Week 1: Introduction Flashcards
the process of growing old; the rate and magnitude of change in each system of the body
Aging
the study of social, psychological, cognitive, and biological aspects of aging
Gerontology
healthcare concerned with the aging
Geriatrics
the average length of life a kind of organism or of a material object especially in a particular environment of under specific circumstances; the duration of existence of an individual
Life span
the number of years a person is expected to live based on statistical average. It is affected by geographical area and era, lifestyle, genetics, gender, access to healthcare, diet/nutrition, economical status, occupation, physical condition, and activity (average= 78.8 yrs)
Life expectancy
the length of time a person has lived measured in years, months, and days from the date the person was born
Chronological age
measure of how well or poorly your body is functioning relative to your actual calendar age. Takes into consideration objective measures like resting HR, BP, and visual acuity, as well as subjective criteria like ease of performing daily tasks, muscle strength, and general mobility
Physiological age
condition or process of deterioration with age, state of being old, or process of becoming old
Senescence
What are the categories of elderly?
Young old (60-75), Old (75-85), and Old old (85+)
negative perception of older adults based on their age alone. The subtle negative attitudes towards older adults that are often identified among health care practitioners become more obvious and influential when old age is combined with the perception of the patient as having low motivation, poor compliance, and poor prognosis
Ageism
most developed countries have accepted the chronological age of 65 years, UN accepts 60+
Older adult
multidimensional, encompassing the avoidance of disease and disability, the maintenance of high physical and cognitive function, and sustained engagement in social and productive activities.
Successful aging
within the category of normal aging, aging that occurs when extrinsic factors heighten the effects of aging alone (how rapidly a person ages is a product of their lifestyle choices)
Usual aging
the capacity to function across many domains- physical, functional, cognitive, emotional, social, and spiritual- to ones satisfaction and in spite of ones medical conditions
Optimal aging
decline in overall physiological ability, observed with increased aging
Slippery slope of aging
What are the 4 functional status thresholds?
Fun (highest level, unrestricted participation) → Function (can still accomplish most work/home activities, but possible not leisure activities) → Frailty (majority of physical capacity consists of completion of ADLs with significant limitations in participation of activities) → Failure (assistance required for basic ADLs, possibility of being completely bedridden)
the state of being subject to death
Mortality
the quality of being unhealthful (diseased); the relative incidence of disease taking into account disease normalcy for age group
Morbidity
basic self-care; personal hygiene; everyday routines involving functional mobility
Activities of daily living
areas that are essential to living independently as an adult (cooking, shopping, washing, housekeeping, ability to drive, etc.)
Instrumental activities of daily living
assess ones ability to carry out activities that require physical actions, ranging from self-care to more complex activities that require a combination of skills, often with social context; measures level of disability a person presents with taking into consideration chronic diseases, age, etc.
Physicial function
patterns of behavior that emerge over long periods of time during which an individual experienced functional limitation to such a degree that an inability to fulfill desire social roles resulted
Disability
chronic condition in older adults that occurs in at least 80% of the population, with 50% having two or more conditions: arthritis, hypertension, heart disease, stroke, diabetes, hearing and vision impairments, and fractures
Prevalent chronic conditions
decreased mobility (transfers), hearing impairments, visual changes, decreased reaction time (increased risk of falls), difficulty with ADLs, IADLS, and work. Higher in obese, nonwhites, women, or lower socioeconomic status
Prevalent activity limitations
a disorder or incorrectly functioning organ or system, which results from the effect of developmental errors, infection, lack or adequate nutrition, critical environmental factors, illness, or sickness
Disease
simultaneous presence of 2 or more chronic disease or conditions (related or unrelated)
Comorbidity
What were the 3 leading causes of death in 1980?
- Heart disease
- Malignant neoplasms
- Cerebrovascular disease
What were the 3 leading causes of death in 2013?
- Heart disease
- Malignant neoplasms
- Chronic lower respiratory disease
What are the categories involved in basic actions difficulty?
movement, emotional, sensory, or cognitive functioning
____% of individuals over 65 have at least 1 chronic condition.
80%
What are the 3 categories of theories on aging?
