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Gerontology > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

“Silver Tsunami”:

A

Number of aging people is rapidly growing and will continue to grow (baby boomers)

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2
Q

Chronological Aging

A

based on person’s years lived from birth

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3
Q

Biological Aging

A

The physiological changes that reduce the efficiency of organ systems, affect functioning over time, but not necessarily result in disease or death.

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4
Q

Psychological Aging:

A

Alterations that occur in cognitive abilities, emotions and adaptive capacity and personality
- Memory, learning, intelligence

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5
Q

Social Aging:

A

consists of individuals’ changing roles and relationships

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6
Q

Birth Cohort:

A

groups of people born at approximately the same time; share common life expectations

Cohorts now in their 90s experienced the Great Depression and WW2

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7
Q

Baby Boomers:

A

cohort of people born between 1946 and 1964, a period starting at the end of WW2

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8
Q

US Bureau defines “older” as

A

65+

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9
Q

Administration on Aging considers what “old”?

A

60; that is when people can receive social services funded by AoA

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10
Q

AARP stands for

A

American Association of retired persons

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11
Q

AARP criteria for membershi

A

age 50

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12
Q

Since January 2011: how many baby boomers turn 65 each day? what is this called?

A

10,000 baby boomers turn 65 each day, “senior boom”

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13
Q

What is one of the most dramatic demographic changes in the US (and worldwide)

A

population aging

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14
Q

Population aging is a result of ..?

A

Result of aging baby boomers, increased life expectancy and declines in birth rates and death rates

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15
Q

By 1900, ___ were 4% of population (1 in 25 people); In 2011, increased to ___ of population

A

65+; 13.1%

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16
Q

By 2020, there will be more people 65+ than children under age _____?

A

5

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17
Q

By 2050, 65+ will be _____ of the population at 87 million

A

20%

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18
Q

Increased life expectancy explains what?

A

Explains why older population is growing rapidly (people are living longer)

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19
Q

Life expectancy at birth in 1900 vs today?

A

47 years ; 78 years

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20
Q

Life expectancy by 2050?

A

mid-80s

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21
Q

The US lags behind 51 other countries when it comes to life expectancy? (despite medical technology) - why?

A
  • Prenatal care
  • Early childhood services
  • Access to healthcare and healthier foods in other countries
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22
Q

Why are life expectancy rates in southern US are declining

A

increased poverty, obesity, heart disease, diabetes, cigarettes, income

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23
Q

old-old

A

75-85

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24
Q

oldest-old

A

85+

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25
Q

what is growing more rapidly, old-old or oldest-old? why?

A

Both growing rapidly but oldest old is growing most rapidly due largely to success of modern medicine and baby boomers

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26
Q

What is oldest-old population expected to reach by 2050?

A

Oldest old will reach 19 million of 4% of US population by 2050 (currently at 5.5 mil)

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27
Q

Centenarians and Super Centenarians:

A

people 100+ years

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28
Q

how many centenarians in 2010

A

72,000; doubled since 1990

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29
Q

Centenarians are Expected to hit how many by 2050

A

600-800 thousand

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30
Q

Why people are living longer: Largely due to eradication of many diseases that caused high infant and child mortality

A

Improves sanitation, antibiotics, advances in medicine

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31
Q

Why people are living longer: Advances in medicine at middle and old age

A

Increased number of people with chronic disease that require long term support and services

Heart disease, cancer, diabetes, COPD, etc.

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32
Q

Why people are living longer: Female and white elders have higher life expectancy rates due to

A

Lifestyle factors, healthcare disparities, unequal access to preventive healthcare services, and poverty are major explanations

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33
Q

Why people are living longer: Genetics

A

Predicts chronic illness, coping (hardiness), disease progression, and becoming centenarian

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34
Q

Why people are living longer: Environment

A

Life expectancy is impacted by environmental and lifestyle factors (diet, physical activity, social interaction, spirituality, adaptability, outlook, substance use)

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35
Q

How much of the population over the age of 65 is of color?

A

slightly more than 20%

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36
Q

largest and smallest color group

A

African american; american indians

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37
Q

What is predicted to happen by 2050 regarding population to the older minority groups?

A

older minorities will double in proportion by 2050 (likely growth in Latinos and Asian groups due to high immigration levels)

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38
Q

LGVTQ Elders are referred to as

A

“most invisibly of an already invisible minority”

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39
Q

Limiting existing empirical data/research due to failure to measure sexual orientation and gender identity refers to what older group

A

LGBTQ elders

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40
Q

LGBT research often fails to include

A

older adults

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41
Q

LGBTQ Participants may under-report because of

A

stigma

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42
Q

Estimated to be at least 2 million older lesbians and gay men. What is the predicted population trend by 2030?

