Physiological Changes in the Elderly
Özet
Advancements in medicine and science are leading to longer life expectancy. The physiological decline in organs and systems caused by aging makes it difficult to maintain homeostasis. The aging population worldwide poses challenges in healthcare, finances, and caregiving. It is essential to protect the health of elderly individuals and ensure they can participate in society as independent individuals. To prevent or delay chronic diseases and causes of disability, healthcare providers must first know the physiological changes in the elderly. In this chapter, we present general and specific characteristics of aged tissues/organs in many systems in the body associated with aging.
Referanslar
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Guilbaud A, Mailliez A, Boulanger É. Aging: a global, multidimensional and preventive approach. médecine/sciences. 2020;36(12):1173-1180.
Surugiu R, Burdusel D, Ruscu M-A, et al. Clinical Ageing. In: Biochemistry and Cell Biology of Ageing: Part IV, Clinical Science. Springer; 2023:437-458.
Hemagirri M, Sasidharan S. Biology of aging: Oxidative stress and RNA oxidation. Mol Biol Rep. 2022;49(6):5089-5105.
https://data.tuik.gov.tr/
Mori MA. Aging: a new perspective on an old issue. An Acad Bras Cienc. 2020;92.
Cai N, Wu Y, Huang Y. Induction of accelerated aging in a mouse model. Cells. 2022;11(9):1418.
Dumic I, Nordin T, Jecmenica M, et al. Gastrointestinal tract disorders in older age. Can J Gastroenterol Hepatol. 2019;2019.
Nagler RM, Hershkovich O. Relationships between age, drugs, oral sensorial complaints and salivary profile. Arch Oral Biol. 2005;50(1):7-16.
Durazzo M, Campion D, Fagoonee S, et al. Gastrointestinal tract disorders in the elderly. Minerva Med. 2017;108(6):575-591.
Wirth R, Dziewas R, Beck AM, et al. Oropharyngeal dysphagia in older persons–from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clin Interv Aging. Published online 2016:189-208.
Besanko LK, Burgstad CM, Cock C, et al. Changes in esophageal and lower esophageal sphincter motility with healthy aging. J Gastrointestin Liver Dis. 2014;23(3):243-248.
Gidwaney NG, Bajpai M, Chokhavatia SS. Gastrointestinal dysmotility in the elderly. J Clin Gastroenterol. 2016;50(10):819-827.
Roy N, Stemple J, Merrill RM, et al. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Ann Otol Rhinol Laryngol. 2007;116(11):858-865.
Wilson JAP, Rogers EL. Gastroenterologic disorders. In: Cassel CK, Cohen HJ, Larson EB et al (eds). Geriatric Medicine, third edition. Springer-Verlag. New York. 1997, p. 637-52.
Hall KE, Proctor DD, Fisher L, et al. American gastroenterological association future trends committee report: effects of aging of the population on gastroenterology practice, education, and research. Gastroenterology 29: 1305, 2005.
Quirk DM, Friedman LS. Approach to gastrointestinal problems in the elderly. In: Yamada T, Alpers DH, Laine L, et al.,(eds): Textbook of Gastroenterology, third edition. Lippincott Williams and Wilkins. Philadelphia. 1999, 1015-33.
Parlesak A, Klein B, Schecher K, et al. Prevelance of small bowel bacterial overgrowth and its association with nutrition intake in nonhospitalized older adults. J Am Geriatr Soc 51: 768-73, 2003.
Phillips RJ, Powley TL. Innervation of the gastrointestinal tract: patterns of aging. Auton Neurosci. 2007;136(1-2):1-19.
Camilleri M, Lee JS, Viramontes B, et al. Insights into the pathophysiology and mechanisms of constipation, irritable bowel syndrome and diverticulosis in older people. J Am Geriatr Soc 48: 1142-50, 2000.
Odunsi ST, Camilleri M, Bharucha AE, et al. Reproducibility and performance characteristics of colonic compliance, tone, and sensory tests in healthy humans. Dig Dis Sci. 2010;55:709-715.
Turnheim K. When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol 38: 843-49, 2003.
Froom P, Miron E, Barak M. Oral anticoagulants in the elderly. Br J Haematol 120:526-31, 2003.
