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GE cluster Aging > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Instrumental activities of daily living – summarize an individual’s ability to perform more complex multidimensional activities and interact effectively with environment

A

Managing money, meal preparation, grocery shopping (most common), phone calls

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2
Q

Disability

A

Impairments in ability to complete multiple tasks

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3
Q

Health status

A

Presence/absence of disease and degree of disability in an individual’s level of functioning

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4
Q

Activities of daily living – measure functional health, summarize an individual’s ability to perform basic personal care tasks

A

Eating, bathing, dressing, walking (most common)

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5
Q

Frailty

A

Unintended weight loss, slow walking speed, low physical activity levels, chronic exhaustion, weak grip strength

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6
Q

Leading cause of injuries and injury related deaths for 65+ group

A

Falls (Account for 95% of all hip fractures)

Over 1/3 of those 65+ fall every year

9th leading cause of death among seniors

Most effective fall intervention is comprehensive clinical assessment combined with individualized fall risk reduction and patients follow up

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7
Q

Most common chronic condition affecting older people

A

Hypertension, Arthritis, Heart disease

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8
Q

Advanced activities of daily living

A

Patient specific functional activities like recreational, occupational, community service

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9
Q

Geriatrics vs gerontology

A

Geriatrics is the clinicals study of treatment of older people and the diseases that affect them (medical specialty)

Gerontology focuses on understanding the biological psychological social and political factors that influence people’s lives (interdisciplinary study)

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10
Q

Good health

A

More than absence of disease or disability – complete mental, physical, and social state of well-being

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11
Q 
Risk factors for falls include all of the following except: 
a) Being overweight 
B) multiple diseases 
C) unfamiliar environments 
D) fear of falling
A

A) being overweight

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12
Q

Risk factors for falls

A

Lack of balance control, impaired gait, arthritis, cognitive impairment, increased age, use of 4+ medications that cause blood pressure to drop/affect balance, use of multiple drugs that affect CNS, visual impairment, sarcopenia

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13
Q

Sensory threshold

A

Minimum intensity of a stimulus that is required to detect the stimulus

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14
Q

Recognition threshold

A

Intensity of a stimulus needed for an individual to identify it

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15
Q

Sensory discrimination

A

Difference between two or more stimuli necessary in order for a person to distinguish between them

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16
Q

Sensation

A

Taking in information through the sense organs

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17
Q

Perception

A

Higher function in which information received through senses is processed in the brain

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18
Q

Changes in cornea

A

Cornea protects from dust and infection

Usually first affected is the cornea – surface of cornea thickens and smooth/rounded surface becomes flatter and less smooth

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19
Q

Changes in pupil

A

Pupil is the opening where light comes in then travels to the back of the eye

Pupil becomes two thirds smaller and more fixed in size thus less able to dilate/contract as necessary and slow response to light changes

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20
Q

Changes in rods and cones

A

Cones-color (more detailed)
Rods-general shapes
Part of retina

Slower shift from rods to cones in low light situations and affects ability to read small text

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21
Q

Changes in lens

A

Helps focus light which is connected to the optic nerve to be perceived in brain

Lens is a simple structure biochemically - all cells are of same type and composed of proteins (collagen). Collagen thickens and hardens with age making it less elastic + muscles that help stretch lens deteriorate–> less able to alter its shape when accomodating.

When collagen hardens there’s differential hardening (some surfaces let in more light than others) and this leads to uneven refraction of light onto the retina

When combined with poor refraction of light through uneven, flattened cornea surface, glare sensitivity results

Lens becomes more yellow and leads to reduced color sensitivity

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22
Q

Accommodation

A

Focusing from near to far

Deteriorates w age

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23
Q

Glaucoma

A

Aqueous humour fills front portion of eye and vitreous humour is in posterior chamber. Aqueous humour drains through Schlemm canal

Drainage is less efficient in glaucoma leading to pressure on optic nerve and resulting in tunnel vision

Treatment: medication to eliminate fluid backup

Leading cause of IRREVERSIBLE blindness in elders in US, 2nd leading cause of blindness in US, primary cause of blindness among blacks

