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Age related changes of each system in the elderly. Physical changes - lean body mass reduced and fat tissue increase until around age 60, bone mass decreases, extracellular fluid remains constant, however, intracellular fluid decreases and leads to reduced total body fluid. Elders are at risk of dehydration. Integument -The skin becomes drier and more fragile, the hair loses color, the fingernails and toenails become thickened and brittle, and in women over 60, facial hair increases. These integumentary changes accompany progressive losses of subcutaneous fat and muscle tissue, muscle atrophy, and loss of elastic fiber, resulting in a "double" chin, sagging of eyelids and earlobes, and wrinkling of skin, especially in areas exposed to sun. Bony prominences become visible. In older women, the breasts become smaller and may sag; if large and pendulous, they may cause chafing where the skin surfaces touch. Loss of subcutaneous fat also decreases elders tolerance of cold. Neuromusculoskeletal - gradual reduction in the speed and power of skeletal or voluntary muscle contractions and sustained muscular effort. After 50 decrease in muscle fibers. Often balance is impaired with age. The person's reaction time slows with age. Decrease muscle tone as a result of diminished physical activity. Ran out of room. Fundamentals pg 401-412