I’m working on a nursing discussion question and need an explanation and answer to help me learn.

Submission Instructions:

• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
• All replies must be constructive and use literature where possible.

Discussion #1

Changes that Occur on the Neurological System Associated to Age

The nervous system is a vital element of any animal’s body including human being. It is responsible for transmitting signals to different part of the body from the brain and coordinates the general functionality of the body. In the human body the nervous system consists of two main parts, that is, the central nervous system (CNS) and the peripheral nervous system (PNS) (Devlin & Craven, 2018). The CNS is made up the brain and the spinal cord while the PNS is made up of nerves which are long fibers that connect the CNS to the other body parts. At the most basic level, the function of the nervous system is to control movement of the organism and to affect the environment (Devlin & Craven, 2018). This is achieved by sending signals from one cell to others, or from one part of the body to others.

The output from the nervous system derives from signals that travel to muscle cells, causing muscles to be activated, and from signals that travel to endocrine cells, causing hormones to be released into the bloodstream or other internal fluids (Fisch, 2018). The input to the nervous system derives from sensory cells of widely varying types, which transmute physical modalities such as light and sound into neural activity. Internally, the nervous system contains complex webs of connections between nerve cells that allow it to generate patterns of activity that depend only partly on sensory input. The nervous system is also capable of storing information over time, by dynamically modifying the strength of connections between neurons, as well as other mechanisms (Fisch, 2018).

As an individual advances in age, some natural changes in the nervous system both the CNS and the PNS are evident. Some of these changes are not physical and can only be characterized by certain symptoms. The brain and the spinal cord lose nerve cells and weight a condition known as atrophy (Roca, Lang, & Chassagne, 2019). The nerve cells begin to gradually pass the signals at a quite slower pace than in the past. As the nerve cells break down, waste products can accumulate in the brain tissues leading to abnormal changes in the brain known as plaques and tangles (Roca, Lang, & Chassagne, 2019). The brain function declines with advancement in age with varying impact on different people. The decline in the brain function affects different aspects at different times. At a relatively early period of ageing, the short-term memory and the ability to learn new things tend to be affected. At the age of 70 years vocabulary, word usage and the general verbal abilities start to decline. In a situation where an individual has no underlying vascular or neurological disorders, he or she has the capacity to retain the ability to process information and other intellectual performance until the age of 80 years at least (Roca, Lang, & Chassagne, 2019). The reaction time and performance of tasks may generally decline because of slow processing of the impulses by the brain.

As an individual advances in age, the disks between the back bones vertebrae become hard and brittle, and parts of the vertebrae may overgrow. As a result, the disks lose some of their capacity to cushion, so more pressure is put on the spinal cord and on the branches of the nerves that emerge from the spinal nerve roots (Roca, Lang, & Chassagne, 2019). The increased pressure may injure nerve fibers at the point where they leave the spinal cord. Such injury can result in decreased sensation and sometimes decreased strength and balance. With age progression, peripheral nerves may conduct impulses more slowly, resulting in decreased sensation, slower reflexes, and often some clumsiness (Ryan & Lipsitz, 2019). Nerve conduction can slow because the myelin sheaths around nerves degenerate. Myelin sheaths are layers of tissue that insulate nerves and speed conduction of impulses. Degeneration also occurs because as people age, blood flow decreases, nearby bones overgrow and put pressure on the nerves, or both (Ryan & Lipsitz, 2019). Age-related changes in function can become more noticeable when the nerves are injured by something else such as diabetes. The peripheral nervous system’s response to injury is reduced. When the axon of a peripheral nerve is damaged in younger people, the nerve is able to repair itself as long as its cell body, located in or near the spinal cord, is undamaged (Ryan & Lipsitz, 2019). This self-repair process occurs more slowly and incompletely in older people, making older people more vulnerable to injury and disease.

Dementia is a progressive decline in memory and at least one other cognitive area in an alert person. These cognitive areas include attention, orientation, judgment, abstract thinking and personality (Davis, 2019). Dementia is rare in under 50 years of age and the incidence increases with age. Dementia results from brain damage. The causes include the following; Alzheimer’s Disease, Stroke, Pick’s disease, Huntington’s, Downs Syndrome, Creutzfeldt-Jacob, AIDS, alcoholism, Parkinson’s disease and other neurodegenerations (Davis, 2019). Delirium is an acute confusion state. A diagnosis of delirium is typically based on clinical observation of behaviors and cognition, because no diagnostic tests are available. Delirium often develops in patients with dementia (Davis, 2019).

Delirium and dementia are separate disorders but are sometimes difficult to distinguish (Davis, 2019). In both, cognition is disordered; however, delirium affects mainly attention and is typically caused by acute illness or drug toxicity and sometimes life threatening and is often reversible while dementia affects mainly memory and is typically caused by anatomic changes in the brain, has slower onset, and is generally irreversible (Davis, 2019). Dementia and delirium are the most common causes of cognitive impairment, although affective disorders such as depression can also disrupt cognition.

