Ch. 1 - 3

Demographics

characteristics of our population such as its size, distribution of the very old and very young and geographic location

Demographic trends

describe the changes in such characteristics over time

Population aging

sheer increase in the size of population age 65 and older and a gain in the average age of population

fueled by baby boomers; one of the most dramatic demographic changes in the US

Life expectancy

average length of time one could expect to live if one were born in a particular year and if death rates remain constant

What is the cause of population aging?

falling birthrates: when children are a smaller percent in the population, the average age of the population increases

Which of the two sex lives longer? Why?

Women born today lives 5-6 years longer than men

Two X choromosomes makes women more physiologically more robust

Lifestyle factors such as preventive health behaviors, low rates of smoking, substance abuse and other high-risk behaviors across the life course

Represent 58 percent of the population age 65 and older, and 70 percent over age 85

Why do African Americans have lower life expectancy than whites?

Health care disparities, inequities experienced as children and young adults in poverty,, education, and health care are often intensified in old age (more chronic illness)

Older African-American women have a longer average life expectancy than their male-counterparts

Which minority group of women live the longest racially?

Asian women

Maximum life span

length of years a given species could expect to live if all environmental hazards are eliminated (does not go beyond 120 years)

What is the soft limit to the human life span?

85-90 years

How can we achieve maximum life span?

Effectively manage chronic disease such as cancer, heart disease, diabetes, and kidney diseases as well as obesity (in middle and young-old age); sometimes referred to as an ideal survival curve or a compression of morbidity

What percentage of babies born after 2000 in developed countries are expected to reach age 85?

50 percent

Population pyramids

visually capture the changing age distribution of the American population, the shift in proportion of older adults in relation of younger persons

What is the “pig in a python phenomenon mean?”

In the projected resident population of the US, key points in time show a bulge in the area of the pyramid reresenting those residents born during the baby boom period. As years pass, that bulge moves higher up the pyramid, changing the shape of the pyramid into one that widens at the top

Contributions of declining birthrates and reduced death rates for older cohorts

Dependency ratio

changing age distribution in our population, refers to the number of people age 65 and older to every 100 people of traditional working ages; the higher the ratio, the greater the burden of dependent older adults

Ex. In 2010, ratio was 22 people age 65 and older to every 100 people age 18-64, expected to rise to 37 to 100 in 2030

Support ratio

indicates the relationship between the proportion of the population that is employed and the percentage that is not in the workforce

Fewer employed persons support retired older persons today

Ex. 1910, 10 employed per retired older person and now there is fewer than 5

Old-old age group versus oldest-old

Between ages 75 - 84

People age 85+, growing most rapidly due to modern medicine

Demographers

people who study population

projects that the oldest old will reach 19 million or 4 percent of the U.S. population by 2050

Considered to be significant demographic trend because of its impact on social institutions as well as individual lives

What does the term “silver tsunami” means?

growth of the oldest-old has profound consequences for families, health and social services, long-term services and supports, retirement and workplace policies, political power, etc.

Centenarians

people age 100 and older

They are remarkably healthy, mentally alert, free of major disability, able to perform most daily activites, and engaged in their communities

What percentage of age is heritable?

one-third, we are partly responsible for our own old age

Hardiness

genetic factors determines how well an older person copes with disease or other stressors in their lives

Ex. oldest-old have higher threshold for disease and a lower risk of autoimmune diseases

Do women or men score higher on cognitive function tests after age of 90?

Men, women do score higher between ages 65 and 89

What is factors of lower rates of disease among centenarians in Okinawa?

Low-calorie diet with high intake of vitamins B6, B12, D, calcium, omega-3 fats, and high-fiber foods.

What is the percentage of the population in person of color over age of 65?

slightly more than 20 percent due to higher fertility and mortalitity rates among the younger nonwhite population and high rates of immigration of younger adults

will double from 20 percent to 40 percent in 2050 in the US

Which group is the general invisibility of being old?

LGBT due to stigma

What is the aging experience like for LGBT adults?

High rates of social isolation and mental distress and health disparities

Low percentage of 3 percent and the highest it can go is 18-20 percent

Compression of morbidity

lengthening the period of youthful vigor and experiencing only a few years of major illness in very old age

What is the concept of compressed morbidity?

Premature death is minimized because disease and functional decline are compressed into a brief period of 3-5 years before death

Population aging

older adults grow in both real numbers and in proportion to the larger population

What affects a country’s population aging?

Life expectancy, median age

Demographic divide

dichotomy between the needs of young and old between developed and developing countries

Median age

the age at which half the population is older and half is younger

What affects the country’s median age?

Birthrate because it adds to the number of people younger than the median age in a given country

Ex. Africa’s median age will increase from 19 to 27.4 in 2050 due to fertility rates being 3 times higher and high mortality rates

What is the estimate percentage of increase in 65+ in 2040?

14 percent

Why is China projected to have a population increase of people 60 years or older?

One child policy

Economic implications of population aging

increase in pension or retirement age, baby bonsuses and benefits to increase fertility rates, aiding the economy through immigration and other incentives

Traditional societies view older adults as

wisdom, security (wealth and property rights), power (civil and political), traditions (culture passed down), services provided (childcare), honor and respect

Filal Piety

everyone should respect and care of their elders

In modern societies, older people do not share the same status because of decline in respect, power, prestige, and influence

Theory of modernization

transformation of society from relatively rural way of life toward urban, industralized centers

all parts of the world increasingly urbanizing, 50% of the world population now living in urban areas

What happens in modernization?

young people move from rural areas to cities to seek better opprotunities; older adults remain

residential segregation impacts family interactions (distance, isolation, decline of intergenerational support, education)

older adults have lower social status and position

How many of foreign-born residents are 65+?

