PHYSICAL CHANGES WITH OLD AGE

1
PHYSICAL CHANGES WITH OLD AGE THEIR IMPACTMary
C. Sengstock. Ph.D.Sociology, Wayne State
University

• BIOLOGICAL THEORIES
• Will Not Discuss in Detail
• Will Consider Major Biological Issues
• As They Impact on the Sociological Perspective

2
VARIATION IN FUNCTIONAL LEVELS

• Variability Between Individuals of Same Age
• Variability Between Different Functions of Same
  Individual
• Heart Rate vs. Brain Function
• Breathing Rate vs. Renal Flow Etc.
• Greater Variability Among the Aged Than Among
  Younger Persons?
• Experts Disagree About This Issue

3
FUNCTIONAL AGE

• Defining a Persons Age in Terms of Their Ability
  to Function
• Great Variability Among Individuals
• She Doesnt Look That Old!
• Oh! Only 65? I Thought He Was Older!
• EX 2 Patients Sharing Hospital Room
• 65 Yr Old 95 Yr Old

4
SENSORY DECLINE

• All Senses Decline in Acuity AS We Age
• Sight Hearing Touch Taste Smell
• All Result in Changes in Ability to Perceive
  React to Environment
• Sight Stronger Glasses, Bifocals, Cataracts
• Smell Taste Affects Appetite Eating Habits
• Touch Peripheral Neuropathy
• Difficult to Feel Pain, Recognize Problems
• Diabetic Foot Problems

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MOST SERIOUS DECLINE?

• Which Would You Think Would be the Most Serious
  Type of Sensory Decline?
• Sight
• Touch
• Hearing
• Smell
• Taste

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MOST SERIOUS DECLINEHEARING

• Severe Impact on Social Interaction
• Hard to Hear What Others Say
• Make Odd or Inappropriate Responses
• Makes It Difficult to Interact With Others
• Lose Ability to Participate in Social Relations
• Lose Contact Decrease Social Stimulation

7
EX 1 ELDERLY WOMAN FAMILY

• Theres Mike Shay. What Did Mike Say?
• Theres John Hagan. Doors Shaking? Fix it!
• Write the Senate. Call Sheriff? What For?
• Where My Pants? Pen? Were Going Out!
• Phone Well Be Late. Theyre Not Home. Call
  Back Later.
• Im Not Hard of Hearing! You Dont Talk Loud
  Enough! Even My Friends Dont Talk Loud Enough
  Anymore!

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EX 2 PRES. REAGAN AIDES

• Conversation John Poindexter Oliver North
• Told Reagan of Plans to Sell Arms to Iran Use
  the Funds to Support Diversionary Actions in
  Nicaragua
• Reagan Didnt Understand Like Most Hard of
  Hearing People, Was Embarrassed to Admit It
• So He Nodded Absent-Mindedly
• They Took This As a Sign of Consent

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PHYSICAL HEALTH IN OLD AGE

• Health Status Declines As We Age
• What Are Some of These Changes?
• Definition of HEALTH Is a Critical Issue
• 4 Definitions
• WHO (World Health Organization)
• Functional Definition
• Alternate Functional Definition
• Coping Definition

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HEALTH DEFINED BY WHO (World Health
Organization)

• Complete Physical, Mental, Social Well-Being,
  Not Just the Absence of Disease or Infirmity
• Is This Realistic?
• May Cause Medicalization of the Social
• I.e., Use of Medication or Therapy for
• Disruptive Behavior
• Opposition to Social Structure

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HEALTH FUNCTIONAL DEFINITION

• Talcott Parsons
• State of Optimal Capacity of the Individual
• For Effective Performance of Roles
• Typical for a Structural-Functionalist!
• Only the Social Structure is Important!
• Emphasizes a Market Economy
• Health Care Useful to Get People Back to Work
• Elderly Not Useful Why Provide Health Care?

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ALTERNATE FUNCTIONAL DEFINITION OF HEALTH

• James OBrien, M.D.
• Maintaining Highest Possible Functional Capacity
  of Individual
• For As Long as Possible
• The Approach of Most Geriatric Physicians

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COPING DEFINITION OF HEALTH

• Dubos
• Achieving A Rewarding Not Too Painful Existence
  
• In Coping With an Imperfect World
• Question Which One(s) Do You Think Are Most
  Useful or Appropriate?