A

likely to triple by 2030

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43
Q

Why is it assumed that aging experience is more difficult for LGBT elders

A

social isolation, mental distress, legal and societal obstacles

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44
Q

Maximum Lifespan:

A

length of years a given species could expect to live if all environmental hazards were eliminated

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45
Q

Soft limit

A

85-90 years

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46
Q

Maximum lifespan for human cells:

A

122 years

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47
Q

longest documented human life

A

122 years

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48
Q

state w higher number of elders

A

FL

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49
Q

Why do some states have higher proportions of elders?

A

Some states have older adults retiring and migrating there

Other states like IA have young persons moving out of state for employment, which increases the number of elder people

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50
Q

Nearly ___ of older adults live in metropolitan areas (cities and suburbs)

A

80%

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51
Q

Geographic distribution is relevant to what?

A

planning and delivery of social, health, and long-term services and supports

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52
Q

in 1960, what percent of the older population has a HS degree?

A

less than 20% of population

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53
Q

Dependency Ratio:

A

number of people 65+ to every 100 people of traditional working ages (18-64 years); used to measure pressure on productive, working population

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54
Q

Dependency Ratio 2010

A

22 people age 65+ to every 100 people aged 18-64

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55
Q

Dependency Ratio 2030

A

35 to 100

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56
Q

Dependency Ratio 2050

A

37 to 100

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57
Q

The higher the Dependency Ratio…

A

the greater the potential burden of “dependent” older adults

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58
Q

Support Ratio:

A

relationship between the proportion of population that is employed (productive, able to support others) and percentage that is not in workforce (dependent)

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59
Q

Support Ratio 1910

A

10 employed people per retired older person

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60
Q

Support Ratio today

A

less than 5 employed people per retired person

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61
Q

Support ratio 2030

A

3 employed people per retired person

There are fewer employed persons to support older retired people

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62
Q

If more elders remain in workforce longer there will be…?

A

fewer retired elders who require economic support from younger employed adults

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63
Q

In past generations, elderly used to be considered what

A

held in great esteem-treasured, honored, and respected

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64
Q

Society now tends to view aging as what?

A

A crisis or problem to be solved (“silver tsunami”), rather than recognizing opportunities and benefits

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65
Q

“Ageism” coined when and by who?

A

coined in 1969 by psychiatrist Robert Butler

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66
Q

In what ways does ageism lead to discriminatory behavior

A
  • Abilities and productivity in the workplace often undervalued or invisible
  • Tendency to regards older persons as debilitated, unworthy or attention, or unsuitable for employment
  • Refuse to hire/promote or fire/lay off because of age
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67
Q

How is Ageism pervasive in our society but often flies under the radar

A
  • Greeting cards to make fun of older adults
  • Advertising portrays as youthful: “anti-aging” ads that promote products that make us look young and as attractive as possible
  • Views of how people should behave based on their age
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68
Q

How is Ageism is impacting healthcare

A
  • Elderly may not be treated with same care and compassion as a younger patient
  • Not enough geriatric coursework, rotations or training in medical schools
  • People over 65 aren’t receiving appropriate screenings
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69
Q

How is Ageism a self-fullfilling prophecy

A

We unquestionably accept and follow ideas and beliefs about old people then become the old people we envision (“I cant do that im too old”)

Confirms our own ageist beliefs and fuels other people biases to when they see us acting out the stereotype

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70
Q

ageism

A

negative beliefs and stereotypes about old age; attributing certain traits to all members of a group solely because of a characteristic they share

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71
Q

Gerontophobia

A

morbid fear or dislike of old people or the idea of growing old

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72
Q

Resiliency

A

accessing resources that enable us to survive and thrive

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73
Q

Life course

A

the idea that we age as a part of our human development across a lifespan, but we also include a recognition of historical, political, cultural, economic and other factors impact how we age

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74
Q

World population

A

7 bil

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75
Q

population in 1950

A

3 bil

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76
Q

2050 population

A

more than 9 bil

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77
Q

in 1950, what was the global population for 65+

A

131

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78
Q

in 2008, what was the global population for 65+

A

506 million, or 7% of total population

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79
Q

in 2012, what was the global population for over 60

A

810 million over 60

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80
Q

in 2040, what is the expected global population for 65+

A

65+ expected to increases to 1.3 billion, or 14% of population

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81
Q

each year, nearly _____ people around the world turn 60, two people every _____

A

58 million; second

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82
Q

increase in the number of older adults is evident where? why?

