Exam 1 Flashcards
“Silver Tsunami”:
Number of aging people is rapidly growing and will continue to grow (baby boomers)
Chronological Aging
based on person’s years lived from birth
Biological Aging
The physiological changes that reduce the efficiency of organ systems, affect functioning over time, but not necessarily result in disease or death.
Psychological Aging:
Alterations that occur in cognitive abilities, emotions and adaptive capacity and personality
- Memory, learning, intelligence
Social Aging:
consists of individuals’ changing roles and relationships
Birth Cohort:
groups of people born at approximately the same time; share common life expectations
Cohorts now in their 90s experienced the Great Depression and WW2
Baby Boomers:
cohort of people born between 1946 and 1964, a period starting at the end of WW2
US Bureau defines “older” as
65+
Administration on Aging considers what “old”?
60; that is when people can receive social services funded by AoA
AARP stands for
American Association of retired persons
AARP criteria for membershi
age 50
Since January 2011: how many baby boomers turn 65 each day? what is this called?
10,000 baby boomers turn 65 each day, “senior boom”
What is one of the most dramatic demographic changes in the US (and worldwide)
population aging
Population aging is a result of ..?
Result of aging baby boomers, increased life expectancy and declines in birth rates and death rates
By 1900, ___ were 4% of population (1 in 25 people); In 2011, increased to ___ of population
65+; 13.1%
By 2020, there will be more people 65+ than children under age _____?
5
By 2050, 65+ will be _____ of the population at 87 million
20%
Increased life expectancy explains what?
Explains why older population is growing rapidly (people are living longer)
Life expectancy at birth in 1900 vs today?
47 years ; 78 years
Life expectancy by 2050?
mid-80s
The US lags behind 51 other countries when it comes to life expectancy? (despite medical technology) - why?
- Prenatal care
- Early childhood services
- Access to healthcare and healthier foods in other countries
Why are life expectancy rates in southern US are declining
increased poverty, obesity, heart disease, diabetes, cigarettes, income
old-old
75-85
oldest-old
85+
what is growing more rapidly, old-old or oldest-old? why?
Both growing rapidly but oldest old is growing most rapidly due largely to success of modern medicine and baby boomers
What is oldest-old population expected to reach by 2050?
Oldest old will reach 19 million of 4% of US population by 2050 (currently at 5.5 mil)
Centenarians and Super Centenarians:
people 100+ years
how many centenarians in 2010
72,000; doubled since 1990
Centenarians are Expected to hit how many by 2050
600-800 thousand
Why people are living longer: Largely due to eradication of many diseases that caused high infant and child mortality
Improves sanitation, antibiotics, advances in medicine
Why people are living longer: Advances in medicine at middle and old age
Increased number of people with chronic disease that require long term support and services
Heart disease, cancer, diabetes, COPD, etc.
Why people are living longer: Female and white elders have higher life expectancy rates due to
Lifestyle factors, healthcare disparities, unequal access to preventive healthcare services, and poverty are major explanations
Why people are living longer: Genetics
Predicts chronic illness, coping (hardiness), disease progression, and becoming centenarian
Why people are living longer: Environment
Life expectancy is impacted by environmental and lifestyle factors (diet, physical activity, social interaction, spirituality, adaptability, outlook, substance use)
How much of the population over the age of 65 is of color?
slightly more than 20%
largest and smallest color group
African american; american indians
What is predicted to happen by 2050 regarding population to the older minority groups?
older minorities will double in proportion by 2050 (likely growth in Latinos and Asian groups due to high immigration levels)
LGVTQ Elders are referred to as
“most invisibly of an already invisible minority”
Limiting existing empirical data/research due to failure to measure sexual orientation and gender identity refers to what older group
LGBTQ elders
LGBT research often fails to include
older adults
LGBTQ Participants may under-report because of
stigma
Estimated to be at least 2 million older lesbians and gay men. What is the predicted population trend by 2030?
likely to triple by 2030
Why is it assumed that aging experience is more difficult for LGBT elders
social isolation, mental distress, legal and societal obstacles
Maximum Lifespan:
length of years a given species could expect to live if all environmental hazards were eliminated
Soft limit
85-90 years
Maximum lifespan for human cells:
122 years
longest documented human life
122 years
state w higher number of elders
FL
Why do some states have higher proportions of elders?
