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Chapter 4

Personal Health and Well-Being

Biological Aging: Intrinsic

Senescence
Normal functional decline over time
Effects differ from person to person
What causes intrinsic aging?
Why does skin become less elastic?
Why don’t cells live forever?

Programmed Theories of Biological Aging

Programmed Senescence
Cell division has a limit
“Hayflick Limit”
Why do cells stop dividing?
Structure and function changes
Produce less energy, make enzymes slowly, allow waste buildup
The Phase II Phenomenon

Programmed Theories of Biological Aging

Endocrine and Immunological Theory
Endocrine system responds to internal and external body changes
Changes in levels of estrogen and testosterone
Immune system

Error Theories of Biological Aging

Somatic Mutation Theory
Cross-linking Theory
Free Radicals Theory
Population dynamics
Life history of the organism
Theory of natural selection

Effects of Aging: Musculoskeletal System

Muscle and bone content decrease
Can decrease 50% by age 80
Age 20 +
Loss of bone mass in older men & women
Exercise improves bone strength, health, balance and prevents fractures, falls

Effects of Aging: Sensory Changes

Taste
Buds decline in number and decrease in size
Smell
Some loss with age
Touch
Decreased sensitivity to touch, temperature, vibration

Effects of Aging: Sensory Changes

Sight
Changes begin as early as age 30
By 55, most need glasses for reading
Functional effects of physical change
Hearing
Some loss each year after age 50
Forms of hearing loss and causes

Changes in Health Status: Chronic Disease

The epidemiological transition
Lower rates of acute illness
Increased rate of chronic illness
Why?
People are living longer
More chronic disease
Shift from younger to older population

Figure 4.1 The Four Leading Causes of Death by Age Among People 65+

United States, 2006

Figure 4.2 Chronic Health Conditions Among People Age 65+

By Sex, 2007–2008

Figure 4.3 Limitation on Usual Activities Due to Chronic Conditions

Adults, United States, 2006

Changes in Health Status: Chronic Disease

Examples of Non-lethal Chronic Diseases
Arthritis; Hearing impairment; Cataracts
Race and Gender
African American compared with White American
Older women compared with older men

Figure 4.4 Activity of Daily Living Limitations

Community-Dwelling People, Age 65 and Over, by Race/ Ethnicity, 2004

Figure 4.5 Instrumental Activity of Daily Living Limitations

Community Dwelling People, Age 65 and Over, by Race/Ethnicity, 2002

ADL and IADL Limitations

Functional losses Increase with age
2005 NCHS study
Medicare beneficiaries aged 65-74
Racial and ethnic differences in disability from limitations
Will increase in older population lead to more people with disability in later life?

Disability and the Future

Some evidence now that some older people overcome limitations
Regain functional ability through
Health promotion
Disease prevention
Effective management of disability

Improvements in Technology

New medical technologies will keep older people healthy and active longer
Many technologies today
Drugs
Mobile phones
Adaptive devices and assistive technology
Computers

Improvements in Technology

Two groups of older people today
Comfortable using new tech
Uncomfortable using new tech
Could lead to a “digital divide”
Suggestions
Web designers should design sites to accommodate older users

Table 4.1 Persons Using the Internet in and Outside the Home, by Age

United States, 2009

Improvements in the Environment

Changes in the environment can also improve the quality of life for older people
Technology can allow families to monitor older relatives at risk of falling
Can also detect wandering, a problem faced by Alzheimer’s patients.

Improvements in Self Care

Information can enhance self-care
Older people will use it, if on hand
Self-care lowers health care costs
Older people in programs benefit from
Encouragement
Contact with good role models
Supportive environment; Social support

Changes in Life-Style: Smoking and Nutrition

Life experiences influence later health
Abuse; Poverty; Broken home
Low SES and relationship to self-destructive behavior
Lifestyle changes for improving health
Decreased smoking among adult population
Better nutrition

Figure 4.6 Overweight, Obesity, and Healthy Weight

As Measured by BMI; Among Persons 65 Years of Age and Over, by Selected Characteristics: United States, 2003–2006.

Changes in Life-Style: Exercise

Aerobic exercise improves a whole range of physical conditions
Overweight body doesn’t work as well
American focus on weight loss and diet misses the point of successful aging
Healthy weight must be coupled with exercise and activity

Changes in Life-Style: Stress Reduction

Regular practice of tension reduction improves health and well-being in later life
Relaxation techniques
Meditation
Religious retreats

Compression of Morbidity Hypothesis

Will longer life expectancy be good?
Fries (1980, 1987) predicted
Life expectancy increase accompanied by fewer years of disability
Less suffering from chronic disease
Less need for medical care
“Rectangularization of the life curve”

Figure 4.7 Compression of Morbidity

Compression of Morbidity

Successful Aging: Rowe & Kahn

Gerontologists should spend time studying people who age well
Should include focus on lifestyle choices, psychological, and social conditions
Should recognize that people differ in rates of aging
Suggest a “New Gerontology”

Successful Aging: The SOC Model

Baltes & Baltes & others
SOC
Selective Optimization with Compensation
Anyone can make the most of their abilities
Can live a full and engaged life

Successful Aging: A Life Course Model

Successful aging is largely within a person’s power
One needs to
Preserve the health they’ve got
Do as little damage as possible to their body
Strengthen what they can

Anti-Aging Medicine and Science

The anti-aging movement has some beneficial options
But movement poses some dangers
Wasting money on unproven supplements
Substituting for medical treatment of serious problems

Social Inequality and Personal Health

Later life with different health resources
Socioeconomic differences
Recommendations
Public policies to improve health in childhood and middle age
Health promotion programs for poorer older people