General Flashcards
Define “Successful aging”
“Successful aging” refers to the concept of aging in a way that maximizes quality of life, well-being, and independence as people grow older. There are many views on the core elements of the concept. The MacArthur Network is a multidisciplinary research which defines 3 key interrelated and overlapping criteria of “successful aging”: 1) freedom of disease and disability 2)High engagement with life 3) High cognitive and physical funtion
Compare the Western and non-western attitude toward aging
Western View : Negative attributes “decline, loss of independence, decreased productivity” . S.A. is about maintaining physical and cognitive health. Old age is a barrier to success, medical efforts towards preventing or delaying aging. Death is viewed with fear and anxiety.
non-Western view: Positive attributes “wisdom, respect, status”. S.A. is about social roles, intergenerational support, and spiritual well-being. Old age is accepted as a natural life cycle. Death is approached with greater acceptance, seen as a transition.
Define “SOC Model”
Baltes and Baltes’ model provides a framework to understand how elderly people adapt to challenges of old age. The definition of “successful aging” should recognise that successful individual development process which includes 3 components: Selection, optimization and compensation. Ex: Elderly person having a problem grocery shopping : Selection : Choosing doable tasks (choosing to shop from the nearest store) Optimization: Individual aims to enhance their ability. (Shopping early in the morning to avoid the crowd) Compensation: Person finds a way to counterbalance their shortcomings. (uses a shopping cart instead of a basket to carry easily)
Discuss the Objective, Subjective and cultural Views on successful Aging
Ideally a biopsychosocial definition would exist. A multidisciplinary understanding which touches biological, psychological and social aspect will have the best chance to be accepted by clinician, researchers and the older adults themselves. Currently, there’s a discrepancy between how scientists define SA and the elderly people’s view. It should also be diverse and representative of various cultures and individual differences.
Discuss the “Future of Gerontology”
Future gerontology aims to
- define SA more comprehensively
- reconcile the various models of SA in research
- take individual differences into consideration
- select primary interactions to emphasise
- understand where dying fits in SA
How is Neuropsychological Assessment Data used in gerontology?
- Distinguish normal vs pathological aging
- Distinguish and classify underlying pathologies in dementing diseases
- Predict risk factors of dementia
- Describe disease trajectory
- Estimate and address functional outcomes
What are the methods used for NPA of the elderly?
-MRI
-PET
-Biomarkers
-CSF
- Test (Subjective / objective)
- Interview (patient / family/ caregiver)
What are the physical changes seen in normal aging?
- Brain volumes declines at all levels (molecular to morphological)
- Dopamine and serotonin production declines
- Sex hormones decline
- Arteries and vein wall get thinner
- Blood pressure changes
What are the cognitive changes seen in normal aging?
- Memory declines (episodic + semantic)
- Reduced functional connectivity in brain networks (ECN, DAN,DMN,SN)
-Neuroplasticity and neurogenesis can still occur - Older brains show more symetrical activation (points to compensation)
- MAO increases
-Sustained attention, simple cognitive functions, procedural memory, language abilities, visuospatial abilities are preserved.
-Attention, learning new info, verbal fluency and reaction time deteriorate - Processing speed declines, visual construction skills, some EF (mental flexbility, abstraction, concept formation) decline
What are the reasons for brain shrinkage?
- Neuronal death
- Neuron shrinkage
- Dendritic arbour
- Spine and synapses change
- Less myelin production
What are some neurophysiological signs of pathological aging?
- Larger than expected or multiregional volume loss in the brain
-Dysregulation of Ca homeostasis - Biomarker evidence (amyloid-Beta / tau proteins)
What emotional changes occur in normal aging?
- Older adults tend to get less angry and more sad.
- People get less aggressive
- Higher well being level reported
- Positivity bias
What emotional changes occur in pathological aging?
- Severe depressive mood
- Increased activation in DMN (more rumination)
- Apathy
- Increased confusion
- Anxiety or agitation
- irritability
- Sundowning in AD
- Mood swings
- Fear
- Loneliness
Define the modal model of emotion
- Situation
- Attention (emotion arise when the person pays attention to the situation)
- Appraisal (appraises it according to values)
- Response
Define the strategies in model model of attention
- Early :
Situation Selection
Situation Modification
Attentional Deployment
(healthy older adults use - requites DLPFC activity)
- Late:
Attentional Deployment
Cognitive change
Response Modulation
(healthy younger adults use - due to less activity in PFC)
Define Socioemotional Selectivity Theory
A lifespan theory of motivation that explains how individuals’ goals and priorities shift as they perceive time as limited.SST posits that people prioritize emotional well-being and meaningful social interactions over long-term goals as they age or when they feel their time horizon shrinking. SST highlights the adaptive nature of aging by showing how emotional well-being becomes a primary driver of behavior in later life.
Older people focus on living in the moment, clear on what matters, non-risky investments, deepening relationships, savouring life.
Younger adults focus on expanding horizon, acquiring knowledge, meeting new people, taking chances.
Explain the vision changes in normal aging
- Vision : Cornea swells, cell density reduces.
Lenses yellow. Decreased number of rods and cones. - Slower dark adaptation
What are the consequences of vision changes? How do they manifest in DL?
