Chapter Two: Theories of Aging (Gerontology) PDF

GERONTOLOGY CHAPTER TWO THEORIES OF AGING INTRODUCTION The study of aging has received much attention in past decades. As the cliché goes, "kalabaw lang ang tumatanda," but the scientists believe they might know why aging occurs. No single theory has been deemed the...

GERONTOLOGY CHAPTER TWO THEORIES OF AGING INTRODUCTION The study of aging has received much attention in past decades. As the cliché goes, "kalabaw lang ang tumatanda," but the scientists believe they might know why aging occurs. No single theory has been deemed the cause of aging; rather there are many theories from a number of disciplines that overlap. If this is the case, there must be a way to delay aging. thereby increasing lifespan. Recognizing that theories of aging offer varying degrees of universality, validity, and reliability, gerontological nurses can use these information to better understand the factors that may positively and negatively influence the health and well-being of persons of all ages, specially the older persons.  GERONTOLOGY LEARNING OBJECTIVES Discuss the major theories of Identify the Factors that 01 aging, namely: 02 promote positive, healthy *Biological Theories of Aging aging process. Stochastic Theories; Nonstochastic Theories *Sociologic Theories of Aging Describe ways in which Disengagement Theory 03 gerontological nurses can Activity Theory apply theories of aging in Continuity Theory providing comprehensive, Subculture Theory holistic care to older Age Stratification Theory persons. *Psychological Theories of Aging Developmental Tasks Gerotranscendence *Nursing theories of Aging Functional consequences theory Theory of thriving Theory of successful aging TERMINOLOGIES Aging - the process of growing older that begins at BIOLOGIC AGING birth. Nonstochastic Theories - Explain biological aging as THEORIES resulting from complex predetermined, holistic care Biologic aging is the progressive loss of function. to older persons. Biologic aging is a multifactorial process involving generics, oxidative stress, diet, and environment. Stochastic Theories - View the effects of biological Research on biological aging attempts directed at aging as resulting from random assaults from both increasing both the average life span and quality of life of the internal and external environment adults including older persons. The process of biologic aging differs not only from species to species but also from one human being to another. TWO CATEGORIES OF BIOLOGIC AGING THEORIES b. Nonstochastic Theories of Biologic Aging: a. Stochastic Theories of Biologic Aging: Apoptosis (Programmed Cell Death Theory) Cross-Linking Theory Genetic Theories Wear and Tear Theories Autoimmune Reactions ( Immunologic Theory) Evolutionary Theories Neuroendocrine and Neurochemical Theories Biogerontology Theory Radiation Theories Environmental Theories STOCHASTIC THEORIES OF BIOLOGIC AGING 1. Cross-Linking Theory - Avers that over time and as a 3. Wear and Tear Theory - Attribute aging to the repeated result of exposure to chemicals and radiation in the use and injury of the body over time as it performs its highly environment, cross-links form between two lipids, specialized functions. Like any complicated machine, the proteins, and carbohydrates as well as nucleic acids. body will function less efficiently with prolonged use and 2. Free Radicals and Lipofuscin Theories - Proposes that a numerous insults (e.g., smoking, poor diet, substance abuse). free radical is a highly reactive atom or molecule that Physical and psychological stresses to the body can have carries an unpaired electron and thus seeks to combine adverse effects and lead to conditions such as gastric ulcers, with another molecule causing an oxidative process. heart attacks, thyroiditis, and inflammatory dermatoses. Common Diseases such as atherosclerosis and cancer are 4. Evolutionary Theories - These theories of aging are associated with oxidative stress. related to genetics and hypothesize that differences in the Free radicals are natural by-products of normal cellular aging process and longevity of various species occur due to processes and are also created by such environmental interplay between the processes of mutation and natural factors, as smog, tobacco, smoke, radiation, pesticides, selection (Rickle 1998; Gavrilov and Gavrilova, 2002). and other pollutants Attributing aging to the process of natural selection links There are numerous natural protective mechanisms to these theories to those that support evolution. prevent oxidative damage. Recent research has focused on the roles of various antioxidants including vitamins C and E, beta-carotene, and selenium, to slow down the oxidative process and ultimately the aging process. STOCHASTIC THEORIES OF BIOLOGIC AGING There are several general groups of theories that relate aging 5. Biogerontology Theory - This theory believes that to evolution, namely: bacteria, fungi, viruses, and other organisms are responsible a. Mutation Accumulation Theory for certain physiologic changes during the aging process. In - The "Mutation Accumulation Theory" suggests that aging some cases, these pathogens may be present in the body for occurs due to a declining force of natural selection with age. decades before they begin to affect body systems. Although In other words, genetic mutations that affect children will there is no evidence exists to link these pathogens with the eventually be eliminated because the victims will not have body's decline, interest in this theory has been stimulated by lived long enough to reproduce and pass this to future the fact that human beings and animals have enjoyed longer generations. life expectancies with the control or elimination of certain b. Antagonistic Pleiotropy Theory pathogens through immunization and the use of - The "Antagonistic Pleiotropy Theory" suggests that antimicrobial drugs. accumulated mutant genes that have negative effects in late life may have had beneficial effects in early life. c. Disposable Soma Theory - The "Disposable Soma Theory" proposes that aging is related to the use of the body's energy rather than to genetics. NONSTOCHASTIC THEORIES OF BIOLOGIC AGING Hypothesize that aging changes result from a complex predetermined process - that genes program age-related and cellular events. 