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Developmental Health Developmental Health Psychology Psychology

Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

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Page 1: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Developmental Developmental Health PsychologyHealth Psychology

Page 2: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

AgingAging

Primary AgingPrimary Aging– ““normal” senescencenormal” senescence

Secondary AgingSecondary Aging– ““pathological” senescencepathological” senescence

Page 3: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Health during old ageHealth during old age

Most in good health (Stats Can., Most in good health (Stats Can., ’99)’99)

Most common chronic conditions: Most common chronic conditions: late adulthoodlate adulthood– Arthritis, rheumatism – 42%Arthritis, rheumatism – 42%– High blood pressure – 33%High blood pressure – 33%– Allergies – 22%Allergies – 22%– Back problems – 17%Back problems – 17%– Heart problems – 16%Heart problems – 16%

Page 4: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Key ideasKey ideas

Women live longer than menWomen live longer than men– But more likely to have chronic But more likely to have chronic

conditions and limitations in conditions and limitations in activities of daily livingactivities of daily living

Physical health declines, Physical health declines, psychological well-being improvespsychological well-being improves

Page 5: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Determinants of healthDeterminants of health– Health beliefs, behaviours, social Health beliefs, behaviours, social

structure, SESstructure, SES– Often can be changed to improve Often can be changed to improve

healthhealth

Page 6: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

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

Page 7: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Mental HealthMental Health

Attempt to live meaningfullyAttempt to live meaningfully– in a particular set of social and in a particular set of social and

environmental circumstancesenvironmental circumstances– relying on a particular collection of relying on a particular collection of

resources and supportsresources and supports

Page 8: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Self-developmentSelf-development

self-perceptionself-perception integration of various rolesintegration of various roles striving for growthstriving for growth possible commitment to possible commitment to

something beyond selfsomething beyond self Life satisfaction (self image, self Life satisfaction (self image, self

esteem)esteem)

Page 9: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Threats to mental Threats to mental healthhealth Epidemiological Catchment Area Epidemiological Catchment Area

StudyStudy– US Nat’l Inst. of Mental HealthUS Nat’l Inst. of Mental Health– 18,000 structured interviews18,000 structured interviews– 5 regions across US5 regions across US

Dispelled 2 major myths:Dispelled 2 major myths:– Women at greater risk.Women at greater risk.– Older adults at greater riskOlder adults at greater risk

Page 10: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Age-Related Trends in Age-Related Trends in Mental DisordersMental Disorders Lower prevalence in older than Lower prevalence in older than

younger adultsyounger adults– all mental disorders (excluding all mental disorders (excluding

dementias)dementias) Younger (18-64 years):Younger (18-64 years): 11-11-

25%25% Older (65+):Older (65+): 6-14%6-14%

Page 11: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Mood disorders (including Mood disorders (including depression)depression)

– Younger:Younger: 3-8%3-8%– Older:Older: 2-3%2-3%

DementiaDementia– Older:Older: 6-10%6-10%– Possible co-existence and Possible co-existence and

interaction with physical illnessinteraction with physical illness

Page 12: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Are Elderly Less Prone Are Elderly Less Prone to Mental Illness?to Mental Illness? Diagnostic criteria not “age fair”Diagnostic criteria not “age fair”

– depression symptoms different in depression symptoms different in elderlyelderly

Elderly typically visit physicians Elderly typically visit physicians before mental health professionalsbefore mental health professionals

– physical symptoms mask physical symptoms mask psychological onespsychological ones

– e.g., difficulty sleeping, changes in e.g., difficulty sleeping, changes in diet, heart palpitations (depression)diet, heart palpitations (depression)

Page 13: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Myths, stereotypes about agingMyths, stereotypes about aging– must distinguish normal aging from must distinguish normal aging from

disease disease – ageism in treatmentageism in treatment

Cohort effects: “stigma”Cohort effects: “stigma”

Page 14: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Alzheimer’s DiseaseAlzheimer’s Disease

Progressive, degenerative brain Progressive, degenerative brain disorderdisorder

Loss of memory, awareness, Loss of memory, awareness, ability to control body functionsability to control body functions

Page 15: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

First reported in 1907First reported in 1907– Shrinkage of cortexShrinkage of cortex– Large masses of amyloid plaquesLarge masses of amyloid plaques

Spherical protein deposits outside of Spherical protein deposits outside of nerve cellsnerve cells

– Neurofibrillary tanglesNeurofibrillary tangles Twisted protein filaments inside neuronsTwisted protein filaments inside neurons

– Spread from bottom (midbrain) to Spread from bottom (midbrain) to top (cortex)top (cortex)

Page 16: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Plaques, tangles present in Plaques, tangles present in normal aging brainnormal aging brain

In Alzheimer’s: excessive, In Alzheimer’s: excessive, interfere with communication interfere with communication between neuronsbetween neurons

Page 17: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

PrevalencePrevalence

Rare under 50Rare under 50 6-10% over 656-10% over 65 30-50% over 8530-50% over 85

Page 18: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

SymptomsSymptoms

Permanent forgetting of recent Permanent forgetting of recent eventsevents

Unable to do routine tasksUnable to do routine tasks Forget simple wordsForget simple words Confusion in familiar locationsConfusion in familiar locations Forget what numbers meanForget what numbers mean Put things in inappropriate placesPut things in inappropriate places

– Watch in fishbowlWatch in fishbowl

Page 19: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Rapid, dramatic mood swingsRapid, dramatic mood swings Loss of language, communication Loss of language, communication

skillsskills

Page 20: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

CausesCauses

Very little knownVery little known Possibly:Possibly:

– Genetic factors (permitting tangles Genetic factors (permitting tangles to form)to form)

– Environment (sporadic AD – no Environment (sporadic AD – no family history; possible toxins)family history; possible toxins)

– Build up of plaques in body, free Build up of plaques in body, free radicals in brainradicals in brain

Page 21: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Risk FactorsRisk Factors

AgeAge Family historyFamily history Brain damage (accident)Brain damage (accident)

Predictors: Kentucky Nun StudyPredictors: Kentucky Nun Study– ““richness” of early writingrichness” of early writing

Page 22: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

TreatmentTreatment

Anti-oxidantsAnti-oxidants Enzyme-blocking agents (prevent Enzyme-blocking agents (prevent

plaques)plaques) Genetic engineering (promote Genetic engineering (promote

neuron growth)neuron growth) Respite care: caregiver stressRespite care: caregiver stress Behaviour Modification (activities Behaviour Modification (activities

of daily living)of daily living)

Page 23: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Physical activityPhysical activity Social involvementSocial involvement Good nutritionGood nutrition Calm structured environmentCalm structured environment

Page 24: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Coping with ADCoping with AD

PatientPatient– Aware of changesAware of changes– Shame, self image, fear of desertionShame, self image, fear of desertion– Behavioural changes (stages)Behavioural changes (stages)

Caregiver: physical, Caregiver: physical, psychological, socialpsychological, social– 70% family members (female 70% family members (female

usually)usually)– 50% severe stress50% severe stress

Page 25: Developmental Health Psychology. Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Caregiver StressCaregiver Stress– Physically exhausting: constant Physically exhausting: constant

vigilancevigilance– Psychological effectsPsychological effects

Grief: adjust to gradual lossGrief: adjust to gradual loss Increasing social isolationIncreasing social isolation Stigma: cover-up, try to avoid social Stigma: cover-up, try to avoid social

interactionsinteractions Stress: severity depends on availability of Stress: severity depends on availability of

social support (respite care, counselling, social support (respite care, counselling, support groups)support groups)