Week 2 Flashcards
These theories of aging address aging processes at the organism, molecular, cellular levels
Biological Theories of aging. There is no true measure of aging in the body.
Theory postulating that cells and tissues have a vital part in aging and when they wear down, aging occurs.
Wear and Tear
Free Radical Theory
Most aging changes due to production of free radicals (chemically reactive agents generated in electron transfer rxns to metabolism) during cellular respiration. When free radicals damage cells and tissues and accumulate over time, leads to cells and organs stop functioning
What can help battle free radicals?
Antioxidants! E.g., exercise, estrogen
Theories of aging that seek to explain multiple changes in the individual behavior in the middle and later years of life span; boundaries addressed are amorphous
Psychological Theories of aging. Focus largely on activity, client factors, performance skills and performance patterns in Practice Framework. Includes Life-span Development theory
Theory that second half of life is characterized by significant individual differentiation, multidirectionality, and intraindividual plasticity
Life-Span Development Theory. Potential for development present from infancy to old age. No stage is supreme, events at each stage affect future development. The 2nd half of life is very different from earlier development b/c outside factors
T/F: According to the Life-Span development theory, development becomes more plastic and opportunities for change become more prevalent
False. Development becomes less plastic and opportunities for change are more limit with age.
T/F: According to the life-span development theory, the origination and development of an organism (ontogenetic development) is solely biologically constructed.
False! According to the life-span development theory, the origination and development of an organism (ontogenetic development) is both biologically and socio-culturally constructed. Individual’s development is both universally and individually affected e.g., both genetics and environment/social class involved
What are the 3 principles that regulate biology and culture dynamics in lifespan, thus contributing to human development?
- Evolutionary selection benefits decrease with age (less genetic advantages with age e.g., men stronger than women less true as they age)
- Need for cultural resources increases (need more resources to maintain functioning as we age)
- Efficacy of cultural resources decreases (Resources become less affective e.g., adult needs sock aid)
A life-span developmental theory that identifies three fundamental mechanisms for managing adaptive development in later life
Selective Optimization with Compensation Theory. The central focus is on managing dynamics between gains and losses as one ages in order to successfully age. Consists of 3 fundamental mechanisms: selection, optimization, compensation
What are the 3 fundamental mechanisms associated with the selective optimization with compensation theory?
- Selection: Focuses on choice and priorities of what they want to focus on. Sometimes decision is involuntary e.g., can’t play music b/c decrease in hearing
- Optimization: After choosing what’s important, how to allocate resources to priorities; how to participate, invest resources. E.g., if can’t drive and want to go to church, find friend/family to drive
- Compensation: use of alternative methods to achieve activities. Look at how to compensate to complete goal. Assistive devices, technology. E.g., lose eyesight and can’t read music, so use brail to do choir
These types of theories of aging consider the context in which aging occurs and the demands of the activities and the environments
Sociological Theories of Aging.
This sociological theory of aging looks at changes in life over an entire life span
Life Course Perspective. To understand older people now, must know their past. Emphasizes social and cultural factors (macro -> micro levels) that might influence the aging experience over time and explain how they got to where they are now. Pathways between life phases and circumstances in early life affect later life health. Both population and individual levels e.g., social policy, cohort effects, sociocultural factors.
This theory emphasizes social and cultural factors (at micro and macro levels) that might influence the aging experience over time.
Life Course Perspective. Pathways between life phases and circumstances in early life affect later life health. Multidisciplinary and dynamic approach, focussing on life cycle in entirety and drawing from sociology, psychology, anthropology, history
In Life Course Perspective theory, these are stable patterns of behavior or health across time (small changes)
Trajectories
In Life Course perspective theory, these are changes in social roles or responsibilities
Transitions. Large changes that change one’s life direction.
In life course perspective theory, these are transitions that are major changes in ongoing social role trajectories; life takes different direction
Turning point
In life course perspective theory, these are events and externalities that shape and constrain the process of change and adaptation
Cultural and contextual influences e.g., historical events, influence from peers or neighbors, race, gender, SES
In life course perspectives, the interaction between age or stage of life course and timing of event or transition
Timing in lives
In this aging theory, there are 7 key concepts including trajectories, transitions, turning points, cultural and contextual influences, timing in lives, linked lives, and adaptive strategies
Life Course Perspective. Pathways between life phases and circumstances in early life affect later life health.
