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Please, checkout the uploaded file below, where you will find information and instructions. psych_140_module_8_with_set_1__2__3__and_4.docx Unformatted Attachment Preview Psych 140-Module 8 with Set 1, 2, 3, and 4 Page 1 Biological Aging Late adulthood, which begins in one’s 60s, can be the longest age grouping in one’s life if an individual lives to a ripe old age. However, there are many misconceptions and misunderstandings about late adulthood. For example, consider the following questions. • Do most older adults develop dementia? • Why do women typically outlive men? • Are memory problems inevitable as we get older? • Do most older adults need to live in a nursing home? We cannot spend extensive time answering these questions that hit on some very real fears about old age. However, a quick summary answer to each is below, and this module will continue to discuss typical development in late adulthood. • Do most older adults develop dementia? No. Some adults describe memory lapses as “senior moments” or “senility.” Professionals now use the terms dementia or neurocognitive disorder to describe the loss of cognitive abilities due to a physical reason such as Alzheimers Disease or stroke. It is not typical for an older adult, or anyone, to have a neurocognitive disorder. This is not a normal part of aging. Neurocognitive disorders can be caused by various diseases, severe drug/alcohol abuse, stroke, or progressive deterioration caused by a variety of factors (as is likely the case with Alzheimer’s Disease, to be discussed later). Neurocognitive disorders are extremely rare prior to age 60. Only a small percentage of 65-75 year-olds have a neurocognitive disorder. However, this number increases with age so that approximately 50\% of individuals 85 and older have a neurocognitive disorder. • Why do women typically outlive men? This is a multi-faceted issue, but experts today indicate that the answer to this question is partly genetics but is particularly environmental. Men are more likely to engage in risky behaviors, abuse drugs and alcohol, and be less vigilant about their overall health. • Are memory problems inevitable as we get older? There are certainly cognitive changes that occur as adults age. One typical change is that elders have trouble remembering the precise source of information. For example, after telling a story for many years, an elder might forget that the story was based on an event that happened to someone else rather than himself. However, as mentioned earlier, neurocognitive disorders and dementia are not a typical part of aging. • Do most older adults need to live in a nursing home? No. Most elders are able to care for themselves and are able to carry on their normal activities. However, elders who are physically unwell are more likely to have cognitive impairments or mobility issues that may necessitate long term care. Please, watch the video below as you study the material in this module. {I’m going to upload the video in a few minutes}. The rest of this module will cover biological aging, neurocognitive disorders, and a variety of socioemotional topics pertaining to late adulthood. The module will close with end-of-life issues. Aging seems to be such a natural part of life that few people (besides scientists!) may stop to consider why we age. There are actually two types of aging: Primary and Secondary aging. Primary aging is genetically influenced and is thought to be unavoidable at this point. What triggers this process, however, is up for debate. Secondary aging is aging that is not inevitable. It is a result of choices that we make and environmental exposure. For example, smoking cigarettes and frequent sun exposure cause wrinkles. Regarding why we age, many people may believe in the “Wear and Tear” theory. According to this theory, time and exertion is the enemy. As we get older, we simply wear out. However, there are numerous holes to this theory, and it doesn’t take into account that the body does an amazing job of repairing itself under normal circumstances. What is it about getting older that results in the body not being able to keep up with these repairs? Thus, this theory does not explain what actually causes this issue. That is, this theory focuses primarily on Secondary Aging but sidesteps the root of the problem, that is, Primary Aging. Also, individuals who engage in moderate to vigorous exercise and activity are typically healthier and longer-lived compared to more sedentary individuals. So, it is not simply the case that slowing down and taking it easy will minimize the effects of aging. Healthy levels of activity, at least for humans, are necessary for good health throughout the lifespan. Scientists currently look at DNA for answers to the aging riddle. For example, specific genes seem to be at least partly responsible for longevity as well as the age at which noticeable physical changes occur in aging. Other genetic