5. Longevity and Health Flashcards
Includes chapter 5 (82 cards)
1
Q
what are maximum and average longevity?
A
- maximum longevity - the oldest age to which any individual of a species lives (about 120 right now)
- average longevity - the age at which half of the individuals who are born in a particular year have died
2
Q
what are the main factors influencing longevity?
A
- genetics
- gender
- environment
3
Q
what is active life expectancy (healthspan) and dependent life expectancy?
A
- active life expectancy (healthspan) - refers to years living in a healthy state
- dependent life expectancy - refers to remaining years living in a dependent state
4
Q
what is some evidence that genetics contribute to longevity?
A
- the parents and siblings of people who live till 90 were less likely to die young, but there was no impact on spouses
- after the age of 60, genetics increasingly influences lifespan for twins, and there is more of similarity between identical twins than fraternal twins
5
Q
how does gender affect longevity?
A
- in developed countries, women tend to live much longer than men (about 5 years)
- in developing countries, life expectancy is almost equal
- women often die in childbirth and baby girls are more unwanted
6
Q
what are some possible reasons why women in developed countries live longer than men?
A
- biological differences - different chromosomes, hormones, immune system efficiency, metabolic rates
- lifestyle differences - men tend to drink and smoke more, have poor social support, more risky behaviour
- types of work/war - men tend to have more dangerous jobs and engage in war more often
7
Q
what are our different types of immunity? what is immunosenescence?
A
- innate immunity - first line of defence, recognizes threat, rapid response
- adaptive immunity - comes in if innate immunity doesn’t work, is slower, able to target invaders the next time they’re introduced
-
immunosenescence - gradual deterioration of the immune system brought on by natural age advancement
- difficult to isolate the impact of aging on the function of the immune system
8
Q
what happens to older adults as the immune system changes?
A
older adults are/have
- more susceptible to certain infections
- much higher risk of cancer
- benefit less from immunizations
- adaptive immunity is less efficient, tend to gert vaccinations early
- immune systems take longer to build up immune defenses
- more prone to serious consequences from illnesses
- immune system can begin attacking the body itself (autoimmunity)
9
Q
what are acute vs. chronic diseases?
A
-
acute diseases - conditions that develop over a short period of time and cause a rapid change in health
- contracted less as we age because we build immunity and familiarity, but impact is more severe
-
chronic diseases - conditions that last a longer period of time (at least 3 months) and may be accompanied by residual functional impairment that necessitates long-term management
- believed to be a part of aging until the 1990
10
Q
what are the most common chronic illness amongst those 65 years of age and older?
A
45% had arthritis, 43% had high blood pressure, and 18% had diabetes
11
Q
what is multi-morbidity?
A
- having multiple chronic illnesses
- related to being a women and having low income
12
Q
what population has the highest levels of chronic illness and why?
A
- aboriginal communities have higher levels of chronic illness
- may be due to food insecurity, high cost of food, and less nutrient dense food
- lack of culturally safe health care is a concern for aboriginal communities
13
Q
what do we measure in order to assess level of health?
A
- we assess ability to perform activities of daily living (ADL) to assess level of health
- these measure provide functional assessment of health status by indicating degree of independence
14
Q
how has the percentage of deaths by age changed?
A
- in 1921, the biggest proportion of deaths are in the first year of life (over 25%)
- in 1921, people are dying throughout adulthood (about 3-5% at every age group)
- in 1996, the age with the most deaths is about 70, but in 2011 it is about 85
- in the past, most deaths were due to acute illnesses but now they are due to chronic illness (cancer)
15
Q
what lifestyle habits contribute to diseases?
A
- tabacco smoking
- physical inactivity
- unhealthy diet
- harmful alcohol use
- all contribute to cardiovascular disease, cancer, diabetes, chronic respiratory disease
16
Q
what is diabetes?
A
- a chronic disease in which the body
- cannot produce insulin, or
- does not make enough insulin, or
- cannot properly use the insulin it produces (insulin insensitivity)
17
Q
what is type 1 diabetes? what are some treatments?
