Developmental Health Psychology Aging n Primary Aging normal

Developmental Health Psychology

Aging n Primary Aging – “normal” senescence n Secondary Aging – “pathological” senescence

Health during old age Most in good health (Stats Can. , ’ 99) n Most common chronic conditions: late adulthood n – Arthritis, rheumatism – 42% – High blood pressure – 33% – Allergies – 22% – Back problems – 17% – Heart problems – 16%

Key ideas n Women live longer than men – But more likely to have chronic conditions and limitations in activities of daily living n Physical health declines, psychological well-being improves

n Determinants of health – Health beliefs, behaviours, social structure, SES – Often can be changed to improve health

n Despite attention paid to sickness and treatment, self-care is the most predominant form of care

Mental Health n Attempt to live meaningfully – in a particular set of social and environmental circumstances – relying on a particular collection of resources and supports

Self-development self-perception n integration of various roles n striving for growth n possible commitment to something beyond self n Life satisfaction (self image, self esteem) n

Threats to mental health n Epidemiological Catchment Area Study – US Nat’l Inst. of Mental Health – 18, 000 structured interviews – 5 regions across US n Dispelled 2 major myths: – Women at greater risk. – Older adults at greater risk

Age-Related Trends in Mental Disorders n Lower prevalence in older than younger adults – all mental disorders (excluding dementias) Younger (18 -64 years): 11 -25% n Older (65+): 6 -14% n

n Mood disorders (including depression) – Younger: 3 -8% – Older: 2 -3% n Dementia – Older: 6 -10% – Possible co-existence and interaction with physical illness

Are Elderly Less Prone to Mental Illness? n Diagnostic criteria not “age fair” – depression symptoms different in elderly n Elderly typically visit physicians before mental health professionals – physical symptoms mask psychological ones – e. g. , difficulty sleeping, changes in diet, heart palpitations (depression)

n Myths, stereotypes about aging – must distinguish normal aging from disease – ageism in treatment n Cohort effects: “stigma”

Alzheimer’s Disease Progressive, degenerative brain disorder n Loss of memory, awareness, ability to control body functions n

n First reported in 1907 – Shrinkage of cortex – Large masses of amyloid plaques n Spherical cells protein deposits outside of nerve – Neurofibrillary tangles n Twisted protein filaments inside neurons – Spread from bottom (midbrain) to top (cortex)

Plaques, tangles present in normal aging brain n In Alzheimer’s: excessive, interfere with communication between neurons n

Prevalence Rare under 50 n 6 -10% over 65 n 30 -50% over 85 n

Symptoms Permanent forgetting of recent events n Unable to do routine tasks n Forget simple words n Confusion in familiar locations n Forget what numbers mean n Put things in inappropriate places n – Watch in fishbowl

Rapid, dramatic mood swings n Loss of language, communication skills n

Causes Very little known n Possibly: n – 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 Age n Family history n Brain damage (accident) n n Predictors: Kentucky Nun Study – “richness” of early writing

Treatment Anti-oxidants n Enzyme-blocking agents (prevent plaques) n Genetic engineering (promote neuron growth) n Respite care: caregiver stress n Behaviour Modification (activities of daily living) n

Physical activity n Social involvement n Good nutrition n Calm structured environment n

Coping with AD n Patient – Aware of changes – Shame, self image, fear of desertion – Behavioural changes (stages) n Caregiver: physical, psychological, social – 70% family members (female usually) – 50% severe stress

n Caregiver Stress – Physically exhausting: constant vigilance – Psychological effects n Grief: adjust to gradual loss n Increasing social isolation n Stigma: cover-up, try to avoid social interactions n Stress: severity depends on availability of social support (respite care, counselling, support groups)