theories consider cumulative effects that damage DNA and therefore result in aging. For example, free radicals triggered by certain environmental contaminants might be linked to various diseases and maladies that coincide with aging. Accumulating free radicals over time might be associated with problems such as cataracts and arthritis (this is the “Free Radical theory”). However, much more work needs to be done to understand the process and causes of aging. As you watch the video in this module, be sure to note the following biological theories of aging: Rate of Living Theory, Cellular Theories, and Programmed Cell Death Theories. Here are some additional notes to help guide you as you watch the video: Cellular Theories of aging: These theories include the phenomenon known as the Hayflick Limit (named after the discoverer of the phenomenon), which states that human adult cells have a limited number of times that they can divide (approximately 20). After this limit is reached, the cells will begin to die. The Free Radicals theory would also be a cellular theory. Programmed Cell Death theories: These theories focus on how cells appear to be designed to self-destruct. A variety of processes contribute to this programmed cell death, and many of the diseases associated with aging, such as osteoporosis and Alzheimers, have evidence of being at least partly caused by these processes. Page 2 Problem Set 1 1. Reflection question: Prior to reading this module, what did you believe regarding the four opening questions? Do you think that there are societal misconceptions about old age? Ans.#1: 2. Compare and contrast Primary and Secondary aging. Ans.#2: 3. What are some logical and scientific problems with the “Wear and Tear” theory of aging? Ans.#3: 4. What are some current explanations for why we age biologically? Ans.#4: Page 3 Cognitive Problems As we’ve already learned, developing dementia (also known as a neurocognitive disorder) is not a normal part of aging. However, the older one gets, the more likely it is that one will develop a neurocognitive disorder. The likelihood increases with age. Individuals can have either mild or major versions of neurocognitive disorders, and there are a number of potential causes. For example, the following are some examples of causes of neurocognitive disorders. These are therefore various subtypes of neurocognitive disorders/dementias. Again, individuals may have mild or major versions of each subtype. • Parkinson’s Disease may cause a neurocognitive disorder. Symptoms include anxiety, depression, hallucinations, and personality changes. • Cognitive declines due to Vascular Disease are due to a cerebrovascular event such as a stroke. Risk factors include hypertension, smoking, obesity and any factors that contribute to cerebrovascular disease. • A Traumatic brain injury (which involves trauma to the brain from impact to the head, paired with a number of symptoms such as loss of consciousness or amnesia) can result in cognitive impairment such as difficulty concentrating and slowed processing. • Substance/medication induced neurocognitive disorder is due to usually a lifetime of heavy drug use such as alcohol abuse. This may result in the individual having severe problems with concentrating as well as some motor problems. • A Prion disease is caused by transmissible agents called prions. For example, a form of Creutzfeldt-Jakob disease is known as mad cow disease. In humans, Creutzfeldt-Jakob disease is very rare. While the precise process for developing a prion disease is not well understood, research indicates that transmission can occur by corneal transplantation, injection, and possibly physical contacted with contaminated matter. • A number of individuals with an HIV Infection have a neurocognitive disorder that is tied to this disease. Approximately 25\% of individuals with HIV have symptoms for at least a mild neurocognitive disorder. The module video discusses the percentage of individuals with AIDs who have neurocognitive disorders. Happily, great gains have been made with treatment for HIV/AIDS. Individuals receiving HAART (highly active antiretroviral therapy), which suppresses HIV replication, often experience lower rates of neurocognitive issues. • Alzheimer’s disease (named after the discoverer, Dr. Alzheimer) is the most common type of dementia (60\% of cases). Like a few other disorders (for example, Autism and Schizophrenia), the great variety of symptoms displayed by individuals with Alzheimer’s Disease supports the current belief among professionals that Alzheimer’s is not just one disorder. That is, what we currently call “Alzheimer’s Disease” is actually a variety of dementias. Further research will hopefully help to uncover the causes and symptom patterns of each. For now, we will briefly discuss what is currently understood about Alzheimer’s Disease. Alzheimer’s Disease (AD) is progressive, so that as long as the person is alive, cognitive functioning will continue to deteriorate. While individuals differ greatly in what this looks like, the course of the disease can be basically divided into three timepoints. 