Biological Theories of Aging Flashcards
____ _____ try to explain how individuals differ in the aging process, and how aging affects the person physically.
Biological theories
- The ______ stimulates the production of lymphocytes, increasing resistance to infection.
thymus
- Immunity theory suggests a link between aging and the disappearance of the ____ ____ by late middle age.
- Absence of this gland results in weakening of the body’s natural defense against foreign bodies.
thymus gland
___ ____ ____:
1. Our proteins, DNA, and other molecules develop inappropriate attaclunents or cross-links to one another.
Cross-linkage Theory
- Inappropriate ____ ____ results in:
a. Decreased mobility of proteins and other molecules
b. Damaged or inhibited proteins can cause problems
cross-linkages
- ____-_____ of the skin protein, collagen, is partly responsible for wrinkling.
Cross-linking
- ____ ____ are one of the toxic by products of normal cell metabolism.
Free radicals
- Substances within one’s cells contain or ______ dangerous free radicals.
neutralize
- Free radicals that escape the neutralization process can result in:
a. DNA damage
b. Cross-linking of proteins
c. Formation of age ________
pigments
____ ____ ___ Theory
- Age is not chronological, but is determined by the amount of stress to the body and the resulting damage.
a. Analogous to mechanical breakdown of equipment
Wear and Tear
- Each person has an inherited amount of adaptability that can be used in dealing with the ____ to the body.
stress
- Although not widely accepted, _____ places stress on the body, but it is acknowledged that _______ is beneficial to overall health.
Exercise
_______ _____ ______:
1. Reduction of food intake, rather than decreased body fat or decreased metabolic rate, contributes to an anti-aging process.
Nutrition Restriction Theory
- Potential connection between reduction of food intake and:
a. Metabolic changes control the aging process, decline in ___ ______, and reduction in reactive oxygen molecules (free radicals)
protein synthesis
_____ _____
1. Aging is due to internal or external assaults that affect cells or organs so they can no longer function properly.
a. Changes in the DNA
b. Increased amounts of error in the RNA transcription
or protein synthesis
2. These resulting cell mutations are thought to the result of exposure to radiation.
Error Theory
____ ______ ______
- Hereditary basis in aging as shown by similar life spans of blood relatives.
a. Twin studies show that identical twins have much
more similar life spans than non-identical twins. - Researchers also point to cell division studies
a. Normal in vitro cells multiply finitely.
b. Abnormal cells may double an infinite amount of
times.
Biological Programming Theory
_______ ______:
1. Older people and society mutually “disengage” or
withdraw.
a. May be instigated by the elder or others in society.
Disengagement Theory
Disengagement Theory:
- Benefit to _______
a. Reflect and be centered on self
b. Relieved from societal roles
individual
Disengagement Theory:
3. Value to ______
a. Orderly means to transfer power from the young to
old
society
- Issues with the disengagement theory
a. Theory does not consider _____ and
contributions of older adults
b. Not observed in all cultures
activity
_____ _____
- People who remain socially active are more likely to adjust well to becoming older.
a. Social activity is needed for ongoing role enactment and positive self-image.
b. People with multiple roles have a broad spectrum to endorse a positive selfimage.
c. Theory supported by a number of studies
Activity Theory
Activity Theory:
2. Older adults should think of middle-age lifestyle ______ as the norm.
activity
Activity Theory:
- Replacement of discontinued activities should be encouraged. For example:
a. After retirement, one may move into ______.
b. Activities with close personal contact are typically most beneficial.
volunteering
- This theory is criticized as being too simplistic.
