Geriatrics by Khuyen Nguyen

Hypertension and stroke

tt209vn — 2017-11-20 17:46:09 UTC

-Causes: age, increased intake of salt, alcohol use, lack of physical activity and obesity, medications. Other diseases can cause secondary hypertension.
-Optimal pressure: <120/80
-Target pressure: <140/90
-Prevention: lifestyle changes: loosing weights, quiting smoking, <5g of salt intake, exercises.
-Stroke: blockages in the cerebral arteries, intracranial haemorrhages or subarachnoid haemorrhages.
-Hypertension is one of the main factors predisposing patients to strokes.
-Possible symptoms include the insufficient functioning of the limbs either on one or both sides of the body; losses or disturbances in tactility; and problems with the production of speech.
-When suspecting a stroke, a simple and fast way of checking the patient’s condition is asking them to tell their own name, lifting both their hands up and making a facial gesture.
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Geriatric infection

tt209vn — 2017-11-20 17:46:30 UTC

-Aging causes tissue diminishment which leads to weaker response to vaccines and an increased infection and cancer risk.
-Pneumonia is a fatal infection in elderly. Risks: deterioration of the immune system and the lungs, malnutrition, comorbid diseases, bad physical functioning and swallowing problems. Symptoms include cough, shortness of breath and fever. Treatment is by antibiotics either orally or intravenously.
-Influenza is a significant cause of death among the elderly population. Symptoms are a quickly developing fever, shivering, muscle pains, head ache and a loss of strength. Treatment by viral drugs like zanamivirin and oseltamivir and prevented by vaccines.
-Urinary tract infection is mostly caused by E.Coli virus. Symptoms differ according to the severity of the disease such as increased need to urinate, pain and stinging when urinating, fever and sensitivity to palpation at the location of the urinary bladder.

Geriatric depression

tt209vn — 2017-11-20 17:46:37 UTC

-Risk factors: the structural changes of the nervous system caused by old age and the decrease in the amount of neurotransmitters. Some diseases can cause depression such as hyroidal diseases; adrenal gland diseases; parathyroid gland diseases; diabetes and anaemia. Loneliness, deterioration of physical functioning and the loss of loved ones are all factors that predispose people to depression
-Symptoms: decreased mood; the loss of activity; the loss of interest; the loss of pleasure; feelings of worthlessness; self-destructive behaviour; memory problems; the loss of initiative; the loss of appetite and weight; crying; irritation; self-blame and insomnia.
-Diagnosis: interview and observation
-Treatment: The patient’s social safety network plays a large role. Medicinal treatment is done primarily by SSRI and SNRI drugs.

Memory disorder

tt209vn — 2017-11-20 17:46:54 UTC

-Symptoms: disruptions in memory, logical thinking and functional capacity, aphasia, agnosia.
-Diagnosis: MMSE, CERAD, lab tests, brain CT and MRI.
-Alzheimer: the most common progressive memory disease causing dementia. Risk factors are aging, allele of the ApoE-gene, cholesterol, hypertension and diabetes. Alzheimer develops slowly and when Alzheimer occurs for 4-6 years, patients start to develop a stooped posture and walks with short steps. Stiffness, slowness and the loss of facial expression are other symptoms.On average, after 5-8 years from the onset of the symptoms, the patients lose their walking ability and the patient will be bedridden unless regular walking exercises, stretching and the maintenance of mobility are taken care of.
-Lewy body dementia represents about 15% of all dementia cases. Unlike Alzheimer’s disease, Lewy body dementia does not significantly affect the patients learning abilities or short-term memory, whereas, the decrease in motor functions is more significant than in Alzheimer’s disease.
- 15% suffer from vascular dementia, which is caused by blockages of the small and large arteries of the brain.