Biological Processes Chapter 3

1. Biological ProcessesChapter 3 HPR 452

2. Intro • “Every day you grow older, that is the law” • Butch Cassidy • Growing older is an inevitable part of living • Aging is a progressive process that doesn’t occur suddenly • Great variability in aging between and within an individual – Old age based on Chronological age is not appropriate • There are also some generalizations in aging

3. “Aging” and “Senescence” • “Aging” refers to any changes, including things not harmful to the body (i.e. wrinkles) • “Senescence” refers to decline of body functions that increase the risk of “disease, disability, or death • Used interchangeably in this Chapter • Aging and Senescence = “gradual and progressive loss of various functions over time, beginning in early adulthood, leading to decreasing health, vigor, and well-being, increasing vulnerability to disease, and increased likelihood of death” • President’s Council on Bioethics (2003)

4. The Aging Process • Physical decline occurs at different rates in different individuals (i.e. hearing) due to: • Genetic makeup (species and individual) • Environmental and lifestyle (ie. diet, exercise) • Interaction between biological and psychological (ie. Social support, personal attitudes, opportunities to exercise control) • Organ reserve capacity – ability of the body to return to homeostasis after stress – decreased during aging

5. Potential role of physical decline should not be overestimated – Most older adults adapt to the slow declines and compensate for losses • The body works hard to preserve life and functioning as long as possible • Over ½ of all Americans over 65 report some type of disability, 37% a severe disability, 16% need assistance to meet daily needs

6. Primary and Secondary Aging • Service providers must understand to minimize functional losses so they may identify techniques to keep functional losses at minimum • Primary Aging – (Genotypical) “pure” biological aging • deteriorative, degenerative – not reversible • Secondary Aging – (Phenotypical) • Factors that accelerate natural decline • stress, poor nutrition, radiation, untreated disease, unhealthy lifestyle habits

7. Role of Healthcare Providers and the Individual • Healthcare providers can assist aging individuals in cleaning the path of primary aging of secondary aging debris – narrow the gap – See Figures 3.1and 3.2 in book • Proven to reduce physical decline – • Exercise (can reduce or prevent ½ of physical decline associated with aging), strength training, nutrition, stress reduction, smoking cessation • Individuals can take control through active approach– Lifestyle more important than genetics

8. Why Do People Age? • Many theories – none proven • According to National Institute on Aging (2006) Biological theories fall into 2 categories • Programmed theories – Age follows a timeline – change occurs on the timetable • Damage or Error theories – Environmental assaults gradually cause things to go wrong • It is estimated that 7,000 genes are involved • Environmental and Personal forces also

9. One type of Senescence Theories • Programmed Theories • Programmed longevity – sequence of genes switching on and off causes aging • Endocrine Theory – Hormones, driven by a biological clock control the aging process • Immunological Theory – a decline in the immune system results in vulnerability to infectious diseases, aging and death

10. Another type of Senescense Theory • Error Theories • Wear and Tear Theory – preprogrammed process that sets off a biological clock – Humans gradually wear out until lifespan is “used up” • Crosslinking Theory – Accumulated crosslinked proteins slow down body processes by damaging cells and tissues • A perspective - Gradual decline in cells’ ability to replicate/reproduce based on a “clock” • Overall genetic, environmental & personal factors all contribute

11. Biological Systems • Physical appearance – May affect self-image and self-concept • Skin – wrinkles, skin breakdown, decubitus, temperature regulation • Nail Care (hand and foot) – infections, locomotion, loss of independence • Teeth – cosmetic and functional • Body shape and size – fat toward center of body replaces lean muscle mass, height decreases – affects balance, gait, mobility

12. Ulyssean approaches through Education • Self-concept, dental and foot care, accepting changes, avoid sunlight and cigarettes, shift weight and adjust positions, diet, apply meds when minor abrasions first noted • Musculoskeletal System • Loss of Muscle mass and decrease elasticity • Atrophy – decrease in number and bulk of muscle fibers – stiffness and mobility problems

13. Decrease in bone mass – extreme is osteoporosis • Curvature of spine (scoliosis), knee, elbow, ankle, hip stiffness, arthritis osteo (cartilage degeneration) and rheumatoid (disease of connective tissue) • Poor posture, diminished height, gait changes lead to accidents including falls • Ulyssean approaches – prevention and early detection (appropriate exercise and strength training and environmental factors including stairs, snow, furniture, slippery surfaces, footwear, rugs, etc.) - EXERCISE (preventive to rehab)

14. Cardiovascular System • Arteriosclerosis – (hardening of arteries) – thickening and loss of elasticity of arterial walls • Atherosclerosis – Deposit of pasty, fatty tissues in the arteries restricting blood flow • Cardiovascular disease is major cause of death in later years • Myocardial Infarction, Cerebrovascular Accident (Arteries blocked by clots or burst) – Thrombosis (large clots), Embolism (free floating clots), Hemorrhages (weakened arterial wall ruptures) • Hypertension

15. Ulyssean Aproach – Again, education and prevention and treatment • Diet, excessive weight, cigarettes, blood pressure, diabetes, internalization of emotions, exercise, stress reduction and PHYSICAL ACTIVITY

16. Respiratory System • Skeletal changes restrict lung capacity, loss of lung elasticity, less air exchange, each breath less effective  fatigue, shortness of breath, COPD (emphysema, chronic bronchitis, asthma) • Ulyssean approach – again…education on environmental factors and lifestyle

17. Gastrointestinal System • Less saliva, # of taste buds decrease, loss of teeth, esophageal decline, loss of stomach muscle and digestive enzymes, intestinal deficiencies, constipation, gallbladder disease • Ulyssean Approach - Again…education on proper nutrition and meal preparation, caloric intake, food safety, eating clubs, hydration, food varieties, oral health (brushing, flossing), denture care

18. Urinary System • Kidney blood flow decreases, filtration decreases, loss of muscle tone and elasticity in urinary structures, decreased bladder capacity (feelings of urgency), incontinence (result of disease, drugs, prostate enlargement, etc – not “old age”) • Ulyssean – Sensitivity to the needs - Accommodate with frequent restroom breaks

19. Other Effects… • Systems – • Endocrine, (Pancreas – Diabetes) Reproductive, and Nervous (Reaction time) • Senses (Compensate for one with another) • Vision • Hearing • Touch and balance • Taste • Smell

20. Technological Solutions • Assistive Technology to compensate for functional deficits • Daily Living adaptive devices • Self-care • Mobility aids • Vision and Hearing aids • Communication • Environmental controls • Work and Education • Leisure • Consideration for “technophobia”