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
Nearly ___ of older adults live in metropolitan areas (cities and suburbs)
80%
Geographic distribution is relevant to what?
planning and delivery of social, health, and long-term services and supports
in 1960, what percent of the older population has a HS degree?
less than 20% of population
Dependency Ratio:
number of people 65+ to every 100 people of traditional working ages (18-64 years); used to measure pressure on productive, working population
Dependency Ratio 2010
22 people age 65+ to every 100 people aged 18-64
Dependency Ratio 2030
35 to 100
Dependency Ratio 2050
37 to 100
The higher the Dependency Ratio…
the greater the potential burden of “dependent” older adults
Support Ratio:
relationship between the proportion of population that is employed (productive, able to support others) and percentage that is not in workforce (dependent)
Support Ratio 1910
10 employed people per retired older person
Support Ratio today
less than 5 employed people per retired person
Support ratio 2030
3 employed people per retired person
There are fewer employed persons to support older retired people
If more elders remain in workforce longer there will be…?
fewer retired elders who require economic support from younger employed adults
In past generations, elderly used to be considered what
held in great esteem-treasured, honored, and respected
Society now tends to view aging as what?
A crisis or problem to be solved (“silver tsunami”), rather than recognizing opportunities and benefits
“Ageism” coined when and by who?
coined in 1969 by psychiatrist Robert Butler
In what ways does ageism lead to discriminatory behavior
- 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
How is Ageism pervasive in our society but often flies under the radar
- 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
How is Ageism is impacting healthcare
- 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
How is Ageism a self-fullfilling prophecy
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
ageism
negative beliefs and stereotypes about old age; attributing certain traits to all members of a group solely because of a characteristic they share
Gerontophobia
morbid fear or dislike of old people or the idea of growing old
Resiliency
accessing resources that enable us to survive and thrive
Life course
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
World population
7 bil
population in 1950
3 bil
2050 population
more than 9 bil
in 1950, what was the global population for 65+
131
in 2008, what was the global population for 65+
506 million, or 7% of total population
in 2012, what was the global population for over 60
810 million over 60
in 2040, what is the expected global population for 65+
65+ expected to increases to 1.3 billion, or 14% of population
each year, nearly _____ people around the world turn 60, two people every _____
58 million; second
increase in the number of older adults is evident where? why?
developing countries that have shifted from agricultural to urbanized, industrial economy because access to modern healthcare is more widely available
Why has life expectancy increased in developing countries?
Better public health practices, advances in medical tech., and availability of medicines to treat certain diseases
Global aging researchers are following demographic changes where? why?
Japan, Germany, and Italy because of high median ages
Demographic Divide
division between the needs of young and old between developed and developing countries (where populations are still young)
Economic Complications
if workforce numbers decline, who is going to pay into government to fund pension programs, social services, education, etc.?
Describe Chinas Elder Crisis
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
Fastest aging developed country
japan
in japan, what % of the population is 65+
25%
By 2050, how many other countries will join Japan in having older adults compromise large percentage of population
65 other countries
Country experiencing most rapid rate of population aging
japen
Japanese society and politicians have resisted what as a way to increase number of young workers contributing to economic support of retirees
immigration
Where do Baby boomers account for 9% of workforce
japan
in order to prevent collapse of Japan’s pension system, U.N. projects are in need of what
13-17 million new immigrants by 2050
In past 25 years in Japan, how many have been accepted as immigrants
only 1 million
in the US, the majority of later-life immigrants are sponsored by who? and how was it made easier
their children; Made easier by a 1965 policy change
biculturalism
Process of integrating 2 cultures into ones life style
What percent of recent older immigrants unable to speak English or have poor proficiency
Nearly 75%
Social isolation and depression often result from what
language barriers, biculturalism, Financial problems, lack of health insurance, multiple chronic diseases, and grief over leaving home and friends
depression among immigrant elders
26%
Language and cultural barriers often exacerbate elders’ difficulties in what
accessing health care
Poverty rate for older immigrants
twice that of native US born elders
To qualify for SS benefits, a worker must have been employed by what and for how long? (i think for older immigrants)
by a “covered employer” for at least 10 years (40 quarters)
Covered employer:
job in which you and employer pay SS taxes
Why do Immigrants often face barriers in finding employment
language, cultural, ethnic, educational factors or discrimination
Anthropology of Aging:
helps researchers differentiate what aspects of aging are universal or biological, and which are largely shaped by sociocultural system
Traditional Societies:
often agricultural culture and multigenerational family units; long-standing norms and values – tradition based social structure
Modern Societies:
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
Traditional Societies: Filial Piety (Asia)
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)
Traditional Societies
Filial Piety (Asia), Native American and Native Hawaiian
Traditional Societies: Native American and Native Hawaiian
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
Kupuna:
Hawaiian term for respected elder
Modern, Urban Societies: characteristics
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
Modernization Theory:
the transformation of a society from living a rural way of life toward an urban way of life
Modernization Theory: Rural to Urban transitions of younger generations
Increased social distance between family members
Residential segregation
Lack of caregivers
Modernization Theory: Communication and technology
Jobs created primarily for the young
Modernization contributes to lower status of older adults through:
- Urbanization
- Communication technology
- Health technology
Scientific technology used in economic productivity and distribution - Literacy and mass education
Early modernization resulted in
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
Rapid urbanization in India has left how many elders in rural areas without family nearby to care for them
30%
What affects how we age?
