.
Inactive community-dwelling older adults
are generally 15% slower than active elders.
Factors that alter gait efficiency include
decreases in lower extremity ROM, muscle
strength and endurance.

DIZZINESS & VERTIGO

Dizziness is a common and often
complicated in geriatric age groups.
Subtypes: Vertigo, Presyncopal
lightheadedness & Dysequilibrium
Vertigo: Sense of rotational
movement and spinning, suggests
vestibular pathology.

 Presyncopal lightheadedness: An impeding

faint and is due to cerebral hypoperfusion.
Dysequlibrium: feeling of imbalance and
unsteadiness of body, not of head, which
may be the pathology of motor control
system(visual, vestibulospinal,
proprioceptive, somatosensory, cerebellar,
motor) and vestibular system (inner ear,
middle ear, brainstem, cerebellum).
A vague or floating feeling much of the time
is felt. Causes: Psychological reason,
change in vision as with cataract removal.

OSTEOPOROSIS
It is a systemic disease characterized by
low bone mass and micro architectural
detoriation of bone tissue, with a
consequent increase in bone fragility and
susceptibility to fracture.
By age of 40 years there s a slow decline
in bone mass in both men and women.
Estrogen deficiency accelerates the rate
of bone loss.

 Aging alters the tight coupling

between bone resorption and
formation.
It is associated with a great deal of
functional loss as well as skeletal
deformities, pain, dependence &
depression.
Vertebral fractures occur more
frequently than hip fracture.

LESS CALORIE INTAKE

Protein energy malnutrition is the chief
nutritional problem associated with aging.
Elderly individuals commonly consume
less than 2/3rd of the recommended daily
allowance (RDA) for multiple nutrients.
Less calorie intake is the combined effect
of accumulated illness, medications and
social circumstances.

 Causes of calorie intake:

I. The senses of smell diminish, thus
rendering foods less palatable.
II. Illness and medications may suppress
the appetite or impair the absorption of
nutrients.
III. Senile functional problems making it
difficult to proper access to food or to
prepare food properly.
IV. Social factors like less income, social
isolation and depression , that impair
their ability to obtain food or their desire
t consume it.

CONSTIPATION
From a medical prospective: it is defined as
a frequency off less than 3 bowel
movements a week.
From an individuals prospective: it can
mean that stools are difficult to expel, too
hard, or too small, or there may be the
sensation of incomplete evacuation or
bloating.
The frequency of bowel movements in
healthy older populations is essentially the
same as it is in the younger population
despite use of laxatives are common.

 Causes of constipation in old age

1. Dietary: poor dentition, inadequate calorie
intake, low fiber diet, swallowing problems.
2. Psychological: depression, emotional stress
3. Functional :Poor bowel habits,
immobility/lack of exercise, inadequate
toileting, weakness
4. Colonic/ anorectal disorders
5. Neurogenic disorders
6. Endocrine / metabolic disorders
7. Drugs: antacids (aluminum, calcium),
anticonvulsants, antidepressants,
antihypertensive, iron supplements, misuse
of laxatives.

DEHYDRATION
Dehydration is the significant cause of mortality
in the elderly.
The total body water of elderly adults is lower
because they have a higher percentage of fat
than younger adults.
Causes of dehydration in elderly people:
a. Functional deficits that hinder to access to water.
b. Less intracellular reserve of fluid.
c. Reduction in the action of a number of hormones
respond to dehydration.
d. Impaired central thirst mechanism.
e. Certain medications causing dehydration

INCONTINENCE

Incontinence represents a failure of the physical and

mental processes that allow a person to hold their
urine and empty their bladder at an appropriate time.
Causes of acute incontinence: (DRIP)
Delirium: temporarily unaware of the urge to void or
can not communicate the need to use the bathroom.
Restricted mobility: any conditions like trauma, stroke
may restrict the mobility may cause incontinence.
Sometimes it is regarded as functional incontinence.
Infection, Inflammation or Impaction
Pharmaceuticals: Diuretics are the common drugs.
Other drugs are narcotics, anticholinergics etc.

 Chronic UI:
1. Stress Incontinence: leakage of urine with
any increase in the abdominal pressure.
(during coughing, laughing, sneezing,
lifting the heavy weight)
2. Urge Incontinence: loss of urine after an
uncontrollable desire to void. It is due to
the detrusor instability.
3. Overflow incontinence: leakage of urine
from a distended bladder
4. Functional incontinence: loss of function
due to inability to move to the toilet,
undress and coordinate movements
required for normal toileting.

Activities
of Aging

Self
The capacityCare
to do something useful for

yourself and for others is key to

personhood, whether it involves the ability
to earn a living, cook a meal, put on the
shoes in the morning, or whatever other
skill needs to be mastered at the moment.

-MARY CATHERINE BATESON, Enfolded

activity and the concept of occupation,
1996, page-11

 Self-care is daily activity comprising

duties and chores ranging from
personal care (e.g. bathing, dressing,
grooming) to personal business (e.g.
using the telephone, managing the
medications, banking, shopping for
food).