A

developing countries that have shifted from agricultural to urbanized, industrial economy because access to modern healthcare is more widely available

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83
Q

Why has life expectancy increased in developing countries?

A

Better public health practices, advances in medical tech., and availability of medicines to treat certain diseases

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84
Q

Global aging researchers are following demographic changes where? why?

A

Japan, Germany, and Italy because of high median ages

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85
Q

Demographic Divide

A

division between the needs of young and old between developed and developing countries (where populations are still young)

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86
Q

Economic Complications

A

if workforce numbers decline, who is going to pay into government to fund pension programs, social services, education, etc.?

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87
Q

Describe Chinas Elder Crisis

A

Demographic shift is likely a result of declining fertility rates

Likely due to government’s one-child policy to limit couples to one child

4-2-1 phenomenon

China uses 90-7-3 plan

Huge discrepancies in services needed versus services available

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88
Q

Fastest aging developed country

A

japan

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89
Q

in japan, what % of the population is 65+

A

25%

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90
Q

By 2050, how many other countries will join Japan in having older adults compromise large percentage of population

A

65 other countries

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91
Q

Country experiencing most rapid rate of population aging

A

japen

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92
Q

Japanese society and politicians have resisted what as a way to increase number of young workers contributing to economic support of retirees

A

immigration

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93
Q

Where do Baby boomers account for 9% of workforce

A

japan

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94
Q

in order to prevent collapse of Japan’s pension system, U.N. projects are in need of what

A

13-17 million new immigrants by 2050

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95
Q

In past 25 years in Japan, how many have been accepted as immigrants

A

only 1 million

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96
Q

in the US, the majority of later-life immigrants are sponsored by who? and how was it made easier

A

their children; Made easier by a 1965 policy change

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97
Q

biculturalism

A

Process of integrating 2 cultures into ones life style

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98
Q

What percent of recent older immigrants unable to speak English or have poor proficiency

A

Nearly 75%

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99
Q

Social isolation and depression often result from what

A

language barriers, biculturalism, Financial problems, lack of health insurance, multiple chronic diseases, and grief over leaving home and friends

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100
Q

depression among immigrant elders

A

26%

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101
Q

Language and cultural barriers often exacerbate elders’ difficulties in what

A

accessing health care

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102
Q

Poverty rate for older immigrants

A

twice that of native US born elders

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103
Q

To qualify for SS benefits, a worker must have been employed by what and for how long? (i think for older immigrants)

A

by a “covered employer” for at least 10 years (40 quarters)

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104
Q

Covered employer:

A

job in which you and employer pay SS taxes

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105
Q

Why do Immigrants often face barriers in finding employment

A

language, cultural, ethnic, educational factors or discrimination

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106
Q

Anthropology of Aging:

A

helps researchers differentiate what aspects of aging are universal or biological, and which are largely shaped by sociocultural system

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107
Q

Traditional Societies:

A

often agricultural culture and multigenerational family units; long-standing norms and values – tradition based social structure

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108
Q

Modern Societies:

A

rapidly changing values, norms, and lifestyles; urban, modernized areas began to emerge and attracted a wide mix of people in search of a new way of life

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109
Q

Traditional Societies: Filial Piety (Asia)

A

a. A high status of elders in more traditional societies
b. Honor ones ancestors
c. Slowly changing as more Chinese women have opportunities in workplace, education, and marriage prospects (has impacted traditional roles and relationships)

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110
Q

Traditional Societies

A

Filial Piety (Asia), Native American and Native Hawaiian

111
Q

Traditional Societies: Native American and Native Hawaiian

A

a. Elders respected for wisdom, knowledge and experience
b. Regardless of tribe, elders assume significant roles as teachers and caretakers of the young
c. treasure elders

112
Q

Kupuna:

A

Hawaiian term for respected elder

113
Q

Modern, Urban Societies: characteristics

A

a. Popular culture appears largely youth oriented
b. Older people may be overlooked, ridiculed, scorned
c. 50% of world’s population living in cities, compared to 30% in 1950; urban populations are expected to double even in developing countries

114
Q

Modernization Theory:

A

the transformation of a society from living a rural way of life toward an urban way of life

115
Q

Modernization Theory: Rural to Urban transitions of younger generations

A

Increased social distance between family members

Residential segregation

Lack of caregivers

116
Q

Modernization Theory: Communication and technology

A

Jobs created primarily for the young

117
Q

Modernization contributes to lower status of older adults through:

A
  • Urbanization
  • Communication technology
  • Health technology
    Scientific technology used in economic productivity and distribution
  • Literacy and mass education
118
Q

Early modernization resulted in

A

residential segregation as young people were attracted to cities and older parents/grandparents remained on family farm or in rural areas

  • Dramatic impact on family interactions and disrupted family support for elders
119
Q

Rapid urbanization in India has left how many elders in rural areas without family nearby to care for them

A

30%

120
Q

What affects how we age?