Continuity Theory
Continuity Theory
- Four patterns of personality and coping:
b. ____ ______: Hold onto middle-age values and fret over changes that occur with age
Defended personalities
Continuity Theory
- Four patterns of personality and coping:
c. ____-_____ ____: High dependency needs or are apathetic
Passive-dependent personalities
Continuity Theory
- Four patterns of personality and coping:
d. ___-____ _____: Inflicted with mental illness
Un-integrated personalities
Continuity Theory:
- Maintaining same level of ________t is thought to lead to optimum adjustment to aging
a. In general, shy, quiet loners should not be encouraged to become more active.
b. Extremely active individuals should be encouraged to stay active and not “watch life pass by from the rocking chair.”
involvemen
Continuity Theory:
- Greatest chance of adjustment for people continuing middle-life activities into old age:
a. People who like to garden may do so until mobility restricts them.
b. People who like to mountain bike or kick box may have ______ problems adjusting.
more
______ _____
- Adjustment to aging is ameliorated by:
a. Previously developed adaptive coping skills
b. Maintenance of previous roles and activities
Continuity Theory
Development Theories and Tasks
Erikson’ s Stages of Psychosocial Development (1963)
1. _______: Identity vs. role confusion
Adolescence
Development Theories and Tasks
Erikson’ s Stages of Psychosocial Development (1963)
2. _____: Intimacy vs. isolation
Adulthood
Development Theories and Tasks
Erikson’ s Stages of Psychosocial Development (1963)
3. ____ ___: Generativity vs. stagnation
Middle Age
Development Theories and Tasks
Erikson’ s Stages of Psychosocial Development (1963)
4. ____ ___: Ego identity vs. despair
Old Age
Peck’s Refinement of Challenges to the Elderly (1968)
- ___ ____ vs. role preoccupation
a. Develop satisfaction as a person, rather than through occupational or family roles
Ego differentiation
Peck’s Refinement of Challenges to the Elderly (1968)
- ____ ____ vs. body preoccupation
a. Find psychological pleasures, rather than worrying about health problems or physical limitations
Body transcendence
Peck’s Refinement of Challenges to the Elderly (1968)
- _____ _____ vs. ego preoccupation
a. Satisfaction through reflection, rather than worrying about the limited amount of years left
Ego transcendence
Principles of _________ _____
Being an effective educator involves understanding how adults leam best. The educator must be aware that adult learners are:
1. Internally motivated and self-directed: Adults learners resist learning when they feel others are imposing information or ideas on them. The role of the educator is to get the student moving toward more self-directed and responsible learning.
a. Routinely provide constructive and specific feedback
b. Review goals and acknowledge goal completion
c. Set projects or tasks
d. Acknowledge preferred learning styles
Adult Learning
Principles of Adult Learning
- Knowledgeable through___ _____ Adults like to use their own existing knowledge and apply it to new learning experiences.
a. Learn about your student’s interests and past experiences
b. Guide them to draw on those experiences with respect to current national standards of care
life experiences:
Principles of Adult Learning
- ____ ___: Adults become ready to learn when they have a need to learn information to better cope with real-life conflicts and events.
a. Provide meaningful learning experiences
b. Provide real case studies
c. Ask questions
Goal-oriented
Principles of Adult Learning
- _____ _____: Adult learners want to know the relevance of what they are learning with regard to what they want to achieve.
a. Ask the student to reflect on what they expect to learn before the experience.
b. Provide some choices and options of fieldwork
Relevancy-oriented
Principles of Adult Learning
- ____: Adults want to apply their knowledge through practical fieldwork experiences, and interactions with real clients and situations.
a. Expound upon clinical reasoning
b. Be clear about how knowledge is applied to the job and with patients
c. Facilitate hands-on experience and active participation
Practical
Principles of Adult Learning
6. Like to be ______
a. Take real interest in your learner
b. Acknowledge the experiences of your learner
c. Encourage the expression of ideas and feedback
d. Treat adult learners as a close colleague and friend,
while maintaining high standards
respected
The _____ ____ _____ suggests that individuals cannot be understood in isolation from one another but rather as a part of their family, as the family is an emotional unit.
