Download Three categories of aging

Three categories of aging
 Young-old: older people who are in generally
good health, financially secure, socially
integrated; age range usually 75 or younger
but can vary.
 Old-old: typically over age 75; suffer from at
least one debilitating physical, psychological,
or social deficit; require supportive health
care
 Oldest-old: 85+; dependent on other people
for almost everything.
Aspects of aging
 Biological: age-related changes in
appearance, vision, agility, strength
 Psychological: adjusting to physical changes
that accompany aging, coming to terms with
memory loss & reduction in reaction times
and information-processing
 Social: changes in our self-concepts from
growing old, which reflect cultural beliefs and
changing social values.
What bothers people about
getting old?
 Main fear—becoming dependent on
other people due to mental decline;
increasing isolation and loneliness
 Most of us have a need to remain
intellectually vigorous and socially
connected to others; the threat of losing
these things is paralyzing.
 Most dread going to a nursing home.
Physical changes in aging
 Hair becomes thinner
 Skin becomes less elastic, more wrinkled and
dry; may have “age spots”
 Hair turns gray (body loses ability to produce
melanin, the pigment that colors hair.
 Hair turning gray correlates more
accurately with biological age than any
other physical change.
 Older adults lose an inch or so in height and
several pounds in body weight because of a
decline in bone calcium & loss of muscle
Sensory changes
 Vision changes—pupil becomes smaller and
lens cloudier; presbyopia (become more farsighted)
 Hearing loss—25% of adults between 50 and
80 suffer significant hearing loss; declining
ability to hear high-pitched sounds is called
presbycusis.
 Smell & taste decline with age. Old people
lose taste buds.
Physical peak and decline
 People reach physical peak around age 30.
 After that, they’re in a period of senescence—
a gradual decline in physical strength,
sensory acuity, reaction time, and
cardiovascular strength.
 Rate of senescence depends on genetics and
health habits. You can slow it down by
lifestyle changes.
Signs of senescence
 Reduced lung capacity
 Increased body mass index due to loss of
lean body mass (starting at age 20, you lose
7 lbs of muscle tissue per decade; this rate
accelerates after age 45)
 Loss of muscle strength
 Decreased metabolism
 **Eating well and exercising will prevent or
reverse these declines.
Aging and Disease
 80% of people over age 70 have at
least one chronic health condition
 Biggest killers of older people: heart
disease, cancer, stroke
 People get sick when they’re old
because their immune systems have
decreased.
Chronic health conditions from
most to least common
 Arthritis
 Hypertension
 Hearing impairment
 Heart disease
 Cancer
 Cataracts
 Diabetes
 Stroke, visual impairment, and varicose veins
(equal in frequency)
Memory and intelligence
 Neural processing slows with age
 Memories begin to decay.
 By age 80, people have lost 5-7% of brain
weight
 Intelligence doesn’t really decline with age,
but there are wide differences in how you use
your intelligence in later years.
 Use it or lose it--By remaining intellectually
active, you can prevent decline in intellectual
or processing abilities.
Dementia and Alzheimer’s
Disease
 Dementia is a dramatic deterioration in
reasoning ability and memory, caused
by strokes, tumors, brain infections,
alcohol abuse, or Alzheimer’s Disease.
 The leading cause of dementia
(accounts for 57% of all dementias)
 AD strikes 3% of population by age 75
and kills 100,000 Americans each year.
Symptoms of AD
 First stage: subtle cognitive changes,
especially in short-term memory.
Routine tasks become harder.
 Second stage: Impairments in a number
of higher mental functions (reading,
writing, arithmetic)
 Third stage: seizures and striking
changes in language
Aphasia and apraxia
 Aphasia: can’t find the right word to
express thoughts
 Apraxia: loss of memory for muscular
movements, such as brushing teeth;
can’t carry out basic “activities of daily
living”
 These are the two criteria most often
used to informally diagnose AD.
Differences of AD brain in
autopsy
 Currently, an autopsy is the only definitive test
for AD. MRI can provide clues, though.
 Neuritic plaques seen on autopsy: clumps of
degenerative nerve cells.
 Neurofibrillary tangles are seen as well.
 Plaques and tangles appear mostly in the
part of the brain that produces acetylcholine,
which is found in reduced levels in people
with AD.
What causes AD?
 Genetic vulnerability is a big factor.
 No one knows the cause, but the reduction of
acetylcholine seems to be involved.
 Drugs such as Tacrine, Aricept, and Namenda
slow the rate of decline by increasing neural
activity in remaining healthy acetylcholine
neurons.
 Regular use of ibuprofen and antiinflammatories may ward off AD by
preventing brain inflammation.
Depression in older people
 Slightly more common in older people than
rest of the population (1 in 6 will suffer clinical
depression in the older population)
 Generalized anxiety also more common
 Depression is more likely because of activity
restriction due to chronic illnesses, grief over
loss of loved one, financial problems, and
lack of social support.
 Nursing home residents are especially prone
to depression.
Death
 Older people die of degenerative diseases—
cancer, stroke, heart failure, or just general
decline that predisposes them to infectious
disease or organ failure.
 Actual death in older people is usually easier;
the terminal stage is shorter because there’s
more than one biological competitor for
death.
 More likely than other age groups to achieve
death with dignity.
Why do some people live into
their 90s and 100s?
 Some people are less likely to have
preexisting or chronic health conditions due
to stronger genetic/biological constitutions.
 Psychosocial conditions are important—those
with close family ties live longer, especially
ties between a widowed parent and adult
children.
 Reduced satisfaction with life and depression
predict health declines among elderly.
Women living longer
 Women live about 6 years longer than men.
 Women may be more biologically fit than
men. Could be something protective about
the X chromosome or something about
estrogen & prolactin.
 Male death rates are higher at all ages of life.
More likely to take risks.
 Women have more social support than men,
which offers a protective benefit for them.
Health focus for elderly
 No longer on the reduction of mortality
 Focus is more on improving the quality
of life.
Is there a right to die?
 1990: Congress passed Patient Self-
Determination Act, requiring that Medicare
and Medicaid health care facilities have
written policies and procedures concerning
patients’ wishes for life-prolonging therapy.
(Includes DNR: do not resuscitate)
 Derek Humphrey’s book Final Exit, which is a
how-to manual for how to commit suicide or
assist suicide for the dying. Huge seller.
 1975: 41% of Americans believed that
someone in pain with a terminal illness had a
right to die; in 1999, 61% believed it.
Euthanasia vs. Assisted
Suicide
 Euthanasia: the act of ending someone’s life
who is suffering from a painful terminal
illness; illegal in the U.S. but legal in some
countries.
 Assisted suicide: helping someone commit
suicide (“victim” has more control over the
situation and actively chooses to die)
 Public support for assisted suicide is
increasing; for euthanasia, it’s decreasing.
Stages of Dying (Kubler-Ross)
 Denial
 Anger
 Bargaining
 Depression
 Acceptance
 This is not really a stage-like process;
people can skip stages or omit some.
Can go back and forth.