Old age is characterized by slowing down of physiological functions and the impeded renewal of body tissues. As the body breaks down, the geriatric becomes weaker. Every system in the body shows reduced functioning as the metabolic process is slowed down. As there is a slower and reduced renewal of body tissues, the various organs and their systems are adversely affected in their functionalities (Alvis & Hughes, 2015).
The brain starts to decline at the age of 40 (Alvis & Hughes, 2015). By the time the person is 70, this rate increases. It atrophies, reducing both its volume and weight. The decline accounts for the cognitive changes such as memory loss observed during this stage. The connective tissues within the blood vessels and the heart stiffen with advanced age. This results in higher blood pressures and increased work by the cardiac muscles. The lung tissue also becomes stiffer with age as elastin is replaced by collagen. The compliance of the respiratory system is reduced, and there is increased work of breathing. The affected renal function is linked to the stiffening of the blood vessels.
The cognitive decline during this stage is linked to dementia, where memory is mainly affected. In dementia, persons may display the following psychotic symptoms: aggression and agitation, apathy, sleep disturbances, and perceptual disturbances such as hallucinations and delusions (Kratz, 2017). Dementia is linked to old age. These changes should have been absent during his younger years. A person who had previously presented with hallucinations and behavioral impairment during his/ her younger years may have had schizophrenia. During the assessment of the patient, the health practitioner should perform tests to investigate treatable causes of dementia such as hormonal profiles, especially thyroid function tests (Falk, Cole, & Meredith, 2018).
Hypothyroidism may present with depression which also has symptoms of impaired memory and judgment. Recent trauma should be ruled out in the individual as this may manifest in memory loss and new strange behaviors. Infective causes such as viral meningitis or encephalitis should also be investigated to eliminate reversible causes. Trauma and infections can occur in both young people and the elderly. Injury due to trauma will be visible on computed tomography scans. For infections, they may have a history of fever or recent contact with a person showing similar symptoms. Most of the causes unrelated to old age are usually both acute and rapid in onset. However, cognitive changes in old age are insidious, worsening slowly over a long time. It is important to note that the normality of a behavior change is a diagnosis of exclusion. Failure to find any pathology designates it as normal.
Functional assessment incorporates functional status, cognitive function, depression, mobility, and communication with others (Muszalik, Kornatowski, Zielińska-Więczkowska, Kędziora-Kornatowska, & Dijkstra, 2014). The functional status investigates whether they can perform their normal, daily activities. Inability to perform these activities is linked with impaired cognitive function. The extent to which these activities are compromised is a pointer to the severity of the abnormal behavior. Dementia is associated with a significant loss in cognitive function, which forms its main presenting feature. Behavior linked with forgetfulness may be termed as normal in this case. However, the occurrence of hallucinations or delusions points to abnormal behavior and another cause of the condition. Due to the degenerative nature of the disease on the central nervous system, mobility is usually affected by markedly. Worsening mobility with a similar degree of cognitive impairment is an indicator of age-related changes. Mobility that is better compared to cognitive function is a pointer to non-age-related etiologies of the abnormal behavior.
In summary, it is important to note for any behavior changes in old age. This may be a pointer to the development of dementia or the occurrence of new abnormal behaviors unrelated to the cognitive decline. It is crucial as the prompt remedy of these disorders ensures improved quality of life for the geriatric.
References
Alvis, B., & Hughes, C. (2015). Physiology considerations in geriatric patients. Anesthesiology Clinics, 33(3), 447-456. Web.
Falk, N., Cole, A., & Meredith, J. (2018). Evaluation of suspected dementia. American Family Physician, 97(6), 398-405.
Kratz, T. (2017). The Diagnosis and Treatment of Behavioral Disorders in Dementia. Deutsches Aerzteblatt Online, 114(26), 447-454. Web.
Muszalik, M., Kornatowski, T., Zielińska-Więczkowska, H., Kędziora-Kornatowska, K., & Dijkstra, A. (2014). Functional assessment of geriatric patients in regard to health-related quality of life (HRQoL). Clinical Interventions in Aging, 10, 61-67. Web.
