Ageing Well or Not So Well Flashcards
(41 cards)
What is demographics?
Study of populations based on factors such as race, age and gender
What is demographic data?
socio-economic info expressed statistically.
Income, education, marital status, employment status etc
Are population demographics static?
No
Why are population demographics not static?
birth
death
migration
= these are all measurable, balance of factors
What factors influence population growth?
- cost of education
- female labour market participation
- economic growth
- stability of society
- availability of contraception
- social norms
- government policy
- healthcare standards
- net migration
- cultural attitudes to family size
What are the 5 stages of demographic transition?
Stage 1 – pre-industrial; birth and death rates high – population size fairly constant – wars and pandemics etc can have a big impact.
Stage 2 – modern medicine – lower death rates esp. among children. Birth rates remain high – rapid population growth.
Stage 3 – birth rates gradually decrease, improved economic conditions and contraception. Population growth continues but at a lower rate.
Stage 4 – population stabilises as birth rates and death rates low. Stronger economies, better education, better healthcare, more women in work.
Stage 5 – in the future fertility rates fall and elderly population > younger.
What can affect life expectancy?
deprivation
ie lower life expectancy in least deprived areas eg 10yrs in least deprived areas in Scotland for females and 13.3 years for males.
What can be used to measure deprivation?
Scottish index of multiple deprivation (SIMD)
What 7 factors does the SIMD include?
- income
- employment
- education
- health
- access to services
- crime
- housing
(deciles each containing 10% of population and quintiles each containing 20% of the population)
What were the leading causes of death in Scotland?
- ischaemic HD
- dementia and alzheimer’s
- lung cancer
- cerebrovascualr disease (inlc stroke)
- chronic lower resp diseases (eg bronchitis and emphysema)
What does the risk of preventable death increase with?
deprivation
What is healthy life expectancy linked to?
life expectancy and deprivation (where someone lives has a profound impact on morbidity and mortality)
What is the impact of an ageing population?
- need for health and social care
- increased spending on pensioners
- increase in dependency ratio
- housing needs
- workforce shortages
What do populations change due to?
changes in birth rates, death rates, immigration and emigration
What do populations curves in different countries and in different regions of the same country reflect?
local socio-economic differences
Are life expectancy and health life expectancy linked?
yes
what does deprivation have a significant impact on?
both life expectancy and healthy life expectancy
What is the physiology of ageing?
- decline
- loss of cells
- loss of function
- across body systems
- less ability to respond to metabolic stress
- less reserve capacity
- less ability to recover
Cardiovascular system – hypertension, arteriosclerosis, reduced ejection fraction.
Respiratory system – reduced lung volumes, alveolar enlargement, reduced respiratory muscle strength.
Musculoskeletal system – osteopenia, sarcopenia, degeneration of articular cartilage.
Ocular system – dry eyes, presbyopia, cataracts, macular degeneration.
Vestibulocochlear system – hearing loss, loss of balance.
Urinary and renal systems – reduction in GFR, reduction in bladder capacity, reduction in urinary flow rate
how can long term conditions affect people?
by age 65 - 2/3 of people have long term conditions
60% of all death and 80% of of GP consultations due to long term conditions
Cancer, asthma, diabetes, COPD, depression, anxiety, alcohol and substance abuse, heart disease, chronic pain, multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease, psoriasis, sight loss, hearing loss, learning disability.
what is multimorbidity?
presence of 2 or more long term conditions
1/4 of people aged 75-84 have 2 or more long term conditions
Linked with reduced quality of life, higher mortality, higher use of health services and polypharmacy.
Multiple symptoms, multiple medications, burden of disease and treatment. Complex.
does deprivation affect multimorbidity?
yes - most deprived experience multimorbidity 10-15yrs earlier than most deprived
what is the commonest multimorbidity in deprivation?
mental health
what is polypharmacy?
definitions vary = 4-9 or >10
- multiple meds introduced for each condition
- appropriate vs inappropriate
- increased treatment burden
- increased likelihood of interactions
- “law of diminishing returns”
- reduced ability of patients to adhere to treatment
what is the complexity involved in polypharmacy?
Guideline based treatments focus on single diseases.
Medications are tested in isolation.
Drugs often interact with one another.
Drugs that help one system hinder another.
Multimorbidity – frailty – less reserve – higher likelihood of harm.
