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CHAPTER FOUR Longevity, Health, and Functioning

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Presentation on theme: "CHAPTER FOUR Longevity, Health, and Functioning"— Presentation transcript:

1 CHAPTER FOUR Longevity, Health, and Functioning

2 Average Longevity for Men and Women in the US, 1900-2003
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.

3 Genetic and Environmental Factors in Average Longevity
Genetic Factors Living a long time runs in families Centenarians: people over 100 Research in Italy showed a connection between genetics and disease vulnerability/progression.

4 Genetic and Environmental Factors in Average Longevity
Disease Toxins Lifestyle Social class

5 Ethnic Differences in Average Longevity
Ethnic/cultural differences are complex and include varied access to resources for healthy living Socioeconomic status involves where one lives, education level, income level, occupation

6 Why do women outlive men by 7 years on average?

7 Gender Differences in Average Longevity
Women have nearly a seven year edge over men. 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?

8 International Differences in Average Longevity
Dramatic Differences in Longevity Around the World From 38 years in Sierra Leone, West Africa to 80 years in Japan Factors Genetic Sociocultural Economic Anything else?

9 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. Active life expectancy –the age to which one can expect to live independently Dependent life expectancy – the age to which one can expect to live with assistance

10 Changes in the Immune System
Our defense and immune systems help fight off foreign invaders in our body throughout life. Aging is related to how well the system works. Autoimmunity Immune system can attack the body itself. Rheumatoid arthritis Human Immunodeficiency Virus (HIV) – 15,000 people in US over 65 have AIDS

11 Changes in the Immune System
Psychoneuroimmunology The study of how psychological, neurological and immunological system changes affect a person’s vulnerability to contract or recover from disease. Acute Diseases Conditions that develop over a short period of time and cause a rapid change in health. Usually decrease in frequency with age May be harder to recover for older person Chronic Diseases Conditions that last a long time (min. 3 mo.) and may be accompanied by residual functional impairment that necessitates long-term management. Usually increase in frequency with age

12 The Role of Stress Stress as a Physiological State
Prolonged arousal (chronic stress) associated with: Viral infections Hypertension Impaired memory and cognition Inhibited menstruation – women Impaired immune system functioning Increased risk of cardiovascular disease Cancer

13 The Role of Stress Coping – dealing with stressful events
Stress and Coping Paradigm (Lazarus and Folkman, 1984) Interaction of a thinking person and an event Two people stuck in traffic – different levels of stress? Primary appraisal: categorize the event as irrelevant, benign/positive, or stressful Secondary appraisal: if stressful, evaluate the event and ones own ability to cope with harm, threat, or challenge Reappraisal: changes in the situation may change the primary or secondary appraisal

14 The Role of Stress Aging and the Stress and Coping Paradigm
Who has more stress? Older or Younger? Management strategies Reappraise situation Avoid stressful situations Try to counteract effects of stress with relaxation

15 Common Chronic Conditions
Arthritis –Most people over 60 have some form Cardiovascular and Cerebrovascular Disease – circulatory problems Diabetes Mellitus – occurs when pancreas produces insufficient insulin Incontinence – inability to control the elimination of urine and feces More embarrassing than dangerous Cancer – second leading cause of death Risk increases with age – males at greater risk

16 Cancer incidence crude rates, nine registries, 1973—2000
Figure 4.5 Cancer incidence crude rates, nine registries, 1973—2000

17 Managing Pain How to manage pain? Pharmacological Non-pharmacological
Non-narcotic and narcotic medications Non-pharmacological Therapeutic touch, massage, vibration, heat, cold Electrical stimulation to spine or pain site Acupuncture and acupressure Biofeedback Distraction techniques Relaxation, meditation, and imagery Hypnosis, self-induced or by another person

18 Pharmacology and Medication Adherence
How Medications Work Absorption - Time needed for medications to enter the bloodstream (can take longer to enter older person’s system) Once in the bloodstream the drug is distributed throughout the body (toxic levels more likely to develop in older person) Drug Metabolism- liver gets rid of medication in bloodstream Drug Excretion –kidneys create urine; also through sweat, feces, and saliva

19 Medication Side Effects and Interactions
Polypharmacy The use of multiple medications in the same person Interactions Potentially dangerous Good strategy: “start low and go slow.”

20 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. Good organization and attention to detail is important with any medication regimen.

21 Functional Health and Disability
Disability: the effects of chronic conditions on people’s ability to engage in activities that are necessary, expected, and personally desired in their society. (Verbrugge,1994) Compression of morbidity Becoming disabled later with a shorter period of disability before death

22 A model of the disablement process Extraindividual factors -environmental and health care Intraindividual factors -behavioral and personality Figure A model of the disablement process

23 Functional Health and Disability
Determining Functional Health Status Frail older adults: have physical disabilities are very ill may have cognitive or psychological disorders need assistance with everyday tasks Activities of daily living (ADL) include basic self-care tasks: Eating Bathing Toileting Walking Dressing Instrumental activities of daily living (IADL) are actions that involve some intellectual competence and planning.

24 Functional Health and Disability
What Causes Functional 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

25 Prevalence of disability and the need for assistance by age
Figure Prevalence of disability and the need for assistance by age

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