Aging and Disability

1
Aging and Disability

• Chapter 28

2
Demographics

• Increase of older people today
• 2000 - over 65 12 of population
• 2020 - over 65 20 of population
• Increase of people over 85 years

3
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

4
Why Persons Age

• Descriptors
• Older or old 65
• Young-old 65 - 74
• Old 75 - 84
• Old-old 85 99
• Oldest-old 100

5
Why Persons Age

• Life expectancy - average number of years
  remaining
• Cohort - group of people with similar life
  experience

6
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

7
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

8
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

9
Chronic Diseases of Aging

• Arthritis
• Cancer
• Diabetes
• Diseases of heart and blood vessels
• Osteoporosis

10
Arthritis

• Arthritis - joint inflammation
• Results in joint soreness, pain, and stiffness
• Over 100 forms
• Osteoarthritis
• Rheumatoid Arthritis

11
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

12
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

13
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

14
Cancer

• Cancers with the highest mortality rate
• Lung cancer
• Breast cancer
• Prostate cancer
• Colorectal cancer

15
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

16
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

17
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

18
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

19
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

20
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

21
Diseases of the Heart and Blood Vessels

• Hypertension
• Heart Attack
• Stroke
• Reduction of risk includes weight control and
  exercise

22
Hypertension

• High blood pressure
• Silent killer - no obvious symptoms
• Leads to cardiovascular complications
• Controllable through diet, exercise, and
  medication

23
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

24
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

25
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

26
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

27
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

28
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

29
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

30
Alzheimers 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

31
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

32
AD and Exercise

• Activity guidelines for early-stage dementia
• Patience
• Dropout prevention
• Simplify
• Praise
• Maintain frequency
• Later-stage dementia presents additional
  challenges

33
Parkinsons 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

34
Parkinsons 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

35
Depression

• Not a normal part of aging
• Occurs with other conditions (comorbid)
• Affects moods
• Apathetic
• Loss or stressful changes

36
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

37
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

38
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

39
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

40
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

41
Aging with Disability Acquired When Young

• Unique changes in aging associated with other
  disabilities
• Spinal cord injury
• Congenital or childhood onset disabilities
• Mental retardation

42
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

43
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

44
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

45
Down syndrome

• Alzheimers 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

46
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