chapter 4 Flashcards
Average longevity
age at which half the individuals born in a particular year will have died. born in 2016- turn 70, half are expected to be dead, people who die before 70 don’t get counted
Maximum longevity
the oldest age to which any individual of a species lives. around 120
Active life expectancy
living to a healthy, independent old age. adding life to years
Dependent life expectancy
years of living after losing independence. adding years to life
Genetic and Environmental Factors in Average Longevity
genetic factors are a
-most environmental facts are _____ and ____ lives
– Genetic Factors
▪ A strong predictor of your longevity(genetics +immunity go hand and hand)
– Environmental Factors (goes hand and hand with genes)
▪ Disease, toxins, lifestyle, social class
▪ Most environmental factors are the result of human activity and needlessly shorten lives
Ethnic Differences in Average Longevity
– People of different ethnic groups do not have the same average longevity at birth.
▪ African Americans average longevity is lower compared to European Americans (environmental factors).
▪ Latinos have higher average life expectancies than European Americans.(even though they have less access to health care)
Gender Differences in Average Longevity
– Women live about five years longer than men.
▪ Men are more vulnerable to disease than women.
▪ Men are risk-takers.
▪ Men smoke and use alcohol more than women.
▪ Men allow stress to enter their lives more than women.
▪ None of these hypotheses have been strongly supported.
-woman have more effective natural killer cells
-woman have two X chromosomes
-men have higher metabolic rate
• International Differences in Average Longevity
– Dramatic differences around the world
▪ From 38 years in Sierra Leone, West Africa, to 80 years in Japan
▪ Factors (differences in diff countries between these factors)
– Genetic
– Sociocultural
– Economic
– Access to healthcare
– Health
A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity (WHO).
Illness
Presence of a physical or mental disease or impairment.
– Self-ratings of health are
self ratings of health reveals
self-ratings of health tend to be
-self-related health is a powerful predictor of
very predictive of future health outcomes. (go hand in hand)
self ratings of health reveals available health resources,->
▪ Socioeconomic and ethnic differences in good or poor self related health
self-ratings of health tend to be relatively stable and then decline overtime
-self-related health is a powerful predictor of mortality
- Quality of Life
* Valuation of life
– Relating to specific diseases or conditions, or relating to end of life issues
• A successful use of the selection, optimization, and compensation model to manage one’s life resulting in successful aging
– Health-related aspects- includes all aspects of life that are affected by changes in one’s health status
– Non-health-related aspects- reflects things in the environment such s entertainment, economic recourses, arts that affect our overall experience and enjoyment of life
• Valuation of life—degree to which one is attached to his or her present life.-enjoyment of life, hope for the future, finding meaning in life
selection optimization and compensation model (SOC model)
selection optimization and compensation model- used to manage one’s life, resulting in successful aging
- important in studying cultures
- harder to determine quality of life in people with Alzheimer’s
natural killer cells
primary defense against cancer
five major types of specialized antibodies called
immunoglobulins
• Changes in the Immune System
– Older adults’ immune systems take longer to build up defenses. (t and B lymphs decrease, more susceptible)
– More prone to serious consequences from illnesses
– Autoimmunity
▪ Immune system can attack the body itself. ▪ Rheumatoid arthritis( imbalance of B and t lymphocytes giving rise to autoantibodies)
• Changes in the Immune System
– Psychoneuroimmunology
– Psychoneuroimmunology- is the study of the relations between system changes that raise or lower susceptibility to recover from disease
▪ Psychology
▪ Neurological
▪ Immunological system changes
▪ Raises or lowers our susceptibility to and ability to recover from disease (Reed & Raison, 2016)
– HIV/AIDS and Older Adults
▪ 25% of people with HIV are over age 50.
▪ Older adults may be more likely to contract HIV due to physiological changes.
– Acute diseases
Conditions that develop over a short period of time and cause a rapid change in health. (cold, influenza, food poising, strep)
Chronic diseases
Conditions that last at least three months and may result in impairment that necessitates long-term management.
– As age increases acute diseases _____ and chronic diseases______.
– As age increases acute diseases decline and chronic diseases increase. but older adults get really sick with acute diseases if they do get them (cardiovascular disease, arthritis, diabetes)
• The Role of Stress
– Stress and Coping Paradigm
-stress hass both a physiological and psychological aspects
– Stress as a physiological response
▪ Prolonged exposure results in damaging influences from the sympathetic nervous system.( heart rate and respiration)
▪ Cardiovascular disease
▪ Impaired immune system function
▪ Some forms of cancer
▪ Shortening telomeres
– Stress and Coping Paradigm
▪ An interaction of a thinking person and an event
– Two people stuck in traffic—different levels of stress?