Hu KC, Chu CH, Wang HY, et al. How Does Aging Affect Presentation and Management of Biliary Stones? J Am Geriatr Soc. 2016 Nov;64(11):2330-2335. doi: 10.1111/jgs.14481. Epub 2016 Sep 27. PMID: 27676699.
Matsuda Y. Age-related morphological changes in the pancreas and their association with pancreatic carcinogenesis. Pathol Int. 2019 Aug;69(8):450-462. doi: 10.1111/pin.12837. Epub 2019 Jul 24. PMID: 31339204.
Hommos MS, Glassock RJ, Rule AD. Structural and functional changes in human kidneys with healthy aging. J Am Soc Nephrol JASN. 2017;28(10):2838.
Roseman DA, Hwang S-J, Oyama-Manabe N, et al. Clinical associations of total kidney volume: the Framingham Heart Study. Nephrol Dial Transplant. 2017;32(8):1344-1350.
Wang X, Vrtiska TJ, Avula RT, et al. Age, kidney function, and risk factors associate differently with cortical and medullary volumes of the kidney. Kidney Int. 2014;85(3):677-685.
Silva FG. The aging kidney: a review–part I. Int Urol Nephrol. 2005;37:185-205.
Denic A, Lieske JC, Chakkera HA, et al. The substantial loss of nephrons in healthy human kidneys with aging. J Am Soc Nephrol JASN. 2017;28(1):313.
Bolignano D, Mattace-Raso F, Sijbrands EJG, et al. The aging kidney revisited: a systematic review. Ageing Res Rev. 2014;14:65-80.
Schmitt R, Melk A. Molecular mechanisms of renal aging. Kidney Int. 2017;92(3):569-579.
Luft FC, Wienberger MH, Fineberg NS, et al. Effect of age on renal sodium homeostasis and its relevance to sodium sensitivity. Am J Med 82 (suppl 1 B): 9-15, 1987.
Litviňuková, M., Talavera-López, C., Maatz, H., et al. (2020). Cells of the adult human heart. Nature 588, 466–472.
Karamitsos, T.D., Arvanitaki, A., Karvounis, H., et al. (2020). Myocardial tissue characterization and fibrosis by imaging. JACC-Cardiovasc Imag 13, 1221–1234.
Triposkiadis, F., Xanthopoulos, A., and Butler, J. (2019). Cardiovascular aging and heart failure: JACC review topic of the week. J Am College Cardiol 74, 804–813.
Kocyigit SE, Erken N, Dokuzlar O, et al. Postural blood pressure changes in the elderly: orthostatic hypotension and hypertension. Blood Press Monit. 2020 Oct;25(5):267-270. doi: 10.1097/MBP.0000000000000466. PMID: 32675475.
Chadda, K.R., Ajijola, O.A., Vaseghi, M., et al. (2018). Ageing, the autonomic nervous system and arrhythmia: from brain to heart. Ageing Res Rev 48, 40–50.
Rostagno, C. (2019). Heart valve disease in elderly. World J Cardiol 11, 71–83.
López-Otín, C., Blasco, M.A., Partridge, L., et al (2013). The hallmarks of aging. Cell 153, 1194–1217.
Reece, A.S., and Hulse, G.K. (2013). Reduction in arterial stiffness and vascular age by naltrexone-induced interruption of opiate agonism: a cohort study. BMJ Open 3, e002610.
Lowery, E.M., Brubaker, A.L., Kuhlmann, E., et al (2013). The aging lung. CIA 8, 1489–1496.
The Merck Manual of Geriatrics. Aging and the lungs. Beers MH, Berkow R (eds), third edition, Merck&Co., Inc., U.S.A. 2000, p. 753-758.
Sharma, G., and Goodwin, J. (2006). Effect of aging on respiratory system physiology and immunology. Clin Intervent Aging 1, 253–260.
Davies GA, Bolton CE. Age-related changes in the respiratory system. In: Fillit HM, Rockwood K, Woodhouse K (eds): Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, seventh edition. Saunder Elsevier. Philadelphia. 2010, p.97-100.
O’Flaherty EJ. Modeling normal aging bone loss, with consideration of bone loss in osteoporosis. Toxicol Sci 55: 171-88, 2000.
Friedman, S.M., and Mendelson, D.A. (2014). Epidemiology of fragility fractures. Clin Geriatric Med 30, 175–181.
Cruz-Jentoft, A.J., Bahat, G., Bauer, et al. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48, 16–31.
