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Developmental Developmental Health PsychologyHealth Psychology
AgingAging
Primary AgingPrimary Aging– ““normal” senescencenormal” senescence
Secondary AgingSecondary Aging– ““pathological” senescencepathological” senescence
Health during old ageHealth during old age
Most in good health (Stats Can., Most in good health (Stats Can., ’99)’99)
Most common chronic conditions: Most common chronic conditions: late adulthoodlate adulthood– Arthritis, rheumatism – 42%Arthritis, rheumatism – 42%– High blood pressure – 33%High blood pressure – 33%– Allergies – 22%Allergies – 22%– Back problems – 17%Back problems – 17%– Heart problems – 16%Heart problems – 16%
Key ideasKey ideas
Women live longer than menWomen live longer than men– But more likely to have chronic But more likely to have chronic
conditions and limitations in conditions and limitations in activities of daily livingactivities of daily living
Physical health declines, Physical health declines, psychological well-being improvespsychological well-being improves
Determinants of healthDeterminants of health– Health beliefs, behaviours, social Health beliefs, behaviours, social
structure, SESstructure, SES– Often can be changed to improve Often can be changed to improve
healthhealth
Despite attention paid to sickness Despite attention paid to sickness and treatment, self-care is the and treatment, self-care is the most predominant form of caremost predominant form of care
Mental HealthMental Health
Attempt to live meaningfullyAttempt to live meaningfully– in a particular set of social and in a particular set of social and
environmental circumstancesenvironmental circumstances– relying on a particular collection of relying on a particular collection of
resources and supportsresources and supports
Self-developmentSelf-development
self-perceptionself-perception integration of various rolesintegration of various roles striving for growthstriving for growth possible commitment to possible commitment to
something beyond selfsomething beyond self Life satisfaction (self image, self Life satisfaction (self image, self
esteem)esteem)
Threats to mental Threats to mental healthhealth Epidemiological Catchment Area Epidemiological Catchment Area
StudyStudy– US Nat’l Inst. of Mental HealthUS Nat’l Inst. of Mental Health– 18,000 structured interviews18,000 structured interviews– 5 regions across US5 regions across US
Dispelled 2 major myths:Dispelled 2 major myths:– Women at greater risk.Women at greater risk.– Older adults at greater riskOlder adults at greater risk
Age-Related Trends in Age-Related Trends in Mental DisordersMental Disorders Lower prevalence in older than Lower prevalence in older than
younger adultsyounger adults– all mental disorders (excluding all mental disorders (excluding
dementias)dementias) Younger (18-64 years):Younger (18-64 years): 11-11-
25%25% Older (65+):Older (65+): 6-14%6-14%
Mood disorders (including Mood disorders (including depression)depression)
– Younger:Younger: 3-8%3-8%– Older:Older: 2-3%2-3%
DementiaDementia– Older:Older: 6-10%6-10%– Possible co-existence and Possible co-existence and
interaction with physical illnessinteraction with physical illness
Are Elderly Less Prone Are Elderly Less Prone to Mental Illness?to Mental Illness? Diagnostic criteria not “age fair”Diagnostic criteria not “age fair”
– depression symptoms different in depression symptoms different in elderlyelderly
Elderly typically visit physicians Elderly typically visit physicians before mental health professionalsbefore mental health professionals
– physical symptoms mask physical symptoms mask psychological onespsychological ones
– e.g., difficulty sleeping, changes in e.g., difficulty sleeping, changes in diet, heart palpitations (depression)diet, heart palpitations (depression)
Myths, stereotypes about agingMyths, stereotypes about aging– must distinguish normal aging from must distinguish normal aging from
disease disease – ageism in treatmentageism in treatment
Cohort effects: “stigma”Cohort effects: “stigma”
Alzheimer’s DiseaseAlzheimer’s Disease
Progressive, degenerative brain Progressive, degenerative brain disorderdisorder
Loss of memory, awareness, Loss of memory, awareness, ability to control body functionsability to control body functions
First reported in 1907First reported in 1907– Shrinkage of cortexShrinkage of cortex– Large masses of amyloid plaquesLarge masses of amyloid plaques
Spherical protein deposits outside of Spherical protein deposits outside of nerve cellsnerve cells
– Neurofibrillary tanglesNeurofibrillary tangles Twisted protein filaments inside neuronsTwisted protein filaments inside neurons
– Spread from bottom (midbrain) to Spread from bottom (midbrain) to top (cortex)top (cortex)
Plaques, tangles present in Plaques, tangles present in normal aging brainnormal aging brain
In Alzheimer’s: excessive, In Alzheimer’s: excessive, interfere with communication interfere with communication between neuronsbetween neurons
PrevalencePrevalence
Rare under 50Rare under 50 6-10% over 656-10% over 65 30-50% over 8530-50% over 85
SymptomsSymptoms
Permanent forgetting of recent Permanent forgetting of recent eventsevents
Unable to do routine tasksUnable to do routine tasks Forget simple wordsForget simple words Confusion in familiar locationsConfusion in familiar locations Forget what numbers meanForget what numbers mean Put things in inappropriate placesPut things in inappropriate places
– Watch in fishbowlWatch in fishbowl
Rapid, dramatic mood swingsRapid, dramatic mood swings Loss of language, communication Loss of language, communication
skillsskills
CausesCauses
Very little knownVery little known Possibly:Possibly:
– Genetic factors (permitting tangles Genetic factors (permitting tangles to form)to form)
– Environment (sporadic AD – no Environment (sporadic AD – no family history; possible toxins)family history; possible toxins)
– Build up of plaques in body, free Build up of plaques in body, free radicals in brainradicals in brain
Risk FactorsRisk Factors
AgeAge Family historyFamily history Brain damage (accident)Brain damage (accident)
Predictors: Kentucky Nun StudyPredictors: Kentucky Nun Study– ““richness” of early writingrichness” of early writing
TreatmentTreatment
Anti-oxidantsAnti-oxidants Enzyme-blocking agents (prevent Enzyme-blocking agents (prevent
plaques)plaques) Genetic engineering (promote Genetic engineering (promote
neuron growth)neuron growth) Respite care: caregiver stressRespite care: caregiver stress Behaviour Modification (activities Behaviour Modification (activities
of daily living)of daily living)
Physical activityPhysical activity Social involvementSocial involvement Good nutritionGood nutrition Calm structured environmentCalm structured environment
Coping with ADCoping with AD
PatientPatient– Aware of changesAware of changes– Shame, self image, fear of desertionShame, self image, fear of desertion– Behavioural changes (stages)Behavioural changes (stages)
Caregiver: physical, Caregiver: physical, psychological, socialpsychological, social– 70% family members (female 70% family members (female
usually)usually)– 50% severe stress50% severe stress
Caregiver StressCaregiver Stress– Physically exhausting: constant Physically exhausting: constant
vigilancevigilance– Psychological effectsPsychological effects
Grief: adjust to gradual lossGrief: adjust to gradual loss Increasing social isolationIncreasing social isolation Stigma: cover-up, try to avoid social Stigma: cover-up, try to avoid social
interactionsinteractions Stress: severity depends on availability of Stress: severity depends on availability of
social support (respite care, counselling, social support (respite care, counselling, support groups)support groups)