Aging

Alfredo Bambang 2012 060 193

 Biological age is the relative age or condition of a persons organs and body systems. Psychological age refers to a persons adaptive capacities. Social age refers to a persons habits and roles relative to societys expectations. Legal age is based on chronological years. Functional age is how people compare physiologically to others of similar age.

Normal Effects of Aging on the Body

Copyright 2010 Pearson Education, Inc.

Declines in Sensory-Perceptual Processes with Age:

Vision and Hearing Taste and Smell Somethesis: Skin, Temperature, Pain Proprioception sensations generated by the body that let you know the location of limbs in space Kinesthesia ones sense of location while moving through space

Changes in Hearing:
Presbycusis age related hearing impairment
Caused by deterioration of mechanisms in the inner ear, long-term exposure to loud noises, certain drugs, an improper diet, or genetic factors.

Decline in sensitivity to tones and pitches different frequencies decline at different rates with advancing age.

Decline in Hearing Sensitivity

80
Decibel

60 40 20 0 30 40 50 60 70 80 Age

1 khz 2 khz 4 khz 8 khz

From Ordy et al. (1979), Age differences in the functional and structural organization of the hearing system in man, in, Ordy and Brizzee (Eds.), Sensory Systems and Communication in the Elderly.

I. Overview of Some Primary Changes Across Adulthood

Function: Vision Hearing Age of Change: Mid-40s Mid-50s Nature of Change Lens thickens, poorer near vision Loss of high and low tones

Smell
Heart & Lungs Height

About 40
35-40 40

Poorer detection and discrimination

Aerobic capacity during work Compression of disks in spine

Skin Bones

40 35

Wrinkling, oil secretion poorer Loss of calcium, osteoporosis increased porosity

Successful Aging
Heterogeneity of various values and functions Many associated with physical inactivity

Some General Points on Physical Aging- Nuland (2007)

Individual variability is great

Systems generally maintain competence despite some losses at maximums

Several factors: biological changes, disease, environment, personal attitudes all interact in predicting and explaining aging process These changes themselves are not diseases, but they predispose some people to certain diseases Physical changes have important implications for psychological functioning

II. Sensory Predictors of Cognitive Functioning Lindenberger & Baltes (1994)

Chronic Conditions in Later Life Percentages Suffering From Each Type

IV. Changes in Brain - Major Components at Cellular Level

Neurons: axons plus cell bodies electrical pathways
Synapses = 1,000,000,000,000,000 in brain Dendrites = connect to next neurons at synapses Neurotransmitters: chemical pathways that cross synapses

Changes in Brain with Age

Overall weight loss = 5% Some loss of neurons, but new ones can grow and new synapses can form too

Substantial loss of dendrites leads to some slowing at synapses one of the key markers of aging Changes in some neurotransmitters loss in dopamine and acetylcholine, but some increases too
Most of these changes more marked with disease!

Some Modest Increases in Alzheimer-Like Problems Brain Sections

Tangles: tadpoles, axon fibres twisted together
Plaques: blobs, dying neurons coalesce around protein core

If these are common enough, they can be used to indicate 6 stages of Alzheimers disease

Cell Senescence and Death

Cell senescence much like apoptosis
Occurs throughout life Arresting growth of damaged/dysfunctional cells Beneficial early in life; may contribute to aging later

Biological Theories of Aging

Genetic Theories
Gene Error Somatic mutation Programmed

Nongenetic Theories
Immunologic / Autoimmune Free Radical Wear & Tear Cross link or Collagen
http://prolongyouth.com/theories.htm l

 Aging Theories 36 Error Catastrophe Theory 36 Genes and Programmed Aging 38 Telomeres Rate-of-Living Theory 41 Free Radicals 42 Neuroendocrine Theory

THEORY OF AGING
Basic Theory : 1. Wear & tear Theory 2. Neuroendocrine Theory 3. Genetic Theory 4. Free radical Theory

 Biological Theory
1. Programmed Theory
1.1 Programmed Longevity 1.2 Endocrine/Neuroendocrine Theory 1.3 Immunological Theory

2. Damaged Theory
2.1 Wear & Tear Theory 2.2 Rate of Living Theory 2.3 Cross Linking Theory 2.4 Free Radical Theory 2.5 Somatic DNA Damage Theory/Errors & Repair 2.6 Mitochondrial Damage Theory 2.7 Waste Accumulation Theory 2.8 Faulty Reconstruction Theory

AGING PHASE
Fowler (2003), Aging , devided into 3 phase : 1) Subclinical phase (25-35 yo). hormone decline no sign or symptom

2) Transitional phase (35-45 yo) hormone decline 25%. loss of mucle mass Clinical symptoms: hearing loss & vision, loss of skin elasticity, hair turn to grey. aging disease : cancer, arthritis, diabetes, coronary disease

3) Clinical phase ( > 45 yo). Hormone decrease > > Nutrition, vitamin, mineral reabsorbstion bone density , loss of muscle mass 1 kg/3 years, increase body fat & weight

Psycho-Social Theories of Aging

Disengagement Theory Activity Theory Continuity Theory

Biological Theories of Aging

Programmed Aging theory- genetics and heredity responsible for how an individual ages Cross-Linkage Theory- deterioration of organs/cells causing decreased mobility Somatic Mutation Theory- DNA changes result in physical decline Stress Theory-causes structural & chemical changes thru the lifespan

Theories of Aging
Most experts believe that a combination of genetic and stochastic (random) events are responsible for aging. Any single limited theory is insufficient.