Genetic inheritance
Nutrition and diet
Physical activity
Environment
Many fear these regarding health as we age:
Pain and inconvenience of illness
How it affects ability to perform daily tasks and remain at home
Senescence:
The gradual accumulation of irreversible functional losses to which the average person tries to accommodate on some socially acceptable way
Theory
A system of plausible or scientifically acceptable idea intended to explain something or justify a course of action
Wear and Tear Theory:
like a machine or car, organism simply wears out over time
Cells continually wear out and existing cells cannot repair damaged components within themselves
The wear and Tear Theory is influenced by
Influenced by environmental stress, like poverty and poor nutrition
Cellular Aging Theory:
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
Immunological Theory:
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
Immunological Theory may be responsible for
chronic / inflammatory conditions
Inflammatory conditions:
immune system attacks own bodies cells or tissues
Free Radical Theory (or Oxidative Stress Model):
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
Changes in body composition
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
Skin and Hair Changes
- 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
Ultraviolet light from sun is primarily responsible for
wrinkles, dried, and tougher texture or skin
Cell replacement in epidermis (outer layer) and dermis thins (second layer) slows, results in
reduced elasticity and fullness of our skin (increased sagging and wrinkling)
Skins blood circulation diminishes, which can
damage effectiveness of temperature-regulating mechanism – increases sensitivity to hot and cold
The Kinetic System:
What allows us to sense the position and the movements of the body
The Kinetic System is controlled by
central nervous system
As we age, we face changes in the kinetic system such as
- 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
Changes in The Respiratory System:
- 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
Changes in the The Cardiovascular System:
Structural changes in the heart
Heart valves can become thicker and stiffer which can increase BP
Arterial and vessel walls can thicken
Changes in the The Urinary System:
- 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
What percent of adults living in own home experience incontinence
50%
Changes in the Gastrointestinal System Changes:
- 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
Increase risk for what cancers as we age
stomach and colon cancer
Enzymes and simple sugars are absorbed more slowly where
SI
Endocrine System Changes:
Increase in some hormones, decrease in other s
Changes in insulin which may affect ability to metabolize glucose
Nervous System Changes:
- 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
Describe how the eyeball changes as you age
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
Describe how skin sensitivity decreases overtime
changes in the skin and loss of number of nerve endings
what can impact the decrease in one’s taste and smell
Tooth decay
Poor mouth care and hygiene
Sinus issues
Medications
Describe how hearing changes overtime
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
macular degeneration
loss of acuity in the center of the visual field
Describe vision changes
- Cataracts are common
- glaucoma more evident
glaucoma
excess production of fluid which causes pressure on an optic nerve
describe how taste changes as you age
Decrease of taste buds, saliva production and receptor cells in the nose
Most biological theories of aging have one of two general orientations:
- Aging occurs due to random genetic mutations and oxidative stress
- Aging is a result of programmed senescence
Pro-longevity:
Extending the length of a healthy life but not disrupting fundamental again process
Healthy Life Span:
The number of years in good health and with quality of life
Functional Capacity:
The capacity of a given organ to perform its normal function, compared with its function under conditions of illness, disability, and aging
Good Health
A state of physical, mental, and social well-being
Active Aging
The ability of older adults to do what they want in their home and community
Health Status
The presence or absence of disease, as well as the degree of disability in an individual’s level of functioning
Functional Capacity
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.
