FAD3343 Ch. 4

What physiological factors may deter individuals from having proper diet & nutrition?

(*D*ead *P*eople *D*on't *R*un.) • Digestive processes slow down. • Dental problems can limit an adult to certain foods. • Physical handicaps can limit preparation & consumption. • Reduced taste, sight, & smell can lessen appetite.

What social & psychological factors may deter individuals from having proper diet & nutrition?

(*L*ittle *G*irls *W*ere *B*awling.) • Low-socioeconomic status individuals may be limited on how much money they can spend on food. • Grief may cause individuals to lose their appetite or forget to eat. • Widows & widowers may be less inclined to shop & cook for themselves. • Busy schedules allow little time for healthy eating.

What is *arthritis*?

• *Arthritis* is the inflammation or degeneration of a joint.

What are the two major disorders of the circulatory system?

• *Atherosclerosis* is a type of arteriosclerosis because it involves the hardening or loss of elasticity in the arteries. It occurs when fat & cholesterol accumulate on the interior walls of the arteries & reduce the size of passageways. • *Hypertension* refers to excessive arterial blood pressure. The factors associated with hypertension are obesity, smoking, & excessive alcohol. It can be treated with medication that reduces excessive fluid & sodium, and healthy lifestyle choices.

How does the performance of an individual's body systems change with aging? Are these changes an inevitable result of the aging process?

• An individual's body systems tend to reach a peak level of performance, from which functioning either remains constant or begins a slow decline. For some, this peak is reached in youth; for others, it is reached in old age. • However, physical decline doesn't *always* happen because of the aging process; it can result from various diseases or unhealthy behaviors.

What influences longevity?

• Longevity is a complex trait influenced by genes, the environment, & chance.

What is the role of diet in longevity?

1. *Calorie restriction increases longevity in a number of species*. In studies of animals, calorie restriction by 50-70% extended the lifespan by 30%. In addition, it delayed disease until the end of the lifespan. In humans, calorie restriction enables biological functions - such as DNA repair, glucose repair, & immune function - to work longer & better. 2. *Poor diet contributes to disease*. However, good nutrition in early life is directly related to health in later life. Luckily, our awareness of the importance of fresh fruits, fresh vegetables, & whole grains has increased, and we are decreasing our intake of salt, red meat, & saturated fat.

What are the two approaches to research on the causes of aging?

1. The search for an "aging gene," or understanding what causes cells to die. This represents a damage theory. 2. The search for a "longevity gene," or determining what stimulates cell repair & regeneration. This represents a programmed theory.

What is *cancer*? What are some of the suggested causes of cancer? How does cancer affect the aging adult?

• *Cancer* is the second leading cause of death in older adults. It is an uncontrolled, invasive cell growth that interfere with normal body systems. • There may be numerous causes of cancer; some are thought to be exposure to chemicals, radiation, improper diet, & smoking. • Many cancers are treated for extensive periods, during which the combination of age-related physiological decline & cancer greatly impacts an older adult's ability to function in daily life.

What is *coronary heart disease*? What is an *infarct*? Which gender is more likely to die from a heart attack?

• *Coronary heart disease* is the most widespread form of heart disease. It results in a shortened supply of blood to the heart, which can produce an *infarct* (a dead area of the heart). This can lead to heart attack or death. • Women are more likely to die from heart attack than men.

What are *damage theories of aging*?

• *Damage theories* suggest that aging is caused by the accumulation of errors from different sources. • Once source might be free radicals. Through the bombardment of free radicals, we accumulate structural damage to our cells, and this damage may lead to aging.

What are *free radicals*?

• *Free radicals* are highly reactive molecules in the body that damage cells, proteins, & DNA by altering their structures. They are a byproduct of normal metabolism, produced as cells turn food into energy.

What is the leading cause of death in older adults? What is included in this category?

