OBESITY
AGING
1.GENERAL CHARACTERISTICS (DEMOGRAPHIC CONDITION, SOCIOLOGICAL AND PSYCHOLOGICAL ASPECTS)
Aging is the process of becoming older. In humans, aging represents the accumulation of changes being over time, encompassing physical, psychological, and social changes, therefore aging is a combination of bodily changes and the impact of how we take care of ourselves. From a biological perspective, it is inevitable.
Human aging, physiological changes that take place in the human body leading to senescence, the decline of biological functions and of the ability to adapt to metabolic stress. In humans the physiological developments are normally accompanied by psychological and behavioral changes, and other changes, involving social and economic factors, also occur.
There are four types of aging.
Ø Cellular aging: Cells age based on the number of times they have replicated, and over time this genetic material loses the ability to copy accurately.
Ø Hormonal aging: as we get older, hormonal changes lead to a series of changes like dry skin, menopause.
Ø Accumulated damage: Exposure to toxins, the sun, harmful foods, pollution and smoke takes a toll on the body. These external factors can cause tissue damage and the body does not tend the same capacity to maintain and repair cells and tissues.
Ø Metabolic aging: the typical process of metabolizing and creating energy results in damage to the body over time.
Aging can be understood in different ways
Demographically,
–Aging occurs when vital rates are too low. A shift is happening in age distribution.
–Aging is shown to be negatively related to contemporary birth rates and death rates. In a general sense, aging occurs when vital rates are too low
–Relation between the rate of aging to a population´s demographic history, in particular to changes in mortality, migration, and the annual number of births
–The causes are a decrease in BIRTH RATE and life expectancy increased.
–There are some exceptions including:
o Africa due to AIDS epidemic.
oSome of more drastic shifts are occurring in East Asia, where population life expectancy has changed from less than 45 years in 1950 to more than 74 today.
oFertility rates
oShift in leading causes of death from parasitic & infectious disease chronic illness
–By 2030, all baby boomers will be older than age 65. This will expand the size of the older population so that 1 in every 5 residents will be retirement age.
–“The aging of baby boomers means that within just a couple decades, older people are projected to outnumber children for the first time in U.S. history,”
Sociologically,
Ageing can be defined as the combination of biological, psychological and
social processes that affect people, as they grow older. Gerontology is
studying the aging and the elderly in the population.
In the field of sociology and mental health, ageing is seen in five different views: ageing as maturity, ageing as decline, ageing as a life-cycle event, ageing as generation, and ageing as survival. Positive correlates with ageing often include economics, employment, marriage, children, education, and sense of control, as well as many others, being acknowledged that resources and reserves can influence ageing differently.
Psychologically,
the process of aging into the elderly years (ex: 65 years and older) often involves a number of progressive physiological changes. It’s include coping with declines in physical and functional abilities, changing social relationships and roles, and dealing with multiple losses; with an increasing number of life stressors and adjustments. Within the context of these changes, and often related to them, prominent issues of psychological and social adjustment emerge.
World population is living longer
Older adults and older community are working longer
We still like to do the things we did when we were young
Aging is not defined as a disability; they are not synonymous
Those 65+ actual have greater capacity than we credit them for
Up to 33 percent of all older people live alone most of them widowed women over the age of 85; about 5 percent live in some type of long-term care facility
Thebiological-physiological aspects of aging include both the basic biological factors that underlie aging and the general health status. Since the probability of death increases rapidly with advancing age, it is clear that changes must occur in the individual which make him or her more and more vulnerable to disease. For example, a young adult may rapidly recover from pneumonia, whereas an elderly person may die.
Physiologists have found that the performance of many organs such as the heart, kidneys, brain, or lungs shows a gradual decline over the life span. Part of this decline is due to a loss of cells from these organs, with resultant reduction in the reserve capacities of the individual. Furthermore, the cells remaining in the elderly individual may not perform as well as those in the young. Certain cellular enzymes may be less active, and thus more time may be required to carry out chemical reactions.
–The most outstanding psychological features of aging are the impairment in short-term memory and cognition, resulting in slowed thinking and response. While these features may develop naturally as part of the aging process, research suggests that long-term lifestyle factors—such as diet, exercise, and sleep habits—and disease play a critical role. For example, aerobic exercise, which stimulates blood circulation and oxygen delivery in the brain and body, is associated with improved cognitive performance in older individuals. By comparison, chronic disease, depression, and sleep problems negatively affect cognition. Depression, for example, is associated with a reduced density of synapses (neuron connections) in the brain and impairment of memory and thinking skills in the elderly.
