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PSYC 322 > 5. Longevity and Health > Flashcards

5. Longevity and Health Flashcards

Includes chapter 5

1
Q

what are maximum and average longevity?

A
  • maximum longevity - the oldest age to which any individual of a species lives (about 120 right now)
  • average longevity - the age at which half of the individuals who are born in a particular year have died
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2
Q

what are the main factors influencing longevity?

A
  1. genetics
  2. gender
  3. environment
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3
Q

what is active life expectancy (healthspan) and dependent life expectancy?

A
  • active life expectancy (healthspan) - refers to years living in a healthy state
  • dependent life expectancy - refers to remaining years living in a dependent state
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4
Q

what is some evidence that genetics contribute to longevity?

A
  • the parents and siblings of people who live till 90 were less likely to die young, but there was no impact on spouses
  • after the age of 60, genetics increasingly influences lifespan for twins, and there is more of similarity between identical twins than fraternal twins
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5
Q

how does gender affect longevity?

A
  • in developed countries, women tend to live much longer than men (about 5 years)
  • in developing countries, life expectancy is almost equal
    • women often die in childbirth and baby girls are more unwanted
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6
Q

what are some possible reasons why women in developed countries live longer than men?

A
  • biological differences - different chromosomes, hormones, immune system efficiency, metabolic rates
  • lifestyle differences - men tend to drink and smoke more, have poor social support, more risky behaviour
  • types of work/war - men tend to have more dangerous jobs and engage in war more often
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7
Q

what are our different types of immunity? what is immunosenescence?

A
  • innate immunity - first line of defence, recognizes threat, rapid response
  • adaptive immunity - comes in if innate immunity doesn’t work, is slower, able to target invaders the next time they’re introduced
  • immunosenescence - gradual deterioration of the immune system brought on by natural age advancement
    • difficult to isolate the impact of aging on the function of the immune system
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8
Q

what happens to older adults as the immune system changes?

A

older adults are/have
- more susceptible to certain infections
- much higher risk of cancer
- benefit less from immunizations
- adaptive immunity is less efficient, tend to gert vaccinations early
- immune systems take longer to build up immune defenses
- more prone to serious consequences from illnesses
- immune system can begin attacking the body itself (autoimmunity)

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9
Q

what are acute vs. chronic diseases?

A
  • acute diseases - conditions that develop over a short period of time and cause a rapid change in health
    • contracted less as we age because we build immunity and familiarity, but impact is more severe
  • chronic diseases - conditions that last a longer period of time (at least 3 months) and may be accompanied by residual functional impairment that necessitates long-term management
    • believed to be a part of aging until the 1990
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10
Q

what are the most common chronic illness amongst those 65 years of age and older?

A

45% had arthritis, 43% had high blood pressure, and 18% had diabetes

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11
Q

what is multi-morbidity?

A
  • having multiple chronic illnesses
  • related to being a women and having low income
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12
Q

what population has the highest levels of chronic illness and why?

A
  • aboriginal communities have higher levels of chronic illness
    • may be due to food insecurity, high cost of food, and less nutrient dense food
  • lack of culturally safe health care is a concern for aboriginal communities
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13
Q

what do we measure in order to assess level of health?

A
  • we assess ability to perform activities of daily living (ADL) to assess level of health
  • these measure provide functional assessment of health status by indicating degree of independence
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14
Q

how has the percentage of deaths by age changed?

A
  1. in 1921, the biggest proportion of deaths are in the first year of life (over 25%)
  2. in 1921, people are dying throughout adulthood (about 3-5% at every age group)
  3. in 1996, the age with the most deaths is about 70, but in 2011 it is about 85
    - in the past, most deaths were due to acute illnesses but now they are due to chronic illness (cancer)
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15
Q

what lifestyle habits contribute to diseases?

A
  • tabacco smoking
  • physical inactivity
  • unhealthy diet
  • harmful alcohol use
  • all contribute to cardiovascular disease, cancer, diabetes, chronic respiratory disease
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16
Q

what is diabetes?

A
  • a chronic disease in which the body
    1. cannot produce insulin, or
    2. does not make enough insulin, or
    3. cannot properly use the insulin it produces (insulin insensitivity)
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17
Q

what is type 1 diabetes? what are some treatments?

