Theories of Aging (COA Wk2) PDF

THEORIES OF AGING **WHY DO OUR BODIES AGE?** - No single known factor causes or prevents aging. - One theory cannot explain the complexities of this process. - Recent research concentrated on learning about keeping people healthy and active for longer period rather than on extending th...

THEORIES OF AGING **WHY DO OUR BODIES AGE?** - No single known factor causes or prevents aging. - One theory cannot explain the complexities of this process. - Recent research concentrated on learning about keeping people healthy and active for longer period rather than on extending their lives in a state of a long-term disability. AGING THEORIES Biological Aging - The **progressive loss of function.** - It can be viewed as a balance of **positive factors** such as healthy diet, regular exercise. And **negative factors** such as obesity, unhealthy lifestyle etc. Aging - **Chronological aging** - **Time-related deterioration of physiological functions** necessary for survival and fertility. - An intrinsic feature of living beings because of time. Difference - **LIFE SPAN** - **Maximum length of life** or years a member of species **has been known to survive**. - Does not change with age. *Example:* Maximum human life span is to be 121 years; maximum life span of a domestic dog is about 20 years. - **LIFE EXPECTANCY** - **Average length of life** or amount of time a member of species **can expect to live**. - Not a characteristic of species but of **population**. BIOLOGICAL THEORIES OF AGING Concerned with answering basic questions regarding physiologic process that occur in all living organisms' overtime. - Varies among individuals and also within different systems of the same person. - STOCHASTIC THEORIES - Explain aging as events that occur randomly and accumulate over time. View the effects of ageing as resulting from random assaults from both internal and external environment. - Cross-linkage/Cross-linking theory - Free radical theory & lipofuscin theory - Wear and tear theory - Evolutionary theories - Biogerontology theory CROSS-LINKING THEORY - Also called "**Glycosylation**" (Bjorksten, J. 1942) - Some proteins in the body become cross-linked and accumulate waste products in the cells. - **Accumulation of cross-linked proteins damages cells and tissues slowing down bodily processes** resulting in **aging**. **Cells become rigid and stiff/lose elasticity.** - Tissues do not function at optimum efficacy. FREE RADICALS & LIPOFUSCIN THEORIES - Aging is **due to oxidative metabolism and the effects of free radicals** (Hayflick, 1985). - Caused by **accumulation of damage inflicted by reactive oxygen species** (free radicals highly unstable reactive molecules containing extra electrical charge). - When these **byproducts of metabolism accumulate, they damaged the cell membrane which decreases its efficiency.** - **LIPOFUSCIN -** "age pigments", a **lipoprotein** by product of oxidation that can be seen only under fluorescent microscope, in the ageing process. - Accumulation **interferes with the diffusion and transport of essential metabolites** and information-bearing molecules in the cells. A diagram of a free radical Description automatically generated WEAR & TEAR THEORIES - Attribute aging to the **repeated use and injury of the body over time** as it performs highly specialized functions. - Progressive damage to cells and body systems overtime. - **Body will function less efficiently with prolonged use and numerous insults** like: - Smoking - Poor diet - Substance abuse - Result will be osteoarthritis, decreased mobility, arthritis. - The activities you once enjoy on your younger years will change over time resulting to bad effects when aging. EVOLUTIONARY THEORIES - Theories of aging related to genetics and hypothesize that the differences in the aging process and longevity of various species occur due to interplay between the processes of mutation and natural selection. - **Groups of theories that relate aging to evolution**. A. **MUTATION ACCUMULATION THEORY** - suggests that aging occurs **due to a declining force of natural selection with age.** In other words, **genetic mutations** (not original DNA) that **affect children will eventually be eliminated** because the **victims will not have lived long enough to reproduce** and pass this to future generations. - It affects mostly the children with less efficient genes. B. **ANTAGONISTIC PLEIOTROPY THEORY** - suggests that **accumulated mutant genes that have negative effects in late life may have had beneficial effects in early life.