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Gerontology 1

Gerontology Module 1

What is the scientific study of factors impacting normal aging process and the effects of aging? Gerontology
What is the branch of medicine concerned with healthcare for the elderly Geriatrics
What is the process by which a cell loses its ability to divide, grow and function Senescence
What is considered middle age? 50-64 yo
What is considered young old? 65-74yo
What is considered older-old? 75-84
What is considered oldest- old? 85+
What is the crude birth rate? number of births per 1000
What is the general fertility rate? number of births in a year divided by the number of women aged 15-44, multiplied by 1000
What is aging at the apex? when the proportion of the older persons in a population increases
What is aging at the base? when the proportion of younger persons decreases
When were the baby boomers born? And when was the peak/decline? born 1946-1964 -- peaked in 1957, steep decline in the 1960s
What was the avg life expectancy in 1910? 48 yo
What was the avg life expectancy in 2012? 79yo
What do mortality risks reflect? health and disease profile of underlying population
What are some mortality risks? Public health and sanitation, health care access, education of the population
What is a crude death rate and how long have they been constant? CDR is the primary measure of mortality - the number of deaths per 1000 - has been constant since 1950s - it does not take into account differences in age populations (i.e. older vs younger group)
What is a better indicator than CDR? Age adjusted death rates
How many americans are 65+ 40.4 milling - 12.6% of US population - 1 in 8 Americans
How many will be 65+ by 2030? 89 million - 1 in 5 Americans
What will the increase in 65+ impact? Unprecedented demands on public health and aging services - US health care system
What are the US life expectancies at age 65? men - 17.3, women - 19.7 (gap <3 years)
What happens to life expectancies by age 85? women's life expectancy exceeds men's by 1 year
What is the maximum life span? measure of maximum amount of time members of the population have been observed to live from birth to death
How much of the population is 85+? And what will it be by 2020? 2050? Currently (2010) - 5.5 million, 1%; 2020 - 6.6 million, 19%; 2050 - 5.2% of US
What are the ratios of female to male survival? Ages 65-69 - 6 F TO 5 M; Age 85+ - 5 F to 2 M
By 2050, what ratio of women and men will be in the oldest old group (75-84)? 1/4 of women and 1/5 of men
What is the "oldest state" Florida - largest % of population - 17.6% is 65+ (3.3 million)
Which state has the MOST 65+? California - 4.3 million (10.6% of population)
Why do retired older adults move to nonmetropolitan areas? lower housing costs, less traffic, natural amenities when they retire
By 2020, what will be the % that the migration pattern to non-metro areas of ages 55-75? 30% by 2020
What is the marital status for 65+? Married - men 72%; women 42%; Divorced - men 9%, women 11%; Widowed - men 13%, women 40%
What are the % for ages 65+ to live alone? Living alone: Men - 19%, women - 40% -- increases for women up to 47% at 75+
What are the numbers for ages 65+ to live with spouse or live with other relatives? W/ Spouse: Men 72%, Women 42%; W/ other relatives: Men - 7%, Women - 17%
What are % of ages 65+ living in elderly facilities? Long term care facilities - 4%, community housing with services - 2%, traditional community housing - 93%
What are the numbers for 85+ to live in elderly facilities? Long term care - 15%, Community housing with services - 7%
What is the labor force of 65+? 2013 - over 7.7 million (18% of work force) - 57% of which work full time
By 2018, what are the numbers for 65+ in the labor force? Men - 27%, Women - 19%
Why do people work past 65 yo? 1) Employer Pensions/medical benefits for retirees replaced with 401(k)s defined by employee-funded contribution plans; (2) Work til 65 to keep health benefits until they qualify for full medicare/SS at 66; (3) Reduced tax penalty if making income w/ SS
What was the increase for older Americans with high school diplomas from 1970 to 2010? 1970 - 28%, by 2010 - 79.5% -- White = 84.3% – Asian = 73.6% – African-American = 64.8% – Hispanic = 47.0%
How do high school drop outs affect life expectancy? They are expected to live fewer years, with <40% of those years being healthy ones
What is the % of bachelor's degree or higher? 22.5% - Educated men with some college education would spend an average of 62% or more of their remaining years disability- free, regardless of their race
How does physical inactivity change with age? Physical inactivity among older adults increases with age, most dramatically among people ages 75 and older – Recreational activity levels decreased steadily with age – In men, decreases after the age of 70, women age 63
Which is the most sedentary group in the US? Adults > 60yo - spend more than 60% of waking time sedentary
