UCLA Cluster 80a Frontiers of Aging Midterm 1

longevity revolution

the 30 year gain in life expectancy since 1900, which happens to be the most dramatic shift in human history. Nearly equal to what had been attained over the preceding 5000 years of humna history

Measures of aging

Life span and life expectancy

life span

longest number of years any member of a species has been known to survive

life expectancy

the average number of years people in a given population can expect to live; the mean age at death

biomedical perspective

scientific advances that relate to health throughout life and increased independence

Social Perspective

familial support, social capital and the social environment

Public health and policy

leading causes of death, chronic conditions, risk factors and interventions, healthcare reform, health disparities

Gerontology

field of study that focuses on understanding the biological, psychological, social and political factors that influence people's lives

Geriatrics

clinical study and treatment of older people and the diseases that affect them

Chronological age

age measured in years since birth

Psychological age

based on cognitive abilities (memory, intelligence, maturity)

Biological age

based on physical function (ability/disability)

Social age

based on social roles and relationships (student)

Subjective age

you're as young as you feel

Active aging

A process that enables people to maximize opportunities for health, participation and security regardless of physical and cognitive decline so that they can maintain quality of life as they age.

Determinants of active aging

-economic determinants

-health and social services

-behavioral determinants

-personal determinants

-physical environment

-social determinants

Person-Environment Perspective

Continually changing environment as the older person modifies it and adapts to it

Environment press

load of physical and social environment on the person

Ageism

systematic stereotyping and/or discrimination because of age

Stereotyping

Composite of ideas and beliefs attributed to people as a group or social category. May be positive or negative

Discrimination

Action or behavior based on stereotypes that limits a person's opportunities, often in the workplace

Effect of Ageist attitudes

older: greater cardiovascular response to stress, worse health behaviors (smoking), less likely to recover from a sever disability

younger: greater likelihood of cardiovascular events

Biology

The study of living organisms, with reference to origin, growth, reproduction, structure and behavior

Psychology

The study of the mind or of mental states and processes

Sociology

The study of the origin, development, organization and functioning of society

bio-psycho-social perspective

the interaction of biological, psychological and social aspects of aging.

BIo- increased vulnerability, heredity/environment interactions, evolution of lifespan

Psycho- developmental stages, personal life events, coping and adaptation

Social- Role changes, economics, family & support networks, policy implications

heterogeneity

variation in quality

diminished reserve

Less resources to use. Bio resources, psycho resources and social resources. ex. heat wave/air con in europe = old people die

3 different frameworks

-biopsychosocial perspective

-lifecourse perspective

-systems perspective

How to study aging

cross-sectional (humans) and longitudinal (animal models)

individual cells, accidents of nature

Cross sectional

Collection of data on ppl of diff ages at one time

Longitudinal

study of same person over period of months and years

Progeroid syndromes

A group of rare genetic disorders that mimic physiological aging, making affected individuals appear to be older than they are.

-werner's syndrome

-hutchinson-gilford

-down syndrome

Lifecourse framework

An approach to the study of aging that emphasizes how the experiences of individuals (biography) interact w/ the individuals' place in the social system (sociocultural) and the historical period (sociohistorical) in which they live

Sociohistorical factors

Historical period: WW1, Great depression, cold war era

Sociocultural

sex, race/ethnicity, SES

Systems perspective

Stepping back to view an entire process to see how each component connects with the others.

cell->organ->organism (person)->group (family, ethnic group)-> organization (educational institution, health care)-> society (nation)-> supranational system (global)

Ex of living system processes

Boundaries: border delineating systems and sub-parts w/in systems

Feedback:information to allow self-regulation of the system

Equilibrium: dynamic interplay to create homeostasis or system balance

Public Health

science and art of preventing disease, prolonging life and promoting physical health and efficiency through focused community efforts

Public health interventions

activities to promote public's health and organized efforts of society

3 levels of prevention

*Primary prevention* - prevent before it even occurs. Aim to reduce the possibility of the client's encounter with the stressor or to strengthen the flexible line of defense *prevent it before it happens*

*Secondary prevention* - early screening. Begins after the stressor has occurred. Functions to ensure the appropriate treatment and decrease the negate impact of the stressor on the system *you have something and you treat it*

*Tertiary prevention* - Managing disease. Maintain system stability *long haul maintenance*

Modifiable risk factors

risk factors you can change like geography, exercise, life style, diet

Non-modifiable risk factors

genetics, age, gender, race, family history

Aging trends

weight ^

height v

muscle mass v

fat tissue ^

water content v

hair v

skin v -wound healing and temp regulation

obesity

waist circumference and bmi over 30

Diabetes

impaired ability to produce and respond to insulin

Insulin

produced by pancreas and secreted into bloodstream to signal cells to metabolize carbs

Repeated glucose spikes

contribute to heart disease, hypertension, nerve damage, kidney failure, vision problems and poor circulation

Endocrine system

coordinates bodily processes through hormones

A/C imbalance

anabolic (growth) < catabolic (break down)

TSH and GH decreased and melatonin only at night

leads to visceral adiposity

Ecologic model

russian dolls. contextualize risk factors and interventions.

