Lecturer: Dr. Joana Salifu Yendork Department of ...€¦ · –Osteoarthritis is age-related –Rheumatoid arthritis is not strictly an age-related disease. •Can affect young and

College of Education

School of Continuing and Distance Education 2014/2015 – 2016/2017

Longevity, physical health and functioning

Lecturer: Dr. Joana Salifu Yendork, Department of Psychology

Contact Information: [email protected]

Session Overview

• Ever wondered why some people live older than others or what factors explain the disparity between differences in years of life? These questions can be answered through an understanding of the concept of longevity. The session will also introduce students to some common age-related physical illness and strategies for maintaining health and preventing illnesses.

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Session Outline

The key topics to be covered in the session are as follows:

• The concept

• Health and illness

• Common chronic conditions

• Ageing and medication

• Health maintenance and disease prevention

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Reading List

• Read Chapter 3 of Recommended Text – Adult development and aging, Cavanaugh & Blanchard-Fields (2006).

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THE CONCEPT OF LONGEVITY Topic One

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Understanding longevity: Life expectancy

• Longevity is the number of years one lives, as jointly determined by genetics and environmental forces (Cavanaugh & Blanchard-Fields, 2006)

• Types include: – Average longevity (average life expectancy): the age at which half of the

individuals who are born in a particular year will have died • Affected by genetic and environmental factors

• Increased in USA

– Linked to decline in infants mortality rates by elimination of diseases, better health care, maternal mortality

– Maximum longevity: oldest age to which any individual of a species lives • Eg. Methuselah-969 years

• Most scientists estimate about 120 years when diseases are eliminated Slide 6


• A distinction also made between: – Active life expectancy: living a healthy old age

– Dependent life expectancy: simply living a long time

• Active life expectancy ends when one loses independence or rely on others for most activities of daily living

• These depend on interaction of genetic, environmental, ethnic and gender factors – Genetic factors: having long-lived family members

– Environmental factors: diseases, toxins, lifestyle and social class

– Ethnic factors: ethnic differences in average longevity • Compared to European Americans, the average longevity for African

Americans is 6.5 years lower for males and 5 years lower for females

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• Active life expectancy is also dependent on:

• Gender: women live longer than men (for industrialized countries but not developing countries) – Men in developed countries:

• more causes of death,

• infectious diseases,

• biological reasons (2 chromosomes in women and higher metabolic rates in men)

– Women in developing countries: • maternal mortality,

• infanticide of baby girls,

• access to health care,

• work and educational opportunities,

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HEALTH AND ILLNESS Topic Two

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Health and illness

• Health is defined as the absence of acute and chronic physical or mental disease and impairments (Deeg et al., 1996).

• Illness is the presence of a physical or mental disease or impairment.

• Quality of Life: multidimensional concept encompassing biological, psychological, and sociocultural domains at any point in the life cycle

– quality of life in the context of specific diseases conditions

– quality of life relating to end-of-life issues.

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Ageing in the immune system • Immune system comprise 3 cells

– Cell-mediated immunity (consisting of T-lymphocytes) • produce antibodies to attack infected and cancerous cells, as well as rejecting foreign tissues

– Humoral immunity (B-lymphocytes) • produce specific antibodies that can bind and inactivate viruses

– T- & B-lymphocytes fight against cancerous cells, viral infection, fungal infection, and some bacteria

– Non-specific immunity (monocytes & polymorphonuclear neutrophil leukocytes)

• Immune system changes mostly occur in the lymphocytes – Immune system takes longer to build up defenses against diseases (associated with changes

in T-lymphocytes) – Decrease in functioning of B-lymphocytes

• Immune system changes lead to: – Older adults become prone to serious consequences of illnesses – Increase in various forms of leukemia with age – Autoimmunity: immune system attacking itself

• Results from an imbalance of B- and T-lymphocytes

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Ageing and stress

• Stress could be: – specific physiological responses (Gewirtz et al., 2002) – evaluation of events in the context of available resources (Lazarus & Folkman,

1984) – a property of specific events, such as the death of a partner (McLeod, 1996)

• As physiological response, prolonged exposure can damage the sympathetic nervous system (controls heart rate, respiration, perspiration, etc): – cardiovascular disease – impaired immune system function – some forms of cancer

• From Lazarus and Folkman perspective, stress is an interaction of appraisal and an event – Appraisal is more important than the event itself – May explain age-related difference in the experience of stress

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Ageing and stress

• Younger adults experience more stress in the areas of finance, work, home maintenance, personal life, family, and friends than do older adults. – Catering for young children and job