Drey M. Sarcopenia - pathophysiology and clinical relevance. Wien Med Wochenschr. 2011 Sep;161(17-18):402-8. doi: 10.1007/s10354-011-0002-y. Epub 2011 Jul 29. PMID: 21792531.
Mejia-Ramirez, E., and Florian, M.C. (2020). Understanding intrinsic hematopoietic stem cell aging. Haematologica 105, 22–37.
The Merck Manual of Geriatrics. Aging and the blood. Beers MH, Berkow R (eds), third edition, Merck&Co., Inc., U.S.A. 2000, p. 672-674.
Jaiswal S, Fontanillas P, Flannick J, et al. Age-related clonal hematopoiesis associated with adverse outcomes. N Engl J Med 371:2488-91, 2014.
Isaia G, Greppi F, Ausiello L, et al. D-dimer plasma concentrations in an older hospitalized population. J Am Geriatr Soc 59: 2385, 2011.
Calcinotto, A., Kohli, J., Zagato, E., et al. (2019). Cellular senescence: aging, cancer, and injury. Physiol Rev 99, 1047–1078.
Chakravarti B, Abraham GN. Aging and T cell-mediated immunity. Mech Aging Dev 108: 183-206, 1999.
Latz, E., and Duewell, P. (2018). NLRP3 inflammasome activation in inflammaging. Semin Immunol 40, 61–73.
Mariotti S, Franceschi C, Cossarizza A, et al. The aging thyroid. Endocr Rev 16: 686-715, 1995.
Almela M, Hidalgo V, Villada C, et al. The impact of cortisol reactivity to acute stress on memory: sex differences in middle-aged people. Stress. 2011 Mar;14(2):117-27. doi: 10.3109/10253890.2010.514671. Epub 2010 Oct 31. PMID: 21034293.
Shaw ND, Srouji SS, Histed SN, et al. Differential effects of aging on estrogen negative and positive feedback. Am J Physiol Endocrinol Metab. 2011 Aug;301(2):E351-5. doi: 10.1152/ajpendo.00150.2011. Epub 2011 May 10. PMID: 21558550; PMCID: PMC3154535.
Fuh VL, Bach MA. Growth hormone secretagogues: mechanism of action and use in aging. Growth Horm IGF Res. 1998 Feb;8(1):13-20. doi: 10.1016/s1096-6374(98)80317-1. PMID: 10990440.
Secomandi, L., Borghesan, M., Velarde, M., et al. (2022). The role of cellular senescence in female reproductive aging and the potential for senotherapeutic interventions. Hum Reprod Update 28, 172–189.
Kaufman, J.M., Lapauw, B., Mahmoud, A., et al. (2019). Aging and the male reproductive system. Endocrine Rev 40, 906–972.
Preston, A.R., and Eichenbaum, H. (2013). Interplay of hippocampus and prefrontal cortex in memory. Curr Biol 23, R764–R773.
Davis DG, Schmitt FA, Wekstein DR, et al. Alzheimer neuropathologic alterations in aged cognitively normal subjects. J Neuropathol Exp Neurol 58: 376-388, 1999.
Dickstein DL, Kabaso D, Rocher AB, et al. Changes in the structural complexity of the aged brain. Aging Cell 6: 275-84, 2007.
Laubach M, Lammers F, Zacharias N, et al.; BioCog Consortium. Size matters: Grey matter brain reserve predicts executive functioning in the elderly. Neuropsychologia. 2018 Oct;119:172-181. doi: 10.1016/j.neuropsychologia.2018.08.008. Epub 2018 Aug 10. PMID: 30102906.
Fromy B, Sigaudo-Roussel D, Gaubert-Dahan ML, et al. Aging-associated sensory neuropathy alters pressure-induced vasodilation in humans. J Invest Dermatol. 2010 Mar;130(3):849-55. doi: 10.1038/jid.2009.279. Epub 2009 Sep 3. PMID: 19727122.
Levine, J.M. (2020). Clinical aspects of aging skin: considerations for the wound care practitioner. Adv Skin Wound Care 33, 12–19.
Zou, Z., Long, X., Zhao, Q., et al. (2021). A single-cell transcriptomic atlas of human skin aging. Dev Cell 56, 383–397.e8.
