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Kathleen Stassen Berger


                      Part VII               Chapter Twenty

       Adulthood: Biosocial Development

The Aging Process

The Impact of Poor Health Habits

Measuring Health

Variations in Aging
                      Prepared by Madeleine Lacefield Tattoon, M.A.   1
Adulthood: Biosocial Development

Age matters…
    How old are you? Do you feel
        your age?




                                   2
The Aging Process
• Senescence
  – a gradual physical decline related to
    aging… happens to everyone in every
    body part but the rate of decline is highly
    variable




                                              3
The Aging Process
• Physical Appearance
  – outward signs of senescence are present long
    before old age arrives
    • first visual in the skin
        – collagen – the connective tissue of the body,
          decreases by about 1% per year
    •   hair turns gray and get thinner
    •   skin becomes drier
    •   “middle-age spread”
    •   people get shorter
    •   muscles weaken



                                                          4
The Aging Process
• Sense Organs
  – senescence varies from organ to organ
    • the five senses become less sharp…
      each organ loses some functions faster
      than others
      – changes in eyesight is the most obvious
      – losses occur in hearing
        » presbycusis
        » the loss of hearing associated with senescence
          often does not become apparent until after age 60




                                                              5
The Aging Process
• The Aging Brain
  – the brain slows down with age
  – neurons fire more slowly and messages
    sent from the axon of one neuron are
    not picked up as quickly by the
    dendrites of another neuron
  – multitasking is more difficult



                                            6
The Aging Process
• The Sexual-Reproductive System
  – is slower and fertility is reduced with
    age, but adults of all ages enjoy “very
    high levels of emotional satisfaction and
    physical pleasure from sex within their
    relationships”




                                                7
The Aging Process
• Infertility
   – 2% of healthy couples in their earlier 20s, in
     medically advanced nation, are infertile
   – 33% of 30 year-olds in poor nations are
     infertile
   – the highest rate of infertility occurs in countries
     with the highest birth rates, due in part to the
     lack of contraception and the high incident of
     untreated sexually transmitted diseases



                                                       8
The Aging Process
• Assisted Reproduction
  – assisted reproductive technology (ART)
     • the collective name for the various methods of
       medical intervention that can help infertile
       couples have children
  – in vitro fertilization (IVF)
     • a technique in which ova (egg cells) are
       surgically removed from a woman and fertilized
       with sperm in the laboratory… after the original
       fertilized cells (the zygotes) have divided
       several times, they are reinserted into a
       woman's uterus.



                                                          9
The Aging Process
• Menopause
 – the time in middle age, usually around
   age 50, when a woman’s menstrual
   periods cease completely and the
   production of estrogen, progesterone,
   and testosterone drops considerably
 – strictly speaking, menopause is dated
   one year after a women’s last menstrual
   period



                                         10
The Aging Process
• Menopause
 – hormone replacement therapy (HRT)
   • treatment to compensate for hormone
     reduction at menopause following
     surgical removal of the ovaries… such
     treatment, which usually involves
     estrogen and progesterone, minimizes
     menopausal symptoms and diminishes
     the risk if osteoporosis in later adulthood



                                               11
The Aging Process
• Menopause
 – andropause
   • a term coined to signify a drop in
     testosterone levels in older men, which
     normally results in reduced sexual
     desire, erections, and muscle mass
   • also know as male menopause




                                               12
The Impact of Poor Health Habits
“Almost all diseases and chronic
  conditions that are normally
  associated with aging (arthritis to
  strokes) are powerfully affected by
  the routines of daily life”.




