Unit 2 - Chapter 4 of Text Flashcards
1
Q
What are the two types of longevity?
A
1) Average longevity
2) Maximum longevity
2
Q
What is average longevity?
A
- Commonly called average life expectancy and refers to the age at which half of the individuals who are born in a particular year will have died.
- Is affected by genetics and environmental factors
3
Q
What are increases in longevity due to?
A
1) Decline in infant mortality
2) Eliminating diseases such as smallpox, polie
3) Decline in number of women who die in childbirth
4) Medical technology
4
Q
What is maximum longevity?
A
- The oldest age to which any individual of a species lives.
- Even if we were able to eliminate all diseases, most researchers estimate the limit to be somewhere around 120 years because key body parts, such as the cardiovascular system have limits on how long they’ll last
5
Q
What factors influence our longevity?
A
1) Genetics
2) Environmental
3) Ethnicity
4) Gender factors
6
Q
Interesting facts on longevity
A
- If your mother lives to at least age 80, roughly 4 years are added to your average longevity
- Children of parents who lived beyond 80 survived about 20 years longer than children whose parents had both died before they were 60
7
Q
What is the Human Genome Project (2003)?
A
An international scientific research project with the goal of determining the sequence of chemical base pairs which make up human DNA, and of identifying and mapping all of the genes of the human genome from both a physical and functional standpoint
8
Q
What do researchers with the Human Genome Project hope to do with their work?
A
1) Improve the way medicines work
2) Implant “correcting” genes into people in the hopes that the good genes will reproduce and eventually wipe out the defective genes
9
Q
What sorts of environmental factors affect the life span?
A
1) Disease - cardiovascular, Alzheimer’s, smoking, lack of exercise
2) Toxins
3) Lifestyles
4) Social class
10
Q
Generally, how are environmental factors involved in the life span?
A
1) Air and water pollution
2) Toxins in fish
3) Bacteria and cancer-causing agents in drinking water
4) Airborne pollutants
11
Q
What is the negative impact of social class on life span?
A
1) Reduced access to goods and services, especially medical care
2) Ethnic groups that experience poverty
3) Little or no health insurance
4) Air pollution in crowded cities and unable to afford to move
5) Lead poisoning from old lead pipes
6) No money for a more healthful lifestyle
12
Q
How do we differentiate between active life expectancy and dependent life expectancy?
A
- Active life expectancy is living to a healthy old age
- Dependent life expectancy is simply living a long time
- One’s active life expectancy ends at the point when one loses independence or must rely on others for most activities of daily living (cooking, bathing, etc.) The rest of one’s life constitute living in a dependent state
13
Q
Give an example of how a change in circumstances can significantly alter expected life span
A
Acquired immunodeficiency syndrome (AIDS) has had a devastating effect on life expectancy in Africa where some countries (Botswana, Namibia, South Africa, and Zimbabwe) average longevity may be reduced by as much as 30 years
14
Q
What are some ethnic differences in average longevity?
A
- Ethnic groups do not have the same average longevity at birth
- African Americans’ average longevity at birth is roughly 6.5 years lower for men and about 5 years lower for women than it is for European Americans
- By age 85, African Americans tend to outlife European Americans
- Latinos have higher average life expectancies than European Americans at all ages despite having less access to health care
15
Q
What are the gender differences in average longevity?
A
- Women’s average longevity is about 5 years more than men at birth, narrowing to 1 year by age 85
- This is typical of most industrialized countries, but not developing countries
16
Q
Why did the female advantage in average longevity in the US become apparent only in the early 20th century?
A
- Fewer women died in childbirth
- Death in childbirth explains the lack of a female advantage in developing countries
- Access to better health care, work and educational opportunities
17
Q
Are men or women more likely to die from infection or disease?
A
- Men’s rates of dying from the top 15 causes of death are significantly higher than women’s at nearly every age
- Men are also more susceptible to infectious disease
- Great susceptibility in men of contracting certain fatal disease and genetics
18
Q
What advantages may women have over men?
A
- Women have two X chromosomes whereas men have just one
- Men have a higher metabolic rate whereas women have ahigher brain-to-body weight ration
- Women have lower testosterone levels
19
Q
How do men and women compare with respect to cognitive testing?