12 percent of US population

Grown from 2.7 to 4.3 million

Which state is one of the top states for older adult immigrants?

California

What percentage of older immigrants do not speak English and what is the impact?

75 percent, social isolation, grief and loss over leaving home country

Elder immigrants have twice the poverty levels, lack of health insurance when needed the most, dependency on younger family members

Biculturalism

intergrating two cultures into one’s lifestyle

intergration often means loss of filal piety, less likely to be sent to retirement homes, may choose to live in an ethnic enclave

Which country makes it illegal to not fiancially support your parents?

Singapore

Biological aging

Or senescence is the normal process of alterations over time in the body and its organ systems that eventually affect our functioning but do not necessarily result in disease or death

What are two general orientations that most biological theories of aging have?

1. Aging occurs due to random genetic mutations and oxidative stress

2. Aging is the result of programmed senescence

Four Primary theories of biological aging

Wear-and-tear theory, cellular aging theory, immunological theory, radical theory

Wear-and-tear theory

Like a machine, the organism simply wears out over time influenced by environmental stress

Cellular aging theory

aging occurs as cells slow their number of replications; cells are programmed to follow a biological clock and stop replicating after a fixed number of times

Immunological theory

aging is a function of body’s immune system becoming defective; less efficient in making the body resistant to pathogens and infections that attack and interfere with normal functioning

Radical theory

Or oxidative stress model states that the progressive, irreversible accumulation of oxidative damage to cells explain loss of physiological functions as we age

when organism cannot easily detoxify or repair the damage caused by free radical

Prolongevity

extending the length of healthy life and eliminating some disease associated with aging

Healthy life span

expanding the number of years we spend in good health

What are some of the ways we can reverse aging?

Growth hormones: increase lean muscle mass and bone density and reduced fat levels

Caloric restriction: reducing the intake of fat, protein, or carbohydrates is found to extend the life of experimental animals without causing malnutrition

What leads to changes in body composition?

lean body mass in muscle tissue is lost, whereas the proportion of fat increases

muscle fibers steadily decreases after age 50 leading to muscle tissue losing its elasticity and flexibility and muscle mass declines

What is the 4 causes of changes in skin?

1. Ultraviolet light from the sun, which damages the elastic fibers beneath the skin’s surface

2. Cell replacement in epidermis (outer layer of skin) slows down, the connective tissue that makes up the second layer of the skin (dermis) thins leading to reduced elasticity and fullness of our skin increasing sagging and wrinkling

3. Sweat glands deteriorate, deep skin layers lose fat and water

4. Skin’s blood circulation is diminished making temperature-regulating mechanism damaged (which is why elders feel cold all the time)

How many inches do we lose per year after the age of 30?

1/16th inch

Why do old people shrink?

Loss of bone mineral density and strength in our trunk, arms, and legs, the spine becomes more curved, and disks in vertebrae become compacted

Kyphosis

crush fractures of the spine cause the vertebrae to collapse

Kinesthetic system

lets us know our position in physical space

Age-related changes in the central nervous system as well as muscle weakness and diminished vision makes older people less able to judge the position of their bodies in physical space

Respiratory system

Decrease in vital capacity which is the require coordination of the respiratory, nervous, muscular systems

Oxygen in lungs declines by 50 percent for men between ages 25 and 70

Atherosclerosis

Arterial and vessel walls become increasingly lined with fats

What happens to our urinal system?

Kidneys lose their capacity to absorb glucose and their concentrating and diluting ability leading to increased problems with dehydration

Urinary incontinence

Bladder capacity reduced as much as 50 percent and sensation of needing to empty the bladder is delayed resulting from medications, acute illness, urinary tract infections

Gastrointestinal system

Changes in esophagus include a decrease in contraction of the muscles and more time for the cardiac sphincter (allows food to pass into the stomach) to open — more time for food to reach the stomach — sensation of being full before finishing a meal

What leads to chronic inflammation of the stomach lining and greater risk for colon stomach cancer?

diminish of secretion of digestive juices in stomach

Menopause

reduced production of two important hormones in women, estrogen and progesterone

What is the affect of neuronal loss?

reduced blood flow do slightly impair cognitive and motor function, resulting in a slower reaction time

Normal physiological changes in women and men

Health status

presence or absence of disease and the degree in level of functioning

Functional ability

what someone can do - or think they can do - and how healthy they are

Disability

impairments in the ability to complete daily tasks that may need assistance is required

Instrumental Activites of Daily Living

measures of functional ability based on point of level of care they may need

Why do we have more chronic illness?

Life expectancy is increasing, treatment advances, higher rates of unhealthy behaviors, and increased public awareness of conditions

What is the leading cause of injury-related deaths in older adults?

Fall; increasing fall rates since 1990, if it leads to hip fracture — 20 percent die within a year

Older Drivers

90 percent of people 65+ drive

only cause about 7 percent of accidents but high death rates

Use of Physician Services

adults 65+ average 7 doctor visits yearly

on average have 3x as many hospital days

take 8-9 medications on average

geriatricians can better serve older adults