CHRONIC ILLNESS AND AGING CHRONIC ILLNESS A longlasting

CHRONIC ILLNESS AND AGING

CHRONIC ILLNESS: • A long-lasting illness (in contrast to ACUTE illness, which is temporary) • Most common in older adults Heart disease – Cancer – Cerebrovascular disease (stroke) –

HEART DISEASE: • Principal cause of death among o. a. ’s • Accounts for significant morbidity, disablement & inactivity among o. a. ’s • Dominant factor--atherosclerosis (build-up of fatty deposits within arterial walls)

Mechanism: • Atherosclerotic buildup------> • Narrowing of arteries supplying blood to the heart-----> • ISCHEMIA (denial of adequate blood supply)

• Ischemic heart disease also known as: coronary heart disease (CHD) – coronary artery disease – A common form: myocardial infarction (heart attack) – persistence of deficient blood supply, tissue dies. Dead area: an infarct –

Heart attack may also result from: • Cardiac arrest-- some interruption of normal pattern of cardiac contraction • Coronary thrombosis--sudden blockage of coronary artery with a blood clot • Strenuous exercise resulting in suddenly increased need for O 2

Mortality associated with MI: • Over 70 --2 x that under age 70 • Symptoms of MI may differ in older people than in younger ones

• “…while complete absence of chest pain is very rare in acute myocardial infarction up to middle age, it is a ‘mundane occurrence’ in old people” • “…only about 1/3 of elderly patients present with a classical prolonged episode of chest pain”. (Kart & Kinney, p. 111)

Heart Disease: Modifiable Risk Factors: • Cigarette smokers 2 x MI rate of nonsmokers • High BP • High serum cholesterol levels • Diabetes • Obesity • Sedentary lifestyle

Healthy People 2000 goals: • 1. Increase prop. Of people whose high BP is under control • 2. Reduce mean-serum cholesterol levels • 3. Reduce dietary fat intake & average unsaturated fat intake • 4. Reduce prevalence rates of obese/oveweight adults

• 5. Increase proportion of children & adults engaging in regular, daily physical activity at least 30 min/day • 6. Reduce cigarette smoking among people age 20 and older • http: //www. health. gov/healthypeople

CANCER • 2 nd leading cause of death in U. S. • Incidence increases with age--Why? Most forms of cancer have a long latent period; initiating factors start during youth – increasing age and accompanying physiological changes make one more susceptible to actions of carcinogens –

CA, cont’d • …onset and management of many cancers do not vary greatly in the old and young. Prevention is still the order of the day regarding cancer. ” p. 113. • This includes:

• 1. Avoiding unnecessary exposure to ionizing & ultraviolet radiation • 2. Implementing hygienic measures in occupations involving exposure to CAproducing chemicals & dusts • 3. Avoiding exposure to tobacco & cigarette smoke • 4. Have periodic preventive medical exams.

CEREBROVASCULAR DISEASE • Results from: changes in blood vessels that serve the brain tissue – cerebral infarction – cerebral hemorrhage –

• When a portion of the brain is completely denied blood, a cerebrovascular accident (CVA), or stroke results • Severity is determined by location and total amount of brain tissue involved

• After diseases of the heart, malignant neoplasms, & accidents, cerebrovascular disease is the fourth -leading cause of death in the U. S.

Cerbral Thrombosis • Main cause of stroke in o. a. ’s • Occurs when a formed clot becomes lodges in an already narrowed artery.

• Stroke in evolution: May develop over hours or even days – Symptoms can appear within minutes or hours after onset –

Transient ischemic attacks (TIA’S)--”mini-strokes” • Warning signs of an impending stroke • Transitory symptoms: – – – sudden motor weakness speech dysfunction dizziness sudden changes in vision (especially in one eye) sudden falls

Cerbral Embolism: Another cause of strokes • Thrombus forms elsewhere in the body and travels to obstruct a vessel supplying the brain • The onset of the stroke and its damage is immediate

Damage from Strokes • • One-sided weakness or paralysis Sensory disturbances Aphasia (speech disorders) Mental symptoms • Rehab should begin immediately

APHASIA • Impaired ability to comprehend or express verbal language • Receptive aphasia: difficulty in processing external stimuli; – may not understand other’s speech or what is read – familiar objects may become unrecognizable –

• Expressive aphasia – A person understands what is said but cannot form the words or gestures to respond to stimuli – May be incorrectly associated with mental deterioration