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GRT2111 Final Exam Review.doc

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Department
Gerontology
Course
GRT2111
Professor
Vanessa Taler
Semester
Winter

Description
GRT2111 Final Exam Review Sensation and Perception  •Definitions: •Arcus senilis: gray ring that forms around the edge of the cornea. Caused by fat lipid  deposits deep in the edge of the cornea. It doesn’t affect vision or require treatment •Floater: shadows caused by loose cells which float in the virtuous humor •Critical flicker fusion: the rate at which consecutive visual stimuli can be perceived as separate •Useful field of view (UFOV): the visual are in which information can be acquired within one eye fixation. This is useful in predicting crash risk for drivers, and begins to reduce at age 20 or younger •Saccades: fast movement of an eye from one position to another •Older readers make longer saccades and skip target words more frequently •Fixations: maintaining the visual gaze on a single location, as one ages they have longer fixations and make more fixations •Regressions: looking back to material already read •Because of longer fixations and saccades results in more regression to the target words •At what age does a decline in acuity begin? Need for stronger stimuli. •Gradual reduction in acuity behins in 40s and 50s but does not appreciably limit behavior until 70s or 80s •Stronger stimuli are needed to activate sensory receptors •Be able to name and explain 3 reasons why measuring sensory acuity in older adults cannot predict behavior? •Variability cross individuals •Variability across sensory modalities in a given individual •Some sensory systems are more important to others •You should know the anatomy presented on slides 5-7 • The structure of the eye • Sclera  white of the eye • Cornea:  surface of the eyeball (avascular)  • Anterior chamber:  space between cornea and  lens, it is filled with aqueous humor • Iri  changes pupil size • Lens  changes shape to focus light rays on  retina  • Virtuous humor:   maintains shape of eyeball • Retina  contains rods and cones which are  nerve pathways • Cones : for day and color vision; eye has about 6  million  • Rods : for night vision; eye contains 125 million  •The optic nerve leaves the eye via the optic disk  •Be able to name 3 age-related changes in the visual system and recognize the rest • Cornea becomes thicker and less curved •  Arcus senilis  gray ring that forms around the edge of the cornea. Caused by fat  lipid deposits deep in the edge of the cornea. It doesn’t affect vision or require  treatment  •  Anterior chambers gets smaller  • Aqueous humor may drain, causing increased intraocular pressure and possibly  glaucoma  • Iris color fades and pupil diameter decreases • The lens •Continues to grow •Becomes less elastic, denser, and yellower •This causes changes in color vision • Likelihood of prebyopia (farsightedness) increases  •  Virtuous humor:   becomes more liquid. Loose cells may cause shadows (floaters) •  Retina  •Vessels and capillaries narrow •Loss and change in chemical sensitivity of rods and cones  •  Cataracts  lens becomes cloudy or develops opaque areas that block light from  passing through (opacities) •Usually associated with blurred vision •Around 50% of americans 80+ have cataracts or have had cataract surgery  •  Glaucoma  : second leading cause of blindness  •Usually caused by inadequate drainage of aqueous humor, leading to damage of  the optic nerve •  Macular degeneration:   tissue in the macula (part of retina responsible for center of  visual field) deteriorates, causing a blind spot to form in the center of vision •One of the most frequent causes of vision loss in people aged 60+; usually  irreversible, but extent of vision loss may be reduced if caught early  •You should be able to explain the implications of these changes (slides 12 & 13) • Decreases visual acuity due to: •Changes in refraction by cornea and lens •Decreased accommodation ability •Less light admitted due to smaller pupils •Reduced number of rods and cones • Decreased light/dark adaption • Higher visual threshold (minimum light required to stimulate receptors)  • Increased sensitivity to glare • Increased critical flicker fusion (rate at which consecutive visual stimuli can be  perceived as separate)  •Useful field of view •at what age does it begin to change: by age 20 or younger •how does it change in aging? •It is a decrease in the efficiency of information extraction from a cluttered scene,  not a shrinking of the field of view per se • Diminished efficiency in older adults is worse under •what is the effect of dividing attention? •Divided attention: The participant identifies a target object as before but must also  localize a simultaneously presented target displayed in the periphery of the screen   •Predicts crash risk •Eye movements in reading: how and why do they change in aging? (slide 23) • Older adults read more slowly than younger readers • They have longer eye fixations and make more fixations  • Older readers also make longer saccades and skip target words more frequently,  resulting in them making more regressions to the target words • May be due to a riskier reading strategy in which they guess the next word more  often than younger readers to compensate for slower text processing  •Definitions: •Presbycusis: hearing loss that gradually occurs in most individuals as they grow older •30­35% of adults 65­75 and 40­50% of those 70+ have a hearing loss •Usually greater for high­pitches sounds •Types of presbycusis  •Sensory: degeneration of organ of Corti •Neural: loss of neurons of cochlea and higher auditory pathway •Strial/metabolic: atrophy of fibrous vascular cochlear tissue •Mechanical: affects basilar membrane of cochlea •Tinnitus: ringing, roaring, clicking, or hissing sounds in the ears that can be severe  enough to interfere with ADLs •>360,000 canadians have tinnitus in an annoing form; for about 150,000 these  noises seriously impair their quality of life  •Causes •Hearing loss, exposure to loud noise, more than 200 medications can cause  tinnitus, allergies, tumors, and problems in the heart and blood vessels, jaws and  neck