A
- Older men who survive beyond age 90 are the hardies segment of their birth cohort in terms of performance on cognitive tests
- Between ages 65 and 89, women score higher, but beyond 90, men do much better
20
Q
How does the World Health Organization (WHO) define “health”?
A
A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity
21
Q
How do we define “illness”?
A
The presence of a physical or mental disease or impairment
22
Q
What are the 4 reasons why self-report on one’s health status is accurate?
A
1) Self-rated health captures more aspects of health than other measures
2) Poor self-related health reflects respondents’ belief that they are on a downward trajectory
3) People’s self-ratings affect their health outcomes
4) Self-rated health may actually represent an assessment of people’s internal and external resources that are available to support health
23
Q
What does research show about self-reporting on health?
A
- Self-ratings of health are very predictive of future health outcomes
- Self-ratings also tend to be fairly stable over time
24
Q
Who self-reports better health … men or women?
A
- Men rated their health worse than women did
- Among the oldest-old, self-rated health is a powerful predictor of mortality across cultures even after socio-economic status and health conditions had been accounted for
25
What two areas does research on quality of life focus?
1) Quality of life in the context of specific diseases or conditions
2) Quality of life relating to end-of-life issues
26
What is the SOC model?
The model of selection, optimization, and compensation (SOC) posits that these three fundamental processes of developmental regulation are essential for successful development and aging. Selection, optimization, and compensation are thought to advance the maximization of gains and minimization of losses associated with aging, thus promoting successful development and aging.
27
What factors determine quality of life?
- Quality of life depends upon a person's valuation of life, the degree to which a person is attached to his or her present life
- How much one enjoys life, has hope about the future, and finds meaning in everyday events
28
How does our immune system work?
- How does the immune system differentiate between our cells and invader cells?
- Some mechanism involves recognizing certain substances called **antigens** on the surface of invading bacteria and cells that have been taken over by viruses
- Once the immune system has learned to recognize the invader, it creates a defence against that invader
29
How does the defence system work?
- Based on 3 types of cells that form a network of interacting parts:
1) Cell-mediated immunity
2) Humoral immunity based on antibodies
3) Nonspecific immunity
30
What is the role of cell-mediated immunity?
- Consists of cells originating in the thymus gland or *T-lymphocytes*
* -* T cells or T lymphocytes are a type of lymphocyte (in turn, a type of white blood cell) that plays a central role in cell-mediated immunity. They can be distinguished from other lymphocytes, such as B cells and natural killer cells (NK cells), by the presence of a T-cell receptor (TCR) on the cell surface.
31
What is the role of humoral immunity based on antibodies (*B-lymphocytes*)?
- A type of lymphocyte that originates in the bone marrow and produces antibodies.
- A precursor of the plasma cell, it is one of the two lymphocytes that play a major role in the body's immune response. Also called **B lymphocytes**
32
What is the role of nonspecific immunity (monocytes and polymorphonuclear neutrophil leukocytes) cells?
A white blood cell, usually neutrophilic, having a nucleus that is divided into lobes connected by strands of chromatin. Also called multinuclear leukocyte.
33
What are natural killer (NK) cells?
- Special type of lymphocytes that monitor our bodies to prevent tumor growth and are the primary defence against cancer
- Also fight viral infections and parasites
34
What is the primary job of the T- and B- lymphocytes?
- To defend against malignant (cancerous) cells, viral infection, fungal infection and some bacteria
35
What are the 5 major types of specialized immunoglobulins (antibodies)?
1) IgA
2) IgD
3) IgE - is involved in allergies and asthma
4) IgG - also called g-globulin, helps fight hepatitis
5) IgM - includes the first responders in the immune system
36
What are some of the changes in the immune system over the life span?
- Older adults are more susceptible to certain infections and have a much higher risk of cancer
- Older adults immune systems take longer to build up defences against specific diseases, even after an immunization injection
- This is probably caused by the changing balance in T-lymphocytes and may partially explain why odler adults need to be immunized earlier against specific diseases such as influence
- Similarly, B-lymphocytes decrease in functioning
37
What research is there regarding administering growth hormones to older adults?
