CORNELL NOTE

Topik Pembelajaran: AGING PROCESS - It's impact on body system

Date : 30th September 2013

Name : DHININTYA HYTA NARISSI

NIM : 10/298372/KG/8650

1. Tugas / pertanyaan : Catat dan cermati permasalahan yang seringkali muncul pada lansia !

Problems :

1. Age related macula degeneration

2. Cancer

3. Cataract

4. Cholera

5. Cronic Obstructive Airway Disease

6. Colorectal Cancer

7. Constipation

8. Coping with Anxiety

9. Coronary Heart Disease

10. Dementia

11. Depression

12. Diabetes Mellitus

13. Dyspepsia

14. Frozen Shoulder

15. Gout

Explanation :

1. Macula is located at the center of the retina. It is full of photoreceptors and is responsible for detailed central vision

and color discrimination. Age-related macular degeneration is a progressive disease of the macular that is related to

aging.

2. Cancer is the unlimited growth of abnormal cells, which can spread to different parts of the body. It can affect the

normal function of different organs and may lead to death. Cancer is also called 'Malignant Tumor'.

3. Cataract is an eye disease due to opacity of the lens. The most common is age related (degenerative), affecting most

of the older elders. Other causes include inborn or congenital, injuries to the lens, and effects of drugs. Systemic

illnesses like diabetes mellitus may lead to earlier onset of cataract.

4. Cholera is a communicable disease caused by the bacteria Vibro cholerae. It is transmitted through contaminated

food and water. The severity of the disease varies with individuals. Main symptoms include diarrhoea and vomiting

which can cause dehydration, acute renal failure and even death. However, some people may not have any

symptom and become a carrier and can spread the bacteria. Elderly are more prone to infection as their acid

secretion in the stomach may be less, weakening their immunity.

5. Chronic bronchitis and emphysema (also known as chronic obstructive airway disease or COAD) is the commonest

cause of shortness of breath in the elderly, especially those with history of smoking or passive smoking. Usual

symptoms include frequent cough, sputum and wheezing. Patients with mild disease experience shortness of breath

during moderate exercise such as walking upstairs, but those with more severe disease will develop shortness of

breath even when they walk on level ground or at rest. Some may need to depend on oxygen therapy

6. In East Asia, there are over 2000 new cases of colorectal cancer every year. Colorectal cancer is the second most

common cancer and it ranks number three amongst the deaths in Hong Kong . Data show that the incidence of

colorectal cancer is on an uprising trend.

7. After we ingest food, the peristaltic movement of the intestine pushes it forward to facilitate digestion and

absorption. Finally the leftovers are excreted outside the body as faeces. Abnormal bowel movements include

constipation and diarrhoea.

8. In fact, anxiety is a natural reaction in the face of crisis. It serves to heighten awareness, to speed up action taken to

avoid the danger or to handle the difficulty faced, so as to go through the crisis safely. Therefore, anxiety of short-

term nature and moderate amount is natural and beneficial. However, if the anxious emotion becomes chronic and

is not managed properly, it could lead to anxiety disorder. Anxiety in older persons is quite common. Overseas

research found that anxiety symptoms were present in 20% of community dwelling elders. Another Asian study

found that 26% of Asian people elderly showed anxiety symptoms.

9. Coronary arteries are arteries which supply blood to the heart to provide nutrients and oxygen. Coronary heart

disease occurs when these arteries are narrowed or even blocked.

10. Dementia is a progressive disease of the brain. There is decline in cognitive and intellectual function such as

memory, comprehension, learning capacity, the ability to think and calculate, as well as language and judgment.

Patients gradually deteriorate with impaired functioning in daily activities, some also with emotional and

behavioural problems.

11. It is normal to experience emotional changes. However, unduly severe pessimism or sadness may be an indication

of illness.

12. Diabetes Mellitus (DM) is a chronic metabolic disease. The pancreas does not produce enough insulin or the body

cannot use insulin effectively. As a result, sugar accumulates in the blood and the excess sugar is excreted in the

urine.