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24
Q

Age related cataract

A

Lens becomes more opaque and less light passes through with age

Age-related cataract is severe opacification to the point that the lens prevent like from entering
associated with lack of antioxidants and alcohol consumption

Treatment: cataract surgery - extract lens and implant new lens, most frequent outpatient surgical procedure on 65+ group

Like looking through a waterfall, leading cause of REVERSIBLE blindness in US and primary cause of blindness worldwide (more than half of people 60+ have cataracts)

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25
Q

Other vision changes

A

Depth and distance perception deteriorate, narrower peripheral vision, reduced tear secretion

Elevator muscles (which move eyeball up and down within socket) and ciliary muscle (aid lens in changing shape) deteriorate

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26
Q

Macular degeneration

A

Loss of central vision (macula is in center of retina with sharpest vision)

leading cause of blindness in US adults

WET (blood vessels form and block nutrition) or DRY (changes in cells that transmit nutrients to the macula, more common)

Smoking, Long term UV exposure, lack of antioxidants

Laser treatment or light activated drug treatment

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27
Q

Anatomy of ear

A

Outer ear- pinna (outside of the ear) and consists of auditory canal.

Tympanic membrane (eardrum) separates outer ear from middle ear

Middle ear consists of 3 small bones aka ossicles (malleus, incus, stapes) that transfer sounds to inner ear

Inner ear is the cochlea - snail shaped, fluid filled chamber with vibrating hair cells that perceive frequency and intensity of sound
(sounds are Converted to nerve impulses in cochlea and sent through internal auditory canal and cochlear nerve to brain)

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28
Q

Hearing age related changes

A

Supporting walls of external auditory canals deteriorate, arthritic conditions affect joints between malleus and stapes, stiffening eardrum as it thins

Declines in middle ear affect ability to detect and localize sound

hearing loss at lower volume and high frequency range (more common among smokers, hypertension, diabetes)

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29
Q

Presbycusis

A

Sensorineural loss that accompanies aging in the cochlea

Leading cause of hearing loss in elders

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30
Q

Otosclerosis

A

Condition in which stapes can’t vibrate and becomes fixed

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31
Q

Tinnitus

A

High pitched ringing related to occupations noise

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32
Q

Speech comprehension can be first sign of hearing loss

A

Low frequency hearing loss has minimal impact on speech comprehension, high frequency sounds can be heard by raising intensity

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33
Q

Changes in taste/smell

A

Changes in taste acuity are minimal but older people have more difficulty discriminating between different intensities of flavor

perceive airborne stimuli as less intense and do less well on odor identification

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34
Q

Iris

A

Gives eye color, controls size of pupil

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35
Q

eye health care professionals

A

Ophthalmologist (M.D.)
optometrist (checks vision)
optician (sells glasses)

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36
Q

Presbyopia

A

Can’t focus on near objects (farsightedness) due to decreased lens elasticity

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37
Q

What percent of hearing impaired use hearing aids?

A

20-25%

Stigma, expensive, uncomfortable, background noise also raised

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38
Q

3 systems of sensation responsible for sense of balance

A

Peripheral, vestibular, visual

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39
Q

Gut microbiome

A

Over 1000 bacterial species live in gut, about 160 diff species in avg person

They help break down food and boost immunity, driven by diet

Later in life, Number of bacterial species in the gut varies tremendously

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40
Q

What are some Strategies to deal w declines?

A 
Use nonverbal cues 
use external devices 
stand closer to hear and see better 
reduce level of excessive stimulation in environment 
face and make eye contact
Avoid noisy and move to quieter
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41
Q

Successful aging

A

Combination of physical and functional health, high cognitive functioning, active involvement in society

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42
Q

Resilience

A

Ability to thrive under adverse conditions, turning adversity into a catalyst for growth

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43
Q

Productivity

A

Any paid or unpaid activity that produces goods and services for the benefit of society, reciprocally benefiting both elders and society