A
- cannot produce insulin because cells have been attacked by own immune system
- generally develops in childhood and adolescents
- treated with insulin, diet planning and exercise
18
Q
what is type 2 diabetes? what are some treatments?
A
- cannot properly use the insulin it produces (insulin insensitivity/insulin resistance) or does not make enough
- usually because cells are over-worked
- developed mostly in adults
- managed by physical activity, dietary planning, and medication and/or insulin if necessary
19
Q
what are some complications and risks of high blood sugar?
A
- damage to and narrowing of arteries
- nerve damage
- chronic kidney disease - responsible for cleaning blood, there is a lack of blood flow to kidney
- lower limb amputation - people often don’t feel lower limbs, won’t notice injuries/infections
- diabetic retinopathy → blindness
- heart attack
- stroke
- erectile dysfunction
- death
20
Q
what is the prevalence of diabetes by age? what people are more likely to develop diabetes?
A
- we are 30% more likely to get type 2 diabetes as we age
- aboriginal people are diagnosed at a younger age, and they experience greater severity, more complications from the disease and have poorer treatment outcomes
21
Q
what is gestational diabetes?
A
- impacts 20% of pregnant women
- managed through diet, exercise, and medication
- greater risk of child developing type 2 diabetes
22
Q
how can we prevent diabetes?
A
- maintain healthy weight with physical activity and healthy diet
- eat whole grains, lean meat, fruit and veggies, cut sugar
- screening over 40 years of age
- can catch prediabetes - higher than normal blood sugar
- be aware of relatives with Type 2 and of gestational diabetes
23
Q
what are some barriers to self-care of diabetes?
A
- difficulty to adhere to treatment
- attitudes and beliefs about diabetes
- co-morbidities
- poor patient-practitioner communication and fit
- lack of social support
- financial restrictions
24
Q
how do attitudes and beliefs act as a barrier to self-care of diabetes?
A
- some see insulin therapy as a sign of failure in managing diabetes
- think injections are restrictive, ineffective, may exacerbate
- think meds will worsen condition
- cultural beliefs - some think that you just need to stop having sugar
- also think that exercise is recommended to get rid of toxins, so they go to a sauna and sweat instead of exercise
25
how does cancer occur?
- cancer starts when cells change abnormally and cancer grows as cells multiple over and over
- most cancers start due to to gene changes that happen over a person’s lifetime
- not usually genetic
- more rarely, cancers start due to inherited faulty genes passed down in families
26
what are some environmental agents that contribute to the development of cancer?
- physical carcinogens (radiation), chemical carcinogens (asbestos), or biological carcinogens
- cancers become more prevalent with increasing age in adulthood because age is associated with greater cumulative exposure to harmful toxins (carcinogens)
- cancer can be caused by HPV, helicobacter pylori, Epstein‐Barr, and hepatitis B and C
- increased testosterone can lead to prostate cancer, estrogen in post-menopausal women increases likelihood of getting uterine cancer
27
how has detection of cancer and number of survivors changed?
- until the early 20th century, detection of cancer depended on gross signs and symptoms
- at that point, the cancer is already quite advanced and treatment is less likely to be successful
- 1982: 3 million cancer survivors living in the US (1.3%)
- 2016: 15.5 million cancer survivors in the US (4.7%) 3x the amount of people in 1982
- change is due to earlier detection, not necessarily more effective or different treatment
28
what was the social context surrounding cancer in the past?
1. cancer associated with dread, fatalism, shame, silence, and stigma
2. lack of control over treatment
3. lack of support and acceptance
29
what is the prevalence of cancer and cancer deaths in Canada?
- 1 in 2 Canadians is expected to develop cancer during their lifetime
- 49% of men and 45% of women
- 1 in 4 Canadians is expected to die from cancer
- 28% of men and 24% of women
30
how has the age of people developing cancer changed?
