3620 - Study Guide for Exam 1

treatment of AD

treatment of AD

medications, behavioral and functional interventions, memory aids, personal care

medications to treat cognitive symptoms

cholinesterase inhibitors (Aricept, Exelon, Razadyne)

memantine (Namenda)

Aging

Refers to the orderly changes that occur in both physiological and behavioral function across the adult years

three options for personal care

family care

nursing home/skilled nursing

in home health care

Developmental psychology

The study of age-related interindividual differences and age-related intraindividual change; the study of human development

Goals: describe, explain, predict, and improve or optimize age-related behavior change

Gerontology

discipline dedicated solely to aging; hybrid degree

Reasons to study aging

Academic interests

Personal interest

Service/altruistic interests

People are living longer

We are currently experiencing the “graying of America”

Psychological processes are an important part of the human experience and change as we age, including memory and cognition; life satisfaction and happiness; mental health (depression, dementia); relationships

You, your family, and friends will grow old

Intra-individual change

changes that occur as we change

age-related changes that occur within individuals

Interindividual difference

how people differ

differences in the way that groups of people age

Graying of America

the idea that older adults are increasing in numbers and percentage compared to other age groups

implications of the graying of America

social security, society, medicare

reasons why people are living longer

improvements in hygiene and sanitation

disease control (antibiotics)

other medical advancements

we are living in a safer country than we used to

life-span developmental approach

three assumptions:

development is a lifelong process

development is a process of adaptation

development is multidirectional

Traditional view

aging is characterized by maturity, deterioration, losses, death

life expectancy

refers to the average predicted length of life

longevity

refers to the number of years an individual actually lives

concept of age

age is a multidimensional concept

chronological age

the number of years that have elapsed since a person’s birth

how old we actually are

biological age & biomarkers

estimate of the individual’s position with respect to their potential life span

involves measuring the status of an individual’s vitality or neurobiological health

genetic information, how old the body is

psychological age

an individual’s adaptive capacities - the ability to adapt to changing environmental demand

social age

refers to the social roles and expectations people hold for themselves as well as those others impose on them

age stratification; changes to the age pyramid

20th century in undeveloped countries, the number of people in different ages in a society, you typically see a pyramid but in developed nations the pyramid squares are turning more into a pyramid rectangle

the pyramid has “squared” in developed nations = longer life expectancies; less deaths

life expectancy: sex differences

In the U.S.: females begin to outnumber males at age 25

about 61% is female in the population ages 75 and older

about 70% is female in the population ages 85+

women live approximately 5 years longer due to biological and social reasons; they get more checkups and live healthier lives while men live a more dangerous life (job wise)

more deaths by violence, war and vice (drug and alcohol abuse)

demographics of our aging society compared to the past and compared to other countries

US population is growing (higher birth rates = larger population)

pushes economic growth

US population is more ethnically diverse

Japan has a lot of older adults - in the 80s, Japan was the China of today

The U.S. is not among the “oldest” countries

stereotyping

assumptions about individuals based on perceived membership and established beliefs about that group

negative stereotyping

many studies show increasing variability with age; the outcome of aging is not always declining

internalization

if a person is continually presented with a negative image of growing old, the person will come to believe that image - people accept socially constructed images and behave accordingly

ageism

discrimination against an older person based on that person’s age or perceived age

firing in the workplace

companies want to get rid of older workers because they are more expensive; have lack of motivation; slower; and more prone to mistakes

hiring in the workplace

most applications don’t ask for age, just if you’re over 18

benefits in the workplace

have been cut back: life, health, and disability insurance; pension plans, employer contributions

elderspeak

characterized by: slow speech, simplified sentence structure, over pronunciation, raised voice, clarification strategies, demeaning emotional tone

based on belief that older person is hard of hearing or slow to understand

age irrelevant society

age matters less than it used to

suggests that people are becoming somewhat more enlightened about aging processes