** - A particular gene can have multiple effects- some positive and some negative. - **More mutations occur with aging**, and these will ultimately result in **functional failure**. C. **DISPOSABLE SOMA THEORY** - proposes that **aging is related to the use of the body's energy like on what a person eat rather than genetics.** - It claims that the body must use energy for metabolism, reproduction, maintenance of functions, and repair. - With a finite supply of energy from food to perform these functions, some compromise occurs. - Decreased energy = decreased functioning = aging. BIOGERONTOLOGY THEORY - Believes that **bacteria, fungi, viruses, and other organisms are responsible for certain physiologic changes** during the aging process. - PTB is dormant to people. - In some cases, these pathogens may be present in the body for decades before they begin to affect body systems. - Although there is no evidence exists to link these pathogens with the body's decline, it has been stimulated by the fact that human beings and animals have enjoyed longer life expectancies with the control or elimination of certain pathogens through immunization and the use of antimicrobial drugs. NON-STOCHASTIC THEORIES - View aging as certain predetermined, timed phenomena. These are theories that see aging changes resulting from a complex, predetermined process. - Apoptosis - Genetic theory - Autoimmune theory - Neuroendocrine and neurochemical theories - Radiation theory - Nutrition theory - Environmental theory APOPTOSIS - is the process of programmed cell death or **"cellular suicide" that continuously occurs throughout life due to biochemical events**. - Different from necrosis (cellular death) because apoptosis is an orderly process in which cell contents are packaged into small packets of membrane for garbage collection by immune cells. - **Cellular suicide → Cells are shrinking and there is nuclear and DNA fragmentation → decreased function when aging**.  GENETIC THEORY - **Programmed theory of aging** proposed that animals and humans are born with a genetic program or biological clock that predetermines the life span (Hayflick, 1965). - Aging is programmed in our body. - **Life expectancy was generally seen as preprogrammed**, within a species-specific range; this **biologic clock for humans** was **estimated at 110 to 120 years** (Gerhard & Cristofalo, 1992; Hayflick, 1996). - Also called the **"Hayflick Limit Theory", "Biologic Clock,"** or **"Cellular Aging,".** A. **ERROR THEORY** - on genes mutation as the responsible for aging by causing organ decline as a result of self-perpetuating cellular mutations, like **trisomy disorders**. - Aging results when a growth substance fails to be produced leading to the cessation of cell growth and reproduction. - An aging factor responsible for development and cellular maturity throughout life is excessively produced, thereby hastening aging. AUTO-IMMUNE THEORY - **IMMUNE SYSTEM** is a network of specialized cells, tissues, and organs that provide the body with protection against invading organisms. - **Primary role is to differentiate self from non self, thereby protecting the organism from attack by pathogens.** *(Cells of the body shouldn't be the cells of a pathogen).* - **"Immunosenescence"** term for age-related decrease in immune system's function. - **Thymus and bone marrow** **are primary organs of immune system** and are believed to be affected by the aging response. - Immune system is programmed so that it's no longer able to faultlessly distinguish foreign proteins from the body's own proteins. - **THYMUS**- produces and secretes thymosin- a hormone necessary for T cell development and production. - **BONE MARROW**- makes stem cells which produce platelets, wbc, and rbc. - T-lymphocytes and B-lymphocytes are essential components of immune system. - **T-lymphocytes** are responsible for **cell-mediated immunity.** Body uses to help destroy infected or cancerous cells (if damaged, there won't be any fighting of cancerous cells). - **B-lymphocytes** responsible for **antibody-mediated immunity.** With assistance from T-cells, it will differentiate into plasma B cells that can produce antibodies against specific antigen (antibodies production or B cells against the antigen) - The changes that occur with aging are most apparent in T lymphocytes. **Low rate of T cells proliferation in response to stimulus causes older adults to respond more slowly to allergic stimulus.** - The reduction in immunologic function is also evidenced by increased incidence of infections and many cancers with age. - Cell reacting to another cell threat and misidentified for a foreign cell = **auto-immune reaction**. Result = destroyed own cell. NEUROENDOCRINE & NEUROCHEMICALS THEORIES - Examined the interrelated role of the neurologic and endocrine systems over the life span of an individual. - **Suggests that ageing is the result of changes in the brain and endocrine glands.