What % of older adults adhere to physical ex recommendations (i.e. 30 min/day, 3 days/wk of vigorous activity that breaks a sweat)? Ages 60+ - <12%; Ages 75+ - <6%
What are the most common recreational activities with older adults? walking, home maintenance, gardening
In 2009, what % of older adults were overweight or obese? Over 35% of adults ages 65 and older were overweight or obese – Among the young old (ages 65 to 74) – obesity increased among both men and women ages 75 and over to one-fourth of adults in this age group
What are risk factors for chronic conditions? diabetes, HTN, high cholesterol, heart disease, arthritis and cancer - – Lifestyle changes to manage chronic diseases and weight i.e. exercise, medication
What are the leading cause of death in 65+? Leading cause of death: – Heart Disease = 27% – Cancer = 22% – Respiratory Diseases = 7% – Stroke = 6% – Alzheimer's = 5% – All other diseases = 33%
What is the disability affecting function aged 65+? – Severe disability 1-in-4 for those aged 65 to 69 needed assistance with one or more ADLs – Oldest age group (people 80 years and older) = 70.5%
What is Number of years a person may expect to live disability-free due to improvements in prevention and treatment of disability, decreasing incidence of disability and increasing chance of recovery from disability? Healthy life expectancy
In 2010, what % of the population was 65+ minorities? 20% (8.1 million) - – African-Americans = 8.4% – Hispanic = 6.9% – Asian or Pacific Islander = 3.5% – Native American or Alaskan = 1%
How many grandparents 65+ had the primary responsibility for their grandchildren who lived with them? 485,000
What are the trends for the world average annual growth rate of aged 80+? Expected to grow in less developed regions, by 2050 will be 57% of world's 80+ population; Majority of nations 80+ age group growing faster than any younger segment, will inc to more than 70%;
How much of the major countries account for the total number of 80+? Major countries account for 54% of total number 80+ (will increase by a projected 10 million) – China, = 12 million + US = 9 million, India = 6 million + Japan = 5 million, Germany and Russian Federation = 3 million
How many more women are 60+ vs men in the world's aging population? 63 million more women 60+ vs men
What are different dependency or support ratios? • Number of working-age adults ages 18 to 64 for every elderly person ages 65 and older • Number of working-age adults closely associated with employment • Size of population expected to pay taxes to support benefits for older group
What is the support ratio? And what is it projected to be by 2050? Support ratio is 5 working to every person requiring government support - will decline to just under 3 by 2050
What are the % of medicare enrolees in long term care facilities and community housing for 65+? And for 85+? 65+ –- 4% = long term care facilities; 2%=community housing with services; 85+ -- – 15% = long-term care facilities; 7%=community housing with services; Social Security Trust Fun—will be exhausted around 2037
When are medicare expenditures projected to exceed social security? And why? Projected to exceed by 2030, driven by rising costs and use of health care services and number of people getting benefits
What does hospital insurance pay for in the Medicare program? pays for hospital, home health, skilled nursing, and hospice care for those aged 65 and older and disabled individuals who have enrolled
What are the housing options to assist older adults? Continuing care retirement communities (CCRC0 - 3 basic types; Skilled nursing facility (SNF); Assisted living facility (ALF); Nursing Home
What are the 2 primary groups of aging theories? Fundamentalist or development-genetic theories (i.e. wear and tear and intrinsic factors) and Non-genetic, environmental, or Stochastic (i.e. Extrinsic factors)
What are some Fundamental considerations? Aging is developmental, scientific advances, normal aging vs pathological aging, no universally accepted theory of aging
What is involved in Fundamentalist theories of aging? • Fundamentalist: development-genetic theories – Wear and tear = Years of damage to cells, tissues and organs eventually wears them out, killing both them and the body – Pathological decrements that are tissue specific
What is involved in stochastic theories of aging? Environmental, non-genetic – Environmental insults i.e. toxins, cosmic rays impact the aging pro
What are the genetic theories of aging? Hayflick Limit, Evolution theory, Stress theory, Neuronendocrine/hormonal, Intrinsic mutagenesis, immunological, caloric restriction and free radical
Which genetic theory of aging involves a limited amount of cell population doublings (average of 50 per cell's life cycle)? Hayflick Limit Theory
Which genetic theory involves expansion of natural selection, where each generation is more resistant to mutation? Evolution Theory
