KNPE 335 Midterm 1 Flashcards
Why is it important topic not only for students and healthcare workers, but the entire Canadian Public?
-We are all affected by aging, old and young
-Aging Population
What are the 4 effects of the baby boom generation?
1)Changed social structure
2)Increasing life expectancy in Canada
3)Older Population
4)More women than men
When is the baby boom?
1946-64
How does the decline in children and incline in seniors create a strain?
Creates a gap
-loss of people working in
True or False: Is life expectancy increasing?
True
Why may certain provinces have a lower amount of seniors compared to youth, regardless of a aging population?
-People Leave certain Provinces to go to retirement areas (people want to be together)
-It is harder for people to live their and get healthcare resources
True or False: Aging increases occur just in north america?
False, they are occurring across the globe,
9.6% increase
What are the 4 life span predictions?
1)Decreasing in infant mortality rate
2)Advances in public health (effect of chronic diseases in modern times)
3)Plateau in life expectancy
4)Adding life to years, instead of years to life
True or False: Living Longer doesn’t mean living better?
No, decreased QoL as we age
-We need to educate and promote how to increase QoL
Why does QoL decrease as we age?
1)Decrease in physical, cognitive, mental and social health
2)Increases in common morbidities and comorbidities
Chronological Age?
Number of years a person has lived
Biological Age?
A description of individuals development based on biomedical markers that are determined by molecular or cellular events
Psychological Age?
A description of one’s own experiences using nonphysical features such as experience, logical and emotional
Social psychological/subjective age?
The personal subjective age of a person based on how old the individual feels and how they feel towards age
Social Age
The social roles that an individual has placed on them by society that determines their age
-Retired vs. working. vs. student
Functional Age
A combination of chronological, biological, and psychological age.
-Considered to be the wholistic picture of a persons described as age
What are the 4 types of functional aging?
1st:Childhood
2nd: Working and Parenting
3rd: “young, old” age (between 65-84)
4th: Above 85
WHO definition of healthy aging?
the continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course
Healthy Aging aspects include x5
1)Meet their basic needs
2)Learn, grow and make decisions
3)Be mobile
4)Build and maintain relationships
5)Contribute to society
What theory did Fries (1980) discouver?
Compression of Morbidity
-Compression into the last years of life
-Sickest/At worst prior to death
Who discovered Human Aging: usual and successful?
Rowe and Kahn (1987) defined healthy aging
What researchers are widely cited in geriatrics, gerontology, and ageing research literature?
Rowe and Kahn 1987
Who discovered the 3 things in which healthy aging is comprised of, and what are they?
Rowe and Kahn 1987
1)Avoiding disease and disability
2)High cognitive and physical function
3)Engagement with life
What was the MacArthur Foundation Study on Successful aging (1984-1993)
-Lead by Rowe
-American gerontology perceived to be in crisis
-Interdisciplinary cooperation
What were the discoveries of Strawbridge et al. 2002?
-Need to include the effect of chronic conditions and functional difficulties with successful aging- higher rates of successful aging
What were the discoveries of Reichstadt et al. 2010?
-Qualitative interviews on successful aging in older adult perspectives
-Wisdom in a large contributor, importance of knowledge and education
What are the 2 categories of theories of aging?
1)Stochastic theories of aging
2)Programmed Theories
What is Stochastic Theories of aging?
-Aging occurs randomly and persistently with time through random error and damage to cells and organs
What is the Free Radical Theory of aging?
The most prevalent stochastic theory of aging
-Metabolic reactions occurring continuously in the body produce unstable molecules called free radicals.
-Free radicals cause oxidation, which damages cells and genetics resulting in aging
-Age Spots
What type of theory is a non-stochastic theory of aging?
programmed theories
Who made the non-stochastic theory of aging?
Hayflick and Morrehead (1981)
What is the non-stochastic theory of aging?
Aging is predetermined through programmed cell changes or changes in the neuroendocrine or immunological systems.
