week 11 - longevity

Question 1

Learning Outcomes

Answer 1

Understanding of the factors that influence
longevity

Ability to describe key issues in adult health
and illness
–Have an in-depth understanding of the 3 most common
chronic conditions in older age

Describe the steps in the transactional
model of stress and coping

Identify the key risk and protective factors
for ill health in older age

Question 2

How Long Will We Live?

factors

Answer 2

Genetic factors
•
Environmental factors
•
Ethnic Differences
•
Gender Differences

Question 3

australian life expectancy

see slides 4-8

Answer 3

82.45 years (2015)

In Australia, a boy born in 2014–2016 can expect to live to the age of 80.4 years and a girl would be expected to live to 84.6 years compared to 47.2 and 50.8 years, respectively, in 1881–1890.

Life expectancy changes over the course of a person’s life because as they survive the periods of birth, childhood and adolescence, their chance of reaching older age increases. The life expectancy at different ages can be presented as the number of additional years a person can expect to live, or, their expected age at death in years.

Men aged 65 in 2014–2016 could expect to live another 19.6 years (an expected age at death of 84.6 years) and the life expectancy of women aged 65 in 2014–2016 was 22.3 years (an expected age at death of 87.3 years).

Question 4

Leading causes of burden

Answer 4

see slides 9-11

Question 5

leading causes of death

Answer 5

slide 11

Question 6

Health Issues and Aging

Answer 6

Reductions in immunity

• Influenenza
• Pnuemonia
• Respiratory tract

Injury

Chronic Conditions

• Medication
• Disability
• Stress

Question 7

Injury

Answer 7

During 2014 there were over 100k hospitalisations due to falls in people aged 65 and over.
Average time spent in hospital from falls increases from 4 (65-69) to 17 (85+)

Question 8

Chronic conditions /non-communicable disease

Answer 8

Chronic conditions are characterised by their long-lasting effects. Once present, they tend to persist throughout a person’s life. ABS data show:

50% of Australians have at least 1 of 8 selected
common chronic conditions

70% 65+ had a chronic disease

50% aged 65–74 had to cope with 5 or more chronic diseases, increasing to 70% of those aged 85+

Question 9

Arthritis and Osteoporosis

Answer 9

14% of Australians have arthritis in comparison to 60% of 75+ women and 42% of 75+ men

3% of Australians have osteoporosis in comparison to 23% of 65+ women and 5% of 65+ men

Question 10

Cardiovascular disease

Answer 10

22% of Australians have some form of CVD vs 54% 65-74 and 66% of 75+

Aged 65+
66% of heart failures
71% strokes
9x more likely to have CHD than 45-54 year olds

Question 11

Cancer

Answer 11

Accounts for 31% of all deaths in Australia

Risk of being diagnosed with cancer by 85 1 in 2 for men, 1 in 3 for women

Question 12

estimated age specific incidence and mortality rates for all cancers combined by sex 2017

Answer 12

see slide 18

Question 13

Disability

Answer 13

18% of people in Australia have a disability, and 5.8% have a severe or profound disability

53% of those aged 65+ have a disability

20% have severe or profound activity limitation

Question 14

Model of Disability

Answer 14

extra individual factors

the main pathway

risk factors

intraindividual factors

SEE SLIDE 20

Question 15

Functional Health and Disability

Answer 15

see slide 21

issues with bathing/showering, dressing, eating, getting in and out of bed/chairs, walking, using toilet… et

Question 16

Medication

Answer 16

Pain management
Effectiveness of medication
Side effects and interactions
Adherence

Question 17

Given the frequency of chronic disease in later life what proportion of Australians aged 75+ rate their health as good, very good or excellent.

Answer 17

??/

Question 18

Stress and Coping

Answer 18

Our health is shaped by
Stress
The process by which we perceive and respond to certain events, or stressors, that we view as challenging or threatening

Coping
The processes that are involved with managing the demands (internal and external) of life events and situations that are self-appraised to be stressful

Adaptation
Developmental changes that are the result of experiencing and eventually managing stress

Question 19

Stress and coping

lazarus/folkman

Answer 19

Lazarus and Folkman (1984)
Appraisal
-Primary appraisal
-Secondary appraisal
-Reappraisal

Coping

• Problem focused
• Emotion focused

Question 20

Primary appraisal

Answer 20

1 Irrelevant / Non significant
2 Benign or positive
3 Stressful

Question 21

Secondary appraisal

Answer 21

Can you deal with it?

Evaluate internal and external options and assess or reappraise

• Threat
• Harm-loss
• Challenge

Question 22

Coping

Answer 22

Problem-focused coping: attempts to deal with the stressor

Emotion-focused coping: attempts to deal with one’s feelings about the stressor

see slide 28 for examples

Question 23

Transactional model of stress

slide 29

Answer 23

We become stressed when demands (pressure) exceeds resources

Resources for Effective Coping: health and energy, positive beliefs, social skills, material resources personal control, and social support

Question 24

Age and stress

Answer 24

Coping strategies change

Sources of stress change

Question 25

Stress and aging

Answer 25

We get better at dealing with stress throughout the lifespan

This is good, because we need it
–Illness, death, loss, more common in later life

Question 26

the effects of stress on the body

Answer 26

Chronic stress results in increased secretion of cortisol
>raises blood sugar and blood pressure and increases inflammation and immune system resistance to infection

> ALSO suppresses telomerase activation in immune system cells so that telomeres are no longer protected during cell division

Question 27

Outcomes of Stress

Answer 27

• Bonanno Patterns of coping
• Chronic Disruption
• Delayed
• Recovery
• Resilience
• –Hardiness
• –Self-Enhancement
• –Meaning
• –Positive emotion and laughter

Question 28

What can we do?

Answer 28

Postponement of ill health and disease involves 4 strategies:

1. Prevention of risk factors for ill health
2. Reduction of the prevalence of risk factors (before ill health occurs)
3. Prevention of progression of ill health after onset
4. Reduction of morbidity

Question 29

The key risk factors

Answer 29

Smoking
Heavy drinking
Physical inactivity
Depression
Social isolation
Fair or poor perceived health
Lack of meaning
Low mastery
Low SES

Question 30

proportion of disease burden atributed to selected risk factors

Answer 30

see slide 36

Question 31

Learning Outcomes
(do you know this shit?)

Answer 31

Understanding of the factors that influence longevity

Ability to describe key issues in adult health and illness
—Have an in-depth understanding of the 3 most common chronic conditions in older age

Describe the steps in the transactional model of stress and coping

Identify the key risk and protective factors for ill health in older age