LECTURE TWO: Predictors of Successful Aging

Question 1

True or False: The number of centenarians in 2009 living in the US has more than doubled since 1990.

Answer 1

TRUE.

In 1990, 38,300 vs 96,548 in 2009.

Question 2

When asked about her longevity if it is genetics, what did Esther Tuttle have to say?

Answer 2

Perhaps. – Parents dead at 42 and 50. She had 3 siblings. She had one sibling live to 96.

Question 3

What is the more dominant factor of longevity?

Answer 3

Lifestyle is more dominant than genetics in terms of longevity

Question 4

The three ‘R’s’ of Longevity?

Answer 4

• Resolution
• Resourcefulness
• Resilience

Question 5

According to the New England Centenarian study at Boston, Mrs. Tuttle and others are introverted or extroverted?

Answer 5

Extroverted. With a healthy dose of SELF ESTEEM and strong ties to Family and Community

Question 6

What were the findings of a study done on centenarians in Sardinia?

Answer 6

They tend to…

• be physically active
• have extensive social networks
• maintain strong ties with family and friends
• be less likely to be depressed than the average 60-year-old.

Question 7

Do Optimists live longer than pessimists?

Answer 7

YES!

After following 97000 women for 8 years – optimistic less likely to die of heart disease, less likely to have high blood pressure or diabetes or high cholesterol.

This suggests better overall health than pessimistic women, who are seen as “cynically hostile”. Study shows they are more likely to smoke, be overweight, avoid exercise.

Question 8

How much does genetics determine the aging process?

Answer 8

20-30%

Question 9

What are 8 factors to consider about successful aging?

Answer 9

• Genetics (20-30%)
• Gender and culture
• Life events
• Lifestyle choices and behaviours
• Socio-economic status (to a limit)
• Social and physical environment
• Social and health services
• Psychological attributes

Question 10

In the “Modern; Biological Theories of Aging” Commentary, what are the TWO categories / theories on aging:

Answer 10

1. PROGRAMMED THEORY
   - Biological timetable dependant on gene expression and which affect the systems responsible for maintenance, repair and defense responses
2. DAMAGE THEORY
   - Environmental stress to living organisms would induce cumulative damage at various levels as the cause of aging.

Question 11

What does senescence mean?

Answer 11

The process of deterioration with age

Question 12

What are the THREE sub categories of the PROGRAMMED theory?

Answer 12

1. Programmed longevity (GENES)
   - Aging is the result of a sequential switching on and off of certain genes, with senescence being defined as the time when age-associate deficits are manifested
2. Endocrine theory (HORMONES)
   - Biological clocks act through HORMONES to control the pace of aging.INSULIN plays a key role in the hormonal regulation of aging
3. Immunological theory (IMMUNE)
   - The immune system is programmed to decline over time, which leads to an increased vulnerability to infectious disease and thus aging and death.
   - –> immune disregulation LINKED TO:
   - CVD, Alzheimer’, and cancer.

Question 13

What are the FIVE sub categories of the DAMAGE / ERROR theory?

Answer 13

1. Wear and tear Theory: Cells and tissues have vital parts that wear out resulting in AGING (from repeated use)
2. Rate of Living theory: The greater an organism’s rate of oxygen basal metabolism, the shorter its lifespan
3. Cross-Linking Theory: An accumulation of cross-linked proteins would damage cells and tissues, slowing down bodily processes resulting in aging.
   Bjorksten, 1942.
4. Free-Radical Theory: Superoxide and other free radicals would cause damage to the macromolecular components of the cell, causing cells, and eventually organs to stop functioning
   Introduced by Gerschman, 1954. Developed by Harman.

What macromolecules are susceptible to free radical attack?
- nucleic acids, lipids, sugars and proteins.

What does the body possess in the form of enzymes?

• NATURAL ANTI-OXIDANTS\

5. Somatic DNA Damage Theory: Aging would result from damage to the genetic integrity of the body’s cells. In particular, genetic mutations and damage to mitochondrial DNA would affect body’s cells.
   Continuous damage in cells of living organisms; some repaired, some accumulate

Question 14

Is there a consensus on which theory of aging is better?

Answer 14

NO. there is no consensus, many of the theories interact with each other in a complex way.

Question 15

According to the psychological theory of selective OPTIMIZATION with COMPENSATION:
SUCCESSFUL AGING is the ability of an OA to adapt to what?

Answer 15

Physical, mental and social losses in later life.

Question 16

What are the three BEHAVIOURAL Life-Management Strategies to Maintain Functional independence in later life?