Guilbaud A, Mailliez A, Boulanger É. Aging: a global, multidimensional and preventive approach. médecine/sciences. 2020;36(12):1173-1180.
Surugiu R, Burdusel D, Ruscu M-A, et al. Clinical Ageing. In: Biochemistry and Cell Biology of Ageing: Part IV, Clinical Science. Springer; 2023:437-458.
Hemagirri M, Sasidharan S. Biology of aging: Oxidative stress and RNA oxidation. Mol Biol Rep. 2022;49(6):5089-5105.
https://data.tuik.gov.tr/
Mori MA. Aging: a new perspective on an old issue. An Acad Bras Cienc. 2020;92.
Cai N, Wu Y, Huang Y. Induction of accelerated aging in a mouse model. Cells. 2022;11(9):1418.
Dumic I, Nordin T, Jecmenica M, et al. Gastrointestinal tract disorders in older age. Can J Gastroenterol Hepatol. 2019;2019.
Nagler RM, Hershkovich O. Relationships between age, drugs, oral sensorial complaints and salivary profile. Arch Oral Biol. 2005;50(1):7-16.
Durazzo M, Campion D, Fagoonee S, et al. Gastrointestinal tract disorders in the elderly. Minerva Med. 2017;108(6):575-591.
Wirth R, Dziewas R, Beck AM, et al. Oropharyngeal dysphagia in older persons–from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clin Interv Aging. Published online 2016:189-208.
Besanko LK, Burgstad CM, Cock C, et al. Changes in esophageal and lower esophageal sphincter motility with healthy aging. J Gastrointestin Liver Dis. 2014;23(3):243-248.
Gidwaney NG, Bajpai M, Chokhavatia SS. Gastrointestinal dysmotility in the elderly. J Clin Gastroenterol. 2016;50(10):819-827.
Roy N, Stemple J, Merrill RM, et al. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Ann Otol Rhinol Laryngol. 2007;116(11):858-865.
Wilson JAP, Rogers EL. Gastroenterologic disorders. In: Cassel CK, Cohen HJ, Larson EB et al (eds). Geriatric Medicine, third edition. Springer-Verlag. New York. 1997, p. 637-52.
Hall KE, Proctor DD, Fisher L, et al. American gastroenterological association future trends committee report: effects of aging of the population on gastroenterology practice, education, and research. Gastroenterology 29: 1305, 2005.
Quirk DM, Friedman LS. Approach to gastrointestinal problems in the elderly. In: Yamada T, Alpers DH, Laine L, et al.,(eds): Textbook of Gastroenterology, third edition. Lippincott Williams and Wilkins. Philadelphia. 1999, 1015-33.
Parlesak A, Klein B, Schecher K, et al. Prevelance of small bowel bacterial overgrowth and its association with nutrition intake in nonhospitalized older adults. J Am Geriatr Soc 51: 768-73, 2003.
Phillips RJ, Powley TL. Innervation of the gastrointestinal tract: patterns of aging. Auton Neurosci. 2007;136(1-2):1-19.
Camilleri M, Lee JS, Viramontes B, et al. Insights into the pathophysiology and mechanisms of constipation, irritable bowel syndrome and diverticulosis in older people. J Am Geriatr Soc 48: 1142-50, 2000.
Odunsi ST, Camilleri M, Bharucha AE, et al. Reproducibility and performance characteristics of colonic compliance, tone, and sensory tests in healthy humans. Dig Dis Sci. 2010;55:709-715.
Turnheim K. When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol 38: 843-49, 2003.
Froom P, Miron E, Barak M. Oral anticoagulants in the elderly. Br J Haematol 120:526-31, 2003.
Hu KC, Chu CH, Wang HY, et al. How Does Aging Affect Presentation and Management of Biliary Stones? J Am Geriatr Soc. 2016 Nov;64(11):2330-2335. doi: 10.1111/jgs.14481. Epub 2016 Sep 27. PMID: 27676699.
Matsuda Y. Age-related morphological changes in the pancreas and their association with pancreatic carcinogenesis. Pathol Int. 2019 Aug;69(8):450-462. doi: 10.1111/pin.12837. Epub 2019 Jul 24. PMID: 31339204.
Hommos MS, Glassock RJ, Rule AD. Structural and functional changes in human kidneys with healthy aging. J Am Soc Nephrol JASN. 2017;28(10):2838.
