chapter 15; physical and cognitive development in late adulthood Flashcards
The term for the maximum number of years an individual can live is considered as
the life span
in life span what are the maximum number of years an indiividual can live
120 to 125 years
are more or less individuals living past the age 65
more
since the 1900s what has allowed for life expectancy to increase by an average of 31 years
improvements in
medicine
nutrition
exercise
life style
before the twentieth century did many individuals live past or die before or after reaching the age of 65
die before
the concept of a period called “late adulthood” begins in the
60s or 70s
what is the term for the number of years that the average person born in a particular year will probably live
life expectancy
what is the average that 65 year olds in the United States today can expect to live an average of more years
19.5
females - 20.6
males - 18.4
what is the average years that people who are 100 years of age expect to live more
2.3 years longer
in 2015, what is the country that had the highest estimated life expectancy at birth of 90 years
monaco
followed by
Japan
singapore
macau
in 2015, which countries had the lowest estimated life expectancy
(50) Chad and Guinea Bissau (African countries)
(51) Swaziland and Afghanistan
the differences in life expectancies across countries are due to factors such as
health conditions and medical care
ethnic differences
why is the life expectancy in the US expected to be the lowest
has highest;
- child and maternal mortality rates
- homicide rate
- Body mass index of high income countries in the world
why is the life expectancy for South Korea expected to have the largest growth
- delayed onset of chronic diseases is occurring
- children’s nutrition is improving
- low rate of obesity
- high blood pressure isn’t as high
in 2017, what was the overall life expectancy for women and for men
women - 81 years of age
men - 77 years of age
is there a gender gap in longevity between men and women
yes decreased from 7.8 to 4 years
when does the gender gap in longevity begin between women and men
beginning in the mid thirties (when women outnumber men)
gap widens during the remainder of the adult years
in lists of the oldest people alive in the world today are there men and women in the top 25
no men
what are social factors that say that women can expect to live longer than men
health attitudes
habits
lifestyles
occupation
are probably important
what are the leading causes of death that men rather than women are likely to die of
cancer of the respiratory system
motor vehicle accidents
cirrhosis of the liver
emphysema
coronary heart disease
(associated with lifestyle)
are women or men more likely to die from some diseases such as Alziehmers disease and some aspects of cardiovascular disease, such as hypertension related problems
women
since men are more heavier smokers than women are what does the difference in sex cause higher chances of death due to the smoking
lung cancer and emphysema
can sex differences in longevity also be influenced by biological factors
yes
why can females outlive males in virtually all aspects
- more resistance to infections and degenerative disease
- estrogen production helps to protect her from arteriosclerosis (hardening of the arteries)
does the addition X chromosome that women have associate with outliving males
yes
why?
because may be associated with the production of more antibodies to fight off disease
the sex difference in mortality is still present in late adulthood but […] pronounced than earlier in adulthood, and it is especially linked to the […] level of cardiovascular disease in men and women
less
higher
despite physical limitations, what do centenarians have a low rate of and most have
low rate of age associated diseases
most had good mental health
how old are supercentenarians considered
110-119
does being 100 to 119 years of age affect the onset of disease and function
yes, it laters the onset
- cancer and cardiovascular disease
- functional decline
what are centenarians
individuals 100 years and older
is the rate of centenarians increasing or decreasing
increasing 7% each year in industrialized countries
what did Thomas Perls and his colleagues research in the New England Centenarian Study (NECS)
that it is not true that the older you get, the sicker you get
Thomas Perls’ term for the process of staving off high mortality chronic diseases until much later ages than is usually the case in the general population: he calls it the
compression of morbidity
in the list of super centenarians were men in the list of the top 25
only two
what did NECS study discover a strong component to living to be 100 that consists of many genetic links, each with modest effects but collectively having a strong link
strong genetic component
what are among the factors that are associated with living to be 100 regarding centenarians
longevity genes and the ability to cope with stress effectively
where is the highest ratio of centenarians in the world
in Okinawa
what are characteristics of centenarians in the NECS studying
- few of the centenarians are obese,
- habitual smoking is rare
- only a small percentage (less than 15) have had significant changes in their thinking skills (disproving the belief that most centenarians likely would develop Alzeihmers disease)
what were US and Japanese centenarians linked to a higher level of well being in
health resources
(better cognitive function, fewer hearing problems, positive activities in daily living)
what did 34.7 centenarians for every 100,000 inhabitants, attribute to
diet
low stress lifestyle
caring community
activity
spirituality
what are four biological theories producing explanations on why we age
evolutionary
cellular clock
free radical
hormonal stress
in the biological theories of aging what is evolutionary theory of aging
natural selection has not eliminated many harmful conditions and nonadaptive characteristics in older adults
why has natural selection not eliminated many harmful conditions and nonadaptive characteristics in older adults
because natural selection is linked to reproductive fitness, which is present only in the earlier part of adulthood
what is a critic of the evolutionary theory
- The idea that natural selection shapes human traits and behaviors is hard to challenge or test because evolution happens over such long periods that it can’t be directly studied through experiments.