Aged people tend to become more cautious and rigid in their behaviour and to withdraw from social contacts.
2.AGING FACTORS
BIOLOGICALLY: we saw our genes are given to us; no control over this aspect; telomeres shorten, cell division stops
ENVIRONMENTALLY:habits > smoking, alcoholism; diet ; UV exposure; exercise; exposure to harmful chemicals
AGING: Natural selection, tissue damage, decline or loss of cellular function, drop in number of cells, oxidative damage, DNA modification, unhealthy lifestyle
SOME FACTORS IN AGING: TELOMERE SHORTENING: Chromosomes lose telomeres over time// CHRINILOGICAL AGE: risk factors increase over time// OXIDATIVE STRESS: oxidants damage DNA, proteins and lipids// GLICATION: glucose sugar binds to and inhibits DNA, proteins and lipids
3.NON-TYPICALNESS OF ILLNESS COURSES AS MANIFESTATION OF OLD AGE PATHOLOGY
AGING IS INENVITABLE
Not
all ailments are manifest in all individuals. As we age predispositions become
evident. Also, environmentally add increased risk
Some make argument for
aging as a disease due to the increase in medical occurrences
AGING better defined as umbrella term for a
series of co-morbid symptoms:
•inevitability of degradation of body
•osteoporosis
•arthristis
•cataracts
•tinnitus
•prostate cancer
•gum disease
•skin cancer
•incontinenece
•neurodegenerative factors: dementia, muscle strength, balance, coordination, reflexes
•Currently there are common factors that are associated with premature aging: attitude, smoking, drinking, age, sun, cold and, diet, weight, options and stress.
•In addition, ageing is among the greatest known risk factors for most human diseases. There are diseases associated with aging such as Arthritis, Obesity and Metabolic Syndrome, Osteoporosis and falls, Cancer, Cardiovascular Disease, vision and hearing loss, Teeth, Alzheimer’s Disease
•Diseases may develop differently in elderly people, having special symptons that makes treatment difficult. Many diseases go unnoticed because their symptoms are attributed to the normal aging process, the symptoms of dementia and side effects of drugs.
4.SUBJECTIVE SCOPE OF PRIMARY HEALTH CARE
5.ANTI-AGING ACTIVITIES (PROPHYLACTIC, HEALTHY LIFE STYLE)
HEALTHY LIFE STYLE
–Exercise
–Nutricion: Eat the right foods. Vitamins, carotenoids, tocopherols, flavonoids and a variety of plant extracts possess potent anti-oxidant properties.
–Get enough sleep
–Developed a positive attitude
–Enjoy a healthy sexuality
–No smoking
–Protect yourself from the sun
–Good hydration
–social activity
–maintain proper hygiene
–Caloric restriction substantially affects lifespan, including the ability to delay or prevent many age-related diseases. Moderate calorie restriction produce the observed health and longevity benefits.
–The Mediterranean diet is credited with lowering the risk of heart disease and early death. The major contributors to mortality risk reduction appear to be a higher consumption of vegetables, fish, fruits, nuts and monounsaturated fatty acids, i.e., olive oil.
–The amount of sleep has an impact on mortality. People who live the longest report sleeping for six to seven hours each night. Lack of sleep (<5 hours) more than doubles the risk of death from cardiovascular disease, but too much sleep (>9 hours) is associated with depression.
– Physical exercise may increase life expectancy
–Avoidance of chronic stress (as opposed to acute stress) is associated with a slower loss of telomeres in most but not all studies,[148][149] and with decreased cortisollevels. A chronically high cortisol level compromises the immune system, causes cardiac damage/arterosclerosis and is associated with facial ageing, and the latter in turn is a marker for increased morbidity and mortality.
-Ejercitado 3-5 veces por semana
-Comió una dieta baja en grasas y mantuvo un nivel de peso recomendado.
-Mantuvo su presión arterial dentro del rango normal
-No fumé y consumí alcohol con moderación (no más de 1-2 oz / día)
-Enfrentado efectivamente con eventos estresantes.
-Tenía un círculo de amigos con los que socializaba con frecuencia.
-Ahorró suficiente dinero para estar cómodo en su vejez
-Mantuvo una actitud positiva respecto a su propio envejecimiento.
