Learning pack 3 Flashcards
1
Q
What is middle adulthood/mid-life?
A
- A developmental stage ‘halfway’ between the beginning and end of adulthood
- The sandwich generation:between parents/children/grandchildren
- 40 to 60 years of age
- May need revision if we keep living for longer
- it is a substantial time of transition
2
Q
What are the mortality rates in mid-life?
Mok et al (2015)
A
- Longitudinal study of over 2 million
- Estimated that 1 in 50 males (2%) will die by age 40
- 1 in 120 females (0.8%) will die by age 40
3
Q
Biological changes in mid-life
A
- Loss of physical youth
- Less than peak condition
- Andropause, Menopause and the biological clock
- Early indications of Alzheimer’s
4
Q
Psychological changes in mid-life
A
- Slower cognitive processing
- Appraisal of circumstances –> mid-life crisis
- Depression vs. life satisfaction
5
Q
Social changes in mid-life
A
- Concern for health/well-being of parents
- Children leaving home –> empty nest
- Liberated vs. isolated
6
Q
Biological changes in mid-life: Hair and skin
A
- Effects of primary ageing become more obvious
- Grey, thinning hair/baldness
- Extra hair in unwanted places
- Photoageing: wrinkles, age spots, moles
- Sun exposure, smoking and alcohol consumption all contribute to accelerated ageing
7
Q
Biological changes in mid-life Body composition
A
- Expanding waistline/redistribution of fat stores –> so called ‘middle-age spread’
- Slowing of basal metabolic rate –> loss of muscle and hormone production
- Low bone density which is also exacerbated by hormone loss –> osteoporosis
- 50+ years have higher risk of fractures due to brittle bones –> reduced mobility
8
Q
Biological changes in mid-life: Vision
A
- Loss of visual acuity
- Thickening of the lens
- Reduced light at the retina - Poor focus/muscle contraction –> blurry vision
- Less able to adapt rapidly to changing light levels
- Also linked to cognition (Leon-Dominguez et al, 2016)
9
Q
Biological changes in mid-life: Hearing
A
- Auditory nerves and inner ear structure degenerate
- Poor perception of very high and low frequencies
- Not usually problematic until age 50+, and major deficits stem from our own behaviour and occupational hazards
- Secondary ageing: Degree of hearing loss largely due to noise exposure over lifespan (Rabinowitz, 2000)
10
Q
Biological changes in mid-life: Reproduction in women
A
- In women, menopause occurs around age 50 but begins 10-15 years prior, and results in a loss of ability to conceive
- Pre-menopausal: fluctuating hormone levels and irregular periods
- Peri-menopausal: more extreme variation in periods, hot flushes cause multiple issues (Bromberger et al, 2010)
- Post-menopausal: oestrogen and progesterone levels consistently low for a period of 1 year, such that menstruation ceases
11
Q
Biological changes in mid-life: Reproduction in men
A
- In men, loss of reproductive capacity or andropause occurs later on
- Diminishing levels of testosterone: 1% per year from 40s
- Gradually reduced quantity of viable sperm
- Accompanied by loss in muscle tissue and strength
- Erectile dysfunction influences 31% by late 50s
- Can be improved with diet and exercise due to associations with the amount of body fat and individual has (Esposito et. al, 2004)
12
Q
Biological changes in mid-life: Health
A
- Health is the biggest. factor affecting quality of life in middle-age
- Cancer: most likely cause of death in middle-aged women
- Cardiovascular disease: sudden heart attacks as the most likely cause of death in middle-aged men (particularly those with low socioeconomic status)
- The impact of lifestyle is cumulative
- Education is predictive of health behaviour (smoking, drinking, physical inactivity) in mid-life (Clouston et al, 2015)
- Cardiorespiratory fitness in mid-life (approx 49) is associated with lower healthcare costs in later life (65+)
13
Q
Psychological changes in mid-life: Cognition
A
- In mid-life, our brains and cognitive processes become slower
- Cognitive skill is likely to decrease if you don’t stay mentally active (Salthouse, 2004)
- Linked to the function of the circulatory system (Raz and Rodrigue, 2006)
- Correlation between risk of heart disease/cancer and intellectual skills, mediated by physical activity
14
Q
Psychological changes in mid-life: Memory
A
- The older we get the more forgetful we perceive ourselves to be
- Working memory: By age 55, we can no longer accommodate large, complex loads –> at least in vision
- Semantic memory as stable, episodic memory more prone to decline
- Themes are remembered better than specific details
15
Q
Psychological changes in mid-life: Middle age and dementia
A
- One of the biggest financial burdens for society - £1.4 billion in Wales alone
- Cognitive impairment is often the most feared aspect of ageing
- Early-onset familial Alzheimer’s disease: by age 55, highly genetic, accounts for approx 5% of cases
- ‘Prodromal’ dementia in middle age –> Mild cognitive impairment (MCI)
- Associated with high glucose levels (Rosness et al 2016)
16
Q
What are the related risk factors of dementia?