** - **ENDOCRINE GLANDS**- produce chemical messengers called **"hormones"** that regulate many bodily functions including growth and metabolism. - There is a decline/even cessation in many of the components of the neuroendocrine system over the life span. - Some theorists claim that **specific anterior pituitary hormones promote ageing**. - Others believe that an **imbalance of chemicals in the brain impairs healthy cell division throughout the body.** ***EXAMPLE**: Melatonin a hormone produced by pineal gland, declines in old age. (Melatonin in increased light source = decreased hormone, if decreased light source = increases hormone)* RADIATION THEORIES - **Repeated exposure to ultraviolet lights is known to cause [solar elastosis]**, the **"old age" type of skin wrinkling** that results from the replacement of collagen by elastin (UV light is also a factor in the development of skin cancer.) - Radiation may induce cellular mutations that promote ageing. From UVA & UVB. - Increase elastin = stretch but no collagen so the skin is like a loosen thread. NUTRITION THEORIES - **The quality of diet is as important as the quantity.** Deficiencies of vitamins and other nutrients and excesses of nutrients such as cholesterol may cause various disease process. - Although the complete relationship between diet and ageing is not well understood, enough is known to suggest that a good diet may minimize or eliminate some of the ill effects of the ageing process. ENVIRONMENTAL THEORIES - several environmental factors are known to **threaten health** and are thought to be associated with the ageing process. - Ingestion of mercury, lead, certain pesticides, arsenic radioactive isotopes and other substances, trauma and infection can produce changes in human beings. - Factors in the environment like **crowded living conditions, high noise levels and other factors are thought to influence how we age.** SOCIOLOGIC THEORIES OF AGING Address the impact of society on older adults and vice versa. Focused on the roles and relationships within which individuals engage in later life. DISENGAGEMENT THEORY - **Views ageing as a process in which society and the individual gradually withdraw or disengage from each other**; to the mutual satisfaction and benefit of both (Cumming, 1964; **Cumming & Henry**, 1961). - States that aging people **withdraw from customary roles** *(Noon, ano ka? Ano pa ang mga ginagawa na pwede mo pang magawa ngayon: cooking, etc)**.*** - One of the most controversial and widely discussed theories of ageing. - **This theory has now been [discredited] (Johnson**, 2009) because **many older persons desire to remain engaged and do not want their primary satisfaction to be derived from reflection on younger years.** - Although nurses should appreciate that some older individuals may wish to disengage from the mainstream of society, and *this is not necessarily a process to be expected from all ageing persons.* ACTIVE THEORY - Older adults are **"happiest" when they stay active and maintain social interactions.** - **Asserts that older person should continue a middle-aged lifestyle, denying the existence of old age as long as possible and that society should apply the same norms to old age** as activity, interests, and involvement as its members grow old (Havighurst, 1963). - Suggests ways of maintaining activity in the presence of multiple losses associated with aging process including substituting intellectual activities for physical activities when physical capacity is reduced. - As long as it won't compromised their health and safety. CONTINUITY THEORY - Also referred as **"developmental theory".** - **Personality and basic patterns of behavior are said to remain unchanged** (continue to develop but still with the same personalities or habits) as the individual ages. - Older people are inclined to maintain as much as they can the **same habits, personalities, and styles of life.** - **Assumes that persons will remain the same unless there are factors** that stimulate change or necessitate adaptation. - *Example*: activists at 20 years of age will most likely be activists at 70 years of age. - It encourages the young to consider that their current activities will lay a foundation for their own future old age 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). - **Subculture occurs as a response to loss of status** (like their profession when they were young: lawyer, doctor, nurse, etc.) but they have distinction to continue with social groups such as Zumba activities, gardening, etc**.