2. Learning Objectives
What are the average and maximum longevity for
humans?
What genetic and environmental factors influence
longevity?
What ethnic factors influence average longevity?
What factors create gender differences in average
longevity?
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4. Maximum Longevity
House mouse, 4
Dogs, 29
Cats, 36
Polar bears, 42
Horses, 62
Chimpanzees, 59
Average and Maximum Longevity For Asian elephants, 86
Average Longevity – age at which half the
individuals born in a particular year will have died.
Maximum Longevity – the oldest age to which any
individual of a species lives.
What is the difference between active life
expectancy and dependent life expectancy?
The difference between living to a healthy old age and simply living a long time.
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5. Genetic and Environmental
Factors in Average Longevity
Genetic Factors
Family History
Can’t pick your history
Environmental Factors
Disease
Toxins
Lifestyle
Social class 121
We can control most Jeanne Calment
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6. Ethnic Differences
Are ethnic differences associated with genetics? Is
that the only association?
The differences are complex.
Sociocultural, economic conditions, healthcare disease, etc
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7. Gender Differences in Average Longevity
Women have nearly a seven year edge over men.
Why?
Men are more vulnerable to disease than women.
Men are risk-takers.
Men smoke and use alcohol more than women.
Men allow stress to enter their lives more than women.
Anything else?
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8. International Differences
Dramatic Differences in Longevity Around the
World
From 38 years in Sierra Leone, West Africa to 80 years in
Japan
Factors
Genetic
Sociocultural
Economic 111
Anything else?
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10. Learning Objectives
What are the key issues in defining health and
illness?
How is quality of life assessed?
What normative age-related changes occur in the
immune system?
What are the developmental trends in chronic and
acute diseases?
What are the key issues in stress across adulthood?
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11. Defining Health and Illness
Health – A state of
complete physical, mental,
and social well-being, and
not just the absence of
disease or impairment.
Illness – Presence of a
physical or mental disease
or impairment.
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12. Quality of Life
Relating to specific diseases or conditions
To what extent does distress from illness or side effects
associated with treatment reduce the person’s will to live?
Valuation of life – value placed on staying alive
Relating to end-of-life issues
How much one enjoys life, has hope
for the future, and finds meaning in
every day events, determines how
long a person wants to live.
Quality of life – one’s perception of their
position in life in context of their culture
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13. Changes in the Immune System
How does the defense system work?
How does aging affect the immune system?
Not well understood; more susceptible to infection and cancer
Aging is related to how well the system works.
Autoimmunity
Immune system can attack the body itself.
Rheumatoid arthritis
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14. Changes in the Immune System – cont.
Psychoneuroimmunology
Psychology
Neurological
Immunological system changes
(Cohen & Herbert, 1996)
AIDS and Older Adults
15,000 people over 65 have AIDS (CDC, 2008)
Rapid progression from HIV positive to AIDS
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15. Chronic and Acute Diseases
Acute Diseases
Conditions that develop over a short period of time and cause a
rapid change in health.
Example: UTI, strep
Go down in the elderly
Chronic Diseases
Conditions that last a long time (min. 3 mo.) and may be
accompanied by residual functional impairment that necessitates
long-term management.
Example: arthritis and diabetes
Goes up in the elderly
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16. The Role of Stress – bad for your health in the long run
Stress as a Physiological State
Sympathetic nervous system
(heart rate, respiration, blood flow, muscle strength, etc)
Impaired immune system, increase risk of cardiovascular
disease, increase risk of cancer
Gender differences? Men want to be alone, women want
to be with other people. (fight or flight vs. tend and befriend)
Stress and Coping Paradigm
Interaction of a thinking person and an event
(People experience stress differently)
Two people stuck in traffic – different levels of stress. Why?
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18. The Role of Stress (cont.)
Appraisal (Lazarus and Folkman, 1984)
Primary appraisal: categorize the event
Secondary appraisal: evaluate the event
Reappraisal: changes in the situation may change the
appraisal
Coping – dealing with stressful events
Death of a spouse
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19. The Role of Stress
Aging, Stress and Coping
Who has more stress? Older or Younger?