-People have a biological clock and ultimately a person dies at a predetermined time
Why are non-stochastic theories deemed purposeful?
Aging is thought to be a process that is programmed at the cellular level
Why is the term older adult used? x3
1)Senior is too limited
2)Elderly connotes frailty
3)Refers to the individual
What are the 6 physical changes that occur with aging?
1)Increased risk of chronic disease
2)Activity levels declines
3)Decline in lean body mass and bone density
4)Increased risk of falls
5)Impaired oral/eye/ear health
6)Change in skin,taste,smell
What is there a increased risk of when there is a decline in body mass and bone density?
Increased risk of fractures
When does the skeletal system start to see impacts?
30-80 years
What are 4 impacts of aging on the skeletal system?
1)Density of bones begins to diminish
2)Bones are more fragile and likely to break -Osteoprorosis
3)Stiffer Joints
4)Limited range of motion
Why is the skeletal system essential?
Calcium Storage
Movement
Reduce frailty
Why is musculature important?
-Prevent Weakness
-Prevent Fatigue
-Improve ability to perform activities of daily living
-Reduce the risk of falls and injury
When does peak muscle strength occur?
20-30
What are the 3 impacts of aging on the musculature system?
-Muscle Atrophy: Thinning or loss of muscle
-Sarcopenia: Loss of muscle
-Muscle fibres not able to contract as quickly
When do visual changes occur?
50
What causes visual changes to occur?
Anatomical and physiological changes in the eye
What are 4 common diseases of the eye?
-Glaucoma
-Dry Eye
-Macular Degeneration
-Cataracts
t or f: age-related changes occur to the inner ear?
True: Vestibular Changes
How does joint proprioception occur?
Mechanoreceptors change (located in joints, capsules, ligaments, muscle, tendons and skin)
How does joint proprioception effect older adults?
1)Impaired deterioration of proprioception leading to less accurate detection of body position
2)Results in increased risk of falls
3)Increased risk of degenerative joint disease
How many systems are required for balance?
3
1)Vision
2)Vestibular
3)Proprioceptors
All begin to fail as we age
What is a leading health concern for older adults?
Falling–> Balance issues
What are the 6 physical changes of aging?
1)Skeletal
2)Musculature
3)Vision
4)Vestibular
5)Joint proprioception
6)Balance
What percentage of older adults 65+ have at least 1 of 10 common chronic diseases?
73%
What are the 10 chronic health conditions?
1)Ischemic Heart Disease
2)Diabetes
3)Asthma
4)Mood And Anxiety Disorder
5)Hypertension
6)Periodontal Disease
7)Osteoarthritis
8)Osteoporosis
9)Cancer
10)COPD
What are the 4 common risk factors of developing a chornic disease as a older adult?
1)Tobacco and Drinking
2)Not meeting PA guidelines
3)Consume fruit and veggies less than 5X a day
4) Trouble falling asleep
What is Multimorbidity?
The CO-OCCURRENCE in the same person of two or more of the ten common chronic diseases
What is Multimorbidity associated with? x6
Impaired quality of life
Increased use of health care resources
Institutionalization
Adverse Health Effects
Disability
Premature Death
True or False women have a more likelihood of Multimorbidity?
True
What percentage of seniors have Multimorbidity?
30%
Why does there need to be a push for early intervention for Multimorbidity?
Many older adults have them
Increasing Older Adult Pop
Increased Strain of System
T of F: Aging increases risk of diabetes?
True
Why is the management of diabetes more complicated in older adults? x3
1)Coexisting Medical Conditions
2)Cognitive Issues
3)Diabetes self-management is more difficult due to lack of knowledge and access to resources
In what age group is Hypertension most common?
Older Adults
Why is hypertension common in older adults?
Changes in the Vascular System
-Reduced elastic tissues –> Stiff arteries
Why does cancer seem to plateau at 85+?