- the failure to account for cultural influences
in the four biological theories of aging, evolutionary theory’s benefits conferred to evolution decline with age because
natural selection is linked to reproductive fitness
what are the five advances in research regarding genetic and cellular process involving aging
telomeres,
free radicals,
mitochondria,
sirtuins,
and the mTOR pathway
what is Leonard Hayflick’s (1977) cellular clock theory
that cells can divide a maximum of about 75 to 80 times and that as we age out cells become less capable of dividing
based on the way cells divide what did Hayflick place the upper limit of human life span potential at
about 120 to 125 years of age
what are telomeres
tips of chromosomes; DNA sequence that cap chromosomes
(scientists have tried to fill in a hap in cellular clock theory)
after how many times can the the cell replicate before the cell can no longer reproduce
70 to 80 replications
(are dramatically reduced)
did healthy centenarians have longer or shorter telomeres than unhealthy centenarians
longer
what does having a shorter telomere link to
Alzheimer’s disease
what does injecting the enzyme telomerase into human cells grown in the laboratory can substantially do
extend the life of the cells beyond the approximately 70 to 80 normal cell divisions
however, what is telomerase present in approximately 85 to 90 percent of
cancerous cells and thus may not produce healthy life extension of cells
what are researchers training to do with telomerase and lead to with cancer cells
inhibit telomerase and lead to the death of cancerous cells while keeping healthy cells alive
what are telomeres and telomerase increasingly thought to be key components of
stem cell regeneration process, proving a possible avenue to restrain cancer and delay aging
what is free radical theory; the third theory of aging
states that people age because when cells metabolize energy, the by products include unstable oxygen molecules known as free radicals
since the free radicals ricochet around the cells; what does it lead to
damaging DNA and other cellular structures
what can the damage lead to; (disorders)
cancer and arthritis
can overeating cause an increase or decrease in free radicals
increase
what can a calorie restriction do to free radicals when the diet is low in calories but adequate in proteins, vitamins, and minerals
reduces the oxidative damage created by free radicals
what can endurance exercise do to obese men regarding their oxidative damage
reduce it
what is the mitochondrial theory
aging that emphasizes the decay of mitochondria-tiny bodies that supply essential energy for function, growth and repair-that is primarily due to oxidative damage and loss of critical micronutrients supplied by the cell
what has been emphasized as key aspects of the mitochondrial theory of aging
energy sensing and apoptosis (programmed cell death)
what are the range of disorders mitochondrial damage can lead to
cardiovascular disease,
neurodegenerative disease
e.g. Alzeihmers
Parkinson disease
diabetic kidney disease
impaired liver functioning
is it known in the mitochondrial theory if the defects of mitochondria cause aging or are merely accompanying the aging process
not known
what is the Sirtuin theory
family of proteins that have been linked to longevity, regulation of mitochondria functioning in energy, possible benefits of calorie restriction, stress restistance, and a lower incidence of cardiovascular disease and cancer
which sirtuin has been connected to DNA repair and aging
SIRT 1
what is the mTOR pathway theory
cellular pathway that involves the regulation of growth and metabolism , central role in cell life including stem cells (acting as a cellular router for growth)
what does TOR stand for
target of rapamycin.
in mammals its called mTOR
rapamycin is a naturally derived antibiotic and immune system suppressant/modulator, first discovered in the 1960s on Easter Island
yes
since rapamycin is commonly used and is FDA approved what is it used for
preventing organ rejection and in bone marrow transplants
what do scientists argue of the mTOR pathway being linked to
- longevity,
- the successful outcomes of calorie restriction,
- and reduction in cognitive decline
- may influence the course of a number of diseases
e.g. cancer, cardiovascular disease, Alzeihmer disease
has rapamycin not been approved as an anti aging drug
No, has some serious side effects, including increased risk of infection and lymphoma, a deadly cancer
what do some critics argue of the scientific support for sirtoins and the mTOR pathway as a key cause for aging in humans, has not being found and that
research has not adequately documented the effectiveness of using drugs such as rapamycin to slow the aging process or extend the human life span
what is the hormonal stress theory when thinking of biological theories of aging
aging in body’s hormonal system can lower resistance to stress and increase likelihood of disease
since when people experience stressors, the body responds by releasing certain hormone, what happens to the hormones stimulated by stress
remain at elevated levels longer than when people were younger
what are prolonged elevated levels of stress related hormones associated with an increased risk of
many diseases;
including cardiovascular disease,
cancer,
diabetes,
and hypertension
is exercise one of the stress buffering strategies that researchers are exploring in an effort to find ways to attenuate some of the negative effects of stress on the aging process
yes
how does age relate to the decline in immune system
the percentage of T cells (a type of white blood cell essential for immunity) decreased in older adults in their seventies, eighties, and nineties
does aging contribute to immune system deficits that give rise to infectious diseases in older adults
yes
can extended duration of stress and diminished restorative process in older adults may accelerate the effects of aging on immunity
yes
what happens to the aging brain in late adulthood
shrinks and slows, but still has considerable adaptive ability
on average, how much does the brain lose in percentage of its weight
5% to 10% between ages 20 to 90
does the brain volume and volume in key brain structures decrease in late adulthood from 22 to 88 years of age
yes, such as as the frontal lobes and hippocampus
brain volume decreases due to
- shrinkage of neurons
- lower numbers of synapses
- reduced length and complexity of axons
- reduced tree like branching in dendrites
does neuron loss occur for individuals with Alzeihmers
yes
can global brain volume predict mortality in large populations of stroke free community dwelling adults
yes
do all brain areas shrink equally with aging
no, some shrink more than others
Is the prefrontal cortex an area that shrinks with aging
yes, decrease in working memory and other cognitive activities in older adults
what are the sensory regions of the brain that are less vulnerable to the aging process
yes such as the
primary visual cortex,
primary motor cortex,
and somatosensory cortex
When does the general slowing of function in the brain and spinal cord accelerate with aging
Begins in midlife and accelerates in late adulthood
what does it affect?