– Stress and Coping Paradig
views stress not as an environmental stimulus or as a response but as the interaction of a thinking person and an event
stress is a transactional process
its how we interpret the event not the event or reaction itself
– Appraisal
– Coping
– Appraisal (Lazarus and Folkman, 1984) (stress is complex/dynamic)
▪ Primary appraisal: categorizes the events into 3 groups irrelevant(not affected), benign(neutral), or positive or stressful
▪ stressful event leads to Secondary appraisal: evaluates the event (harm, threat)
▪ Reappraisal: changes in the situation may change the appraisal (making a new primary or secondary appraisal resulting from changes in the situation)
– Coping—dealing with stressful events (learned, not automatic)
▪ Problem-focused coping: attempts to tackle the problem head on (taking medication, studying)
▪ Emotion-focused coping: dealing with one’s feelings about the stressful event (express anger or frustration about becoming ill or taking exam)
• Effects of Stress on Health
– Healthy people are better able to cope than frail, sick people.
▪ Older adults are more likely to use past experiences to guide coping.
– Immune system suppression
– Increases the risk of atherosclerosis and hypertension
– Increases the level of LDL cholesterol-can cause Cardiovascular vascular disease
-hippocampus smaller when high levels of stress
• Common Chronic Conditions
– Diabetes Mellitus: pancreas produces insufficient insulin (high glucose in blood and urine)
▪ Type I( requires use of insulin) and Type II (managed through diet)
– Cancer(can be prevented)
▪ Risk increases with age—males at greater risk ▪ Targeting specific genetic structures of tumors
– Incontinence
▪ Four major reasons:
– Stress, urge, overflow, functional
▪ Most forms can be alleviated with interventions.
-medications, surgery, padding, pelvic floor training
stress incontinence
stress incontinence: happens when pressure in the abdomen exceeds the ability to resist urinary flow
lifting heavy object
urge incon.
CNS problem after a stroke or urinary tract infection
overflow incon.
improper contraction of kidneys causes bladder to become overdistended (big)
functional incon.
urinary tract is intact but physical disability or cognitive impairment, they are unaware of need to urinate
• Managing Pain
– Pharmacological approach
▪ Non-narcotic (mild to moderate pain) and narcotic medications (severe pain, steroids, opioids, morphine)
– Nonpharmacological approach
▪ Deep and superficial stimulation of the skin ▪ Electrical stimulation to spine or pain site
▪ Acupuncture and acupressure
▪ Biofeedback (learn to control and change the body processes responsible for the pain)
▪ Distraction techniques (soft music)
▪ Relaxation (meditation)
▪ Hypnosis (self induced or induced by others)
• Patterns of Medication Use
– Explosion of new medication available
– Increase in chronic disease results in increases in the number of medications taken
• Developmental Changes in How Medications Work
– Absorption and distribution
-toxicity
▪ Time needed for medications to enter the bloodstream may increase with age=less medicine entering in bloodstream
▪ Once in the bloodstream the drug is distributed throughout the body.
– Drug metabolism and excretion- decreases with age
– Can lead to toxicity (buildup of drugs that remain free and not distributed to rest of body)
– Several drugs not recommended for older adults
▪ Good strategy: “start low and go slow.”
• Medication Side Effect sand Interactions
– Older adults have the highest risk of
Polypharmacy
Adherence to Medication Regimens
– Older adults have the highest risk of adverse drug affects
– Polypharmacy
▪ The use of multiple medications can cause interactions ▪ Accurate medication histories are essential.
• Adherence to Medication Regimens (taking them correctly)
– Adherence decreases with complexity
– Increase in adverse drug reactions (a lot of side effects to remember)
– Smartphone apps and telemedicine approaches
– Disability:
▪ The effects of chronic conditions on people’s ability to engage in activities that are necessary, expected, and personally desired in their society -longer disability period
– Compression of morbidity
▪ Becoming disabled later with a shorter period of disability before death -shorter disability period
• Verbrugge and Jette Model of Disability
– Exacerbators
– Risk factors
▪ Long-standing behaviors or conditions that increase one’s chances of functional limitation or disability
– Intervention strategies (low economic status, chronic health conditions, smoking)
▪ Extraindividual factors (environmental and healthcare)- aim to reduce the restrictions and difficulties resulting from chronic conditions ex: surgery, medication, wheelchair)
▪ Intraindividual factors (behavioral and personality)
positive outlook, exercise program
– Exacerbators
▪ Situations that make the situation (chornic illness) worse than it was originally
– e.g., inflexible social service agency policies
• Determining Functional Health Status Hieracrchy of loss Frail older adults – Activities of daily living: – Instrumental activities of daily living: – Physical limitations:
– Hieracrchy of loss- sequence of loss of function
– Frail older adults-
▪ Physical disabilities, very ill, cognitive or psychological
– Activities of daily living: ADL
▪ Basic self-care tasks- eating, bathing, walking
-are considered frail if they can’t do these tasks
– Instrumental activities of daily living: IADL
▪ Require intellectual competence and planning (paying bills, making phone calls)
– Physical limitations: PLIM
▪ Limited ability walking or sitting (walking a block, sitting for about 2 hours)
functional health status
how well the person is functioning in daily life
• Causes of Functional Limitations and Disability in Older Adults
-0redictors
– Predictors
▪ Arthritis and cerebrovascular disease
▪ Smoking, heavy drinking, physical inactivity
▪ Depression, social isolation, and perceived poor health
• Socioeconomic status
– Being wealthy helps increase average longevity
• Consistent across racial and ethnic groups
▪ Higher in low-income countries and among women
• Americans have higher rates than Europeans