A
- Obesity
- Smoking
- Alcohol
- Depression
- Anxiety
17
Q
What is the myelin model of neurodegeneration?
Bartzokis (2004)
A
Age-related breakdown in the protective membranes of neurons can increase the likelihood of developing AD
18
Q
What is the interaction of genetics and lifestyle on Alzheimer’s
Rovio et al (2005)
A
- Leisure-time physical activity at least twice a week during mid-life is associated with a reduced risk of AD
- More pronounced among APOE e4 carriers
19
Q
Psychological changes in mid-life: Personality
A
- Largely stable during adult life
- Openness, extraversion and neuroticism decline, potentially because there is less room for your own individual sense of self
- You often become less negative and impulsive in mid-life, as you take on more important responsibilities and roles
- Personality defines biological stress response –> lowest in those high in extraversion and conscientiousness
20
Q
Psychological changes in mid-life: Depression in men
Hiyoshi et al (2015)
A
Those with high cognitive functioning in adolescence are less likely to be diagnosed with a mood disorder during middle age unless they also have low resistance to stress
21
Q
Psychological changes in mid-life: Depression in women
Bromberger et al (2015)
A
The experience of mid-life in unlikely to trigger the onset of depression but changes due to menopause can lead to reoccurrence of depressive symptoms
22
Q
What is a mid-life crisis
A
- Classified as a reaction to changes in life structure (Levinson et al, 1978)
- Erikson predicted ‘crisis’ at all life stages, not just mid-life
- Not as prevalent as you might expect
- May be more likely in your 60s (Wethington et al 2004)
- Often triggered by a specific occurrence: life event approach
23
Q
What are the crises in mid-life?
A
- Not to be confused with mid-life crisis
- Erikson (1963): generativity vs. stagnation –> the need to care for the next generation
- Relationship to mental health: those with high generativity/life satisfaction are the least burdened by being a carer
- Vaillant (2002) work-based goals, ‘career consolidation’ and ‘keeper of the meaning’ stages
24
Q
Social changes in mid-life: Career
A
- Peak work satisfaction despite lack of promotions
- Equally as good as younger employees at a large variety of roles, expect where speed is key
- Anxiety over having to acquire new skills
- Awareness is crucial –> knowing your weaknesses forces you to compensate for them to maintain performance
- Career change - voluntary vs involuntary
25
Social changes in mid-life: Role conflict
- As the 'sandwich generation', middle-aged adults take on the most number of roles
- Partner: Marital conflict declines, marital self-efficacy, control of the relationship, better strategies to cope with arguments
- Friend: more refined social network, genuine friends, less contact, family provides primary support
- Carer: 1/3 women in the UK are multi-generational care givers --> leads to you being the last person you think of
- Grandparent: A great source of satisfaction when the role is more remote
- Parent: pivotal role in young adulthood, less so in middle-age as children grow up and leave home
26
Social changes in mid-life: Multigenerational families
- Due to the dynamics and role changes in mid-life, it may not just be your children who live with you
- You may be responsible for looking after children's children or caring for elderly parents and you may be helping financially (particularly stressful, and a source of conflict, for those of low socioeconomic status)
27
What is older adulthood?
