Content

Principles and concepts:

-The alterations of thermoregulation more frequent in the elderly are hypothermia and hyperthermia or heat stroke.

- Vertigo has a high prevalence and is a frequent cause of consultation. It is a problem that must be evaluated carefully and that when it is described as a sensation of rotation requires the evaluation of an otolaryngologist.

- Syncope is a sudden loss of consciousness, with spontaneous recovery, caused by a decrease in cerebral blood flow. It can also be caused by metabolic changes such as hypoglycaemia.

-The two types of incontinence that occur in the elderly are urinary and fecal, the latter less frequently than the urinary.

-The two digestive symptoms that occur with greater incidence in the elderly are constipation and diarrhea.

-The immobility is the difficulty or lack of ability of the elderly person to perform movements due to the deterioration of their motor functions, a fact that prevents him from performing activities of daily life, so that his relationship with the environment deteriorates and favors the presence or development of skin lesions such as ulcers and vascular ulcers.

- The fall can be defined as sudden, involuntary and unexpected precipitation on the ground, which may or may not cause a secondary injury and which is confirmed by the elderly person or by another person who has seen it fall. Its frequency is high among elderly people admitted to healthcare centers, especially among people who suffer from cardiovascular disorders and who, when in general, are usually conscious and oriented.

-Neurological pathological changes are one of the main causes of chronic processes that lead to disability in elderly people. A high percentage of neurological processes occur in old age for various reasons, among which are the changes that the aging process exerts on the central nervous system and that facilitate the appearance or complication of pathological processes, as well as the fact that lifeexpectancy is increasing and infectious diseases, which are usually the cause of mortality in neurological patients, can be controlled.

-Organic brain diseases (Alzheimer's and dementias) are classified as acute and chronic. In the former we find acute brain syndrome and in the latter there are all dementias.

-The mental health in the elderly has to be faced from the perception of the person as a whole; that is, in it, psychosocial aspects of the care of the elderly have to be treated in a suitable environment.

-Cardiovascular diseases are one of the most important causes of morbidity and mortality among the elderly. The most frequent are angina, ICC, AMI, hypertension, peripheral vascular disease, arteriosclerosis, aneurysms, arrhythmias and valvulopathies. Signs and symptoms in older people have an insidious development and therefore are not recognized, neither by the patient nor by the caregivers.

-The respiratory system is the one that maintains a more direct contact with all environmental pollutants throughout life, which, added to the changes in the aging process, increases their vulnerability and creates large dependencies in the elderly. The most frequent respiratory disorders in the elderly are pneumonia, emphysema, tuberculosis and PE.

-The health problems of the gastrointestinal system are of three types: ingestion, digestion and elimination. These three functions are necessary and help the development and maintenance of metabolism. The most frequent problems in the elderly are xerostomia, hiatus hernia, diverticulitis, hepatic colic, hemorrhoids and anemias.

-The changes in the sexuality of elderly people begin slowly between 30 and 40 years to become evident as the person is older.

-The peak age of incidence in which diabetes mellitus is diagnosed in the elderly is between 60 and 70 years. Classical disorders such as sweating, polyuria or tachycardia are often absent in the elderly.

 -The osteoporosis is the bone disease of metabolic character more prevalent among the elderly and that involves a high morbidity among them. In our country, according to data collected by the Hispanic Osteoporosis Foundation, about three million people suffer from this disease.

-Neoplasic tumors disproportionately affect elderly people, being one of the main causes of death among people over 65 years. Therefore, age is considered a risk factor for suffering a carcinogenic process.

- It agrees that we differentiate the concept of fever with that of hyperthermia. The first is an increase in body temperature due to the activation of interleukin-1, which stimulates the hypothalamic preoptic area, which is where body temperature is regulated, causing an increase in temperature and activation of the immune system with the stimulus. of neutrophils in the bone marrow, favoring muscle proteolysis. In short, fever is a defense mechanism of the organism, since it stimulates the generation of antibodies and acts against antigens sensitive to heat, preventing its development.

-Dehydration is one of the major disorders in the elderly, since in the body composition of the body the liquid element constitutes 60% of body weight, distributed as follows: 40% is in the intracellular space (28 liters approx.) and the remaining 20% is in the extracellular space (approx. 14 liters). This distribution varies in elderly people due to changes in the aging process, which decreases the total water and increases the proportion of fat tissue, which in turn varies the percentage of body water content, decreasing to reach around 40 or 45%. For this reason, it is also the disorder that most often occurs in the elderly, due to various factors that cause a decrease in the supply of fluids or an increase in their losses. The main factor is the low sensitivity of the sense of thirst in elderly people, which, like the temperature regulator, is in the hypothalamus. For this reason, in the presence of dehydration, the sensation of perceived thirst is lower and the intake ofliquids is not sufficient, which translates into a functional deterioration.

-With regard to urinary incontinence, the SIC (International Continence Society, 1991) defined the urinary incontinence as "the involuntary loss of urine that is objectively demonstrable and that constitutes a social and hygienic problem". Urinary incontinence is not a normal process of aging, but quite the opposite: it is caused by some kind of functional or pathological disorder, and has very negative repercussions on physical and psychological health, as well as on social activity, limiting it significantly. In addition, it has an important impact on health costs.

-Fecal incontinence is the inability to control the excrement output voluntarily, producing a change in the normal habits of fecal elimination. It causes important alterations in terms of satisfaction of the basic needs of the elderly, similar to those we have described in urinary incontinence, which have a biopsychosocial and economic impact, representing an important family burden, which is why they are often institutionalized.

- Constipation is the reduction of the frequency of bowel movements that may or may not be accompanied by difficulty in expelling excrement, keeping in mind that normal defecation would be on a weekly frequency that was not less than three times. Other parameters that would complete this definition are also the consistency of the excrement and the presence of symptoms in the evacuation of excrement such as pain and tenesmus.