Transcript Week 10: Health psychology (powerpoint version

Developmental Health
Psychology
Aging
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Primary Aging
– “normal” senescence
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Secondary Aging
– “pathological” senescence
Health during old age
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Most in good health (Stats Can., ’99)
Most common chronic conditions: late
adulthood
– Arthritis, rheumatism – 42%
– High blood pressure – 33%
– Allergies – 22%
– Back problems – 17%
– Heart problems – 16%
Key ideas
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Women live longer than men
– But more likely to have chronic conditions
and limitations in activities of daily living
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Physical health declines, psychological
well-being improves
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Determinants of health
– Health beliefs, behaviours, social
structure, SES
– Often can be changed to improve health
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Despite attention paid to sickness and
treatment, self-care is the most
predominant form of care
Mental Health
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Attempt to live meaningfully
– in a particular set of social and
environmental circumstances
– relying on a particular collection of
resources and supports
Self-development
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self-perception
integration of various roles
striving for growth
possible commitment to something
beyond self
Life satisfaction (self image, self
esteem)
Threats to mental health
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Epidemiological Catchment Area Study
– US Nat’l Inst. of Mental Health
– 18,000 structured interviews
– 5 regions across US
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Dispelled 2 major myths:
– Women at greater risk.
– Older adults at greater risk
Age-Related Trends in
Mental Disorders
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Lower prevalence in older than
younger adults
– all mental disorders (excluding
dementias)
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Younger (18-64 years): 11-25%
Older (65+): 6-14%
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Mood disorders (including
depression)
– Younger: 3-8%
– Older:
2-3%
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Dementia
– Older:
6-10%
– Possible co-existence and interaction
with physical illness
Are Elderly Less Prone to
Mental Illness?
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Diagnostic criteria not “age fair”
– depression symptoms different in elderly
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Elderly typically visit physicians
before mental health professionals
– physical symptoms mask psychological
ones
– e.g., difficulty sleeping, changes in diet,
heart palpitations (depression)
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Myths, stereotypes about aging
– must distinguish normal aging from
disease
– ageism in treatment
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Cohort effects: “stigma”
Alzheimer’s Disease
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Progressive, degenerative brain
disorder
Loss of memory, awareness, ability to
control body functions
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First reported in 1907
– Shrinkage of cortex
– Large masses of amyloid plaques
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Spherical protein deposits outside of nerve
cells
– Neurofibrillary tangles
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Twisted protein filaments inside neurons
– Spread from bottom (midbrain) to top
(cortex)
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Plaques, tangles present in normal
aging brain
In Alzheimer’s: excessive, interfere
with communication between neurons
Prevalence
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Rare under 50
6-10% over 65
30-50% over 85
Symptoms
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Permanent forgetting of recent events
Unable to do routine tasks
Forget simple words
Confusion in familiar locations
Forget what numbers mean
Put things in inappropriate places
– Watch in fishbowl
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Rapid, dramatic mood swings
Loss of language, communication skills
Causes
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Very little known
Possibly:
– Genetic factors (permitting tangles to
form)
– Environment (sporadic AD – no family
history; possible toxins)
– Build up of plaques in body, free radicals
in brain
Risk Factors
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Age
Family history
Brain damage (accident)
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Predictors: Kentucky Nun Study
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– “richness” of early writing
Treatment
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Anti-oxidants
Enzyme-blocking agents (prevent
plaques)
Genetic engineering (promote neuron
growth)
Respite care: caregiver stress
Behaviour Modification (activities of
daily living)
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Physical activity
Social involvement
Good nutrition
Calm structured environment
Coping with AD
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Patient
– Aware of changes
– Shame, self image, fear of desertion
– Behavioural changes (stages)
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Caregiver: physical, psychological,
social
– 70% family members (female usually)
– 50% severe stress
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Caregiver Stress
– Physically exhausting: constant vigilance
– Psychological effects
Grief: adjust to gradual loss
 Increasing social isolation
 Stigma: cover-up, try to avoid social
interactions
 Stress: severity depends on availability of
social support (respite care, counselling,
support groups)
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