Decrease Cell Growth and therefore decreased mutations
___ of falls are life threatening?
1/5
What is the most common injury in older adults?
Falls
What is post-fall syndrome?
Cycle of increasing weakness and instability through joint and mobility reductions, physical deconditioning and poor balance
What are 7 factors that can cause post-fall syndrome?
1)Dependance
2)Loss of autonomy
3)Loss of self-confidence
4)Depression
5)Confusion
6)Immobilization
7)Restriction to daily activities
What are the best two places to intervene in the fall cycle?
1)Loss of balance and Fear of Falling Again: Talk to somebody
2)Self Restriction of PA: Tell them how to do it in a safe way
What are the seven steps of the fall cycle?
1)Fall
2)Loss of Balance Confidence
3)Fear of Falling again
4)Self Restriction of PA
5)Reduced muscle strength –> Impaired balance
6)Abnormal gait, more unstable on feet
7)Increased risk of falling
What is cautious gait?
Excessive degree of age-related changes in walking and fear of falling
What is Frozen Gait?
Abnormal gait patter in which there are sudden short temporary episodes of an inability to move the feet forward despite intention to walk
(Feet stay but body moves/ Want to but can’t)
What is the best way to target gait problems?
PT
What are some examples of gait and what is there purpose?
Purpose: Thought to reduce risk of falling when actually increases risk
-Slow
-Wide Base
-Cautious
-No-Arm Movement
-Small Steps
-Lean Forward
What is Fraility?
A State of increased vulnerability to disease and disability
What term is used to reduce risk of fraility?
AVOID
A:Activity
V:Vaccinate
O:Optimize Medications
I:Interact
D:Diet and Nutrition
What is cognition?
Set of all mental abilities and processes relate to knowledge.
What are some examples of cognition? x9
-Attention
-Memory
-Working memory
-Judgment/Evaluation
-Reasoning
-Problem Solving
-Decision Making
-Comprehension
-Language
What is Cognitive Health?
A brain that can perform all the mental processes that are collectively known as cognition
What are the 7 cognitive changes that occur as we age?
Memory
Attention
Language
Intelligence
Brain Changes
Everyday Functioning in Familiar Environments
What does a low brain reserve mean?
Lower Threshold for the expression of functional impairments
-Symptoms are expressed fast and harsh
What is brain reserve (BR)?
Passive form of capacity that is though to depend
What is cognitive reserve (CR)?
Active mechanism for coping with brain pathology analogous to the brain software.
-The brain connections
-Robustness of a particular cognitive function against brain pathology
-Ability to use cognitive functions when a default function is rendered
What reserve would be considered building ne pathways and relearn and recouver
CR
What are 3 cognitive aging trends that decline with age?
1)Delayed Free recall
2)Source Memory
3)Prospective Memory
What are 3 cognitive aging trends that remain the same with age?
1)Recognition Memory
2)Temporal Orde Memory
3)Procedural Memory
Delayed Free recall
Spontaneous retrieval of information from memory without a cue
(Recalling a list of items to purchase at grocery store without cue)
Source Memory
Knowing the source of learned information
(Remembering you know a fact cuz you saw it on TV)
Prospective Memory
Remembering to perform intended actions in future
(Take medicine before going to bed)
Recognition Memory
Ability to retrieve info when given a cue
(Correctly giving details to a story when given yes/no questions)
Temporal Order Memory
Memory for the correct time or sequence of past events
(Last Saturday you went to dinner before you went to the club)
Procedural Memory
The memory of how to do things
Second Nature/Muscle Memory
(How to ride a bike)
Long term memory increases or decreases as we age?
Increases
short term memory increases or decreases as we age?
Decreases
T or F, there is more activity in the hippocampus as we age?
False
Why is there less activity in the hippocampus as we age?
Loss of cells in hippocampus means there is more overlap of cells representing different memories causing interference.
Why is it easier to extract commonalities among experiences to see the entire picture rather than details?