                                        13
The Impact of Poor Health Habits
• Tobacco and Alcohol Use
  – tobacco
    • in all its forms contains harmful drugs
    • nicotine is the most addictive
    • fewer people are starting to smoke
    • many quit by late adulthood
    • death from lung cancer is down by 20%
      from 1980 - 1995



                                                14
The Impact of Poor Health Habits
• Tobacco and Alcohol Use
  – alcohol
    • adults who drink wine, beer, spirits, or other
      alcohol in moderation (no more than two
      moderate-sized drinks a day) live longer than
      those who never drink
    • moderate drinking is a reduction in coronary
      heart disease
    • alcohol increases high-density lipoprotein
      (HDL), the" good” cholesterol and reduces low-
      density lipoprotein, the “bad” cholesterol that
      causes clogged arteries and blood clots



                                                    15
The Impact of Poor Health Habits
• Lack of Exercise
  – adults exercise less as they age
  – low exercise rates are blamed…
    • lack of commitment
    • lack of support in the immediate social
      context
    • community’s failure to provide
      appropriate facilities



                                                16
The Impact of Poor Health Habits
• Lack of Exercise




                               17
The Impact of Poor Health Habits
• Overeating
  – too much eating combined with too little
    activity




                                           18
The Impact of Poor Health Habits
• Resistance to Good Nutrition
  – misinterpreting scientific research
  – high-fat diets
  – heavy drinking and smoking




                                          19
The Impact of Poor Health Habits
• Obesity
  – the leading cause of premature adult
    death
  – a worldwide epidemic, followed by
    diabetes
  – U.S. the global leader in obesity and
    diabetes



                                            20
The Impact of Poor Health Habits
• Obesity
  – in late adulthood, few people are obese
    • thinner ones are more likely to survive
    • older people eat less
    • the current cohort have always been
      thinner
    • older people are more protective of their
      health



                                              21
The Impact of Poor Health Habits
• Obesity
  – additional reasons…
    • genes - regulating hunger, metabolism,
      and fat accumulation
    • parental attitudes and practices -
      children are taught to overeat
    • environment – modern cultures
      encourage overeating



                                               22
The Impact of Poor Health Habits
• Obesity
  – weight-loss drugs urge caution
    • Phen-fen was found to increase the risk of heart
      disease
    • commercial diet drugs are additive and
      ineffective over time
    • other drugs upset the stomach
  – surgery
    • gastric bypass surgery which permanently alters
      the anatomy of the digestive system
    • death can occur



                                                    23
The Impact of Poor Health Habits
• Preventive Medicine
  “The damage and death caused by tobacco,
    alcohol, and obesity make it obvious that
    prevention is less risky than treatment.”
  – much prevention involves choices people
    make
  – preventive screening and medical measures
    are helpful
  – social measures that protect against harm and
    help those who suffer from trauma


                                                24
Measuring Health
• Mortality and Morbidity
  – mortality
     • death—as a measure of health, mortality
       usually refers to the number of deaths each
       year per 1,000 members of a given population
  – morbidity
     • disease—as a measure of health, morbidity
       refers to the rate of disease of all kinds in a
       given population—physical and emotional,
       acute (sudden) and chronic (ongoing)



                                                         25
Measuring Health
• Disability and Vitality
  – disability
    • long-term difficulty in performing normal
      activities of daily life because of some
      physical, mental, or emotional condition
  – vitality
    • a measure of health that refers to how
      healthy and energetic—physically,
      intellectually, and socially—an individual
      actually feels


                                                  26
Measuring Health
• Disability and Vitality
  – quality-adjusted life years QALYs
    • a way of comparing mere survival
      without vitality to survival with good
      health—QALYs indicate how many years
      of full vitality are lost to a particular
      physical disease or disability—they are
      expressed in terms of life expectancy as
      adjusted for quality of life



                                             27
Measuring Health
• Disability and Vitality
  – disability-adjusted life years (DALYs)
    • a measure of the impact that disability
      has on quality of life—DALYs are the
      reciprocal of quality-adjusted life years—
      a reduction of QALYs means an increase
      in DALYs




                                              28
Variations in Aging
rates of aging vary, but they are not random…
   –   gender
   –   genes
   –   ethnicity
   –   income
   –   education
   –   location
   –   lifestyle
   –   culture
…speed up some aspects of senescence and slow
 down others



