TY  - CHAP
M1  - Book, Section
TI  - Geriatric Assessment and Pharmacotherapy
A1  - Schwinghammer, Terry L.
A1  - DiPiro, Joseph T.
A1  - Ellingrod, Vicki L.
A1  - DiPiro, Cecily V.
PY  - 2021
T2  - Pharmacotherapy Handbook, 11e
AB  - Table  Graphic  Jump  LocationTABLE  A2-1Physiologic  Changes  with  AgingView  Table||Download  (.pdf)TABLE  A2-1Physiologic  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↑  Afterload↓  Coronary  perfusionCentral  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,  thyroid-stimulating  hormone,  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↓  Glomerular  filtration  rate↓  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  due  to  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  due  to  more  hairs  in  the  restingphase  and  shortening  of  the  growth  phase  as  well  as  changes  in  follicular  melanocytesSource:  Data  from  Cefalu  CA.  Theories  and  mechanisms  of  aging.  Clin  Geriatr  Med.  2011;27:491–506;  Alvis  BD,  Hughes  CG.  Physiology  considerations  in  geriatric  patients.  Anesthesiol  Clin.  2015;33:447–456.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1178899252
ER  -