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44
Q

Most salient social factor that shapes what is possible in old age

A

Social class

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45
Q

Leisure

A

Any activity characterized by the absence of obligation

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46
Q

Leisure disagreement

A

Leisure cannot substitute for employment because it is not legitimated by social norms versus leisure can provide personal satisfaction and activities to challenge abilities

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47
Q

Most common choice for elders for organize participation

A

Religious affiliation

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48
Q

Religion

A

Narrower than religiosity, and refers to an organized system of spiritual beliefs values and behaviors shared by community and transmitted over time

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49
Q

Religiosity

A

Encompasses trust and faith in a power greater than oneself

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50
Q

Spirituality

A

Belief in a relationship with a higher power – broader than religion or religiosity, provides framework for individuals to make sense of the world: who they are and how they should live, emphasis on personal experience

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51
Q

An ageless self

A

Someone who is not discouraged by their aging and has an identity that maintains continuity and is on a spiritual journey in time

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52
Q

Civic engagement

A

Process in which individuals actively participate in the life of the communities through individual and collective activities such as voting, joining community groups and service volunteering

Those with college experience have greater civic engagement

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53
Q

Different views on civic engagement: conservatives, progressives, social constructionists

A

Conservatives: favor voluntary involvement to fill gaps created by budgetary cuts in social service programs

Progressives: advocate for elders to be politically active to ensure that public policies safeguard their rights

Social constructionists: Focus on civic engagement may devalue those who can’t be engaged

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54
Q

Volunteer work

A

Distinguished by choosing to serve others rather than by it’s unpaid nature or by formal activity

Depression era elders actively engaged in community service the baby boomers are less engaged
volunteerism is highest among adults at midlife (but elders spend more time volunteering )
higher rates of volunteerism in employed than unemployed
elders participate more in informal volunteering

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55
Q

2 benefits of volunteering

A

Provide individuals with meaningful social roles and give organizations reliable workers w no cost

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56
Q

Generativity

A

Focus on caring and doing for others and guiding the next generation

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57
Q

Experience corps

A

Older adults help high need elementary kids, benefitting both elders and children

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58
Q

Civic health index 9 categories

A 
Connecting to civic and religious groups 
trusting other people
 connecting to others through family/friends giving and volunteering
 staying informed 
understanding Civics and politics 
participating in politics 
trusting major institutions 
expressing political views
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59
Q

Social capital

A

Collective value of all social networks as a force to create change

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60
Q

Urban sprawl

A

Migration of population from populated cities to more rural land

Each additional 10 min of commuting reduces involvement in community activities by 10%

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61
Q

The Greatest Generation (born before 1930) compared to grandchildren were:

A

Twice as trusting
75% more likely to vote
Twice as likely to participate in community projects

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62
Q

Graph that is steady over past 40 years

A

Charitable giving and volunteering

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63
Q

In graphs, there was a decline in civic engagement after:

A

1960s

But some signs of hope w our generation

64
Q

Repotting hypothesis

A

Putnam, frequent changes of residence prevent people from planting deep enough roots in communities to nurture civic engagement (potting of plants damages roots)

65
Q

Robert Putnam interview

A

In the short-term diversity results in decreased civic engagement but in the long term diversity is good

66
Q

Civic engagement/volunteering at macro level vs micro level

A

Macro level: addresses social needs, supports economic growth, improves social capital (and states with high social capital, kids are better off, violent crime rarer, better health, economic equality)
Micro: health and longevity

67
Q

Leading cause of death for Americans age 1–44

A

Unintentional injury

68
Q

Public health approach to injury prevention

A

Define problem, identify riskand protective factors, develop and test prevention strategies, assure widespread adoption of effective injury prevention principles and strategies

69
Q

Infants and toddlers (1-3)
Leading cause of Injury death
Leading cause of death
2nd leading cause of injury death

A

Unintentional suffocation
Motor vehicle crashes
Drowning

70
Q

Children (4-11)
Leading cause of death
Cause of injury related death
4th leading cause

A

Motor vehicle crashes
Drowning
Homicide

71
Q

Adolescents(12-19)
Leading cause of death
2nd leading cause of death
3rd leading cause of death