Lost of cells in hippocampus and overlap interference
What is a Fluid Task/Intelligence?
Tasks that involve quick thinking, info manipulation, activities involving allocation and reallocation of attention
What are examples of fluid tasks?
Memory Tests
Spatial Relations
Abstract and Inductive Reasoning
Free Recall
Mental Calculations
Does our ability to do fluid task increase or decrease as we age?
Decrease
What are Crystallized Tasks/Intelligence?
Tasks that tap well-learned skills, language, and retrieval of well-learned material
Examples of Crystallized intelligence?
Verbal Meaning
Word Associatio
Social Judgement
Number of Skills
Does our ability to do crystallized tasks increase or decrease as we age?
Increase
What is a result of decline in visual and auditory processesing?
Limitation in activity and social function
What occurs as auditory processes decline?
Understanding Speech in noise
What occurs as visually processes decline?
Light Sensitivity, visual acuity, colour vision, contrast sensitivity
What are the 4 reasons why fluid intelligence decreases with age?
1)Slowed Processing Speed
2)Lack of inhibitory control
3)Perceptual processing resources (working memory capacity) reduction (hard to learn new things)
4)Perceptual processing efficiency reduction
What are the 10 factors of cognitive aging?
1)Medications
2)Sensory Changes
3)Health-Related Changes
4)Changes in mood
5)Age
6)Educational period
7)Gender
8)Social Factors
9)History of Disease
10)Lifestyle choices
What is Dementia?
Describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life
What does dementia result in?
Cognitive and Psychological Changes
Why does dementia occur?
Damage to or loss of nerve cells and their connections in the brain
-Neurodegeneration
What are the 5 types of dementia?
1)Alzheimers
2)Lewy body dementia
3)Vascular Dementia
4)Frontotemporal Dementia
5)Others: Parkinsons and Huntington’s
Can you have multiple types of dementia?
Yes, but if you have multiple does not mean it is more severe
Why do patients with dementia often go undiagnosed of their comorbidities?
-Forget they have them
-Don’t realize they have them
What chronic diseases can increase the risk of dementia? x3
Hypertension
Diabetes
CHD
What chronic diseases are associated with dementia? x5
Stroke
Parkinsonism
Epilepsy
SMI
Despression
____ of seniors 85+ have dementia?
1/4
Why is the prevalence of dementia increasing?
-Aging Pop
-People are living longer
What are the 7’As of dementia?
Anosognosia
Agnosia
Aphasia
Apraxia
Altered Perception
Amnesia
Apathy
Anosognosia
Ignorance of the presence of disease
Agnosia
Inability to recognize objects by using senses
Aphasia
Loss of ability to speak or understand spoken, written, or sign language
Apraxia
Inability to perform purposeful movements
Altered Perception
Misinterpretation of info from senses
Amnesia
Memory Loss
Aptahy
Lack on interest, inability to begin activities
What is the most common form of progressive dementia?
Alzheimers
Why are the 7 A’s used?
Diagnose Dementia
Why does Alzheimers occur?
Occurs due to a increase in plaques and tangles
When are most people diagnosed with alzheimers?
Mild
What stage of Alzheimers:
Memory Loss
Wandering and getting lost
trouble handling money and paying bills
Repeating questions
Personality and behavior changes
Taking longer to complete normal daily taks
Mild
What stage of Alzheimers:
-Increased Memory Loss
-Increased Confusion
-Starting to have problems recognizing family and friends
-Unable to learn new things
-Unable to carry out multistep tasks
-Difficulty coping with new situations
-Hallucination, delusions, paranoia
Moderate
What stage of Alzheimers:
-Cannot Communicate
-Completely Dependent on others
-Body shutting down (brain shrinkage and organs)
-Immobile
-Insitutionalized
Severe
What are 6 ways alzheimers is diagnosed?
