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1. 114 Mary Jo Ray 1 of 40
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? 2 of 40
3. Average Longevity 1900-2003 80 yrs 74 yrs 3 of 40
4. Maximum Longevity House mouse, 4 Dogs, 29 Cats, 36 Polar
bears, 42 Horses, 62 Chimpanzees, 59Average 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. 4 of 40
5. Genetic and EnvironmentalFactors in Average Longevity
Genetic Factors Family History Cant pick your history Environmental
Factors Disease Toxins Lifestyle Social class 121 We can control
most Jeanne Calment 5 of 40
6. Ethnic Differences Are ethnic differences associated with
genetics? Is that the only association? The differences are
complex. Sociocultural, economic conditions, healthcare disease,
etc 6 of 40
7. Gender Differences in Average LongevityWomen 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? 7 of 40
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? 8 of 40
9. International Data on Life Expectancy 9 of 40
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? 10 of 40
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. 11 of 40
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 persons 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 ones perception of
theirposition in life in context of their culture 12 of 40
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 13 of 40
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 14 of
40
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 15 of 40
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? 16 of 40
17. 17 of 40
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 18 of 40
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 19 of 40
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 20 of 40
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? 21 of 40
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 22 of 40
23. Cancer Incidence Rates 1973-2000 23 of 40
24. Leading Sites of New Cancer Cases 24 of 40
25. Cancer Rates by Race & Ethnicity 25 of 40
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 all meds
prescribed Non-pharmacological Therapeutic touch, massage,
vibration, heat, cold Acupuncture and acupressure Biofeedback
Distraction techniques Relaxation, meditation, and imagery 26 of
40
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? 27 of 40
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. 28 of 40
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. 29 of 40
30. Medication Side Effects and Interactions Polypharmacy The
use of multiple medications in the same person Interactions
Potentially dangerousAdherence to Medication Regimens Difficult
with older patients Many older patients go to more than one doctor
so accurate knowledge of drugs taken is important. 30 of 40
31. Example of a Drug Regimen 31 of 40
32. 32 of 40
33. Functional Health and DisabilityLearning 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? Britains Oldest Married Couple
Ralph 107 Phyllis 101 Married 77 years 33 of 40
34. Functional Health and DisabilityDisability in Late Life
Definition of disability? Effects of a chronic condition on a
persons 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) 34 of 40
35. Model of theDisablement Process 35 of 40
36. Functional Health and DisabilityDetermining 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) 36 of 40
37. Functional Health and DisabilityLimitations 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 37 of 40
38. Percentage of Medicare Enrollees Age 65 and Older 38 of
40
39. Disability and the Need forAssistance 39 of 40
40. Functional Health and DisabilityWhat Causes Functional
Limitationsand Disability in Older Adults? How Important are
Socioeconomic Factors? Do Gender and Ethnicity Matter? Britains
Oldest Married Couple Ralph 107 Phyllis 101 Married 77 years 40 of
40