A
  • cannot produce insulin because cells have been attacked by own immune system
  • generally develops in childhood and adolescents
  • treated with insulin, diet planning and exercise
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18
Q

what is type 2 diabetes? what are some treatments?

A
  • cannot properly use the insulin it produces (insulin insensitivity/insulin resistance) or does not make enough
    • usually because cells are over-worked
  • developed mostly in adults
  • managed by physical activity, dietary planning, and medication and/or insulin if necessary
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19
Q

what are some complications and risks of high blood sugar?

A
  • damage to and narrowing of arteries
  • nerve damage
  • chronic kidney disease - responsible for cleaning blood, there is a lack of blood flow to kidney
  • lower limb amputation - people often don’t feel lower limbs, won’t notice injuries/infections
  • diabetic retinopathy → blindness
  • heart attack
  • stroke
  • erectile dysfunction
  • death
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20
Q

what is the prevalence of diabetes by age? what people are more likely to develop diabetes?

A
  • we are 30% more likely to get type 2 diabetes as we age
  • aboriginal people are diagnosed at a younger age, and they experience greater severity, more complications from the disease and have poorer treatment outcomes
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21
Q

what is gestational diabetes?

A
  • impacts 20% of pregnant women
  • managed through diet, exercise, and medication
  • greater risk of child developing type 2 diabetes
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22
Q

how can we prevent diabetes?

A
  • maintain healthy weight with physical activity and healthy diet
    • eat whole grains, lean meat, fruit and veggies, cut sugar
  • screening over 40 years of age
    • can catch prediabetes - higher than normal blood sugar
  • be aware of relatives with Type 2 and of gestational diabetes
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23
Q

what are some barriers to self-care of diabetes?

A
  • difficulty to adhere to treatment
  • attitudes and beliefs about diabetes
  • co-morbidities
  • poor patient-practitioner communication and fit
  • lack of social support
  • financial restrictions
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24
Q

how do attitudes and beliefs act as a barrier to self-care of diabetes?

A
  • some see insulin therapy as a sign of failure in managing diabetes
  • think injections are restrictive, ineffective, may exacerbate
  • think meds will worsen condition
  • cultural beliefs - some think that you just need to stop having sugar
    • also think that exercise is recommended to get rid of toxins, so they go to a sauna and sweat instead of exercise
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25
Q

how does cancer occur?

A
  • cancer starts when cells change abnormally and cancer grows as cells multiple over and over
  • most cancers start due to to gene changes that happen over a person’s lifetime
    • not usually genetic
  • more rarely, cancers start due to inherited faulty genes passed down in families
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26
Q

what are some environmental agents that contribute to the development of cancer?

A
  • physical carcinogens (radiation), chemical carcinogens (asbestos), or biological carcinogens
  • cancers become more prevalent with increasing age in adulthood because age is associated with greater cumulative exposure to harmful toxins (carcinogens)
  • cancer can be caused by HPV, helicobacter pylori, Epstein‐Barr, and hepatitis B and C
  • increased testosterone can lead to prostate cancer, estrogen in post-menopausal women increases likelihood of getting uterine cancer
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27
Q

how has detection of cancer and number of survivors changed?

A
  • until the early 20th century, detection of cancer depended on gross signs and symptoms
    • at that point, the cancer is already quite advanced and treatment is less likely to be successful
  • 1982: 3 million cancer survivors living in the US (1.3%)
  • 2016: 15.5 million cancer survivors in the US (4.7%) 3x the amount of people in 1982
  • change is due to earlier detection, not necessarily more effective or different treatment
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28
Q

what was the social context surrounding cancer in the past?

A
  1. cancer associated with dread, fatalism, shame, silence, and stigma
  2. lack of control over treatment
  3. lack of support and acceptance
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29
Q

what is the prevalence of cancer and cancer deaths in Canada?

A
  • 1 in 2 Canadians is expected to develop cancer during their lifetime
    • 49% of men and 45% of women
  • 1 in 4 Canadians is expected to die from cancer
    • 28% of men and 24% of women
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30
Q

how has the age of people developing cancer changed?

A
  • we are seeing more and more people in their 30s and 40s developing cancer
  • raw numbers of cancer are increasing, but survival rates are also increasing
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31
Q

what are the most common forms of cancer and their 5 year survival rates?