-Medical History
-Physical Exam and Diagnostic Exam for other conditions
-Neuro Exam
-Mental cognitive status exam
-Mini-mental State Exam
-Brain Imaging
Cognition
Attention, Memory and Problem Solving
Self and Personality
Moods and Emotions
Who You are
What you value
Temperament
Character
Social Relationships
How you relate to others
Social support groups
Networks
Mental Health
Differentiating regular changes that occur with aging as opposed to pathological changes in each of the above areas (social, self, cognition)
What are the 3 neurotransmitters that are related to healthy aging and decline as we age?
1)Dopamine
2)Norepinephrine
3)Serotonin
What is dopamine?
-Reward-motivation system
-Motor-control, decision making and teaching, motivation, pleasure
What is norepinephrine?
-Regulate Blood pressure
-Memory Formation
-Stress and Sleep Regulation
What is serotonin?
-Boost when you feel significant and important
-Mood, memory, sleep, cognition
What is Mental Illness?
Mental disorders are health conditions that are characterized by alternations in thinking, mood, or behaviour associated with distress and/or impaired function
Mental Illness vs Mental health
Illness =Disorder such as depression (diagnosed)
Health = Cognition
Is it possible to have high mental health but high mental illness?
Yes
What percentages of older adults 65+ have mental health problems?
20-30%
What is the most common mental health condition in older adults?
Depression
What is the difference between a mental health condition vs disorder?
Disorder = Diagnosed
Condition =Non diagnosed
What are the 9 common mental health disorders in older adults?
- Depression
- Suicide (men)
3.Anxiety Disorders
4.Dementia
5.Loneliness and Isolation - Delusional Disorders
7.Delirium
8.Paraphrenia
9.Concurent Disorders (substance abuse +disorder)
What are the 4 effects that effect mental healths?
- physical factors
2.Emotional (loss of family and friends) - Spiritual (connection to religion and find meaning and peace)
- Social
Chronic Conditions decrease or increase risk of a mental health disorder?
Increase
Mental health disorder increase or decrease risk of a chronic condition?
Increase
Is depression a normal part of aging?
NO
T or F living in an institution increases the likelihood of developing depression.
False
Why is depression sometimes not diagnosed in older populations?
Symptoms similar to dementia (late-onset depression)
What is the word they describes depression in late life?
Reactive (such as after in long-term care admission)
What are the 3 Symptoms of depression that occur in older adults?
-Memory Problems
-Vague Complaints of Pain
-Delusions/Hallucinations
What is required for a diagnosis of depression?
During a 2-week period or more, have 4 or more symptoms including depressed mood or loss of interest of pleasure:
-Weight Loss or Gain
-Insomnia or Hypersomnia
-Fatigued
-Feeling of worthlessness
-Diminished ability to think or conncentrates
-Recurrent thoughts of death
What is SIGECAPS?
How to look out for depression
SIGECAPS
SLEEP Disturbance
Loss of INTEREST
Inappropriate or excessive feelings of GUILT
Decreased ENERGY and increased fatigue
Diminished ability to think or CONCENTRATE
APPETITE change
PSYCHOMOTOR agitation
SUICIDAL idealation
What are the 6 impacts of depression in older adults?
1) More Doctors/ER visits
2) Increased use of medicine
3)Higher Outpatient Charges
4)Longer hospital stays
5)Increased readmission rates
6)Higher risk for suicide compared to other groups
What are the cons of the screening for depression scales?
-Not specific for cultures, ages, environment
-Not age friendly terminology
What are the pros of the screening for depression scales?
-Generalizable in multiple pop.
-Easy to keep track of if improvement or decline (keep track of scores and do multiple times)
What are the 5 reasons mental illness are missed in older adults?
- Signs and symptoms differ
- Less likely to self-identify problems
- Early signs if dementia
- Environmental, Social, and Cultural factors can affect a person’s signs and symptoms of a mental illness and willingness to seek help.