physical coordination and intellectual performance
In the concept of the aging brain, what is aging linked to
- reduction in synaptic functioning
- and the production of neurotransmitters
after age 70 what do many adults no longer show, what happens by age 90
a knee jerk reflex, and by age 90 most reflexes are much slower
what does slowing of the brain do to performance to older adults with intelligence and especially timed tests
impair performance
since aging reduces the production of neurotransmitters, what does the reduction of acetylcholine link to
memory loss, especially in people with Alzheimer’s disease
in the concept of the aging brain what are severe reductions in dopamine involved in the reduction in
motor control in Parkinson disease
is demyelination (deterioration in the myelin sheath that encases axons and is associated with information processing) occur in the brains of older adults
yes
since the human brain has remarkable repair capability, can activities older adults engage in still influence the brains development
yes, since the brain loses only a portion of its ability to function, the activities can still influence the brains development
in the concept of the adaptive brain, in an fMRI study, what do higher levels of aerobic fitness link to
greater volume in the hippocampus, which translate into better memory
what is neurogenesis
generation of new neurons
in only the hippocampus (memory)
olfactory bulb (smell)
what are the functions of the neurogenisis neurons and how long go they last
not know what function they perform, last only for several weeks
can dendritic growth occur in human adults, possibly even in older adults
yes;
are the receiving portion of the neuron
from what age did the growth of the dendrites increase, and from what age did growth no longer increase
growth - 40s to the 70s
no growth - 90s
older brains rewire to compensate for […]
losses
decrease in lateralization is using both hemispheres to …
process information.
(improves cognitive functioning)
lateralization is the specialization of function in one hemisphere of the brain or the other
yes
In older adults are using neuroimaging techniques, researchers have found that brain activity in the prefrontal cortex is lateralized […] when they are engaging in cognitive tasks
less
e.g.
when younger adults are given the task of recognizing words they have previously seen the process the information primarily in the right hemisphere, older adults are more likely to use both hemispheres
does using both hemispheres improve the cognitive functioning of older adults in their aging brain
yes
in the Nun study directed by David Snowdon studied
ow their intellectually challenging life, contributes to their quality of life as older adults and possibly their longevity
are the timing of physical problems related to aging uniform
no
what physical appearance changes that began in midlife become more pronounced that are the most noticeable
wrinkles and age spots
in late adulthood do we get shorter as we get older
yes,
because of bone loss in their vertebrae
what happens to weight after age 60
drops (gives sagging look);
muscle loss
exercising is beneficial for overall heath and fall risk reduction
since muscle loss occurs in late adulthood, what was linked with greater muscle strength in 65 to 86 year olds
long term aerobic exercise
do older adults move more slowly or faster than young adults
slowly
is having adequate mobility have an important aspect of maintaining an active lifestyle in late adulthood
yes
by maintaining an independent and active lifestyle
does obesity link to mobility limitation in older adults
yes
can at risk overweight and obese older adults can lose significant weight and improve their mobility considerably by participating in a community based weight reduction program
yes
can exercise benefit frail elderly adults
yes
through?
high intensity walking
(increase walking speed + balance)
a 10 week exercise program improved the physical (aerobic endurance, agility, and mobility) and cognitive function (selective attention and planning) of elderly nursing home residents
yes
what happens to the risk of falling in older adults, does it increase or decrease with age. does it increase more for women or men.
increases with age
greater for women than for men
falls are the leading cause of injury deaths among adults who are […] years and older
65
side note;
approx. 200k adults over 65 (many women) fracture a hop in a fall
half of the older adults who take a fall and may fracture a hip…
die within 12 months, frequently from pneumonia.
exercise […] falls in adults 60 years of age and older
reduces
in summary, from 65 to 74 regarding the loss of vision; there is a […] of acuity even with corrective lenses. […] transmission of light occurs through the retina (half as much as in young adults). […] susceptibility to glare occurs. Color discrimination ability […]
loss
less
greater
decreases
in summary, from 75 y/o and older what happens regarding the loss of vision; there is a significant […] of visual acuity and color discrimination, and a […] in the size of the perceived visual field. in late old age, people are at significant risk for visual dysfunction from cataracts and glaucoma.
loss
decrease
in summary, from ages 64 to 74 years old in hearing loss, there is significant [..] of hearing at high frequencies and some […] at middle frequencies. these losses can be helped by a hearing aid. there is […] susceptibility to masking of what is heard by noise
loss
loss
greater
in summary, hearing loss in 75 years and older. there is a significant […] at high and middle frequencies. a hearing aid is more likely to be needed than in young old age
loss
what are the most prevalent chronic conditions in late adulthood
- arthritis
- hypertension
- hearing impairments
- heart conditions
- chronic sinus problems
- visual impairments
- orthopedic impairments of the back, extremities, etc.