- 60+
- Young old: 65-74
- Old old: 75-84
- Oldest old: 85+
- Diversity in later lifestyle --> lifestyle choices catch up with you
28
Biological changes in older adulthood
- More prevalent, deeper wrinkles
- Continued loss of elasticity
- By 75 most people have completely grey hair
- Thinning, pattern balding, hair loss (95% men, 20% women)
29
Biological changes in older adulthood: Teeth loss
- 26% of over 65's
| - Impact on facial structure
30
Biological changes in older adulthood: Weight/build
- 60+
- Loss of weight due to reduction in muscle mass
- Weight gain due to lower metabolism, but can be offset by exercise
- Advised to start strength/balance training before attempting aerobic activity
- Mental as well as physical benefits --> reduced 'social physique anxiety'
31
Biological changes in older adulthood: Bones
- Loss of bone mineral content
- 50-60s
- Linked to loss of sex hormones --> worse in women
- Reduced risk with dietary protein, calcium, and vitamin D but 70% of bone loss is genetic
32
Biological changes in older adulthood: Mobility
- Loss of strength
- Stiff tendons
- Arthritis
- Joint inflammation
- Increased risk of falling
- Half of adults over 75 have difficulty with daily living
- Strength training is recommended, even in those 90+
33
Biological changes in older adulthood: Cardiovascular system
- Fats lining arteries, preventing blood flow --> often due to diet and high cholesterol levels
Risk of heart attack and stroke is more pronounced in:
- Males (due to lifestyle, lack of cardioprotective hormones, distribution of weight
- Smokers (carbon monoxide restricts oxygen)
- Someone 65+ has 40% less cardiovascular efficiency than a young adult
34
Biological changes in older adulthood: Immune system
- Less able to respond to infection e.g. influenza
- People 65+ serious complications from flue e.g. bronchitis and pneumonia
- 90% of flu deaths occur in those aged 65+
- Vaccination is approx 88% effective in young adults but only 56% in older adults
- Efficiency of flu vaccination is increased by physical exercise (Kohut et al, 2004)
35
Biological changes in older adulthood: Digestive system
- Less motivation to eat aa healthy, varied diet
| - 'Anorexia of ageing" (Soenen and Chapman, 2013)
36
Biological changes in older adulthood: Urinary system
- Elasticity in bladder is reduced, particularly in smokers
- Frequent urge to urinate (30%, 65+)
- Incontinence and overactive bladder (25%, 65+)
37
Biological changes in older adulthood: Sleep
- Far more fragmented than in younger adults
- Frequent waking to go to the toilet and physical issues, such as arthritis and lung disease, influence sleep quality
- Decrease in stage 4 and REM (Kamel and Gammack, 2006)
- Sleep deprivation can lead to adverse effects in mental health and physical well-being
- Sleep disturbance in those over 60 promotes depression, risk of CVD and neurological dysfuntion (Gamaldo et al, 2016)
38
Biological changes in older adulthood: Smell/taste
- Half of 80 year olds have no sense of smell
| - Relationship between poor cognition/inability to identify odours
39
Biological changes in older adulthood: Vision
- An 85 year old has 80% less visual acuity than a 40 year old
40
Biological changes in older adulthood: Balance
- Fear of falling leads to restricted movement, becoming less physically active leads to further loss of strength
41
Biological changes in older adulthood: Brain chanages
- Reduced weight
- Loss of grey matter
- Decline in dendrite density/number of connections
42
Biological changes in older adulthood: Genes
- Genes play a role in longevity
- Identical twins have more similar lifespans than non-identical twins
- They also have similar illness rates
- Centenarians run in the family (Murabito et al, 2012)
- Genes linked to common age-related diseases are depleted in those who age exceptionally (Fortney et al, 2015)
43
Behavioural effects of physical changes in old adulthood
- General slowing (Salthouse, 1996)
- Errors in retrieving knowledge/performing actions
- The use of behavioural feedback to compensate for mistakes e.g. when driving
- Learned skills remain butt are more difficult to perform
- It becomes harder to acquire new skills
44
Psychological changes in older adulthood: Memory
- At age 60, decline in remembering telephone numbers (West and Crook, 1990)
- Good general knowledge/recall, given contextual cues (Matzen and Benjamin, 2013)
- Need more time to learn things
- Given time, performance may be equivalent to younger adults
- Reduction in hippocampal volume may account for changes