A
  1. prostate (95%)
  2. lung (17%)
  3. breast (87%)
  4. colorectal (64%)
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32
Q

what are the different stages of cancer?

A

stage 0: no cancer, only abnormal cells with the potential to become cancer.

stage I: the cancer is small and only in one area (early-stage cancer)

stage II : the cancer is larger

stage III: the cancer is larger and has grown into nearby tissues or lymph nodes.

stage IV: the cancer has spread to other parts of your body (advanced or metastatic cancer)

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33
Q

what are some signs and symptoms of cancer?

A
  • fatigue
  • unexplained weight loss
  • fever
  • pain
  • skin changes
  • unusual lumps (tumours)
34
Q

what do the signs and symptoms of cancer depend on?

A
  • where the cancer is
  • it’s size
  • how much it affects the nearby organs or tissues
  • if it has spread (metastasized)
35
Q

what are the 5-year survival rates for breast, ovarian, and lung cancers depending on whether there was early or late diagnosis?

A
  • breast cancer: 90% (early) vs 15% (late)
  • ovarian cancer: 90% (early) vs 5% (late)
  • lung cancer 1-year survival rate: 80% (early) vs 15% (late)
36
Q

how does distress in patients and caregivers differ in women and men?

A
  • women patients and caregivers report higher levels of distress than healthy controls
  • male patients, but not caregivers, report higher levels of distress than healthy controls
  • women report higher levels of distress than their husband with cancer
37
Q

what are some reasons that caregivers that are women are more distressed than caregivers that are men?

A
  • women pay more attention to relationships and are more in charge with taking care of family
    • traditional gender roles cause women to be expected to care for their sick family
    • for men, it is not an expected role, so they feel good about helping and supportive
38
Q

how does quality of life differ for cancer patients before and after treatment?

A
  • most survivors are unlikely to encounter long-term decreases to activities of daily living after surgery
  • quality of life also increases after the operation, when compared to life prior to operation
  • fear of cancer recurrence is among the most commonly reported problems
39
Q

what are some predictors of quality of life for breast cancer survivors?

A
  • co-morbidities
  • use of chemotherapy
  • social support increases QOL
  • income
  • employment status
  • having children under 18 living at home
40
Q

what is higher fear of cancer recurrence associated with?

A
  • younger age
  • presence and severity of physical symptoms
  • lower quality of life
  • lower religiosity
41
Q

what is post-traumatic growth? what is it influenced by?

A

positive psychological change experienced as a result of the struggle with highly challenging circumstances

it is influenced by…
* perceptions of oneself
* focus on family and friends
* re-evaluation of life priorities
* appreciation of life

42
Q

what are the most common cancer treatments?

A
  • radiation - use of high‐energy X‐rays to damage cancer cells and stop their growth
  • surgery - most common treatment for most types of cancer when it is probable that all of the tumours can be removed
  • chemotherapy - uses drugs to kill cancer cells
    • most likely to receive chemotherapy when the cancer has metastasized to other parts of the body
43
Q

what is atherosclerosis?

A
  • when fatty deposits collect at an abnormally high rate, reducing the width of the arteries and limiting circulation of blood
  • you can live with atheroscleroris, but eventually it will block blood flow to a part of the body and it will suffer lots of damage
44
Q

what is coronary (ischemic) heart disease?

A

when atherosclerosis affects the arteries that feed the heart

45
Q

what is a myocardial infarction?

A

when blood flow to part of the heart muscle is severely reduced or blocked

46
Q

what is hypertension? what is systolic and diastolic pressure?

A
  • chronic abnormally elevated blood pressure
    • systolic - pressure exerted by the blood as it is pushed OUT of the heart (contraction)
    • diastolic - pressure when the blood is relaxed between beats
47
Q

how does hypertension interact with atherosclerosis?

A
  • atherosclerosis contributes to hypertension as the acumulation of plaques force blood to be pushed throuogh narrower and narrower arteries
  • increased pressure places strain on the artery walls making them weak and inflamed
    • this causes more plaque to be accumulated
  • hypertension also increases the workload on the heart, causing it to pump harder to push out the blood
    • heart muscle in the left ventricle becomes thicken and overgrown
48
Q

what is congestive heart failure?

