TY - CHAP M1 - Book, Section TI - Geriatrics A1 - Wells, Barbara G. A1 - DiPiro, Joseph T. A1 - Schwinghammer, Terry L. A1 - DiPiro, Cecily V. PY - 2017 T2 - Pharmacotherapy Quick Guide AB - Table Graphic Jump Location|Download (.pdf)|PrintTABLE A2–1: Physiologic Changes with AgingOrgan SystemManifestationBalance and gait↓ Stride length and slower gait↓ Arm swing↑ Body sway when standingBody composition↓ Total body water↓ Lean body mass↑ Body fat↔ or ↓ Serum albumin↑ α1-Acid glycoprotein (↔ or ↑ by several disease states)Cardiovascular↓ Cardiovascular response to stress↓ Baroreceptor activity leading to ↑ orthostatic hypotension↓ Cardiac output↑ Systemic vascular resistance with loss of arterial elasticity and dysfunction of systems maintaining vascular tone↓ Resting and maximal heart rateCentral nervous system↓ Size of the hippocampus and frontal and temporal lobes↓ Number of receptors of all types and ↑ sensitivity of remaining receptors↓ Short-term memory, coding and retrieval, and executive functionAltered sleep patternsEndocrine↓ Estrogen, testosterone, TSH, and DHEA-S levelsAltered insulin signalingGastrointestinal↓ Motility of the large intestine↓ Vitamin absorption by active transport mechanisms↓ Splanchnic blood flow↓ Bowel surface areaGenitourinaryAtrophy of the vagina with decreased estrogenProstatic hypertrophy with androgenic hormonal changesDetrusor hyperactivity may predispose to incontinenceHepatic↓ Hepatic size↓ Hepatic blood flow↓ Phase I (oxidation, reduction, hydrolysis) metabolismImmune↓ Antibody production in response to antigen↑ AutoimmunityOralAltered dentition↓ Ability to taste salt, bitter, sweet, and sourPulmonary↓ Respiratory muscle strength↓ Chest wall compliance↓ Arterial oxygenation and impaired carbon dioxide elimination↓ Vital capacity↓ Maximal breathing capacity↑ Residual volumeRenal↓ GFR↓ Renal blood flow↓ Filtration fraction↓ Tubular secretory function↓ Renal massSensoryPresbyopia (diminished ability to focus on near objects)↓ Night visionPresbycusis (high-pitch, high-frequency hearing loss)↓ Sensation of smell and tasteSkeletal↓ Skeletal bone mass (osteopenia)Joint stiffening caused by reduced water content in tendons, ligaments, and cartilageSkin/hairThinning of stratum corneum↓ Langerhans cells, melanocytes, and mast cells↓ Depth and extent of the subcutaneous fat layerThinning and graying of hair caused by more hairs in the resting phase and shortening of the growth phase as well as changes in follicular melanocytes(DHEA-S, dehydroepiandrosterone-S; GFR, glomerular filtration rate; TSH, thyroid-stimulating hormone.) SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1144733266 ER -