Chapter 5: Health and Prevention Flashcards
Whats the definition of Morbidity Rate?
- this is illness rate at which acute and chronic conditions occur
- greater for younger adults
What are Acute Conditions?
- these are conditions that develop over a short period of time, rapid change in health
- eg. flu and colds
What are Chronic Conditions?
- conditions lasts a long time (minimum of 3 months)
- increased risk with age
What are the 5 most common chronic conditions?
- Allergies
- Back Problems
- Hypertension
- Osteoarthritis
- Diabetes
What is Mutual-morbidity
- experiences more than one condition at a time
- low income females are at the greatest risk
- older indigenous adults experience higher prevalence rates across all conditions
What is a Disability?
- WHO: “health” state of well-being, physical, mental and social well being
- often resulting from chronic conditions, unable to complete activities that are necessary, expected and personally desired
- closely related to quality of life
- fairly high rates for chronic conditions but the majority reported satisfied or vey satisfied with lives (90%)
What are Activities of Daily Living (ADL)?
- personal care for self maintenance
- eating, dressing, getting around the house
- necessary to live independently
What are Instrumental Activities of Daily Living (IADL)
- these are more complex (cognitive) activities
- medication, finances, cooking
- getting around the community
- culture specific
- rates of disability have declined
What are the risk factors for Cardiovascular disease
- tobacco use, alcohol use, unhealthy diet, sedentary lifestyle, obesity
What are the risk factors for Cancer
- tobacco use, alcohol use, unhealthy diet, sedentary lifestyle, obesity
Risk factors for Diabetes
- unhealthy lifestyle, sedentary lifestyle, obesity
Risk factors for Chronic Lung Disease
tobacco use
Statistics about Disease
- chronic disease and disability is not an inevitable part of aging
- 75% of adults over 65 have no aspects of disability
- 80% over 85 are aging place
What are Cardiovascular Diseases
- involves the heart and blood vessels
- number one cause of death worldwide
What is Arteriosclerosis
- cardiovascular disease
- the thickening and hardening of arteries
- primary aging, cross linking (collagen)
What is Atherosclerosis
- cardiovascular disease
- fat deposits (plaques) and calcification of arterial walls
- secondary aging
What is Coronary Heart Disease
- cardiovascular disease
- this is damage caused by atherosclerosis affects arteries that feed the heart (chronic condition)
What is Myocardial Infarction (MI)
- cardiovascular disease
- heart attack
- acute condition
- decreased blood supply to the heart
What is Hypertension
- cardiovascular disease
- chronically elevated blood pressure
What is Congestive Heart Failure
- cardiovascular disease
- when the heart cannot meet the demands of the body, gets backed up (fluid buildup), causing the heart to pump insufficiently
What is a Cerebrovascular Accident (CVA)
- cardiovascular disease
- this is when the leading artery to the brain burst or is clogged and then brain becomes deprived of oxygen (blood clots or burst blood vessels in the brain)
- results in stroke, permanent damage
What is Transient Ischemic Attack (TIA)
- cardiovascular disease
- mini strokes, temporary blockage (typically a blood clot)
- blood flow should come back, where as with a stroke there is permanent damage to the brain
Gender differences for Heart Attack
- cardiovascular disease
- gender differences in progression , reoccurrence and symptoms
What are the risk factors for cardiovascular disease
- smoking : damages arteries
- inactivity
- unhealthy diet- not enough fruits and veg
- obesity- LDLs
- high alcohol consumption
What is a Metabolic Syndrome
- a group of 5 conditions that can lead to cardiovascular diseases
1. High blood sugar
2. high blood pressure
3. low HDL and high LDL
4. high triglycerides
5. excess fat around waist
What type of cancer is the leading cause of death in Canada?
- lung: most deadly and most common in older adults
- death rate is declining rapidly- treatment, detection and prevention is getting better (better screening)
What are the risk factors for cancer?