- arteriosclerosis
- diabetes
visual decline in late adulthood 65+ is linked to
- cognitive decline
- having fewer social contacts and engaging in less challenging social/leisure activities
when is the decline in vision becoming more pronounced for most adults
began in early or midlife
when vision starts to decline can it adapt as quickly when moving from a well lighted place to one of semidarkness. can it also tolerate glare
no
since vision declines, the visual field becomes […], and events that occur away from the center of the visual field are sometime not […]. all f these changes can make night driving especially […]
smaller
detected
difficult
since depth perception also decline in late adulthood what does depth perception make difficult
make it difficult for older adults to determine how close or far away or how high or low something is
what does a decline in depth perception make difficult to navigate
steps or street curbs
what are the three vision diseases that can impair the vision of older adults
cataracts, glaucoma, and macular degeneration
what is the cataract disease
the thickening of the eye’s lens causes vision to become cloudy, opaque, and distorted
30% by age 70
how can cataracts be treated
by glasses
or if worsen through a simple surgical procedure that replaces the natural lenses with artificial ones
what is the glaucoma eye disease
damage to the optic nerve because of pressure created by fluid buildup in the eye
what was the difference between older adults who had cataract surgery than those who did not have the surgery, with the mean age being 76 years old
less likely to develop mild cognitive impairment than their counterparts
how can glaucoma be treated
eye drops
if left untreated, can ultimately destroy a person’s vision
what does the eye disease Macular degeneration
deterioration of the retina’s macula, which corresponds to focal center of the visual field
what do individuals with macular degeneration have
relatively normal peripheral vision but be unable to see clearly what is in front of them
(increased using stem cell based therapy to treat it)
what is hearing loss
inability to hear sounds softer than 25 dB with their better ear
what are older adult’s hearing problems associated with spending less time of, an increase of, reduction in functioning, and what
out of home and in leisure activities, increase in falls, and reduction in cognitive functioning, and loneliness
what does having dual sensory loss in vision and hearing link to
reduced social participation and less social support, as well as increased loneliness
in another study, dual sensory loss in vision and hearing, with a mean age of 82, involved greater or less functional limitations, increased or decreased loneliness, cognitive increase or decrease, and communication benefits or problems
greater
increased
decrease
problems
+ depressive symptoms
do most older adults lose some of their sense of smell or taste beginning around 60 years of age
most, and some lose both
74% impaired taste
22% impaired smell
do older adults show a greater decline in smell or taste
smell
+
smell and taste decline less in healthy older adults than in their less healthy counterparts
are changes in touch and pain also associated with aging
yes
(70% impaired touch)
is a decline in touch sensitivity problematic for most older adults
not for most adults
since an estimated 60 to 75 percent of older adults reported at least some persistent pain, what are the most frequent pain complaints of older adults
back pain - 40%
peripheral neuropathic pain - 35%
chronic joint pain - 15 5o 25%
does the presence of pain increase with age in adults, are women or men more likely to report having pain
increases
women
since older adults have lower pain sensitivity than their younger counters but only for lower pain intensities, what can it help older adults cope with
disease and injury, it can also mask injuries and illnesses that need to be treated
since cardiovascular disorders increase in late adulthood, what do 64% of men and 69% of women 65 to 74 years of age have
- hypertension (high blood pressure)
more common in men than women
why should consistent blood pressures above 120/80 be treated to reduce the risk of
heart attack
stroke
or kidney disease
What can reduce the risk of cardiovascular disease in older adults
various drugs,
a healthy diet,
(a mediterranean diet)
exercise
to reduce heart failure, what type of exercise, level of smoking, level of alcohol intake, and avoiding do to lower the risk
faster exercise walking pace
not smoking
modest alcohol intake
avoiding obesity
high blood pressure can be linked to
illness
obesity
anxiety
stiffening of blood vessels
lack of exercise
why does lung capacity drop 40% between the ages of 20 and 80, even without disease
lungs lose elasticity, the chest shrinks, and the diaphragm weakens
however;
can improve lung functioning with diaphragm strengthening exercises
since approx. 50% of older adults complain of having difficulty sleep, older adults sleep is
lighter and more disruptive (takes longer to fall asleep and also involves more awakenings and greater difficulty in going back to sleep)
In late adulthood poor sleep becomes a risk factor for […], […], and earlier […]. It is also linked to [higher or lower] level of cognitive function when sleep less than […] or more than […] hours.
falls,
obesity,
earlier
7. 9.
since 50% of older adults report having difficulty sleep what can it be linked to
health and mental health problems
lowering of cognitive functioning
and if sleeping too much predicts earlier all cause mortality
in a Chinese study were older adults who engaged in a higher level of overall physical activity, leisure time exercise, and household activity less likely to have sleep problems
yes
what changes does aging cause to mens sexuality, regarding their orgasms
less frequent in men with age, occurring in every second to third attempt either than every time
since orgasms are less frequent with age what is usually needed to produce an erection
more direct stimulation
since many older adults are sexually active as long as they are healthy but orgasms are harder to reach, what can they use
erectile dysfunction medication (Viagra) to be able to have an erection
what can be treated with testosterone replacement therapy to improve sexual functioning in males
declining levels of serum testosterone which is linked to erectile dysfunction
regarding health it the probability of having some disease or illness increase with age
yes
what health problem is common in late adulthood
chronic disease with slow onset and long duration
do majority of adults still alive at 80 years of age or older have some type of impairment
yes
is low income also strongly related to health problems in late adulthood
yes
how many times do poor as non poor older adults report that chronic disorders limit their activities
three
nearly 60% of 65 to 74 year olds die of
cancer or cardiovascular disease
since cancer replaced cardiovascular disease as the leading cause of death in US middle aged adults, what is the leading cause of death in US 75 to 84 and 85+ age groups
cardiovascular disease
in the concept of health problems, as individuals age through the late adult years, they become more and more likely to die from
cardiovascular disease than from cancer
what is arthritis
inflammation of the joints accompanied by pain, stiffness, and movement problems
what can arthritis, an incurable disorder affect of the body
hips
knees
ankles
fingers
and vertebrae
since arthritis is especially prevalent in older adults, what can adults often experience
difficulty moving about and performing routine daily activities
since having leisure physical inactivity was found to be a risk factor for subsequent development of arthritis, can exercise in older adults with arthritis benefit them
yes; those engaging in the most vigorous category of leisure time activities were the least likely to develop arthritis
what is osteoporosis
extensive loss of bone tissue
what does osteoporosis cause older adults to walk with
stoop
women more vulnerable - leading cause of broken bones
to who is osteoporosis more common in
non latina white, thin, small framed women
what is osteoporosis related to deficiencies in
calcium,
vitamin D,
and estrogen,
lack of exercise
to prevent osteoporosis what can young and middle aged women eat
foods rich in calcium, exercise regularly, and avoid smoking
what drugs can be used to reduced the risk of osteoporosis
Fosamax
since we are not meant to live out our remaining years passively in the evening of our lives (late adulthood), what suggests that older adults do when they are healthier and happier
the more active they are
accidents are the […] leading cause of death in older adults. […] are the leading cause of injury death for adults 65+
eighth
falls
exercise is linked to […] longevity and […] of chronic disease. associated with […] in the treatment of diseases/
increased
prevention
improvement
exercise […] older adults’ cellular functioning and immune system functioning. […] body composition and […] decline in motor skills as aging occurs.