Family Systems Theory
Social Support
1. The _____ is typically the touchstone of a person’s
social support network.
family
Social Support
2. The amount of contact and support is at least, partially
_____.
cultural
Social Support
3. In general, in America:
a. The _______ family has more members
who are older than members who are younger, as a
result of longer life spans and decreased child
bearing.
intergenerational
Social Support
3. In general, in America:
b. More often, it is noted that ______ and childless
siblings care for each other.
spouseless
Social Support
3. In general, in America:
c. More often, is it noted that an “____” generation
person (in his 60s) is taking care of an “older”
generational person (in his 80s).
old
Social Support
3. In general, in America:
d. _____ generally have greater intergenerational
communication and roles than men
Women
Family Functions
- Socialization and role support
a. Older generations pass down ___ and ____.
wisdom and skills
Family Functions
1. Socialization and role support
b. Younger generations pass up information on
______ times, technologies, etc.
changing
Family Functions
1. Socialization and role support
b. Younger generations pass up information on
______ times, technologies, etc.
changing
Family Function:
2. Affection and _____ _____
a. Well-being is closely related to strong parent-child
relationships.
b. Relationships between siblings are important for
childless, spouseless couples.
emotional support
Family Function:
- Caregiving
a. There is a lower risk of institutionalization with those having ____ family ties.
close
Family Function:
- Caregiving
b. Increasingly, middle-aged adults take care of the older generation, with _____ being primarily responsible.
women
Family Function:
- Caregiving
c. ____-____ or widowed daughters provide more caregiving for parents than married, separated, or divorced women.
Never-married
Family Function:
- Caregiving
d. Children providing caregiving are susceptible to_______, anxiety, and feelings of guilt (e.g., “I should be doing more.”).
depression,
Marital Relationships
1. Over one-half of people ___ and older are married.
65
Marital Relationships
- Marital roles ____ over time:
a. Care through illness, household management, emotional fulfillment
change
Marital Relationships
3. ____ generally report a higher level of fulfillment than ___ in marriage.
Men
women
Marital Relationships
- Changes in interdependencies may cause ____.
a. Retirement changes interdependencies and may result in _____.
stress
Marital Relationships
- Highest impact in stress from elder transitions due to:
a. Retirement
b. Illness
c. Change in ________
residence
Marital Relationships
6. Couples with more flexible role delineations have an easier time with ______.
transitions
Marital Relationships
- Loss of a spouse requires appropriate grieving, but most people adapt well.
a. Bereavement may take more than _____ years.
two
Parent-Child Relationship
1. Studies show that _____ does not diminish with age.
contact
Parent-Child Relationship
2. The _____ of the contacts is more relevant than the
number of contacts.
quality
Sibling Relationships
1. _____ lasting family relationship
Longest
Sibling Relationships
- Most even-handed
a. Role loss of older people is often better handled with sibling support than child or parent support because of ____ _____.
peer status
Sibling Relationships
3. ____relationships exist with spouseless and childless siblings.
Closer
Grandparent Relationships
- Styles:
a. _____: Rigid role expectation and authoritarian
Formal
Grandparent Relationships
- Styles:
b. ____ ___: Interaction centered on fun activities
Fun seekers
Grandparent Relationships
- Styles:
c. _____ _____: Assume caregiving roles
Surrogate parents
Grandparent Relationships
- Styles:
d. ___ ____ ____ _____: Pass down information about culture and family
Reservoirs of family wisdom
Grandparent Relationships
- Styles:
e. ______: Get together infrequently
Distant
Grandparent Relationships:
2. Early interaction often determines the ________ of the relationship through life.
closeness
Grandparent Relationships:
3. _____ may interfere with the grandparent-child relationship.
