HLTC22H3 Chapter Notes -Urinary Incontinence, Antibody, Angina Pectoris
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Total dependency ratio (TDR) – (a+c)/b
The leading cause of death used to be infectious disease but has changed dramatically.
Compression of morbidity – people would remain healthy longer, until a few months before their
maximum life span and would then die after a relatively short period of disability. Others have
said that extension of morbidity – people living longer with disabilities.
Whether there is a maximum life span in humans has not been resolved
Half the world’s population of older adults live in developed countries and the other half in
developing countries but this will change where by 2030, more than twice as many older people
will be in developing countries.
Demographic transition is used to describe the process by which a society or nation moves from
one of high birthrate and high mortality to one of low birthrate and low mortality.
Demographic Factors and Rate Of Aging
Gender – men and women used to have similar life expectancies largely due to infectious disease.
Now, women live longer than me – expectancy increased for both genders but more for women.
Reasons – reduced pregnancy and childbirth mortality rates that started in the late 1800s and
early 1900s. More males are conceived and born than females, but male death rates exceed female
death rates at every age of life. Males are more likely to have prenatal and neonatal problems and
are more susceptible. In adulthood, men develop heart disease earlier than women, typically
beginning in midlife. Despite the longeiveity, women typically report poorer health than men.
They also have higher rates of disability. Why are men likely to die more than women if they are
sicker? Because women often report more illnesses that are nonfatal while men suffer more fatal
ones. In very late life, there are indeed ‘two girls for every boy’.
Marital Status – marriage appears to provide the greatest health benefits, divorce the most
difficult problems, and widowhood mixed results. Men are much more likely to be married than
women. Married people often have better health behaviour habits, more likely to have better diets
and exercise regularly, have higher incomes and thus higher socioeconomic status, also the social
integration that accompanies marriage is important for health. Both men and women appear to
suffer from mental health problems after being widowed, although it may be more prominent
among men than women.
Ethnicity – asian and pacific islanders had the greatest life expectancy at birth, followed by
European Americans, American Indians, and African Americans. Immigrants tend to be healthier.
There seems to be a crossover of age age-specific life expectancy in later life.
Socioeconomic Status (SES) – tweeners – they make too much money to receive most federal and
state services such as Medicaid or SSI, but too little to have financial security. They myth persists
that older people need less money, and poverty levels are set accordingly. Therefore, a younger
person making a certain amount of money would be considered living in poverty while a older
person would not. Older women are among the poorest people in the country, especially if they
are widowed and live alone – factors include inadequate education, resulting in low paying jobs.
The longer a person lives, the greater the risk of poverty. The effect of SES on longevity may
decrease as a person gets older.
Chapter 3 – Theories of Aging
Two reasons why there is a lack of integration in theories of gerontology. First, there are
three different aspects of age on which theories can focus: characteristic of the aging
population, the developmental or aging process, and the way in which the age is
incorporated into the social structure. Second, gerontology has historically been a bottom
up discipline; it starts from facts that may be grouped loosely into models and only rarely
Maruyama’s deviation amplification model – most systems have deviation-countering
mechanisms to maintain homeostasis. Systems can change over time. Once a system is
jarred out of homeostasis, then deviation amplification mechanisms can take over,
accelerating the change or imbalance.
Chaos theory shows how initially small changes can result in very large differences
between systems or individuals.
Biological Theories of Aging
Programmed Cell Death (Apoptosis) – existence of a death gene- a gene that
regulates sudden cell death. There may be a positive correlation between the life span of a
species and the number of times a cell will replicate. The number of times a cell will
replicate is partially regulated by the length of telomeres. The absence of these processes
could well shorten life, as apoptosis and senescence may be one way of getting rid of
damaged and cancerous cells. senescence is the major protection against cancer and is a
form of antagonistic pleiotropy – a process that is helpful and promotes reproduction in
early life but may have harmful effects in later life.
Stochastic Processes – there may be a limited number of times that a cell can
replicate without error. DNA in the mitochondria may be particularly susceptible to
damage and is because of the close proximity of mitochondrial DNA to reactive oxygen.
DNA repair mechanisms – base excision repair, nucleotide excision repair,
mismatch repair, and repair of strand breaks. Sometimes the errors don’t get detected and
other times it could be tolerated and the cell uses replication bybass.
Molecular/Cellular Theories of Aging:
Oxidation – free radicals or reactive oxygen species (ROS) are molecules that are
generated during the oxidation process. ROS is chemically unstable and can interfere
with the functions of other molecules. Superoxide dismutase (SOD) are cells that produce
antioxidant factors. The concentration of free radicals increases with age, because more
free radicals are generated in aging cells, there appears to be a decrease in the ability of
the cell to generate antioxidants, and cellular repair mechanisms become less efficient.
Lipofuscin - aging cells accumulate waste matter called lipfuscin.
Heat Shock Proteins – play a major role in protecting cells from nearly every kind
of stressor, from radiation to infection to oxidation. They are found in every living
organism. These are also called ‘molecular chaperones’ because they assist in protein
synthesis and repair. They also control inflammation. Apoptosis – a cell systematically
dismantles and repackages itself. Necrosis – the cell ruptures and spews toxic chemicals
and distress signals.
System Level theories:
Homeostasis – as we age, it becomes harder to maintain homeostasis. Three
factors: there may be a decline in the production of hormones (estrogen), the target organs
becomes less responsive either due to fewer receptors or degradation in the functioning of
receptor sites, and third the target organ may synthesize less than optimal amounts of its
Wear and Tear Theories – with continual use, our organs and joints simply wear
out. For most organ systems, this does not hold. The one exception to this is the skeletal
Stress – a modern reincarnation of the wear and tear theories. Hormesis –
moderate exposure to toxins or stressors may promote future resistance to stress and
Interrelationships Among Levels of Analysis – these are all linked.
Psychosocial Theories of Aging
Ontogenetic Models – posit that development stems from internal forces and
consists of stages that are universal, sequential, and irreversible. Erickson’s eight stages
that all are dialectical is a prime example of ontogenetic.
Sociogenic Models – ontogenetic theories were strongly criticized for positing one
primary goal or developmental pathway and ignoring differences in life courses due to
gender, social class, and cohort. Sociogenic focuses on changes in adulthood that varies
as a function of social roles and historical contexts. Transitions that follow social norms
are said to be on time and those that occur earlier or later are said to be off time.
Disengagement theory – a mutual withdrawal between the individual and society as one
ages. Activity theory – the more active the older person is, the greater the life satisfaction.
The moderating factor is personal desire: The activity level preferred by older adults.
Life Course Theory – examines the ways in which cohort and historical periods
affect the life course structure of individuals. Development is seen as a series of