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102 Cards in this Set
- Front
- Back
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What is the primary complaint about hearing loss in older adults? |
Difficulty understanding speech, especially when in noise |
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What percent of people with hearing loss actually get treated? |
30% |
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True/False: Hearing changes related to aging are typically gradually progressive |
TRUE |
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What is tinnitus? |
Hearing a sound (usually sounds like ringing) when it is not actually present in the environment |
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In what frequencies do men tend to have a greater hearing loss? |
High frequencies |
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In what frequencies do women tend to have a greater hearing loss? |
Low Frequencies- more to do with blood flow, medication, or other disorders |
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What are some peripheral age related changes that affect the pinna? |
Loss of elasticity, decrease in collagen, increase in size of ear and lobes and presences of creases, pigment spots (pre-cancerous), ulcerations/carcinomas (cancerous) primarily from sun exposure |
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What is chondrodermatitis? |
-tender pink ulceration on the helix or antihelix -occurs as a result of degeneration of the skin or cartilage from chronic sun exposure, pressure, or head trauma -peripheral change |
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What is squamous cell carcinoma? |
-appears as a red-brown nodule -90+% occur on fair skin people, on face and ears -primarily found in the elderly |
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What is basal cell carcinoma? |
-2nd most malignant -tumor of pinna -occurs more often in males -secondary to sun exposure |
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True/False: As we get older, the skin of our ear canal begins to atrophy and thin |
TRUE |
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What are some other age related changes that happen in the ear canal? |
-Reduction in cerumen in most -Some people have excessive amounts of cerumen produced and/or epithelial migration may be inadequate leading to impaction (this is less common) -Increase in the number of hair follicles that point toward the TM -EAM may narrow due to sagging of the skin |
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Why would it be better to use inserts instead of headphones in older clients? |
Headphones could collapse the older ear canals |
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True/False: As we get older the TM stiffens, thins, and becomes less vascular |
TRUE |
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What are some other age related changes that happen in the middle ear? |
-Muscles and ossicular ligaments atrophy and fiber degeneration occurs (system is just not working as well as it should be) -Thinning and calcification of ossicular joints related to arthritis -Calcification of eustachian tube cartilage and muscular atrophy
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What might the loss of ossicular and TM flexibility result in in the elderly? |
Air-bone gap at 4k |
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What is Presbycusis? |
Hearing loss related to aging effects |
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What did Framingham Cohort (1985) reveal about hearing loss? |
Much of hearing loss is related to factors other than the aging process |
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True/False: Early monitoring of extended high frequencies in younger adults considered at risk may help with early identification of loss and aggressive management to prevent or reduce hearing loss |
TRUE |
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As we get older what happens to the neural population of our auditory system? |
Greatly reduces |
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What effect does this neuron reduction have on processing? |
Negative effect on processing complex stimuli -ex: degraded speech and sequential non-speech signals |
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What are some of the things the CANS is responsible for? |
-Afferent signal transmission -Recoding -Binaural correlation -Frequency coding -Final processing of signal |
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True/False: Reduction in neural inhibitory transmitters could produce a reduction in ability to suppress external noise, which could further degrade speech perception in noise |
TRUE |
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What does CANS help us do? |
Helps us focus and attend to things EX: In a restaurant you can listen to your conversation and tune out other people, over time however you lose your ability to be able to do this, what you hear is like Charlie Brown's teacher "wa wa wa" |
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What is gap detection? |
Ability to detect a brief silent interval in the stimulus waveform -Tells the difference btwn where one sound stops and the next begins |
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As we get older what happens to our gap detection? |
We need bigger gaps in order to discriminate between sounds -the extent is highly influenced by the listening task
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True/False: We have greater difficulty with discrimination of duration, especially for speech (complex stimuli) as we get older |
TRUE |
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Aging effects on both frequency and intensity discrimination suggest what? |
A common mechanism underlying the age related deficit |
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Age related changes in speech in noise perception are most likely to occur in what population? |
80+ |
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What are two factors of temporally distorted speech? |
1) Longer reverberation times result in greater detrimental effects on speech recognition ex:sitting in the back of church and not being able to hear 2) Poorer performance in recognizing rapid speech |
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When linguistic and semantic cues in speech are reduced or enhanced, the age-effects are what? |