- we are seeing more and more people in their 30s and 40s developing cancer
- raw numbers of cancer are increasing, but survival rates are also increasing
31
what are the most common forms of cancer and their 5 year survival rates?
1. prostate (95%)
2. lung (17%)
3. breast (87%)
4. colorectal (64%)
32
what are the different stages of cancer?
stage 0: no cancer, only abnormal cells with the potential to become cancer.
stage I: the cancer is small and only in one area (early-stage cancer)
stage II : the cancer is larger
stage III: the cancer is larger and has grown into nearby tissues or lymph nodes.
stage IV: the cancer has spread to other parts of your body (advanced or metastatic cancer)
33
what are some signs and symptoms of cancer?
- fatigue
- unexplained weight loss
- fever
- pain
- skin changes
- unusual lumps (tumours)
34
what do the signs and symptoms of cancer depend on?
- where the cancer is
- it’s size
- how much it affects the nearby organs or tissues
- if it has spread (metastasized)
35
what are the 5-year survival rates for breast, ovarian, and lung cancers depending on whether there was early or late diagnosis?
- breast cancer: 90% (early) vs 15% (late)
- ovarian cancer: 90% (early) vs 5% (late)
- lung cancer 1-year survival rate: 80% (early) vs 15% (late)
36
how does distress in patients and caregivers differ in women and men?
- women patients and caregivers report higher levels of distress than healthy controls
- male patients, but not caregivers, report higher levels of distress than healthy controls
- women report higher levels of distress than their husband with cancer
37
what are some reasons that caregivers that are women are more distressed than caregivers that are men?
- women pay more attention to relationships and are more in charge with taking care of family
- traditional gender roles cause women to be expected to care for their sick family
- for men, it is not an expected role, so they feel good about helping and supportive
38
how does quality of life differ for cancer patients before and after treatment?
- most survivors are unlikely to encounter long-term decreases to activities of daily living after surgery
- quality of life also increases after the operation, when compared to life prior to operation
- fear of cancer recurrence is among the most commonly reported problems
39
what are some predictors of quality of life for breast cancer survivors?
- co-morbidities
- use of chemotherapy
- social support increases QOL
- income
- employment status
- having children under 18 living at home
40
what is higher fear of cancer recurrence associated with?
- younger age
- presence and severity of physical symptoms
- lower quality of life
- lower religiosity
41
what is post-traumatic growth? what is it influenced by?
positive psychological change experienced as a result of the struggle with highly challenging circumstances
it is influenced by...
* perceptions of oneself
* focus on family and friends
* re-evaluation of life priorities
* appreciation of life
42
what are the most common cancer treatments?
- **radiation** - use of high‐energy X‐rays to damage cancer cells and stop their growth
- **surgery** - most common treatment for most types of cancer when it is probable that all of the tumours can be removed
- **chemotherapy** - uses drugs to kill cancer cells
- most likely to receive chemotherapy when the cancer has metastasized to other parts of the body
43
what is atherosclerosis?
- when fatty deposits collect at an abnormally high rate, reducing the width of the arteries and limiting circulation of blood
- you can live with atheroscleroris, but eventually it will block blood flow to a part of the body and it will suffer lots of damage
44
what is coronary (ischemic) heart disease?
when atherosclerosis affects the arteries that feed the heart
45
what is a myocardial infarction?
when blood flow to part of the heart muscle is severely reduced or blocked
46
what is hypertension? what is systolic and diastolic pressure?
- chronic abnormally elevated blood pressure
- systolic - pressure exerted by the blood as it is pushed OUT of the heart (contraction)
- diastolic - pressure when the blood is relaxed between beats
47
how does hypertension interact with atherosclerosis?
- atherosclerosis contributes to hypertension as the acumulation of plaques force blood to be pushed throuogh narrower and narrower arteries
- increased pressure places strain on the artery walls making them weak and inflamed
- this causes more plaque to be accumulated
- hypertension also increases the workload on the heart, causing it to pump harder to push out the blood
- heart muscle in the left ventricle becomes thicken and overgrown
48
what is congestive heart failure?