1) Apoptosis (Programmed Cell Death Theory) - Proposes that there is an impairment in the ability of the cell to continue dividing Apoptosis is the process of programmed cell death that continuously occurs. throughout life due to biochemical events (Green, 2011). 2) Genetic Theory - One of the genetic theories, "The Programmed Theory of Aging" advocates that animals and humans are born with a genetic program or biological clock that predetermines the life span (Hayflick, 1965). Various studies support this idea of a predetermined genetic program for span. For example, studies have shown a positive relationship between parental age and filial life span. NONSTOCHASTIC THEORIES OF BIOLOGIC AGING 3. Autoimmune Reactions (Immunologie Theory) - 6. Nutrition Theories - The importance of good nutrition Proposes declining functional capacity of the immune system throughout life is a theme hard for c nutrition-conscious, as the basis for aging. It believes that aging is not a passive society. It is no mystery that diet impacts health and Obesity wearing out of systems but active self-destruction mediated is shown to increase the risk of many diseases and shorten by the immune system. life 2001; Preston, 2005, Taylor and Ostbyte, 2001). 4. Neuroendocrine and Neurochemical Theories - Propose that aging occurs because of functional decline in neurons 7. Environmental Theories - Several environmental factors and associated hormones. It believes that neural and are known to threaten the health and are thought to be endocrine changes may trigger many cellular and physiologic associated with the aging process. The ingestion of mercury, aspects of aging. It hypothesizes that in aging there is an lead, arsenic, radioactive isotopes, certain pesticides, and organism's loss of responsiveness of neuroendocrine to other substances can produce pathologic changes in human various signals. The main focus of this theory is the functional beings. changes in the hypothalamic-pituitary system. 5. Radiation Theories -The relationship between radiation and age continues to be explored. Research using rats, mice, and dogs has shown that a decreased life span results from nonlethal doses of radiation. SOCIOLOGIC THEORIES OF NURSING Describe the aging individual in terms of his or her social One must constantly struggle to remain functional and group/culture. take on new activities to replace lost ones. 1) Disengagement Theory Activity is generally assumed to be more desirable than The basis of this theory arises from the fact that human inactivity because it facilitates physical, mental, and social beings are mortal and must eventually leave their place well-being. and role in society. 3) Continuity Theory It views aging as a process in which society and the Accounts for the continuous flow of phases in the life individual gradually withdraw, or disengage, from each cycle and does not limit itself to change. other to the mutual satisfaction and benefit of both. It assumes that persons will remain the same unless there The disengagement theory is quite controversial because are factors that stimulate change or necessitate disengagement is necessarily a process expected from all adaptation. aging persons. Personality and basic patterns of behavior are said to 2) Activity Theory remain unchanged as the individual ages. Assumes that the same norms exist for all mature Aging is a complex process, and the continuity theory individuals. The degree to which the individual "acts like" considers these complexities to a greater extent than or "looks like" a middle-aged is the determinant of the most other theories. aging process. SOCIOLOGIC THEORIES OF NURSING 4) Age Stratification Theory This theory, suggests that society is stratified by age groups (Riley, Johnson, and Foner, 1972). Persons within a A component of this theory is the argument for social similar age group generally have similar experiences, reform and greater empowerment of the older beliefs, attitudes, and life transitions that offer them a populations so that their rights and needs can be unique shared history. respected. New age groups are continually being formed with the As the population of older adults become more diverse, birth of new individuals thus the interaction between their needs better addressed and their power recognized, society and the aging population is dynamic. As 'each the question can be raised that this theory is less relevant group ages, they have their own unique experience with today than it was in the 1960s when it was first and influence on society, and there is an introduced. interdependence' between society and the group. 