Research examining the administration of substances such as growth hormones to older adults to stimulate lymphocyte functioning indicates that some specific lymphocyte functioning returns to normal with treatment and can regenerate the thymus gland, both of which are important in treating individuals with HIV
38
What is the difference between when an older adult versus a younger adult faces a serious illness?
- Older adults become more prone to serious consequences from illnesses that are easily defeated by younger adults
39
What happens to the chances of getting leukemia as one ages?
Various forms of leukemia, which are cancers of of the immune cells, increase with age, along with other forms of cancer
40
What is autoimmunity?
- When the immune system attacks the body itself
- Autoimmunity results from an imbalance of B- and T-lymphocytes, giving rise to autoantibodies and is responsible for several disorers, such as rheumatoid arthritis
41
What is psychoneuroimmunology?
The study of relations between psychological , neurological, and immunological systems that raise or lower our suceptibility to and ability to recover from disease
42
What has been the focus of much of the research into psychoneuroimmunology?
- Identifying the psychological triggers that start the process and result in cancer
- Two types of investigations have been conducted:
1) Predicting which healthy older adults are likely to eventually get cancer
2) Predicting those who will live longer after being diagnosed with cancer
- Having a positive attitude, support system predicts longer life for middle-aged patients with cancer, but not for older ones
- Social support appears more important for women than men
43
What are the characteristics of AIDS in older adults?
- An increasing number of older adults have AIDs
- People who contracted HIV during middle age and survived to later life and people who contracted the disease as older adults
- Many physicians do not test older patients for HIV/AIDs
- Older men are at a higher risk for AIDs - the most common risk factor is homosexual or bisexual behaviour
- Older women usually contract AIDs through heterosexual sex with an infected partner
- Older adults may be more susceptible to HIV infection because of the changes in the immune system
44
What is the prognosis when older adults are diagnoses with AIDs?
Once older adults are diagnosed with AIDs, their lifespan is considerably shorter than the same diagnosis in younger adults
45
What is the biggest problem in getting older adults to practice prevention re: AIDs?
- Most physicians assume that older people aren't sexually active, so they don't discuss HIV and AIDs with their patients
46
What is an acute disease?
-Conditions that develop over a short period of time and cause a rapid change in health
47
What is a chronic disease?
- 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
- Examples of chronic diseases are arthritis and diabetes mellitus
48
Does the rate of acute illnesses increase with age?
- No, the rate of of acute diseases go down whereas the rates of chronic diseases go up
- Older adults have fewer colds than younger adults
- However, when they do get an acute disease, they get sicker and recovery takes longer
49
What is the rate of deaths from pneumonia and influenza with older adults
Older adults are at more at risk from things like respiratory infection is about the same for younger and older adults, but people over age 65 account for roughly 90% of deaths from pneumonia and influenza
50
What is the position on stress?
- Long-term stress is bad for your health
- Scientists do not agree on a definition of stress
- Stress is defined by the person experiencing it, so no two people have the same experience of stress
51
What are the 2 views for studying stress and how people deal with it?
1) Involves specific physicological responses
2) People's evaluation of events in the context of the various resources they have.
52
What is the physiological response to stress?
- Prolonged exposure damages the sympathetic nervous system, which controls things likeheart rate, respiration, perspiration, blood flow, muscle strength, mental activity
- Increased risk of cardiovascular disease
- Impaired immune system function
- Some forms of cancer
53
What is stress and the coping paradigm?
The paradigm views stress not as an environmental stimulus or as a response, but as the interaction of a thinking person and an event
54
Definition of stress from the coping paradigm perspective
A particular relationship between a person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well being.
55
What is the transactional process of stress?
- A transactional process between a person and the environment
- The transactional model of stress says that each time you are in a traffic jam you make a separate judgment as to whether it is stressful
56
What are the 3 ways in which we appraise stress? What is primary appraisal?
Primary appraisal categorizes events into three groups based on the significance they have for our well being:
1) Irrelevant
2) Benign or positive
3) Stressful
57
What are irrelevant events?
Events that ha bearing on us personally such as an earthquake in a distant country
58
What are benign or positive events?
Events that have good effects, such as long-anticipated pay increase
59
What are stressful events?
Ones that are appraised as harmful, threatening, or challenging
60
How do primary appraisals act?