• *Heart disease* is the leading cause of death in older adults. It includes coronary heart disease, arrhythmias, heart attack, stroke, heart failure, & hypertension.

What is *life expectancy*? What is the current life expectancy?

• *Life expectancy* is a projection of how many years we expect people to live. • Life expectancy continues to increase with advances in health care. The current life expectancy is about *78* years, although women live longer.

What is *maximum life span*? What is *senescence*? What is *average life span*?

• *Maximum life span* is the greatest age reached by one member of a species. For example, the maximum life span of a human is 122 years old. • *Average life span* is the average age reached by members of a species.

What is *osteoarthritis*? Which joints are commonly affected? When does osteoarthritis begin?

• *Osteoarthritis* is the most common form of arthritis, and poses a great problem for those 65+. • It occurs when the tissue surrounding the joint wears away, exposing the underlying bone. This may cause pain, stiffness, & tenderness. • The joints commonly affected are the spine, knees, & hips. • Osteoarthritis may begin early in life & affect small joints; may begin later in life & affect large, overused joints; or may result from injury or vigorous activity.

What is *osteoporosis*? Which hormones may influence the development of osteoporosis?

• *Osteoporosis* is characterized by a gradual decline in bone mass that begins around age 50. The main consequence of this disease is a risk of bone fractures (especially of the vertebrae, wrists, ribs, & hips). • In women, a decrease in estrogen after menopause is associated with osteoporosis; in men, a decrease in testosterone has a weak but similar effect.

What are *programmed theories of aging*?

• *Programmed theories of aging* suggest that aging has a strong genetic component and is *not* a product of random damage, but is driven by genetically regulated processes. • In accordance with these theories, scientists have discovered a family of genes that strengthen an organism's ability to withstand a stressful environment. These "longevity genes" keep the organism's repair activities going strong, and thus, maximize the organism's change of getting through a crisis. • Furthermore, human longevity runs in families. Studies reveal that identical twins have similar lifepans, whereas siblings have greater variations in lifespans.

What is *senescence*? How is medical technology changing the aging process?

• *Senescence* is the age-related loss of functioning. This becomes apparent when an individual is between 40-45. • Medical technology is slowing the aging process & increasing the average life span.

What is *thrombosis*? When does it occur?

• *Thrombosis*, or blood clotting, occurs when undissolved fatty deposits cut off blood supply to the heart.

What is *wear & tear theory*?

• *Wear & tear theory* suggests that irreplaceable body parts simply wear out. • It views the cell as a complex piece of machinery, such as an automobile. The organisms that maintain themselves more carefully will live longer, and the organisms that live more recklessly will wear out sooner. • Unfortunately, this theory ignores the fact that cells can repair damage caused by wear & tear.

Which three conditions account for 75% of all deaths?

• 75% of all deaths are caused by heart disease, cancer, & stroke.

What is the role of the social environment in longevity?

• A social environment that is positive, hopeful, & stimulating lengthens life. - Our social class is also correlated with longevity; those with more money for health care liver longer. - A shortened life is correlated with divorce (in men), accents, substance abuse, sleep problems, an imbalance of work & leisure, risk-taking or self-destructive behavior, & being a loner.

When does aging begin? When does aging end?

• Aging is a gradual process beginning at birth. • Our "life" - the period between birth & death - is finite; we will not survive indefinitely.

What is the *Power 9 Pyramid*?

• Dan Buettner developed the *Power 9 Period* following his global study of centenarians. He asked, "Why have you lived this long?" & distilled the answers into 9 points: 1. Exercise 2. Do not eat too much 3. Eat mostly fruits & vegetables 4. Drink red wine, but do not drink excessively. 5. Do something you love. 6. Have a meditative practice. 7. Belong to a spiritual community. 8. Surround yourself with supportive family & friends. 9. Make these people a priority.

What did Leonard Hayflick discover about our cells?

