Week 8 readings – notes .docx

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Health Sciences
Health Sciences 2711A/B
Aleksandra Zecevic

Week 8 readings – notes Chap 17; physical & cognitive development in late adulthood (455 - 462) Physical disabilities: • Illness and disability climb at the end of lifespan o Cardiovascular disease & cancer are leading causes of death (increased dramatically from mid-late life) o Before: men were more prone to cancer/cardiovascular, but sex differences decrease w/ age o Stroke: 3 most common killer, more so in women  Blood clot blocks a blood vessel/blood vessel hemorrhage in brain  Damage to brain = late life disability / death after 75 o Respiratory disease: increase sharply w/ age  Lung inflammations = pneumonia • Other diseases are less frequent killers & imit ability to live fully & independently • Physical & mental disabilities are related to age, doesn’t mean they are entirely caused by aging o Primary aging: (biological aging) genetically influenced declines that affect all members of our species and take place even in the context of overall good heath o Secondary aging: declines due to hereditary defects & negative environmental influences (poor diet/exercise/disease/substance abuse/stress/pollution)  Difficult to distinguish b/w Frailty: weakened fxning of diverse organs & body systems, profoundly interferes w/ everyday competence and leaves elder vulnerable to infection, hot/cold temps/injury • Primary aging contributes, but secondary aging is a larger factor Arthritis: condition of inflamed, painful, stiff & maybe swollen joints and muscles • Osteoarthritis: o most common arthritis, deteriorating cartilage on the ends of bones of frequently used joints. Only affects certain joints (wear-and-tear / degenerative joint diease) o Age related, appears around age 40-50 o Almost all older adults show symptoms of osteoarthritis, but severity varies • Rheumatoid arthritis: o autoimmune response leading to inflammation of connective tissues (membranes lining joints) all over the body = overall stiffness, inflammation & aching. o Cartilage tissue grows and damages surrounding tissues/organs/bones = deformed joints + severe loss of mobility • US: disability due to arthritis is 45% of men over 65 • US: disability due to arthritis is 50% of women at 65-84, and 70% of those over 85 • Can happen at any age, usually after 60 • Strong heredity contribution, but even ID twins have varying severity so environment important • Early treatment w/ anti-inflammatory, pain relief, rest, physical activity (stretching) Diabetes: the imbalance of glucose in bloodstream & insulin produced/insensitivity to it = type 2 diabetes: diabetes mellitus • High blood glucose damages blood vessel, increases risk of heart attack/stroke/circulatory probs in legs/injuries to eyes, kidneys, nerves Week 8 readings – notes • Extra blood glucose = decreased blood flow to hippocampus (memories) = cognitive decline/ increase risk of Alzheimer’s • Elders w/ diabetes have 65% increased risk of developing alzheimers • Incidence doubles from mid-late adulthood, affects 10% of elderlies in US • Hereditary + inactivity/fat in abdomen • Higher risks for African-American/Mexican-American/native-American • Requires lifestyle change (diet, exercise, weight loss) Unintentional injuries: • Death rates is twice as high that in adolescence/early adult • Motor vehicle accidents: o Elders = highest (less than under age 25 drivers) traffic violations/accidents/fatalities  30% of all pedestrian deaths o Visual processing difficulties + decline in capacity to engage in multiple activities  Try to be cautious, but fail to heed signs/yield/turn appropriately o Want to drive as long as possible because it’s freedom & control over life + self esteem • Falls: o 30% of adults over 65 & 50% of adults over 80 have exp fall within the year o declines in hearing/vision/mobility/strength/cognitive fxn/moods increase risk o 10% of falls are serious injuries (commonly are hip fractures) o 20% increase from age 65-85 in mortality, survivals might lose ability to walk w/o assistance o impairs health indirectly = promote fear, avoid activities Mental disabilities: • Normal age-related cell deaths in brain don’t lead to loss of ability to do daily activities. • Cell death & structural & chemical abnormalities are profound, serious deterioration of mental & motor functions occur • Dementia: o Set of disorders occurring almost entirely in old age where thoughts& beh are impaired so ADL are impaired o Damage in cerebral cortex, not so much subcortical brain = cortical dementia o STATS ARE WESTERN SOCIETY + USA o 13% of adults over age 65, equal in sex (8-10% USA) o 1% affected in 60’s o 45-50% after age 85 (45% USA) o African Americans have elevated incidence because maybe intermarriage w/ Caucasians heighted genetic risk o Some are reversible, others are not o Cortical dementia has 2 types: o Alzheimer’s disease  Most common form of dementia, structural & chemical brain deterioration, gradual loss of though & beh  60% of all dementia cases Week 8 readings – notes  expected 7.7 million cases in 2030 (increased more than 50%)  5% of all deaths involve alzheimers  Symptoms & course of disease • Severe mem prob (names/dates/appnts) • Cant recall distant events (basic facts – date/time/places) • Personality change (anxiety/aggression/reduced initiative) • Depression in early phase • Skilled movement disintegrate • Disrupted sleep by delusions/fears • Lose ability to comprehend/produce speech • No longer recognize people/objects • Vulnerable to infections • Death • Men @ age 70 can live 4.5 years more • Woman @ age 70 can live 8 years more  Brain deterioration • Alzheimer’s is diagnosed through exclusion, after every other possibility is ruled out. Need to inspect brain after death • PET & MRI scans show us 3D pics • In the cerebral cortex has abundant: o Neurofibrillary tangles: bundles of twisted threads that were collapsed neural structures containing abnormal forms of protein (tau)  Tau facilitates amyloid-induced damage o Amyloid plaques: dense deposits of deteriorated protein (amyloid – causes synapses to malfxn) surrounded by clumps of dead nerve & glial cells develop  Abnormal breakdown of amyloid, brain trying to eject harmful amyloid from neurons but builds up and gets toxic when chopped differently and causes cell death  Amyloid causes higher, abnormal electrical activity = neural network malfxn • Synapses deteriorate = death of neurotransmitters/neurons/ acetylcholine releasing neurons (transport msgs b/w distant brain regions) = shrinking brain vol & disrupted neuronal networks therefore hard to remember/reason/judge o Also drop in serotonin = bad sleeping/aggression  Risk factors • 2 types: o Familial: runs in families  Usual early onset and dominant gene  (chrom. 1, 14, 21 generate harmful amyloid) o Sporadic: no obvious family history Week 8 readings – notes  Through somatic mutation (chrom 19) = excess ApoE4 (blood protein that carries cholesterol) therefore, high concentration of it affects insulin = high glucose in blood = diabetes = lead to mem deficiency & buildups of amyloid  Fatty food increase chance of ApoE4 gene  Protective factors: • Mediterranean diet: fish, unsaturated fat (olive oil), red wine linked
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