Aging and Disability
Chapter 28
Demographics
• Increase of older people today
• 2000 - over 65 ~ 12% of population
• 2020 - over 65 ~ 20% of population
• Increase of people over 85 years
Why Persons Age
• Gerontology - scientific study of aging that examines individual differences including biological, psychological, and sociological perspectives
• Chronological age - number of years since birth
Why Persons Age
Descriptors:
• Older or old 65 +
• Young-old 65 - 74
• Old 75 - 84
• Old-old 85 – 99
• Oldest-old 100 +
Why Persons Age
• Life expectancy - average number of years remaining
• Cohort - group of people with similar life experience
Why Persons Age
• Morbidity - absence of health
• Behavioral slowing is the biggest sign of aging - changes affect information processing
• Overall health of older populations is increasing
Psychological Benefits of Physical Activity
• Immediate benefits– Relaxation
– Reduces stress and anxiety
– Enhanced mood state
• Long-term effects– General well-being
– Improve mental health
– Improve cognitive function
– Motor control and performance
– Skill acquisition
Social Benefits of Physical Activity
• Immediate benefits– Empowered older
individuals
– Enhanced social and cultural integration
• Long-term effects– Enhanced integration
– Formation of new friendships
– Widened social and cultural networks
– Role maintenance and new role acquisition
– Enhanced intergenerational activity
Chronic Diseases of Aging
• Arthritis
• Cancer
• Diabetes
• Diseases of heart and blood vessels
• Osteoporosis
Arthritis
• Arthritis - joint inflammation– Results in joint soreness, pain, and stiffness– Over 100 forms
• Osteoarthritis
• Rheumatoid Arthritis
Osteoarthritis
• Arthritis caused by breakdown of joint cartilage (hands and weight-bearing joints)
• Most common in women over 45
• Goals of treatment include reducing pain and improving range of motion
Rheumatoid Arthritis
• Caused by chronic inflammation of the synovia or lining of multiple joints
• Affects the entire body systematically• Autoimmune disease - natural immune
system does not operate properly and attacks healthy joint tissue
• Goals of treatment include reducing pain, and balancing rest and exercise
Cancer• Over half of all adult cancer incidents are among
people over 65– Seven warning signs of cancer:
• Change in bowel or bladder habits
• Sores that do not heal
• Unusual bleeding or discharge
• Thickening lumps
• Indigestion or difficulty swallowing
• Obvious change in wart or mole
• Nagging cough or horseness
Cancer
Cancers with the highest mortality rate
• Lung cancer
• Breast cancer
• Prostate cancer
• Colorectal cancer
Lung Cancer
• Leading cause of cancer death– Most often ages 55 – 65– Most people die within one year of diagnosis– Smoking is greatest risk factor– Symptoms include chronic cough, shortness of
breath, chest pain, loss of weight, bone pain, and others
Breast Cancer
• Most common form of cancer for women– Generally develops after age 50– Treatments depend on stage of development– Lumpectomy– Mastectomy – Chemotherapy following surgery increases
survival rate– Risk reduced by physical activity
Prostate Cancer
• Greatest risk is increasing age
• Highest prevalence in men over age 65
• Generally growth is very slow
• Early detection and prompt treatment reduce the spread
Colorectal Cancer
• Cancer of the colon and rectum
• Third most common form of cancer
• Detected and treated early almost all cases can be cured
• 90% of cases found in people over 50
• Diet may play an important role
Diabetes
• Diabetes impairs glucose utilization
• Type 1 - onset before age 25 and insulin dependent
• Type 2 - noninsulin dependent usually occurs in overweight adults over 40
Type 2 Diabetes
• Linked to inactivity, family history of diabetes, and ethnic heritage
• Treatment includes weight reduction, diet, exercise, and oral medications
• Exercise helps the body use insulin appropriately
Diseases of the Heart and Blood Vessels
• Hypertension
• Heart Attack
• Stroke
• Reduction of risk includes weight control and exercise
Hypertension
• High blood pressure
• Silent killer - no obvious symptoms
• Leads to cardiovascular complications
• Controllable through diet, exercise, and medication
Hypertension
• Prehypertension - blood pressure levels just below the risk for stroke
• Postural hypotension - blood pressure drops and dizziness or lightheadedness occurs - may occur in persons using diuretic drugs– Maintain hydration– Use the bathroom
Hypertension
• Medications– Beta blockers - reduces workload of the heart
– Calcium channel blockers - reduces constriction in blood vessels
– Angiotensin converting enzyme inhibitors - allow blood vessels to dilate
Heart Attack
• Coronary Heart Disease (CHD) - leading cause of death in U.S.