A

Motor vehicle injuries
Homicide
Suicide

Risk is higher among 16–19-year-olds than in any other age group (4times more likely than older drivers to crash)

72
Q

Adults (20-49)
Leading cause of death
4th leading cause of death
5th leading cause of death

A

Motor vehicle injuries
Suicide
Homicide

73
Q

Older adults (50+)
Leading cause of injury death
Leading cause of death

A

Falls
Heart disease

Drivers have higher crash death rates per mile driven than all BUT TEENS

74
Q

1 leading cause of death in US (all age groups taken together)

A

Heart disease

Not cancer, injuries, stroke, or diabetes

75
Q

1 leading cause of death in US (15-24 years old)

A

Unintentional injuries

Not suicide, homicide, heart disease, or diabetes

76
Q

Leading cause of death age 1-44

A

Unintentional injuries

77
Q

Unintentional injuries have more years of potential life lost before age 65 than any other cause of death

YPLLs describe how much impact a cause of death has on a lifespan

A

If someone dies at 15, compare it to 65 and they’ve lost 50 years of potential life

78
Q

Leading cause of injury death out of all age groups

A

Unintentional poisoning

79
Q

Motor vehicle crashes: prevention strategies and environmental/structural strategies

A

Prevention strategies: graduated licensing, Insurance rates, maximum speed limit, seatbelt laws, child safety seats, texting bans

environmental/structural strategies: speed bumps, stop signs, red light cameras, airbags, crash barrels and guard rails, speed trailers, runaway lanes

80
Q

Among older drivers the most commonly cited reason for no longer driving is

A

Poor vision

Not loss of hearing, longer reaction time, slower reflexes, or fear of being involved in a crash

81
Q

Driving prevention strategies for elders

A 
Increased vision and driving testing 
condition specific limits on driving on drivers license 
graduated licensing for elders 
more frequent renewals 
roundabouts
82
Q

Reducing fall risk

A

Education, environmental interventions, tai chi, preventative meds, informal social support, assessment tools

83
Q

Universal design

A

Designing the environment to accommodate both young and old, healthy and disabled

Removing stairs, widening doors for wheelchairs, elevator, replacing door knobs with easier to use levers

84
Q

Gerotechnology

A

Field where engineers and gerontologists work together to create assistive technology

85
Q

Assistive technology

A

Electronics that allow elders to perform ADLs and to remain independent longer

Med dispenser, cameras to sense falls and sense alerts, granny pods, monitor when they pick up pill bottle

86
Q

Telemedicine

A

Providing care from far away
Transmission of data to improve healthcare

Pros: increases compliance w meds, reduced hospitalization
Cons: expensive, can’t replace love, caregivers don’t trust it

87
Q

Cognitive functioning

A

Intelligence, memory, learning

88
Q

Intelligence

A

Theoretical limit of an individual’s performance

consists of three major sets of abilities: problem-solving, verbal, and social competence

89
Q

IQ

A

Individuals relative abilities compared to others of the same chronological age

90
Q

Fluid intelligence

A

Skills that are biologically determined, independent of experience/learning, requires flexibility in thinking

Spatial orientation, abstract reasoning, word fluency, inductive reasoning

91
Q

Crystallized intelligence

A

Knowledge and abilities that the individual acquires through education and lifelong experiences, includes social judgment and ability to understand subtle meanings in the verbal communication

Verbal meaning, word association, social judgement, # skills

92
Q

Classic aging pattern

A

Consistent pattern of WAIS scores – people over 65 perform worse on fluid intelligence test but their scores for crystallized tests remain stable

93
Q

Most significant declines occur in intellectual abilities that are:

A

Less practiced and require speed

94
Q

Terminal drop aka terminal decline hypothesis

A

Those who declined more sharply are found to die sooner than good performers therefore age is not as significant in intellectual decline as proximity to death

95
Q

Executive function

A

Ability to organize ones learning

Includes planning, decision making, avoiding distraction, ability to shift attention