In life course perspective theory, dependence of development of one person on presence, influence, or development of another
Linked lives. All lives are linked together and impacted by each other e.g., eating habits of ones around you affect own habits
In life course perspective theory, these are conscious decisions that people make to improve their health or well-being or social norms that frame the way in which decisions are made to adapt to external changes
Adaptive strategies e.g., dieting
This aging theory claims that past experiences, decisions, and behaviors form the foundation for the present and future
Continuity Theory. Focuses on past experiences, because history affects what you do now and in the future.
According to the continuity theory, what is the goal and strategies used for adaptation to changes in aging?
Goal of adapting to changes is to maintain patterns of thought, activities, and habits. Basic personality is stable throughout life. Help clients maintain occupations during aging. Strategies used for adaptation come from past experience e.g., can’t dance, but instead teach dance to maintain occupation
Changes in nervous system due to aging:
- Loss of neurons and myelin –>common diseases e.g., Alzheimer’s, Parkinson’s
- Frontal lobe atrophy –> reduced executive function, slowed rxn and mental processing.
- Unbalanced NTs –> Less stage 3 and 4 sleep
- Cognitive changes –> slower fine motor and postural reflexes
- Altered motor skills –> shorter, hesitant gait
- Diminished sensory input –> lower proprioception, vestibular sensation, kinesthesia
The regulatory measure in the body that makes sure all parts are working together well
Nervous System
Result of loss of neurons and myelin due to aging (Nervous System)
Common disease e.g., Alzheimers
Result of frontal lobe atrophy due to aging (nervous system)
Reduced executive functioning, slowed reaction and mental processing. Require more decision making time and favor slow, deliberate approach to tasks
Result of unbalanced neurotransmitters due to aging e.g., seratonin
Less stage 3 and 4 sleep (deepest levels of sleep). Many older adults complain of insomnia
Result of cognitive changes due to aging (nervous system)
Slower fine motor and postural reflexes
Result of altered motor skills due to aging (nervous system)
Shorter, hesitant gait, shuffling
Result of diminished sensory input due to aging (nervous system)
Lower proprioception (sense of body position), vestibular sensation (sense of head movement), and kinesthesia (sense of body movement). Affects where you are in world.
Age related changes in cardiovascular system
- Increase in adiposity (fat)
- endocardium scarring
- loss of autorhythmic cells (pacemaker cells)
- decreased cardiac output
- decreased max heart rate
- Atherosclerosis (hardening and narrowing of arteries, SMC creates plaque. Can cause heart attack, stroke, etc)
- Ulcerations
Responsible for circulation in blood, delivering oxygen to nutrients, eliminating waste
Cardiovascular system
Results of cardiovascular system changes in older adults
- Hypertension (high blood pressure)
- Quickly tiring and SOB
- Postural/orthostatic hypotension: become lightheaded when get up
- Stroke, heart attack
- Aneurisms: bulging area of artery. Can cause narrowed blood vessels, blood clot, swelling, pain when exercising.
- Peripheral vascular disease (narrowing of arteries due to artherosclerotic plaque)
- Thrombus: blood clot. If blood clot, can affect occupation. May need more AE or technology to participate
- May need pacemaker if loss of autorhythmic cells
Result of decreased cardiac output due to cardiovascular changes?
Quickly tiring, SOB
Result of postural/orthostaic hypotension due to cardiovascular system
Lightheaded when getting up, result of falling BP
Result of decreased max heart rate in older adults
Fatigue
Hardening of arterial wall, SMC create plaque
Atherosclerosis
Atherosclerosis can result in what age-related problem?
Stroke, heart attack, peripheral vascular disease (narrowing of arteries due to plaque), thrombus (blood clot), aneurysm (bulge in arterial wall)
Result of increased adiposity in cardiovascular system
Increased BP
Bulging, weak area of artery wall that can cause narrowed blood vessels, blood clot, swelling, pain when exercising
Aneurysm.