cross-sectional studies

compare different groups who are different ages for their performance

most popular design

people from different age groups are tested at the same time

advantages of cross-sectional studies

economical and efficient

useful when cohort effects are small or nonexistent

few problems with attribution

disadvantages of cross-sectional studies

no direct evidence of age change, cohort effects, often biased against the old

longitudinal studies

studies age change

individuals are tested on two or more occasions to track age-related changes within individuals

advantages of longitudinal studies

examines age change, can be used to chart individual development

disadvantages of longitudinal studies

expensive and time consuming

time of measurement effects, practice effects, attrition, positively biased for older adults

progeria

caused by a mutation that occurs in the Lamin A gene

genetic disease which speeds up the process of aging

results in weakened cell walls which succumb more easily to biological pressures; cells die off more rapidly than new stem cells can be made

why do we age?

reasons or causes for aging are often specific to the processes that operate at particular levels

genetic switching theory

suggests that certain genes cease to operate, or switch off, causing aging

info needed to produce DNA is no longer available, so the cells atrophy

genetically programmed events: genes turn on & off at certain ages; these switches engage the aging process; study of centenarians

immunological changes

the immune system loses ability to produce antibodies

autoimmune diseases

T cells can accidentally kill off good cells

osteoarthritis causes deterioration of joints and results in pain and disability

cross-linking (glycosylation)

binding of glucose (simple sugars) to proteins

cells become bloated with cross-linked material and become ineffective

cellular garbage theory

our cells over time become ineffective

Telomere shortening and the Hayflick limit

Leonard Hayflick observed that cell division is limited

in cells that reproduce, the tip of the DNA molecule shortens with each cell division

free radicals

hinges on the fact that certain molecules within a cell display a violent reaction when they encounter oxygen

an atom or molecule that has a single unpaired electron

causes oxidative damage

free radical theory

asserts that organisms age because cells accumulate free radical damage over time

what to do to prevent free radicals

antioxidants, berries, dark chocolate, vitamins (rich in antioxidants)

beta amyloid effects

builds up in neural tissue

kills neurons located in its vicinity

skin aging

as we age our skin changes

baldness

growth of ear and nose hair

loss of muscle tissue

aging around the eyes

age spots (due to exposure to sun)

3 kinds of skin cancer

basal cell carcinoma

squamous cell carcinoma

melanoma

basal cell carcinoma

develops from abnormal growth of the cells in the lowest layer of the epidermis

most common

treatable, may come back but can be treated again

squamous cell carcinoma

affects cells in the middle layer of the epidermis

usually treatable

melanoma

occurs in the melanocytes (cells that produce pigment)

leading skin related cause of death

muscle and skeletal aging

lose height (around the late 60s and after)

spine starts to curve in older adults

change in weight - women usually gain weight to about 65 and then start to lose and men gain weight until 55 and then start to lose

50% loss of muscle by age 70

osteoporosis

affects bone density

affects 1 in 5 women over 50

50% of women will have a fracture of the hip, wrist, or spine

lose balance + trips/falls

arteriosclerosis

hardening of the arteries

may result in high blood pressure

atherosclerosis

buildup of fats in and on artery walls (plaques)

can restrict blood flow and cause heart attacks

exercise: 3 types

aerobic

strength training

light stretching

aerobic

constant motion to raise heart rate and exercise muscle groups

30-40 minutes

strength training

light weight training approximately 20 reps

light stretching

stretch large muscle groups

dietary recommendations

maintaining a healthy diet that includes vegetables and maintaining body weight at the low end of the normal range can delay cognitive impairments and the onset of disease

importance of sleep

lack of sleep can negatively affect health and effective cognitive function at any age

sleep hygiene recommendations

have a dedicated, dark, and quiet sleeping environment

do not read, watch TV, or work in bed

have comfortable bedding

keep a regular sleep schedule

avoid extended naps; limit naps to 30 minutes

avoid alcohol, caffeine and heavy, spicy,, or sugary foods 4-6 hours before bedtime

exercise regularly, but not right before bedtime

do an activity until you feel sleepy

retina

back of the eye

cornea

flattens, becomes less sensitive to irritable stimuli, more permeable

presbyopia accommodation (changes in lens)