A
  • when the heart is unable to pump enough blood to meet the needs of the body’s other organs
    • blood flows out of the heart at a slower rate, causing the blood returning to the heart through the veins to back up
    • this causes the tissues to be congested with fluid
  • can be caused by coronary heart disease, scar tissue from a past myocardial infarction, hypertension, disease of the heart valves, disease of the heart muscle, infection of the heart, or heart defects present at birth
49
Q

what happens when people with congestive heart failure exert themselves?

A
  • people with congestive heart failure are unable to exert themselves without becoming exhausted and short of breath
    • legs may swell due to edema, a condition in which fluid builds up in their bodies
    • may also experience a fluid buildup in lungs, and kidney problems
50
Q

what is a cerebrovascular accident?

A
  • an acute condition in which an artery leading to the brain bursts or is clogged by a blood clot or other particle
    • usually cause by a cerebrovascular disease
51
Q

what is a transient ischemic attack/ministroke?

A
  • caused by the development of clots in the cerebral arteries
  • the same as a stroke, except the symptoms last for less than 24 hours
    • must treat TIAs as a full-blown stroke
    • full stroked often follow TIAs
52
Q

how prevalent are cardiovascular diseases in Canada?

A
  • heart and cerebrovascular diseases are two of the three leading causes of death in Canada (25%)
  • heart attacks and heart failure accounted for two of the five top reasons for hospitalization
  • 9 in 10 Canadians have at least one risk factor for heart disease and stroke
    • 80 percent of these conditions are preventable through lifestyle change
53
Q

what are behaviour risk factors for cardiovascular diseases?

A
  • tobacco smoking (damages arteries)
  • sedentary lifestyle
  • high alcohol intake
  • metabolic syndrome
54
Q

what is metabolic syndrome?

A
  • people who have a cluster of symptoms associated with high‐risk factors for cardiovascular diseases
  • criteria: obesity, high levels of triglycerides, high levels of bad cholesterol, hypertension, and high levels of glucose
  • three of these criteria must be present for the person to be considered to have metabolic syndrome
55
Q

what are some sociocultural factors that are associated with lower and higher risk of cardiovascular diseases?

A
  • lower risk is associated with higher socioeconomic advantages, higher educational levels, greater trust between neighbours, and more social support
  • higher risk is associated with barriers to accessing routine health care, taking prescription medication, and the inability to pay for prescription medication
56
Q

what are statins?

A

medications that lower the levels of harmful cholesterol (LDL) in the blood

57
Q

what diet is best for a healthy heart?

A
  • high in fruits and vegetables
  • nuts, seeds, whole grains, olive oil
  • minimum amount of red meat and dairy
58
Q

what is chronic obstructive pulmonary disease (COPD)?

A
  • group of diseases that involve obstruction of the airflow into the respiratory system
    • chronic bronchitis and chronic emphysema—often occur together in this disease
  • people with COPD experience coughing, excess sputum, and difficulty breathing even when they carry out relatively easy tasks
  • main cause of COPD is cigarrette smoking
59
Q

what is chronic bronchitis?

A
  • inflammation of the bronchi which causes an increase in mucus
60
Q

what is chronic emphysema?

A
  • causes permanent destruction of the alveoli
    • elastin within the terminal bronchioles is destroyed
    • causes the airways to lose their ability to become enlarged during inspiration and to empty completely during expiration
61
Q

how is cigarrette smoking related to chronic emphysema?

A
  • link between smoking and emphysema is thought to involve the release of an enzyme known as elastase
    • elastase - breaks down the elastin found in lung tissue
  • cigarette smoke stimulates the release of this enzyme
  • cigarette smoke inactivates AAT (which inhibits elastase) and allows the elastase to destroy more lung tissue
62
Q

how can people with COPD be treated?

A
  • individuals with COPD can benefit from medications and treatments
    • inhalers that open the airways to bring more oxygen into the lungs or reduce inflammation
    • machines that provide oxygen
    • or in severe cases, lung surgery to remove damaged tissue
63
Q

what are some social determinants of health and prevention?

A
  • rural communities have fewer community health services
    • health care policies and practices that work well in urban environments often do not translate well into rural environments
  • also important to continue preventative practices even in late age
64
Q

what is an ischemic stroke?

