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Physiology & Science: Ageing > Introduction to ageing and disease > Flashcards

Introduction to ageing and disease Flashcards

1
Q

Describe demographic trends in the first 50 years of the NHS (1948-1996) that account for an increased life expectancy in old age

A
  • Infant mortality/1000 live births has decreased considerably
  • Proportion of deaths below 65 (eng/wales) have decreased
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2
Q

How has the population structure changed over the last 50 years of the NHS?

A
  • Overall population increased by 20%
  • 0-4 age - increased by 9%
  • 80+ age - increased by 240%

Older population have grown fastest - by 2007, there were more people over 65 than under 18. The over 85s are fastest growing group, set to double by 2020.

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3
Q

Which ‘group’ of people born in the 20th century are contributing to the current ageing population?

A

Baby boomers - born in late 40s, 50s, 60s - now oldies!

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4
Q

What is a survival curve?

A

Graphical representation of population survival with age

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5
Q

What is meant by ‘squaring of the rectangle’ in reference to survival curves?

A

A steep survival curve (red) is characteristic of populations that do not age or live under such severe conditions that none survive to old age.

A less steep (more horizontal) curve (green) suggests improvements in living conditions + less death.

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6
Q

What are the reasons for squaring the rectangle of survival in the UK?

A
  • Decreased infant mortality
  • Increased standard of living
  • Improvements in public health
  • Improvements in sanitation
  • Improved diet - 1842 abolition of corn laws allowed importation of cheap American food
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7
Q

Describe the trends in retirement with age/time

A
  • Expected length of retirement inc 4-8 fold since 1870
  • Nearly all of this due to inc life expectancy rather than early retirement
  • Avg length of retirmenet inc by 5 years between 1981 and 2001 - [substantial, not meagre].
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8
Q

Name some chronic disabling diseases that have an exponential relationship with age

A
  • Stroke
  • Alzheimer’s
  • Parkinson’s
  • Osteoarthritis
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9
Q

What factors impact on disability?

A
  • Isolation + poverty
  • Physiological ageing bringing clinical threshold closer
  • Acute illness -> global impact
  • Chronic illness
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10
Q

What are the four scenarios in regards to the future of old age and woe?

A
  1. 1 year of additional woe for every year of life gained (pessimistic)
  2. Less than 1 year of additional woe for one year of life gained (some good/bad)
  3. No additional woe for each year of life gained (things stay same)
  4. Less woe despite life gained: Fries’ Compression of morbidity (optimistic)
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11
Q

What is healthy life expectancy (HLE) and how has it changed?

A

HLE refers to life expectancy but free from limiting long-standing illness, and it has also increased like life expectancy itself.

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12
Q

What are the Global Health Survey trends (1980-2001)?

A
  • No overall change in proportion of elderly people reporting their health as good, fairly good or not good
  • Proportion of people reporting long-standing illness has not changed significantly either
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13
Q

Has an ageing population meant that more older people are taking up beds in hospitals?

A

No - results from a seven-year cohort study in Germany found that use of acute hospital beds does not increase as the population ages.

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14
Q

What is ageing?

A
  • Progressive generalised impairment of function
  • Resulting in loss of adaptive response to stress
  • Growing risk of age related disease
  • Non focal + symptom free
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15
Q

Frailty is not the same as ageing. What is frailty?

A

A physiological syndrome characterised by decreased reserve + diminished resistance to stressors, resulting from cumulative decline across multiple physiological systems and causing vulnerability to adverse outcomes.

Predicts morbidity and mortality.

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16
Q

What is physical frailty?

A

Combination of weight loss, fatigue, impaired grip strength, diminished physical activity or a slow gait + loss of muscle.

17
Q

What is the relationship between ageing and disease?

A
  • Disease needs to be identified as it may respond to treatment or be preventable.
  • Ageing is not reversible but may be compensatable.
  • All changes should not be put down to age.
18
Q

Name the 4 Strehler’s Concepts that must be required for a true ageing process to occur

A
  • Universal
  • Intrinsic
  • Progessive
  • Deleterious
19
Q

What is meant by ‘universal’?

A
  • Identifiable in all members of a species
  • May effect individuals to a diff extent
  • Eg. collagen cross links, loss of calcium from bones
20
Q

What is meant by ‘intrinsic’?

A
  • Restricted to changes of endogenous origin
  • Eg. skin in axilla, hair loss
21
Q

What is meant by ‘progressive’?

A
  • All changes continue progressively with time
  • Eg. greying of hair, loss of muscle power
22
Q

What is meant by ‘deleterious’?

A
  • Should be eventually harmful to the organism
  • Eg. reduced visual acuity, loss of hearing
23
Q

How is ageing different to disease in relation to Strehlers’ concepts?

A
24
Q

What does J Grimley Evans’ theory suggest?

A
  • Spend a longer time living and shorter time dying
  • Eg. stroke at 90, probably die, if not die then shortly die after anyway - In comparison to stroke at 50, live another 40 years with disability
  • The older the age one attains without becoming disabled the shorter the period of dependency to be expected before death.
  • Suggests that for disability in later life, postponement of age of onset would result in prevention of suffering
25
Q

What reasons underly postponement of disability in old age?

A
  • Health promotion
  • Illness prevention
  • Appropriate use of existing technologies
  • Technologies around the corner
26
Q

Describe problems in drug treatment of older people

A
  • 10% on contraindicated drugs
  • 6% acute admissions due to inappropriate prescriptions
27
Q

Name 2 problems in regards to the ageing population

A
  • Economics of health costs
  • Combating ageism
28
Q

Why is keeping older people healthy the cheaper option?

A
  • Prevention is cheaper than cure
  • Postponement and compression of morbidity is cheaper than community or institutional care for people with chronic disability
29
Q

Describe the health expenditure of old age in the UK

A
  • Age specific need for health care is falling
  • Expenditure on health care always maximal in last year, irrespective of age of death (so the overall spending is increasing)
  • BUT smaller increase in per capita costs for older ages compared w/ younger age groups (but not increasing per individual old person)
  • Combined NHS + hosp/comm services for 85+ has decreased in real per capita costs between 1985 and 1996/99

Physiology & Science: Ageing (13 decks)

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