CONCEPTS OF AGING AND CHRONIC ILLNESS
EXAM 4 WITH SOLUTIONS 2025
skin of older adults
*Exposure to heat, cold, water, trauma, friction, and
pressure affects skin integrity
*Genetics and environmental factors (ultraviolet [UV]
radiation, tobacco smoke, inflammatory responses, and
gravity) contribute to age-related skin changes
*Those who are immobilized or medically fragile are at
risk for fungal
infections and pressure ulcers
Purpose of sleep and rest
helps the body to
-conserve energy
-prevent fatigue
-provide organ respite
-relieve tension
*sleep is a basic need, and rest occurs with sleep
Biorhythm and sleep
With aging, the natural circadian rhythm may
become less responsive to external stimuli such
,as light
• The amplitude of all circadian endogenous
responses—such as body temperature, pulse,
blood pressure, and hormonal levels— reduces
Sleep and aging
sleep has 4 stages
• Sleep complaints are linked to other health problems or
disorders
• Older adults sleep better when they
• Are in general good health
• Have a positive mood
• Are engaged in an active lifestyle
• Perform meaningful activities
With Aging
• there is a reduction in the amplitude of all circadian
endogenous (internal)
responses: body temperature, pulse rate, blood pressure,
hormonal levels
• the natural circadian rhythm may become less
responsive to external stimuli such as changes in light
during the course of the day
,• endogenous changes in the production of melatonin and
are diminished in resulting in less sleep efficiency
Sleep changes and Poor sleep
• More time spent in bed awake before falling asleep
• Total sleep time and sleep efficiency are reduced
• Periods awake are frequent, increasing after age 50 years
(>30 min of wakefulness after sleep onset in >50% of older
subjects)
• Daytime napping
• Changes in circadian rhythm (early to bed, early to rise)
• Sleep is subjectively and objectively lighter (more stage
1, little stage 4, more disruptions)
• Rapid eye movement (REM) sleep is short, less intense,
and more evenly distributed
• Frequency of abnormal breathing events is increased
• Frequency of leg movements during sleep is increased
Different Sleep Disorders
• Insomnia
• Sleep apnea
• Restless leg syndrome
• REM sleep behavior disorder
• Circadian rhythm sleep disorder
, Risk Factors for Sleep Disturbances in Older Adults-
external
• Medications
• Life stressors/response to stress
• Loss of spouse
• Relocation to new environment
• Sleep habits (daily sleep/activity cycle, napping)
• Poor sleep hygiene
• Lack of exercise
• Lack of socialization/stimulation
• Excessive napping
• Caregiving for a dependent elder
• Environmental noise, institutional routines
• Limited exposure to sunlight
• Alcohol
• Smoking
Risk Factors for Sleep Disturbances in Older Adults-
internal
• Age-related changes in sleep
EXAM 4 WITH SOLUTIONS 2025
skin of older adults
*Exposure to heat, cold, water, trauma, friction, and
pressure affects skin integrity
*Genetics and environmental factors (ultraviolet [UV]
radiation, tobacco smoke, inflammatory responses, and
gravity) contribute to age-related skin changes
*Those who are immobilized or medically fragile are at
risk for fungal
infections and pressure ulcers
Purpose of sleep and rest
helps the body to
-conserve energy
-prevent fatigue
-provide organ respite
-relieve tension
*sleep is a basic need, and rest occurs with sleep
Biorhythm and sleep
With aging, the natural circadian rhythm may
become less responsive to external stimuli such
,as light
• The amplitude of all circadian endogenous
responses—such as body temperature, pulse,
blood pressure, and hormonal levels— reduces
Sleep and aging
sleep has 4 stages
• Sleep complaints are linked to other health problems or
disorders
• Older adults sleep better when they
• Are in general good health
• Have a positive mood
• Are engaged in an active lifestyle
• Perform meaningful activities
With Aging
• there is a reduction in the amplitude of all circadian
endogenous (internal)
responses: body temperature, pulse rate, blood pressure,
hormonal levels
• the natural circadian rhythm may become less
responsive to external stimuli such as changes in light
during the course of the day
,• endogenous changes in the production of melatonin and
are diminished in resulting in less sleep efficiency
Sleep changes and Poor sleep
• More time spent in bed awake before falling asleep
• Total sleep time and sleep efficiency are reduced
• Periods awake are frequent, increasing after age 50 years
(>30 min of wakefulness after sleep onset in >50% of older
subjects)
• Daytime napping
• Changes in circadian rhythm (early to bed, early to rise)
• Sleep is subjectively and objectively lighter (more stage
1, little stage 4, more disruptions)
• Rapid eye movement (REM) sleep is short, less intense,
and more evenly distributed
• Frequency of abnormal breathing events is increased
• Frequency of leg movements during sleep is increased
Different Sleep Disorders
• Insomnia
• Sleep apnea
• Restless leg syndrome
• REM sleep behavior disorder
• Circadian rhythm sleep disorder
, Risk Factors for Sleep Disturbances in Older Adults-
external
• Medications
• Life stressors/response to stress
• Loss of spouse
• Relocation to new environment
• Sleep habits (daily sleep/activity cycle, napping)
• Poor sleep hygiene
• Lack of exercise
• Lack of socialization/stimulation
• Excessive napping
• Caregiving for a dependent elder
• Environmental noise, institutional routines
• Limited exposure to sunlight
• Alcohol
• Smoking
Risk Factors for Sleep Disturbances in Older Adults-
internal
• Age-related changes in sleep