A

Genetic inheritance
Nutrition and diet
Physical activity
Environment

121
Q

Many fear these regarding health as we age:

A

Pain and inconvenience of illness

How it affects ability to perform daily tasks and remain at home

122
Q

Senescence:

A

The gradual accumulation of irreversible functional losses to which the average person tries to accommodate on some socially acceptable way

123
Q

Theory

A

A system of plausible or scientifically acceptable idea intended to explain something or justify a course of action

124
Q

Wear and Tear Theory:

A

like a machine or car, organism simply wears out over time

Cells continually wear out and existing cells cannot repair damaged components within themselves

125
Q

The wear and Tear Theory is influenced by

A

Influenced by environmental stress, like poverty and poor nutrition

126
Q

Cellular Aging Theory:

A

Aging that occurs as cells slow their numbers in replications

Each species has a biological clock that determines it’s max lifespan and rate at which each organ system will deteriorate

Cells will stop dividing and replicating after a certain number of times

Limits bodies ability to regenerate and respond to injury/stress

127
Q

Immunological Theory:

A

Rate of aging is controlled by immune system

Defective immune system causes aging

Immune system is important protective function – becomes less efficient in helping body resist pathogens/infections that attack and interfere with normal functioning

128
Q

Immunological Theory may be responsible for

A

chronic / inflammatory conditions

129
Q

Inflammatory conditions:

A

immune system attacks own bodies cells or tissues

130
Q

Free Radical Theory (or Oxidative Stress Model):

A

Progressive, irreversible accumulation of oxidative damaged cells

Occurs when organism cannot easily detoxify or repair damage caused by free radicals

Damage accelerates in older adults, wears down organism, causes vulnerability to degenerative diseases

Supports that ingesting antioxidants like Vitamin E and C can inhibit free radical damage and slow again process by delaying loss of immune function

131
Q

Changes in body composition

A

a. Proportion of body weight contributed by water declines with age
b. Lose lean body mass in muscle tissue
c. Proportion of fat increases
d. Decrease in muscle fibers; muscle tissue loses elasticity and flexibility

132
Q

Skin and Hair Changes

A
  • Increased pigmentation (melanin) and age spots (liver spots) increase on body
  • Hair decreases in diameter, more limp looking
  • Pigment loss of hair follicles and roots lead to gray/white hair
133
Q

Ultraviolet light from sun is primarily responsible for

A

wrinkles, dried, and tougher texture or skin

134
Q

Cell replacement in epidermis (outer layer) and dermis thins (second layer) slows, results in

A

reduced elasticity and fullness of our skin (increased sagging and wrinkling)

135
Q

Skins blood circulation diminishes, which can

A

damage effectiveness of temperature-regulating mechanism – increases sensitivity to hot and cold

136
Q

The Kinetic System:

A

What allows us to sense the position and the movements of the body

137
Q

The Kinetic System is controlled by

A

central nervous system

138
Q

As we age, we face changes in the kinetic system such as

A
  • Decreased ability to judge the position of our bodies
  • Decrease to touch sensitivity
  • decreased abillity to maintain balance
  • move very slowly; more cautious
  • Dizziness, vertigo may result
  • Can lead to falls and injuries
139
Q

Changes in The Respiratory System:

A
  • Inhaling can become difficult as some people age and experience structural changes in rib cage; the amount of O2 declines
  • Weakening muscles can make it hard to cough
  • Most damage is done by pollutants and infections as it diminishes the amount O2 given to rest of body
140
Q

Changes in the The Cardiovascular System:

A

Structural changes in the heart

Heart valves can become thicker and stiffer which can increase BP

Arterial and vessel walls can thicken

141
Q

Changes in the The Urinary System:

A
  • Renal function deteriorates with age
  • Blood vessels to the kidneys harden
  • Number of nephrons decrease overtime
  • Kidneys lose capacity to absorb glucose and their concentrating and diluting ability
  • Bladder functions weaken and become less elastic so you cant hold as much urine
142
Q

What percent of adults living in own home experience incontinence

A

50%

143
Q

Changes in the Gastrointestinal System Changes:

A
  • Decrease in contracting of esophagus muscles
  • Takes more time for food to reach the stomach
  • Stomach decreased elasticity – feel more full easily which can lead to poor nutrition
  • Secretion of digestive juices in stomach decreases with age
  • Increase incidence of chronic constipation
144
Q

Increase risk for what cancers as we age

A

stomach and colon cancer

145
Q

Enzymes and simple sugars are absorbed more slowly where

A

SI

146
Q

Endocrine System Changes:

A

Increase in some hormones, decrease in other s

Changes in insulin which may affect ability to metabolize glucose

147
Q

Nervous System Changes:

A
  • Neuron loss (begins at age 30)
  • Brain mass and weight reduced
  • Neuron loss results in slower moving neurotransmitters and reduced blood flow which can impair cognitive function, slower reaction time, and reduce and limit sensations and reflexes
148
Q

Describe how the eyeball changes as you age

A

a. Cornea becomes flatter and irregularly shaped
b. pupils are less sensitive to light levels and the opening is reduced and difficult to see in darkness
c. narrow peripheral vision
d. increase sensitivity to glare

149
Q

Describe how skin sensitivity decreases overtime

A

changes in the skin and loss of number of nerve endings

150
Q

what can impact the decrease in one’s taste and smell

A

Tooth decay
Poor mouth care and hygiene
Sinus issues
Medications

151
Q

Describe how hearing changes overtime

A

the degeneration of hair cells and membranes in the cochlea change auditory threshold (so you can’t hear different volumes as well)

mainly environmental causes

152
Q

macular degeneration

A

loss of acuity in the center of the visual field

153
Q

Describe vision changes

A
  • Cataracts are common

- glaucoma more evident

154
Q

glaucoma

A

excess production of fluid which causes pressure on an optic nerve

155
Q

describe how taste changes as you age

A

Decrease of taste buds, saliva production and receptor cells in the nose

156
Q

Most biological theories of aging have one of two general orientations:

A
  1. Aging occurs due to random genetic mutations and oxidative stress
  2. Aging is a result of programmed senescence
157
Q

Pro-longevity:

A

Extending the length of a healthy life but not disrupting fundamental again process

158
Q

Healthy Life Span:

A

The number of years in good health and with quality of life

159
Q

Functional Capacity:

A

The capacity of a given organ to perform its normal function, compared with its function under conditions of illness, disability, and aging

160
Q

Good Health

A

A state of physical, mental, and social well-being

161
Q

Active Aging

A

The ability of older adults to do what they want in their home and community

162
Q

Health Status

A

The presence or absence of disease, as well as the degree of disability in an individual’s level of functioning

163
Q

Functional Capacity

A

The capacity of a given organ to perform it’s normal function, compared with its function under conditions of illness, disability, and aging, which influences an individual’s ability to perform daily tasks.

164
Q

Activities of Daily Livings (ADLs):

A

Summary of an individual’s performance on personal care tasks such as bathing, dressing, eating, toileting, and walking

165
Q

Instrumental Activities of Daily Livings (IADLs):

A

Summary of an individual’s ability to perform more complex activities such as household and financial management, making phone call, grocery shopping, meal preparation and taking medications

166
Q

Disability

A

An impairment in the ability to complete multiple daily tasks

167
Q

Comorbidity

A

The coexistence of two or more chronic illnesses

168
Q

Health disparities

A

Inequalities in health, well-being, and mortality across the life course, which often reflect a lifetime of disadvantages in employment, finances, and education

169
Q

Healthcare disparities

A

The difference in access, quality, and use of healthcare services; these typically result in health disparities

170
Q

Quality of life

A

Encompasses an individual’s functional health, relative independence in performing daily tasks, and satisfaction with their circumstances

171
Q

Frailty

A

Severe limitations in ADLs, such as unintended weight loss, difficulty walking up more than one flight of steps, slow walking speed, low PA levels, weak grip strength, chronic exhaustion. This increases the risk of an older person becoming disabled, dependent and dying earlier that other of their age.

172
Q

chronic illness

A

Lasts more than 3 months, often require long-term management or care rather than a cure.

173
Q

Acute illness

A

Typically short-term and more readily treated

174
Q

Have disability rates been rising:

A

yes they have been rising since 2000

175
Q

WHY have disability rates been rising?