Management strategies
Avoid stressful situations
Change thinking about the situation
Relaxation techniques --- deep breathing
--- Progressive Muscle Relaxation
--- visualization
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20. Effects of Stress on Health
Short-term stress vs. long-term stress
Chronic Stress
Immune system suppression
Increased susceptibility to:
Viral infections
Risk of atherosclerosis
Hypertension
Impaired memory and cognition
Inhibited menstruation – women
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21. Learning Objectives
What are the most important issues in chronic
disease?
What are some common chronic conditions across
adulthood?
How can people manage chronic conditions?
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22. General Issues in Chronic Conditions
Common Chronic Conditions
Arthritis
Cardiovascular and Cerebrovascular Disease
(leading cause of death in US)
Diabetes Mellitus
Cancer
(2nd leading cause of death in US)
Risk increases with age – males at greater risk
Incontinence
More embarrassing than dangerous
15% community dwelling elders
35% community dwelling elders with dementia
70% nursing home residents
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26. Managing Pain
Myths and Stereotypes
Part of growing old
Elders should just accept the pain
How to manage pain?
Pharmacological
More meds than any other age group
½ all meds prescribed
Non-pharmacological
Therapeutic touch, massage, vibration, heat, cold
Acupuncture and acupressure
Biofeedback
Distraction techniques
Relaxation, meditation, and imagery
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27. Learning Objectives
What are the developmental trends in using
medication?
How does aging affect the way the medications work?
What are the consequences of medication
interactions?
What are the important medication adherence issues?
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28. Patterns of Medication Use
Explosion of new medication available
People over 60 take nearly 50% of all prescription and over
the counter medication.
New drugs can be dangerous to older adults.
New drugs are frequently very expensive.
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29. Developmental Changes and Medication
Absorption
Time needed for medications to enter the bloodstream
Once in the bloodstream the drug is distributed
throughout the body.
Drug Metabolism
Drug Excretion
Drugs not recommended for older adults
Good strategy: “start low and go slow.”
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30. Medication Side Effects and Interactions
Polypharmacy
The use of multiple medications in the same person
Interactions
Potentially dangerous
Adherence to Medication Regimens
Difficult with older patients
Many older patients go to more than one doctor so
accurate knowledge of drugs taken is important.
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33. Functional Health and Disability
Learning Objectives
What factors are important to include in a model of
disability in late life?
What is functional health?
What causes functional limitations and disability in
older adults?
Britain's Oldest Married Couple
Ralph – 107
Phyllis – 101
Married – 77 years
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34. Functional Health and Disability
Disability in Late Life
Definition of disability?
Effects of a chronic condition on a person’s ability to engage in activities
that are necessary, expected, or desired in their society
Compression of morbidity
Becoming disabled later with a shorter period of disability before death
A model of the disablement process
Interventions strategies:
Extraindividual factors – environmental & healthcare
(surgery, meds, social support services, physical environment support)
Intraindividual factors – behavioral & personality
(exercising, positive outlook,etc)
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36. Functional Health and Disability
Determining Functional Health Status
Determining Functional Health Status
Frail older adults
physical disabilities, very ill, cognitive decline or psychological
disorders, and need assistance with everyday tasks
*(minority of older adults; chance increases with age)
*Needs help with more than one ADL
Activities of daily living: ADL
basic self-care task – eating, dressing, bathing, toileting, walking
Instrumental activities of daily living: IADL
actions requiring planning & intellectual competence
(shopping, paying bills, taking meds correctly, keeping appointments)
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37. Functional Health and Disability
Limitations and Disability in Older Adults?
Strong predictors
Cerebrovascular disease
Arthritis
Coronary artery disease (weaker predictor)
Other predictors
Smoking
Heavy drinking
Physical inactivity
Depression
Social isolation and perceived poor health
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40. Functional Health and Disability
What Causes Functional Limitations
and Disability in Older Adults?
How Important are Socioeconomic Factors?
Do Gender and Ethnicity Matter?
Britain's Oldest Married Couple
Ralph – 107
Phyllis – 101
Married – 77 years
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