Part VII

1. 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.

2. Adulthood: Biosocial Development Age matters… How old are you? Do you feel your age?

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

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

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

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

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”

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

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.

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

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

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

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”.

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

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

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

17. The Impact of Poor Health Habits • Lack of Exercise

18. The Impact of Poor Health Habits • Overeating • too much eating combined with too little activity

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

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

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

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

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

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

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)

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

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

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

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

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

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