** - **Individual status is based on health and mobility** instead of education, occupation & economic achievements - A theoretical perspective that **people maintain their self-concepts and social identities through their membership in a defined group** (subculture). AGE STRATIFICATION - **Where similar experiences, beliefs, attitudes, and life transitions that offer them a unique shared history are shared with similar people or age group.** - As each group ages, they have their own unique experience with and influence on society, and there is an interdependence between the society and the group. - *Example*: Baby boomers and millennials PSYCHOLOGICAL THEORIES OF AGING explore mental processes, behavior, and feelings of persons throughout the lifespan, along with some mechanisms people use to meet the challenges they face in old age. DEVELOPMENTAL TASKS are the challenges that must be made in response to life experiences that are part of an adult's continued growth through the life span. A. **ERIK ERIKSON (1963)** described eight stages through which human beings progress from infancy to old age and the challenges, or tasks, that confront individuals during each stages.  - **EGO INTEGRITY VS. DESPAIR (65 years old and above): reflect on their lives or the life they have lived. (Either negative which is despair, or positively which is on ego integrity).** To achieve ego integrity: older adult must have at least on companion in life, stable financial status, and productive social, civic, and religious activities. - **Ego integrity:** sense of fulfillment from a well lived life. Fully accepting oneself and coming to terms with death. Accepting responsibilities for your life and able to undo the past and achieve satisfaction with self. Bringing serenity and wisdom. - **Despair:** Sense of regret and despair over a life. Inability to accept one's fate. Desperate, hopelessness and gives rise to feeling with frustration, bitterness, anger, discouragement. A sense that one's life has been worthless. B. **ROBERT PECK (1968)** **detailed three specific challenges** facing the older adults that influence the outcome of ego integrity or despair. - **EGO DIFFERENTIATION VS ROLE PREOCCUPATION**: stage where an old adult thinks about what he is going to do after retirement. - Finding ways to affirm self-worth/satisfaction from oneself outside the work role (as a grandparent or gardener). - **"successful ager**" is the one who is purposefully active in preserving the culture by doing all he could do to make it a good world for his familial/cultural descendants. - **BODY TRANSCENDENCE VS BODY PREOCCUPATION:** to **find psychological pleasures** rather than become absorbed with health problems or physical limitations imposed by aging. - Older adults undergo significant changes in their physical capabilities because of aging. - Older adults must learn to **cope with the significant changes in their physical capabilities** (they can go beyond on what they can still do) - **EGO TRANSCENDENCE VS EGO PREOCCUPATION**: to achieve satisfaction through reflection on one's past life and **accomplishments (healthy ego)** rather than be preoccupied with the finite number of years left to live. - Accepting the life as "finite" by finding ways to contribute to the welfare of the future generations. - **EGO TRANSCENDENCE**: If older people, see these **contributions**, they will experience - **EGO PREOCCUPATION:** If not, they become **preoccupied** with the question whether their lives had value and worth to society C. **ROBERT BUTLER & MYRNA LEWIS (1982)** outlined additional developmental tasks of later life. ❑ Adjusting to one's infirmities (physical weakness/ailment). ❑ Developing a sense of satisfaction with the life that has been lived. ❑ Preparing for death. Older people must make a tremendous or huge adjustments from their physical weakness or ailments. *Examples*: ▪ Make your doctor a partner in care. ▪ Involve the family or make it a family affair. ▪ Be patient with the pace of treatment and recovery GEROTRANSCENDENCE a recent theory that suggests aging entails a transition from a rational, materialistic metaperspective to a cosmic and transcendent vision (Tornstam, 2005). - Aging people are less concerned with their physical bodies, material possessions, meaningless relationships, and self-interests and instead **desires a life of more significance and a greater connection with others**. - Development involving new understanding of the self, relationship to others and their existence. - **Redefinition of self and relationship to others**. - Increase feelings of being part of the flow of generations. NURSING THEORIES OF AGING FUNCTIONAL CONSEQUENCES THEORY - For Promotion of Wellness in Older Adults (Miller, 2014) integrates theories from ageing and holistic nursing. - It holds that **nurses can promote wellness** by addressing individuals holistically, recognizing the interconnection of body, mind, and spirit. - Older adult experiences functional consequences because of age-related changes and additional factors, **this theory provides a framework for wellness promotion in OA by helping nurses to recognize their potentials for growth and using wellness nursing diagnosis to foster a sense of value and dignity.