13. Dyspepsia is a common symptom in the elderly. It refers to various abdominal discomforts like nausea, bloating,

feeling of fullness, stomach ache, loss of appetite, heartburn, and acidic plash.

14. Frozen shoulder is caused by inflammation of the soft tissue around the shoulder joint. It is more common in

females and in people aged over 50.

15. Gout is the symptomatic manifestation caused by deposition of urate in tissues and raised uric acid level in blood.

2. Tugas / pertanyaan : Kaitkan kondisi 1 -14 dengan perubahan-perubahan organ pada lansia !

Kondisi:

1. Immobility

Perubahan organ yang terjadi:

1. Ossification of joint, osteoporotic bone change, decreased muscle strength and endurance, also decreased of

height and body mass because of compression of invertebretal discs and remineralisation.

2. Instability

3. Intelectual impairment

4. Impairment of vision & hearing

5. Insomnia

6. Isolation (depression)

7. Immune deficiency

8. Infection

9. Irritable colon

10. Inanition (malnutrition)

11. Incontinence

12. Impotence

13. Iatrogenesis

14. Impecunity

2. Structures in the inner ear that help with balance stiffen and deteriorate slightly, also the part of the brain

that controls balance (cerebellum) may degenerate.

3. Brain and nervous system; the number of nerve cells in the brain typically decreases, atrophy of brain

surface, brain cells, spinal cord synapse degenartion.

4. Eyes (iris fades, conjunctiva thinner and yellow, acommodate decreased) and Ears (irreversible,

sensorineural loss with age).

5. Neurons of central and peripheral nervous system degenerate, reduce REM sleep, decrease deep sleep.

6. Pshycososial changes (lack of social support), decrease self-imaging because of numerous losses, and change

and loss of nervous system.

7. As we grow older, our bodies are less able to produce antibodies which are important in fighting infections.

As a result older adults are at greater risk for infections and the mortality rate from infection is much higher

than in the young. Fatty marrow replace red marrow, thymus gland degenerate, and antibody response

decrease because of the decreased immune system function.

8. Infection happens due to the lack of immune system; fatty marrow replaced red marrow, thymus gland

degenerate, and antibody response decreased.

9. Liver degenerate and produce lack of enzym that will protect the large intestine to circulate the food.

Atrophy of mucosal linings; diminished production of hydrochloric acid and other digestive enzymes,

then disorganized oesophageal motility, decreased weight of liver, reduced regenerative capacity of liver,

also liver metabolizes less efficiently.

10. Approximately 40 renal function decreases, decreased bladder and tonicity, renal blood flow, glomerular

filtration rate, and tubular function declined. Metabolic rate decrease, water depletion, and nutrient

deficiency.

11. Kidney mass decreases by 25-30 percent and the number of glomeruli decrease by 30 to 40 percent. These

changes reduce the ability to filter and concentrate urine and to clear drugs. With aging, there is a reduced

hormonal response (vasopressin) and an impaired ability to conserve salt which may increase risk for

dehydration. Bladder capacity decreases and there is an increase in residual urine and frequency. These

changes increase the chances of urinary infections, incontinence, and urinary obstruction.

12. Erections that do not last as long, are less rigid, or take more time. Less testosterone is produced. Blood flow

to the penis decreases.

13. Most changes do not cause clinically significant disease or disability, but they do leave the kidney

vulnerable to illness or medications that can depress renal function and lead to acute or chronic renal

failure. Medication dosages often need to be reduced in the elderly because the reduction in kidney

function can affect clearance of some drugs and lead to toxicity or adverse effects. The major functional

changes with age include reduced blood flow, altered clearance of some drugs, and a diminished capacity

to regenerate damaged liver cells.

14. People often fear cognitive decline in later life more than any other disabling condition. Cognitive ability is

crucial to the capacity to live independently. Most of us do not want to be dependent on others as we age.

Impairment in cognitive capacity can threaten autonomy and the ability to manage our daily activities,

often asked people help, loss energy for making money, could lead to poverty or impecunity.