Practical Importance of SelfCare

Importance of self care for social
relationship.
Importance of self-care for self
identity.
Importance of self-care for
psychological wellbeing
The ability to perform self care
activities promotes better general
health, adequate personal hygiene,
sanitation protects the individual

FUNCTIONAL LIMITATIONS
INFLUENCING SELF CARE

Cerebrovascular disease
Joint inflammation and diseases
Vision problem
Hearing
Taste and Smell
Cognition

Work & Retirement

Retire? Are you kidding? Im
having the time of my life. What
would I do, go finishing? Fish
dont applaud, do they?
BOB HOPE, from DAVID MELTON,
Images of Greatness, Independence Press,
Independence, MO, 1977, p20

WORK

Unique issues for working elderly people

Early retirement issues
Staffing shortages
Career patterns
Training and retraining
Performance
Productivity
Health and Disability

Factors affecting Work

capacity

Poor Health Condition

Poor Functional Capacity
Poor Psychological condition
Disability

Retirement
Retirement comes with lots of free
times and decrease in income.
Retirement is not necessarily a
complete withdrawal from the
workplace, although the likelihood of
reentry decreases with age.

Leisure in old age

Generally, Leisure can be defined in three ways
as:
Discretionary time, that is, time not obligated to
work, self-care, or instrumental activity (e.g.
shopping, child care)
Culturally sanctioned activity, that is, an activity
readily recognized as leisure (e.g. fishing, golfing)
An experience, that is, the perception that leisure
activities are intrinsically motivated and freely
chosen, and allow one to disengage from some of
the concerns of real life.

Benefits of leisure

Just for the pleasure

Welcome change from the work
New experience
Contact with friends
Chance to achieve something
Make time pass
Allows creativity
Benefit to society
Helps financially
Promotes self-respect
Give me more standing with others
Makes me popular

Successful
Aging

Successful aging is
multidimensional,
encompassing the
avoidance of disease and
disability, the maintenance
of high physical and
cognitive function, and
sustained engagement in
social and productive

Genetics of successful aging

Several researches showed that,
SUCCESSFUL AGING has some
genetic impacts.
Specifically, genes such as APOE,
GSTT1, IL6, IL10, PON1, and SIRT3
may to have individual effects on the
likelihood of aging successfully.

 Additionally, the genes contributing to

successful aging can be grouped in several
main categories (ontologies):
Genes involved in the maintenance of
cholesterol, lipid or lipoprotein levels. Their
ability to metabolize and transport molecules
such as cholesterol relates to cardiovascular
health, which could directly influence
physical activity levels and longevity.
Genes related to cytokines, which influence
inflammation and immune responses. These
genes could influence successful aging by
regulating cellular senescence, determining
susceptibility to age-related cancers, or
other mechanisms.

Genes involved in drug metabolism

and insulin signaling.
Genes related to age-associated
pathological processes (e.g.,
Alzheimers disease.)
Recently, successful aging has been
also linked to expression levels of
genes and length of chromosomal
telomeres.

Aging-associated Wisdom
It has been found that mental and psychosocial
functioning often improve with age, even if physical
health, and some elements of memory decline.
Age-related wisdom might serve to compensate for the
biological losses in old age, thereby enabling older
adults to better utilize their remaining resources and
age successfully.
Age-associated wisdom may help to overcome the
negative effects of diseases and stressors that are
common in late life and lead to improved mental health
and psychosocial functioning.
Neurological research has demonstrated that brain
growth and development continue into old age the
concept known as neuroplasticity of aging.

Successful aging and recent

trends
As successful aging tends to be more
dependent on behavior, attitude and
environment than to the hereditary traits,
researchers and clinicians are developing
strategies to enhance aging well.
Current strategies include restricting
calories intake, exercising, quitting
smoking and substance use, obtaining
appropriate health care, and eating
healthy.

 Seeking help for mental illnesses

such as depression is critical, as
these conditions interfere with nearly
all determinants of successful aging.
Additionally, it is considered
important to develop cognitive and
psychological strategies such as
positive attitude, resilience, and
reducing stress.

REFERENCE
Text book of geriatrics-Nicholas Coni & Stephen
Webster.
Geriatric Secretes (3rd Edition)-Mary Ann Forcia, Edna P.
Schwab, Donna Brady Raziano, Risa Lavizzo.
Geriatric Rehabilitation Manual-Timothy L. Kauffman
Functional Performance in Older Adults (2nd Edition)Bette R. Bonder, Marilyn B. Wagner
Biology of Aging (Research Today for Healthier
Tomorrow)-National Institute on Aging, National Institute
of Health, U.S. Department of Health & Human Services.
Principles of Geriatric Physiotherapy, Narinder Kaur
Multani, Satish Kumar Verma
World Wide Web

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