Theories of Aging (Slides) PDF

# Theories of Aging(SLIDES) ## Defining Old **How do you define “old?”** * 70: DRI category * 60: Elderly Nutrition Program * 65: Eligible for Medicare * 60: World Health Organization * U.S. Census Bureau: * “young old” * "aged” * "oldest old” **Gerontology examines:** * Biological...

# Theories of Aging(SLIDES) ## Defining Old **How do you define “old?”** * 70: DRI category * 60: Elderly Nutrition Program * 65: Eligible for Medicare * 60: World Health Organization * U.S. Census Bureau: * “young old” * "aged” * "oldest old” **Gerontology examines:** * Biological age * Psychological age * Social age * Legal age * Functional age ## The Graying of America A line-graph that shows the number of millions of people in the United States who are 65 and older, and 85 and older from 1900 - 2050. * The data is shown for 1900-2010 and is projected for 2020-2050 * The number of people 65 and older has dramatically increased since 1900. * The number of people 85 and older has also dramatically increased since 1900. ## Vital Statistics ### Life expectancy * Average number of years of life remaining for persons in a population cohort or group. * Most commonly reported as life expectancy from birth * Life expectancy in the US is 78.8 years. The global average is 72.0 years. ### Life Span * Maximum number of years someone might live. * Human life span is projected to range from 110 to 120 years. ## Factors Contributing to Longevity * The CDC suggests that longevity depends on: * 10% Access to health care * 19% Genetics * 20% Environment * Pollution, etc. * 51% Lifestyle factors * Not smoking * A healthy diet & * Ample exercise. ## Theories of Aging * Theories try to explain physical and mental changes that accompany aging. * Theories fall into 2 groups: * **Programmed Aging** * Hayflick’s theory of limited cell replication * Molecular Clock theory * **Wear & Tear Theories** * Free-Radical or Oxidative Stress Theory * Rate of living theory * Autoimmune theory ## Hayflick's Theory * Leonard Hayflick, 1961 * Normal human cell populations divide a finite number of times. * Each cell’s DNA telomeres shorten each time cell divides, until they reach a critical length. * Telomere shortening eventually makes cell division impossible. * Cellular aging correlates with the overall physical aging of the human body. * **Senescence** = phase when cells reach their division limit. A diagram shows a chromosome with the two paired strands of DNA with the protective tips or Telomeres. ## Molecular Clock Theory * Similar to Hayflick's Theory: progressive telomere damage due to cell division leads to aging, and eventually all cell division ceases. * If telomerase activity could be controlled: * Increasing telomerase production in injuries could speed healing time. * Decreasing telomerase in cancer cells – cure? ## Free Radical/Oxidative Stress Theory * **Free Radical: pro-oxidative, unstable (charged) oxygen molecules damage cells.** **Anti-oxidative** 1. **Antioxidant Enzymes:** Catalases, glutathione, peroxidase reductases, superoxide dismutases (SOD) 2. **Electron donors:** * Vitamins C and E * Carotenoids (pre-A): * Flavonoids, isoflavones * Resveratrol **Pro-oxidative** * Normal metabolic processes * Exercise * Overuse of acetaminophen * Smoking * Ozone, solar radiation * Environmental pollutants ## Free Radical/Oxidative Stress Theory A table shows foods rich in each of the following: | Food Group | Examples | | -------- | -------- | | Carotenes | Pumpkin, Carrots, Spinach, Sweet Potato, Tomatoes| | Xanthophylls | Dark green leafy, Papaya, Peaches, Prunes, Squash | | Flavonoids | Red, blue & purple berries & grapes, Red wine, Tea, Chocolate, Soy | | Resveratrol | Pinot Noir, Merlot, Cab. Sauvignon, Peanuts, Red grapes | | Vitamin C | Bell peppers, Strawberries, Oranges, Papaya, Tomatoes | | Vitamin E | Sunflower seeds, Almonds/Butter, Hazelnuts, Tuna, sardines, Wheat germ/oil | ## Rate of Living Theory * **"Fast living" = fast dying.** * Metabolic rate directly related to rate of deterioration. * Faster tissue turnover and accumulation of cellular damage. * **"Slow living" = greater longevity.