LECTURE ON the SUBJECT Gerontology and general geriatrics

LECTURE ON the SUBJECT: "Gerontology and general geriatrics" Senior lecturer S. I. Sadikova

Aging of the person is a physiological, destructive process accruing with age which develops at all levels of the human organization, as a result of damaging action of the exogenous and endogenous factors conducting to restriction of adaptive opportunities of an organism and increase in probability of death.

Aging divide on: The physiological The pathological

Process of aging divide on: • geterohrom • geterotrophy • geterokinetics

Geterohrom Distinction in time of approach of aging of various bodies and fabrics

Geterotrophy Expressiveness of process of aging isn't identical to different bodies and for different structures of the same body

Geterokinetics Various speed of development of age changes of an organism.

Old age - naturally coming final period of age development

• • • Borders of elderly age - 60 -74 years Than senile age - 75 also is more senior The longevity - is more than 90 years

The subject studying process of aging – gerontology

Aspects of gerontology the medical the sociological the economic the behavioural the ecological

Geriatrics Studies human health of advanced and senile age Consists of the following aspects: • The preventive • The clinical • The medical • The rehabilitation • The dispensary

Homogeneous groups of the senior generation Young elderly-55 -64 let The elderly - 65 -74 years Old elderly-75 -84 years And very elderly 85 years and above

Age changes of respiratory organs The bone and muscular device of a thorax grows old There is a thorax deformation Mobility of a thorax decreases Pulmonary ventilation decreases The gleam of bronchial tubes decreases The epithelium of the mucous will atrophy The reflex decreases cough Will be broken drainage function of lungs Elasticity of pulmonary fabric is lost Vital capacity of lungs decreases The residual volume of lungs increases

Respiratory insufficiency Proceeds more hard in combination with HLS Gipoksemiya and giperkapniya Violation of KSS (acidosis) The residual volume of lungs increases There is an irreversible obstruction of bronchial tubes The attitude of alveolar ventilation towards the general is lowered Overflow of cervical veins Increase in a liver Hypostases on anklebones and a shin Symptomatic stomach ulcers

Age changes of bodies by CCC Sclerous defeats of vessels of heart, small and large vessels Sokratitelny ability of a myocardium decreases Reserve and adaptation opportunities of CCC decrease There comes dystrophy of muscular fibers with an atrophy and replacement with their connecting fabric Arterial pressure increases, and venous pressure decreases Elasticity of walls of large vessels decreases

Coronary heart disease Stenocardia Adverse meteorological factors, physical overstrain, rough emotions, plentiful food, intestines swelling can cause attacks Unstable forms of stenocardia are often observed Pain behind a breast less intensive Irradiation of pain it is frequent in a nape, a neck, a jaw Often the attack begins with short wind or arrhythmia

Myocardial infarction The reason is formation of atherosclerotic plaques, hyper coagulation with aggregation of platelets, emotional overloads, violation of a fatty exchange, violation of a warm rhythm The disease beginning atypical – gastralgical, peripheral, asthmatic, arhythmic, cerebral forms

Myocardial infarction The disease is accompanied by dynamic violations of brain blood circulation Frequent complications – cardiogenic shock, a tromboemboliya of a pulmonary artery, hypostasis of lungs, a rupture of aneurism of heart, development of insufficiency of blood circulation

Myocardial infarction Changes on an electrocardiogram often are absent the first days Activity of enzymes the insignificant At treatment it is necessary to consider features of a growing old organism in which fast medicamentous intoxication (it is impossible to apply streptokinase, antagonists of calcium) develops Rehabilitation long, careful, includes all types of rehabilitation

Hypertensive illness Criterion of hypertensia at advanced and senile age by definition of Committee of WHO experts it when the GARDEN equally or exceeds 160 mm hg, or diastolic pressure equally or exceeds 95 mm Hg which is registered at three measurements, in situation sitting, executed three times with an interval in some days.

