Adult Lifespan Development Overview

Adult Lifespan Development

• Adult lifespan development covers three major stages: Young Adult (20-40), Middle Adult (40-65), and Older Adult (65+).

Purpose of Lifespan Course

• The course aims to understand the whole person (psychosocial, cognitive, and physical) across different age groups.
• It also aims to prepare professionals (clinicians, educators, colleagues, supervisors) to apply this understanding in practice. This includes considering experiences patients might have at home, school, or work.

Clinician and Teacher Considerations

• Considerations include patient experiences at home, school, or work.
• Therapists should take into account injuries and impairments that affect patients throughout their lifespan.
• This should encompass temporary impairments and permanent impairments (including those present since birth).

Biopsychosocial Model

• This model illustrates interconnected aspects of health.
• Biology: physical health, genetic vulnerabilities, and drug effects.
• Social: peers, family circumstances, and family relationships.
• Psychological: coping skills, social skills, family relationships, self-esteem, and mental health.

Experiences Affecting Patient Care

• Therapists also need to consider life experiences that impact patients (especially in relation to family, community commitments outside of work).
• Understanding these experiences and how they affect patients is integral to providing effective care.

Lifespan Course as a Framework

• This course provides a framework for other DPT courses (specifically, those focused on body systems).
• Exam courses will use relevant tests and measures for differing age groups.
• Intervention courses tackle patient problems across age groups.

Psychosocial Development

• Personality: Stability and change in characteristics differentiating individuals.
• Social Development: Interactions and relationships with others that grow, evolve, and remain stable throughout life.

Cognitive Development

• Cognitive processes and development impact behavior.
• Factors include problem-solving skills, memory, learning, and intelligence.

Physical Development

• Physical makeup impacts behavior.
• This includes the brain, nervous system, muscles, senses, and the inherent needs for food, drink, and sleep.

Accident Scenario (Crisis)

• This is a specific example illustrating how the biopsychosocial model is crucial even in an acute situation like a recent accident.
• Specific consideration of the patient's age is essential; different ages will present different considerations regarding the patient and their psychological, social, and physical situations.

Aging/Senescence Definition

• Aging is a complex process, encompassing cells, tissues, organs, and systems.
• Aging usually refers to changes throughout life.
• Some changes like wrinkles and hair graying are considered superficial.
• Senescence refers to the natural decline, which affects survival characteristics associated with increasing age, and which elevates the risk of health problems, disability, and death.

Aging Definition (cont'd)

• Senescence is a poorly understood process, making understanding its beginning crucial.
• Senescence may begin at birth, or afterward, after peak reproductive years.

Delaying Senescence

• Advancements in environmental conditions, antibiotics, medical care, and lifestyle choices contribute to increasing life expectancy

Average Life Expectancy

• Life expectancy has improved significantly (demonstrated by graphs and figures).
• Various age groups and regions show varied trends in life expectancy.
• There are noticeable differences across different regions of the world.

Mortality Rates

• Mortality rates have experienced significant shifts over time.
• Many more people live well past 50, thus reducing the rates for individuals dying in the age range between 50-79.

Leading Causes of Death

• Infectious diseases were a significant cause of death historically.
• Nowadays, heart disease and cancer are the leading causes of death.

USA Life Expectancy Trends

• Over time, female life expectancy in the USA shows a consistent upward trend, and male life expectancy is also trending upward.

Quick Quiz (theoretical aging reasons)

• Identifying various theoretical causes of aging, paired with ways physical therapists can address these concerns (either directly or indirectly).

Theories of Aging/Senescence

• Programmed Theories: Aging is inherent and programmed into our cells (programmed longevity, endocrine/hormone theory and immunological theory).
• Error/Damage Theories: External forces cause gradual damage to cells and organs. (wear and tear, rate of living, cross-linking, free radicals, somatic DNA damage).

Programmed Theories (details)

• Programmed Longevity: Aging controlled by genes, activating/deactivating over a lifetime. Death is also programmed
• Endocrine (Hormone) Theory: Hormones influence aging. Some believe an unknown hormone drives the aging process.
• Immunological Theory: Immune system declines over time, raising vulnerability to diseases.

Error/Damage Theories (details)

• Wear and Tear Theory: Gradual cell/tissue damage from usage/time
• Rate of Living Theory: faster metabolism=shorter life span
• Cross-Linking Theory: Accumulation of cross-linked proteins damages tissue, slowing processes.
• Free Radicals Theory: Active molecules causing damage to body/cells. -Somatic DNA Damage Theory: Gradual damage to DNA, leading to errors and accumulation with age.

Psychodynamic Perspectives

• Much of behavior is driven by inner conflicts, memories, and influences experienced in childhood.
• Insights from Freud and Erikson are relevant.

Behavioral Perspectives

• Observable behavior and environmental stimuli are key factors shaping development.
• Concepts including classical/operant conditioning, social cognitive theory, and observational learning.

Social Cognitive Theory (further details)

• Social Cognitive Theory describes learning by modeling behavior from other people.
• Includes four key steps: Attention, Retention, Reproduction, and Motivation.

Health Trends

• Lifespan trends show life expectancy increases alongside specific health conditions affecting different age groups and specific populations.
• Death rates, health insurance coverage, and incidence of diseases are changing over time.
• Relevant data are available that show these changes.

NCD Trends

• Non-communicable diseases now dominate the causes of death, especially in low/middle-income countries.
• Several types of non-communicable diseases feature as prominent factors (e.g., chronic respiratory diseases, heart disease, cancer, diabetes).
• Some NCDs are preventable.

Activity Limitations & Disability Trends

• Arthritis and musculoskeletal problems are substantial causes of activity limitation.

Other factors

• Factors like COPD, prescription drug use (and related deaths), insurance trends, and health spending are showing trends over time.

Questions

• Future patient populations
• Role of physical therapists in addressing negative lifespan trends.