Narrowing or occlusion by atherosclerotic plaques of arteries
Peripheral Vascular disease
Changes in respiratory system associated with aging
- Forced vital lung capacity (amount air volume when exhale) decreases
- Lungs lose elastic recoil
- Loss of surface area of alveoli
- Stiffening rib cage
- Decrease O2 saturation
- Diaphragm flattens
Results of respiratory system changes due to aging
- Decreased tolerance of physical activity
- Difficulty expanding rib case, especially during PA
- Disease (COPD, emphysema, chronic bronchitis)
- Pneumonia (trouble coughing up food)
- May need to limit ADLs
Changes related to endocrine system due to aging
- Decreased efficiency of hormone release
- Decreased thyroid activity (regulates tissue growth and development, sympathetic NS, mental alertness, body temp, metabolic rate)
- Decreased aldosterone: regulates salt and water in body, thus has effect on blood pressure
- Elevated cortisol response to stress
- Decreased insulin production; insulin resistance
- Important for bone strength, osteoporosis
Results of changes related to endocrine system due to aging
- Decreased cognitive function, strength, sexual function
- Reduced metabolic rate and mental alertness, subpar thermo-regulation, increased atherosclerosis
- Increased BP
- Hyperglycemia (high blood sugar levels)
- Immunosuppression (suppression of immune response)
- Disease exacerbation (e.g., diabetes, HTN)
- NIDDM: form of type II Diabetes where insulin production inadequate or body becomes resistant to insulin
- But, can be slowed/prevented with lifestyle changes
Hemotologic changes in older adults
-Decreased erythroiesis (RBC production)–> anemia
Results of changes in hemotologic system due to aging
-Anemia, hypoproliferative (less RBC produced, less iron intake) and ineffective erythropoiesis (RBC destroyed, VB12 deficiency)
Decreased erythropoiesis due to aging results in…
Anemia, both hypoproliferative (less RBC produced, decreased iron intake) or ineffective erythropoiesis (RBC destroyed, VB12 deficiency). Lower than normal O2 carrying cells. Syndrome, not disease. Decreased energy levels, changes in diet, affects activities, may need to take more rest breaks
Results in decreased energy levels, changes in diet, and possibly greater need for rest breaks
Anemia
T/F: Anemia is very common in older adults
True
Result of decreased number of T cells:
Infectious diseases
Immune system changes due to aging:
- Decreased # T-cells –> infectious diseases
- Altered immune surveillance of cancer cells –> cancer
- Slow destruction of thymus (produces T cells) -> Autoimmune disease e.g., RA, Lupas, Chronic hepatitis
- Increased autoantibodies (attack own cells) –> autoimmune disease
Result of altered immune surveillance of cancer cells:
Cancer!
Result of slow destruction of thymus
Autoimmune disease e.g., RA, Lupas, Chronic hepatitis. May be more easily tired, fear of what’s going on with self
Result of increased autoantibodies
Autoimmune disease e.g., RA, Lupas, Chronic hepatitis. May be more easily tired, fear of what’s going on with self
What often happens to teeth of older people when they age?
- Loosened, browned teeth
- Due to cavities
- Dry mouth, saliva doesn’t wash away bacteria, harder to swallow
Changes in breathing due to aging?
Forced vital lung capacity (amt air volume when exhale) decreases
Changes in lungs due to aging
- Lungs lose elastic recoil
- Lose surface area of alveoli
T/F: With age, the rib cage tends to become for relaxed
False, rib cage stiffens with age
How does O2 saturation change with age?
It decreases
System that helps control body temp, basal metabolic rate, growth rate, stress response, reproductive events
Endocrine system
How does insulin production change as we age?
It decreases
T/F: older adults tend to produce less cortisol during stress response?
False, they produce more cortisol as stress response
Gland responsible for regulating tissue growth and development, sympathetic NS, mental alertness, body temp, metabolic rate
Thyroid. Thyroid activity decreases with age
Results of decreased thyroid activity
Reduced metabolic rate and mental alertness, subpar thermoregulation, increased atherosclerosis
Decreased aldosterone can result in
Increased BP
Elevated cortisol levels, common in old age, may cause higher or lower BP?
Increased BP. May also cause immunosuppression, Diabetes, disease exacerbation
Possible affects of elevated cortisol levels
Increase in BP, immunosuppression, disease exacerbation, Diabetes
What happened to digestive structures and nerves with aging?
They weaken e.g., tongue
T/F: Taste and smell is in tact as we age
False, changes in taste and smell
Changes in gastric acid with age?
Decreased gastric acid, leads to poor digestion and gut inflammation
T/F: with age, vitamin absorption decreases
True. Vit D., B12, iron, and calcium absorption decreases
What changes in bile of galbladder do we see with age?
