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CHAPTER 4 OUTLINE
(1) These are short-term illnesses in which the cause is known and the condition is curable.
(2) Chicken-pox, colds, and influenza are examples of acute diseases.
(1) The difference in the average health status of the 45 and 65 year old is not great.
(2) People do not reach 65 and suddenly become decrepit.
(1) Those age 75 and over usually have noticeable physical declines compared with the middle-aged, and those over 85 have even more noticeable declines.
(2) With advanced age come more numerous and longer hospital stays, more doctor visits, and more days of disability, but declines are typically very gradual.
(1) Of the noninstitutionalized elders with chronic conditions, 58 percent report no activity limitation whatsoever, almost 29 percent report physical disabilities of some sort, just under 11 percent report some form of mental disability, and 20.4 percent report difficulty going outside the home.
(2) Heart conditions and arthritis impose the most limitations on older people.
III. Major Health Problems
(1) Atheroschlerosis occurs when fat and cholesterol crystals, along with other substances, accumulate on the interior walls of the arteries, thereby reducing the size of these passageways.
(2) The accumulation of some deposits of fat in the arteries seems to be part of normal aging; however, the increased incidence in Western countries of heart attack suggests that excessive deposits are linked to factors such as smoking and serum cholesterol levels that might be controlled by lifestyle changes.
(1) It is present in about 40 percent of people age 65 and older and 25 percent of those in the 45-to-65-year age range.
(2) Hypertension can be treated with medications that rid the body of excess fluid and sodium.
(3) Factors associated with risk of hypertension include obesity, smoking, and excessive alcohol consumption.
(4) Some pain medications (nonsteroidal anti-inflammatory drugs) may increase blood pressure when taken over a long period of time.
(5) Hypertension is responsive to diet and exercise.
(1) The body mass index (BMI), or weight divided by height in square meters, is commonly used in research as an estimate of overall weight.
(2) The Honolulu Heart study found that, among men, a high waist-to-hip ratio (WHR) accompanied by elevated cholesterol (HDL-C) was more strongly related to coronary heart disease then was predominantly peripheral fat accumulation or excess weight accumulated more uniformly on the body.
(1) It is more cost-effective to prevent CAD than to treat it after it is clinically apparent.
(2) Elevated cholesterol in young adult men establishes increased CAD over the next 40 years.
(3) Lowering blood cholesterol in young hypercholesterolemic persons would decrease rates of CAD over their life span.
(4) Cholesterol lowering can be accomplished at low cost.
(5) Cholesterol lowering is equally effective in women and the elderly.
(1) Embryonic stem cell therapy transplants ES cells in a patient.
(2) The cells then search out, detect, and attempt to repair damage.
(3) They additionally release growth factors that stimulate the body’s repair mechanisms.
(1) Mortality for cancer of the liver peaks between the ages of 85 and 90.
(2) Lung cancer seems to plateau between 80 and 84 years of age.
(3) The incidence of ovarian cancer decreases beginning at about 75 years of age.
(1) Cancer is the second leading cause of death among the elderly.
(2) Cancer is a leading chronic conditions among the elderly.
(1) When brain cells do not receive blood from the heart, they die.
(2) The death of brain cells indicates the occurrence of a stroke.
(1) Rehabilitation is remarkably effective.
(2) One study found marked improvement in exercise capacity and obesity indices and modest improvement in plasma lipids in older women in addition to improved quality-of-life parameters.
(a) Falls are the most common cause of accidental death among those 65, followed by motor vehicle accidents.
(b) Suffocation from an object that has been ingested, surgical and medical mishaps, fires and burns are also major causes.
(c) The 90 and over group has an alarmingly disproportionate share of deaths due to accidents in two of these categories: falls and suffocation by ingestion of food.
(1) About half of these falls can be attributed to accidents (e.g., toppling from a shaky ladder) and extrinsic causes (e.g., slippery floors).
(2) The other half are from causes such as weakness of the lower extremities, gait disorders, effects of medications, or illness.
(1) Some programs help train people for balance.
(2) Learning and relearning skills of balance can be accomplished at any age and have been shown to be quite effective with elders.
(1) Because we instinctively use the hip to absorb most falls and bones are often weakened by osteoporosis, a hip fracture is a common ailment to be feared: one-third of women (those most likely to have osteoporosis) and one-sixth of men who live to age 90 will suffer a hip fracture.
(2) About 90 percent of hip fractures are due to osteoporosis.
(a) Older women with smaller body size are at increased risk of hip fracture because of lower hipbone mineral density.
(b) Only 25 percent recover fully, and one in four dies within six months of the injury.
(3) Compared with women, older men hospitalized with hip fracture in one study were shown to have higher mortality and more risk factors for osteoporosis; like women, they are unusually fragile, with preexisting illnesses that contribute to an overall poor outcome.
(1) They may try to lift loads that are too heavy or poorly balanced, or they may climb to reach overhead without sufficient strength to manage the task.
(2) Changes in automobile traffic conditions can happen too swiftly for them to react.
(1) For some, osteoarthritis starts early in life and affects mostly the small joints.
(2) For others, osteoarthritis results from injury or vigorous wear and tear.
(3) It occurs later in life for the large or overused joints.
(1) Some doctors recommend calcium supplements.
(2) The vitamin D metabolite calcitrol has been shown to help correct problems with calcium absorption and has been particularly useful with steroid-induced bone loss.
(1) In 2004, markers were identified that are early indicators of progressive disease in rheumatoid arthritis (RA), a form of arthritis.
(2) From that information, early, aggressive baseline treatment was developed to stop or slow the development of the arthritis.
(1) Monkeys were provided a diet with 30 percent fewer calories than the control group but the same level of nutrition.
(2) The diet resulted in lowered blood sugar and insulin levels compared with age-related increases in these markers in the control group of monkeys.