96
Q

Selective attention

A

Selecting important information while ignoring irrelevant information

97
Q

Vigilance/sustained attention

A

Requires individual to look out for specific stimulus overtime

98
Q

attentional control under conditions of divided attention

A

Ability to determine how much attention should be directed at specific stimuli and when to shift focus to other stimuli
Under conditions of divided attention, the individual must try to perform multiple tasks at same time

99
Q

General slowing hypothesis

A

Processing of information slows down in the nervous system with aging

100
Q

Recall

A

Process of searching through vast store of information in secondary memory, perhaps for a cue or specific question

101
Q

Recognition

A

Information in secondary memory must be matched with stimulus information in environment

102
Q

Cue overload

A

Same cues that were once helpful in remembering info are also used to recall recent events so Cues strongly associated with older life experiences make newer information harder to retrieve

103
Q

Disuse theory

A

Information can fade unless exercised

104
Q

Interference theory

A

New info interferes with material that’s been stored over many years

105
Q

Decrement model

A

Suggests memory networks w aging and TOTs are a manifestation of these impaired networks

106
Q

Incremental knowledge gain

A

Cumulative knowledge and vocab of elders can cause more names in secondary memory to interfere with the name to be recalled

107
Q

Positivity effect

A

Elders recall twice as much info with positive emotional content than negative/neutral info and respond faster

108
Q

Cognitive retraining

A

Teaching research participants to use various techniques to keep mind active and maintain good memory skills

109
Q

Mediators

A

Use of visual and verbal links between info to be encoded and info that’s already in secondary memory

110
Q

Look, snap and connect- practical method for retaining info efficiently to recall it

A

Look- actively focus on what you want to learn and record info from multiple senses
Snap- mental snapshot
Connect- visualize a link between images created through mental snapshots

111
Q

Selection, Optimization, and Compensation (SOC)- focuses on adapting and regulating individual resources

A

Selection - selecting specific cognitive domains in which to adapt
Optimization- maximizing abilities in selected areas
Compensation- loss in some areas require enhancement of skills in other areas

112
Q

Cognitive plasticity

A

Ability to accomplish three mechanisms of SOC and to recognize where one must compensate for these deficits in cognitive abilities

113
Q

Neural plasticity

A

Changes in brain structure and function that occur as a result of the addition of new neurons and synaptic connections between neurons, activating specific regions of the brain

114
Q

Dementia

A

Includes conditions caused by damage of brain tissue, resulting in impaired memory and at least one of:
Coherent speech/understanding language
Recognizing objects
Thinking abstractly and performing executive functions

115
Q

All dementias have these characteristics

A

Change in ability to recall recent events, problems with comprehension/attention span/judgment, disorientation to time place and person

116
Q

Reversible dementia

A

Cognitive decline that may be caused by drug toxicity, hormonal or nutritional disorders, and other reversible diseases

117
Q

Irreversible dementia

A

No discernible environmental cause with no cure

Alzheimer’s, vascular dementia, (small strokes), Lewy body (protein deposits inside nerve cells called Lewy bodies), huntingtons, picks disease, creuzfeldt-Jacob, kuru, korsakoff

118
Q

Delirium

A

Reversible dementia that has more rapid onset

Abrupt behavior changes, irrational speech, disturbed sleep

119
Q

Alzheimer’s

A

Most common irreversible dementia (60-80% of all dementias)

Familial Alzheimer’s disease- rare early onset in multiple generations of same family

120
Q

Alzheimer’s risk factors

A

Major: Obesity, hypertension, diabetes, low education, smoking, physical inactivity, depression

stroke, slow walking pace, severe head injury, stress

Reduced # of cholinergic nerve cells reduces acetylcholine available to transfer info from one cell to another, beta amyloid protein –>death of brain cells, mutations of APOE-E4

121
Q

Hippocampus

A

Region in limbic system in the brain involved in learning new info and retrieving old info, first region where plaques and tangles occur

122
Q

Stages of AD

A

1-no cognitive decrements
2-mild forgetfulness
3-mild cognitive impairment, concentration probs, some work difficulty
4-late confusional stage, increased financial probs, denial/withdrawal
5-poor recall of recent, remind about clothing/bathing
6-need assistance of ADLS and personality changes
7-late dementia, loss of verbal abilities, incontinence, no walking, maybe coma

