L7: Healthy Ageing Flashcards
exp. “picture yourself in 60 years”
experimental studies with face morphing into your imaginary older self:
- participants looked into a mirror and saw either their own reflection or their morphed future self.
- were then asked what they’d do if they’d receive 1000 euro’s now
- those looking at their present selves thought of how to spend it now
- those looking at their future selves thought of how to save/invest it for late
wat is a cause of loneliness in elderly
- humans are poor at connecting to our older selves
- humans are even worse at connecting to older others
prevalence loneliness in Amsterdam
- 40.000 inhabitants (5%) reports to feel seriously lonely
- no more than one meaningful social interaction per week
- mostly seniors of 70+ and Gen Z
ageism in nederlands=
seniorisme
ageism =
prejudice, stereotyping, and discrimination based on age.
- stereotyping: lumping everyone together – iedereen over een kam scheren -> (all) older adults are slow, inflexible, conservative, fragile and vulnerable
- takes people’s individual dignity away because of their age, not their individual qualities
prevalenties ageism
- 50% van de ouderen heeft het wel eens meegemaakt
- meer dan 50% van de mensen (senioren hierbij geincludeerd) hebben middelmatige tot serieuze negatieve gedachtes/attitudes richting senioren
voorbeelden van ageism
- explain something to an older person in more simple, perhaps even childish language (elderspeak)
- treat an older person as if they’re less competent in handling things (physical or mental)?
- fail to take someone seriously because of stereotypes about their age?
- entertain some prejudice about older adults (e.g., assume that older adults are slow in understanding and not completely intelligible? or that older adults are slow in thinking, moving, or acting?)
- feel that an older person contributes little to society?
- consumes a large proportion of health care, retirement funds etc.?
ageism within institutions: stereotypes en werkelijkheid
stereotypes:
- less efficient, energetic, flexible, stress-resilient
- no point in investing in trainingen or education
- more often ill
- more costly in terms of sick leave/duration of sick leave/insurance/salary
werkelijkheid:
- more experience, less panic in case of stress
- mentoring
- more loyal, less job hopping
stereotypes and prejudices about elderly in the media
- older adults are largely under-represented
- many ads treat seniors as either: dependent and in need of help, or people who stay young forever
- ageing is typically advertized as something negative: products to look/feel younger
ageism in health-care
- doctors and nurses dont communicate with seniors (bv vooral tegen familie praten) or belittle them
- focus on deterioration, therefore there is an undertreatment because of age (“dit is normaal op deze leeftijd” -> terwijl bv het andere been nog wel goed is). complaints are attributed to age instead of medical causes
- lack of vision on activation: we need tailor-made care -> try to stimulate seniors to self manage
hoe werkt ageism towards oneself
stereotype (older adults are physically vulnerable) -> internalization (i am becoming physically vulnerable) -> expectation (i’d better be careful with physical activities, as i’m getting vulnerable) -> behaviour (i’d better start avoiding physically challenging activities) -> stereotype….
-> self-fulfilling prophecy! (= acting in accord with the (mis)conceptions about ageing in society)
zs
ageism vs. andere vormen van discriminatie
- ageism is more socially accepted than racism or sexism (seen as innocent, no harm intended, everyone knows that ageing comes with decline
- humorist (a senior moment, a grey tsunami when talking about population changes)
- but it is still based on prejudice, stereotyping, discrimination!
impact of ageism
ageism can;
- influence the way we look at ourselves (self-fullfilling prophecies)
- turn generations agains one another
- impact health, quality of life, mental wellbeing
9 consequenties van ageism in een persoon
- reduced longevity (minder lang leven)
- hampers recovery
- induces an unhealthy lifestyle (what does it matter)
- reduces physical health
- impacts mental health
- promotes/speeds cognitive decline
- promotes loneliness and social isolation
- reduces quality of life
- reduces lust for life
COVID pandemic and ageism
- did ageism grow worse as the pandemic lingered?
- did that impact quality of life and mental well-being?
- did effects depend on people’s own believes about ageing?
Interview: seniors reported experiencing more ageism during the pandemic, including hostile and benevolent ageism from older adults’ families
Questionnaire: Perceived Ageism worsened as the pandemic-driven restrictions lasted. The stronger the increase in perceived ageism during COVID, the greater the decline in QoL & MWB
These findings are utterly disconcerting: ageism has become a pandemic with massive impact, findings emphasize the urgency of combatting ageism and promoting ageism-awareness in our society
what can you do as an individual
- be aware of ageism: speak out if you encounter ageism, try to be led as little as possible by prejudice and stereotypes about ageing yourself
- prevent ageism by treating seniors just as you treat non-seniors
- find, show, and cherish counter-examples
- promote inter-generational contact as much as possible: visits, shared volunteer activities
why do we age?