- risk factors increase with age
- genetics: breast and colon
- smoking
- inactivity
- overweight (red and processed meats)
- UV rays- tanning beds before age 30 increase you chance of skin cancer by 75%
- hormones
- environmental and lifestyle factors
What are detection factors for Cancer
- screening and early detection are key
- genetic testing (gene mutation BRCA1 and BRCA2, breast and ovarian cancers)
Prevention methods for Cancer
- surgery, radiation, chemotherapy
- screening for mammograms, prostate cancer, are there risks to this? (not super effective)
Which gene mutations are linked to breast and ovarian cancer?
BCRA1 and BCRA2
What is Osteoarthritis
- musculoskeletal system
- cartilage deterioration In joints
- exercises like swimming is good because it has less strain on the joints
What is Osteoporosis
- musculoskeletal system
- bones become weak and brittle (cross-linking of collagen)
- more common in women
What are the risk factors for osteoporosis
- women of european and asian descent
- small bone structure
- underweight
- post-menopausal
- excessive alcohol and smoking
- strength bearing exercise are beneficial
Prevention and Treatment methods for Osteoporosis
- calcium
- protein, magnesium, potassium, vitamins K Bs and D, Carotenoids
- exercise
- hormone replacement
What are the types of Diabetes?
- type 1: childhood
- type 2: adult onset
- unable to metabolize glucose
What factors are associated with Diabetes
- older age
- obesity
- inactivity
Diabetes increases your risk of?
- increased risk of heart disease
- stroke
- cause of blindness
- kidney disease
What are the ethnic differences for diabetes
- indigenous individuals
- culturally sensitive initiative important
What is Chronic Obstructive Pulmonary Disease (COPD)
- there are two kinds of this disease that are not really treatable
1. Chronic Emphysema
2. Chronic Bronchitis
What is Chronic Bronchitis
- respiratory diseases
- this is inflammation of bronchi
- increased mucus and coughing
- bronchial tubes become inflamed and irritated
- main cause is smoking
What is Chronic Emphysema
- respiratory disease
- this is the loss of elasticity in the alveoli which leads to permanent destruction of alveoli (elastin is destroyed)
- 82% self induced by smoking
- smoking leads to elastase to be released and other changes causes damage to lung tissue
What is Dementia
- Neurocognitive Disorder
- dementia is a family of disorders that include cognitive and behavioural deficits
- there is also some form of permanent damage to the brain
What is Alzheimer’s Disease?
Canadian Statistics?
- 90% of cases develop after 65 years of age
- most common form of dementia
- 5% of Canadians 65 and up
What are the stages of the psychological symptoms in the development of Alzheimer’s Disease
- Early stage: short term memory loss, symptoms may not be noticeable to everyone
- Middle Stage: mental confusion, loss of self awareness, people notice
- Late Stage: severe cognitive impairment, speech impairment, name forgetting, neglect hygiene
(survival time following diagnosis is about 5 years)
What are the Biological Changes involved with Alzheimer’s Disease
- Neurofibrillary Tangles
- Amyloid Plaques
- Vacuoles
What are Neurofibrillary Tangles?
- made of tau protein
- disrupt communication and cause cell death
What are Amyloid Plaques
- this is the build up of protein fragments called beta-amyloid
- disrupt communication and causes cell death
What are Vacuoles
- these are gaps in the brain that get bigger, more indirect
- due to the loss of cells due to plaques and tangles.
Steps in the formation of beta-amyloid plaque
- amyloid precursor protein APP sticks through the membrane
- enzymes leave beta-amyloid protein, which releases it into the space outside the neuron
- Clumps of beta-amyloid collect and begin to form a plaque
Steps in the formation of Neurofibrillary Tangles
- disintegrating microtubule
- microtubule subunits and falls apart
- tangled clumps of tau proteins
Proposed causes of Biological changes of Alzheimer’s
- existence of plaques and tangles do not guarantee symptoms
- still unclear which comes first
What is the Theory ApoE Abnormality ?
- gene thought to be involved with Alzheimer’s Disease
- Chromosome 19
- ApoE binds to beta amyloid and may lead to plaques
What is the Theory APP gene ?