Activities of Daily Livings (ADLs):
Summary of an individual’s performance on personal care tasks such as bathing, dressing, eating, toileting, and walking
Instrumental Activities of Daily Livings (IADLs):
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
Disability
An impairment in the ability to complete multiple daily tasks
Comorbidity
The coexistence of two or more chronic illnesses
Health disparities
Inequalities in health, well-being, and mortality across the life course, which often reflect a lifetime of disadvantages in employment, finances, and education
Healthcare disparities
The difference in access, quality, and use of healthcare services; these typically result in health disparities
Quality of life
Encompasses an individual’s functional health, relative independence in performing daily tasks, and satisfaction with their circumstances
Frailty
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.
chronic illness
Lasts more than 3 months, often require long-term management or care rather than a cure.
Acute illness
Typically short-term and more readily treated
Have disability rates been rising:
yes they have been rising since 2000
WHY have disability rates been rising?
Obesity over the last 3 decades
Although people are living longer, many are also living sicker
Compression of Morbidity:
Relatively long periods of healthy, active, high quality existence, and relatively short periods of illness and dependency in the last few years of life
Epidermis:
The outermost layer of the skin
Health and Function-ability –> per World Health Organization:
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
Functionability determines
- 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
Functionability is Commonly categorized into 2 different themes
they can be assessed by the individual or by family/friend/professional
When addressing functionability, we tend to look at
ADL and IADL
What percent of older people living in community need help with at least one ADL
40%
2/3 of older adults deaths are due to
chronic conditions (heart disease, cancer, stroke, diabetes)
Risk of chronic illness _____ with age
Acute chronic conditions _____ with age
increases; decrease
Cerebrovascular Accident (CVA) or stroke:
when a portion of the brain is completely denied blood; such as through a blood clot
Primary cause of disability
Cerebrovascular Accident (CVA) or stroke
4th leading cause of death in older adults
Cerebrovascular Accident (CVA) or stroke
second most common cause of death among elders
cancer
Almost _____ of all new cancers occur in older adults – over _____ survive at least 5 years
60%; 8%
Why is diagnosing caner harder in older adults
other illnesses and symptoms
Arthritis
second most common condition that affects 50% of older adults, major cause of limited daily activities
Osteoarthritis
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
rheumatoid arthritis
chronic inflammation of membranes of the lining joints and tendons
osteoporosis
when bones become brittle and fragile
Chronic Obstructive Pulmonary Disease (COPD)
Umbrella term used to describe progressive lung disease (emphysema, chronic bronchitis)
Develop slowly, progressive, debilitate overtime
Prevalence of diabetes has increase among all age groups but mostly what age does it target?
30-39 year olds
what percent of older adults has diabetes and that is expected to increase 3-fold because obesity epidemic in culture
25%
Severe complications of diabetes:
infections, cognitive impairment/dementia, painful nerves in limbs, poor circulation, kidney disease, heart failure
Older adults have life expectancy of about ____ years less than those without diabetes
15
Diverticulitis
Little pouches on inside of intestine that result from weakness of intestinal wall
Cause infection, bowel changes, nausea
HIV/AIDs largely due to
unprotected sex
25% of people with HIV/AIDs are over what age
50
what percent of all accidents are caused by older adults driving
7%
older people have ___ as many hospital days than younger people
3x
Adults 65+ have how many doctor visits annually
7
Why are physician services more expensive
medical out-of-pocket costs and prescription costs, even with Medicare
Why is there limited healthcare and resources for older adults
a lot of physicians are not trained to work with older adults
What is the concern with medicating older adults
Issues with over-medicating, inappropriate usage, adverse drug reactions, high medications costs
Hypokinesia
he disease of “disuse”
Little D
sadness, grief and brief period of sadness = normal
- situational
- may resolve in time
most frequently diagnosed mental health disorder among older adult
Depression
Minor or Reactive Depression
Responds to a typical life event; Typically short term
Minor or Reactive Depression symptoms
- loneliness
- loss of interest
- neglect of self-care
- changes in eating and sleeping patterns
- feelings of emptiness an anxiety
Major Depressive Disorders
- Persist beyond 6 months
- Likely originated earlier in life (but not always)
Major Depressive Disorders Symptoms
- 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
Bipolar Depression
- 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
Diagnosing anxiety in older adults requires what?
a medical workup to rule out the cause they symptoms are not being caused by a medical condition
Why can it be hard to diagnose anxiety in older adults?
- 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
What is anxiety?