As a filter for events, any event that is appraised as either irrelevant or as benign or positive is not stressful
-We decide which events are potentially stressful and which ones are not
61
What is secondary appraisal?
- If one believes that an event is stressful, a second set of decisions are made
- Secondary appraisal evaluates our perceived ability to cope with harm, threat, or challenge
62
What are the 3 responses to secondary appraisal?
1) What can I do?
2) How likely is it that I can use one of my options successfully?
3) Will this option reduce my stress?q
63
What happens as a stressful event unfolds?
As the event continues to unfold, you begin to get an idea as to whether your primary (and secondary, if necessary) appraisal was accurate
64
What is reappraisal?
- Involves making a new primary or secondary appraisal resulting from changes in the situation
- Reappraisal can either increase or decrease stress
65
What is coping?
- During the secondary appraisal of an event labeled stressful in primary appraisal, we may believe there is something we can do to deal with the event effectively. Collectively, these attempts to deal with stressful ervents are called coping.
- Coping is learned, not automatic. That is why we often do not cope very well with stressful situations we are facing for the first time
- Coping takes time and effort
- Coping entails only managing the situation, we need not overcome or control it
66
What are the two ways in which people cope can be classified in several ways?
1) Problem focused coping - involves attempts to tackle the problem head-on
2) Emotion focused coping - involves dealing with one's feelings about the stressful event
67
What is aging and the Stress and Coping Paradigm?
- Two important age related differences in the stress and coping paradigm are the sources of stress and coping strategies
- Younger adults experience more stress in the areas of finance, work, home, personal life, family
- Older adults may be more age related than a role related
- Environmental stress may be caused by a decreased ability to get around rather than by a specific role
- Maybe in late life people begin to narrow their focus and thus have fewer areas of life that could produce stress or may adopt a more philosophical outlook on life
68
How do adults over 80 use coping strategies?
- Adults over age 80 are less likely to use active coping strategies and are more likely to use past experience in coping as a guide
- Active coping styles are related to better health outcomes
- Approaches to coping tend to be consistent across different domains, meaning that people tend to deal with stress related to family and health issues in roughly the same ways
69
What are two strategies can older people use to handle stress?
Two strategies become apparent:
1) Reducing stress
2) Using more active coping
- As people age, soome older adults become better at managing their lives so as to avoid problems in the first place so they don't need to cope with stress
70
What are the effects of stress on health?
- Chronic stress has several potentially serious effects
- Negative effects on the immune system can cause increased susceptibility to viral infections, increased risk of atherosclerosis, hypertension and impaired memory and cognition
- In women, chronic stress can also inhibit menstruation and women react to a wider range of outside stressors than do men
71
Are different types of stress associated with different emotions?
- Different types of stress are associated with different emotions, which trigger differnt neural pathways
- How the body reacts to stress depends on the appraisal process - the reaction to different types of stress is not the same
- The effects of coping strategies on physiological outcomes and health depend on whether they have affected a person's sense of well-being
72
What are some of the issues connected to chronic conditions?
- Chronic conditions can make life unpleasant and in some cases can increase susceptibility to other diseases
- Psychological aspects key to chronic disease include the coping skills people bring to bear on their conditions
- Sociocultural factors include the lack of adequate health care
- Ethnic group differences in some chronic conditions such as hhypertension
- Life cycle factors help us understand why reactions to the same chronic condition vary with the age of onset.
73
What are some common chronic conditions?
_Arthritis_
- Everyone over age 60 shows some physical evidence of one form of arthritis
Rheumatoid arthritis
- Is not strictly an age-related condition
- The cause remains unknown
Osteoarthritis
- Is age related
74
Due to the pain of arthritis seniors tend to not want to exercise ... what is the problem with this?
- Reducing physical activity has a paradoxical effect
- Movement stimulates the secretion of synovial fluid, which lubricates the surfaces between and increases blood flow to the joints
- Movement also keeps muscles toned and limber
- All are important in keeping joints flexibile, regraining from movement ultimately makes the joints hurt worse
75
What is one of the dangers of not exercising if one has arthritis?
- Joints can "freeze", a condition called **contrature** that may require physical therapy
- It is vital to keep moving as the pain of arthritis is less than the pain associated with not moving
76
What medications can be used to treat arthritis?