Psychosocial Theories of Aging

Disengagement Theory- withdrawn, introspective, self-focused Older theory; not widely accepted. Continuity theory-characteristics, values remain constant thru life repeat behaviors that brought success in the past Activity Theory- satisfaction depends on involvement in new interests /activities or maintenance of high levels of functioning.

Disengagement Theory
developed by Cummings and Henry in late 1950s. aging is an inevitable, mutual withdrawal or disengagement, resulting in decreased interaction between the aging person and others in the social system he/she belongs to.

Activity Theory
developed by Robert Havighurst in the 1960s. supports the maintenance of regular activities, roles, and social pursuits. persons who achieve optimal age are those who stay active. as roles change, the individual finds substitute activities for these roles.

Continuity Theory
proposed by Havighurst and co-workers in reaction to the disengagement theory basic personality, attitudes, and behaviors remain constant throughout the life span

Psychosocial Theories of Aging

Erikson - ego integrity vs despair Life review or reminiscence Acceptance and happiness with past life Havighurst - maintenance of social contacts & relationships be flexible & adapt Successful aging = ability to adapt to the changes associated with aging.

Cognitive Changes
Ability to perceive and understand ones world Mild short term memory loss Long term memory remains intact Slower responses and reactions

Cognitive Changes Abnormal Aging Confusion Alzheimers disease Sundowning syndrome The 3 Ds: 1. Dementia Severe cognitive loss & memory
loss

2. Depression 3. Delirium

Theories about Sundowning

Possible Causes for increasing confusion: Person cant see well in dimming light Hormone imbalances r/t biological clock Person tired @ end of day; decreased coping Restlessness because daytime activities are decreasing Caregivers communicate their own fatigue & stress to clients

Psychological Theories of Aging

Life span: The second half of life is characterized by significant individual differentiation, multidirectionality, and intraindividual plasticity
Selective optimization: A model of psychological and behavior adaptation with compensation identifying three fundamental mechanisms for managing adaptive development in later life Socioemotional selectivity: Describes individual choices in interaction, based on self-interested need for emotional closeness that leads to selective interactions Cognition and aging: Distal determinant Factors that affect cognition reside outside the individual, for example, in the social and cultural environment Proximal determinant Specific individual differences are the cause of cognitive change

Personality and aging: Theories that focus on the extent and nature of personality stability and change over time

Bonder, Bette; Bello-Haas, Vanina Dal, Jan ,2009, Functional Performance in Older Adults.

Life Span Development Theory

Social & psychological forces throughout ones life course such as individual dynamics, transitions, social context, cultural meanings and social structural location will each contribute to ones life span. Life-Span Development Theory: Baltes & Smith identify three principles: 1) Evolutionary selection benefits decrease with age 2) the need for culture increases with age, and 3) the efficacy of culture decrease with age.

Their focus is on how these dynamics contribute to the optimal expression of human development and the production of outcomes of adaptive fitness. They also postulate that a condition of loss, limitation, or deficit could play a catalytic role for positive change. (Bonder, B., Bello-Haas, Vanina Dal, Jan ,2009)

Selective Optimization With Compensation Theory

Optimization = Engagement in behaviors that will enrich ones life and help people age successfully.

Socioemotional Selectivity Theory

The theory that social exchanges and interactions are reduced over time. As one ages a person may become more selective with whom they choose to spend their time with. Emotional closeness may become more important with significant others. The idea to which one can selectively choose with whom they want to dedicate their time for becomes more important as ones ages. * (quality verses quantity)

Cognitive and Aging Theories

The theory of cognition is the age-related decline in fluid cognitive performance (the efficiency or effectiveness of performing tasks of learning, memory, reasoning and spatial abilities.) However, crystallized abilities are more stable across the life span and may even increase with age. (Representing social cultural influences on general world knowledge). (Bonder, 2009)

Personality & Aging Theories

Theories focus on the nature and extent of personality stability and how they change over a persons life span. Developmental Explanations and Personality Trait Explanations based on the big five: 1) neuroticism 2) extroversion 3) openness to experience 4) agreeableness 5) conscientiousness Many believe that personality traits are more stable later in life whereas goals, values, coping styles and control beliefs are more that likely to change. (Bonder, 2009)

Changes in the Body and Mind (cont.)

Typical mental changes
Intelligence Memory Adaptability Depression Senility

Alzheimers Disease
Progressive brain impairment that interferes with memory and normal intellectual functioning Most common form of dementia Affects an estimated one in ten persons over the age of 65 and nearly half of those over age 85

Alzheimers Disease (cont.)

Progresses in stages
First stage involves forgetfulness and memory loss. Second stage sees accelerated first-stage symptoms and agitation, restlessness, and repetitive actions. In the final stage, disorientation is complete, control of body functions are lost, and dependence on others is complete.

Strategies for Healthy Aging

Develop and maintain healthy relationships Enrich the spiritual side of life Improve fitness Eat for health

Kbler-Rosss Stages of Dying

Copyright 2010 Pearson Education, Inc.

What Is Normal Grief?

Acute grief syndrome often includes
periodic waves of physical distress lasting 20 minutes to an hour. a feeling of tightness in the throat. choking and shortness of breath. a frequent need to sigh. a feeling of emptiness in the abdomen. a sensation of muscular weakness. intense anxiety.

Wordens Model of Grieving Tasks

William Worden developed a more active grieving model that defined four tasks necessary for the individual to complete in the grief-work process.
1. Accept the reality of the loss. 2. Work through to the pain of grief. 3. Adjust to an environment in which the deceased is missing. 4. Emotionally relocate the deceased and move on with life.