Wear and Tear Theory of Aging What It Is: The wear and tear theory of aging believes that

the effects of aging are caused by damage done to cells and body systems over time. Essentially, these systems "wear out" due to use. Once they wear out, they can no longer function correctly. Wear and tear theories of biological aging propose that aging in humans and other animals is simply the result of universal deteriorative processes that operate in any organized system. According to these theories, humans age for the same reasons and because of the same processes that cause aging in automobiles and exterior paint. These theories (also called simple deterioration theories) are attractive to many people who are mainly concerned with human aging but have severe problems. The Somatic Mutation Theory of Aging What It Is: This theory states that an important part of aging is determined by what happens to our genes after we inherit them. From the time of conception, our body's cells are continually reproducing. Each time a cell divides, there is a chance that some of the genes will be copied incorrectly, this is called a mutation. Additionally, exposures to toxins, radiation or ultraviolet light can causes mutations in your body's genes. The body can correct or destroy most of the mutations, but not all of them. Eventually the mutated cells accumulate, copy themselves and cause problems in the body's functioning related to aging. The Somatic Mutation Theory of Aging tries to explain why healthy cells suddenly begin to produce unhealthy cells. The simple idea behind a complex theory is that with the tens of thousands of genes that are reproduced every time a cell in your body divides to make a new cell, an occasional error happens. Most of these incorrectly copied genes never create any problems. However, without being repaired, later copies make the problem worse. Eventually, the line of cells coming from the errant copy no longer quite function like the original cell. This process happens over and over and over during a span of several decades until enough poorly functioning cells are present to cause changes in the tissue that they comprise. The outcome is called aging.

Aging: what happens when adaptation goes away As Weismann and other evolutionary biologists have realized over the last century and more [9], when natural selection pays attention to survival to, and reproduction at, later ages it is trivial for evolution to build adaptations that will enable organisms to do both of these things. Thus it is easy for evolutionary biologists to deliberately produce organisms with slowed or postponed aging, as our publications have shown since 1980 [1,4]. All we have to do is extend the period during which the forces of natural selection act with full force. Furthermore, it is clear that this entails genetic and functional changes involving many loci [10].

The study of adaptation over entire genomes is laden with both conceptual and experimental complexities. I now give some typical examples of relevance to the study of aging. These complexities illustrate the extent to which standard gerontological experiments are entangled with issues from evolutionary biology. (1) Inbreeding depression tends to degrade adaptation at every age. This makes the study of heavily inbred laboratory animals particularly inappropriate for research on aging, because aging is a phenomenon which hinges on the loss of adaptation with adult age. Inbred animals will show impairments of adaptation at every age, obscuring the essential feature of aging as a period of progressively impaired adaptation that follows a period of adequate adaptation. (2) Genotype-by-environment interactions arise when organisms are assayed in different environments, particularly environments that are evolutionarily novel [12]. In the context of aging research, this can make genetic effects on longevity difficult to reproduce when protocols are changed [13]. More profoundly, studying the loss of adaptation in an organism that has not already adapted to the laboratory setting employed in an experiment will obscure what is going on in its aging, functionally, genetically, and physiologically. (3) The adaptive "costs of reproduction" underlie the well-known antagonistic pleiotropy mechanism for the evolution of aging [14]. The costs of reproduction can also supply a ready way to generate extended lifespan, simply by reducing fecundity [15]. Thus evolutionary biologists expect that experimental manipulations which attenuate reproduction will often increase longevity, but because this involves trading one adaptation for another, we do not regard the resulting demography as a case of slowed or postponed aging. (4) Significantly, these last two genetic mechanisms can interact, genotype-byenvironment interaction making it difficult to detect genetic trade-offs, even when

