NURS2003 Chapter Notes - Chapter 14: Vascular Dementia, Presbycusis, Presbyopia
CHAPTER 14 – THE PHYSICAL CHALLENGES OF OLD AGE
Tracing Physical Aging
Normal aging changes: the universal, often progressive signs of physical
deterioration intrinsic to the aging process
Chronic disease: any long-term illness that requires ongoing management. Most
chronic diseases are age-related and are the endpoint of normal aging changes
Activities of daily living (ADL): difficulty in performing everyday tasks that are
required for living independently. ADLs are classified as either basic or
instrumental
Instrumental ADL problems: difficulties in performing everyday household tasks
such as cooking and cleaning
Basic ADL problems: difficulty in performing essential self-care activities, such as
rising form a chair, eating and getting to the toilet
Normal aging changes progress into chronic disease and finally, during the old-
old years, may result in impairments in ADLs, either less incapacitating
instrumental ADL problems or basic ADL problems
Although living much beyond a century is impossible, the statistical odds of
reaching the upper ends of the lifespan vary depending on our socioeconomic
status, culture, gender and cohort
Socioeconomic health gap: the disparity, found in nations around the world,
between health of the rich and poor. At every step up on the socioeconomic
ladder, people survive longer and enjoy better health
Refers to the fact that – within each nation – people who are affluent live
healthier for a longer time
A variety of forces, from health-compromising lifestyles to inadequate medical
care make poverty a major risk factor for early disability and death
Still, education and close attachments can buffer us from the health
consequences of being poor and Latinos do better “illness-wise” than we
might expect
Unfortunately, African Americans do worse – dying earlier (particularly from
cardiovascular diseases) than other ethnic groups
Being male is also a risk factor for dying younger, especially of a heart attack
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Women outlive men but report more health problems at every stage of adult
life
Depressing new research suggests that due to the obesity epidemic, the baby
boomers may be emerging into their older years more “ill” than their parent’s
generation
Sensory-Motor Changes
Presbyopia: age-related midlife difficulty with near vision, caused by the inability
of the lens to bend
Impairments in near vision
Lens: a transparent, disk-shaped structure in the ye, which bends to allow us to
see close objects
The classic age-related vision problems – presbyopia, difficulties seeing in dim
light and problems with glare – are caused by a rigid, cloudier lens
Modifying lighting can help compensate for these losses
Cataracts, the endpoint of a cloudy lens, can be easily treated, although the
other major age-related vision impairments often result in a more permanent
loss of sight
If vision losses are permanent people often rely on external aids and their own
emotional resources to cope
Presbycusis: age-related difficulty in hearing, particularly high-pitched tones,
caused by the atrophy of the hearing receptors located in the inner ear
Presents special problems because it limits a person’s contact with the human
world
Because exposure to noises causes this selective loss for high-pitched tones,
men are at higher risk of having hearing handicaps, especially at younger
ages – although in our noisy society, hearing problems are increasing for both
sexes
To help a hearing-impaired person, limit low-pitched background noise and speak
distinctly – but avoid elderspeak, the impulse to talk to the older person like a
baby
For your own future hearing, protect yourself against excessive noise
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