                                                29
Variations in Aging
• Gender Differences
  – senescence affects women more than
    men
    • small, superficial signs of aging, changes
      in skin, hair, weight, are of more concern
      (to both sexes) to women
    • women age slowly, females live longer
      worldwide
      – twice as many in the U.S. by age 85



                                              30
Variations in Aging
• Socioeconomic Status (SES)
  – well-educated, financially secure people
    live longer, avoid chronic illness and
    disability, and feel healthier than the
    average person of their age, sex and
    ethnicity




                                           31

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Chapter 20

  • 1. Kathleen Stassen Berger Part VII Chapter Twenty Adulthood: Biosocial Development The Aging Process The Impact of Poor Health Habits Measuring Health Variations in Aging Prepared by Madeleine Lacefield Tattoon, M.A. 1
  • 2. Adulthood: Biosocial Development Age matters… How old are you? Do you feel your age? 2
  • 3. The Aging Process • Senescence – a gradual physical decline related to aging… happens to everyone in every body part but the rate of decline is highly variable 3
  • 4. The Aging Process • Physical Appearance – outward signs of senescence are present long before old age arrives • first visual in the skin – collagen – the connective tissue of the body, decreases by about 1% per year • hair turns gray and get thinner • skin becomes drier • “middle-age spread” • people get shorter • muscles weaken 4
  • 5. The Aging Process • Sense Organs – senescence varies from organ to organ • the five senses become less sharp… each organ loses some functions faster than others – changes in eyesight is the most obvious – losses occur in hearing » presbycusis » the loss of hearing associated with senescence often does not become apparent until after age 60 5
  • 6. The Aging Process • The Aging Brain – the brain slows down with age – neurons fire more slowly and messages sent from the axon of one neuron are not picked up as quickly by the dendrites of another neuron – multitasking is more difficult 6
  • 7. The Aging Process • The Sexual-Reproductive System – is slower and fertility is reduced with age, but adults of all ages enjoy “very high levels of emotional satisfaction and physical pleasure from sex within their relationships” 7
  • 8. The Aging Process • Infertility – 2% of healthy couples in their earlier 20s, in medically advanced nation, are infertile – 33% of 30 year-olds in poor nations are infertile – the highest rate of infertility occurs in countries with the highest birth rates, due in part to the lack of contraception and the high incident of untreated sexually transmitted diseases 8
  • 9. The Aging Process • Assisted Reproduction – assisted reproductive technology (ART) • the collective name for the various methods of medical intervention that can help infertile couples have children – in vitro fertilization (IVF) • a technique in which ova (egg cells) are surgically removed from a woman and fertilized with sperm in the laboratory… after the original fertilized cells (the zygotes) have divided several times, they are reinserted into a woman's uterus. 9
  • 10. The Aging Process • Menopause – the time in middle age, usually around age 50, when a woman’s menstrual periods cease completely and the production of estrogen, progesterone, and testosterone drops considerably – strictly speaking, menopause is dated one year after a women’s last menstrual period 10
  • 11. The Aging Process • Menopause – hormone replacement therapy (HRT) • treatment to compensate for hormone reduction at menopause following surgical removal of the ovaries… such treatment, which usually involves estrogen and progesterone, minimizes menopausal symptoms and diminishes the risk if osteoporosis in later adulthood 11
  • 12. The Aging Process • Menopause – andropause • a term coined to signify a drop in testosterone levels in older men, which normally results in reduced sexual desire, erections, and muscle mass • also know as male menopause 12
  • 13. The Impact of Poor Health Habits “Almost all diseases and chronic conditions that are normally associated with aging (arthritis to strokes) are powerfully affected by the routines of daily life”. 13
  • 14. The Impact of Poor Health Habits • Tobacco and Alcohol Use – tobacco • in all its forms contains harmful drugs • nicotine is the most addictive • fewer people are starting to smoke • many quit by late adulthood • death from lung cancer is down by 20% from 1980 - 1995 14