– These factors may be absent in old age

• For the aged, stress mostly result from difficulty getting around, doing activities of daily living

• Age-related differences in coping – The aged tend to use past experiences as a guide

– E.g., younger adults tend to use defensive strategies whereas older adults chose strategies based on their perception of personal control over the event

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Stress and well-being

• Short-lived and less intensive stress may have little or no effect on health

• Chronic or severe stress can lead to

– immune system suppression

– Increased risk of atherosclerosis and hypertension

– impaired memory and cognition

– Inhibition of menstruation in women

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COMMON ACUTE AND CHRONIC CONDITIONS

Topic Three

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Acute and chronic diseases

• Acute diseases: conditions that develop over a short period of time and cause a rapid change in health – E.g., Malaria, colds, influenza, food poisoning

– Can be cured with medications or allowed to run its course

• Chronic diseases: conditions that last longer period of time (at least 3 months) and may be accompanied by residual functional impairment that necessitates long-term management – E.g., arthritis and diabetes mellitus

• With age, the rate of acute diseases reduces and chronic ones increase – higher risk of death from acute disease due to decline in functioning

of immune system Slide 16

Common chronic diseases

• Causal factors include heredity, age-related changes, individual’s coping strategies, inadequate health care, stress, lifestyle, among others.

• Unknown Consequences include: • Loss of function and mobility • Loss of independence • Disability • Pain • Death

• Examples: – Diabetes – Heart Disease – CVA – Arthritis – High blood pressure – Cancer – Low Vision and hearing – Kidney Disease

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Common chronic conditions

• Arthritis: About 60% of the aged experience some form of arthritis – Osteoarthritis is age-related

– Rheumatoid arthritis is not strictly an age-related disease.

• Can affect young and middle-aged adults

– Symptoms include stiffness and chronic pain and may result in deformity and loss of independence

• Diabetes Mellitus: Insufficient insulin production in the pancreas

– Type I: develops early in life and requires insulin use

– Type II: develops in adulthood and can be managed through diet

• May result in nerve damage, diabetic retinopathy kidney disorders, cerebrovascular

accidents (CVAs), cognitive dysfunction, damage to the coronary arteries, skin

problems, and poor circulation in the arms and legs, atherosclerosis and coronary heart

disease

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• Osteoporosis: increased porosity and brittleness of bones due to loss of minerals in the bones and reduced bone mass that accompanies aging – 4 times more common postmenopausal women than in men – more common among whites and Asians than among blacks

• May result in – chronic pain in the joints of the lower spine and hips – a height reduction of several inches – other skeletal deformities (eg, dowager’s hump) – an increased danger of fractures to the vertebrae, hips, ribs, and

wrists

• Associated with chronic hyperthyroidism, long-term steroid therapy, and heredity

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• Heart disease – Principal cause of death among older adults

– Accounts for significant morbidity, disablement & inactivity among older adults

• Dominant factor: atherosclerosis (build-up of fatty deposits within arterial walls) – Atherosclerotic buildup

– Narrowing of arteries supplying blood to the heart

– ISCHEMIA (denial of adequate blood supply)

• Heart attack may also result from: – Cardiac arrest: some interruption of normal pattern of cardiac contraction

– Coronary thrombosis- sudden blockage of coronary artery with a blood clot

– Strenuous exercise resulting in suddenly increased need for O2

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• Modifiable risk factors:

– Cigarette smokers

– High BP

– High serum cholesterol levels

– Diabetes

– Obesity

– Sedentary lifestyle

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• Cancer: second leading cause of death in USA • Incidence increases with age because:

– Most forms of cancer have a long latent period; initiating factors start during youth

– increasing age and accompanying physiological changes make one more susceptible to actions of carcinogens (cancer causing agents, e.g., radiation)

• Actual cause is unknown but possible causes include – cumulative effects of exposure to pollutants, – Exposure to cancer-causing chemicals

• Some forms such as lung cancer may be caused by lifestyle

• May result in illness, disability, and death.