- Acetaminophen
- Aspirin
- Monosteroidal anti-inflammatory drugs
- Cyclo-oxygenase inhibitors
- Corticosteroids
- Disease modifying anti-rheumatic drugs
- Tumor necrosis factor blockers
77
What changes to diet and vitamins can improve arthritis?
- Glucosamine and chondroitin
- Diet rich in antioxidants and omega 3 fatty acits - found in salmmon, nuts (walnuts)
78
What is diabetes melitus?
- A disease that occurs when the pancreas produces insufficient insulin
- People have above normal sugar (glucose) in the blood and urine and can go into a coma if the level of sugar goes too high
-
79
What are the 2 types of diabetes?
1) Type 1 diabetes develops earlier in life and requires the use of insulin. It is sometimes called **insulin dependent diabetes**
2) Type 2 diabetes develops later in life and can be managed through diet. This type of diabetes is often associated with obesity
80
What symptoms are seen in young adults with insulin-dependent insulin?
- Excessive thirst
- Increased appetite
- Increased urination
- Fatigue
- Weakness
- Weight loss
- Impaired wound healing
81
Is diabetes more common with ethnic groups?
- Members of minority groups - African Americans and Latinos have a 2 in 5 risk, which is twice the rate for European Americans
82
What are the long-term effects of diabetes?
- Nerve damage
- Diabetic retinopathy
- Kidney disorders
- Cerebrovascul accidents
- Cognitive dysfunctions
- Damage to coronary arteries
- Skin problems
- Poor circulation in limbs -} gangrene
83
Cancer is the leading cause of death in the US after coronary disease ... what are the statistics?
- Nearly 1 in 2 American men will develop cancer
- 1 in 3 American women will develop cancer
84
Are cancers are preventable?
- Some cancers are due to poor lifestyle such as lung cancer (1 in every 5 deaths) from smoking and colorectal cancer from poor diet
- Skin cancer is preventable by staying out of the sun and wearing sunscreeen
85
How does the risk for getting cancer change over the life span?
- Risk of getting cancer increases markedly with age
- Largest number of cases occur in the 80 to 84 age group
86
What are the most common cancers for men and women?
- Prostate cancer is the most common form of cancer in men
- Breast cancer is the most common form of cancer in women
- Lung cancer is more common in men
87
What are the death rates associated with cancers?
- Lung cancer kills more than 3 times as many men as prostate cancer and far more than breast cancer
- Only 15% of lung cancer patients are alive after 5 years, whereas 86% of females with breast cancer and 97% of patients with prostate cancer are alive after 5 years
88
Why do so many cancers appear in old age?
- Cumulative effect of poor health habits over a long period of time
- Exposure to pollutants and cancer-causing chemicals
- Normal changes in the immune system, resulting in a decreased ability to inhibt the growth of tumors
- Genetic links
89
What program did the is the National Cancer Institute initiate?
- The Cancer Genome Anatomy Program (CGAP) has listed all the genes responsible for cancer
- Genetic screening for cancer may be available in the future
90
What does the presence of telomerase mean?
The discovery that the presence of telomerase causes cells to grow rapidly and without limits on the number of divisions they can undergo provides more insight as to how cancers develop
91
What kinds of treatment are involved in cancer care?
1) Surgery
2) Chemotherapy
3) Radiation
4) Gene therapy, bonne marrow transplants
5) Alternative medicines
92
What is incontinence?
- The loss of the ability to control the elimination of urine and feces on an occasional or consistent basis. It is a source of great concern and embarrassment
- 20% of women and 10% of men have urinary incontinence
- Rates are higher if the person is in the community, or in a nursing home
93
What are the 5 major reasons for incontinence?
1) **Stress incontinence** - when pressure in the abdomen exceeds the ability to resist urinary flow. May occur when a person coughs or picks up something heavy
2) **Urge incontinence** - caused by a central nervous system problem after a CVA or urinary tract infection. People feel the need to urinate but cannot get to a toilet in time
3) **Overflow incontinence** - results from improper contraction of the kidneys, causing the bladder to become overdistended. Certain drugs, tumors and prostate enlargement are common causes
4) **Functional or environmental incontinence** - when the urinary tract is intact but because of physical disability or cognitive impairment the person is unaware of the need to urinate
5) **Latrogenic incontinence** - caused by medication side effects
94
Is pain in a young adult the same as pain in an older adult?