Developmental-genetic, Stochastic, New
Theory: there is a limited amount of cell population doublings, the average being fifty per life cycle of the cell
Hayflick Limit Theory
Theory: an expansion of natural selection and states that each successive generation is more resistant to mutations and when mutations occur, they occur at a later age
Evolutionary Theory of Aging
Theory: survival into old age is enhanced by high vitality and resilience due to an underlying resistance to stress by the genes
Stress Theory
Theory: functional decrements in neurons and their associated hormones are central to the aging process
Neuroendocrine Theory
Theory: each species has specific characteristics of its genes that regulate the rate of errors, thereby affecting the lifespan
Theory of Mutagenesis
Theory: The functional capacity of the immune system declines with age as a result of reduced T-cell function
Immunological Theory
Theory: aging changes are due to damage caused by free radicals
Free Radical Theory
Theory: a life committed to a high-nutrient & low-calorie diet is beneficial and longer
Caloric Restriction Theory
Theory: any accident or error in either the machinery or the process of making proteins would cascade in multiple effects that would be incompatible with proper function and life
Error Theory of Aging
Theory: biological age changes are a result of errors accumulating in genes. An accumulation of these takes over the system until it is exhausted
Redundant DNA Theory
Theory: mutations or genetic damage result from radiation and these accumulate and create functional failure and death
Somatic Mutation Theory
Theory: a control mechanism responsible for the appearance and the sequence of aging exists in the nuclear chromatin complex
Transcription Theory
Theory: the large reactive proteins such as collagen cross-link & are responsible for aging
Cross-Linkage Theory
Theory: prolonged sleep loss effects homeostasis & species’ ability to repair tissue
Sleeping and Aging
Theory: there is too much growth hormone and not enough insulin, which leads to a less healthy and shorter life
The Hormonal Imbalance-Growth Factor Exposure Theory
Theory: the length of the telomere is predictive of life span for that cell and ultimately of that organism
Telemeres Theory
Theory: there is a strong relationship between genetic influences and longevity
Progress of Cell Culture Aging Models Theory
Theory: normal people carry variants of the gene that influence the life spans or predispose them to an early death
Werner Syndrome Theory
What are the key elements of evidence informed practice?
- best available evidence
- clinical experience and judgement
- patient preferences and motivation
What are the 5 steps of evidence based practice?
Ask, Find, Appraise, Apply, Evaluate
What does PICOTT stand for?
Patient/Population/Problem, Intervention/PrognosticFactor, Comparison to Intervention, Outcome, Type of Question you’re asking, Type of study you want to find
What are the types of questions/domains?
Therapy/Treatment Diagnosis Prognosis Harm/Etiology Prevention Quality Improvement
What type of study is used for selection of treatments or interventions that do more good than harm and that are worth the effort and cost (therapy/treatment)?
- Double blind randomized controlled trial
- Systematic Review/Meta Analysis
What type of study is used for selection and interpretation of diagnostic tests in order to confirm or exclude a diagnosis based on considering their precision, accuracy, acceptability, expense, safety, etc. (Diagnosis)?
- Controlled Trial
- Systematic Review/Meta Analysis
What type of study is used for estimation of a patient’s likely clinical course over time and anticipation of likely complications of disease (Prognosis)?
- Cohort studies: case control, case series
What type of study is used for identification of causes or risk factors for disease (Harm/etiology)?
- Cohort studies
What type of study is used for prevention?
- Randomized controlled trial: cohort studies
What type of study is used for quality improvement?
- Randomized controlled trials
What are the different types of evaluation criteria?
Credibility (internal validity)
Transferability (external validity)
Dependability (reliability)
Confirmability (objectivity)
Which type of eval criteria looks at truth and quality and asks “can you believe the results?”
Credibility
Evaluation Criteria: were patients randomized? Were patients analyzed in the groups to which they were originally randomized? Were patients in the treatment and control groups similar with respect to known prognostic factors?
Credibility
Which type of eval criteria looks at external validity and asks “can the results be transferred to other situations?”
Transferability
Evaluation Criteria: were patients in the treatment and control groups similar with respect to known prognostic factors? Was there a blind comparison with an independent gold standard? Were objective and unbiased outcome criteria used? Are results valid?
Transferability
Which type of eval criteria looks at consistency of results and asks, “would the results be similar if the study was repeated with the same subjects in a simlar context?”
Dependability
Evaluation Criteria: aside from the experimental intervention, were the groups treated equally? Was follow up complete? Was the sample of patient’s representative? Were patients sufficiently homogenous with respect to prognostic factors?
Dependability
Which type of eval criteria looks at neutrality and asks, “was there an attempt to enhance objectivity by reducing research bias?”
Confirmability
Evaluation Criteria: were 5 important groups (patients, caregivers, collectors of outcome data, adjudicators of outcome, data analysis) aware of group allocations? Was randomization concealed?
Confirmability