-Estaban orientados hacia el futuro
-Permaneció activo aprendiendo cosas nuevas.
6.ROLE OF PRIMARY HEALTH CARE CENTERS
Consultation on Global Strategy and Action Plan on Ageing and Health
- Commitment to Healthy Ageing. Requires awareness of the value of Healthy Ageing and sustained commitment and action to formulate evidence-based policies that strengthen the abilities of older persons.
- Aligning health systems with the needs of older populations. Health systems need to be better organized around older people’s needs and preferences, designed to enhance older peoples intrinsic capacity, and integrated across settings and care providers. Actions in this area are closely aligned with other work across the Organization to strengthen universal health care and people-centred and integrated health services.
- Developing systems for providing long-term care. Systems of long-term care are needed in all countries to meet the needs of older people. This requires developing, sometimes from nothing, governance systems, infrastructure and workforce capacity. WHO’s work on long-term care (including palliative care) aligns closely with efforts to enhance universal health coverage, address non-communicable diseases, and develop people-centred and integrated health services.
- Creating age-friendly environments. This will require actions to combat ageism, enable autonomy and support Healthy Ageing in all policies and at all levels of government. These activities build on and complement WHO’s work during the past decade to develop age-friendly cities and communities including the development of the Global Network of Age Friendly Cities and Communities and an interactive information sharing platform Age-friendly World.
- Improving measurement, monitoring and understanding. Focused research, new metrics and analytical methods are needed for a wide range of ageing issues. This work builds on the extensive work WHO has done in improving health statistics and information, for example through the WHO Study on global AGEing and adult health (SAGE)
Age-friendly
Primary Health Care (PHC) Centres
The Department of Ageing and Life Course (ALC) has
developed a toolkit that assists health care workers in being well versed in
the diagnosis and management of the chronic diseases and the so-called four
giants of geriatrics (memory loss, urinary incontinence, depression and
falls/immobility) that often impact people as they age.
The toolkit’s purpose is to:
·improve the primary health care response for older persons.
·sensitize and educate primary health care workers about the specific needs of their older clients.
·provide primary care health workers with a set of tools/instruments to assess older people’s health.
·raise awareness among primary care health workers of the accumulation of minor/major disabilities experienced by older people.
·provide guidance on how to make primary health care management procedures more responsive to the needs of older people’s needs.
·offer direction on how to do environmental audits to test primary health care centres for their age-friendliness.
The toolkit comprises a number of instruments (evaluation forms, slides, figures, graphs, diagrams, scale tables, country guidelines, exam sheets, screening tools, cards, checklists, etc.) that can be used by primary health care workers to assess and address older persons’ health. These resources are meant to supplement and not to replace local and national materials and guidelines.
NOT ONLY ASPECT OF AGING BUT ALSO AGING AS CHALLENGE FOR HEALTH CARE SYSTEM
The aging of the population will be a problem in the near future. A large proportion of people with advanced age will be multi-pathological patients, without a cure, who must be cared for and controlled in their environment, either in their homes or in their homes.
It will be necessary to adapt the health system to this situation, before which the nurses will bear the burden of caring for these people.
In Spain, 20% of the population is over 65 years old, and it is estimated that by 2030 they will exceed 30%. The increase in life expectancy and the decrease in the birth rate lead us to a worrisome aging with repercussions in multiple fields, from which Health does not escape.
These millions of elderly people will suffer chronic, incurable diseases, and many of them will have an important degree of dependence. They should be controlled and cared for in their homes or in the residences of their environment. It will be necessary to establish specific care plans, because it is no longer a matter of whether one falls and breaks a hip, to operate on it. It is about avoiding the fall. To put the means so that it does not occur or does not happen again.
Primary Care will have to be strong as necessary, with health teams that work more and more at home and in the community, implementing prevention programs and individualized care plans. It must be important the increase of nursing professionals to dispense care at home and teach people to self-care whenever they can.
The objective of the health model with a strong Primary Care is to DECREASE the demand for hospital services, the rate of hospital admissions, the rate of readmissions, the length of hospital stay, the number of imaging tests and the expense in the Emergency Department.
The socio-health care can not be isolated, it must provide continuity of care and quality care that promotes the independence, dignity and well-being of the dependent person and, where appropriate, the caregiver or caregivers.
Health resources and budgets are limited, and in situations of economic crisis, with an aging population that consumes a large amount of these resources, innovation and a change in the health model is necessary. The change must point to Primary Care to strengthen it.