Which genetic theory involves survival to old age enhanced by high vitality and resilience due to underlying resistance to stress by genes? Stress theory
Which genetic theory has functional decrements in neurons and hormones with a decrease central to the aging process? Neuroendocrine and hormonal theory
Which genetic theory says each species has specific characteristics of its genes that regulate rate of error effecting lifespan? Theory of intrinsic mutagenesis
Which genetic theory says there is a functional capacity of immune system that declines with age as a result of reduced T-cell function? Immunological theory
Which genetic theory involves a life committed to high nutrient and low caloric diet? Caloric restriction theory
Which genetic theory says aging changes are due to damaged caused by free radicals? Free radical theory - Free radica l“grabs” electron – Electrons exist in pairs – “grabs” an electron from other molecule causing damage 
What are the Stochastic (non-genetic) theories of aging? error, redundant DNA, somatic mutation, transcription, and cross-linkage
Which stochastic theory says that Any accident or error in either the machinery or process of making proteins would cascade in multiple effects that would be incompatible with proper function and life? Error Theory
Which stochastic theory says that biological age changes are a result of errors accumulating in genes, where the accumulation of these takes over the system until it is exhausted? Redundant DNA
Which stochastic theory involves Mutations or genetic damage result from radiation and these accumulate and create functional failure and death? Somatic Mutation
Which stochastic theory involves a Control mechanism responsible for appearance and the sequence of aging exists in nuclear chromatin complex? Transcription
Which stochastic theory involves Large reactive proteins i.e. collagen cross-link are responsible for aging? Cross Linkage
What are the New Theories of Aging? Sleep and Aging, Hormonal imbalance-growth factor exposure, Telomeres, Progress of cell culture, Implications of the genome project and Werner syndrome
Which new theory involves prolonged sleep loss effects homeostasis and species' ability to repair tissue? Sleep and aging
Which new theory involves too much GH and not enough insulin leading to less healthy and shorter lives? Hormonal imbalance - growth factor exposure theory
Which new theory says the length of telomeres are predictive of life span for that cell and organism? Telomeres
Which new theory involves Dysregulation of non-traumatic and non-inflammatory cell death has been implicated in development of diseases more prevalent in older person? Progress of cell culture aging models
Which new theory suggests there is a strong relationship between genetic influences and longevity? Implications of the genome project
Which new theory involves a Normal person who carries variants of gene that influence their life span or predispose them to an early death? Werner syndrome: fast forwarding aging
What are some factors influencing your life expectancy Heredity, disease processes, medical treatment, lifestyle choices, nutrition
What type of aging Exhibits typical non-pathological age-related changes? Usual Aging
What is the unified definition of successful aging? There is none!
What is a major characteristic to successful aging? Adaptability!
What are some definitions of successful aging from Phelan/Larson and Bowling/Dieppe? Refers to maintenance of physical/mental well-being and functional indep w/o chronic disease, ability to adapt to change, ability to compensate for limitations. – The capacity to age successfully is highly variable from one individual to another.
How do PTs aid in successful aging? Promotion of regular exercise is one of the main non-pharmacological measures that should be promoted in older subjects - Education/exercises programs esp regarding a preventive approach for successful aging – Community programs and proper rehabilitation
What did Depp et all include in their operational definitions of successful aging? – Absence of disability – Good physical and cognitive functioning – Greater physical activity – More social contacts – Fewer medical conditions
What are 2 predictors of successful aging? Non-smoking and Absence of disability/depression/arthritis/diabetes
What are Bowling's definitions for aging in the BIOMEDICAL approach of successful aging? Life expectancy, physical function, mental and psychological/cognitive health
What are Bowling's definitions for aging in the PSYCHOSOCIAL approach of successful aging? life satisfaction and well-being, personal growth, social networks, social, community and leisure activities, pyschological
What are Phelan/Larson's definitions of successful aging? • Life satisfaction • Longevity • Growth • Active engagement • Independent functioning • Positive adaptation
What will exercise effect with aging? – Physiological Functions – Functional reserve – Impact on Cardiovascular systems – Cancer – Osteoporosis
Created by: rjchokito