Divorce
Grandparent Relationships:
4. Frequently “____ ___” and support in times of stress: Financial support, emotional support, mediation, etc.
Step in
______ is prejudice or discrimination based on:
a. Age
b. “Characteristic”
Ageism
Examples of Ageism and Stereotypes:
a. Slow thinking,
b. Physically feeble
c. Non-sexual
d. Grey hair
e. ______
f. Pessimistic
g. Insecure
h. Meddlesome
i. Lonely
Wrinkles
- ______ is usually negative and is perpetuated by diminished contact between one generation and another
a. Older people may also “buy into” such stereotypes.
b. Contempt at the younger generation due to
“generation gap”
Ageism
- Older adults may be excluded from ________.
a. Misinfonned beliefs by law makers, judges, health insurance companies, and the healthcare profession may not do just service to elderly people.
opportunities
- Additionally, society may “____ ____” on the contributions of older, more experienced people.
lose out
- It is not uncommon for a healthcare professional to stereotype the elderly; the patient is blamed in a “___-___-___” mentality.
a. Example: An elderly in-patient wets the bed, and the result is that she is padded with incontinence pads. She is not given assistance to get out of bed to go to the bathroom because “she is incontinent,” and this spirals to being catheterized.
b. Example: An elderly patient in a nursing home complains about the cleanliness of his bathroom. This results in him being labeled “cranky” (annoyingly irritable).
blame-the-victim
- All healthcare professionals need to be on guard against labeling a medical or other legitimate concern as “part of the ___ ____” and thus not thoroughly treating the patient with dignity and respect.
aging process
Adolescents (age 11 to 19): Adolescents have complete PE including: a. Height/ weight (check for eating disorders) b. Skin exam c. Oral cavity ( Gingivitis/ caries) d. hearing e. abuse/ neglect/ depression f. BP (normal = < 120/80) at age \_\_\_\_\_ to \_\_\_\_
11 to 19
When to start Health assessment for adolescents?
11 to 14 years
How often should adolescents have health assessments?
Three visits ( 11 to 14 years, 15 to 17 years, and 18 to 21 years)
When to start giving Gardasin 9?
Age 9 to ____
Age 15 to ____
Age 9 to 14
Age 15 to 26
Adolescents health assessment for ____/STD in both male and females at age 11 to 19 years
Syphilis
Adolescents health assessment for males in age of 11 to 19 years should be self ____/ testicular exams.
breast
Adolescents age 11 to 19 years should be checked for HIV depending on level of sexual activity or ____ drug use.
IV
Adolesents age 7 years Tetanus- diphtheria (Td) ; substitute 1 dose of ____ (Adacel) for Td
Tdap
Adolescents age 11 to 19 years Meningococcal other names are _____; Menveo
Menactra
Adolescents age 11 to 19 years need I_______ immunization
Influenza
You need this immunization if your advanced age, smoker, asthmatic, COPD, diabetes, or alcoholic
Pneumococcal
Adolescents age 11 to 19 years need P__ Screening
PPD
How often should adolscents visit?
Three visits
a. 11 to 14 years
b. 15 to 17 years
c. 18 to 21 years
HPV:
Series of two 6 months apart
or series of three at ___, ___ and ___ months
0, 2, and 6 months
Tetanus- diphtheria (Td); substitute 1 dose of Tdap for Td. Give this immunization every ____ years
10 years
Meningococcal Controversial: Revaccinate * ___ only fo high risk (e.g. college freshman living in dorms) after five years from last
1
Influenza vaccine how often?
annually
PPD screening every _____ years if at risk or with any exposure to tuberculosis
two
HPV not to be used for women aged < ___ years old
30
HPV should be done how often?
every 5 years
Self breast exam should start at what age?
21 years
How often should you complete self breast exam?
optional
Clinical breast exam should start at what age? What age group (not a specific age)?
adolescence
Clinical breast exam should be done how often?
every three years; annually starting at age 40
Self-breast and testicular exam should start when? In what age group?
adolescence
Self-breast and testicular exam how often?
a. year
b. monthly
c. 3 years
d. 2 months
monthly
When to start taking blood pressure?
now
How often should blood be complete?
