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