Features of a current of GB Clinic poor, m. dizziness, loss of balance, dream and memory violation, ring in ears or asymptomatic. Sometimes establish casually Hypertensive crises rare, especially sympathyadrenal type

Features of a current of GB Often kardial crises being accompanied sharp left ventricular insufficiency meet. Cerebral ischemic option of crisis Frequent heavy complications – cardiac asthma, hypostasis of lungs, violation of brain blood circulation, ischemia of mezenteralny arteries Treatment individual

Age changes of bodies of system of digestion Reduction of volume of a mouth Change of salivary glands, decrease in production of a saliva Atrophy of mimic and chewing muscles Bite violation consequence of an atrophy of the top jaw Nibble and chewing violations There is an atrophy mucous a stomach owing to what sekretorny fermentativny activity decreases Motor function of a stomach is slowed down

Age changes of bodies of system of digestion Functional activity of a liver decreases Level of bilirubin decreases and cholesterol level raises The gall bladder increases in volume at the expense of lengthening, decrease in a tone of muscles of a wall of a bubble In a pancreas atrophic processes and weight it develop activity of juice decreases, decreases The motility of a small and thick intestine decreases, the structure of microflora of intestines changes

Stomach ulcer The ulcer in a stomach meets 2 times more often than an ulcer 12 finger guts Frequent localizations of an ulcer at elderly on small curvature and a forward wall of a stomach The pain syndrome atypical, without a certain localization, is more often than pain stupid, aching, have accruing character, can be scramble, cutting, drilling Heavy current Aggravations more frequent, long, persistent Size and depth of ulcer defect big, scarring slow Frequent complications at the elderly – bleeding, a malignization

Lock Chair delay more than 48 hours "disheziya" – violation of the act of a defekation "konstipation" – a chair delay "dyskinesia" – violation of motor function atonicheskiya

Locks can be The alimentary - at the use of the low-slag refined food The Nevrogenny – strong emotions, a mental depression The hypodynamic – a confinement to bed The Proktogenny – hemorrhoids, anal cracks, intestines tumors The medicamentous – ganglioblokator, holinolitiks, sedative, tranquilizers, antatids, diuretic The endocrine – mixedema, a climax, diabetes At violation of a water and electrolytic exchange – the Tax Code, HPN, ascites, holestaz

Age changes of bodies of an urinary system Atrophy and sklerozining of nefrons Decrease in weight of kidneys Decrease in a blood-groove of kidneys Decrease in a glomerular filtration Kidney lokhanka and mochetochnik are exposed to atrophic changes The bladder tensile properties decrease

Pyelonephritis The often secondary – obturatsionny At advanced age men are ill more often Current latent, malosimptomny, under a sharp current Reasons urolithic illness, adenoma and cancer of a prostate gland, cancer of a bladder It is combined with other renal pathology: Nefrosklerozy, diabetic nephropathy The serous inflammation quickly passes in purulent that leads to a lethal outcome, owing to urosepsis and septitsemiya

Cytomedines – peptide bioregulators Possess geroprotektive action, restore normal activity of cages of a complete organism when aging. It is developed 22 medicines united in 6 classes. Raw materials for receiving polypeptides are fabrics of cattle of young age.

Cytomedines – peptide bioregulators Timalin and timogen. Raw materials vilochkovy gland Korteksin. Raw materials cerebral cortex Vazolin. Raw materials vessels Kordialin. Raw materials heart Gemalin. Raw materials red marrow Retilin. Raw materials eye retina Kristalin. Raw materials eye crystalline lens Kutilin. Raw materials skin Pankreolin. Raw materials pancreas

Atherosclerosis prevention Klofibrat (atromidin, mickleron, lipamid) on 500 mg 3 times a day Nicotinic acid (RR vitamin, B 3 vitamin) on 200 mg 3 times a day Holestiramin (questran) on 4 gr to food 3 times a day Probucol on 500 mg 2 times in day Lovastatin (a mevakor, a mefakor) on 40 mg in the evening

Thanks for attention!