gerontologists are trying to find them [11]. This difficulty will be still greater when gerontologists are not particularly keen to find evidence for such trade-offs. (5) "Longevity mutants" will characteristically suffer from adverse pleiotropic effects in at least some environments, because generally superior "longevity assurance" mutants will be favored in nature. Vastly more mutations will have been generated in the evolution of any species than we will ever produce in our laboratories in the comparatively short-term and small-scale mutation screens that we can perform. Generally beneficent alleles should have already been fixed in the course of evolution by natural selection, since they would be key adaptive substitutions. stress theory of aging, a stochastic theory of aging that hypothesizes that aging and death result from the effects of environmental stressors that cause wear and tear on cells and disrupt their function. The generation of free radicals during oxidative cell processes is sometimes cited as a specific stressor that disrupts DNA and protein function and so causes aging theories of aging, theories proposed to explain aging and death of cells and organisms. They are generally divided into two major groupings. The first group consists of programmed causes, with timed functional changes, and is generally based on genetic theories. This group includes programmed senescence of cells, shortening of telomeres, and declines in hormonal or in immunologic function. The second group, called stochastic theories, consists of theories based on random events occurring over time and includes free radical generation, gradual wear and tear, mutation over time, and differences in metabolic rate. Disengagement Theory of Aging The disengagement theory, one of the earliest and most controversial theories of aging, views aging as a process of gradual withdrawal between society and the older adult. This mutual withdrawal or disengagement is a natural, acceptable, and universal process that accompanies growing old. It is applicable to elders in all cultures, although there might be variations. According to this theory, disengagement benefits both the older population and the social system. Gradual withdrawal from society and relationships preserves social equilibrium and promotes self-reflection for elders who are freed from societal roles. It furnishes an orderly means for the transfer of knowledge, capital, and power from the older generation to the young. It makes it possible for society to continue functioning after valuable older members die. Critics of disengagement theory do not support certain conclusions and aspects of the theory. It could be viewed as an excuse to explain why society is less welcoming to older adults, and justifies the barriers to participation in social activities for older people. A person who must stay at home with a broken hip, for example, may not actually want to be isolated, but may be forced into being alone because people may not be able to visit since they have their own health problems, and the individual may not have access to an assistant to help him get out and about. Likewise, older adults

may not want to leave community organizations, but may have to because their planning does not accommodate the needs of older members. According to their theory, as people age, they tend to withdraw from society, and this can be mutual, with society being less likely to engage with and include older people. They argued that this was a consequence of people learning their limitations with age and making way for new generations of people to fill their roles. In modern gerontology, the study of aging and society, disengagement theory is controversial, and many people do not agree with it. Activity theory (aging) The activity theory, also known as the implicit theory of aging, normal theory of aging, and lay theory of aging,[1] proposes that successful aging occurs when older adults stay active and maintain social interactions.[2] The activity theory rose in opposing response to the disengagement theory.[3] The activity theory and the disengagement theory were the two major theories that outlined successful aging in the early 1960s. Activity theory reflects the functionalist perspective that the equilibrium that an individual develops in middle age should be maintained in later years.[2] The theory predicts that older adults that face role loss will substitute former roles with other alternatives.[2] The activity theory is one of three major psychosocial theories which describe how people develop in old age.[6] The other two psychosocial theories are the disengagement theory, with which the activity comes to odds, and the continuity theory which modifies and elaborates upon the activity theory. Continuity theory (aging) The continuity theory of normal aging states that older adults will usually maintain the same activities, behaviors, personalities, and relationships as they did in their earlier years of life.[1] According to this theory, older adults try to maintain this continuity of lifestyle by adapting strategies that are connected to their past experiences.[2] The continuity theory is one of three major psychosocial theories which describe how people develop in old age.[3] The other two psychosocial theories are the disengagement theory, with which the continuity theory comes to odds, and the activity theory upon which the continuity theory modifies and elaborates. Unlike the other two theories, the continuity theory uses a life course perspective to define normal aging. The continuity theory can be classified as a micro-level theory because it pertains to the individual, and more specifically it can be viewed from the functionalist perspective in which the individual and society try to obtain a state of equilibrium. The Aging Process Aging (American English, occasionally British English) or ageing (British English) is the accumulation of changes in a person over time.[1] Aging in humans refers to a multidimensional process of physical, psychological, and social change. Some dimensions of aging grow and expand over time, while others decline. Reaction time, for example, may slow with age, while knowledge of world events and wisdom may expand. Research shows that even late in life, potential exists for physical, mental, and social growth and development. Some age-related physical changes are obvious: an extra laugh line or two, graying hair, and additional weight around the midsection, for instance. But many changes, such as the gradual

loss of bone tissue and the reduced resiliency of blood vessels, go unnoticed, even for decades. Even though you're not aware of them, they're happening, nevertheless. Knowing how and why your body changes with age will help you discourage alterations in cell, tissue, and organ function that slow you down. This knowledge will also help you take steps to stop the development of conditions such as diabetes and eye disease that are more common with advancing age. growth (gr th) An increase in the size of an organism or part of an organism, usually as a result of an increase in the number of cells. Growth of an organism may stop at maturity, as in the case of humans and other mammals, or it may continue throughout life, as in many plants. In humans, certain body parts, like hair and nails, continue to grow throughout life. 1. a. The process of growing. b. Full development; maturity. 2. Development from a lower or simpler to a higher or more complex form; evolution. 3. An increase, as in size, number, value, or strength; extension or expansion: What Is Development? Answer: Development describes the growth of humans throughout the lifespan, from conception to death. The scientific study of human development seeks to understand and explain how and why people change throughout life. This includes all aspects of human growth, including physical, emotional, intellectual, social, perceptual, and personality development. The scientific study of development is important not only to psychology, but also to sociology, education, and health care. Development does not just involve the biological and physical aspects of growth, but also the cognitive and social aspects associated with development throughout life.