** - *Example of Wellness Nursing Diagnosis: (human responses to level of wellness)* - Readiness for enhanced family coping: describe human responses to levels of wellness in an individual, family, or community. - *Example of Health Promotion Diagnosis* - Readiness for enhanced nutrition: this is the preparedness to implement behaviors to improve their health condition. THEORY OF THRIVING - Propose that everything that impacts people throughout their lives must be linked to create a holistic view of ageing (Haight, Barba, Tesh, & Courts,2002). - Based their theory on the failure to thrive concept as it related to older adults in nursing homes (Newbern & Krowchuk, 1994). - Clinical characteristics of older adults\' failure to thrive include disconnectedness, inability to find meaning in life problems with social relationships, and physical and cognitive dysfunction. - **Thriving** is **possible when harmony exists between individuals and their physical and human environments.** - Reinforces the importance of nurses considering the many factors that can impact health and quality of life for older adults. Especially on how are we going to be able to lift them to thrive and give them reasons. THEORY OF SUCCESSFUL AGING: Flood, 2005 - Includes individual's **self-appraisal**. - Flood hypothesizes that people **with *high levels of personal control and a positive affect* will experience *higher levels of wellness in ageing* = ability to participate in health promoting activities.** - **By aiding older adults in achieving high levels of personal control over their lives, NURSES can help older people to have a positive view of their lives** like health promotion activities (ACTIVE OR PASSIVE ROM) which in turn can promote their ability to cope and achieve greater life satisfaction. APPLYING THEORIES OF AGING TO NURSING PRACTICE - **When nurses consider ageing as a progressive decline ending in death**, may view old age as a depressing, useless period and foster helplessness in older patients. - **When nurses who view ageing as a process of continued development** may appreciate late life as an opportunity to gain new satisfaction and understanding, thereby promoting joy and a sense of purpose in patients. +-----------------------------------------------------------------------+ | Important Note/Key concepts | +=======================================================================+ | - The aging process varies not only among individuals but also | | within different body systems of the same person. | | | | - It is beneficial for nurses to advise aging persons to scrutinize | | products that claim to cause, stop, or reverse the aging process. | | | | - On continuity theory: Basic psychological patterns are consistent | | throughout the life span. | | | | - On psychological theories: Nurses can promote joy and a sense of | | purpose in the older adults by viewing old age as an opportunity | | for continued development and satisfaction rather than a | | depressing, useless period of life. And how nurses take action | | that can influence the older adults to find meaning in old age. | | | | - The biological, psychological, and social processes of ageing are | | interrelated and interdependent. The ageing process varies not | | only among individuals but among systems within an individual. | | | | - Frequently, loss of a social role affects an individual's sense | | of purpose and speeds physical decline. | | | | - Poor health may force retirement from work, promoting social | | isolation, and the development of weakened self-concept. | | | | - Gerontological nurses play a significant role in helping ageing | | persons experience health, fulfilment, and a sense of well-being. | | | | - Nurses must be sensitive to the tremendous impact of their own | | attitudes toward ageing can have on patient. Nurses' attitude | | towards aging matters to apply the theories. | +-----------------------------------------------------------------------+