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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