1. In the beginning stages, memory begins to decline. Typically, deficits in declarative memory are most common, such as routinely forgetting basic words and substituting them with odd words (“I put on my cat”). The individual may begin having trouble with some activities. This may or may not, however, be evident to others. What may be noticeable to others is the social withdrawal and other social changes that result as the individual tries to cope with increasing memory difficulties. Because the individual is likely very aware of the memory problems, depression is common at this point. 2. In the middle stages, the individual’s problems with basic activities of daily living increase to the point that the elder loses some independence and cannot (or should not) cook or drive. Cognitive problems might result in the elder leaving uncooked food out on a table for days or forgetting to turn off the stove. The elder may forget names of spouses and children, be unaware of current events (including the year), and may have personality changes. Gait problems are common since Alzheimer’s Disease impacts more than memory. The brain begins to have problems interpreting visual stimuli, so that cluttered hallways filled with confusing patterns on the floor might make it impossible for the elder to navigate through it. Even in a room without clutter or chaotic colors, the elder may begin to walk with a shuffling step due to visuospacial reasoning problems. 3. If the elder survives to the final stages of Alzheimer’s he/she might not be able to speak, eat, walk, or use a toilet. All of these deficits have to do with forgetting how to do these things rather than any impairment of the limbs. However, persons in the final stages of Alzheimer’s typically do have health problems resulting from the sedentary and bed-ridden lifestyle. The length of time it takes to reach the final stages vary greatly. For some, it is a more rapid decline of a few years. For others, it takes 15 years. Women typically live longer with the disease. While many older adults (and middle-aged ones!) may become nervous at the slightest change in memory performance, cognitive changes are common in later life. Older adults simply do not perform at the same level as their younger counterparts on certain memory tasks. However, other types of cognitive ability (for example, vocabulary) tend to improve across the lifespan. An older adult does not have to be concerned about having Alzheimer’s Disease (AD) unless the cognitive deficits are disruptive to everyday life. Please read the Alzheimer’s Association article on the 10 warning signs of Alzheimer’s Disease. Also, please read their description of common myths about AD. Since so much research has focused on Alzheimer’s Disease, it may be surprising that the causes of AD are still unknown. It is not the case that we have no knowledge; much research over the past decade or so has ruled out hypothesized ideas of what might cause AD. Genetics do play a role, but most clearly in a very small (5\%) subset of individuals with early-onset (before late adulthood) Alzheimer’s Disease. What happens to a brain with Alzheimer’s Disease is well-documented. The brain shrinks as the disease kills neurons (brain cells). A few abnormalities have been noted that seem to facilitate this process. 1. Amyloid plaques (beta-amyloid protein deposits) disrupt normal communication between neurons. AD is thought to be at least partly attributed to problems processing beta-amyloid. 2. Neurofibrillary tangles are formed when threads in the tau protein twist and tangle, which disrupts the brain’s ability to transport necessary nutrients throughout the brain. While it may appear clear that these two abnormalities cause Alzheimer’s Disease, experts are more cautious. The reason for this is that brain imaging of the brains of older adults with no symptoms of AD may also have plaques and tangles! As stated before, our brains and bodies are incredibly resilient and can often function successfully even with damage. The issue, then, is not just whether or not these abnormalities are present. Better questions are: “Why, for some individuals, do these plaques and tangles form so extensively?” and “Why can some adults function normally despite structural brain changes while others cannot?” Page 4 Problem Set 2 1. Describe three subtypes of neurocognitive disorders discussed in this module. Ans.#1: 2. Summarize what the progression of Alzheimer’s Disease often looks like, being sure to incorporate the three timepoints in your summary. Ans.#2: 3. Your grandmother is concerned that she might have Alzheimer’s Disease. What is your response to her, based on the 10 warning signs of Alzheimer’s Disease, linked in this module? Ans.#3: 4. Summarize current findings regarding what causes AD. Ans.