improves
optimizes
reduces
exercises […] the likelihood of developing mental health problems, […] negative effects of stress. and is linked to […] brain , cognitive, and affective functioning
reduces
reduces
improved
sedentary participants (low fitness) of a study, were more than […] as likely to die during the eight year span of the study as those who were moderately fit and more than […] times as likely to die as those who were highly fit
twice
three
individuals with low physical fitness, increased from low to intermediate or high fitness were at a lower risk for all cause mortality
yes
what exercise do gerontologists increasingly recommend
strength training
in addition to aerobic activity and stretching for older adults
in exercise what did core resistance and balance training improve in older adult women
balance, trunk muscle strength, leg power, and body composition better than pilates training
what are the current recommendations for older adults to do physical activity of moderate intensity aerobic activity (e.g. brisk walking) per week and muscle strengthening activities on 2 or more days a week
2 hours and 30 minutes
there are even greater benefits that can be attained with 5 hours of moderate intensity aerobic activity per week as well as walking on a regular basis
+ walking a dog regularly was associated with better physical health
yes
exercise is linked the to the prevention or delayed onset of […] diseases, such as; […] disease, type [..] diabetes, and obesity, as well as improvement in the treatment of these diseases
chronic
cardiovascular
2
does exercise improve cellular functioning in older adults
+
os aerobic exercise linked to greater telomere length in older adults
yes
what happens to the prefrontal cortex and hippocampus volume, a higher level of brain connectivity, and more efficient brain activity when the older adult is more physical fit and active
improves
+ superior memory functioning and a higher level of executive function
in nutrition and weight it is important getting […] nutrition, […] overweight and obesity, role of calorie restriction in […] health and […] life, determining whether to take specific vitamin supplements to slow the aging
adequate
avoiding
improving
extending
why is the quality of nursing homes and other extended care facilities for older adults varying enormously and is a source of national concern
- fail federally mandated inspections b/c they do not meet the minimum standards for physicians, pharmacists, and various rehabilitation specialists (occupation and physical therapists)
- patients right to privacy
- access to medical information, safety, and lifestyle freedom within the individuals range of mental and physical capabilities
what are good alternatives than nursing homes
home health care
eldercare centers
preventative medicine clinics
(potentially less expensive than hospitals and nursing home)
what are home health care, eldercare centers, and preventative medicine clinics, less likely to do
endanger the feelings of depersonalization and dependency
is there an increase or decrease demand for, and a shortage of, home care workers because of the increasing number of older adults and their preferences stay out of nursing homes
increase
in classic study, Judith Rodin and Ellen Lander (1997) found that an important factor related to health, and even survival, in a nursing home is the patient’s …
feelings of control and self determination
since having feelings of control and self control is important in nursing home health according to Judith Rodin and Ellen Lander, those who are given extra responsibility were
healthier, happier, and more alert and active than the residents who had not received added responsibility
what can having perceived control over one’s environment, can be a matter of
life or death
what are geriatric nurses helpful in
treating the health care problems
why is there a need to expand disease management programs
b/c older adults with health problems receive necessary recommended medical care only half the time
is there an increase or decrease percentage of older adults who live in nursing homes
decrease
although some dimension of cognition might decline as we age, other might
remain stable or even improve
is attention an important aspect of cognitive aging in the multidimensionality and multi directionality
yes
older adults are […] able to ignore distracting information
less
yoga and meditation may improve goal directed attention
selective attention is focusing on a specific aspect of experience that is …
relevant while ignoring others that are irrelevant
(generally decreases in older adults)
can selective information deficits be linked to older adult’s less competent driving
+ what is the exemption where age differences are minimal
yes
+ simple tasks involving searching for a feature
since the 20 one hour video game training session with a commercially available program named luminosity showed a significant reduction in distraction and increased alertness, what does the luminosity program sessions focus on
- problem solving
- mental calculation
- working memory
- and attention
sustained attention is being focused and having extended engagement with
an aspect of the environment
what have researched found about older adults performing in sustained attention with middle aged and younger adults on measures of sustained attention
perform as well as middle aged and younger adults
of course consistency of attention is important. in a study of older adults it was found that the greater the variability in their sustained attention (vigilance), the more likely there were to experience
falls
do all types of memory change during aging
no not all change with age in the same way
explicit memory are the facts and experiences that individuals
+
what is it sometimes called
consciously know and can state
+
declarative memory
e.g. recounting the plot of a movie you have seen or being at a grocery store and remembering what you wanted to buy
does explicit memory increase or decline as a person ages
decline
implicit memory is memory without […] recollection that involves skills and routine procedures that are […] performed
conscious
automatically
e.g. driving a car or typing on a computer keyboard that you perform without having to consciously think about what you are doing
is explicit or implicit memory less likely to be adversely affected by aging than the other
implicit than explicit memory is
what two types of memory are viewed as form of explicit memory
episodic and semantic memory
episodic memory is the retention of information about the
where and when of life’s happenings
e.g. “what did you eat for breakfast this morning?” + “what was the color of the walls in your bedroom when you were a child?”
semantic memory is the person’s
knowledge about the world
e.g. a persons field of expertise, general academic knowledge, “everyday knowledge”
older adults often take […] to retrieve semantic information , but usually they can ultimately […] it. however, can the ability to retrieve very specific information (such as names) decline in older adults
longer
retrieve
yes
do younger adults have better episodic memory than older adults do
yes
do older adults think that they can remember long ago events or than more recent years better
think they can remember long ago events better than more recent years
+ however;
researchers have found that the older the memory is, the less accurate it is in older adults
episodic memory performance can predict which individuals would develop […] 10 years prior to the clinical diagnosis of the disease
dementia
+ mindfulness training is effective in improving episodic memory recall in older adults
for the most part does episodic or semantic memory decline more in older adults
episodic memory
what are the two important cognitive resource mechanisms
working memory and perceptual speed
what is working memory closely linked to
short term memory but places more emphasis on memory as a place for mental work
is working memory and perceptual speed are cognitive resource mechanisms that [ increase or decrease] as person ages
Decrease
working memory continues to decline from 69 to […] years of age
89
why?