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MORBIDITY (DISEASES) OF OLD AGE

• Major Causes of Death in Old Age
• Heart Disease Atherosclerosis
• Hypertension Cancer Diabetes Mellitus
• Cerebrovascular Accidents (Strokes)
• Oral Dental Problems Cirrhosis of Liver
• Suicide Pneumonia Accidents
• Multiple Pathologies

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HEART DISEASE

• Heart Attacks
• Coronary Infarction (Tissue Death)
• Highest for Older Men
• Increases for Post-Menopausal Women
• Higher for Non-Whites

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ATHEROSCLEROSIS

• Hardening of Arteries
• Fatty Deposits Inside Arteries
• Leads to Narrowing (Thrombosis)
• Followed By Occlusion (Complete Closing Tissue
  Death)
• Can Cause Death Impairment

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HYPERTENSION

• High Blood Pressure
• Sneaky Disease
• Very Difficult to Diagnose
• Causes Organ Damage Due to Increased Pressure on
  Organs
• Higher Rates for Non-Whites

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MALIGNANCY (CANCER)

• Cancer Rates Are High Throughout Life
• Types of Cancer Vary By Age
• Young Patients
• Lung Breast Cervix
• Aged Patients
• Stomach Intestine Prostate
• Skin Kidney Leukemia

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DIABETES MELLITIS

• Inability of Body to Metabolize Sucrose (Sugar)
• Due to Non (Low) Production of Insulin
• Approx 4 of Population 65
• Slightly More Frequent with Women
• More Frequent With Obese
• More Frequent for Patients in Their 60s 70s
• Severe Effects on Heart, Kidneys, Arteries

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CEREBROVASCULAR ACCIDENTS(STROKES)

• Embolisms (Blood Clots) That Cut Off Blood Supply
  to Brain
• Loss of Blood Flow Causes Brain Damage
• Results in Body Damage Depending on the Portion
  of the Brain Affected
• Speech Aphasia
• Memory Loss
• Paralysis

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ORAL DENTAL PROBLEMS

• Lost Teeth
• Gum Problems
• 90 of Population 65
• Can Cause Inability to Eat
• Improper Nutrition
• Many Elderly Do Not Go to Dentists

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CIRRHOSIS OF LIVER

• Normal Liver Tissue is Replaced
• By Scar Tissue or Fibrous Tissue
• Decreases Liver Function
• Major Causes Are Alcoholism Hepatitis
• Much More Frequent in Men Than Women

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PNEUMONIA

• Inflammation of Lungs Lung Tissue
• Symptoms Are Coughing, Breathing Problems
• Common Side Effect of Other Chronic Illnesses
• Often the Actual Cause of Death Listed
• Especially True for the Elderly

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ACCIDENTS SUICIDE

• ACCIDENTS
• Primarily Home Accidents For the Aged
• Less Likely to Be Car Accidents
• SUICIDE
• Very Much More Common Among Elderly Men Than
  Women

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MULTIPLE PATHOLOGIESIN THE ELDERLY

• Many Chronic Conditions Occur Together
• Diagnosis Is Complicated
• Specialty of Geriatric Physicians
• Many Physicians Are Not Trained to Diagnose
  Treat These Simultaneously Occurring Conditions
• Results in Missed Conditions, Over-Medication

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ILLNESSES IN OLD AGE VS. YOUNGER PATIENTS

• YOUNGER PATIENTS
• Acute Illneses
• Often From Exogenous Causes
• Bacterial or Viral Infections
• Trauma
• Definite Onset ? Crisis ? Self Limiting End

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ILLNESSES IN OLDER ADULTS

• Chronic Illnesses Not Acute
• 85 of Aged (65) At Least 1 Chronic Illness
• Persons lt50 Only 10 Have a Chronic Illness
• Elderly Often Have Several at One Time
• Complex Symptomology Many Drs Not Used to
  Diagnosing Treating
• Medications Often Interact or Conflict