Correspondingly enhanced or reduced |
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Phonemic Regression: |
Unusually poor word identification in comparison with hearing thresholds -May exhibit rollover in performance -intensity functions (occurs more among 80+) -this problem is a brain or nerve problem |
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When do we begin to see frequent reports of hearing loss? |
Age 65+
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Those with _______ to _________ losses report significant impact on communication and emotional reaction to difficulties |
mild to moderate |
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True/False: Older people report less handicap than younger people with the same degree of loss |
TRUE |
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Do women or men often express feelings of frustration,anger, and stress associated with hearing loss? |
women |
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Older women are more likely to: |
-Admit to communication problems -Assign more importance to effective communication -Use nonverbal strategies to circumvent communication problems |
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What is the definition for a hearing handicap? |
Communication and personal adjustment problems related to hearing loss may not be eliminated by use of a hearing aid |
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Why is a hearing handicap different than the degree of hearing loss? |
Could have two people with the same degree of hearing loss but a totally different impact on their lives. One could say "I'm fine" and the other could say "I'm deaf". One we would prescribe hearing aids, the other we would not |
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What percent of individuals who may benefit from hearing aids actually have them? |
28.5% |
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What percent of adults 65-74 years of age have hearing loss? |
30% |
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What percent of adults 75 years and older have hearing loss? |
47% |
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1 out of 3 people over what age fall each year? |
65 |
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What is the leading cause of both fatal and nonfatal injuries? |
Falls |
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In 2010 how many nonfatal fall injuries among older adults were treated in emergency rooms? |
2.3 million |
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How much money did those falls cost in medical bills? |
$30 billion |
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What percent of people who fall suffer moderate to severe injuries? |
20-30% |
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What percent of fatal falls were due to TBI? |
46% -Falls are a common cause of TBI |
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Where do most fractures occur during falls? |
Spine, hip, forearm, leg, ankle, pelvis, upper arm and hand |
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In 2010, approx. how many older adults died from unintentional fall injuries? |
21,700 |
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True/False: Older caucasians are 2.4 times more likely to die from falls as their African American counterparts |
TRUE -Due to the isolation that caucasian families have and also higher numbers of osteoperosis |
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People over the age of 75 are ___ times more likely than those 65-74 to be admitted to a long term care facility for a year or longer |
4 |
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Rates of fall related fractures among older women are more than __________ those for men. |
twice |
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What percent of hip fractures are caused by fractures? |
over 95% |
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What are some ways to prevent falls? |
-Exercise regularly -Ask Dr. and pharmacist to review all meds. -Have eyes checked at least once a year and have their eye glasses updated -Reduce tripping hazards in the home |
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What makes up the outer layer of the eye? |
-Sclera -Cornea |
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What does the sclera do? |
Dense, white, opaque outer layer that is continuous with the cornea (whites of eyes) |
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What is the cornea? |
Primary function is to refract light onto the focal point on the retina (Gather light and focus it) |
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What are the parts of the middle eye? |
-uveal tract -lens -iris -vitreous humor |
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What is the uveal tract responsible for? |
Highly vascular middle layer of the eye that provides the blood supply and nutrition to the other 2 portions of the eye |
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What are the lens responsible for? |
Focuses light on the retina by relaxing and contracting muscles -Changes the shape of the lens, making it thicker or thinner |
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What is the Iris? |
Colored part of the eye -Contrast sensitivity -Ability to discriminate between an object and its background |
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What is the vitreous humor? |
Clear, avascular gelatin making up 2/3 of the volume and weight of the eye -keeps your eye full and clear -if it has anything in it you will see it in your vision |
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What are the parts of the inner most layer of the eye? |
-retina -cones -rods |
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Retina: |
Semitransparent Continuos with the optic nerve |
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Cones: |
-Color sensitivity -Visual acuity -Vision in bright light |
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Rods: |
-Peripheral vision, especially in dim rooms -Black/white vision -helps with vision at night |
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Parts of the retina: |
-Optic Disc -Macula |
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What is the optic disc? |
-Region where retina meets the optic nerve -Contains no light receptors therefore it is known as a natural "blind spot" |
