Adult Development and Aging, Ch 4

What are some common chronic conditions across adulthood?

Arthritis is the most common chronic condition. Arthritis and osteoporosis can cause mild to severe impairment. Cardiovascular and cerebrovascular diseases can create chronic conditions after stroke. Diabetes mellitus cannot be cured, but can be managed effectively. However, some serious problems, such as diabetic retinopathy, can result. Many forms of cancer are caused by lifestyle choices, but genetics also plays an important role. The risk of developing cancer increases markedly with age. Prostate and breast cancer involve difficult treatment choices. For many people, incontinence, is a source of great concern and embarrassment. Effective treatments are available.

Active longevity vs. dependent life expectancy

Active longevity is the time during which people are independent. Dependent life expectancy is the time during which people rely on others for daily life tasks.

What are the developmental trends in chronic and acute diseases?

Acute diseases are conditions that develop over a short period of time and cause a rapid change in health. Chronic diseases are conditions that last a longer period of time (at least 3 months) and may be accompanied by residual functional impairment that necessitates long-term management. The incidence of acute disease drops with age, but the effects of acute disease worsen. The incidence of chronic disease increases with age.

what is the average and maximum longevity for humans?

Average longevity is the age at which half of the people born in a particular year will have died. Maximum longevity is the longest time a member of a species lives. Average longevity increased dramatically in the first half of the 20th century, but maximum longevity remains at about 120 years. The increase in average longevity resulted mainly from the elimination of many diseases and a reduction in deaths during childbirth.

What are the most important issues in chronic disease?

Chronic conditions are the interaction of biological, psychological, sociocultural, and life-cycle forces.

What ethnic factors influence average longevity?

Different ethnic groups in the US have different average longevity. However, these differences result primarily from differences in nutrition, health care, stress, and socioeconomic status. In late life, people in some ethnic minority groups live longer than European Americans.

What factors are important to include in a model of disability in late life?

Disability is the effects of chronic conditions on people's ability to engage in ADLs. A model of disability includes pathology, impairments, functional limitations, risk factors, and intraindividual factors. This model includes all 4 main developmental forces.

How can people manage chronic conditions?

Effective pain management can be achieved through pharmacological and nonpharmacological approaches. Pain is not a normal outcome of aging and is not to be dismissed.

What is functional health?

Frail older adults are those who have physical disabilities, are very ill, or may have cognitive or psychological disorders and who need assistance with everyday tasks. ADLs include basic self-care tasks such as eating, bathing, toileting, walking, and dressing. IADLs are actions that entail some intellectual competence and planning. Rates of problems with ADLs and IADLs increase dramatically with age.

What genetic and environmental factors influence longevity?

Having long- or short-lived parents is a good predictor of your own longevity. Living in a polluted environment can dramatically shorten longevity; being in a committed relationship lengthens it. Environmental effects must be considered in combination with each other and with genetic influences.

What are the key issues in defining health and illness?

Health is the absence of acute and chronic physical or mental disease and impairments. Illness is the presence of a physical or mental disease or impairment. Self-rated health is a good predictor of illness and mortality. However, gender and cultural differences have been found.

What are the consequences of medication interactions?

Older adults are more prone to harmful side effects of medications. Polypharmacy is a serious problem in older adults and may result in serious drug interactions.

What are the developmental trends in using medication?

Older adults use nearly half of all prescription and OTC drugs. The average older adult takes 6 or 7 medications per day. However, the general lack of older adults in clinical trails research means we may not know the precise effects of medications on them.

What are the important medication adherence issues?

Polypharmacy leads to lower rates of correct adherence to medication regimens.

2 major categories of coping:

Problem-focused coping and emotion-focused coping. People also use religion as a source of coping.

How is the quality of life assessed?

Quality of life is a multidimensional concept that encompasses biological, psychological, and sociocultural domains at any point in the life cycle. In the context of health, people's valuation of life is a major factor in quality of life.

WHAT causes functional limitations and disability in older adults?

The chronic conditions that best predict future disability are arthritis and cerebrovascular disease. Other predictors include smoking, heavy drinking, physical inactivity, depression, social isolation, and fair or poor perceived health. Being wealth helps increase average longevity but does not protect one from developing chronic conditions, meaning that such people may experience longer periods of disability late in life. w Women's health generally is poorer across cultures, especially in developing countries. Ethnic group differences are also important. The validity of measures of functioning sometimes differs across ethnicity and gender.

What normative age-related changes occur in the immune system?

The immune system is composed of 3 vmajor types of cells, which form a network of interacting parts: cell-mediated immunity (consisting of thymus-derived, or T-lymphocytes), humoral immunity (B-lymphocytes), and nonspecific immunity (monocytes and polymorphonuclear neutrophil leukocytes). Natural killer (NK) cells are also important components. The total number of lymphocytes and NK cells does not change with age, but how well they function does. The immune system can begin attacking itself, a condition called autoimmunity. HIV and AIDS are growing problems among older adults.

How does aging affect the way that medications work?

The speed with which medications move from the stomach to the small intestine may slow with age. However, once drugs are in the small intestine, absorption rates are the same across adulthood. The distribution of medications in the bloodstream changes with age. The speed a drug metabolism in the liver slows with age. The rate at which drugs are excreted from the body slows with age.

What are the key issues in stress across adulthood?

The stress and coping paradigm views stress, not as an environmental stimulus or as a response, but as the interaction of a thinking person and an event. Primary appraisal categorizes events into 3 groups based on the significance they have for our well-being: irrelevant, benign or positive, and stressful. Secondary appraisal assesses our ability to cope with harm, threat, or challenge. Reappraisal involves making a new primary or secondary appraisal that results from changes in the situation. There are developmental declines in the number of stressors and in the kinds of coping strategies people use. Stress has several negative consequences for health.

What factors create gender differences in average longevity?

Women tend to live longer than men, partly because men are more susceptible to disease and environmental influences. Numerous hypotheses have been offered for this difference, but none have been supported strongly.