PATTERNS OF GROWTH AND DEVELOPMENT*Growth quantitative changes, measurable; increase inphysical appearance*Development qualitative change, cant exactly measure;ability to functionEx. Behavior, attitude, maturity, intelligence (MultipleIntelligence Theory of Howard Gardner) 1. Directionala. Cephalocaudal head to tail; head is developed first2 months of intrauterine life - head is the size of bodyAt birth head is biggest part of body; 1/3 of the body*head lag dont have control of head and neck*increased incidence of SIDS (sudden infant death syndrome) idiopathic, related to suffocation because of head lag*dont place baby at prone position prone position providegood sleeping pattern but head must be turned to one sidebecause the baby will not be able to breathe; contraindicatedwhen baby is 1-3 months*pillows hollow pillows are not allowed only thin pillows*2 months head will pull up together w/ body; diminishinghead lag*3 months absence of head lag expected; baby knows how toturn left to right; control of head and neck*4 months baby can turn body left and right; control chest*5 months willful/voluntary roll over; control of abdomen* BE: 6mos + head lag = cerebral palsyDevt screening test = DDST (Denver Developmental ScreeningTest) b. Proximodistal

*Proximo refer to midline; center*Distal peripheral, outerEx. Teeth: 1 st to erupt Central lower incisorsLateral incisorsCanineMolars18 months baby needs tooth brushing1 2 yrs oral care only because baby cant digest fluorideyet; water before and after meal feeding2 yrs old complete 18 deciduous teeth5-6 yrs old deciduous teeth will fall out18 yrs old ideally will have complete set of teeth* Age (months) 6 = estimated # of teeth the baby is having7 months first tooth erupts6 months teething starts; takes 1 month before teeth erupts c. General to specific - the child will master simple task 1 st before complicatedfunctioningEx. Language earliest sign of giftedness in childrenCrying 1 st evidence of babys language1 st 3hrs if not crying the baby may have problem speakingand crying*Coos and gurgles meaningless sounds*Babbling sounds kids playing with saliva*Mono syllables dada, mamaDada is first uttered than MamaBaba is first uttered*words, sentences, sing*speaking is easier than singing 2. Sequential - growth and development follow a predetermined sequenceEx. Ability to ambulate1 st evidence we can ambulate:1 . C r e e p i n g c h e s t a n d a b d o m e n 2 . C r a w l i n g - a r m s a n d knees3 . s i t w i t h s u p p o r t 4 . w / o s u p p o r t 5 . s t a n d w i t h support6.walk with support7.stand w/o support8.Walk w/o s u p p o r t 9 . r u n , h o p , s k i p , j u m p *developmental universal and individual; growth anddevelopment does not happen at same rate and paceEx. Increases in height* Period of accelerated growth and period of growth gap:1. Adolescent maturity of hormonesFor women increase in height happens before menarcheFor guys increase in height happens after SpermarcheSpermarche production of sperm; ability of guy to reproduceThelarche sexual devt; enlargement of breast2. Infancy - fastest*Sigmund Freudall human behavior is energized by psychodynamic forces,divided into 3 components of personality- Father of ____- proponent of psychoanalytic psychosexual theory*Components of Personality:1. ID- pleasure principle- requires immediate gratification*refers to infants- born with no ego and superego, purely ID, someoneconsidered to be Narcissistic, wont stop crying unless fed andcuddled; ID develops and peaks2. EGO- reality principle- develops during late infancy- peak: Toddler- toddlers are egocentric*Egocentrismuse of words such as I, Me, Im, MY- everything is directed towards them- MY: toddler are possessive borrowing of toys is a no no3. SUPER EGO- moral principle/arbitration- developed during preschool but does not peak- peak during School Agea. Ego Ideal do good and you felt goodb. conscience did bad and felt badtoddlers boastful liars; 6-12: honest*Principles of Growth and DevelopmentTODDLERHOOD- refers to age 1-3 P period of negativism, parallel play, push & pull toys (cart),phone, pounding toys R regression, ritualistic behavior A accident, Autonomy vs. Shame and Doubt I - independence S separation anxiety E egocentrism*most common word uttered is NO: No I can do this bymyself *Parallel Play refers to kind of play, 2 toddler are playing sideby side with no communication and sharing*Therapeutic play - if