Successful prevention of disease

leads to compression of morbidity

Compression of morbidity

a shortening of the time a person spends ill or infirm, accomplished by postponing onset of illness through primary prevention. Reducing lifestyle risks

3 factors of disability

lack of exerise, smoking, obesity

Reversal of compression may be caused by

growing rates of obesity and accompanying chronic illnesses

Cohort view of the world shaped by

historical period: events, opportunities, constraints

compositional characteristics: gender, ethnic, life expectancy, cohort size

structural characteristics: edu system, workplace, family

Issue in life course research

age/period/cohort problem

Age effect

change/event that occurs as a result of advancing age. "Age changes"

period effect

impact of a historical event on the entire society

cohort effect

impact of a group bounded by time or a common life experience "age differences"

Cross-sectional study

Advantages: cheaper, no waiting, no attrition

Disadvantages: Can't separate age and cohort effects, Life-course fallacy

Life-course fallacy

erroneously assuming that cross-sectional age differences refer to process of aging

Longitudinal design

follows same group of ppl over time

advantages: allows analysis of long-term indiv changes. More suitable for aging research

disadvantages: high cost, attrition and selective survival

Social determinants of health

condition in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life

5 social determin

-Neighborhood and built environment

-Health and health care

-Social and community context

-Education

-Economic stability

Neighborhood and built environment

-Access to health foods

-Crime/violence

-Environment

-Housing

Health and Health Care

-Access to health care

-Health literacy/management

Social and Community context

-Civil engagement

-Discrimination

-Social cohesion

Education

-Development

-Attainment

-Literacy

-Optimism

Economic Stability

-Housing/food

-EMployment

-Poverty

How can education affect health?

Edu-> health knowledge, income, status

-> smoking, diet, exercise, housing, coping, behavior, resources

Social determinants

Physical conditions, social identity, behaviors, gov programs

Income and education

less relevant in older populations

Upstream factors related to aging population

-social engagement

-aging friendly neighborhoods

Interventions w/ most impact on older adults

-Educational

-Employment/volunteer opportunities

-Benefits/retirement policies

-Neighborhood conditions

5 theories of aging

-wear and tear

-antagonistic pleiotropy

-immunological theory

-free radical theory

-cellular senescence theory

Antagonistic pleiotropy

A gene/process can have several difference effects w/in an organism. Reproductive hormones and late life cancers

Replicative senescence

the loss of the ability of cells to reproduce. We age as cells slow replication. Telomeres shorten and stop, lose DNA and RNA. Occurs in vivo

Hayflick limit

the maximum number of times a cell can divide before dying. 40-60 replications. Through in vitro experiments w/ normal human somatic cells. Go into growth arrest.

Telomerase

An enzyme that have protein and RNA. catalyzes the lengthening of telomeres. The solution to the "end replcation" problem. Present in >85% of tumors. In bone marrow stem cells, germ cells and immune cells

Fibroblasts

Cells in connective tissue that produces collagen and other fibers. Cells w senescent markers increase in frequency in samples from elderly donors. Rate of wound healing decreases with age.

Senescent fibroblasts

produces collagenase, which is an enzyme that destroys collagen. Enhances growth of tumor cells w/ favorable environment

Cellular aging can interfere w proper organ function

vasculature- atherosclerosis

lymphocytes- immuno deficiency

Cancer's greatest risk factor

age

Why cancer is related to aging

-6-7 mutations have to accumulate before becoming a tumor

-accumulation of senescent fibroblasts make a favorable environment

-decline in immuno surveilance

Four major cancers in older people

Lung, prostate, breast, colorectal

Non-modifiable risk factors of breast cancer

age, race, sex, family history & genetics, early menarche and late menopause

Modifiable risk factors of breast cancer

older at first pregnancy, nulliparity (never had a baby)

Demographic transition

changes in a population's age structure from "young" to "middle age" to "old"

Demography

study of the characteristics of human populations such as size, growth , density, distribution adn vital statistics

Demographic transitions based on 3 shifts in population

-fertility

-mortality

-migration

Replacement rate

2.1

fertility

average number of children born to a woman over her lifetime

fertility rate

# live births in a year/ # of (15-44 yo) women in the year

Mortality rate

deaths in a population. # deaths in a year/ # ppl in same year

Leading causes of death

overall: heart disease

Depends per group

Migration

establish criteria/boundaries of region. Higher immigration of certain groups add to the changing age structure/pyramid of the US

Stages of demographic transition

1.High fertility rates/ high death rates

2.High fertility rates/ declining death

3. low fertility/low death

Changes that create an aging society

- societal level: better food supply, clean water, sanitation

- public health interventions

Epidemiological transition

changes in a population's age structure due to disease patterns. mortalities, and other factors.

from infectious disease to chronic illnesses