With every health care visit or every two years (normal <120/80)
When to start total cholesterol and HDL?
age 20
How often should cholesterol be taken?
every five years unless cholesterol >200 mg/dl
When to start self skin exams?
now
How often to complete self-skin exams?
regularly
Tetanus- diphtheria (Td) when to start?
When was the last?
How often to give Tetanus- diphtheria (Td)?
Every 10 years
How often to get influenza?
annually
When to start Penumococcal (PPSV23)?
Age 19 to 64 if smokes, has asthma, COPD, diabetes, alcoholism
When to start PPD?
young adult
How often PPD?
Controversial but annually for high risk populations
When to start dental cleaning and checkup?
Now
How often with dental cleaning and ckeckup?
every six to 12 months
Female: When to start pap smear (with GC and Chamidia screens)?
age 21
Female: When to start Cytology (convertional or liquid based)?
30 to 65 years of age
Female: When to start HPV Co-test (cytology + HPV test administered together)?
30 to 65 years of age
Female: How often HPV Co-test (cytology + HPV test administered together)?
every 5 years
Female: When to start self breast exam?
Now
According to the ACOG in Females: How often will self-breast exams?
ACOG: Not recommended
Female: When to start clinical breast exam (by a clinician)?
Adolescence now
Female: How often to start clinical breast exams (by a clinician)?
every year
Female: When to start mammography?
Beginning at age 40
Female: How often to start mammography?
every one to two years for women ages 40 to 49, then annually for age 50 to 74 or as long as in good health
Males: Self breast/ testicular exams?
young adult
When to start prostate screening (digital rectal exam and prostate surface antigen (PSA)
a. controversial
b. Digital exam beginning at age 40 to PSA at age 40 for men with a family history of prostate CA or if African American
c. All males 50 years of age should have a digital exam and PSA test
How often should PSA and digital be checked?
annually
When should HIV be tested?
depending on level of sexual activity or IV drug use
Young adults (age 20 to 39) How often should HIV be?
assess knowledge of prevention, contraception, protection
Young adults (age 20 to 39) How to start blood pressure?
now
Young adults (age 20 to 39) How often check blood pressure?
With every health care visit or every two years (normal <120/80)
Young adults (age 20 to 39) When to start Total cholesterol and HDL (or full fasting panel)?
age 20
Young adults (age 20 to 39) How often is total cholesterol and HDL checked?
Every five years unless cholesterol > 200 mg/dL
Young adults (age 20 to 39) When to start Self skin exam?
now
Young adults (age 20 to 39) How often to start self skin exam?
regularly
Young adults (age 20 to 39) When to start Tetanus - diphtheria (Td)?
When was last?
Young adults (age 20 to 39) How often to start Tetanus - diphtheria (Td)?
every 10 years
Young adults (age 20 to 39) When to start PPD?
young adult
Young adults (age 20 to 39) How often PPD?
Controversial but annually for high risk populations
Middle aged adults (age 40 to 59):
When to start ECG?
Age 40 (for baseline or with cardiac risk factors)
Middle aged adults (age 40 to 59):
How often ECG obtained?
PRN as indicated
Middle aged adults (age 40 to 59):
When to start Colorectal Cancer (second leading cause of cancer deaths)
age 45
Middle aged adults (age 40 to 59):
How often to start Colorectal Cancer (second leading cause of cancer deaths)
- Annual Fecal occult blood test (FOBT)
- Flexible sigmoidoscopy every fiaver years
- Total colon examination by colonoscopy every 10 years or by double contrast barium enema (DCBE) every five to 10 years
Middle aged adults (age 40 to 59):
How often to start Glaucoma screening?
annually
Middle aged adults (age 40 to 59):
When to start glaucoma screening?
now
When to start Herpes Zoster (Shingrix)?
age 50
How often to start Herpes Zoster (Shingrix)?
once
_______: True positives; the degree to which those who have a disease screen/test positive
Sensitivity
________: True negatives; the degree to which those who do not have a disease screen/test negative
Specificity
______: The frequency with which a disease or disorder appears in a particular population or area at a given time; the rate in which new cases occur during a specific time period; example: 20 cases of botulism per 500,000 people were reported in Alaska during 2010.