• Coronary arteries that supply blood to the heart narrow and cause a heart attack
• Controllable factors - smoking, obesity, high blood pressure, high cholesterol, sedentary lifestyle, and diabetes
• Family history of CHD also increases the risk
Stroke
• Associated with hypertension
• Interrupted blood flow to the brain damaging brain cells– Lack of oxygen– Sudden bleeding– Timely treatment can save damaged cells
• High incidence rate
Stroke
• Knowledge of warning signs essential for quick treatment
• Recovery depends on damaged area, rehabilitation services available, and attitude of person who had the stroke
• Prevention strategies - diet, exercise, monitoring blood pressure, sugar, and identification of other problems
Osteoporosis
• Osteopenia - loss of bone mass
• Osteoporosis - combination of osteopenia and mechanical failure of the skeleton
• Bones become fragile and risk of fractures increases
• Prevention/treatment - focuses on diet, exercise, and hormone replacement therapy
Falls and Posture Training
• Many older people fear falling and hurting themselves
• Fear leads to sedentary lifestyle
• Physical activity can improve strength, reaction, balance, confidence, and reduce the risk of falling
• Tripping is most common cause of falls
Alzheimer’s Disease
• Severe changes in memory• Dementia - loss of memory and other
intellectual capacities• Rate of AD increases dramatically with age• Exercise during early-stage AD can be
beneficial• Exercise contributes to aerobic capacity and
cerebral circulation
AD and Exercise
• Exercise during early-stage AD can have positive impact– Change in sleep patterns– Reduction in restless behavior– Reduction in aggressive incidents
• Enhances functioning of neurons• Increase physical and mental arousal
AD and Exercise
• Activity guidelines for early-stage dementia– Patience– Dropout prevention– Simplify– Praise– Maintain frequency
• Later-stage dementia presents additional challenges
Parkinson’s Disease
• Progressive neurological disorder that is most commonly seen in individuals older than 50
• Degeneration of neurons causes loss of dopamine
• Affects voluntary movement and results in shaking or tremor-type movements
Parkinson’s Disease
• Incidence increases with age• No cure• Drug treatments restore dopamine levels• Relaxation exercises can reduce tremors• Flexibility exercises can stretch tightened
muscles• Breathing exercises strengthen respiratory
muscles
Depression
• Not a normal part of aging
• Occurs with other conditions (comorbid)– Affects moods– Apathetic
• Loss or stressful changes
Depression
• May go unreported or undiagnosed
• Severe depression may lead to suicide
• Incidence increases with age
• Physical activity and exercise– Improve physical well-being– Improve social well-being– Improve psychological well-being
Vision and Hearing
• Visual and auditory acuity steadily decline with age
• Structural changes occur in eyes and ears with age and result in reduced vision and hearing
Vision and Hearing
• Macular Degeneration– 10-12 million adults affected
– Deterioration of the central portion of the retina
– Diet, eye protection, and vitamin supplements need to be modified after diagnosis
Vision and Hearing
• Cataracts– Leading cause of blindness– Cataracts can be removed with surgery
• Glaucoma – Glaucoma increases over 65– Treated with drugs and eye drops to
lower pressure in the eye
Vision and Hearing• Exercise and activity program considerations
– Use brightly colored markers– Keep floor clear of all objects– Sit rather than stand– Face the participant– Give clear verbal instructions and demonstrations– Keep equipment in the same place– Keep hands away from your face– Speak in a normal tone
Aging with Disability Acquired When Young
• Unique changes in aging associated with other disabilities
• Spinal cord injury
• Congenital or childhood onset disabilities
• Mental retardation
Spinal Cord Injury
• Prolonged duration of SCI
• Secondary complications
• Pathological processes not related to SCI
• Degenerative changes of aging
• Environmental factors such as societal, community, and cultural issues
Congenital or Childhood Onset Disabilities
• Aging problems associated with the musculoskeletal system– Soreness of joints– Pain and weakness in muscles– Decline in energy
• Secondary conditions impacting quality of life
• Loss of independent walking
Mental Retardation
• Health problems are similar to the older population as a whole
• 50% have at least one major chronic physical problem
• Service delivery in terms of physical activity, recreation, and leisure programs for this population is lacking
Down syndrome
• Alzheimer’s disease and Down syndrome (trisomy 21) linked
• Brain changes in adults with DS and AD are same
• Higher rates of vision and hearing loss, osteoporosis, epilepsy, motor disabilities, chronic lung disease, diabetes, and stroke
Interactions with People Who Are Older
• Ageism - prejudice against a person based on old age
• Based on stereotyped expectations communication decreases between younger and older people
• Avoid baby-talk and patronizing speech
• Listen and treat with respect