- Pain is one of the most common complaints of older adults
- It indicates that something is wrong and can be the cause of depression, sleep disorders, decreased social interaction, impaired mobility, increased health care costs
95
What are the 2 ways in which pain is controlled in older adults?
1) Pharmacological
2) Nonpharmacological
96
What is the pharmacological approach to handling pain?
- Includes narcotics and nonnarcotics
- Nonnarcotics are best for mild to moderate pain
- Narcotics are best for severe pain
- Nonnarcotics are ibuprofen, acetaminophen
- Narcotics include morphine, codeine
97
What are some nonpharmaceutical ways of handling pain?
1) Massage, vibration, heat, cold, and ointments
2) Electrical stimulation over pain site or spine
3) Acupuncture or acupressure
4) Biofeedback
5) Distraction
6) Relaxation, medication
7) Hypnosis
98
Were older adults used in drug trials?
- Until the late 1990s, clinical trials were not required to use older adults
- Medication on the market now ... effecitve for older adults?
- Effective dosage of medications may change as people get older
- Great risk of overdose or the need to increase the dose to get the desired effect
99
What can be a big barrier to older adults taking their meds properly?
1) Many can't afford their meds
100
What are the 4 ways in which drugs work in the body?
1) **Absorption** - time needed for the drug to enter the bloodstream. Needs to go into the small intestine where maximum absorption occurs. This transfer may take longer in adults
2) **Distribution through the body** - depends on the adequacy of the cardiovascular system. Maximal effecitveness depends on the balance between portions of the drug that bind with plasma protein and the portions that remain free. Toxic levels of a drug can build up more easily in older adults. Drugs that are soluble in water or fat tissue can build up easily. Effective dosage depends on the amount of free drug in the body.
3) **Drug metabolism** - job of the liver and the process is slower in older adults. This creates the potential for toxicity if the medication schedule does not take this into account
4) **Drug excretion** - through the kidneys in urine, or feces, sweat, or saliva. Changes in kidney function related to lower total body water content is common. Drugs often are not excreted as quickly by older adults
101
What dosage do physicans recommend and why?
- In order to avoid possible adverse drug reactions and the way that older adults take longer to process drugs, doctors recommend using 1/3 to 1/2 of the usual dose
102
Why do older adults have the highest risk of adverse drug reactions?
1) They tend to take many drugs
2) The way in which older adults process drugs may not taken into account by doctors
3) Changes in liver and kidney function affect how rapidly the drug is removed and excreted
103
What is polypharmacy?
- Treating multipe conditions with the use of multiple medications
- Some drugs boost each other when taken together
- Some drugs do not interact well when taken together and can create an adverse reaction
- Drug interactions can mimic other illnesses ... example confusion and memory loss from a poor drug mix may mimic Alzheimer's
104
What are some of the problems with adherence to medication?
- The more drugs people take, the greater the chance that they'll miss or skip taking one of them
- The regimen can be very complex as to which should be taken in the morning, evening, with food, without food, with milk ...
- Most common problem is that they simply forget
105
What is the answer to the problem of medication adherence?
1) Keep number of meds to a minimum
2) Periodic review of all meds to see if they are still necessary
3) Discontinue drugs as soon as is possible
4) Prescribe the lowest effective dose
106
What is the model of disability?
- Chronic conditions often involve some level of discomfort and physical limitation
- Generally the problems increase resulting in more efforts by patients and health workers trying to slow the advance of the disease
- In the context of chronic conditions, disability is the effects of chronic conditions on people's ability to engage in activities that are necessary, expected, and personally desired
107
What is compression of morbidity?
- Declining rate of disabilities of 2% per year since 1980's
- When compared to the overall decline in mortality of 1% per year over the same period, these changes create what is called the compression of morbidity
- This refers to the situation in which the average age when one becomes disable for the first time is postponed, causing the time between the onset of disability and death to be compressed into a shorter period of time
108
What are the 4 main parts of the model of the disablement process?
1) Main pathway
2) Risk factors
3) Intraindividual factors
4) Extraindividual factors
109
What factors are included in the risk factors of the model of the disablement process?