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• Incontinence: inability to control elimination of urine and faeces on occasional or consistent basis

– Urinary incontinence is the most common

• Five main causes include:

• Stress incontinence: when excessive abdominal pressure exceeds the ability to resist urinary flow

• Urge incontinence: central nervous system problem after a cerebrovascular accident or urinary tract infection

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• Overflow incontinence: improper contraction of the kidneys, causing the bladder to become over bloated

– Causes: drugs, tumors, and prostate enlargement

• Functional incontinence: due to physical disability or cognitive impairment although urinary tract is intact

• Iatrogenic incontinence: medication side effects

• In general, incontinence result in social isolation and lower quality of life

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• Cerebrovascular disease: results when a portion of the brain is completely denied of blood (stroke)

• Severity is determined by location and total amount of brain tissue involved

• Common types are: – Ischemic stroke: occurs when blood clot blocks a blood vessel in

the brain

– Hemorrhagic stroke: occurs when a blood vessel burst and bleeds into the brain

– Transient ischemic attacks/mini strokes: occurs when the blood supply to the brain is briefly interrupted

• The fourth-leading cause of death in the U.S.

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• Symptoms include: – Sudden numbness or weakness of face, leg, or arm – Sudden confusion, trouble speaking or understanding speech – Sudden trouble seeing in one or both eyes – Sudden trouble walking, dizziness, loss of balance or coordination – Sudden severe headache with no known cause

• Result from: – cerebral infarction (dead tissues) – cerebral hemorrhage (excessive bleeding) – a cerebrovascular accident (CVA) – Cerebral thrombus (blood clot) forms elsewhere in the body and

travels to obstruct a vessel supplying the brain – changes in blood vessels that serve the brain tissue

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• The onset of stroke and its damage is immediate

• Damages from stroke include:

– One-sided weakness or paralysis

– Sensory disturbances

– Aphasia (speech disorders)

– Mental symptoms

• WORK\Second Sem_2016-2017\PSYC 336\SLIDES\VIDEOS\Stroke.mp4

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WORK/Second Sem_2016-2017/PSYC 336/SLIDES/VIDEOS/Stroke.mp4















• Aphasia: impaired ability to comprehend or express verbal language following CVA

• Expressive (Broca’s) aphasia – A person understands what is said but cannot form the words or

gestures to respond to stimuli

– May be incorrectly associated with mental deterioration

• Receptive (Wernicke’s) aphasia – difficulty in processing external stimuli;

– may not understand other’s speech or what is read

– familiar objects may become unrecognizable

• Global aphasia encompasses both receptive and expressive aphasia

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AGEING AND MEDICATION Topic Four

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Aging and medication

• There are age-related changes in medication absorption, distribution, metabolism, and excretion

• Absorption: time needed for medications to enter the bloodstream. – Longer in older adults and may result in over or under absorption depending on

the drug

• Distribution: dispensing of medication through out the body once in the blood stream – Effectiveness of drug depends on the balance between the portion that binds

with plasma protein and amount that remains free – With age, less portion binds with plasma protein and more portion remain free

• This lead to easy build up of toxic levels

• Metabolism: getting rid of medications in bloodstream – Slower rate with age and can create possible toxicity if medication schedule take

into account

• Excretion: slower time of excretion and can lead to possible toxic effects

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• Due to high rate of medication use, coupled with age-related changes, older adult have the highest risk of adverse drug effects

• Polypharmacy (the use of multiple medications) can also be dangerous because:

– many medications do not interact well

– the action of some drugs is enhanced in combination with others, whereas other drugs may not work at all in combination

– Drug interactions may create secondary medical problems and the primary condition may not be treated as effectively

– Drug interaction may induce symptoms similar to other diseases Slide 31


• Adherence to medication regimens becomes problematic

– Due to memory problems

– Number of medications to be taken

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HEALTH MAINTENANCE AND DISEASE PREVENTION

Topic Five

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Health maintenance and disease prevention

• Proper exercise can enhance wellbeing and prevent diseases

• Walking, swimming, jogging, and other moderate aerobic exercises – reduce the severity of system disorders

– reduced body fats, poisons, blood pressure, the response times of body cells and organs, and nervous tension

– enhances one’s sense of wellbeing, feelings of self-efficacy and control, the ability to cope with psychologically stressful situations, and general psychological health

– Reduce depression, anxiety and other psychological disorders

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Health maintenance and disease prevention

• Nutritional awareness

– Reduction in calories and increase in proteins, vitamins and mineral at recommended levels can prevent many diseases and slow the aging process

• Long-term health care

• Effective stress management

• Lifestyle changes:

– Refraining from or reducing cigarette smoking and consumption of alcoholic beverages

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Sample Questions

• Distinguish between average longevity and maximum longevity.

• State three components of the immune system and describe the function of each.

• Enumerate two age-related changes in the immune system/in what two ways can aging affect the immune system.

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References

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Documents

Lecturer: Dr. Joana Salifu Yendork Department of ...€¦ · –Osteoarthritis is age-related –Rheumatoid arthritis is not strictly an age-related disease. •Can affect young and