Geriatric Physiologic Changes Summary & Study Notes

🧭 Overview

Geriatric physiology involves predictable changes across body systems. This study note highlights the expected age related changes, common disorders, and safety implications to guide safe, effective nursing care.

🧴 Integumentary System

Expected Age-Related Changes:

• Senile lentigo
• Seborrheic keratosis
• Cutaneous papilloma or skin tags
• Crow’s feet or wrinkles
• Hair color fades to gray
• Hair distribution changes
• Fingernails grow more slowly
• Toenails thicken
• Xerosis (dry skin)
• Senile purpura

Common Disorders Seen with Aging:

• Melanoma, basal cell carcinoma, and squamous cell carcinoma
• Pressure injuries
• Inflammation and infection: Rosacea; contact, allergic, and seborrheic dermatitis; herpes zoster; fungal, yeast, and bacterial infections; scabies infestation
• Hypothermia

Notes for Safety: Caregivers must handle skin gently; fragile vessels may bleed with minor trauma. Identify skin changes early and report progression.

🦴 Musculoskeletal System

Bones:

• Bones consist of protein, calcium, and phosphorus
• To keep bones strong: adequate intake of vitamins A, C, D; weight bearing activity; hormone balance

Vertebrae:

• Series of small bones stack to form a strong, flexible structure; supports the head and allows back movement; spinal cord passes through the canal; disks cushion impact

Joints, Tendons, and Ligaments:

• Joints are the places where bones meet; bursa provides lubrication; tendons connect muscles to bone; ligaments connect bones to each other

Expected Age-Related Changes:

• Decrease in bone calcium; greater fracture risk
• Loss of height; loss of teeth
• Less fluid in intervertebral disks
• Decrease in blood supply to muscles; decrease in tissue elasticity
• Decrease in muscle tone and mass

Common Disorders Seen with Aging:

• Osteoporosis
• Degenerative joint disease: Osteoarthritis, Rheumatoid arthritis; bursitis; gouty arthritis

Notes for Safety: Encourage weight bearing activity within tolerance to maintain bone density; assess fall risk and implement safety measures.

🫁 Respiratory System

Expected Age-Related Changes:

• Fewer body fluids; fewer cilia; fewer macrophages
• Decrease in tissue elasticity in the alveoli; reduced lung capacity
• Less muscle strength and endurance; fewer capillaries
• Greater calcification of cartilage

Common Disorders Seen with Aging:

• Chronic obstructive pulmonary disease (COPD) including emphysema and chronic bronchitis
• Asthma; Influenza; Coronavirus disease (COVID-19); Pneumonia; Tuberculosis; Lung cancer

Notes for Safety: Vaccination and infection control are crucial; monitor respiratory status and prevent aspiration by proper feeding position.

❤️ Cardiovascular System

Expected Age-Related Changes:

• Less cardiac muscle tone; larger heart size; thicker left ventricular wall
• Decrease in cardiac output; decreased elasticity of heart muscle and blood vessels
• Fewer pacemaker cells; decreased baroreceptor sensitivity
• Lower incidence of valvular calcification; greater risk of atherosclerosis

Common Disorders Seen With Aging:

• Coronary artery disease; coronary valve disease; cardiac arrhythmias; heart failure; cardiomegaly
• Peripheral vascular disease: occlusive problems, varicose veins, aneurysm; hypertensive disease

Hypertension (HTN):

• Essential HTN cannot be cured; management includes medications plus lifestyle changes such as rest, no smoking, stress reduction, weight loss, and sodium restriction

Notes for Safety: Regular blood pressure monitoring; assess for signs of heart failure; educate on safe activity pacing and medication adherence.

🧬 Hematopoietic and Lymphatic System

Expected Age-Related Changes:

• Increased plasma viscosity; decreased red blood cell production (anemia)
• Less mobilization of neutrophils; higher infection risk
• Greater immature T-cell response alterations

Common Disorders Seen with Aging:

• Anemia; leukemia

Notes for Safety: Watch for pallor, fatigue, edema; manage infections promptly; monitor complete blood counts as indicated.

