Fundamentals - Gerontology, part 6: Immune and Integumentary Changes in Aging Adults

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Hi, I'm Ellis, and in this video, I'll be discussing the physiological changes of the older adult as it relates to their immune system and their integumentary system. This card can be found in the gerontology section of our fundamentals flashcard deck, so if you have that deck, grab this card, and you can follow along with me. Immune system changes in the older adult include a decrease in their T cell function and a decrease in just their general immune function, and that means that they are at a much higher risk for infections. They also are at a higher risk for cancers and autoimmune disorders. The integumentary system changes in a lot of ways as we age. First, our skin is just different. It's thinner, it's less elastic, it's not as strong, and it thus is much more prone to tearing. Even in situations where you might not think it should tear, it will and it does. For example, when I remove an IV covering or tape from an older adult, sometimes their skin comes with it. It's just a lot more fragile. Older adults also develop what's called senile lentigines, which is just a fancy way to say age spots or liver spots if that's what you call them, and their skin can appear more pale. The blood vessels under the skin are also a lot more fragile, which is why you'll see older adults with more bruising. They bruise more easily. It's easier for them to bleed under their skin if their blood vessels are more fragile. There's a decrease in oil production, which can cause the older adult skin to feel dry or flaky or even itchy.

There's also a decrease in subcutaneous tissue, which sounds like a good thing, but it increases the risk for skin injuries, especially pressure injuries. Because if you think about it, the less subcutaneous tissue there is, the less cushion there is between you and the surface that you're sitting or laying on, so you are more likely to develop a pressure injury because your bony prominences are coming into more contact with that surface without that cushion of subcutaneous tissue. The lack of subcutaneous tissue can also lead to a risk of hypothermia because there's not that extra layer to keep them warm. The older adults also experiences a decrease in the sweat function, so they don't sweat as well, which can cause overheating. They also experience slower wound healing. So there's a lot of factors that go into that, but they definitely have delayed wound healing, just impaired wound healing. Sometimes their wounds don't heal, but it definitely takes much longer. And then finally, due to years of sun exposure and just living and being outside, the older adult is at a higher risk for skin cancer. What is the medical term for age or liver spots? Senile lentigines. Why are older adults more likely to have dry and/or itchy skin? They experience a decrease in oil production. Which integumentary change I mentioned puts the older adult at a higher risk for skin injuries, more specifically pressure injuries? A decrease in subcutaneous tissue.