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What is the macula? |
-sharp central vision -oval, yellowish spot to the side of the optic disc -contains the fovea, largely composed of cones -the area of sharpest vision -LOTS of cones |
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What are some age related changes that happen to the lens? |
-thickens and becomes less elastic -changes interfere with the ability shift focus from distant to near objects (age related far sightedness) -yellows and becomes opaque causing cooler colors to be difficult to see -pin point opacities develop that produce dazzle from bright light sources -better able to distinguish between bright colors |
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What is presbyopia? |
Age related changes in vision |
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What age related changes are associated with the Iris? |
-Eye color fades -Not seeing colors as clearly as when you were younger |
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What are some changes related to age associated with the vitreous humor? |
-becomes less transparent -allows light to scatter instead of highly focused -floaters -higher visual threshold (need more light before we can tell something is there) |
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What are a few other changes to the eye associated with aging? |
-Pupil diameter decreases -sensitivity to glare -Loss of peripheral vision |
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Cataracts: |
-opacities on the lens as a result of protein build up -May: see halos around objects, experience blurred vision, decreased light,color perception |
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What is the most common ocular disease related to aging? |
Cataracts |
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What is glaucoma? |
Increased pressure in eye leads to degeneration of the optic nerve and blindness if not treated -occurs slowly over time -can result in loss of peripheral vision
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True/False: Older women are most at risk for glaucoma |
TRUE |
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What are some causes of glaucoma? |
-Inflammation: Fluid is closing duct -Diabetes:causes the inflammation -Tumors:volume of tumor closing duct |
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What is the leading cause of adult blindness? |
Diabetic Retinopathy |
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What is diabetic retinopathy? |
Small retinal blood vessels develop small aneurysms which cause hemorrhages |
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What are some symptoms of diabetic retinopathy? |
-cloudy vision -seeing shower spots |
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What is a way to treat diabetic retinopathy? |
Laser photocoagulation-burns vessels shut -try to cauterize the vessels that are breaking -have to have this done regularly b/c this will keep occuring |
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Macular Degeneration: |
Severe loss of central vision -cones are being affected here |
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What are some symptoms of macular degeneration? |
-need increasingly brighter light when reading or doing close work -printed words that appear distorted or increasingly blurred -straight lines will appear bent or curved -colors that seem washed out and dull -a gradual haziness over your whole vision -difficulty seeing when moving from a bright room to a dimly lit room |
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What are some causes of macular degeneration? |
-Genetics -Smoking -Cardiovascular disease -Long term sunlight exposure |
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True/False: Occular diseases account for 98% of vision loss in those over the age of 70 |
TRUE |
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What is low vision? |
Corrected visual acuity between 20/70 and 20/200 -diagnosed when all other treatments are unsuccessful -can be central (reduced visual acuity) or peripheral (reduced visual field) |
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True/False: Stroke can result in loss of peripheral vision |
TRUE |
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What is a major implication of central vision loss? |
detail discrimination -problems reading -problems putting in hearing aids -most often seen as part of macular degeneration |
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Presbylarynges: |
Age related changes in your voice/larynx |
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Presbyphonia: |
Age related changes in phonation-creating sounds |
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What are some age related changes of the larynx? |
-stiffening of the vocal folds -less complaint -aren't able to vibrate as they normally should-causing volume problems -decreased vocal range -more breathiness to voice b/c your vocal folds aren't fully closing |
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What are some age related changes related to phonation? |
-diaphram's ability to pull down becomes weaker, can't take as deep of breaths -calcification can cause rate of speech to slow -controlling resonance becomes harder |
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What is a jitter? |
-varying pitch -frequency (similar to puberty voice) |
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What is a shimmer? |
-varying loudness -amplitude -amount of force to get sounds out is varying |
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What causes a more breathy voice in men as they age? |
-Incomplete closure -Increased tension -More of a bowing of the VF which makes it harder to seal
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What causes a more breathy voice in women as they age? |
-Increased mass -make VF droop |
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What are some age related respiratory changes? |
-decreased rib movement -increased thorax stiffness -increased residual lung volume |
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What are some age related changes that happen to phonemic production? |
-centralize vowels -decrease in formant frequency of vowels -acoustic changes related changes in the vocal tract |
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What does VOT stand for? and what does it mean? |
Voice Onset Time- amount of time before voicing begins |