Excessive worrying, nervousness or uneasiness
Anxiety is almost as common in later life as what?
depression
Symptoms of anxiety
- 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
Anti-depressives:
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
Alcoholism
- alcoholism declines with age, but those who drink consume a higher # of drinks
what % of older people drink alcohol
50%
Polypharmacy
The use of multiple medications
Why is polypharmacy a concern
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
Illicit drug use
- can lead to increase in ER visits
- less common in older adults
The rate of drug abuse in older adults is expected to increase how much from 2001 to 2020
by 50%
suicide rates are about _____ higher in older adults than in younger groups of the population as a whole
50%
Older individuals who are at high risk of suicide
widowed white males above the age of 85 years old who have chronic depression, pain or alcohol use
what percent of individuals who committed suicide visits their primary care doctor in the proceeding month
75%
Signs and risk factors for suicide in older adults:
lack of physical health, loss of a loved one, depression, financial instability, giving away possessions, statements of frustration of life,
Tricyclic Antidepressants (TCAs)
The oldest for of treatment (some of the first medications)
Still around
MAOI’s, Monoamine Oxidase Inhibitors
- 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
Why aren’t MAOI’s always prescribed?
Not always prescribed because of the risk of interactions with other medication and even certain foods
SSRI’s, Selective Serotonin Reuptake Inhibitors
- First line of defense as well as SNRI’s (serotonin and norepinephrine reuptake inhibitors)
- The most common medications to treat mental disorders
how do SSRI’s, Selective Serotonin Reuptake Inhibitors work?
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
Electroconvulsive Therapy (ECT)
- 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
Electroconvulsive Therapy (ECT) can lead to what?
memory loss, nausea, can be traumatic
Transcranial Magnetic Stimulation
- 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
Non-pharmacological treatments to anxiety and depression
Support groups
Psychotherapy
Exercise
Diet
intelligence
The theoretical limit of an individual’s performance.
intelligence consists of
problem solving, verbal skills, and social competence
Fluid intelligence:
- Biologically determined
- Abstract reasoning
- mathematical reasoning
- spatial relationships
- perceptual speed
- Ability to reason and think flexibly
Crystallized intelligence:
- knowledge and abilities acquired
- Verbal meaning
- social judgement
- number skills
- verbal memory
older adults decline in _____ and stay stable in _____ and the speed of _____ deteriorates*
fluid intelligence; crystalized intelligence; cognition processing
_____ and _____ are processes that must be considered together.
learning and memory
Working (primary) Memory
- Temporary stage of holding, processing, and organizing information
- Decides what should be stored or ignored
Secondary (long term) memory:
- 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
Sensory Memory
- 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
Learning
Info must be rehearsed or processed to be retrieved later
Info is retrieved through recall (free or cued) and recognition
Learning occurs when
newly acquired information become encoded or stored in secondary memory
Many factors can impact learning (and appear to impact memory)
- External factors (environment factors like poor lighting)
- Psychological factors: anxiety or expectations
- Other: educational level, language proficiency, slowing of CNS
Executive functioning
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
what can impair executive functioning
Dementia and brain injury
Impairments impact what
every part of daily live including ADLs, employment capability, and relationships/roles
Theories of Loss: Disuse theory:
- Use it or lose it
- Info can fade away if not used
Theories of Loss: Interference Theory
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
Theories of Loss: Spatial Theory
Recognizing where objects are in relation to each other
“you are here” maps study
Theories of Loss: General Slowing Hypothesis
General Slowing Hypothesis
Aging causes a slowing of information processing in the nervous system
Dementia
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
Two of the following must be significantly impaired to be considered dementia
Memory Communication/language Ability to focus and pay attention Reasoning or judgement on things Visual perception
who is at higher risk for dementia
oldest of the old
Reversible dementia
Depression Medication side effects Excess use of alcohol Thyroid problems Vitamin deficiencies
Irreversible dementia
Alzheimer's disease (typical and early onset) Vascular dementia Creutzfeldt-Jakob disease Dementia with Lewy Bodies Huntington's disease More
What consumers 50-80% of all dementias
Alzheimers disease
6th leading cause of death for elders
alzheimer’s disease
How many people does alzheimer’s disease effect
1 out of every 8 americans over the age of 65
how often is someone diagnosed with alzheimer’s
every 68 seconds
What is the life expectancy once diagnosed with alzheimer’s disease
Most people survive 4-8 years after diagnosis
Few live as long as 20 years
AD: Early Stages:
- Hard time remembering new information
- misplacing things
- confusion with time and place
- new problems with words in speaking or writing
AD: intermediate Stages:
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
AD: Late Stage:
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