🍽️ Gastrointestinal System

Expected Age-Related Changes:

• More dental caries and tooth loss
• Decreased thirst sensation increasing dehydration risk
• Decreased gag reflex increasing aspiration risk; less muscle tone at sphincters
• Decreased saliva and gastric secretions; slower gastric motility; smaller liver size with reduced enzyme production

Common Disorders Seen with Aging:

• Hiatal hernia; GERD; gastritis and ulcers; diverticulosis/diverticulitis; cancer; hemorrhoids; rectal prolapse

Notes for Safety: Encourage hydration and dental care; monitor swallowing; ensure safe food textures; screen for dehydration.

🚽 Urinary System

Expected Age-Related Changes:

• Fewer functional nephrons; decreased blood supply; decreased muscle tone and tissue elasticity
• Delayed or reduced perception of need to void; greater nocturnal urine production
• Larger prostate in men

Common Disorders Seen with Aging:

• Urinary incontinence; urinary tract infection; chronic kidney disease

Notes for Safety: Maintain fluid balance; manage incontinence with dignity; monitor for CKD signs.

🧠 Nervous System

Expected Age-Related Changes:

• Fewer brain cells; fewer nerve fibers; fewer neuroreceptors
• Decrease in peripheral nerve function

Common Disorders Seen with Aging:

• Parkinson disease; dementia; Alzheimer disease most common; transient ischemic attack; stroke (ischemic or hemorrhagic)

Notes for Safety: Assess for cognitive changes and fall risk; implement strategies to support communication and safety.

👀 The Eyes

Anatomy:

• Eyes composed of three layers: sclera, choroid, retina; two fluid filled cavities; protective structures of eyelids and tear glands

Expected Age-Related Changes:

• Fewer eyelashes; decreased tear production; lens discoloration
• Decreased tissue elasticity and muscle tone; presbyopia

Common Disorders Seen with Aging:

• Blepharitis; diplopia; cataracts; glaucoma; age related macular degeneration; retinal detachment

Notes for Safety: Regular vision screening; correct refractive errors; ensure safe environment to prevent falls.

👂 The Ears

Anatomy and Function:

• Outer, middle, and inner ear; detect sound and maintain balance

Expected Age-Related Changes:

• Decreased tissue elasticity; decreased joint mobility affecting hearing
• Fewer ceruminous cells increasing cerumen impaction risk
• Atrophy of vestibular structures increasing balance problems; presbycusis

Common Disorders Seen with Aging:

• Otosclerosis; tinnitus; deafness; Ménière’s disease

Notes for Safety: Address hearing loss with assistive devices and communication strategies; ensure environment is safe and accessible.

👃 Taste and Smell

Expected Age-Related Changes:

• Fewer papillae on tongue; fewer nasal sensory receptors

Notes for Safety: Taste and smell changes can affect appetite and safety (gas, smoke, spoiled foods); monitor intake and environment.

🧪 Endocrine System

Expected Age-Related Changes:

• Decreased pituitary secretions (growth hormone); decreased thyroid stimulating hormone; decreased insulin production or increased insulin resistance (risk for Type 2 diabetes); decreased parathyroid hormone

Common Disorders Seen with Aging:

• Diabetes mellitus; hypoglycemia; hypothyroidism

Hypothyroidism:

• Symptoms include cold intolerance, dry skin and hair, constipation, depression, and low energy; diagnosis requires thyroid labs; HYPO equals low and slow

Notes for Safety: Screen for thyroid dysfunction when signs overlap with aging; monitor glucose and adjust diabetes management as needed.

♀ Reproductive and Genitourinary Systems

Female Reproductive Organs:

• Ovaries, fallopian tubes, uterus, vagina; menopause marks cessation of ovarian hormonal function

Male Reproductive Organs:

• Testes and penis; scrotum; prostate gland location

Expected Age-Related Changes:

• Women: decreased estrogen, decreased tissue elasticity, greater vaginal alkalinity
• Men: decreased testosterone, decreased circulation

Common Disorders Seen with Aging:

• Uterine prolapse; vaginal infection; breast cancer; prostate cancer

🛡️ Safety Emphasis: Snowball Effect

Falls are a major safety risk for older adults. A fall can cascade into fracture, surgery, bedrest, constipation, decreased mobility, and infection. Prevent falls, monitor mobility, breathing, GI function, and skin integrity to support overall safety and independence.