Tradition of Excellence

MASALAH NEUROLOGI
PADA LANJUT USIA

Oleh:
Tim Keperawatan Keluarga, Komunitas, dan Gerontik
Fakultas Keperawatan
Universitas Jember
GOALS Tradition of Excellence

• Improve quality of life for people with neurogical

conditions
• Advance understanding and treatment through
research, prevention, and education
• Support for increased research funding
Physical Changes of Aging Tradition of Excellence

• Nervous system
• Slower reaction time and thought processing
• Shortened attention span
• Impairment of fine motor activities
• Memory loss

3
 Neurologic Changes in Aging Tradition of Excellence

Physiologic changes Clinical correlation

 loss of neurone & subdural hematoma after
brain weight trivial head injury
impaired autoregulation ↓ brain blood flow
↓ dendritic connections impaired memory retrieve
short term memory loss ↑interview time
↓ dopamine activity ↑Parkinsonism
↑ neurofibrillary tangle pathologic change of
& senile plaques Alzheimer disease
↓ acetylcholine activity ↑amnesia
Neurologic Changes in Aging Tradition of Excellence

Physiologic changes Clinical correlation

↓ serotonin activity : ↑ depression
change of sleep pattern : unnecessary narcotic drug
change of : ↑sensitivity to benzodiazepine
pharmacodynamics : ↓ intelligence
slow central Processing
& reaction time
 Observed Neurologic Changes Tradition of Excellence

There is neuronal loss in the brain throughout life (the amount & location
varies).
Loss is chiefly gray matter not white matter
there is some evidence that although some neuronal loss occurs with age,
many neurons have ↑ dendrite growth which may (at least partially)
compensate for neuronal loss in some areas of the brain.
Slowed neuronal transmission
Changes in sleep cycle: takes longer to fall asleep, total time spent
sleeping is less than their younger years, awakenings throughout the night,
increase in frequency of daytime naps
Sense of smell markedly decreases
Observed Neurologic Changes
Tradition of Excellence

• The lens of the eye loses fluid and becomes less flexible,
making it more difficult to focus at the near range.

• Dry eyes
 Tradition of Excellence

Changes in the Nervous System

• Normal neurological findings in elderly commonly include
changes in:
• Thinking (cognitive) speed
• Memory
• Postural stability
• Brain decreases in weight and volume.
 Tradition of Excellence

Changes in the Nervous System

• As mental function declines, so does regulation of:

• Respiratory rate and depth
• Pulse rate
• Blood pressure
• Hunger and thirst
• Temperature
Neurologic System Tradition of Excellence

• As people age, they usually experience such memory changes

as slowing in information processing, but these changes are
benign

• Short-term and remote memories aren't usually affected by

aging; recent memory may be affected

• Not progressive and does not interfere with daily function or

independence

10
Age-associated Change Clinical Consequence (s) Tradition of Excellence

Middle ear membranes and bones Decreased hearing sensitivity

less flexible
Pupil size reduced Decreased ability to focus at near
Lens becomes rigid range, less tolerance to glare
Ability to produce tears reduced Dry eyes

Functional smell receptors Diminished sense of smell

reduced
Taste buds reduced in size and Diminished taste
numbers
Touch receptors reduced, Diminished sense of touch
response to painful stimuli
reduced
11
Sensory Changes Tradition of Excellence

• As you age, your senses (vision, hearing, taste, smell, touch)

may become less acute

• The most dramatic sensory changes with age affects vision and
hearing

• Many of the changes can be compensated for with assistive

devices (e.g., glasses, hearing aids, etc.) or by changes in
lifestyle

12
Sensory Changes Tradition of Excellence

• Most sensory organs decline with age.

• Decreased ability to see and hear
• Decreased ability to taste
• Decreased tactile sensation
• Do not assume the elderly are deaf or blind.
Sensory Changes Tradition of Excellence

• Vision problems affect 50% of seniors.

• Most common visual disturbances in elderly:
• Cataracts—hardening of lenses over time
• Glaucoma—optic nerve damaged due to intraocular pressure
• Visual acuity decreases even without disease:
• Difficulty seeing at night
• Inability to adjust to rapid changes
• Presbyopia (far-sightedness)
• Difficulty differentiating between colors
 Tradition of Excellence
Sensory Changes
• Gradual hearing loss is common with aging.
• Presbycusis: Inhibited ability to discriminate between
background noise and particular sound
• Results in decreased ability to interpret speech
• May threaten safety
Sensory Changes Tradition of Excellence

• Hearing aids are very common assistive devices in

the United States
• Consist of microphone and amplifier
• May fit in ear canal
• Mainly battery operated
• Meniere disease: hearing-related impairment
• Two out of 1,000 people, onset in middle age
• Symptom cycles last several months: © Maxx-Studio/ShutterStock, Inc.

• Vertigo
• Hearing loss and tinnitus
• Pressure in ear
Sensory Changes Tradition of Excellence

• Other sensory changes:

• Decrease in number of taste buds
• Decrease in sense of touch
• Sense of smell last to diminish
• Changes may make it difficult to produce speech that is loud enough,
clear, and well spaced.
• Sense of body position may become impaired.
Tradition of Excellence