Answer 16

1. FOCUSING on high-priority areas of life – feelings of satisfaction and personal control

(grandkids, helping others etc.)

2. OPTIMIZING remaining personal skills that enrich and enhance life.

(writing playing sports, making new friends etc.)

3. COMPENSATING for LOSSES of physical and mental function by using personal strategies

(strategies for mobility loss or loss of driver’s license - using a disability scooter, hearing aid, etc.)

Question 17

According to psychological Theory what are some key factors of successful aging / coping with changes and losses later in life (6)?

Answer 17

• COPING STYLE: How one adapts to transitions and handles daily hassles and crises
• COGNITIVE CAPACITY: Memory, mental processing speed, problem solving
• SELF-EFFICACY: A BELIEF in ones capabilities to handle situations and tasks in life
• SELF-ESTEEM: Feelings about oneself.
• INTELLIGENCE Ability to learn and adapt to new environments
• RESILIENCE: Ability to overcome adversity

Question 18

What two theories for successful aging does the Sociology Theory include?

Answer 18

1. ACTIVITY THEORY: Older adults who stay engaged in mental and physical ADL’s tend to age in a healthier and happier way
2. CONTINUITY THEORY: maintain forward positive health habits, preferences, lifestyles and relationships form midlife into later life tend to age in a healthier and happier way.

Question 19

According to the sociology theory; Considering the influence of Environment, what will be the outcome of adequate social and physical environments for older adults?

Answer 19

• DECREASE in mortality and morbidity

- INCREASE in health and well-being

Question 20

What are THREE factors influencing OA Program participation?

Answer 20

1. Personal characteristics
2. Program related factors
3. Environmental factors

Question 21

Are OA’s as active as YA’s?

Answer 21

NO

Question 22

What are Demographic factors of personal characteristics which NEGATIVELY correlate with OA exercise participation (5)?

Answer 22

1. Female
2. Ethnic minority group
3. Older (85+)
4. Rural residence
5. Low socio-economic status

Question 23

What are some HEALTH-RELATED factors of PERSONAL characteristics which negatively correlate with OA exercise participation (4)?

Answer 23

1. Poor health and physical condition
2. Illness and arthritic pain
3. Smoker
4. Weight problems: Too lean (Osteoporosis / frailty) or overweight

Question 24

What type of psychological factors are important personal characteristics that influence exercise behaviours in OA?

Answer 24

Self-efficacy – confidence to complete

Perception of greater benefits of exercise over barriers….

Question 25

What are some Physical benefits and motivators of exercise (5)?

Answer 25

• Prevent disease and disability
• Mange chronic illness
• Improve mobility
• Improve appearance
• Improve HEALTH

Question 26

What are some psychological benefits and motivators of exercise (3)?

Answer 26

• Decrease stress and anxiety
• Reduce risks for depression
• ENJOYMENT

Question 27

What is the most frequently cited barrier by OA to exercise?

Answer 27

LACK of self-motivation

Question 28

What is the 2nd most frequently cited barrier to exercise by OA?

Answer 28

LACK OF TIME

Question 29

What are some environmental (social and physical) factors to consider for an OA and exercise program?

Answer 29

Social support:
- From family, friends, health care providers

Physical factors:

• Distance form facility
• Climate (e.g. snow storm = low attendance)
• Neighbourhood (safety?)

Question 30

What is the first step in improving Exercise program adoption and adherence?

Answer 30

EXPLORE EXPECTATIONS AND EXERCISE OBJECTIVES:

• Different for an overweight OA vs. Frail OA
• Verify expectations are realistic

Question 31

What is the 2nd step in improving exercise program adoption and adherence?

Answer 31

SET GOALS:
- Assist participant in setting goals for achieving his / her overall objectives
WHO TAKES PRIMARY RESPONSIBILITY FOR SETTING THEIR GOALS?
The PARTICIPANT

Question 32

Ask questions to the participant about their exercise goals and request clarifications like (3):

Answer 32

• What is your timeline?
• How many days a week you want to exercise?
• What time of day is best for you?

Question 33

What are characteristics of GOOD GOALS (4)?

Answer 33

• Measurable: Can determine whether or not the goal has been met
• Specific: Area for improvement
• Realistic: Goal that participant is sure to achieve = improve self-efficacy
• Behavioural: walking 3 x a week vs outcome-oriented goals like lose 15 lbs, decrease pain etc.)

Question 34

What type of goals does an OA have more control over?

Answer 34

Behavioural goals over outcome-based goals