Theories of Aging Flashcards
Aging
Gradual and spontaneous changes that occur in maturation from infant to young adult - these changes create a normal physiologic decline seen in middle and late adulthood
Senescence
To grow old
The way scientists approach changes associated with aging
A degenerative process
Most health care dollars are spent on
managing diseases
5% healthcare dollars –> preventative care in 2015
Ageism
Can be seen as a process of systematic stereotyping of and discrimination against people because they are old
Old people are stereotypically chategorized as
Senile, rigid in thought and manner, old fashioned in morality and skills
Primary Aging
Aging that is independent of disease and environmental influences (intrinsic aging)
Determined by genetics
Secondary Aging
Aging superimposed upon genetic environment (extrinsic aging)
Changes due to environment and disease
May be modified
Aging (1/3..)
1/3 disease + 1/3 disuse + 1/3 normal aging
Aging - decreased
homeostatic reserve
less ability to restore baseline function
major loss leads to immobility
Aging - dec homeostatic reserve - consequences
inc dependence
inc risk of falls
inc types of aging
Disease vs. Normal aging (5) - Peola Timiras
- Aging is universal process shared by all living organisms
- Aging is intrinsic, dependent on genetic factors where disease is intrinsic or extrinsic
- Aging is always progressive where disease may progress or regress
- Aging is always deleterious whereas disease is occasionally deleterious
- Aging is irreversible where disease can be treated
Age related changes
Changes associated with aging through adulthood into age are gradual
Adults and aging rate
Factors impact aging
Adults age at different rates
Unique combination for each individual of biological, social, economic, psychological factors impacting aging
Factors affecting rate of aging - Biological changes
Changes in anatomy/physiology
Usually first to be noticed
Used to stereotype person as old
Theories of aging
No universally accepted theory
2 categories of aging theories
Programmed theories - aging as internal biological clock
Error theories - aging is result of internal and external assaults that damage cells or organs so they can no longer function properly
Programmed theories
Hayflick limit theory
Telomere theory
Endocrine/Hormonal Theory
Immunologic Theory
Hayflick Limit Theory
Aging is intrinsic - cells can only divide so many times and then shut off/die
Accumulation of improper functioning cells are responsible for aging
Dec DNA
Telomeric Theory
Cells keep track of their age through shortening of telomeres
Creates gap where end of chromosome can’t be copied
Telomere shortening alters expression of other genes which enables detrimental genes to become active
Telomeric theory - shorted telomere are found in
Atherosclerosis Heart disease Hepatitis Cirhosis Cancer - cancer cells have telomerase which can fill the gaps so they continue to develop and divide
Endocrine/Hormone Theory
Functional decrements in neurons and their associated hormones impact aging - effect growth, metabolism, temp, inflammation, and stress
Immunologic Theory
Decline in immune system
Inc vulnerability to disease, aging, death
Immune system is coded overtime to erode
Error theories
Somatic Mutation theory Wear and Tear theory Rate of Living theory Cross Linking Free Radical
Somatic Mutation Theory
Accumulation of harmful factors injure genes
Environmental factors like radiation, toxic chemicals, free radicals
Wear and Tear Theory
Cells, organs and tissues gradually wear out over continued use
Overcomes the bodies capacity for maintenance and repair
Viewed as result of aging, not the cause of it
Rate of living theory
Inverse correlation between basal metabolic rate and longevity
The greater the basal metabolic rate, the shorter the life span
Cross linking
The accumulation of cross linked proteins damage cells and tissues
Slows down the bodily processes and functions
Leads to loss of flexibility of CT, microvascular changes in arteries, lungs, tendons
Free radical theory
any atom or molecule that has an unpaired electron in the outer ring
Damages DNA, proteins, Lipids
Theory is that the FR grabs an electron from any molecule in the vicinity and damages the other molecule
What can we do - skin aging
Be careful with sun exposure and wear sunscreen
What can we do - Osteoporosis
Weight bearing, exercise, diet
What can we do - Serum cholesterol
Diet, weight control, exercise
What can we do - Glucose tolerance
Weight control, exercise, diet
What can we do - Memory
Training, practice
What can we do - Intelligence tests
Training, practice
What can we do - Social ability
Practice
What can we do - Cardiac reserve
Exercise, nonsmokign
What can we do - Systolic BP
Limit salt, weight control, exercise
What can we do - Physical endurance
Exercise, weight control
What can we do - Physical strength
Exercise
What can we do - Pulmonary reserve
Exercise, nonsmoking
What can we do - Reaction time
Training, practice
What can we do - Dental decay
Prophylaxis, diet
Unique aspects of the older person
Have diff types and numbers of diseases
Have altered reactions to disease
Have altered response to tx
Have unique qualities
Diff types and numbers of diseases
No single dx
Accumulation of non-lethal dx
Serious degenerative dx
Coexistence of normal age changes with pathology
Aged have altered reactions to disease
Altered presentation of dx - tendon reflexes, pain perception Inc mental disturbance (what do you expect at my age) Inc mortality (inability to maintain homeostasis)
Altered presentations
Presentation in wrong system Depression without sadness Mass without sx Silent infection Silent surgical abdomen MI without chest pain Non-dyspneic pulmonary edema Nonspecific presentations Brain altered functioning
Explanation for altered presentation in aged
Altered central processing Inc negativity Fear of illness, tx, hospitalization, loss of ind Fear promotes denial Ignorance of body changes Loss of peripheral sens Depression
Factors influencing presentation of disease
Misconception of what is normal aging
Diff physiologic response to disease
Effect of multiple chronic diseases
Polypharmacy
Why doesn’t aged adult seek medical help
Fear of hospitalization Fear of unpleasant investigations Fear of treatment Risk of being put in res. care Lack of info Imagining sx not amendable to tx Low health expectations Failure to recognize the problem
Aged adult has altered response to treatments
Inc vulnerability to drug effects Dec ability to compensate Tx interactions Drug effects Aging complicates acute and chronic illness
Focus of care for the aged adult - Management of disability -
Focus on function and then diagnosis
Care before cure
Independence before freedom from disease
Interdisciplinary
Iatrogenesis
Harm to patient caused by professional treatment
Major causes of iatrogenesis
Relocation which contributes to disruption, confusion, falling, anorexia, malnutrition
Drugs
Hospitalization
Causes of increased dependence
Geriatric syndromes - common final pathways manifest in multi organ system failure
Confusion, falls, dizziness, immobility, incontinence, fatigue, weight loss, dementia, delirium, hearing or visual impairment…
Red flags in geriatric care
Functional decline Loss of appetite Mood changes Social withdrawal Failure to thrive
Acute illness in aged adult
Aging itself Atypical presentation of dx Affect of patient Advance directives Bleeding Baseline Balance Bowel and bladder
Acute illness in aged adult can be caused by
Change Confusion Complications as presenting feature Caregivers Dx Drugs Dehydration Diarrhea Discharge from hospital