- when the heart is unable to pump enough blood to meet the needs of the body’s other organs
- blood flows out of the heart at a slower rate, causing the blood returning to the heart through the veins to back up
- this causes the tissues to be congested with fluid
- can be caused by coronary heart disease, scar tissue from a past myocardial infarction, hypertension, disease of the heart valves, disease of the heart muscle, infection of the heart, or heart defects present at birth
49
what happens when people with congestive heart failure exert themselves?
- people with congestive heart failure are unable to exert themselves without becoming exhausted and short of breath
- legs may swell due to edema, a condition in which fluid builds up in their bodies
- may also experience a fluid buildup in lungs, and kidney problems
50
what is a cerebrovascular accident?
- an acute condition in which an artery leading to the brain bursts or is clogged by a blood clot or other particle
- usually cause by a cerebrovascular disease
51
what is a transient ischemic attack/ministroke?
- caused by the development of clots in the cerebral arteries
- the same as a stroke, except the symptoms last for less than 24 hours
- must treat TIAs as a full-blown stroke
- full stroked often follow TIAs
52
how prevalent are cardiovascular diseases in Canada?
- heart and cerebrovascular diseases are two of the three leading causes of death in Canada (25%)
- heart attacks and heart failure accounted for two of the five top reasons for hospitalization
- 9 in 10 Canadians have at least one risk factor for heart disease and stroke
- 80 percent of these conditions are preventable through lifestyle change
53
what are behaviour risk factors for cardiovascular diseases?
- tobacco smoking (damages arteries)
- sedentary lifestyle
- high alcohol intake
- metabolic syndrome
54
what is metabolic syndrome?
- people who have a cluster of symptoms associated with high‐risk factors for cardiovascular diseases
- **criteria:** obesity, high levels of triglycerides, high levels of bad cholesterol, hypertension, and high levels of glucose
- three of these criteria must be present for the person to be considered to have metabolic syndrome
55
what are some sociocultural factors that are associated with lower and higher risk of cardiovascular diseases?
- **lower risk** is associated with higher socioeconomic advantages, higher educational levels, greater trust between neighbours, and more social support
- **higher risk** is associated with barriers to accessing routine health care, taking prescription medication, and the inability to pay for prescription medication
56
what are statins?
medications that lower the levels of harmful cholesterol (LDL) in the blood
57
what diet is best for a healthy heart?
- high in fruits and vegetables
- nuts, seeds, whole grains, olive oil
- minimum amount of red meat and dairy
58
what is chronic obstructive pulmonary disease (COPD)?
- group of diseases that involve obstruction of the airflow into the respiratory system
- chronic bronchitis and chronic emphysema—often occur together in this disease
- people with COPD experience coughing, excess sputum, and difficulty breathing even when they carry out relatively easy tasks
- main cause of COPD is cigarrette smoking
59
what is chronic bronchitis?
- inflammation of the bronchi which causes an increase in mucus
60
what is chronic emphysema?
- causes permanent destruction of the alveoli
- elastin within the terminal bronchioles is destroyed
- causes the airways to lose their ability to become enlarged during inspiration and to empty completely during expiration
61
how is cigarrette smoking related to chronic emphysema?
- link between smoking and emphysema is thought to involve the release of an enzyme known as elastase
- **elastase** - breaks down the elastin found in lung tissue
- cigarette smoke stimulates the release of this enzyme
- cigarette smoke inactivates AAT (which inhibits elastase) and allows the elastase to destroy more lung tissue
62
how can people with COPD be treated?
- individuals with COPD can benefit from medications and treatments
- inhalers that open the airways to bring more oxygen into the lungs or reduce inflammation
- machines that provide oxygen
- or in severe cases, lung surgery to remove damaged tissue
63
what are some social determinants of health and prevention?