5) Subculture Theory Views older adults as a group with distinct norms, beliefs, expectations, habits, and issues that separate them from the rest of society (Rose, 1965). Older persons are accepted by and more comfortable among their own age group. PSYCHOLOGICAL THEORIES OF AGING Explore the mental processes, behavior, and feelings of persons throughout their lifespan, along with some mechanisms people use to meet the challenges they face in c. Ego transcendence versus ego preoccupation - to old age. achieve satisfaction through reflection on one's past life and 1) Theory of Developmental Tasks accomplishments rather than be preoccupied with the finite Describes the process of healthy psychological aging as number of years left to live. the result of successful fulfillment of developmental tasks. 2) Gerotranscendence - It suggests that aging entails a Refining Erikson's description of old age tasks, Robert transition from a rational, materialistic perspective to a Peck (1968) detailed three specific challenges facing older cosmic and transcendence vision (Tornstam, 2005). As people adults that influence the outcome of ego integrity or age, they are less concerned with their physical bodies, despair: material possession meaningless relationships, and self- a. Ego differentiation vs. role preoccupation - to interests and instead desire a life of more significance and a develop satisfaction from oneself as a person rather than greater connection with others. There is a desire to shed roles through parental or occupational roles. and invest time in discovering hidden facets of oneself. b. Body transcendence vs. body preoccupation - to find psychological pleasures rather than become absorbed with health problems or physical limitations imposed by aging. NURSING THEORIES OF AGING 1) Functional Consequences Theory The Functional Consequences Theory for Promoting Wellness in Older Adults (Miller, 2014) integrates theories from aging and holistic nursing. 3) Theory of Succesful Aging - Pland (2005) integrated Roy's The consequences of age-related changes and risk factors Adaptation Model, other aging Literature, and the Theary of can result in either position or negative functional Gerotranscendence to develop a nursing theory to guide the consequences (ie., wellness outcomes) for older adults. care of older adults. The Adaptation Model by Sister Callista Roy, saw the 2) Theory of Thriving -This theory proposes that everything individual as biopsychosocial being that continuously that impacts people throughout their lives must be linked to interacts with and adapts to the changing internal and create a holistic view of aging (Haight, Barba, Tesh, and Cour external environment (Roy and Andrews, 2008). 2002) The Theory of Successful Aging not only considers The theory is based on the failure to thrive concept as it successful aging in terms of the older adult's physical, related to older adults nursing homes (Newbern and mental, and spiritual well-being but also includes the Krowchuk, 1994); the clinical characteristics of persons individual's self-appraisal. experiencing failure to thrive include disconnectedness, inability meaning in life, problems with social relationships, and physical and dysfunction harmony exists between individuals and their physical and human environments. SIX POSITIVE LIFESTYLE PATTERN THAT PROMOTES GOOD HEALTH 1. Getting Regular and Adequate Amounts of Sleep - Getting a regular amount of sleep is important to give the 5. Not Using Tobacco Products, Including Smoking or body a chance to and regenerate. Chewing - In the Philippines, 10 people die every hour 2. Eating Regular Well-balanced Meals, Including because of smoking-related diseases. This translates to 240 Breakfast - A healthy balanced diet can help provide deaths every day or 87,600 deaths every year. (The Manila energy and lower risks for the leading killer diseases such Times on Feb. 12, 2015) by Dr. Mary Assunta. as heart disease, hypertension, diabetes, and cancers. 6. Using Alcohol in Moderation or Not at All - Moderate 3. Engaging in Regular Physical Activity - Thirty minutes a alcohol consumption (one drink for women, two for men) is day of regular physical activity contributes to health by associated with a lower risk or heart disease. Higher levels of reducing the heart rate, decreasing the risk for alcohol can lead to health and behavioral problems, including cardiovascular disease, and reducing the amount of bone an increased risk for high blood pressure, stroke, heart loss that is associated with age and osteoporosis, disease, some cancers, accidents, violence, suicide, and 4. Maintaining a Healthy Body Weight - Obesity is deaths in general. associated with a shorter lifespan and also an increased risk of other major diseases. APPLICATION IN NURSING PRACTICE 1) Learn about patients' stories; ask about family backgrounds, faith, work history hobbies achievements and life experiences. 2) Build on lifelong interests and offer opportunities for patients to experience new pleasures and interests threading beads to make bracelets and necklaces, etc growing plants in 6) Use humor therapeutically. small pots, learning how to paint; group singing; etc. 7) If patients reside in an institutional setting (eg, home 3) Accept patients' discussions of their regrets and for the aged), personalize the environment to the dissatisfactions. Help them to put these in perspective of maximum degree possible. their total lives and accomplishments. 8) Recognize the unique assets and characteristics of 4) Encourage reminiscence activities between two patients each patient. and their families. 5) Respect patients' faith and assist them in the fulfillment of spiritual needs (eg, help them locate a church of their religious affiliation, request visits from clergy, pray with or for them, and obtain a Bible or other religious book). GERONTOLOGY THANK YOU FOR LISTENING End of Chapter Two