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FUNCTIONALITY, WEAKNESS OF PARKINSON

FUNCTIONALITY, WEAKNESS OF ELDERLY
Dr. Erika Cyrus Barker

If we now in the aging population increases we will realize the importance of what we have discussed above, since it reinforces the tendency to increased morbidity and mortality from chronic diseases. Already

aging installed considering the physical, mental and social, ie the integral view, it is inevitable for any intervention from the health area. And it is precisely the state of physical function, mental and social, the key concept of quality of life in old age.

The challenge is then prevented. Prevent the presence of chronic diseases that are potentially disabling and, once installed strongly deteriorate the quality of life of the elderly population,

CONCEPT OF FUNCTION
Independence understood as the ability to perform the functions related to daily life ie live in the community receiving little or no help from others. [1] Self-defined as the ability to make decisions for themselves and face the consequences according to their own preferences and requirements of the environment.

[1] WHO, "Active Aging: A policy framework," in: English Journal of Geriatrics and Gerontology, August 2002.

Objective of the TF in geriatric
not increase life expectancy, but how you live a longer life. This means longer life free of disability or a functionally healthy life. Hence the importance of identifying those at risk of losing their ability to function and act at primary prevention, that is, before disability occurs.

The disability is a gradual process that happens in stages. This starts with a stressful situation can cause impediments, that prevent the physical, mental or social, then going to cause functional limitations that are equivalent to restriction to run daily life actions. Culminating in disability or inability to perform activities of daily living for himself.

remarkable thing is that when the functional limitations or disability is detected early and treated properly, can delay, offset, offset, and / or restore the drivers or deepen the process or even prevent total disability and dependence.

Aging and functionality
The normal process of aging process causes a reduction of up to 25 to 30% of the cells that make up the various organs and systems of humans, resulting in a reduction of the role played by that organ and system.

What in normal situation or usual requirement will have no repercussions, it may affect the individual against a demand unusual or stress, since the physiological aging affects the "reserve capacity" [1].
[1] M . Isaac, and G. Comollonga Izquierdo Zamarriego, "Physiology of Aging", in: Salgado Alba. Manual of Geriatrics, 3rd edition, MASSON, Madrid, 2002, pp.: 63-76

normal aging process produces changes in the homeostasis and in the reserve, increasing vulnerability to diseases to chronic and degenerative diseases. Which combined with genetic predisposition, inadequate lifestyles and poor socio-economic and environmental harmful, causes the functional health of older people increases the risk of transition from independence to dependence.

In old age, disease expression, it is often more subtle and the symptoms are modified by example, increases the pain threshold, change the temperature regulation and electrolyte balance, compensatory mechanisms are modified as tachycardia and tachypnea. Even in some cases, existing commitments, the classic signs and symptoms appear normal.

Older Adults age 80, even in the best health systems can have up to three chronic diseases. Thus the co-morbidity in the elderly group, makes it difficult to differentiate between healthy and sick group, since the vast majority of older people present chronic or degenerative illness.

What really make a difference is whether disease or other physical condition, mental or social has encouraged the functional health status or commitment led to the Functional Health Status.

is how one of the first manifestations of disease in the elderly occurs through alterations of functionality. This was set up in the most important warning sign. Hence the fundamental importance of continuous measurement of function in the elderly.


functionality or functionality Functional independence is nothing but the ability to meet or perform certain actions, activities or tasks required in daily living.

The definition formula from a functional perspective, "the elderly people is one able to cope with the change process with an adequate level of functional fitness and personal satisfaction."

loss of function can be detected clinically by loss of autonomy and dependence appear little by little, will limit the quality of life of older people. Moreover, each type of disease causes a specific type of functional loss: each disease affects a particular group of activities.

This loss of independence and autonomy initially affect complex activities (eg travel outside the home), but, if sustained over time and not acted upon, it progresses and comes to affect the independence and autonomy for basic activities of daily living that affect the self: getting up, washing, dressing, eating and mobility within the home. Risk factors
losing functionality

For risk factor is defined as "innate or acquired characteristic that the individual who is associated with a probability of dying or suffering a particular disease or condition." The population considered healthy but have any of the so-called "risk factors", will have a greater chance of developing the disease or condition during the following years. (JM Casado Rivera, Gil Gregory P. 1997).

The functional capacity of an individual can be altered, usually decreased, and various risk factors.

Among them were selected chronic diseases which in themselves constitute a risk factor, ie, they increase the likelihood of the elderly to lose the ability to operate by itself in everyday life and death.

also imply the possibility of producing other risky process due to complications associated with them. considered the following diseases: Hypertension, Diabetes Mellitus, Dislepidemias, coronary heart disease and heart failure, stroke, transient arthritis and Osteoarthritis, Osteoporosis.