• Hayflick discovered that our cells duplicate up to 50 times before they become senescent & stop reproduction. • According to his theory, cells begin reproducing less when they are damaged by our normal metabolism. • The result is a reduced numbers of cells, which creates changes in our body tissues that lead to aging & eventual death.

What were the findings of the Georgia Centenarians Study?

• In terms of personality, they scored high on dominance, suspiciousness, & imagination, and low on conformity. • In terms of cognition, they scored high on practical problem solving, and low on intelligence & memory tests. • Religion was important & a common coping device. • Most were moderate, healthy eaters who did not go on diets. They were not vegetarian, they didn't smoke, they seldom drank, & they ate big breakfasts. However, they had high intake of saturated fat.

How does *guided imagery* help lengthen life?

• In the presence of disease, *guided imagery* has been shown to lengthen life. Individuals image their body parts becoming well again; a positive mental attitude is used to get the immune system activated & fighting.

How can we treat obesity in older adults?

• It is difficult to treat obesity in older adults, because weight loss may have harmful effects on muscle & bone mass.

What are the "observable" changes that take place in the body?

• Most of the changes that take place in the body are observable: - The skin loses elasticity & becomes wrinkled. - The hair treys & thins out. - The body becomes less erect. - Older adults tend to gain fat & lose muscle strength. - In the *30s-40s*, many adults develop *presbyopia* (nearsightedness). - Many adults also develop hearing loss (especially men). - The body's ability to absorb calcium declines, and the body loses calcium from lack of exercise, poor diet, & hormonal shifts. This reduces bone mass & results in brittle bones that are more easily broken. - Dental issues are not uncommon among older adults. For example, loss of bone mass in the jaw may result in the loss of teeth. Also, many older adults experience gum disease.

What influences most of the major health problems of older adults?

• Most of the major health problems of older adults result from pathology & are influenced by poor living habits.

Obesity has a greater impact on ____ than ____.

• Obesity has a greater impact on *morbidity* (quality of life) than *mortality* (rate of death).

What is obesity a risk factor for?

• Obesity is a risk factor for *economic issues*, *chronic health conditions*, & *quality of life issues*. • Excess body fat is a risk factor for heart disease. In addition, obesity is linked with hypertension & diabetes, which are also risk factors for heart disease.

What is the immune system theory?

• Several aspects of immune function decline with advancing age, and this decline is related to many kinds of disease (such as cancer) that attack the body. If the body's immune system becomes less effective, harmful cells are more likely to survive & damage the body. • A related theory suggests that as the body ages, the immune system *increases* its capacity for autoimmune reaction & develops greater amounts of autoimmune antibodies. These antibodies destroy *all* cells; even normal ones. This theory is criticized because most autoimmune diseases begin to develop at younger ages.

How has the rate of obesity in the U.S. changed since 1991?

• Since 1991, the rate of obesity among older adults in the U.S. has been increasing dramatically. Unfortunately, obesity among older adults will be an even greater problem in the future. • 2/3 of U.S. adults are overweight or obese; 28% of U.S. adults are obese.

Why do many people believe that older adults should have their licenses revoked at a certain age? Why is this an unfair suggestion?

• Since these changes lower the functional ability of older adults, many people believe that older adults should have their licenses revoked at a certain age. • However, we must remember that *chronology* is a poor indicator of *functionality*. Declaring that people at age 70 could no longer drive would be unfair to the 70-year-olds whose functioning is unimpaired.

What are the "hidden" changes that take place in the body?

• Some changes are not as apparent as others: - The body has greater difficult returning to homeostasis after a stressful event. - The organs operate at reduced efficiency (e.g. lungs, kidneys, bladder, nervous system, digestive system, level of sex hormones). - The immune system decreases in its ability to protect a person from disease; hence, older adults are less immune to contagious disease (e.g. the flu) & take longer to heal.

What influences the development of chronic conditions? How can they be avoided or lessened?