A

Obesity over the last 3 decades

Although people are living longer, many are also living sicker

176
Q

Compression of Morbidity:

A

Relatively long periods of healthy, active, high quality existence, and relatively short periods of illness and dependency in the last few years of life

177
Q

Epidermis:

A

The outermost layer of the skin

178
Q

Health and Function-ability –> per World Health Organization:

A

good health is a state of physical, mental and social well-being

40% over 65 assess their health as excellent or good compared to 65% younger adults

179
Q

Functionability determines

A
  • What they can do
  • What they think they can do
  • How healthy they are
  • Indicates how much formal and informal assistance they need, which has many implications
180
Q

Functionability is Commonly categorized into 2 different themes

A

they can be assessed by the individual or by family/friend/professional

181
Q

When addressing functionability, we tend to look at

A

ADL and IADL

182
Q

What percent of older people living in community need help with at least one ADL

A

40%

183
Q

2/3 of older adults deaths are due to

A

chronic conditions (heart disease, cancer, stroke, diabetes)

184
Q

Risk of chronic illness _____ with age

Acute chronic conditions _____ with age

A

increases; decrease

185
Q

Cerebrovascular Accident (CVA) or stroke:

A

when a portion of the brain is completely denied blood; such as through a blood clot

186
Q

Primary cause of disability

A

Cerebrovascular Accident (CVA) or stroke

187
Q

4th leading cause of death in older adults

A

Cerebrovascular Accident (CVA) or stroke

188
Q

second most common cause of death among elders

A

cancer

189
Q

Almost _____ of all new cancers occur in older adults – over _____ survive at least 5 years

A

60%; 8%

190
Q

Why is diagnosing caner harder in older adults

A

other illnesses and symptoms

191
Q

Arthritis

A

second most common condition that affects 50% of older adults, major cause of limited daily activities

192
Q

Osteoarthritis

A

damage to a jointed cartilage, result in bone on bone grinding, most common form of arthritis, affects joints that are more subject to stress such as hands/knees/hips, severely limit mobility

193
Q

rheumatoid arthritis

A

chronic inflammation of membranes of the lining joints and tendons

194
Q

osteoporosis

A

when bones become brittle and fragile

195
Q

Chronic Obstructive Pulmonary Disease (COPD)

A

Umbrella term used to describe progressive lung disease (emphysema, chronic bronchitis)

Develop slowly, progressive, debilitate overtime

196
Q

Prevalence of diabetes has increase among all age groups but mostly what age does it target?

A

30-39 year olds

197
Q

what percent of older adults has diabetes and that is expected to increase 3-fold because obesity epidemic in culture

A

25%

198
Q

Severe complications of diabetes:

A

infections, cognitive impairment/dementia, painful nerves in limbs, poor circulation, kidney disease, heart failure

199
Q

Older adults have life expectancy of about ____ years less than those without diabetes

A

15

200
Q

Diverticulitis

A

Little pouches on inside of intestine that result from weakness of intestinal wall

Cause infection, bowel changes, nausea

201
Q

HIV/AIDs largely due to

A

unprotected sex

202
Q

25% of people with HIV/AIDs are over what age

A

50

203
Q

what percent of all accidents are caused by older adults driving

A

7%

204
Q

older people have ___ as many hospital days than younger people

A

3x

205
Q

Adults 65+ have how many doctor visits annually

A

7

206
Q

Why are physician services more expensive

A

medical out-of-pocket costs and prescription costs, even with Medicare

207
Q

Why is there limited healthcare and resources for older adults

A

a lot of physicians are not trained to work with older adults

208
Q

What is the concern with medicating older adults

A

Issues with over-medicating, inappropriate usage, adverse drug reactions, high medications costs

209
Q

Hypokinesia

A

he disease of “disuse”

210
Q

Little D

A

sadness, grief and brief period of sadness = normal

  • situational
  • may resolve in time
211
Q

most frequently diagnosed mental health disorder among older adult

A

Depression

212
Q

Minor or Reactive Depression

A

Responds to a typical life event; Typically short term

213
Q

Minor or Reactive Depression symptoms

A
  • loneliness
  • loss of interest
  • neglect of self-care
  • changes in eating and sleeping patterns
  • feelings of emptiness an anxiety
214
Q

Major Depressive Disorders

A
  • Persist beyond 6 months

- Likely originated earlier in life (but not always)

215
Q

Major Depressive Disorders Symptoms

A
  • apathy
  • fatigue
  • self-blame
  • guilt
  • worthlessness
  • agitation increases
  • weight changes
  • concentration decreases
  • thoughts of suicide
  • Looking for symptoms that are present most days of the week, nearly everyday for at least 2 weeks
216
Q

Bipolar Depression

A
  • Mood swings ranging from a depressed state to a manic state
  • Do not always see a lot of older onset bipolar disorder
  • 17-23 years old is average age of diagnosis
217
Q

Diagnosing anxiety in older adults requires what?

