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Biological Processes Chapter 3 HPR 452 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 “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) 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 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 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 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 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 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 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 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 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 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) 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 Ulyssean Aproach – Again, education and prevention and treatment Diet, excessive weight, cigarettes, blood pressure, diabetes, internalization of emotions, exercise, stress reduction and PHYSICAL ACTIVITY 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 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 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 Other Effects… Systems – Endocrine, (Pancreas – Diabetes) Reproductive, and Nervous (Reaction time) Senses (Compensate for one with another) Vision Hearing Touch and balance Taste Smell 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”