- natural selection (evolutionary pressure) selects for: factors that promote successful adaptation, factors that increase our chances of passing on our genes to the next generatioon
- there is no evolutionary pressure to select for genes that promote successful ageing, since that does not contribute to passing on our genes. therefore there is nothing to prevent the build-up of cellular damage and waste, or neurodegenerative disease. wear and tear makes the body age, and then we die.
hallmarks of normal ageing model
(een aantal)
molecular/cellular: DNA damage and impaired repair, accumulated oxidative damage, impaired molecular waste disposal
neural network: impaired neurogenesis, dysfunctional activity, reduced neuroplasticity, aberrant neuronal network activity
the brain does shrink when you get older
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ontogenesis=
development of the individual
fylogenesis =
development of the species
overeenkomsten fylogenesis and ontogenesis
the prefrontal cortex is the last to mature, in both the individual and the species
welk fenomeen hoort bij de PFC qua ontwikkeling
last-in, first-out: the PFC is the last to mature, and the first to decline
cognitive aspects that decline with age
- regulative functions
- memory
- orienting
cognitive decline: regulative functions
regulative functions are supported by the PFC.
all these 3 processes show remarkable decline with aging:
1. stability vs. flexibility (switching between tasks or mental sets, shielding of goals)
2. working memory (updating of all potentially relevant information, remembering what to do when)
3. planning, impulse control, etc
cognitive decline: memory
- failure to remember the right words (tip of the tongue)
- failure to remember the contextual details of an event (source memory (where did you get this information)
- relies heavily on the hippocampus (which is also among the first ones to decline)
how can we repair source memory
story-telling (“I met Christine when she arrived at school, riding on a green elephant who stole my apple”)
cognitive decline: orienting
- 3D space: notion of place (where you are, in reference to your surroundings and to others)
- temporal space: notion of time and continuity (where were you 15 min. ago? what where you doing there and why?)
- contextual space: notion of context and surroundings (continuity, appropriateness within that context)
- autobiographic space: notion of agency (who you are, why are you where you are now, what were you doing. coherent image of self, consistent across time)
- leans heavily on prefrontal cortex (and those cognitive functions supported by it)
waar gaat intervention & prevention voornamelijk over
how can we;
- promote resilience against stressors
- prevent neurocognitive decline
factors tapping into individual differences in cognitive status with ageing
- lifestyle
- social connectedness and purpose in life
- brain-training and skill training
intervention: nutrition and consumption patterns
- what matters is: calorie restriction
- what works best is: intermittent fasting
- what doesn’t work: supplements (anti-aging industry)
intervention: physical exercise and fitness
- what matters is: burning calories
- what works best is: areobic activities
- what doesn’t work: excessive sports
calory restriction and physical exercise impact almost all hallmarks of normal neural aging
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intervention: social connectedness and purpose in life
- volunteer work
- religious communities
- interactive sports or dance
what matters is:
- (inter-generational) contact
- meaning
- activity
- competence
intervention: training complex skills
- juggling
- tango
- map learning
what matters is:
- willingness to invest (continual) effort
- coordination skills
- fun
intervention: brain gymnastics
- life-long learning (what matters is: use it or lose it)
- brain training (but studies are inconsistent, effects are hard to replicate, effects do not generalise (sudoku spelen heeft alleen effect op sudoku spelen), many studies not properly conducted, lack of proper control groups (stimulation/motivation/expectation)
dus conclusie over brain-training
- cognitive training doesn’t work, replicate, or generalize (although training can’t harm)
- braintraining cannot be shown (conclusively)
to impact any hallmark of normal neural aging
conclusie
- we age b/c there is no evolutionary pressure to select for genes that promote successful aging
- aging impacts a complex system of interacting hallmarks of normal neural aging, from molecular and cellular to network levels
- last-in first-out at the macro level: prefrontal cortex, hippocampus
- cognitive functions that show decline prominently include: regulative functions, memory, orienting
- our best shot at preserving mental functions is: calory restriction / physical exercise, volunteer activities, (complex skill training)
conclusie over need for intervention
- World Health Organization: promoting active & healthy aging: urgent priority. 2021-2030 is the UN decade of active & healthy aging
- we are urgently in need of a new appreciation of the dignity of old age
- we need to combat ageism, which has dramatic impact on the lives and health of our elders, our grand-parents, and (before you know it) ourselves
- the key is with the new generation – it starts with you