Discussion #2

Aging and The Neurological System

The brain governs several aspects of thought, including memory, planning and organization, and decision-making. These cognitive talents affect our ability to perform daily tasks and live freely. As people age, the brain and neurological system undergo regular changes with aging. “Our brain and spinal cord lose weight and nerve cells (atrophy) (Sorond et al., 2015).” Nerve cells may transmit messages more slowly than in the past. As nerve cells degrade, waste products or other substances like beta-amyloid can accumulate in brain tissue. All those changes may impact the daily lives of older people. In this paper, we discuss intensely how aging affects the neurological system.

Memory loss is the most prevalent cognitive change connected with the brain. As one age, it gets increasingly harder to acquire new information, for example. They cannot recall names and numbers because, beginning at age 20, their strategic memory, which aids in remembering names and numbers, begins to decline. “Paying attention is mildly impaired (Peters, 2006).” Moreover, they struggle with multitasking. Some brain regions may have reduced communication between nerve cells as they age. In addition, blood flow to the brain may decrease, as well as inflammation. The breakdown of nerves might impair one’s senses. You may experience diminished or missing reflexes or sensations. This causes issues with mobility and safety. It is a typical component of aging for thought, memory, and thinking to slow down. These alterations vary among individuals. Some individuals have extensive nerve and brain tissue alterations. Others have few modifications. These alterations are not always associated with cognitive impacts.

Age causes the intervertebral discs to become fragile and rigid. In addition, some vertebral elements may overgrow. Consequently, the discs lose some of their ability to cushion, resulting in increased pressure on the spinal cord and nerves. At the point where nerve fibers exit the spinal cord, the force applied may result in nerve fiber damage. This damage may result in diminished sensitivity, balance, and strength.

With age, the peripheral nervous system may conduct impulses more slowly, and neurotransmitter release may become reduced. Therefore, elderly persons may exhibit delayed responses, less feeling, and even clumsiness. In addition, the degradation of the myelin sheaths decreases nerve conduction. The Myelin sheath’s function in the body is to insulate the neuron and accelerate impulse conduction. Age-related decreases in blood flow and the overgrowth of surrounding bones exerting pressure on the nerves result in degeneration. In addition, the peripheral nervous system’s responsiveness to damage diminishes with age. Consequently, the elderly are susceptible to illness and harm.

Delirium and Dementia Definition Similarities Differences

The most frequent causes of altered mental status in elderly patients are delirium and dementia (deWit et al., 2019). As dementia is one of the predisposing factors for delirium, the two frequently coexist. It can be challenging to distinguish between the two in people without a history of dementia when the dementia is fast advancing. This activity emphasizes the role of the interprofessional team in evaluating and managing individuals with delirium and dementia. In contrast, delirium is a rapid shift in the brain that causes mental disorientation. Delirium is characterized by disorientation, inability to think correctly, and confusion in older adults. Both disorders result in impaired judgment and memory, hallucinations, paranoia, disorientation, and confusion. Both conditions influence cognitive function in the elderly.

The onset of dementia is slow, and the condition may progress over months to years (deWit et al., 2019).” The patient is generally alert. Orientation to person, place, and time and recent memory may be impaired. In the later stages of dementia, patients lose remote memory as well. Patients with dementia have difficulty abstracting thoughts and have a poverty of ideas.

Delirium means sudden confusion; It refers to an abrupt, rapid change in mental function that goes well beyond the typical forgetfulness of aging (deWit et al., 2019).” Delirium is a result of abnormal functioning of the brain and requires the attention of a healthcare professional.

Delirium (acute confusion) is characterized by a change in overall cognition and level of

consciousness over a short time. Dementia, on the other hand, is characterized by several

cognitive deficits and memory and tends to be more chronic. Both conditions are

classified according to the cause or origin of the disease. One example of a reason for dementia is multiple small blood clots that cause brain tissue damage, known as vascular dementia. Alzheimer’s disease (AD), a degenerative disease of the brain, is another form of dementia, although the exact cause is unknown. The difference between the two conditions is that delirium is an acute condition that requires immediate treatment, and dementia is a chronic condition. Delirium depends on timely diagnosis and treatment. It also is important to note that delirium can coexist with dementia. If delirium is recognized and promptly treated, a patient with preexisting dementia should be restored to a previous level of functioning.

Delirium primarily impairs the attention of older adults, whereas dementia mainly affects their memory. Fever results from drug toxicity or acute illness and can be reversible. Dementia, infections, extreme pain, sleep deprivation, metabolic problems, and significant sickness are additional causes of delirium. In contrast, dementia is caused by anatomical changes in the brain. Other causes of dementia include prolonged alcohol consumption, diseases of the central nervous system, vascular illnesses, brain trauma, and some types of hydrocephalus.

Dementia is not a specific disease but a broad term for poor memory, thinking, or decision-making that interferes with daily tasks. Alzheimer’s is the most prevalent kind of dementia. Dementia is not a regular aspect of aging, even though it primarily affects older persons.