A

a medical workup to rule out the cause they symptoms are not being caused by a medical condition

218
Q

Why can it be hard to diagnose anxiety in older adults?

A
  • there are conditions that produce similar symptoms as anxiety (hyperthyroidism or other endocrine problems, too much or too little calcium, low blood sugar, heart problems)
  • medications may also cause anxiety
219
Q

What is anxiety?

A

Excessive worrying, nervousness or uneasiness

220
Q

Anxiety is almost as common in later life as what?

A

depression

221
Q

Symptoms of anxiety

A
  • impulsive behavior or panic attacks
  • Fast/irregular heartbeat
  • fatigue
  • sleep disturbances
  • physical/mental restlessness
  • may also have major depression

older adults tend to underreport or minimize anxiety symptoms

222
Q

Anti-depressives:

A

selective serotonin reuptake inhibitors, antihistamines and betablockers (mild forms, usually taken only when needed or immediately before anxiety provoking event), anticonvulsive medications that are beginning to show value in treating some forms of anxiety

223
Q

Alcoholism

A
  • alcoholism declines with age, but those who drink consume a higher # of drinks
224
Q

what % of older people drink alcohol

A

50%

225
Q

Polypharmacy

A

The use of multiple medications

226
Q

Why is polypharmacy a concern

A

When more drugs are being prescribed, especially if they aren’t always needed they are more likely to produce drug reactions which can lead to and increase in ER visit

227
Q

Illicit drug use

A
  • can lead to increase in ER visits

- less common in older adults

228
Q

The rate of drug abuse in older adults is expected to increase how much from 2001 to 2020

A

by 50%

229
Q

suicide rates are about _____ higher in older adults than in younger groups of the population as a whole

A

50%

230
Q

Older individuals who are at high risk of suicide

A

widowed white males above the age of 85 years old who have chronic depression, pain or alcohol use

231
Q

what percent of individuals who committed suicide visits their primary care doctor in the proceeding month

A

75%

232
Q

Signs and risk factors for suicide in older adults:

A

lack of physical health, loss of a loved one, depression, financial instability, giving away possessions, statements of frustration of life,

233
Q

Tricyclic Antidepressants (TCAs)

A

The oldest for of treatment (some of the first medications)

Still around

234
Q

MAOI’s, Monoamine Oxidase Inhibitors

A
  • Among the very earliest treatments
  • These block an enzyme (Monoamine Oxidase) that then leads to an increase in brain chemicals related to serotonin, epinephrine, dopamine
235
Q

Why aren’t MAOI’s always prescribed?

A

Not always prescribed because of the risk of interactions with other medication and even certain foods

236
Q

SSRI’s, Selective Serotonin Reuptake Inhibitors

A
  • First line of defense as well as SNRI’s (serotonin and norepinephrine reuptake inhibitors)
  • The most common medications to treat mental disorders
237
Q

how do SSRI’s, Selective Serotonin Reuptake Inhibitors work?

A

In the brain, neurons are releasing serotonin and norepinephrine naturally; released serotonin into the system, and then sucks some back up to put into the blood stream, but what’s happening in people with depression is that we are finding that these reuptake sensors that are sucking up the extra serotonin in the brain cell are overworking, so they are sucking all of the serotonin back in. So instead of leaving some serotonin in the bloodstream, the serotonin is released, and then it all sucked back up

The SSRI works in to interfere with that ^ process to keep it from reup taking ALL the serotonin; inhibits the reuptake so that some of it remains in the bloodstream

238
Q

Electroconvulsive Therapy (ECT)

A
  • Been around a very long time
  • Effective in treating very very severe depression
  • Using electricity to induce a seizure which can rewire or reset the brain signals; put under anesthesia
  • Repeated several times a week for a few weeks
239
Q

Electroconvulsive Therapy (ECT) can lead to what?

A

memory loss, nausea, can be traumatic

240
Q

Transcranial Magnetic Stimulation

A
  • Only FDA approved to treat depression
  • Similar to ECT but instead of using electric shock, it is using a magnet
  • Patients are awake, wear a clock cap
  • Physician maps out part of the brain that is under excited based on MRI, CT, PET, and use magnet to stimulate that area
241
Q

Non-pharmacological treatments to anxiety and depression

A

Support groups
Psychotherapy
Exercise
Diet

242
Q

intelligence

A

The theoretical limit of an individual’s performance.

