class 1

aging

process of growing old, progressive with time, varies among and within individuals

aging characterized by

declining ability to respond to stress, increased homeostatic imbalance, increasing odds of disease, decreased ability to successfully respond

gerontology

study of factors impacting the normal aging process and the impact of aging

geriatrics

branch of medicine providing care for older adults

life expectancy

avg in US is 78.6, F > M
continuing to rise but not necessarily correlated with QOL
longer in areas with access to healthcare, safe environs

categories of elderly

young elderly 65-74, old elderly 75-84, old old elderly (or old and frail) > 85

ageism

discrimination and prejudice leveled against individuals based on their age
affects F > M, increased when older age combined with low motivation, poor compliance, poor prognosis
leads to poorer physical and mental health, reduced QOL, increased medical costs

frailty syndrome

medical dx
3+ of: weakness in grip strength, slow walking speed, low physical activity, unintentional weight loss >10 lbs over last year, self-reported exhaustion

chronological age

length of time since birth

biological age

changes in biological/physiological processes, can look different from chronological age

psychological age

mental and cognitive function
self-efficacy, self-esteem, learning, memory, perception

social age

societal construct, behaviors that are appropriate for a certain age

cellular theories

microscopic degenerative changes, free-radical oxidation
Bjorksten: cross links between adjacent molecules of hydrogen which disrupts structure leading to DNA damage, mutation, cell death
Stubel: waste product accumulation (lipofuscin) increases with age

free radical oxidation

molecule of oxygen with uneven number electrons is unstable and attempts to link with other molecules leading to more free radicals
disrupts equilibrium, leads to alterations in structure of collagen and elastin, destruction DNA and breakdown of immune system

genetic theories

Medvedev Stochastic Theory: progressive destruction of DNA nucleotide sequences by randomly occurring somatic mutations and leads to decreased ability to reproduce over time
Hayflick: cell death occurs due to programmed, purposeful sequence of events written in genetic code, have finite limit to reproduction

control theories

explain aging in terms of function of systems vital to maintenance of homeostasis
immune system: quality/quantity immune response decreases, decline T-cell activity, more susceptible to autoimmune disease, MHC deteriorates with age
neuroendocrine system: regulates many of the changes that characterize aging at cellular level

structural changes with typical aging

atrophy, dystrophy, edema, demyelination, neoplasm, mutation

functional consequences of typical aging

decreased accuracy, speed, range, coordination, stability, strength

decline with aging

typical linear decline known as linear senescence
plasticity of aging, slowed with protective measures, advanced with disease processes

typical aging

combo of unavoidable age related changes and modifiable factors associated with lifestyle

healthy/optimal/successful aging

absence disease and disability, high cog and physical function, active engagement with life

fun

highest physiological ability that allows unrestricted participation in life

function

modifies performance which will substantially restrict fun because of declining physiological capacity

frailty

managing basic ADLs consumes substantial amount of physical capacity and begins to require help

failure

assistance with all aspects of life

ageism impact on PT

older adults receive less aggressive care plans, ageist PTs underestimate PLOF and rehab potential

dangers of ageism in healthcare

geriatric providers are stigmatized and report less rewarding specialization, under or over treatment of older adults, assumptions about lifestyle considerations, elder speak, contagious thoughts, institutionalized ageism

how to address ageism

remove barriers to older adults engaging fully, reverse long standing hx of institutionalized ageism, change perception of aging through training