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EXAMPLE OF CHRONIC ILLNESSATHEROSCLEROSIS

• Multiple Causes Intrinsic Aging Genetic
  Propensity Environment (Diet)
• Men gt Women
• Leads to Thrombosis (Build Up in Arteries)
• Breaks Loose (Embolism)
• Cuts Off Blood Flow Cannot Be Regenerated
• Leads to Death of Tissue in Area (Infarction)
• Treated By Bypass/Scrape/Balloon

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ACUTE ILLNESSES IN ELDERLY

• Persons 65 Who Have Acute Illnesses or
  Accidents
• Tend to Have Longer Periods of Disability
• Greater Restriction of Activity
• Suffer From Decreased Social Contact
• Illness Makes Elderly Miss Out on More Than Is
  True of Younger Persons

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LIMITATIONS DUE TO ILLNESS

• 1/2 of Persons 65 Suffer Some Limitation in
  Lifestyle Due to Chronic or Acute Illnesses
• NOTE Disease Incidence is Based on of Persons
  Affected Not On Degree of Difficulty
• I.e., 50 of Persons 65 Suffer Limitation
• It Does NOT Mean That Affected Persons Suffer 50
  Limitation

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LIFE STYLE HEALTH

• Many Aspects of Lifestyle Lead to Health Problems
  in Old Age
• Tobacco ? Cancer Heart Disease Osteoporosis
• Alcohol ? Cirrhosis of Liver Gastric Problems
  Some Cancers Mental Problems Falls
• Environmental Threats (Air, Industrial/Occupationa
  l Pollutants) ? Black Lung Disease, Cancers, Etc.

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NUTRITIONAL PROBLEMS IN OLD AGE

• Malnutrition for the Poor
• Obesity for Middle Upper Class
• Nutrition Affected By Several Factors
• Social Isolation Eating Is Social
• Problems With Dentures Poor Taste Smell
• Inability to Shop, Prepare Food

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CONTROLLING LIFE HEALTH

• Goal Prolong VIGOROUS Life (Not Just LIFE)
• 1/3 to 1/2 Aged Health Problems Nutritional
• Need Nutritional Improvements for Elderly
• More Adequate Diet for Poor Aged
• Control of Obesity Less Fat, Sugar for Others
• Repair Dentures Improve Taste, Smell
• Increase Calcium Intake
• Decrease Cholesterol

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LIFESTYLE HEALTH

• Recognize the Health Significance of Lifestyle
• Social Isolation Why Many Elderly Do Not Eat
• Difficult to Cook for 1 Depression
• Exercise Lack of Exercise
• Contributes to Heart Problems, Obesity,
  Osteoporosis, Etc.
• Only 40 of Elderly Exercise Regularly
• Smoking Diminishes Lung Capacity

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LIFE SATISFACTION SUBJECTIVE PERCEPTIONS OF
HEALTH

• Subjective Health May Be More Important Than
  Objective Health
• To Both Well-Being Longevity
• Common Measure How Do You Feel?
• Pretty Good, Considering My Age!
• VS. At My Age, Youre Sick Most of the Time.
• EX Elderly Patient Eating Dinner In Hospital

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IMPACT OF LIFE SATISFACTION

• Feeling Healthy Associated With
• Intact Marriages ()
• Adequate Finances ()
• Stress Free ()
• Cohesive Personality ()
• Comparison to Previous Health ()
• Comparison to Other Aged ()
• Retirement (-)
• Death of Lived One (-)

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SOCIAL CONSEQUENCES OF PHYSIOLOGICAL AGING

• Decreases Capacity for Social Interaction
• Limits Resources for Social Exchange
• Increases Dependence Impacts Family
• Increases Health Needs
• Health Care Cost Time for Medical Care
• Decreases Resources (Time, Money) for Alternates
• Biological Aging Masks Other Needs
• Abuse Ailments Attributed to Aging Youre
  Old!

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CULTURAL IMPACT ON HEALTH

• Decreased Animal Meat/Increased Vegetables
• ? Decreased Cholesterol/Cardiovascular-Japan
• Increased Fish Salt Intake
• ? Increased Hypertension Japan
• Lower Fat ? Lower Hypertension
• Rural African Blacks vs. African Americans
• Ethnic Cultures Which Discourage Members From
  Caring for Health (Mammograms)