There are consistent data to consider risk factors for disability-called geriatric syndromes. considered the following: falls, loss of balance, dizziness, unsteady walking, urinary incontinence, sensory deficits, vision and hearing, foot deformities. Predictors

maintaining the functionality

By studying a set of subjects over a period of time, statistical calculations are discovered through the factors associated with healthy aging and retaining the best possible physical and mental abilities . These are called protective factors that is, those that increase the likelihood of staying healthy and in possession of the physical and mental abilities.

Rowe and Kahn (1997), propose the concept of successful aging. This is a multidimensional concept that included a first approximation, prevent disease and disability and maintain a high physical and mental functioning. The research results enable them to identify risk and protective factors, both predictive in nature.


In general, the risk factors of losing physical function are altered levels of glucose and lipids, obesity and hypertension to what the authors add that the protective factors that can counter these risks are the food habits and physical activity.


Predictors of cognitive functioning
evaluated with neuropsychological tests of language, verbal memory, verbal memory, conceptualization and skills - are: a) the educational level, which is the best protector against the reduced function cognitive, b) physical activity, and c) perceived self-efficacy, defined as the belief in the ability to organize and execute courses of action required to deal with a situation.
Predictors of maintaining good physical functioning assessed by mobility
hands and legs, balance and gait - the categorized into two: one related to individual characteristics, with the risk predictors: being old and low income, being obese and being hypertensive. The other related forms of behavior, and predictors of maintaining the proper functioning: the productive activities, not necessarily income-generating but considered socially valuable, interact with others by exchanging emotional support and do at least a moderate level of exercise . Kahn

Rolwe and mentioned as an additional protective factor mode stress response. Affirming that the elderly, if they are continuously studying, it will move the entering and out of the successful and healthy people can get in and out of disease. In other words, since it is usual that stressful events occur, the most important thing is to empower the elderly to address them.

short, seven are considered protective factors: educational level, four patterns of behavior, namely the mental and physical exercise, eating habits, significant activities to occupy time and maintain relationships with other exchanging emotional support, and possession of two psychological attributes: the perception of self-efficacy and the ability to cope with stressful situations in so that they have the least impact on the well-being and ability to perform for himself the daily life activities. * Definition

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James Parkinson in 1817 defined it as "involuntary shaking movements with decreased muscle strength in areas that are not in activity, propensity to bend the trunk forward and to move from place to run, while the senses and intellect remain unchanged. "

This occurs by disruption and loss of neurons in a given area of \u200b\u200bthe brainstem. This area is the substantia nigra of the basal ganglia, which control the movements are performed automatically as walking. Causes


is a disorder that occurs in middle age and later life, which has a very gradual progression and a prolonged evolution. Although it has been observed in family groups, usually has a sporadic and an unknown cause. Symptoms


The stooped posture, stiffness and slowness of movements and facial blankness and the rhythmic shaking of the members refer to voluntary movements, are the main characteristics of this disease.

The slow movement is usually more or less general, associated with muscle stiffness, which prevents the normal course of business. They also suffer a loss of the ability of healthy people have to make minor changes in automatic and spontaneous posture, to do any activity or to take different positions.

tremor usually is more pronounced in the hands but can also affect legs, lips, tongue and neck muscles. Hence usually affected both speech and writing.

The gait of these people is with rapid steps and awkward, and excessive acceleration as if to catch its center of gravity, which is ahead of them.

usually have continuous feelings of tiredness because of incoordination of different muscle groups.

The severity of symptoms is strongly influenced by emotional factors such as anxiety, tension and feelings of unhappiness, which aggravate the clinical picture.

Although intellectual impairment is not a constant feature, with increasing dementia is often seen in advanced stages of disease. Physiotherapy


The discovery of effective drugs against this disease, such as Levodopa, and the integration of the patient in a rehabilitation program that carries a possible life acceptable and integrated into society.

useful is a progressive program of daily exercises help alleviate various movement disorders, making them feel safe and maintaining an adequate quality of life.
• Exercises to improve muscle strength, coordination and dexterity, reduce stiffness and prevent contractures from disuse of muscles.
• Exercises to improve joint mobility, such as walking.
• Stretching exercises for muscle structures are as flexible as possible.
• postural exercises to try to slow the trend of maximum tilt of the trunk and head.
• Special techniques for the march, in order to overcome the disturbances of the same and the trend mentioned above. From principle is aware the patient to walk as erect as possible, look ahead and open your feet slightly to increase its base of support and stability, combine the swing of the arms and lift your feet.
• The pace and speed of the exercise should be moderate and can help with music that has an appropriate pace and will facilitate the realization of the exercises.
• Coordinate activities with breathing exercises, which will bring the patient to have more stamina and less tiring. Anyway, is it advisable to perform frequent rest periods.

As in any subject with a neurological impairment, work that causes the patient to develop and adapt to their condition, depends on a team of many professionals. In this way, doctors, therapists, psychologists, physiotherapists, occupational therapists and many others, and the family must work together to integrate these people into a life as normal as possible.

Compiled by: Dr. Erika Cyrus Barker

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