- May also be due to changing processing strategies
45
What is Erikson's ego integrity vs. despair
- Achieving the sense that you've lived a useful life or feeling hopelessness
- Part of ego integrity states that older adults value being able to pass on their experiences to younger generations
46
Psychological changes in older adulthood: Depression
- Poor social support
- Low income
- Experiencing loss
- Health problems
- Lower rates in males and African Americans
47
Psychological changes in older adulthood
- Cognitive decline --. due to avoiding challenging situations
- Remaining optimistic means quicker recovery when things go wrong e.g. post-stroke (Hillen et al, 2003)
48
Social changes in older adulthood: Retirement
- Not everyone 65= is retired
- Postponed due to interest/challenge or for financial reasons
- Poor health may lead to early retirement
- Often more of a transition/scaling back than a single stage
- Inequality in pay may means women work longer
- Health doesn't change purely because of retirement --> linked to lifestyle factors
49
Social changes in older adulthood: social life
- steady decrease in social network across adulthood
- Loss of spouse decreased personal network (Wrzus et al, 2013)
- May experience stress over returning to active parent role
- Contact with friends/family --> better life satisfaction ratings than for contact with children
- Productivity/volunteering linked to successful ageing --> lower mortality and less hypertension
- New hobbies give life more structure and foster competence, social interaction and creativity --> offer a renewed sense of purpose
50
Social changes in older adulthood: Loss of partner
- When still together couples report higher satisfaction than in earlier married life
- Relationship based on campanionship
- Caring for each other if sick or disabled
- females expect to be without a spouse for many years as they tend to live for longer
- Men rely more on the social and emotional support of marriage
51
Social changes in older adulthood: Living arrangements
- Common to make changes to existing homes and/or hire someone to assist with daily activities
- Retain independence, physical and mental health
- Moving into the home of a relative e.g. adult children
52
What are social judgements?
- Believing others are worse off
| - Acts as a self-protective mechanism
53
What are the crucial roles of diet, sleep and exercise in reducing depression?
- Diets comprising of vegetables, fruit, meat, fish, and whole grains are associated with a 35% reduced risk of depression (Jacka et al, 2010)
- Non-depressed people with insomnia are predicted to have a two-fold increased risk of developing depression (Baglioni et al, 2011)
- In a longitudinal study of over 9,000 people, regular physical activity was associated with a reduced likelihood of depressive symptoms (Azevedo Da Silva et al, 2012)
54
Maintaining/restoring function in older adulthood: Physical exercise
- Physical activity can help cope with physical changes
- Enhanced mental health and even social interaction, low mobility impedes social engagement (Rosso et al, 2013)
- Frailty as a reason to prescribe exercise not a contraindication --> lower iincidence of cancer, cardiovascular disease, diabetes (Bherer. et. al, 2013)
55
Maintaining/restoring function in older adulthood: Memory
The Synapse Project (Park et al, 2014)
- 221 participants, 60-90 years
- Activities 15 hours a week for 3 months
- Older adults who were randomly assigned to learn digital photography, quilting or both showed enhanced episodic memory function at the end of the study and a year later
56
Maintaining/restoring function in older adulthood: Social factors predict memory decline
Ertel et al (2008)
- In immediate and delayed recall tasks, memory declined twice as fast in those with the least social integration
- This was particularly prominent in those with fewer years of education
- Social contact and education provide a buffer against severe decline
57
Classification of brain structures: Cortical
Superficial
58
Classification of brain structures: Subcortical
Deep
59
What are the lobes of the brain used for
- Primarily based on function
Frontal: Decisions
Temporal: Memory
Parietal: Attention
Occipital: Vision
60
Anatomical terms for the brain
- Anterior: In front
- Posterior: Behind
- Superior: Above
- Inferior: Below
- Dorsal: Above, anterior-posterior axis
- Ventral: Below, anterior-posterior axis
- Rostral: To the front, frontal cortex
- Caudal: To the back, occipital cortex or brain stem
61
What are the different types of methodologies for cognitive neuroscience?