can cause tinnitus  •Otosclerosis: bilateral progressive hearing impairment caused by abnormal bone  formation. Occurs in oval window and eventually immobilizes the stapes •Intervention: hearing aids, surgery (stapedectomy: removal of the stapes boney  prosthesis is substituted for the non­functioning stapes bone) •Visual enhancement: adding visual information (i.e. seeing the speaker) aids in speech understanding, this occurs for younger and older adults •Vestibular system: learn the anatomy (slide 25) and age- related changes (slide 26) •  Utricle and saccule:  compartments that contain hair cell  receptors  • The vestibular system also contains three semicircular  canals that are filled with fluid that are filled with fluid  and have an ampulla at one en d containing hair cell  receptors  • The aging  vestibular system • Age­related  changes •Decreased number of  hair cells, reduced  peripheral neural  fibers • Increased body  sway and general  postural  unsteadiness  •Age­related disorders •Dizziness: disequilibrium, faintness, lightheadedness, vertigo •Meniere’s disease: result of abnormally large amounts of endolymph collecting  in the inner ear  •Gustation and olfaction: relevant only with respect to possible discussion questions and/or questions about nutritional status in aging •Sene of taste remains reasonably intact until extreme old age •slide 29 is not testable material •learn the anatomy (slides 30-33 •Audition •Outer ear  • Pinna : external hear  • Auditory canal  •Middle ear • Tympanic membrane:    eardrum • Eustachian tubes:  from  throat • Ossicles  malleus: hammer;  incus: anvil; stapes: stirrup •Transmits sound  vibrations from eardrum  to oval window •Oval window make fluids  in inner ear vibrate  •This stimulates auditory  receptors  •Tympanic reflex: muscles  pull ossicles away from membranes when a  loud noise occurs  •Bone labyrinth •Vestibule •Cochlea (organ of corti, containing hair cells) •Semicircular canals •Membranous labyrinth •Interconnecting membranous ducts in bony labyrinth  • Perilymph:  fluid that fills the space between the bony and membranous  labyrinth  • Endolymph:   fluid inside the membranous labyrinth  •Fluids play an important role in the transmission of sound waves and the  maintenance of body balance  •be able to name 3 age-related changes and recognize all 4 (slide 35) •Pinna loses flexibility and hairs become stiffer  •Tympanic, oval window and round window membranes become less flexible  •Calcification of the ossicles  •Lessened efficiency of the acoustic reflex  •Disorders •types of hearing impairments: subtypes (slide 34) •Around 60% of those 65+ suffer hearing impairments • Conductive:  something is interfering with transmission of sound through the outer  or middle ear (i.e. impacted cerumen: ear wax, arthritic changes in ossicles)  • Sensorineural:  disorders of inner ear affecting transmission of sound to auditory  receptors or through auditory pathways (i.e. presbycusis) • Mixed:  both conductive and sensorineural  •risk factors (slide 36) •Aging, heredity •Occupational noise (i.e. farming, construction, factory work) •Recreational noises (i.e. explosive noises, such as from firearms, snowmobiling,  motorcycling or listening to loud music)  •Some medications and illness (i.e. meningitis)  •implications (slide 37) •Difficulty in distinguishing spoken words •Personality changes •Hearing aids/cochlear implants for profoundly deaf  •Speech perception: the importance of cognitive factors, why does adding visual information help? •Speech perception in aging •Speech perception declines in aging due to both sensory problems (hearing loss)  and cognitive changes (i.e. processing speed, inhibitory function) •Declines in speech perception are particularly marked when background nouse is  present (i.e. at a party)  •Sensory integration •Adding visual information (i.e. seeing the speaker) aids speech understanding  •This effect is ‘visual enhancement’ and occurs for younger and older adults •Allowing a hearing­impaired listener to watch the speakers mouth is an important  way to improve their understanding  •Elderspeak: what is it? be able to name 4 features & recognize the rest. What are the effects? Why does it decrease comprehension? • Elderspeak:  a manner of communicating to older people using a slow rate of  speaking, simplified syntax, vocabulary restrictions and exaggerated prosody  on the assumption that their age makes them cognitively impaired (common in  nursing homes and hospitals) •Features •Using a singsong voice, changing pitch and tone, exaggerating words. •Simplifying the length and complexity of sentences. •Speaking more slowly and with a limited vocabulary. •Repeating or paraphrasing what has just been said. •Using terms like “honey” or “dear.” •Using statements that sound like questions •Many of these features are present in infant directed speech  •Effects of elderspeak •Elderspeak affects an older adult’s evaluation of his or her abilities. It  can reinforce negative stereotypes about aging and erode older adults'  self­esteem. •Older people exposed to negative images of aging, including words like  “forgetful,” “feeble” and “shaky,” perform significantly worse on  memory and balance tests and show higher levels of stress •Most aspects of elderspeak decease comprehension: •It is confusing when a word is exaggerated.  •It is hard to understand a statement that sounds like a question.  •Talking too slowly affects the listener’s ability to focus on the main  point and retain information Functional Impact  •What is the prevalence of dual sensory decline? •5-20% of adults aged 70+ have dual sensory decline often more than one sense experiences impairment •Also likely to have other chronic conditions such as arthritis, balance disorders, hypertension, heart disease •Cope with multiple losses. Which can reduce independent, make them more likely to have experience disability •Impact of auditory and visual impairment on function (slides 3 & 4; related to discussion question in previous lectures); dual sensory loss reduces ability to compensate with other modality •Hearing: Difficulty hearing environmental sounds (i.e. car beep
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