Functional Problems of Aging

After completing this section of the chapter, you should be able to meet the following objectives:

♦ Compare information obtained from functional assessment with that obtained from a physical examination used to arrive at a medical diagnosis

♦ Cite the differences between chronic and transient
urinary incontinence

♦ State four risk factors for falls in older individuals

♦ List five symptoms of depression in older adults

♦ Name a tool that can be used for assessing cognitive
function

♦ State the difference between delirium and dementia

Although aging is not synonymous with disease, the aging process does lend itself to an increased incidence of illness. As chronologic age increases, so does the probabil­ity of having multiple chronic diseases. It has been esti­mated that 86% of older adults have at least one chronic condition, and most actually have more than one. The ex­tent of these problems is described in Table 3-1. Older adults are more likely to experience a decline in overall health and function because of the increased incidence of chronic illness that occurs with advancing age. Because aging also brings with it a decreased ability to maintain homeostasis, illnesses often manifest in an atypical man­ner. For example, myocardial infarction may occur without chest pain or other presenting symptoms. Sepsis without fever is common, and pneumonia may present with acute confusion but lack the prodromal symptom of cough.

In addition to chronic illnesses, older adults suffer dis­proportionately from functional disabilities, or the inabil­ity to perform the necessary activities of daily living (ADL). It is most likely that the decrements in health that can ac­company the aging process are responsible for these func­tional disabilities. Among the more common functional problems of the older adult are urinary incontinence, insta­bility and falls, sensory impairment, depression, dementia, and delirium.