1. Position emission tomography (PET)
2. Magnetic resonance imaging (MRI)
3. Functional magnetic resonance imaging (fMRI)
4. Diffusion weighted imaging (DWI)
62
How does the grey and white matter change affect older adults?
White matter: Decline in myelin sheath protecting axons declines with age. This leads to slower information processing
Grey matter: Loss of volume and scope for activation corresponds to a lack of available resources to perform cognitive functions
63
Reorganisation of brain activity
- Driven by decline of function
- Breakdown of functional specialisation: dedifferentiation
- Deficits in inter-hemispheric inhibition
- Reorganisation is designed to protect existing function
- More advantageous to work together when demand is high and resources are low
- Co-operation between regions: compensation
64
Current views on compensation?
Grady (2012)
- Defined by studies of individual differences
- Need to combine neuroimaging data with behavioural studies, so we can see what brain activity means in the context of cognitive capacity
- Dominant approach
65
What happens when compensatory mechanisms cannot maintain performance?
- Importance of early intervention
| - Short-term behavioural training to alter processing strategies has worked well
66
What is tDCS?
- Transcranial direct current stimulation
67
What does tDCS do?
- Increase brain plasticity
- Maintain neural connections
- Trying to take the pressure off information processing and executive systems
68
Evidence for cognitive enhancement using tDCS
- Acquisition of a complex motor skill was enhanced 24 hours post-anodal tDCS (Zimermann et al, 2013)
- Improved object-location learning at a 1 week follow-up after temporoparietal tCDS (Floel et al, 2012)
69
Sustained benefits of tDCS
- Improved accuracy of verbal working memory at 4 week follow-up (Park et al, 2014)
- Enhanced verbal/visual working memory at a 1 month follow-up --> enhancement transferred to non-trained tasks (Jones et al, 2015)
- Sustained visual working memory improvement in mild-moderate Alzheimer's disease (Boggio et al, 2012)
70
Neural enhancement due to tDCS
- Currently, few studies have combined behavioural and neuroimaging data
- Older adults experienced a word-generation deficit reversal with tDCS to inferior frontal gyrus
- fMRI activation more 'youth-like' (Meinzer et al, 2013)
- Anodal tDCS improved the semantic word retrieval of participants with Mild Cognitive Impairment (MCI) to the level of healthy controls but reduced over-activity in regions of frontal gyrus (Meinzer et al, 2014)
71
Methodological considerations with tDCS
1. State-dependent effects: older adults may benefit more from stimulation during training (Fertonani et al, 2014)
2. Timing of response: older adults exhibit a delayed response to tDCS (Fujiyama et al, 2014)
3. Individual differences: education and/or baseline performance predict response to tDCS (Learmonth et al, 2015)
4. Stimulation intensity/length: need for higher current levels and stronger durations e.g. 1.5mA for 20 mins (Laakso et al, 2015; Tatti et al, 2016)