Roseman DA, Hwang S-J, Oyama-Manabe N, et al. Clinical associations of total kidney volume: the Framingham Heart Study. Nephrol Dial Transplant. 2017;32(8):1344-1350.
Wang X, Vrtiska TJ, Avula RT, et al. Age, kidney function, and risk factors associate differently with cortical and medullary volumes of the kidney. Kidney Int. 2014;85(3):677-685.
Silva FG. The aging kidney: a review–part I. Int Urol Nephrol. 2005;37:185-205.
Denic A, Lieske JC, Chakkera HA, et al. The substantial loss of nephrons in healthy human kidneys with aging. J Am Soc Nephrol JASN. 2017;28(1):313.
Bolignano D, Mattace-Raso F, Sijbrands EJG, et al. The aging kidney revisited: a systematic review. Ageing Res Rev. 2014;14:65-80.
Schmitt R, Melk A. Molecular mechanisms of renal aging. Kidney Int. 2017;92(3):569-579.
Luft FC, Wienberger MH, Fineberg NS, et al. Effect of age on renal sodium homeostasis and its relevance to sodium sensitivity. Am J Med 82 (suppl 1 B): 9-15, 1987.
Litviňuková, M., Talavera-López, C., Maatz, H., et al. (2020). Cells of the adult human heart. Nature 588, 466–472.
Karamitsos, T.D., Arvanitaki, A., Karvounis, H., et al. (2020). Myocardial tissue characterization and fibrosis by imaging. JACC-Cardiovasc Imag 13, 1221–1234.
Triposkiadis, F., Xanthopoulos, A., and Butler, J. (2019). Cardiovascular aging and heart failure: JACC review topic of the week. J Am College Cardiol 74, 804–813.
Kocyigit SE, Erken N, Dokuzlar O, et al. Postural blood pressure changes in the elderly: orthostatic hypotension and hypertension. Blood Press Monit. 2020 Oct;25(5):267-270. doi: 10.1097/MBP.0000000000000466. PMID: 32675475.
Chadda, K.R., Ajijola, O.A., Vaseghi, M., et al. (2018). Ageing, the autonomic nervous system and arrhythmia: from brain to heart. Ageing Res Rev 48, 40–50.
Rostagno, C. (2019). Heart valve disease in elderly. World J Cardiol 11, 71–83.
López-Otín, C., Blasco, M.A., Partridge, L., et al (2013). The hallmarks of aging. Cell 153, 1194–1217.
Reece, A.S., and Hulse, G.K. (2013). Reduction in arterial stiffness and vascular age by naltrexone-induced interruption of opiate agonism: a cohort study. BMJ Open 3, e002610.
Lowery, E.M., Brubaker, A.L., Kuhlmann, E., et al (2013). The aging lung. CIA 8, 1489–1496.
The Merck Manual of Geriatrics. Aging and the lungs. Beers MH, Berkow R (eds), third edition, Merck&Co., Inc., U.S.A. 2000, p. 753-758.
Sharma, G., and Goodwin, J. (2006). Effect of aging on respiratory system physiology and immunology. Clin Intervent Aging 1, 253–260.
Davies GA, Bolton CE. Age-related changes in the respiratory system. In: Fillit HM, Rockwood K, Woodhouse K (eds): Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, seventh edition. Saunder Elsevier. Philadelphia. 2010, p.97-100.
O’Flaherty EJ. Modeling normal aging bone loss, with consideration of bone loss in osteoporosis. Toxicol Sci 55: 171-88, 2000.
Friedman, S.M., and Mendelson, D.A. (2014). Epidemiology of fragility fractures. Clin Geriatric Med 30, 175–181.
Cruz-Jentoft, A.J., Bahat, G., Bauer, et al. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48, 16–31.
Drey M. Sarcopenia - pathophysiology and clinical relevance. Wien Med Wochenschr. 2011 Sep;161(17-18):402-8. doi: 10.1007/s10354-011-0002-y. Epub 2011 Jul 29. PMID: 21792531.
Mejia-Ramirez, E., and Florian, M.C. (2020). Understanding intrinsic hematopoietic stem cell aging. Haematologica 105, 22–37.
The Merck Manual of Geriatrics. Aging and the blood. Beers MH, Berkow R (eds), third edition, Merck&Co., Inc., U.S.A. 2000, p. 672-674.