- gene thought to be involved with Alzheimer’s Disease
- chromosome 21
- APP appears to control production of APP, protein that generates beta-amyloid
What is the Theory of Presenilin Genes?
- gene thought to be involved with Alzheimer’s Disease
- PS1 and PS2
- lead APP to increase its production of beta amyloid
What are deterministic genes
- genes that guarantee a person will develop the disorder
- early onset (1%)
- eg. Autosomal Dominant Pattern (Huntingtons Disease)
What are risk genes
- probability of the individual carrying a specific disease associated mutation
- The presence of APOE-e4- particular allele on the APEO gene
What are the protective factors for Alzheimer’s Disease
- cognitive reserve: efficiency of brain pathology, minds resistance to damage to the brain
- exercise, social network, mediterranean diet, education
- more brain pathology doesn’t mean worse symptoms
What are the risk factors of Alzheimer’s Disease
- concussions
- psychological disorders
- COVID
How do you diagnose Alzheimers Disease
significant and progressive decline in one or more of
- social cognition
- memory
- aphasia
- apraxia
- agnosia
- executive functioning
What is Aphasia
language difficulties
- symptom of Alzheimer’s
What is Apraxia
gesture and movement difficulties
What is Agnosia
identifying common objects difficulties
What is Anticholinesterases used for
- medical treatment for Alzheimer’s
- decreases action of cholinesterase’s leading to more acetylcholine (related to memory and muscle movement) in the brain, important for hippocampus and memory, mild to moderate AD
What is Memantine and Aricept used for
- medical treatment for Alzheimer’s
- blocks glutamate receptors leading to the reduction in neuronal death
What do antioxidants do for Alzheimer’s Disease
makes oxygen more available to neurons
How can drugs help Alzheimer’s Disease
drugs allow one to stay in early stage a bit longer
What is Aducanumab?
- the first drug getting at the biological causes, removes plaques
What are the Psychosocial Treatments for Alzheimers
- must also consider caregivers and caregiver burden
- Behavioural methods: independent, prompts, cues, modelling, positive reinforcement
- accepting living with the disease
- music therapy
What is Vascular Dementia (MID)
- series of TIAs (mini strokes)
- second leading cause of dementia in Canada
- more rapid
- similar risks as cerebrovascular disease
What are Frontotemporal disorders
- neurocognitive disorder
- changes in personality
- apathy, lack in inhibition, addictive behaviours
What is Parkinson’s Disease
- cluster of motor problems and tremors at rest
- 10-15 year survival
What is Lewy Body Dementia
- neurocognitive disorder
- confusion and hallucinations
What is Pick’s Disease
- severe atrophy of frontal and temporal lobes (similar to frontotemporal)
- symptoms such as disorientation and memory loss, need pick complexes in brain for this diagnosis
- later: pronounced personality changes and loss of social constraints
What is Normal-Pressure Hydrocephalus
- reversible neurocognitive disorder
- block and build up of cerebrospinal fluid in ventricles of brain
- must relieve the pressure
What is a Subdural Hematoma
- reversible neurocognitive disorder
- clot on surface of brain
What is Delirium
- reversible neurocognitive disorder
- confused thinking and reduced awareness about the environment around them
- can be misdiagnosed as dementia
- up tp 40% of hospitalizations in older adults
What does Polypharmacy mean
medications
What Is Wernickes Disease and Korsakoff Syndrome (chronic)
memory impairment
-associated with alcohol use
What is Pseudodementia
depression
What are Blue Zones of the world
- areas of the world that has more centenarians
- answers the question “why do some people live linger and/or are healthier than others
List a few of the Canadian Governments determinants of health
- childhood experiences
- income and social status
- genetics
What are some of the social determinants of health?
- SES
- stress
- education (higher education)
- marital status, people tend to live longer when they are married
What are the genetic factors involved in why some people live longer and/or are healthier than others
- disease
- personality (Type A, hostility, optimism)
Age friendly cities and communities
- outdoor spaces and buildings
- transportation
- housing
- social participation