Increase bile in gallbladder
How does the liver detoxification process change as age? How does this pertain to medication?
Liver detoxification efficiency decreases. If meds aren’t easily expelled, can OD. Sometimes b/c getting higher rx than needed
Digestive problem often in old age defined by trouble swallowing
Dysphagia
Problem in old age when food/drink goes down wrong tube
Aspiration-food/drink down trachea
How does food intake change as become older adult? Why problem?
Often, decreased desire to eat. If don’t want to eat when older b/c not desirable, unintended weight loss and decreased energy for activities. Also feel fuller longer
T/F: Problems related to digestive system when age can affect cognitive function, bone density, and anemia
True
Inflammation of intestine that can occur with old age
diverticulitis
Common age related changes related to digestive system
- Dysphagia (trouble swallowing); aspiration (down trachea)
- Decreased desire to eat
- Cognitive function, bone density, anemia
- Peptide ulcers; gastritis, stomach cancer
- Osteoporosis
- Gallstones; inflammation
- Medication overdose (b/c decreased liver efficiency)
- lengthening of full sensation
- inflammation of intestine; diverticulitis
- Constipation
- Fecal incontinence
- Colon cancer
Changes in nephrons with age?
Nephron filters (filters blood) are less efficient and there is a loss of nephrons
Changes with substance concentration with age?
Diminished substance concentration regulation e.g., Na
Changes in pelvic floor and bladder with age?
Weakened pelvic floor, leading to incontinence, and decreased bladder capacity which causes leaking
Age-related changes of urinary and genital organs
- Less efficient functioning and loss of nephrons (filters blood)
- Diminished substance concentration regulation e.g., Na (issues with Na levels)
- Weakened pelvic floor muscles and sphincters (leads to incontinence)
- Decreased bladder capacity (causes leakage)
- Enlarged prostate
- Reduced hormones
Results of urinary/genital changes in old age?
- Renal failure
- Difficulty excreting drugs
- Increased BP
- Dehydration
- UTI/Kidney damage
- Urinary incontinence
- Sexual dysfunction
4 types of incontinence:
Overflow continence, functional incontinence, Urge incontinence, stress incontinence
condition in which toxic metabolites build up in body b/c inability of kidneys to remove them at sufficient rate
Renal failure
Result of loss of nephrons and less efficient functioning of remaining nephrons
Kidneys have trouble getting rid of toxic substances. So be careful when giving medication, b/c trouble breaking down in body. Give smaller drug dosages
T/F: older adults are more likely to become dehydrated
True! Body has harder time regulating concentration of water. Especially when confusion, immobility, or fear of urinary incontinence prevents them from drinking enough water
T/F: older adults are less likely to have UTIs and sexual dysfunction
False, more likely to have UTIs/kidney damage and sexual dysfunction. Lack of coordination causes urinary retention which increases risk of UTI and kidney damage)
Condition when one cannot completely expel urine, so have some leftover
Overflow incontinence
Condition in which a person is usually aware of the need to urinate, but for one or more physical or mental reasons they are unable to get to a bathroom.
Functional incontinence
e.g., arthritis and can’t zip pants fast enough
How does incontinence affect activities/occupations?
Fear of engaging in activities/occupations because afraid of wetting self. Low social engagement. Diaper as stigma.
T/F: Established incontinence can be cured with medication
False. Established incontinence cannot be cured, only treated
Temporary form of incontinence involving sudden onset from acute condition.
Transient incontinence. E.g., when pregnant, medications
Condition associate with strong, sudden need to urinate
Urge incontinence
Happens when physical movement or activity — such as coughing, sneezing, running or heavy lifting — puts pressure on your bladder
Stress incontinence
Changes in bones with aging
- Reduced bone density and mass (less mineral deposits to create bone strength)
- Osteoporosis
- Collapsing vertebrae
- Decreased synovial fluid leads to pain, arthritis
- Thinned cartilage=pain, stiffness, grinding
Changes in muscles with aging
- Decreased motor units
- Decreased number, size, elasticity of skeletal muscle fibers
- Issues with strength and flexibility
- Muscles not firing as should -> slowed rxn time
T/F: The cardiovascular system is strongly linked to the musculoskeletal system
True. Think of heart as muscle!