- rural communities have fewer community health services
- health care policies and practices that work well in urban environments often do not translate well into rural environments
- also important to continue preventative practices even in late age
64
what is an ischemic stroke?
- caused by blockages which cut off the blood supply to parts of the brain
- accounts for 85% of strokes
- plaque can make arteries narrow, blood clots can cause blockages more easily
65
what is a hemorrhagic stroke?
- caused when a blood vessel bursts within or on the surface of the brain
- caused when an aneurysm that forms because of high blood pressure bursts
- 1/10 people with hemorrhagic stroke die before they get to the hospital
66
what does the incidence of stroke look like?
- stroke occurrence and number of people increases with age
- a higher percentage of men have strokes than women
- number of deaths is increase, but so is our population
- percentage of death from strokes is actually decreasing
67
what are some effects of a stroke?
- weakness or paralysis in arms and legs
- problems with speaking, understanding, reading, and writing (aphasia)
- swallowing problems
- vision problems
- losing bowel and bladder control
- pains and headaches
- fatigue
- problems with memory and thinking
- pseudobulbar affect - uncontrolled inappropriate laughing and crying
68
what do the effects of a stroke depend on?
- type of stroke
- area and side of brain impacted
- amount of damage to the area
- amount of time the brain has no blood
- amount of time before treatment
69
what are the rates of recovery of stroke?
- 10% of stroke survivors recover almost completely
- 25% recover with minor impairments
- 40% experience moderate to severe impairments requiring special care
- 10% require care in a nursing home or other long-term care facility
- 15% die shortly after the stroke
- number of stroke survivors is projected to increase
70
what are some modifiable risk factors of stroke?
- high blood pressure
- high cholesterol
- diabetes (type 2)
- being overweight
- smoking
- excessive drinking
- drug use
- inactivity
71
what are some unmodifiable risk factors of stroke?
- age
- ethnicity
- gender
- family history of heart disease
- diabetes (type 1)
72
what are the warning signs of stroke?
B alance - headache, dizziness
E yes - blurred vision
F ace - is dropping
A rm or leg weakness
S peech difficulty
T ime to call 911
73
what are caregivers more at risk for?
- depression and anxiety (25-35%)
- morbidity and mortality
- impact on immune system
- impact on telomeres
74
what are caregivers the most challenged by?
1. changes to assumptive world
2. unprepared for caregiving role
3. burden of daily demands
4. shifts in relationship
75
how are some ways that someone can be unprepared for caregiving role?
- extensive needs for information and education:
- administering meds
- physical care
- proper nutrition
- safety with transfers
- rehabilitation
- understanding diagnosis and prognosis
76
how can a relationship shift as one person becomes a patient and the other a caregiver?
- marital strain
- spousal support for caregiver is lacking
- intimacy
- illness can bring a couple closer together
77
what is protective buffering?
- caregivers hold in negative experiences to not add additional burden to patient
- actually has no impact on patient, greater distress in caregiver
78
what are the direct effects of chronic stress on caregivers?
- increased time for wound healing
- poor vaccination response, adaptive immunity takes longer to build up
- chronic inflammation, linked to an increase in morbidity
- mortality
79
what are the indirect effects of chronic stress on caregivers?
- higher fat diet
- exercising less
- being a smoker, having less confidence in quitting smoking
80
how does stress impact telomeres in research on women and mothers?
- women with the highest levels of perceived stress have shorter telomeres
- shorter by the equivalent of at least one decade of additional aging
- women who take care of a child who is chronically ill also have shorter telomeres
- women who are stressed give birth to children with shorter telomeres
81
how does exercise buffer the effects of stress?
- for people who exercise, levels of stress don’t affect telomere shortening
- for non-exercisers, a 1-unit increase in perceived stress is related to a 15x increase in odds of having shorter telomeres
82
how do health behaviours buffer the effects of stress?
- as major life events increase, the telomeres of people with low healthy behaviours decrease significantly
- as healthy behaviours increase, stress does not affect length of telomeres