Decline in:
Dynamic vision (moving objects in relation to the observer)
Contrast Sensitivity
Field of View
ADL consequences:
- competence and procedures of ADLs (difficulty preparing food, maintaining personal hygiene, shopping)
- Leisure activities: difficulty reading, walking, travelling (effects emotionally)
- Mobility and independence (difficulty driving, less autonomy)
What are some optimization methods and compensatory tools for vision difficulties?
Optimization
- Better lit environment
- Bigger font size in packages
- Avoiding increased contrast
Compensation tools:
- Magnifier
- Monitor readers
- Trainings to use tool optimally
- Visual and cognitive training
Explain the auditory changes in normal aging
- Ear canal collapses
- Earwax becomes more concentrated
- Increased risk of middle ear diseases and infections
- Reduced hair cell population results in hearing loss
-Spiral ganglian cell loss results in elevaed pure tone thresholds. - Therefore decline in word recognition and speech recognition scores
What are the consequences of auditory changes? How do they manifest in DL?
- Auditory threshold increases
-Issues understanding languge - Difficulty keeping up with conversation
- Tinnitus
- Hypersensitivity for loud sounds (leads to stress, irritability)
- No significant limitations in ADLs
- Leisure activities impacted ( difficulty listening to radio, social impacts, issues with interpersonal communication)
What are some optimization methods and compensatory tools for hearing difficulties?
Optimization
- Social environment, family and friends try to include, spend time 1-1
- Spatial environments: phones with optical ringing, better speaker systems, quiet rooms
compensation tools:
hearing aids
Explain the gait changes in normal aging
- Balance system weakens
- Stiff movements
- Step width increased
- Leaning forward
- Slower and more insecure manner of walking
- Reduced elasticity of the spine
What are the consequences of gait changes? How do they manifest in DL?
- Loss of walking abilities: loss of autonomy and difficulty ADLs
- Reduced mobility : social implications
- Lower life satisfaction
- Risk for social isolation, risk of accidents and falls
What are some optimization methods and compensatory tools for gait difficulties?
Optimization
- Regular practice
- Muscle training
-Aerobic exercise
Compensation tools:
- Walking stick
- Walking frame
-Stair lift
Explain the olfactory changes in normal aging. Consequences?
- Gradual decline
Decreased QoL, appetite and weight changes
What the overall impacts of sensory changes for the elderly?
- QoL decreases
- Negative impact on DL and psychological wellbeing
-Risk for isolation ,depression, dementia and further cognitive decline
-Safety issues: Risk fall, can ingest spoiled food, failure to detect smoke - Intellectual functioning declines with sensory decline
Explain the gait changes in pathological aging
- Gait abnormalities and mucle weakness
- Gross motor skills are seriously impaired (walking, standing, lifting large objects)
- Hemiparetic or hemiplegic gait
- Slower gait speed
- Decreased walking efficiency
-Poor endurance
-Shorter step
Explain the vision changes in pathological aging
- Visual disorders
- Dry eye
-Blindness - Double vision
- Blinking problem
- Blurred vision
- Hemianopia
Explain the auditory changes in pathological aging
- Hearing loss doubles the risk of dementia
- Auditory impairment
- Impacts communication and rehabilitation success
- More vulnerable to cognitive decline
Explain the olfactory changes in pathological aging
- changes in detection, discrimination and identification of odors
- Gradual olfactory loss
- Smell and taste abnormalities leads to weight loss, decreased appetite, depression
Define Alzheimer’s Disease
A progressive, incurable, neurodegenerative disorder that primarily affects memory, thinking, and behavior. Most common form of dementia. Characterized by memory loss, language issues, cognitive impairment.
Explain Alzheimer’s Disease Pathophysiology
- Accumulation of a-Beta plaques outside the neurons and tau tangles inside the neurons lead to cell dysfunction and cell death.
Gradually more neurons and synapses are lost especially in hippocampus and cerebral cortex which leads memory loss and executive dysfunction.
What are AD risk factors?
- Age
- Genetics
- Lifestyle
- Cardiovascular health
- Education level
- Physical activity
- Diet
Define Cerebrovascular Accident Stroke
A medical condition that occurs when there’s a disruption of blood flow to a part of the brain. Leads to brain cell damage, loss of function in the affected area and neurological impairment. 2 types: Ischemic and Hemmorrhagic
Decribe Ischemic Stroke
When blood vessel supplying blood to the brain is obstructed due to a blood clot. Caused by
thrombotic ( a clot in the artery that supplies blood to brain) or
embolic stroke (a clot forms elswewhere in the body then travels to brain)
Describe Hemorrhagic Stroke
When a blood vessel bursts in or around the brain- Caused by :
aneurysm (weak spot in a blood vessel ruptures)
ArterioVenousMalformation: abnormal tangle of vessels
Hypertensions: High blood pressure weakens the blood vessels
What are symptoms of Stroke
Face drooping
Arm weakness
Speech difficulties
Confusion
Trouble seeing
Difficulty hearing
Loss of balance
Severe headache with unknown cause
What are stroke risk factors?
-Age
-Gender
-earlier CerebroVascularAccident
-Family History
-Heart rhythym disorder
-Cholesterol
-Blood pressure
-Diabetes
-Smoking
-Alcohol
-Drugs