  • 15. The Impact of Poor Health Habits • Tobacco and Alcohol Use – alcohol • adults who drink wine, beer, spirits, or other alcohol in moderation (no more than two moderate-sized drinks a day) live longer than those who never drink • moderate drinking is a reduction in coronary heart disease • alcohol increases high-density lipoprotein (HDL), the" good” cholesterol and reduces low- density lipoprotein, the “bad” cholesterol that causes clogged arteries and blood clots 15
  • 16. The Impact of Poor Health Habits • Lack of Exercise – adults exercise less as they age – low exercise rates are blamed… • lack of commitment • lack of support in the immediate social context • community’s failure to provide appropriate facilities 16
  • 17. The Impact of Poor Health Habits • Lack of Exercise 17
  • 18. The Impact of Poor Health Habits • Overeating – too much eating combined with too little activity 18
  • 19. The Impact of Poor Health Habits • Resistance to Good Nutrition – misinterpreting scientific research – high-fat diets – heavy drinking and smoking 19
  • 20. The Impact of Poor Health Habits • Obesity – the leading cause of premature adult death – a worldwide epidemic, followed by diabetes – U.S. the global leader in obesity and diabetes 20
  • 21. The Impact of Poor Health Habits • Obesity – in late adulthood, few people are obese • thinner ones are more likely to survive • older people eat less • the current cohort have always been thinner • older people are more protective of their health 21
  • 22. The Impact of Poor Health Habits • Obesity – additional reasons… • genes - regulating hunger, metabolism, and fat accumulation • parental attitudes and practices - children are taught to overeat • environment – modern cultures encourage overeating 22
  • 23. The Impact of Poor Health Habits • Obesity – weight-loss drugs urge caution • Phen-fen was found to increase the risk of heart disease • commercial diet drugs are additive and ineffective over time • other drugs upset the stomach – surgery • gastric bypass surgery which permanently alters the anatomy of the digestive system • death can occur 23
  • 24. The Impact of Poor Health Habits • Preventive Medicine “The damage and death caused by tobacco, alcohol, and obesity make it obvious that prevention is less risky than treatment.” – much prevention involves choices people make – preventive screening and medical measures are helpful – social measures that protect against harm and help those who suffer from trauma 24
  • 25. Measuring Health • Mortality and Morbidity – mortality • death—as a measure of health, mortality usually refers to the number of deaths each year per 1,000 members of a given population – morbidity • disease—as a measure of health, morbidity refers to the rate of disease of all kinds in a given population—physical and emotional, acute (sudden) and chronic (ongoing) 25
  • 26. Measuring Health • Disability and Vitality – disability • long-term difficulty in performing normal activities of daily life because of some physical, mental, or emotional condition – vitality • a measure of health that refers to how healthy and energetic—physically, intellectually, and socially—an individual actually feels 26
  • 27. Measuring Health • Disability and Vitality – quality-adjusted life years QALYs • a way of comparing mere survival without vitality to survival with good health—QALYs indicate how many years of full vitality are lost to a particular physical disease or disability—they are expressed in terms of life expectancy as adjusted for quality of life 27
  • 28. Measuring Health • Disability and Vitality – disability-adjusted life years (DALYs) • a measure of the impact that disability has on quality of life—DALYs are the reciprocal of quality-adjusted life years— a reduction of QALYs means an increase in DALYs 28
  • 29. Variations in Aging rates of aging vary, but they are not random… – gender – genes – ethnicity – income – education – location – lifestyle – culture …speed up some aspects of senescence and slow down others 29
  • 30. Variations in Aging • Gender Differences – senescence affects women more than men • small, superficial signs of aging, changes in skin, hair, weight, are of more concern (to both sexes) to women • women age slowly, females live longer worldwide – twice as many in the U.S. by age 85 30
  • 31. Variations in Aging • Socioeconomic Status (SES) – well-educated, financially secure people live longer, avoid chronic illness and disability, and feel healthier than the average person of their age, sex and ethnicity 31