243
Q

intelligence consists of

A

problem solving, verbal skills, and social competence

244
Q

Fluid intelligence:

A
  • Biologically determined
  • Abstract reasoning
  • mathematical reasoning
  • spatial relationships
  • perceptual speed
  • Ability to reason and think flexibly
245
Q

Crystallized intelligence:

A
  • knowledge and abilities acquired
  • Verbal meaning
  • social judgement
  • number skills
  • verbal memory
246
Q

older adults decline in _____ and stay stable in _____ and the speed of _____ deteriorates*

A

fluid intelligence; crystalized intelligence; cognition processing

247
Q

_____ and _____ are processes that must be considered together.

A

learning and memory

248
Q

Working (primary) Memory

A
  • Temporary stage of holding, processing, and organizing information
  • Decides what should be stored or ignored
249
Q

Secondary (long term) memory:

A
  • Lasting or permanent storage or information
  • Where things go that you can recall later
  • You have to be encoding this and to do this you must engage in it
250
Q

Sensory Memory

A
  • Memories generated or recalled via touch, smell, taste, sight or sound
  • Based on receiving memory from longterm storage
  • Memories may be activated or easier to remember when a sound or smell is present that was also present at the time you learned something
251
Q

Learning

A

Info must be rehearsed or processed to be retrieved later

Info is retrieved through recall (free or cued) and recognition

252
Q

Learning occurs when

A

newly acquired information become encoded or stored in secondary memory

253
Q

Many factors can impact learning (and appear to impact memory)

A
  1. External factors (environment factors like poor lighting)
  2. Psychological factors: anxiety or expectations
  3. Other: educational level, language proficiency, slowing of CNS
254
Q

Executive functioning

A

the brains ability to organize our learning and efficiently use stored information in our secondary memory to plan, make decisions, and shift from one task to another
- The CEO of the brain

255
Q

what can impair executive functioning

A

Dementia and brain injury

256
Q

Impairments impact what

A

every part of daily live including ADLs, employment capability, and relationships/roles

257
Q

Theories of Loss: Disuse theory:

A
  • Use it or lose it

- Info can fade away if not used

258
Q

Theories of Loss: Interference Theory

A

Poor retrieval due to:

  • Distraction during the learning phase
  • Retroactive interference (new memories disrupt old memories)

Ex. Learning french may impact our memory of previously learning spanish

259
Q

Theories of Loss: Spatial Theory

A

Recognizing where objects are in relation to each other

“you are here” maps study

260
Q

Theories of Loss: General Slowing Hypothesis

A

General Slowing Hypothesis

Aging causes a slowing of information processing in the nervous system

261
Q

Dementia

A

An umbrella terms that describes a group a symptoms associated with the decline in memory or other thinking skills severs enough to reduce the persons ability to do everyday activities

262
Q

Two of the following must be significantly impaired to be considered dementia

A 
Memory 
Communication/language 
Ability to focus and pay attention 
Reasoning or judgement on things 
Visual perception
263
Q

who is at higher risk for dementia

A

oldest of the old

264
Q

Reversible dementia

A 
Depression 
Medication side effects  
Excess use of alcohol 
Thyroid problems  
Vitamin deficiencies
265
Q

Irreversible dementia

A 
Alzheimer's disease (typical and early onset) 
Vascular dementia  
Creutzfeldt-Jakob disease 
Dementia with Lewy Bodies  
Huntington's disease  
More
266
Q

What consumers 50-80% of all dementias

A

Alzheimers disease

267
Q

6th leading cause of death for elders

A

alzheimer’s disease

268
Q

How many people does alzheimer’s disease effect

A

1 out of every 8 americans over the age of 65

269
Q

how often is someone diagnosed with alzheimer’s

A

every 68 seconds

270
Q

What is the life expectancy once diagnosed with alzheimer’s disease

A

Most people survive 4-8 years after diagnosis

Few live as long as 20 years

271
Q

AD: Early Stages:

A
  • Hard time remembering new information
  • misplacing things
  • confusion with time and place
  • new problems with words in speaking or writing
272
Q

AD: intermediate Stages:

A

Hard time performing complex tasks (paying bills)

  • forgetting of recent events
  • moodiness or withdrawals
  • inability to perform challenging arithmetic
  • Typically longest stage of disease
  • Can last for years
  • Increase risk of wandering and becoming lost
273
Q

AD: Late Stage:

A

Repeating same phrases and thoughts
inability to recognize partners, children, and longtime friends;
- major personality changes and becoming more aggressive, suspicious, or delusional;

wandering or becoming lost,

incontinence, agitation, hard time with ADLs and dressing

Gerontology (2 decks)

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