- Risk factors are long standing behaviours or conditions that increase one's chances of functional limitation or disability. Examples are:
1) Low socioeconomic status
2) Chronic health conditions
3) Chronic health-related behaviours such as smoking
110
What factors are included in the extraindividual factors of the model of the disablement process?
- Interventions such as surgery, medication, social support services and physical environmental supports - These factors help people maintain their independence
111
What factors are included in the intraindividual of the model of the disablement process?
- Includes factors such as beginning an exercise program, keeping a positive outlook, taking advantage of transportation to increase mobility
112
What are exacerbators?
- Situations or factors that makes it difficult, if not impossible for people to participate. They make the situation worse than it was.
- They may be unintended
113
What is one of the most important aspects of Verbrugge and Jette's Model of the Disablement Process
- The emphasis on the fit between the person and the environment. When a person's needs are met by the environment, the person's quality of life and adaptation are optimal
114
How do we determine where in Verbrugge and Jette's continuum a person is?
- Ask, how well is the person functioning?
- Determine the difference between tasks that people say they can do versus what they can demonstrate that they can do
115
What are frail older adults?
- Older adults who need help with everyday tasks
- Those who have physical disabilities, are very ill, and may have cognitive or psychological disorders and need assistance with everyday tasks
- They constitute a minority of older adults
- Frail older adults are people whose competence is declining
116
What are Activities of Daily Living (ADLs)?
- To identify the areas in which people experience limited functioning, researchers have developed observational and self-report techniques to measure how well people can accomplish daily tasks
- Everyday competence assessment consists of examining how well people can complete activities of daily living and instrumental activites of daily living
- ADLs include basic self-care tasks such as eating, bathing, toileting, walking, or dressing
- A person can be considered frail if he or she needs help with one or more of these tasks
117
What are Instrumental Activities of Daily Living (IADLs)?
- Are actions that entail some intellectual compedtence and planning to execute
- Shopping, paying bills, making appointments, making phone calls, taking meds
118
What is the profile of older adults that need support with ADLs or IADLs?
- The number of older adults that need help with either ADLs or IADLs increases over time
- Percentage of people who need assistance across ethnic groups varies. European Americans over 65 having the lowest rate. African Americans have the highest rate.
119
What conditions best predict future problems in functioning?
- Study by Boult et al - identify chronic medical conditions that result in severe functional limitations
- Classified 7,000 non-institutionalized over age 70 at 2 points in time ... 1984 and 1988. They then classified everyone according to:
1) Functionally intact
2) Functionally limited because of their inability to perform at least 1 of 7 target activities
3) Deceased
- Boulter et al took exercise habits, demographics, socioeconomic, and psychosocial factors into account
- 2 chronic conditions were strong predictors of functional limitations:
1) Cerebrovascular disease
2) Arthritis
120
What were the findings from Strawbridge's longitudinal study?
- Found that smoking, heavy drinking, physical inactivity, depression, social isolation, and fair or poor perceived health also predicted who would become disabled in some way
121
Do people with higher incomes have the same rate of chronic conditions as poor people?
- Reed et al discovered in their study that the rich had the same prevalence of disease and disability as the US population at large, despite their privileged status and their longer life expectancy
122
What was Rahman et al's findings from their study?
- Compared representative samples of men and women in the US, Jamaica, Malaysia, and Bangladesh
- Found that women's self-reported health was worse in all countries studied
- Self-reported health problems were much more prevalent in ther developing countries than in the US
- Gender makes a difference in health and that the differences between men and women hold up across selected cultures
123
According to Johnson and Wolinsky, do ethnic groups differ from each other?
- In a study of 5,100 African Americans and European Americans Johnson and Wolinsky used the concepts of pathology, functional limitation, and disability to predict people's perceived health
- Their findings were:
1) The components of some scales used to measure such things as ability to care for oneself had different measurement properties for each group
2) Found several gender differences, especially in the European American group
3) For both ethnic groups, women's perceived health status was predicted by both the ability to perform several basic functions and disability involving body mobility whereas men's perceived health status was predicted by the ability to perform basic functions
- These cross-cultural studies point to important gender, ethnic, and cultural differences in health, as well as differences in which specific aspects of chronic conditions, functional limitations, and disabilities predict what people perceive their health status to be