A
  • caused by blockages which cut off the blood supply to parts of the brain
    • accounts for 85% of strokes
    • plaque can make arteries narrow, blood clots can cause blockages more easily
65
Q

what is a hemorrhagic stroke?

A
  • caused when a blood vessel bursts within or on the surface of the brain
    • caused when an aneurysm that forms because of high blood pressure bursts
    • 1/10 people with hemorrhagic stroke die before they get to the hospital
66
Q

what does the incidence of stroke look like?

A
  • stroke occurrence and number of people increases with age
  • a higher percentage of men have strokes than women
  • number of deaths is increase, but so is our population
    • percentage of death from strokes is actually decreasing
67
Q

what are some effects of a stroke?

A
  • weakness or paralysis in arms and legs
  • problems with speaking, understanding, reading, and writing (aphasia)
  • swallowing problems
  • vision problems
  • losing bowel and bladder control
  • pains and headaches
  • fatigue
  • problems with memory and thinking
  • pseudobulbar affect - uncontrolled inappropriate laughing and crying
68
Q

what do the effects of a stroke depend on?

A
  • type of stroke
  • area and side of brain impacted
  • amount of damage to the area
  • amount of time the brain has no blood
  • amount of time before treatment
69
Q

what are the rates of recovery of stroke?

A
  • 10% of stroke survivors recover almost completely
  • 25% recover with minor impairments
  • 40% experience moderate to severe impairments requiring special care
  • 10% require care in a nursing home or other long-term care facility
  • 15% die shortly after the stroke
  • number of stroke survivors is projected to increase
70
Q

what are some modifiable risk factors of stroke?

A
  • high blood pressure
  • high cholesterol
  • diabetes (type 2)
  • being overweight
  • smoking
  • excessive drinking
  • drug use
  • inactivity
71
Q

what are some unmodifiable risk factors of stroke?

A
  • age
  • ethnicity
  • gender
  • family history of heart disease
  • diabetes (type 1)
72
Q

what are the warning signs of stroke?

A

B alance - headache, dizziness
E yes - blurred vision

F ace - is dropping
A rm or leg weakness
S peech difficulty
T ime to call 911

73
Q

what are caregivers more at risk for?

A
  • depression and anxiety (25-35%)
  • morbidity and mortality
  • impact on immune system
  • impact on telomeres
74
Q

what are caregivers the most challenged by?

A
  1. changes to assumptive world
  2. unprepared for caregiving role
  3. burden of daily demands
  4. shifts in relationship
75
Q

how are some ways that someone can be unprepared for caregiving role?

A
  • extensive needs for information and education:
  • administering meds
  • physical care
  • proper nutrition
  • safety with transfers
  • rehabilitation
  • understanding diagnosis and prognosis
76
Q

how can a relationship shift as one person becomes a patient and the other a caregiver?

A
  • marital strain
  • spousal support for caregiver is lacking
  • intimacy
  • illness can bring a couple closer together
77
Q

what is protective buffering?

A
  • caregivers hold in negative experiences to not add additional burden to patient
    • actually has no impact on patient, greater distress in caregiver
78
Q

what are the direct effects of chronic stress on caregivers?

A
  • increased time for wound healing
  • poor vaccination response, adaptive immunity takes longer to build up
  • chronic inflammation, linked to an increase in morbidity
  • mortality
79
Q

what are the indirect effects of chronic stress on caregivers?

A
  • higher fat diet
  • exercising less
  • being a smoker, having less confidence in quitting smoking
80
Q

how does stress impact telomeres in research on women and mothers?

A
  • women with the highest levels of perceived stress have shorter telomeres
    • shorter by the equivalent of at least one decade of additional aging
  • women who take care of a child who is chronically ill also have shorter telomeres
  • women who are stressed give birth to children with shorter telomeres
81
Q

how does exercise buffer the effects of stress?

A
  • for people who exercise, levels of stress don’t affect telomere shortening
  • for non-exercisers, a 1-unit increase in perceived stress is related to a 15x increase in odds of having shorter telomeres
82
Q

how do health behaviours buffer the effects of stress?

A
  • as major life events increase, the telomeres of people with low healthy behaviours decrease significantly
  • as healthy behaviours increase, stress does not affect length of telomeres

PSYC 322 (14 decks)

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