Biological Theory 

-genetic damage leads to functinoal failure and death 

-defects in protein synthesis mechanism leads to error in proteins 

Biological theory 

-the process of aging is continuous with and probably operated through the same mechanisms as development 

biological theory 

-Cellular level changes affect organismal changes 

Biological Theory 

 -genetic errors/accidents over time lead to aging 

Psychological Theories 

-biologically and socially constituted 

-The second half of life is characterized by significant individual differentiation, multi directionality, and intraindividual plasticity 

psychological theories 

A model of psychological and behavior adaptation identifying three fundamental mechanisms for managing adaptive development in later life (selection, optimization, compensation) 

Describe individual choices in interaction, based on self-interested need for emotional closeness that leads to selective interaction 

Distal Determinant: factors that affect cognition reside outside the individual (ex. social and cultural environment) 

Proximal Determinant: Specific Individual differences are the cause of cognitive change 

Theories that focus on the extent and nature of personality and change over time 

Sociological Theory 

-Focuses on expected and normal changes in life over its entire span

Individuals, including elders, make rational choices about interactions with others, based on their needs and on norms of reciprocity

Give priority to gender as an organizing principle for social life across the life span

Focus on the interaction of economic and political forces in explaining how the treatment and status of older adults can be understood

Focuses either on humanistic dimensions of aging or on structural components in attempting to create positive models emphasizing strengths and diversity of age

1927-1942

• Characteristics: sacrifice, hard work, duty before pleasure 
• Personality: conformist, conservitive spender, past oriented 

1946-1964 

• characteristics: optimism, teamwork, personal gratification/growth
• personality: driven, soul searchers, love/hate relationship with authority

1965-1981 

Characteristics: diversity, balance, self-reliance, pragmatism

Personality: Risk-takers, Skeptical, Family-oriented, job focused 

older than 75 often liited by functional disabilities

often good support networks, distance can be a problem. elder provided benefits: money to community, provide reciprocal services like watching grandchildren

transportation frequently a problem, tend to have greatest financial resources but fewer community resources

-  have greatest geographic access to transport & services but less economic capacity. greater ethic variability

Ageism

How we Tx old depends on personal assumptions, expectations & fears @ growing older - fear generally based on a lack of understanding of aging process

Elders typically withdraw from previous activities in preparation for death 

The individual is conceptualized as an open, changing system, with a number of subsystems (volition, habituation, mind-brain-body performance) that reflect successful performance 

Individual, occupation, and environments interact and interaction can be effective or problematic

Elders adapt through these three mechanisms to change in functional ability (Selection, optimization, compensation) 

• Select occupation 
• Optomize Performance 
• Compensate for things that can't be performed effectively 

Occupations change across the life span 

Individuals need to adapt to occupational change 

Dysfunction is the result of ineffective adaptive responses

Explores Self-Efficacy and life Scheme as related to spirituality; 

Measures factors labeled “God Helped”, Family history of religiousness, lifetime of religious social support, cost of religiousness”

Questionable validity; problematic when used with individuals from cultures with different values.

Asks the individual to identify important occupations and rates these numerically in terms of satisfaction

ask the individual to list important projects and then rate these; client might be asked to rate each project for importance, for impact on stress management, on meaning or other variables that help prioritize the projects in terms of centrality for the intervention process. 

Age related changes 

(cardiopulmonary) 

Increased residual volume 

increased functional residual capacity 

decreased vital capacity 

Age related Changes 

(cardiovascular) 

Decreased cardiac output

increased dysrhythmias

decreased blood flow

increased perception of exertion 

pertains to task completion that imposes stress of the oxygen transport system above resting metabolic demand

 the capacity of the cardiovascular system to transport oxygen

·      the ability to perform ADLs to meet the minimum criterion compatible with personal care and independent living

capacity to respond to an exercise stimulus, maintain the physiological adjustments necessary to sustain aerobic exercise for a period of time and then recover appropriately from that stimulus on cessation of exercise.

Getting out of bed in the morning 

(hemodynamic Status) 

o   Accompanied by morning stiffness, imbalance, slowed vital signs, slowed autonomic responsiveness, reduced muscle pump activity in the legs

Getting out of the tub 

(hemodynamic status) 

o   Significant peripheral vasodilatation from having been in warm water for a period of time; Adaptation of the normal fluid shifts will be poor upon standing. Increased cardiac work is required in lifting oneself out of the tub

Getting off the toilet 

(hemodynamic Status) 

o   The period of autonomic changes and physical straining may result in reduced venous return

o   Fluid shifts and pooling of blood in the abdomen and legs during sitting

o   Reflect reduced cerebral blood flow secondary to the sudden movement to erect position and lack of normal rapid compensatory response.

To assess functional performance in older individuals 

-Individual is instructed to walk a measured distance at three different speeds with 5 min rest between each one a. slow b. normal pace c. fast pace, without overexerting yourself

-at least one practice trial required

-Outcome: for each walking trial speed, time to complete the distance and stride frequency are calculated; also the average heart rate, stride length and predicted VO₂ max can be determined. 

2. to prescribe an appropriate walking program

To evaluate functional performance including endurance, strength and balance 

To assess basic functional mobility in the elderly

To assess functional performance in individuals with low functional capacity such as the elderly and those with chronic cardiac and respiratory disabilities 

Chronic Airflow Limitations 

-ineffective ventilation

-impared gas mixing

-impaired ventilation 

____

May have shortness of breath on exertion or rest

-Breathing pattern: prolonged expiration 

-reduced compliance 

-increased effort to inflate lungs 

Breathing Pattern: Rapid, Shallow 

-High blood pressure

-Ischemic chest pain

-Myocardial infarction

___

Hypoglycemia with activity or exercise 

-loss of elasticity in the skin causing the eyelids to be malpositioned 

-decrease in tear production

-eye muscles become weak

-astigmatism 

-loss of color sensitivity 

• Cataracts
• age related macular degeneration 
• glaucoma
• diabetic retinopathy 

• strong prescription reading glasses
• magnifiers
• telescopes
• electronic magnification 

Review box 5-1

• related to prevention of conduction of sound to inner ear
• wax buildup, fluid buildup 

loss or damage to the sensory hair cells of the choclea. 

typically not correctable 

·       Increased threshold for vibration sensation and decreased proprioception

• Narrowing of joint spaces
• bones make contact with bone
• decrease in muscle strength
• decrease in bone formation and increase in reabsorption leading to osteoporosis 
• decrease in flexion/extension of spine
• decrease in posture and gate changes

Not normal age related changes

NMS

• there is a decrease in mobility
• MSK-related posture and gate changes
• Neuro-related gait & proprioception changes
• Environmental hazards 

• Associated with age- and menopause related changes
• occurs more often in women
• age of onset is menopause

• female
• increased age
• white or asian
• estrogen deficiency
• low calcium intake
• prolonged immobility 

nearly universal, affecting men and women

-degenerative joint disease

Normal age changes 

(cognition) 

• Problem solving: declines tend to be delayed until 70s 
• Working memory retained: some limitations minimize the amount of material that can be retained
• Long term (secondary): some decline, deficits in encoding process
• very long term(remote): little decline in remembering info such as details from personal childhood/early adult 

Normal aging changes

(cognitive) 

• psychomotor
• speed of processing
• verbal skills
• reasoning