less efficient inhibition in preventing irrelevant information from entering working memory and their increased distractibility
what has the ability of older adults working memory being able to be improved through training show of the working memory of older adults
plasticity
e.g. strategy training, aerobic endurance , imagery strategy training
since all age groups’ working memory can be improved with memory training, are the older adults able to have as much improvement with training as the younger adults did
less improvement
what is perceptual speed
the amount of time it takes to perform simple perceptual motor tasks
e.g. how long it takes someone to step on the brakes when the car directly ahead stops
perceptual speed shows considerable […] in late adulthood, and it is strongly linked with […] in working memory
decline
decline
what does slower processing speed associate with in old adults
unsafe driving acts
increase in older adults’ falls one year later
increased morality risk
what are the types of efforts done to improve older adults’ processing speed
through exercise interventions
e.g.
high intensity aerobic training rather than moderate intensity aerobic training or resistance training in improving older adults processing speed, playing processing speed games
executive functioning are aspects of working memory that […] in older adults; involves […] memory representation that are relevant for the task at hand, and […] old, no longer relevant information.
decline
updating
replacing
decision making are preserved rather
well in older adults
in executive function, what does its umbrella like concept consist of
a high number of higher level cognitive processes linked to the development of the brain’s prefrontal cortex
in terms of cognitive flexibility, can older adults perform as well as younger adults at switching back and forth between tasks or mental sets
no don’t perform as well
in terms of cognitive inhibition are older adults more or less effective than younger adults at inhibiting dominant or automatic responses
less effective
is there variability in executive function among older adults
yes
e.g.
some better working memory and more cognitively flexible than other older adults
executive function but not memory predicted a higher risk of coronary heart disease and stroke three years later in older adults
true
wisdom is […] knowledge about the practical aspect of life that permits excellent […] about important matters
expert
judgment
executive function increasingly is thought to be involved not only in cognitive performance, but also in health, emotion regulation, adaption to life’s challenges, motivation, and social functioning
yes
wisdom focuses more on life’s
pragmatic concerns and human conditions
having self reflective exploratory processing of difficult life experiences (meaning-making and personal growth) was linked to higher levels
of wisdom
in regard to wisdom what have Paul Baltes and his colleagues reach in conclusion
- high levels of wisdom are rare
- factors other than age are critical for wisdom to develop to a high level
e.g. working involving difficult life problems - personality related factors are better predictors of wisdom than cognitive factors
e.g. openness to experience, generatively, and creativity rather than cognitive intelligence factors
Has cognitive function in older adults, shown that in education there are successive generations in America’s 20th century for better or worse educated
better, a continuing trend
in older adults does having a higher level of education have an effect on cognitive functioning
yes, better cognitive functioning
in cognitive functioning in older adults, how does work have an effect. successive generated have placed a stronger emphasis on
cognitively oriented labor, linked with cognitive advantages post retirement
in work, how does working in low complexity jobs, experiencing novelty in their work (assessed through recurrent work task changes) link to in older adults
better processing speed and working memory
in older adult’s cognitive functioning how does health play a role. successive generations have been […] in late adulthood as more effective treatments for a variety of illness (such as hypertension) have been developed
healthier
what are many of the illness in health that have a negative impact on intellectual performance in cognitive functioning in older adults
- stroke
- heart disease
- diabetes
what has been associated with cognitive decline in older adults
- early stage chronic kidney disease
- mood disorders; depression
some of the decline in intellectual performance found for older adults is likely due to health related factors rather than age
yes
what is terminal decline best described as
slow and steady
changes in cognitive activity patterns might result in disuse and consequent atrophy of cognitive skills, capturing what phrase
“use it or lose it”
what are mental activity under the ‘use it or lose it’ concept that is likely to benefit the maintainance of cognitive skills in older adults
activities such as
- reading books
- doing crossword puzzles
- going to lectures and concerts
research suggest that mental exercise may delay/reduce, and lower the likelihood of developing
delay/reduce cognitive decline
lower the likelihood of developing Alzheimers disease
what did reading daily link to in men in their 70s
reduced mortality
declines in cognitive functioning were linked to subsequent lower engagement in social activities
true
through training cognitive skills what can it do to older adults cognitive function
improve the cognitive skills (restored to a degree)
what are the two key conclusions that can be derived from research in training cognitive skills
- training can improve the cognitive skills of many older adults, but
- there is some loss in plasticity in late adulthood, especially in those who are 85 and older
meta examination of four longitudinal observational studies; Long Beach longitudinal study origins of variance in the oldest old (octo-twin) study in Sweden; Seattle longitudinal study, and Victoria longitudinal study in Canada. of older adults; naturalistic cognitive activities found that changes in cognitive activity predicted
cognitive outcomes as long as two decades later
was the hypothesis that engaging in cognitive ability at an earlier point in development might have improved older adults’ ability to later withstand cognitive decline supported or not
not supported
since engaging in cognitive activities at an earlier point in development does not improve older adults’ ability to later withstand cognitive decline is not supported, what are they able to do to be able to better maintain their cognitive functioning in late adulthood
continue to increase their engagement in cognitive and physical activities
