Flashcards in Week 4 Chapter 14 Late Life Disorders CF Deck (73)
What are the 3 groupings of ageing, defined by gerontologists?
*65-74 years = the young-old
*75-84 years = the old-old
85 and above = the oldest-old
When considering social attitudes to ageing, what is the main difference between Eastern & Western Cultures?
In Eastern Cultures older people are held in high esteem whereas, in Western Cultures, growing old tends to be feared, or even abhorred by many. This is especially true for women in Western Cultures.
Name some of the common myths about ageing.
*we will become doddering and befuddled
*We will become unhappy, cope poorly with our troubles, and become focused on our poor health
*We will become lonely and our sex lives will become unsatisfying
What are some of the findings specific to cognitive functioning from research into ageing that might suggest a more positive future?
Severe cognitive problems do not occur for most people, though a mild decline in cognitive functioning is common
What are some of the findings specific to emotional regulation from research into ageing that might suggest a more positive future?
*Elderly (60 years +) experience less negative emotion than do young people
*The Elderly are more skilled at regulating their emotion
What are some of the findings specific to pain from research into ageing that might suggest a more positive future?
Many older people under report somatic symptoms, perhaps because of beliefs that aches & pains are an inevitable part of late life
What are some of the findings specific to sexual activity from research into ageing that might suggest a more positive future?
Older people have considerable sexual interest & capacity
Among those with a partner, most who are in good physical health remain sexually active
Which myth does the phenomenon of Social Selectivity challenge?
Social Selectivity challenges the myth that older people are lonely and socially isolated
*The number of social activities engaged with is unrelated to psychological well-being among older people
What is the reality of social selectivity?
*When we have less time ahead of us, we tend to place a higher value on emotional intimacy than on exploring the world.
*the tendency to preference time with closest ties rather than acquaintances
What could social selectivity be mistaken for?
To those unfamiliar with the age-related changes, social selectivity could be mistaken for harmful social withdrawl
What is a common prejudice about the elderly held by many people?
That all old people are the same
*Each older person brings to late life a developmental history that make his or her reactions to common problems unique
"Late life would qualify as the Olympics of coping"
- why is this?
*Physical decline & disabilities
*Sensory & neurological deficits
*Loss of loved ones
*The cumulative effects of a lifetime of many unfortunate experiences
*Social Stresses such as stigmatising attitudes towards the elderly
As people age they experience problems with sleep. What are the main issues?
*quality & depth of sleep declines
*by the age of 65, 25% of people report insomnia
*Rates of sleep apnoea also increase with age
*Insomnia is often caused by medication side effects
*Untreated chronic sleep deficits can worsen physical, psychological, & cognitive problems, even increasing the risk of mortality
*However, psychological treatments have been shown to reduce insomnia successfully among the elderly.
Several problems are evident in the medical treatment available during latest life.
What are some of the general issues older people face?
*Chronic health problems generally continue
*Doctors often get frustrated when there is no cure
*There is added time pressure on the health system
What are some of the issues specific to medication faced by older people?
*Polypharmacy: the prescribing of multiple drugs - approximately 1/3 of elderly people have 5 or more prescription medications
*Multiple drugs increase the risk of side effects, toxicity, & allergic reactions
*people may then be prescribed side effects meds
*Most psychoactive drugs are tested on younger people - older people have slower metabolic rate, requiring a different dose
*1/5 of elderly people have filled prescriptions deemed inappropriate for their age range due to side effects
What should GP's ensure they do when treating older patients?
*It is essential to have regular medication reviews, discontinue non-essential drugs and prescribe only minimum required dose
What are 3 key factors that must be taken into account when designing research for elderly clients?
*Time of Measurement effects
What are age effects?
Age effects are the consequences of being a certain chronological age
What are cohort effects?
Cohort effects are the consequences of growing up during a particular time period with it's unique challenges and opportunities. e.g. the Great Depression, WWI or WWII, 9/11 each shape experiences and attitudes
*Similarly, the expectations for marriage have changes drastically in the past century in Western societies from a focus on stability to a focus on happiness & personal fulfilment
What are time-of-measurement effects?
Time of Measurement effects are the confounds that arise because events at a particular point in time can have a special effect on a variable that is being studied. e.g. people tested right after Hurricane Katrina in New Orleans might demonstrate evalated levels of anxiety
What are the 2 major research designs used to assess developmental change?
What are the key characteristics and disadvantages in Cross-sectional research designs?
The investigator compares different age groups at the same moment in time on the variable of interest
*these studies do not examine the same people over time; consequently, they do not provide clear information about how people change as they age
What are the key characteristics, advantages and disadvantages in Longitudinal research designs?
The researcher periodically retests one group of people using the same measure over a number of years or decades
*allow us to trace individual patterns of consistency or change over time
*Results can be biased by attrition where participants drop out due to death, illness, lack of interest
*People with the most problems are likely to drop out of studies
What are the learnings from the Baltimore Longitudinal Study of Ageing which has followed 1,400 people since 1958?
*Much has been learned about mental health and ageing
*people who are happy at 30, tend to be happy as they move to late life
In the context of research design, what is selective mortality?
Selective mortality is the tendency for less healthy individuals to die more quickly leading to sample bias in the long term follow up studies
*Results obtained with the remaining sample are more relevant to drawing conclusions about relatively healthy people than about unhealthy people.
Why is it especially important to be careful before diagnosing an older person with a psychological disorder from the DSM5?
DSM5 states that a psychological disorder should not be diagnosed if the symptoms can be accounted for by a medical condition or medication side effect
*medical conditions are more common in the elderly, so it is particularly important to rule out such explanations.
What are some of the medical conditions that can produce symptoms that mimic schizophrenia, depression, or anxiety?
What are some of the medical conditions that can produce symptoms that mimic anxiety specifically?
*Congestive Heart Failure
*Excessive Caffeine Consumption
What are some of the medications that can contribute to symptoms of depression and anxiety?