• Some chronic diseases emerge after years of poor eating, drinking, smoking, & lack of exercise. • Through making healthy lifestyle choices & using early detection practices, many chronic diseases can be avoided or lessened.

What is the role of exercise in longevity?

• Some exercise is better than none. • The phrase "use it or lose it" is true; many of the physical disabilities found in older adults result directly from the disuse of body systems, which results in a decline in functioning. • Older adults should have a program of *strength training* & *aerobic exercise*.

What is free radical damage theory?

• Some individuals have greater longevity than others, regardless of their lifestyle. For example, some smokers live long lives, whereas some health conscious individuals contract illnesses. *This may be because some individuals are more susceptible to free radicals than others*. • One way to combat aging is to trap the free radical molecules before they can do harm.

What might create a safer driving environment for older adults?

• Still, after age 75, collision rates increase dramatically. • Improved structural changes (e.g. larger road signs, raised pavement reflectors) would create a safer driving environment for older adults.

What is the *absolute human life span*? What is the *mean human life span*?

• The *absolute human life span* is the maximum possible chronological age that a human can live. Humans are considered capable of living about *120* years. • Since few people reach the absolute human life span, a more useful measure of longevity is the *mean human life span*, the chronological age at which 50% of humans will have died.

What is the role of mental health in longevity?

• The connection between physical wellbeing & mental health is strong. • Older adults who are involved in aerobic sports are healthier & happier than those who are not involved in such exercise. • Happy, optimistic people live longer; whereas those with antagonistic hostility, repressed anger, depression, & egocentricity have a shortened life. • Some stress may be a positive factor in life, but too much of the wrong kind is bad. Those who are good at coping with stress will live longer.

What is the role of the environment in longevity?

• The environment plays a role in how long we live. - Pollution, pesticides, secondary smoke, & other chemicals can cause disease & shorten life. - Living in high-crime areas or overcrowded cities is also harmful.

What is the range of the functional limitations of older adults? What are *activities of daily living (ADLs)* & *instrumental activities of daily living (IADLs)*?

• The functional limitations of older adults range from mild arthritis conditions to conditions that interfere with an older adult's ability to perform ADLs & IADLs. • *Activities of daily living (ADLs)* are the abilities that allow a person to survive, including bathing, dressing, & feeding themselves. • *Instrumental activities of daily living (IADLs)* are the abilities that allow a person to live independently, such as light housework, preparing food, shopping for groceries, & managing money.

How has the health status of the elderly changed in the past 50 years?

• The health status of older adults has improved markedly in the last *50* years. • During the 1950's, the U.S. had a dramatic shift in its views on hygiene. New policies promoted cleaner living. This paved the way for better general health. • Today, the difference between the health status of the average 45-year-old & 65-year-old is small & is largely dependent on their lifestyle choices. • Those aged *75+* usually have noticeable physical declines.

What are the most common causes of accidental death for those 65+?

• The most common causes of accidental death for those 65+ are (1) falls & (2) motor vehicle accidents.

How do programmed theorists explain why individuals age at different rates? What is the *biological clock*?

• To explain why individuals age at different rates, programmed theorists emphasize internal programs or cellular coding. • For example, some genetic theorists propose a *biological clock* within us that begins ticking at conception. This "clock" may be in the nucleus of each cell of the body, which follows the idea that our bodies are programmed by specific genes to live a certain length of time.

Why do these changes take place?

• We don't understand why these changes take place. In other words, we don't know what causes aging.

What are *acute conditions*? What are *chronic conditions*?

• Young people tend to have *acute conditions*, short-term illnesses in which the cause is known & the condition is curable (e.g. chicken pox, colds, influenza). • Older people tend to have *chronic conditions*, long-term illnesses in which the cause is typically unknown & the condition is incurable (e.g. hypertension, arthritis, heart disease, diabetes, cancer). These conditions have a profound effect on *health*, *quality of life*, & *health care expenditures*.