what is the concern of the Stanford center for longevity and together the Stanford center for longevity and the max Planck institute for human development
the misinformation given to the public touting products to improve the functioning of the mind for which there is no scientific evidence
e.g. nutritional supplements being advertised as “magic bullets” to slow the decline of mental functioning and improve the mental ability of older adults
cognitive vitality of older adults can be improved through cognitive and physical fitness training and nutritional interventions such as
- ginkgo biloba
(improve some aspects of attention )
and - omega 3 polyunsaturated fatty acids
(reduced risk of age related cognitive decline) - fish oil
(higher cognitive scores and less atrophy in one or more brain regions + improved the working memory of older adults)
is there evidence supporting of cognitive improvements in aging adults who took supplements containing ginseng and glucose
no
in the experimental study with 50 to 70 year old females who took fish oil for 26 weeks, had improved
executive function and beneficial effects in a number of areas of brain functioning compared to those who took placebo pills
has research been able to provide consistent plausible evidence that dietary supplements can accomplish major cognitive goals in aging adults over a number of years
no
+ however;
some software based cognitive training games improve older adults cognitive functioning
cognitive neuroscience is the discipline that studies links between
brain and cognitive functioning
changes in the brain can influence cognitive function, and changes in cognitive functioning can influence the […]
brain
what brain imaging techniques does cognitive neuroscience and aging heavily rely on to reveal the areas of the y that are activated when individuals engage in certain cognitive activities
fMRI, PET, and DTI (diffusing tensor imaging)
aging of the brains prefrontal cortex may produce a increase or decline in working memory
decline
when adults do not regularly use working memory, neural connections in the prefrontal lobe may
atrophy
neural circuits in specific regions of the brain’s prefrontal cortex […], and this […] is linked to […] performance by older adults on tasks involving complex reasoning, working memory, and episodic memory
decline
decline
poorer
two neuroimaging studies revealed that better memory performance in older adults was linked to […] levels of activity in […] hemispheres of the brain during information processing
higher
both
are patterns of neural decline with aging more noticeable for retrieval or for encoding
retrieval than for encoding
do younger or older adults, often show greater activity in the frontal and parietal lobes of the brain on simple tasks, but as attentional demands increase, they had to display less effective functioning in the frontal and parietal lobes of the brain that involve cognitive control
older
what does cortisol thickness in the frontoparietal network predict
executive function in older adults
since the functioning of the hippocampus declines but to a lesser degree than the functioning of the frontal lobes in older adults, what did K. Warner Schaei’s research conclude about individuals whose memory and executive function improved in middle aged not showing
a decline in hippocampus functioning in late adulthood
younger adults have better connectivity between brain regions than older adults
true
since there are an increasing number of cognitive and fitness training studies including brain imaging techniques such as fMIR to assess the results of such training on brain functioning. is it possible for older adults who walk one hour a day three days a week for six months show an increase in volume in the frontal and temporal lobes of the brain
yes
does the labor force include men and women 75 years and older since 2000
yes
women up 87%
men up 45%
Why do older workers work beyond retirement age to improve
their financial status, health, knowledge levels, and sense of purpose
after 1995, adults 65 and older in the workforce, had an increase working in full time or in part time
full time rose substantially and part time decreased considerably
what can the significant rise in full time employment likely reflect the increasing number of older adults to realize
that they may not have adequate money to fund their retirement
47% of Americans 50 years and older now expect retire sooner or later than they had previously envisioned
later
(due to financial reasons)
do baby boomers expect to work shorter or longer than their predecessor in prior generations
longer
do older or younger workers have lower rates of absenteeism, fewer accidents, and increased job satisfaction
older workers
(they can be of considerable value to a company , above and beyond their cognitive competence)
have the changes in federal law allowed for individuals over the age of 65 to continue working in most jobs
yes, allow to continue working
have the numbers of middle aged and older adults embarking on a second or a third career been increasing or decreasing
increasing
since the numbers of middle aged and older adults embarking on a second or third career has been increasing, what are they doing regarding the second or third career
in some cases it is;
entirely different type of work
or a continuation of previous work but at a reduced level
or may participate in unpaid work as volunteers or as active participants in a voluntary association
what have several studies found of older adults who continue to work have better than those who retire
better physical and cognitive profiles than those who retire
does physical functioning decline slower or faster in retirement or in full time work for employees 65 years of age and older, with the difference not explained by absence of chronic disease and lifestyle risks
faster
[…]% of those in their sixties and […]% in their seventies are still working
33
11
Increasing number of adults are beginning to […] the early retirement option.
reject
in the past what was the age when most people reached an accepted retirement age, however the age continues to delay retirement and moving into and out of work
the 60s
what did leading expert Phyllis Moen (2007) describe, that in today, when people reach their sixties, the life path they follow is less clear
- Some people never retire from their careers.
- Some retire from their careers and start a completely different job.
- Some retire from their careers but do volunteer work instead.
- Some retire from one job, then take on another.
- Some move in and out of the workforce, so they never have a single career to retire from.
- Some with poor health transition to disability status and later retire.
- Some consider being laid off as retirement.