As we age, we often get increased strength, endurance, and flexibility ,
False. Decreases in strength, endurance, flexibility with age. More prone to fractures
As we age, lordosis (concave) more common
False. Kyphosis (concave, hunch) is more common
Changes in height as we age?
Decreased height
Result of slowed reaction time in aging?
Difficulties with driving, falls. Behavior may change if know more probe to fractures. May be fearful and decrease engagement.
Changes in Integumentary system
- Slowed skin cell turnover
- Less melanin
- Less collagen (proves rigidity) and elastic (flexibility)
- Decreased elasticity and hydration
- Blunted inflammation (no red and puffiness, so harder to tell damage to skin)
- Subpar sweat gland function
- Decreased tactile sensitivity
- Decreased hair follicles and slowed growth. Thinning hair, leads to sunburn b/c not protected
- Fat layer thinning of face, hands, feet (not going to walk as much b/c hurts)
What happens to the cell turnover as one ages?
Slowed skin cell turnover. Changes begin as age into 20s. More dead cells, bruises, cuts, blemishes
Does tactile sensitivity increase or decrease with age?
Decreases. Pain threshold increases (don’t sense pain as easy).
Why are older adults more prone to abrasions, bruises, cancer
Skin cell turn over is slowed, more dead cells, bruises, cuts, blemishes. Cancer from thinning hair, head not protected
Pigmentation in older adults is due to…
less melanin production
Wrinkles in older adults due to…
less collagen and elastin
T/F: in older adults, damage to the skin is very obvious
False. Damage is less obvious b/c inflammation is blunted, so no red or puffiness occurs. Problem with pressure ulcers
Changes in thermoregulation with aging?
Thermoregulation: ability to maintain core temperature. Due to subpar sweat gland function, can’t sweat normally. If too warm, can overheat/stroke
Why is decreased tactile sensitivity in older adults a problem?
B/c leads to an increased pain threshold, so you don’t sense pain-safety issue
Why is thinning of fat layer of face, hands, and feet a problem?
B/c may prevent older adult from walking if it hurts too much. Also may develop foot conditions
Changes with taste in aging:
- Decreased taste buds and saliva
- Trouble tasting salty, but can still taste sweet. So, pour on salt so they can taste. But alters sodium h20 ratio, increases BP, hypertension issues
- Decreased appetite; malnutrition
- Trouble differentiating food and taste intensity
T/F: Older adults often have trouble tasting sweet foods, but can still taste salty foods well
False. They often have trouble tasting salty foods, so they pour on the salt. Alters sodium water ratio, increases, BP, hypertension issues result. No problem with sweet foods.
Results of decreased taste buds and saliva:
- Trouble differentiating food and taste intensity
- Dry mouth
- Decreased appetite; malnutrition
- Diabetes
Changes in aging related to smell
Decreased olfactory sensations (hyposmia)
Altered mucosal linings and sensations
Changes related to touch
Decreased info processing. Can’t feel, so may affect social connections and/or affects desire to touch/be touched
Why is decreased sense of smell a problem?
If can’t smell, don’t know what foods to avoid.
Discrimination based on age
Ageism
Overall, OTs have more ____ about aging
Positive!
This largely affects one’s social interactions with others
Self-perceptions of self related to aging e.g., as I old I keep getting happier/sadder
Kind of talk often occurring when you talk with caregiver w/o addressing older person–often occurs when working with team
“Ignoring Talk”
When you only talk about self care activity and forget about interpersonal aspect
“Task Talk”
Infantalizing, patronizing speech that is simplified and overly “sugared”
“Elderspeak”
Consequences of “Elderspeak”
- Not effective communication
- Dehumanizing
“interdependence” vs. Independence?
Focusing on independence may not be best b/c may favor having the energy to converse with family rather than walking downstairs to eat. Interdependence may be more valuable to a person. May not want to or be able to be independent. By placing emphasis on people’s capacity to do things alone, essential interdependence of humans being ignored. Interdependence is more inclusive. Focus more on activity! Maybe too much emphasis on individual when working with older people
Factors that negatively/positively influence interest of OTs in geriatrics?
- Having positive experience with older people will help promote positive attitudes toward older adults
- Not required to take gerontology course, but must take peds
What role can OT play regarding ageism?
OTs can play role in perception of aging among other OTs and public. Can play an instrumental role in shaping tone related to perceptions of aging in society.
What can change attitudes/values of OTs related to older adults
Working with older adults, especially if see changes/restoration