123
Q

Greatest risk factor for AD

A

Age

124
Q

Inflammation

A

Normal information protects from infection
brain inflammation associated with memory loss
Decreasing inflammation protect brain health

Antiinflammatory lifestyle strategies: sleep, omega 3 fatty acids, exercise

125
Q

Dementia risk factors

A

Major: Depression/stress, obesity, hypertension, diabetes, smoking, physical inactivity, patient/cognitive inactivity

Genetics

126
Q

Five benefits of service learning

A

Attitude toward self, attitude toward school, academic performance, civic engagement, social skills

127
Q

Service learning recommended practices

A

Linking programs to academic objectives, incorporating use voice, involving community partners, reflection opportunities

128
Q

How many people live in City of LA?

A

4 million

129
Q

LA

A

2nd largest school system, 2nd largest port, most museums, most homeless people, 2nd worst traffic IN COUNTRY

130
Q

How many people live in LA County?

A

10 million

131
Q

Environmental justice movement in LA

A

Boyle Heights was industrialize and polluted, environmental justice movement was born, used to be 100% Jewish but now mostly Latino

132
Q

Most common nutrition disorder in elders

A

Obesity

133
Q

Two age groups in order of severity that have highest crash death rate per mile

A

Teens and 85+

134
Q

Antioxidant compound found in wine that in some studies has been found to have positive effects on brain health

A

Resveratrol

135
Q

Water tanks and guard rails are two types of

A

Environmental/structural intervention

136
Q

Leading cause of death for 65+ group

A

Heart disease

137
Q

Dementia and incontinence are two examples of this category of disease

A

Geriatric syndromes

138
Q

Onset of this type of sensory loss as a predictor of early onset of Alzheimer’s

A

Smell (anosmia)

139
Q

Normal parts of aging

A

Presbycusis, presbyopia, anosmia

140
Q

Abnormal parts of aging

A

Tinnitus, glaucoma, cataracts, macular degeneration

141
Q

Predenentia state which can potentially lead to Alzheimer’s

A

Mild cognitive impairment

142
Q

Disorder appeared to be linked to repeated head impacts in athletes

A

Chronic traumatic encephalopathy

143
Q

Condition when older adults develop problems from multiple meds

A

Polypharmacy

144
Q

2 proteinaceous structures seen in brain with advancing Alzheimer’s

A

Amyloid beta plaques and tau tangles

145
Q

Activity that increases economic growth while addressing particular societal needs in the process

A

Volunteering

146
Q

Leading cause of death for college student age group

A

Unintentional injury

147
Q

Most common unintentional injury

A

Motor vehicle crashes

148
Q

Why is civic engagement declining?

A

Increase of woman in labor force, too busy lack of free time, repotting hypothesis, urban sprawl, technological transformation of leisure

149
Q

Leading cause of death among teens 15-24

2nd leading cause

A

Motor vehicle accidents

Suicide

150
Q

Best way to prevent falls among elders in homes

A

Physical modifications to home

151
Q

Short term, mid range and long term issues

A

Short- present through 1 yr, to restore patient to previous health an reduce future fall risk
Mid range- 1-5 yrs, to provide preventative care
Long- beyond 5 yrs, plan for eventual decline

152
Q

Examples of civic engagement wheel

A

Deliberative dialogue, service learning, internships, community service, community based research, community partnership, volunteerism, get out the vote initiatives, activism

153
Q

1st, 2nd and 3rd LA

A

1st-1880s to eve of WW2 - growth, walkable downtown, streetcar system
2nd-WW2 to turn of millennium, era of suburbs, built freeways and no streetcars
3rd- profound reinvention, no room to sprawl, dense housing, public mass transit, environmental improvements

154
Q

A dementia evaluation should always include

A

MRI or CT scan

155
Q

Reducing fall risk

A

Education, environmental intervention, tai chi, assessment tools, meds, informal social support

GE cluster Aging (1 decks)

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