what is the percentage of American workers who feel very confident that they will have enough money to have a comfortable retirement
+
what is the percentage of individuals who said they feel somewhat or or very confident that they will have enough money to live a comfortable retirement
+
what is the percentage of American workers reported that are preparing for retirement made them feel mentally or emotionally distressed
18
60
30
what are the two main worries of individuals as they approach retirement
- having to draw retirement income from savings, and
- paying for health care expenses
older adults who adjust best to retirement are
- healthy
- active and adequate income
- better educated
- connected with extended social networks and family
- satisfied with their lives before retiring
- flexible and plan key factors
older adults who have the most difficult time adjusting to retirement are the ones who have
- inadequate income and are in poor health
- must adjust to other stress that occurs at the same time as retirement, such as
- death of a spouse
what is the estimated cost of disorder such as dementia in older adults
$40 billion per year in the united states
since mental disorders make the individuals increasingly dependent on the help and care of others , older adults do not have a higher overall incidence of mental disorders than younger adults do
true
since dementia is among the most debilitating of mental disorder In older adults; dementia is a global term for any neurological disorder in which the
primary symptoms involve a deterioration of mental functioning
are women or men more likely to develop Alzheimer’s disease
women because they live longer than men
individuals with dementia often lose the ability to care for themselves and may become unable to recognize familiar surrounding and people-including family members
true
Alzheimer’s disease is the gradual deterioration of
memory, reasoning, language, and eventually, physical function
what is the percentage of individuals 65 and older who have Alzheimers disease
10
it is estimated that Alzheimers disease […] the health care costs of Americans 65 years of age and older
triples
Alzheimer’s involves deficiency in the brain messenger chemical […]
acetylcholine
(plays an important role in memory)
once destruction of brain tissue occurs from Alzheimer disease is it likely that treatment of the disease will reverse the damage, at least based on the state of research now and in the foreseeable future
no can not reverse
as alzeihmers disease progresses, does the brain shrink or grow and does it deteriorate or strengthen
shrinks and deteriorates
the shrinking and deteriorate is characterized by the formation of
amyloid plaques (dense deposits of protein that accumulate in the blood vessel) and neurofibrillary tangles (twisted fibers that build up in neurons)
- linked to the ApoE4 gene (apolipoprotein E4)
what do neurofibrillary tangles consist mainly of a protein called
tau
why has there been an increasing interest in the role that oxidative stress might play in Alzheimer disease
b/c it occurs when the body fails to defend itself against free radical attacks and oxidation
is age an important risk factor plus genes likely to play an important role in what may cause Alzheimers disease
yes
the number of individuals with Alzheimers disease […] for every five years after the age of 65
doubles
what is apolipoprotein E (ApoE) linked to, the increase or decrease presence of plaques and tanlges in the brain
increase
why has special attention been focused on an allele (an alternative form of a gene) labeled ApoE4
is a strong risk factor for Alzheimers disease
more than […]% of individuals with alziehmers disease have at least one ApoE4 allele
60; women are more likely to have this allele than males
despite the links between the precise of the ApoE4, less than […]% of individuals who carry the ApoE4 gene develop dementia in old age
50
APP, PSEN1, and PSEN2, also are gene mutations that are linked to […] onset Alzheimer disease
early
although individuals with family history are at a greater risk, the disease is complex and likely to be caused by a number of factors, including
lifestyles
(DNA methylation (tiny atoms attaching themselves to the outside of a gene))
since a healthy diet, exercise, and weight control can lower the risk of cardiovascular disease, can it lower the risk of Alzheimers disease
yes, lowers risk
what is one of the best strategies for intervening in the lives of people who are at risk for Alzheimer disease by improving their
cardiac functioning through diet, drugs and exercise
what are some of the medical exposures and some of the dietary facts that were linked to a reduced incidence of Alzheimers disease
medical exposures - estrogen, statins, and non-steroidal anti inflammatory drugs
diet - folate, vitamin E/C, and coffee
what are some preexisting diseases that increase the risk of developing Alzheimers disease
arteriosclerosis and hypertension + depression
mild cognitive impairment (MCI) represents transitional state between
cognitive changes of normal aging and very early disease
(increasingly recognized as a risk factor for Alzheimers disease)
do all individuals with MCI develop Alzheimers disease
no but is a risk factor
(those who did develop had at least one copy of the ApoE4 gene)
is it difficult to predict which individuals with MCI will develop Alzheimers disease
yes, distinguishing between individuals merely have age associated declines in memory , and predicting which with MCI will subsequently develop the disease)
fMRI shows [smaller or larger] brain regions involved in memory for individuals with MCI
smaller
what are the five drugs that have been approved by the US Food and Drug Administration (FDA) for the treatment of Alzheimers disease
three medications;
- Aricept (donepezil),
- Razadyne (galantamine),
- and Exelon (rivastigmine)
- Namenda (memantine)
- namzatric (combination of memantine and donepezil)
what are the three medications; Aricept (donepezil), Razadyne (galantamine), and Exelon (rivastigmine) regarding their drug use
are cholinesterase inhibitors designed to improve memory and other cognitive functions by increasing levels of acetylcholine in the brain
what does Namenda (memantine) regulate the activity of
glutamine, which is involved in processing information
what is namzatric designed to improve
cognition and overall mental ability
what was conclude of cholinesterase inhibitors not reducing progression
to dementia from mild cognitive impairment (MCI)
do the current drugs used to treat Alzheimer disease slow the progression or address its cause
only slow the downward progression but do not address its cause (no drugs approved by the FDA for treatment of MCI)
caring for individuals with Alzheimer’s disease can often be emotionally and physically draining for family
true
does the quality of life in the first three years after family begins caring for a family member with Alzheimers disease deteriorate or increase more than that of their counterparts of the same age and gender
deteriorate more than those who were not caring for an Alzheimers patient
too which disease did family perceive has the highest burden; from alzheimrs, cancer, or schizophrenia
alzheimers disease
respite care are services that provide temporary relief for those caring for individuals with
disabilities and illness or the elderly
the other type of dementia is Parkinson’s disease which is the chronic, progressive disease characterized by
muscle tremors, slowing of movement, and partial facial paralysis
what is Parkinson’s disease triggered by
degeneration of dopamine producing neurons in the brain
(necessary for normal brain functioning + why degenerate is not known)
what are treatments for Parkinson’s disease
administering drugs that enhance the effect of dopamine (dopamine agonists) in the diseases earlier stages and later administering the drug L-dopa, which is converted by the brain into dopamine
cam deep brain stimulation be another treatment for advance Parkinson disease
yes; involves implantation of electrodes within the brain
the electrodes, a treatment for advanced Parkinson disease, are then
stimulated by a pacemaker-like device.
what kind of transplantation and therapy also offer hope for treating Parkinson’s disease
cell transplantation
gene therapy
if life expectancy has increased dramatically, has the life span as well
no
although sexual activity declines in late adulthood, many individuals continue to be sexually active as long as they are
healthy
does the probability of disease or illness increase with age
yes (chronic disorders such as arthritis and osteoporosis)