** ## Autoimmune Theory * Attributes aging to decline of the body's immune system. * With age, the immune system becomes less effective in fighting disease. * Bodies subjected to excessive stress show signs of illness and disease. * Lack of sleep * Poor nutrition * Others A diagram shows a circle with the label **Immunity:** Protection/defense against whatever doesn't belong. Arrows point from the circle to the following items: Viruses, Other microbes, Tissue irritants, Other pathogens, Cancer, Chemicals, Toxins, Bacteria and Damage/injury. ## Alzheimer's Disease * **Alzheimer’s disease:** Progressive brain impairment that interferes with memory and normal intellectual functioning. * "Kills a person twice," first through the loss of personhood and second through the deterioration of body systems. ## Alcohol and Drug Use, Abuse & Polypharmacy * 65+ years of age the lowest rates of drinking. * Older people rarely use illicit drugs, may overuse or misuse prescription drugs. * There is no single system to track all prescriptions, so pharmacists may not know about all of the drugs that a patient is taking. ## Recipe for Successful Aging * Staying active, through leisure activities and regular exercise. * Maintaining a normal weight range. * Eating a diet low in saturated fats, high in fruits, vegetables, and whole grains. * Participating in meaningful activities: volunteering and other social outlets. * Avoiding smoking and consuming alcohol in moderation. ## Additional Strategies for Successful Aging * **Improve fitness** * **Eat for longevity** * Adequate protein * Vitamin D, E, folate/folic acid, vitamin B-12 * Calcium, iron, potassium CoQ10 * **Develop and maintain healthy relationships** * Maintain cognitive agility * Enrich the spiritual side of life * **Avoid alcohol and drug use and abuse** * **Financial planning for retirement** ## Blue Zones: The Power 9 * **Move Naturally** * **Purpose** * **Down Shift** * **80% Rule** * **Plant Slant** * **Wine @ 5** * **Belong (Faith)** * **Loved Ones First** * **Right Tribe** A Venn diagram shows the 9 factors that contribute to longevity. The factors are grouped into 3 categories (Life, Community, Outlook). The categories overlap and the factors are: * **Life** * Move Naturally * Plant Slant * Wine @ 5 * **Community** * Loved Ones First * Right Tribe * Healthy Social Circle * **Outlook** * Purpose * Down Shift * 80% Rule * No Time Urgency * Faith **Sardinia, Italy** factors: Fava Beans, High Polyphenols, Wine, Family, No Smoking, High Soy Consumption **Loma Linda, CA** factors: Culturally Isolated, Plant-based diet, Constant moderate physical activity, Social engagement, Legumes, Empowered Women, Sunshine Gardening, No Alcohol. **Okinawa, Japan** factors: Likeability, Turmeric. ## Coping With LOSS * **Bereavement:** The loss or deprivation experienced by a survivor when a loved one dies. * **Grief:** State of mental distress that occurs in reaction to significant loss. * **Disenfranchised Grief:** A loss that cannot be openly acknowledged publicly mourned, or socially supported. * **Mourning:** Culturally prescribed and accepted time periods and behavior patterns for the expression of grief. ## Corr's Coping Approach * Corr recognizes unique challenges and response for the dying person and those who love him or her: * Physical * Psychological * Social * Spiritual A diagram shows the stages of grief with shock at the top and acceptance on the bottom. The diagram has the following stages: * Shock * Denial * Anger * Bargaining * Acceptance. * **Lessons to be learned from Kubler-Ross:** 1. Individuality of the dying 2. Others (caregivers) must listen actively to the dying ## Worden’s Model of Grieving Tasks 1. Accept the reality of the loss. 2. Work through the pain of grief. 3. Adjust to an environment in which the deceased is missing. 4. Emotionally relocate the deceased and move on with life. ## Social Death * Loss of being valued or appreciated by others; condition in which a person is not treated like an active member of society. * Dying patients moved to terminal wards. * Inadequate pain control → contributes to a patient’s suffering, anger, hostility. * Makes caregiver assistance more difficult. * Declining quality of social interactions can harm sense of identity. ## Life-and-Death Decision Making * The right to die: Some states legally allow certain life-support techniques to be refused by competent patients. * Electrical or mechanical heart resuscitation * Mechanical respiration * Feeding via nasogastric tube * Intravenous nutrition * Gastrostomy * Medication ## Rational Suicide * A reasoned, coherent process in which a person chooses death as a preferable alternative to unbearable pain. * **Active euthanasia:** Ending the life of a person who is suffering greatly and has no chance of recovery. * **Passive euthanasia:** Intentional withholding of treatment that would prolong life. ## Advance Directives * Living Wills * Medical Power of Attorney or Healthcare Proxy ## Making Final Arrangements * **Hospice** care: * Relieve the dying person's pain. * Offer emotional support to the dying person and his or her loved ones. * Restore a sense of control to the dying person, family, and friends. * **Funeral arrangements** * Wake or viewing * Burial * Cremation * Organ or body donation