#4: Page 5 Socioemotional Development: Theories of Aging Various theories exist regarding socioemotional changes in late adulthood. We will explore some of the major theories. A. Disengagement theory The first theory (that is, the earliest) is Cumming and Henry’s (1961) Disengagement theory, which states that older adults should withdraw from society in order to prepare for death! Late adulthood, according to this view, is a time for decreasing social interaction. Cummings and Henry felt that older adults would be most satisfied in life if they didn’t overly concern themselves with society in their declining years. This theory has been soundly criticized and largely debunked. As stated earlier, taking it “too easy” can have dire physical consequences. It can also have dire social and cognitive consequences. The “use it or lose it” view is currently the more dominant philosophy among experts, rather than disengagement theory. However, many older adults (and others) today, may more or less subscribe to Disengagement theory. B. Activity theory Numerous researchers, beginning in the 1960s, asserted that not only was Disengagement theory incorrect, the opposite is true. That is, the more active an older adult is, the more satisfied in life he or she will be. Again, recent research seems to support activity theory, showing that early retirement and low levels of physical activity can be detrimental unless the adult finds another avenue for involvement. While there may be many barriers for older adults to maintain social interaction, this theory says that older adults need to be creative in considering ways to maintain an active social life. However, more recent research and theory (see the next theory, below) indicates some important considerations regarding elders’ level of activity. C. Selective Optimization with Compensation theory Baltes and colleagues (for example, Baltes & Baltes, 1990; Freund & Blates, 2002) proposed the Selective Optimization with Compensation theory. This theory links successful aging with three things: selection, optimization, and compensation. Due to some inevitable declines, older adults must be more selective in what they choose to do. They should not completely disengage (as Disengagement theory says), but they may not be able to do the same activities in the same way as in their younger years. Secondly, as we first learned in Module 1, development is multidirectional— one can both improve and decline. Optimization, then, involves maintaining what you can through practice, even if there are declines in other areas. Finally, Compensationoccurs when an older adult simply cannot function as he/she used to and must learn to compensate accordingly (such as by resting after physical activity, driving more slowly, or watching peoples’ lips while they talk). This is something that humans do all the time; it just may be more necessary in late adulthood. All three theories attempt to address successful aging. Aging simply happens, but not all adults age well. While celebrities and the media may make this statement clear to us in terms of physical changes, these theories are more concerned with maturity and social interaction. How should an older adult ensure that he/she will be happy with life, content with day-to-day activities, and connected with others? Selective Optimization with Compensation, in addition to other qualities such as spirituality and humor, are currently considered to be excellent strategies. Page 6 Problem Set 3 1. Compare and contrast the three theories discussed in this section. Ans.#1: 2. Reflection question: What does it mean to age successfully? Ans.#2: Page 7 End of Life A. Definition of Death and Stages of Dying Modern technology has somewhat complicated our definitions of death which, in the past, may have focused on the following: • Cessation of all bodily processes • Stopped heartbeat • Stopped breath In many industrialized nations today, brain death (complete cessation of all activity in the brain and brain stem) is the prevailing definition, although world-wide, it is by no means universal. Even so, declaring brain death is still rather complicated since some argue that cessation of just higher cortical functioning (and therefore, higher thought processes) is all that should be necessary to declare death. It is obvious that how we define death holds strong implications for the types of endof-life decisions that we make. It would take an entire course to adequately cover End-of-Life (just as there are entire college courses to cover Child Development and Adult Development, separately). However, we will focus on the most well-known theory pertaining to death and dying: Elisabeth Kubler-Ross’s theory. Kubler-Ross interviewed over 200 terminally ill individuals and came up with a stage theory to describe their responses to their own approaching deaths. It is important to understand KublerRoss’s research method, since this theory is usually applied to an individual c ... Purchase answer to see full attachment