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Effects of Aging on Mobility and Independence Anthony Poggio, DPM,MS Cal ‘ 79.

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Presentation on theme: "Effects of Aging on Mobility and Independence Anthony Poggio, DPM,MS Cal ‘ 79."— Presentation transcript:

1 Effects of Aging on Mobility and Independence Anthony Poggio, DPM,MS Cal ‘ 79

2 Affects of Aging Muscle Tendon Bone Skin Neurology Vascular Psych

3 Muscle/Tendon Support Skeletal system; Posture Facilitate motion Heat Production Weakness Contracture Gait changes decrease in energy supply (ATP, creatine phosphate and glycogen decreased circulation to bring in O2 and clear lactic acid Changes at the motor end plate, therefore decrease in stimulation potential

4 Muscle/Tendon Changes at the motor end plate, Sarcolemma are fewer, shorter, become smoother decrease in surface area therefore decrease in stimulation potential

5 Muscle/Tendon reduction in size and number of mitochondria hence decrease in available energy decrease in substances to supply energy (ATP, creatine phosphate and glycogen)

6 Muscle/Tendon Decreased circulation to bring in O2 and nutrients breakdown of other substances creating build up of lactic acid

7 Muscle/tendon Increase in fat/fibrinous tissue within muscle decreased ability or muscle repair increased scar tissue therefore there is slower, weaker, irregular contraction with longer recovery period

8 Bone skeletal structure Attachment for muscle, tendons. ligaments, etc Blood cell production Osteoporosis Osteopenia fracture, hip delayed healing

9 Bone Cortical bone: –Dense packed bone, very compact and hard –forms outer shell of bone Trabecular bone: –loosely packed matrix, “spongy” –head and base of long bones –majority of irregular bones

10 Joint Arthritis –Joint Stiffness –loss of cartilage –loss of joint contour –angular deformities Synovial membrane less elastic as are adjacent ligament structure with less movement- joint (ligaments) contract to position Hyaline vs fibrocartilage

11 Joints Loss of hyaline cartilage decreased water content with increased calcium salts, crosslinking of fibers therefore more stiff and less elastic can reform fibrocartilage

12 Joints Synovial fluid decreased in volume secondary to decreased blood flow, Synovial membrane less elastic as are adjacent ligament structure with less movement-joint (ligaments) contract to position



15 Skin Provides barrier –organisms, – chemicals, –water, – light, – trauma

16 E Epidermis PIDERMIS With aging less able to keep out substances; chemicals, microorganisms athletes foot, fissures ROLE: Provides Protective Covering & Generates New Cell Growth

17 D Dermis ERMIS Major Structures: Blood Vessels, Nerve Endings, Hair Follicles, & Sebaceous Glands that secrete sebum to prevent skin from drying out With aging less h20 more crosslinking of collagen therefore thinner and less elastic- fissures ROLE: Provide the Skin with Strength & Elasticity

18 With aging –decreased fat: decreased cushion, callous/corns –less skin support: increased sheer force ***Typically the subcutaneous tissue is poorly vascularized. Subcutaneous tissue UTANEOUS TISSUE ROLE: Provides protection & insulation for the underlying tissue

19 Skin Decubitus ulcers-bed sore –weaker skin –thinner skin –decreased blood supply –skin hygiene –poor nutrition –decreased ability to repair

20 COMMON LOCATIONS Bony Prominences Occiput Scapulae Elbows Sacrum Trochanter Ischium Knees Ankles Heels

21 Annual US healthcare costs are over $1.3 billion Average cost per ulcer = $27,000 Quality of life issues Increased length of stay Tissue and bone infections COSTS OF PRESSURE ULCERS

22 Pressure ulcers occur in 11% of all hospital admissions Pressure ulcers occur in over 25% of long term care residents Certain patient groups have even higher groups have even higher incidences - 66% of femoral fracture patients, 60% of quadriplegic patients PRESSURE ULCERS

23 DEFINITION OF A PRESSURE ULCER Localized area of tissue breakdown resulting from compression of soft tissue between a bony prominence and an external surface



26 SKIN BREAKDOWN: DIABETIC ULCERS Skin breakdown due to loss of sensation coupled with repetitive pressure and shear

27 Vascular Peripheral arterial disease venous disease diminished healing ability, defense micro-circulation to muscle, nerves, etc amputation Function: Transportation



30 Venous disease Return blood to heart slower blood flow-clot formation venous stasis dermatitis- skin damage

31 Capillaries have thin, single-cell thickness walls Venous hypertension causes capillary walls to stretch, creating gaps between cells CAPILLARY HYPERTENSION

32 Neurology Function –monitoring, –communicating –stimulation –coordination

33 Neurologic Nerve Loss –sensory –motor Coordination reflexes

34 Neurology Sensory –requires more stimuli to elicit response –awareness of position reflexes Somatic –decreased transmission speed down axon resulting in slower and weaker contraction ability –prolonged refractory period before next contraction –less coordinated motion


36 Misc Vision –obstacle cardiac pulmonary –stamina

37 Putting it all together

38 Psychological Factors Loss of independence –fear of losing independence –rely on family/friends for simply tasks –must be done at their convenience –isolation

39 Psychological Factors Assistive devices –realization they are old –embarrassment in public –limitation in activities

40 Psychological Factors Self Care –inability to bend to reach items –open bottles, apply dressing

41 Psychological Factors Fear of Falling Decreased stamina Cycle of decreased activity –more stiffness –decreased vasc supply and overall health –less coordination –increased isolation –depression

42 Prevention/Treatment In home support vs nursing home improvement in function –physical therapy, medication Age related or not?? Social agencies –paratransit, special equipment (scooters)

43 Prevention/Treatment Put in perspective Enlist family support active participation-feel in control speak to them, not down to them patience

44 THANK YOU! Good Luck in Your Future Careers GO BEARS!!!

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