old vision

changes in lens ability to accommodate

accommodation

the process of focusing on close objects by changing shape of lens

blue blindness

lens yellows

cataracts

lens become opaque over time

leads to blindness

genetic link

treated surgically by replacing lens

most older adults will get this if they live long enough

glaucoma and treatment

results from increasing pressure inside the eye, which eventually causes irreparable damage to the retina and the optic nerve

can be treated with eye drops

macular degeneration

loss of cells in the fovea

blindness spreads from center outward

leads to blindness

disease predicted by genes, diabetes, age

more disturbing than glaucoma

when you focus on something, you won’t be able to see it

acuity changes

declines from 20:20 to approximately 20:40

visual slowing

system slows by almost 50%

aids for poor vision

wear sunglasses in bright light

bifocals to correct for myopia & presbyopia

magnifiers & large print publications

low vision aids

increase lighting in hallways and rooms

outer ear

penna (direct sound), auditory canal

middle ear

ear drum

ossicles

inner ear

neural pathways (auditory nerve)

ossicles

small bones that transfer (conduct) sound (vibration)

malleus

incus

stapes

cochlea

fluid filled

oval window (receives mechanical impulses from bones)

round window (end of tube)

basilar membrane (lined with hair cells)

hair cells (bend and fire in response to movements on the basilar membrane)

sound amplitude

loudness; measured in Hertz

sound frequency

pitch

presbycusis

begin in 30s and become worse after age 50/60

worse for high pitched sounds

hearing losses greater in men and urbanites

small speech comprehension deficit

loss of neurons in auditory cortex with age

conductive presbycusis

damage to ear drum and/or ossicles (ear infection, too many q-tips, ear wax build up)

reduced function of inner ear bones (arthritis and extremely loud sounds)

sensorineural presbycusis (sensory presbycusis)

hair cells destroyed

inner ear conductive presbycusis

neural and strial presbycusis

tinnitus

hearing disorder

high pitched “ringing” or “whistling” sound in the ears that is present for nearly 11% of those between 65-74 years of age

aids to help the hearing impaired

range from analog to digital

in-the-ear, behind-the-ear, in-the-canal

signal to noise ratio is important

should increase intensity of sounds in the range of human speech

audiologist determines settings

cost varies

takes time to adjust

changes in taste, smell, and balance

taste sensitivity

olfactory sensitivity

taste and smell deficits can result in gustatory problems

as we age, the sensory cells tend to die from the front to the back (sweet, salty, bitter, sour)

older people tend to taste more sour and bitter instead of sweet and salty

dementia

a chronic (does not go away), organic (causes brain damage) disorder in which cognitive, emotional, and biological functioning erode over time

delirium

temporary state

characterized by: disturbed cognition (attention, memory, reasoning, emotional response deficits), disturbed sleep cycle, altered effect, sudden onset, cause by metabolic changes, being over medicated, COPD, etc., acute and treatable

depression

can cause cognitive and emotional problems that are similar to dementia

must be “ruled out” as the root cause of the symptoms

this predicts dementia

Alzheimer’s Disease (AD)

a progressively degenerative dementia in which cognitive, affective, and biological functioning deteriorate over time, eventually leading to death

affects the patient, family, and friends

involves a total loss of self

sort of backwards development

Prevalence of Alzheimer’s Disease

most common dementia accounting for about 60-80% of dementia cases in the U.S.

mediated by age

major symptoms of Alzheimer’s Disease

impaired memory functioning

word finding difficulties

impaired reasoning

impaired discourse

flat, bizarre, or labile affect

increased irritability

delusions and hallucinations

altered sleep patterns

loss of motor function

sun downing

impaired memory functioning (AD)

beginning with an anterograde amnesia (encoding problems) and progressing to a total loss of memory

word finding difficulties (AD)

Boston Naming Test

resorts to phrases like “the-thingy-of-a-mabib” or "the what’s its”

few problems understanding speech

impaired reasoning (AD)

easily confused

spatial memory and reasoning problems

trouble competing a thought

impaired discourse (AD)

speech is empty of content

inappropriate change in topics