Incidence
_______: The proportion of a population that is affected by a disease or disorder at a particular time; example: the prevalence of lupus in women living in Illinois during 2010 was < 1%.
Prevalence
Adolescents (12-19 years of age) a. Motor vehicle crashes (MVCs) b. \_\_\_\_\_\_\_\_ c. Other accidents d. Homicide e. Malignancy f. Cardiovascular or Congenital Disease
Suicide
Young Adult (20-39 years of age) a. Motor vehicle crashes (MVCs) b. Homicide c. Suicide d. Injuries e. \_\_\_ \_\_\_\_\_ f. AIDS
Heart disease
Middle Aged Adult (40-59 years)
a. Heart disease
b. Accidents
c. Lung cancer
d. CVA
e. Breast and colorectal cancer
f. ______
COPD
Elderly Adult (> 60 years)
a. Heart Disease
b. ______
c. COPD
d. Pneumonia and/or influenza
e. Lung and colorectal cancer
CVA
- ____ _____: Includes measures to promote health prior to the onset of any recognizable problems
a. Examples: Healthy diet, exercise, avoiding tobacco,
wearing seat belts, immunizations/vaccinations, safety
initiatives, etc.
Primary Prevention
- ____ _____: Focuses on early identification and treatment of existing problems
a. Examples include: Pap smear screening, prostate cancer screening, cholesterol screening, etc.
Secondary Prevention
- _____ _____: Includes rehabilitation and restoration of health
a. Examples: Cardiac rehabilitation following an MI,
physical therapy following an MVC, etc.
Tertiary Prevention
- _______: Substances capable of inducing a specific
immune response
Antigens
- _______: Molecules synthesized in reaction to an
antigen
Antibodies
- _____ _____: Conferred by antibody formation
stimulated with a specific antigen such as typhoid
fever immunization and toxoids
Active immunity
- _____ _____: Conferred by the introduction of
antibody proteins such as gamma globulin injections or
matemalimmunity transferred to the fetus
Passive immunity
- _____ _____: Decreases pneumococcal
bacteremia; does not decrease pneumonia in the
elderly; revaccination is questionable; CDC
recommendations for revaccination: one time
revaccination in five years for: chronic renal failure,
nephritic syndrome or asplenia, immunosuppression,
long term steroid users; if the patient was vaccinated >
five years previously and the patient was < 65 years of
age at the time of initial vaccination
Pneumococcal vaccine
- ____ ____ _____: Should be considered for military
personnel, travelers to endemic areas, and men who
have sex with men, among others
Hepatitis A vaccine
- ____ ____ _____: Should be given to all health care
workers and high risk patients including sexually active
adults
Hepatitis B vaccine
- Mumps vaccination for healthcare workers:
a. If born before 1957: Consider ____ dose of vaccine
unless evidence of immunity
one
- Mumps vaccination for healthcare workers:
b. Immunity: clinically diagnosed mumps or _____
serology
positive
- Mumps vaccination for healthcare workers:
c. Unless immune, employ ____ doses during mumps
outbreak
one
- Mumps vaccination for healthcare workers:
d. If born during or after 1957: ____ doses of vaccine (if
not
two
- Mumps vaccination for healthcare workers:
e. Note: Post-vaccination serology may be _____
(vaccination gives lower antibody titers than natural
infection)
negative
- _____ ______: Approved for ages two to 55; recommended routinely for adolescents at 11-12; year visit and “catch up” for college, military personnel, immunocompromised, travelers (Africa); clinical efficacy not determined; no current revaccination recommendations; cost effectiveness is questionable
Meningococcal vaccine
- ____ _____ ____: Shingix is preferred, aged 50 years and older; Zostavax may be used if Shingrix is unavailable or contraindicated
Herpes zoster vaccine