Jaiswal S, Fontanillas P, Flannick J, et al. Age-related clonal hematopoiesis associated with adverse outcomes. N Engl J Med 371:2488-91, 2014.
Isaia G, Greppi F, Ausiello L, et al. D-dimer plasma concentrations in an older hospitalized population. J Am Geriatr Soc 59: 2385, 2011.
Calcinotto, A., Kohli, J., Zagato, E., et al. (2019). Cellular senescence: aging, cancer, and injury. Physiol Rev 99, 1047–1078.
Chakravarti B, Abraham GN. Aging and T cell-mediated immunity. Mech Aging Dev 108: 183-206, 1999.
Latz, E., and Duewell, P. (2018). NLRP3 inflammasome activation in inflammaging. Semin Immunol 40, 61–73.
Mariotti S, Franceschi C, Cossarizza A, et al. The aging thyroid. Endocr Rev 16: 686-715, 1995.
Almela M, Hidalgo V, Villada C, et al. The impact of cortisol reactivity to acute stress on memory: sex differences in middle-aged people. Stress. 2011 Mar;14(2):117-27. doi: 10.3109/10253890.2010.514671. Epub 2010 Oct 31. PMID: 21034293.
Shaw ND, Srouji SS, Histed SN, et al. Differential effects of aging on estrogen negative and positive feedback. Am J Physiol Endocrinol Metab. 2011 Aug;301(2):E351-5. doi: 10.1152/ajpendo.00150.2011. Epub 2011 May 10. PMID: 21558550; PMCID: PMC3154535.
Fuh VL, Bach MA. Growth hormone secretagogues: mechanism of action and use in aging. Growth Horm IGF Res. 1998 Feb;8(1):13-20. doi: 10.1016/s1096-6374(98)80317-1. PMID: 10990440.
Secomandi, L., Borghesan, M., Velarde, M., et al. (2022). The role of cellular senescence in female reproductive aging and the potential for senotherapeutic interventions. Hum Reprod Update 28, 172–189.
Kaufman, J.M., Lapauw, B., Mahmoud, A., et al. (2019). Aging and the male reproductive system. Endocrine Rev 40, 906–972.
Preston, A.R., and Eichenbaum, H. (2013). Interplay of hippocampus and prefrontal cortex in memory. Curr Biol 23, R764–R773.
Davis DG, Schmitt FA, Wekstein DR, et al. Alzheimer neuropathologic alterations in aged cognitively normal subjects. J Neuropathol Exp Neurol 58: 376-388, 1999.
Dickstein DL, Kabaso D, Rocher AB, et al. Changes in the structural complexity of the aged brain. Aging Cell 6: 275-84, 2007.
Laubach M, Lammers F, Zacharias N, et al.; BioCog Consortium. Size matters: Grey matter brain reserve predicts executive functioning in the elderly. Neuropsychologia. 2018 Oct;119:172-181. doi: 10.1016/j.neuropsychologia.2018.08.008. Epub 2018 Aug 10. PMID: 30102906.
Fromy B, Sigaudo-Roussel D, Gaubert-Dahan ML, et al. Aging-associated sensory neuropathy alters pressure-induced vasodilation in humans. J Invest Dermatol. 2010 Mar;130(3):849-55. doi: 10.1038/jid.2009.279. Epub 2009 Sep 3. PMID: 19727122.
Levine, J.M. (2020). Clinical aspects of aging skin: considerations for the wound care practitioner. Adv Skin Wound Care 33, 12–19.
Zou, Z., Long, X., Zhao, Q., et al. (2021). A single-cell transcriptomic atlas of human skin aging. Dev Cell 56, 383–397.e8.
Sayfalar
73-90
Gelecek
23 Nisan 2024
Telif Hakkı (c) 2024 Akademisyen Yayınevi Kitap Portalı
Lisans
LisansNasıl Atıf Yapılır
1.
Mutlay F. Physiological Changes in the Elderly. Içinde: Kadiroğlu AK, editör. General Internal Medicine VI (Spring) [Internet]. Türkiye: Akademisyen Yayınevi Kitap DOI Portalı; 2024 [a.yer 13 Temmuz 2026]. ss. 73-90. Erişim adresi: https://www.omp35.books.akademisyen.net/index.php/akya/catalog/book/3053/chapter/13731
