Pryhhh

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Prematur Aging on

Biological Theory’s

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Penuaan/ Aging

Dalam buku ajar geriatri, Prof.Dr. R.Boedi Darmojo dan H. Hadi Martono

mengatakan:

Menua (aging) adalah prosesmenghilangnya secara perlahan-lahan

kemampuan jaringan untuk memperbaiki

diri/ mengganti diri dan mempertahankan

struktur dan fungsi normalnya sehingga

tidak dapat bertahan terhadap jejas

(termasuk infeksi) dan memperbaiki

kerusakan yang diderita

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3 PERSPEKTIF PENUAAN

1. Usia biologis kapasitas fungsi sistem organ

2. Usia psikologis

kapasitas perilaku adaptasi3. Usia sosial

perubahan peran & perilaku sesuai usiamanusia

Teori saling melengkapi

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PERAN TEORI DLM

MEMAHAMI PENUAAN pemahaman tentang fenomena Landasan & sudut pandang untuk melihat fakta Menjawab pertanyaan filosofi

pijakan dan arah untuk diskusi dan penelitian Perawat relevansi

Pertanyaan evaluasi terhadap teori :◦ Konsisten secara internal & logis?◦ Dukungan empiris?◦ Menghadirkan konsep & kondisi yg dapat dimodifikasi?◦ Mampu membuat perubahan besar, yang baik?

DISIKAPI

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BIOLOGIC THEORIES

OF AGING

Stochastic theories

aging as event that occur

randomly & accumulate over time Nonstochastic theories

aging as certain predetermined,

timed phenomena

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The change in the biology of an organism asit ages after its maturity.

Such changes range from those affecting itscells and their function to those affecting the

whole organism. There are a number of theories as to why

senescence

Gene expression changes

Damage caused by biological processes.

Cold blooded

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JANIN/fetus

Kulit

Bulan ke 4: kulit terbentuk dengan

baik, papila dermal nampak jelas,

struktur tambahan mulai terbentuk. Rambut

Bulan ke 5 dan 6: tumbuh lanugo yang

kemudian hilang saat janin berumur 7bulan berganti dgn rambut vellus.

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BAYI BARU LAHIR (newborn)

Kulit:

sangat tipis

Kelenjar

kel. sebasea sangat aktif vernix

caseosa.

akumulasi kel. sebasea milia (bintik

putih di dahi dan hidung hilang padausia 3 minggu.

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ANAK

Kulit

tekstur lembut, lembab, tidak berminyak,

simpanan lemak subkutan banyak.

Rambutrambut kepala bersinar, lembut, kuat, dan

elastis.

Kuku

pink, cembung, halus, keras tapi fleksibel.

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REMAJA/puber

Kulit

lebih berminyak, muncul acne.

Rambut

Tumbuh rambut di aksila, pubis,

kumis/jenggot, dll. (ciri seks sekunder).

Rambut lebih berminyak.

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DEWASA

Penampakan kulit optimal di usia 20-30 tahun.

Paparan lingkungan (angin, sinar

matahari, dll.) terakumulasi bersisik, radang kulit (dermatitis).

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USIA LANJUT

(usila/lansia)

PERUBAHAN

KULIT

AKIBAT

Stratumgerminativum

menipis

Kulit menipis, kurangtahan gesekan (mudah

luka)

Kolagen dan elastinberkurang Kulit berkerut/keriput

Pergantian sel

epidermal melambat

Penyembuhan luka

lambat

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PERUBAHAN

KULIT

AKIBAT

Lemak

subkutanberkurang

Bantalan bony prominence

berkurang, termoregulasiterganggu

Sel Langerhan

berkurang

Respon imun berkurang

kulit mudah rusak dan infeksi Aliran darah ke

kulit berkurang

Kulit dingin shg mudah

kedinginan, absorbsi

transdermal berkurang

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PERUBAHAN KULIT AKIBAT

Jumlah dan

keaktivan melanosit

berkurang

Perlindungan terhadap

UV berkurang kanker

kulitJumlah dan

kepekaan reseptor

sensori berkurang

Kurang peka rangsang

risiko cedera/injuri

Produksi vit. D

berkurang

Penyerapan kalsium dan

fosfat berkurang

kelemahan otot dan tulang

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PERUBAHAN

RAMBUT

AKIBAT

Folikel rambut

berkurang

Rambut tipis,

pertumbuhan lambat

Melanin berkurang Rambut beruban

Wanita: kadangmuncul rambut di

wajah (hirsutisme)

Penampilan terganggu

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Premature Aging Syndromes

Also known as progeria, include two very rareinherited conditions,

Hutchinson-Gilford syndrome and Werner syndrome.

In both conditions, skin changes that indicate

premature aging include: atrophy (skin thinning and loss of elasticity)

loss of cutaneous fat

wrinkling

greying hair

loss of hair

nail dystrophy

defective pigmentation

ulceration

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Hutchinson-Gilford Syndrome Werner Syndrome

Occurs in about 1 in 8 million childrenOccurs in about 1 in 1 million

individuals

Signs of progeria begin to show

around 6-12 months when the baby

fails to gain weight and skin changes

occur

First sign of syndrome is around

puberty when the child fails to have a

normal growth spurt, or may be

delayed until an individual is as old as

30 years

•Characteristic features include:

Baldness, prominent scalp, veins and

eyes, small jaw, delayed tooth

formation

•Thin limbs with prominent joints,

short stature, joint stiffness, hipdislocations

•Thickened, tight and shiny skin over

joints

•Characteristic features include:Striking difference between person's

appearance and his/her real age

•Greying hair and/or balding, wrinkling

and aging of the face, sunken cheeks,

small jaw

•Small stature (usually less than 1.6mtall), muscle weakness

•Thickened, tight and shiny skin over

joints, leading to ulcers

•High-pitched voice

Average life expectancy is 13 years,

with approximately 75% dying from

Death usually occurs in patients

between 30-50 years, with most dying

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Cause Of Prematur Aging

Both Hutchinson-Gilford syndrome and Werner syndrome are

autosomal recessive disorders, which means an individual

has inherited a mutated gene from both parents.

1 in 4 offspring would be expected to have the disorder and

others may be carriers of the gene. Werner syndrome appears to be caused by a defect at the

WS gene (WRN) locus, which provides instructions to a

protein called helicase.

Werner syndrome is caused by a helicase defect, which

affects the way DNA and RNA are replicated and repaired in

the body.

Mutation in the gene LMNA that produces the protein Lamin

A, which is the structural scaffolding that holds the nucleus of

a cell together.

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Complications Of Progeria

In addition to skin changes, patients with

Werner syndrome often develop the following

conditions:

Cataracts – rapidly progressing cataractsdevelop between the ages of 20-40 years

in most cases

Osteoporosis (loss of bone density) –

particularly in the legs, caused bydisturbances in the parathyroid glands

Diabetes mellitus – this occurs in at least

30% of patients, and there is abnormal

glucose tolerance in many others

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Cardiovascular disease – particularly

arteriosclerotic disease, which may lead tofatal heart attack

Pituitary gland underactivity ,

Hypogonadism or agonadism (absent or

underactive ovaries or testes) andpremature menopause

Soft tissue calcification , Cancer – the

incidence of malignancy is high, especially

fibrosarcomas which occur in 10% of patients (carcinomas of the thyroid and

other organs, blood disorders,

meningiomas and skin cancers)

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Pryhhh

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