Chapter 4 longevity, health and functioning

Problem focused coping

Attempts to tackle the problem head on. (taking medications or studying for a test) doing something directly about the problem at hand - typically the way older people cope

Secondary appraisal

( how one chooses to deal with the event) evaluate out perceived ability to cope with hard, threat, or challenge. What can I do? How likely is it that I can use one of my option successful? Will this reduce my stress? How we answer these questions will affect our stress levels, if there is something we can do our stress will decrease and vice versa. Sense of powerlessness -> increase stress

Primary appraisal

(initial feeling to the event happening) categorization of an event into three groups as irrelevant, benign/positive, or stressful (many times our initial categorization can be wrong and the event can turn out to not be stressful or it may turn out to be stressful) the primary appraisals filter the events we experience. Any event that is appraised as either irrelevant (things that don't affect us (or as benign or positive (thing that are good) are not stressful. We sort out the event in our primary stage

What is psychoneuroimmunology?

- (PNI) "host resistance", study of the relation between psychological, neurological, and immunological systems that lower our chances for the ability to recover or fight a disease.

Who is more likely to suffer from acute and chronic illness?

- As you age, there is a decrease in acute illness and an increase in chronic illness. However, when older adults get acute diseases they get sicker, have a longer recovery period, and death is more frequent (pneumonia, influenza) 65+

What are some predictable changes in the immune system that occur with age?

- As you get older, you're more prone to serious illnesses. Older adults don't benefit as much from immunizations, because it takes them longer to build immunity. Rate of leukemia and other cancers increase with age. Shrinking thymus results in a decline of t-cell function. B cells (help immune system) do not function as efficiently in absence of t cells (causes more autoimmune disease).

What is a chronic illness?

- Conditions lasting 3 months or longer, may be accompanied by residual (remaining) functional impairment requiring long term management. Chronic conditions as an interaction of biological, sociocultural, and lifestyle forces.

What is an acute illness?

- Conditions that develop over a short period of time (cold, flu) and cause a rapid change in health

Genetic and environmental factors in average longevity: what are they?

- Genetic factors are a strong predictor of longevity, age of parents and grandparents at death, but environment can effect epigenetics and cause changes, in developed countries its lifestyle factors and in undeveloped countries it's aids, or diseases - causes stress effects on telomeres - higher social class - the longer the telomeres the healthier your cells the longer longevity you have

What is autoimmunity? - cells attack themselves

- Immune system begins attacking the body, results form an imbalance of B- and T- lymphocytes, giving rise to autoantibodies. Causes several diseases like rheumatoid arthritis (inflammatory disease - the tissues essentially attack themselves aka autoimmune)

How is stress defined:

- Stress is interaction of person + event - it is a transactional process (person and the environment)

Verbrugge & Jette

- distinguishes between intrinsic ability and actual ability. Individual factors include environment and health and intraindividual - beginning an exercise program, keeping a positive outlook, and taking advantage or transportation programs to increase mobility - intra and extra individual both look at reducing restrictions and difficulties resulting from chronic conditions. - with low SES (social economic status) increase chance of functional limitation and disability

Frailty - How is it defined?

- having 1 or more ADL (activities of daily living)- illnesses, physical disabilities, cognitive impairments. It is associated with decline, loss of function, and susceptibility

Women tend to live

6-7 years longer than men, narrows to one year by age 85 (big risk factor for smoking men)

African American longevity

6.5 years lower for men and 5 years lower for women then European Americans, however, at age 85 AA tend to live out EA **Cross over effect*

how many medications is a typically older adult on

7-8

Activities of daily living ADLS

Basic functions such as bathing, dressing, toileting, transferring (getting in and out of bed), continence (controls bowel and bladder by self), and feeding

Functional health status: what is it? How is it defined?

Determined by questioning older adults about his or her daily activities, it requires demonstration of abilities in home and clinical. Laboratory setting, measured based on IADLs and ADLs. Defined as how well a person is functioning in daily life.

Disability - what is it?

Difficulty doing activities in any life domain (hygiene, hobbies, errands) due to a health or physical problem. Restriction in ability to perform daily activities of living and reduction of desired/expected activity.

Polypharmacy

It is the use of multiple medications - many drugs don't interact well. Drug interactions often times create secondary medical problems that need to be treated

What are the risk factors for becoming disabled?

Not a personal characteristic, the Verbrugge & Jette model distinguishes between intrinsic ability (ability to perform activity without personal or equipment assistance) and actual ability (ability to perform activity with such assistance). Individual factors include environment and health and intraindividual - beginning an exercise program, keeping a positive outlook, and taking advantage or transportation programs to increase mobility - intra and extra individual both look at reducing restrictions and difficulties resulting from chronic conditions. - with low SES (social economic status) increase chance of functional limitation and disability

Instrumental activities of daily living IADLS

Require certain intellectual capacities and planning abilities such as using the telephone, shopping, food preparation, housekeeping, laundry, transportation, and ability to handle finances.

Stress and coping paradigm: What is it?

The interaction between a thinking person and an event (action vs. emotion) think of the stuck in traffic example - if you have an interview it would be very different stress then if you were just going to the mall.

Does aging affect how older adults respond to medication?

Yes, developmental changes in medication functioning changes as you get older, the time it takes the medicine to enter the blood stream increases, increased risk for toxic buildup in bloodstream due to changes in distribution of medication in the body, slower metabolism of drugs, drugs are in your system longer and increases risk for toxicity. Meds are also not eliminated as often, which is also a risk for toxicity. 7-8 meds per older adult.

The interaction between a thinking person and an event (action vs. emotion) think of the stuck in traffic example - if you have an interview it would be very different stress then if you were just going to the mall.

You appraise your stress - mental processes that influence reactions to stress, environment produces a stressor, we assess our ability to minimize, tolerate, or eradicate the stressor. (example stuck in traffic)

Average longevity:

average age people are expected to live

What effects does stress have on health? How does it relate to immune function and/or risk for atherosclerosis and or hypertension?

chronic stress has negative effects on the immune system such as an increased risk of viral infection, arteriosclerosis (thickening and hardening of the walls of arteries) and impaired memory/ cognition.

b cells help what

immune system but aren't as effective without T cells

intrinsic ability and actual ability

intrinsic ability (ability to perform activity without personal or equipment assistance) and actual ability (ability to perform activity with such assistance).

Active life expectancy

living to a healthy, independent old age

Reappraisal

making new primary or secondary appraisal based upon changes in the situation. First appraisal something as not stressful then find it to be extremely stressful you will reappraise the event. It can either increase stress or decrease stress.

Maximum longevity

oldest age to which any individual of a species lives, 120 might bee the upward limit for humans

Emotion focused coping

this involves dealing with ones feelings about the stressful event. Allowing oneself to express anger or frustration over becoming ill or failing an exam is an example. The goal here is to deal with the situations that are difficult to tackle head on

Differences in longevity, what are ethnic & gender differences in longevity?

women may live longer but typically live with aliments and disabilities more than men

Dependent life expectancy:

years of living after losing independence (women live longer than men, but spend more time in a dependent state)