What are common normal physical changes associated with aging that the nurse should expect in elderly clients?

Normal aging changes affect every body system and influence care: (1) Vision: presbyopia (near vision decline starting ~40), cataracts, glaucoma risk, decreased adaptation to dark and glare; (2) Hearing: presbycusis (high-frequency hearing loss); (3) Cardiovascular: decreased cardiac output, increased BP variability, slower heart rate response to exercise; (4) Respiratory: decreased lung elasticity and reserve, decreased ciliary function (increased infection risk); (5) GI: decreased gastric acid (affecting iron, B12, calcium absorption), slower peristalsis (constipation risk), decreased appetite; (6) Renal: decreased GFR (drug dosing implications); (7) Musculoskeletal: decreased muscle mass (sarcopenia), decreased bone density (osteoporosis), joint changes, decreased flexibility; (8) Neurological: slower reaction time, decreased balance, mild changes in short-term memory normal (dementia is NOT normal aging); (9) Skin: thinning, decreased elasticity, slower wound healing, decreased sensation; (10) Immune: less robust response to infections and vaccines (immunosenescence); (11) Thermoregulation: less effective response to heat/cold; (12) Pharmacokinetics: changes in drug absorption, distribution, metabolism, excretion — most older adults need lower drug doses than younger adults. Polypharmacy is common and concerning. Nurses should distinguish normal aging from pathology — confusion, falls, weight loss, incontinence are not normal aging but signal medical issues. Beers Criteria identify potentially inappropriate medications in older adults.