- Can accompany or stem from serious physical problems
Why isn’t mental health addressed as much as it should be in older adults in Canada? x3
1)Lack of aequate mental health services and community supports
2)Gaps in service outweigh the opportunities for access (resources still not available)
3) Increased needs for focus on primary care, those with dementia or those with serious mental illness (Need better training)
What are the 5 key factors that affect the mental health and wellbeing of older indviduals?
- Discrimination
- Participation in meaningful activities
3.Relationships - Physical Health
- Poverty
What is the Socioemotional Selectivity Theory?
-Explains the progression of social networks while aging
-Older Adults value emotional connections, so older adults have fewer social partners and rather fewer ones they value
Is emotional regulation at its highest as _____?
Older Adult (Ppl have the most influence of their emotions)
What is the Disengagement Theory?
Normal aging is a mutual withdrawal or disengagement between the ageing person ad other in the social systems to which they belong
Who made the disengagement theory?
Cumming and Henry 1961
What occurs if withdrawal from the ageing person and society is not mutual?
More prone to loneliness
What is loneliness?
A state of solitude or being alone
-State of mind/subjective
T or F loneliness can be more of a health risk than smoking?
True
Name 3 symptoms of loneliness? x8
-Suicidal Ideation
-Para-suicide
-Alzheimers
-Dementia
-Neg effects on immune system
-Neg effects on cardiovascular system
-Increased risk of hospitalization
-Increase risk of LTC facility placement
What are the 3 types of loneliness?
1)Developmental Loneliness
2)Internal Loneliness
3)Situational Loneliness
What is developmental loneliness?
Lack of balance between individualism and innate desire to relate to others.
What is internal loneliness?
The perception of being alone.
Associated with low self-esteem and worth
What is situational loneliness?
Socio-economic and cultural milieu.
Affected by the environment (causes self-perceived loneliness)
What are the 5 interventions for loneliness?
1)Activity Involvement
2)Volunteer Roles
3)Developing and Keeping quality relationships
4)Pharmacological management of physical ailments
5) Staying in contact with family and friends
What is social isolation?
A state in which the individual:
-lacks a sense of belonging socially
-lacks engagement with others
-has a minimal number of social contacts
-deficient in fulfilling and quality relationships
What are 4 detrimental health effects common to social isolation?
1)Increased risk for all caused mortality
2)Dementia
3)Increased risk for hospitalization
4)Increased number of falls
How can we limit social isolation systems? x2
1) Avoided through prevention and mitigation efforts if detected early
2)Patient care efforts should be focused on assessing and improving physical, mental AND social well-being
What are the 4 impacts of social isolation?
1)Health Behavioural
(Increases bad health choices such as
drinking, smoking and diet)
2)Psychological
(increases cog. decline and poor mental
health)
3)Physiological
(Increases risk of mortality and
decreases immunity)
4)Other Outcomes
(Rehospitalised and Institutionalized)
T or F: Retirement shows both positive and negative effects on healthy aging
true
Who do older adults rely most on for input on important matters compared to when they were younger?
Family and Long-Term Friendships
Socially what is important for healthy aging?
To feel socially involved and be dependent ON
-Give a purpose/belonging
-Babysitting grandkids
True or False: older adults tend to deal with death with high levels of distress?
False: Low levels of distress
Why may older adults deal with loss and grief better than older adults?
-More at peace
-Had time to think and come to terms with it
Violence against seniors is often perpetrated by?
Family
Is Elder Abuse more common in urban or rural areas?
Rural because have less access to help and services
Is elder abuse more common in men or women?
Women: By Family
Men: Non-Family Violence
What are 5 barriers to the use of technology in older adults?
1)Lack of instructions and knowledge
2)Confidence
3)Financial
4)Health Abilities
5)Trust
What are 5 motivations/benefits for seniors to use technology?
1)Social and Medical Support
2)Enjoyment and Fun
3)Person empowerment
4)Advocacy
5)Bridging generational gaps