done with nurse or therapistPush and pull toys cartsPhone toys increase vocabulary, 300 word vocabulary900 word preschoolPounding toys/boards hammers, given to minimize tempertantrumsTemper tantrums anxiety that could not be verbalized, limitedvocabulary, ignore temper tantrums*Expect a child to regress if:1. Ill2. Sick3. Hospitalized*Autonomy vs. Shame and Doubt*Ritualistic Behavior1. time we expect to learn how to make signs of the cross(2y/o); we learn to say simple prayers2. Time toddler will not sleep unless told of the same story overand over again*Accident leading cause of deatha. Infant: suffocationb. Toddler:Poisoning lock poisonsFalls - fencesDrowning dont leave child alone in CR*Autonomy struggle of child to be independent- eat alone, usually messy*Separation Anxiety - #1 fear of toddlers- fear of abandonmenthappens as early as infancy- peak at toddler- time we have diff. putting child to sleep- should be resolved by age 7*What to do: assure child youll be coming back, use meal timeas time*EGOI, me, my common words uttered, everything is directedtowards them*Elimination developmental milestone during this time isToilet training*When is the best time?18 mos. 2yrs or 18 mos.*How to know? Signs of readiness:1. sit, walk, squat2. complain discomfort3. baby will be able to control urination: dryness for 2hrs.before defecationUrination precursor to defecationOC disorder problems in toilet training*Constantly appreciate effort; praise & recognize for them toachieve autonomy.

The Nutritional Needs at Every Stage of Human Growth & Development Your requirements for nutrients and energy are complex and vary over your life span. We all require the same basic nutrients, but your amount needed varies based on your age, gender, body size, genetic traits, growth, illness, lifestyle, medications and conditions such as pregnancy and lactation.

Adult Nutrition and dietary habits during adulthood can affect your risk of chronic diseases. Nutritional focus at this stage changes from growth and development to maintenance and physiological health. Nutrients of concern for adults include protein, vitamin D, vitamin B12, calcium, iron and omega-3 fatty acids. Aging Older adults experience decreased absorption of vitamin D and vitamin B12 and increased storage of vitamin A and iron. Older adults need more nutrient-dense foods because they consume less but have greater nutritional needs. Older adults generally do not consume enough vitamin E, folic acid, calcium and magnesium.

factors Affecting Fetus Development Photo Credit pregnant image by TEA from Fotolia.com Many factors can affect the development of a fetus. Environmental agents that can negatively affect prenatal development are called teratogens. Teratogen exposure tends to be most detrimental during the first trimester (the first three months) of pregnancy, when formation of the organs and brain occurs. However, some substances, such as alcohol, can have an effect at any point in pregnancy.

Socio-economic factors affecting child development: Children of affluent parents have better growth due to better nutrition and hygienic conditions than those of low socioeconomic status. b) Cultural factors affecting child development: Child-rearing practices vary in different communities, which may significantly impact childs growth. Routine practice of breast- feeding is a positive growthpromoting factor, while delayed weaning, food taboos and unhygienic living conditions are important adverse cultural influences in India. Factors affecting pre-natal development Maternal nutrition Foetus gets the nourishment from maternal blood stream through placenta, so the mothers diet should contain necessary nutrients, like proteins for tissue building and repair, fats to form tissues, etc. 2. Mental health Substances that can harmfully affect pre-natal development are called tetrarogens, which may either cause physical or mental abnormalities. Some diseases, if contracted by the mother, are believed to be tetratogence. A disease causing virus can be transmitted from the mothers blood stream to the babys if it is small enough to pass through the placental screen. 3. Bacterial infections Bacterial infections may also cross the placental screen, one such infection, toxoplasmosis, has recently been blamed for some cases of congenial brain damage and blindness. 4. Drugs Drugs are other chemicals that can filter through the placenta into the blood stream of foetus. The risk is greater during the early stages of pregnancy, when development is progressing more rapidly. 5. Smoking The nicotine in cigarettes is thought to contract the blood vessels in the uterus and placenta. This interferes with the delivery of oxygen and nutrients to the foetus. 6. Alcohol When consumed in moderate amounts, alcohol has no ill effects. But if the mother drinks excessively, she is likely to give birth to a small baby with retarded motor development. 7. Emotional state of mother Emotions can temporarily affect the child. The activity level of the foetus is increased when the mother is emotionally upset. Difficulty of labour and delivery is also related to the mothers level of tension during the preceding months.

8. Maternal age Those woman who are below 21, have chances of miscarriage, still births, and foetal malformations. The reason is that the reproductive organs of the female are not fully mature. Aging Signs and Symptoms However symptoms of aging may vary on an individual features for each person, the most common of them have been gathered. In facts, only your health care provider can perform adequate diagnosis of symptoms and determine whether they are indeed symptoms of aging. Common Symptoms of Aging: - Graying hair - Menopause - Balding - Skin changes - Slight memory loss - Minor memory loss - Reduced eyesight - Loss of hearing - Vaginal changes - Wisdom - Slight mental decline a minor loss of mental acuity is natural; a large loss might be a disorder like Alzheimers The most common external signs of aging involve the skin, hair, and nails. Skin: Over time, the skin loses underlying fat layers and oil glands, causing wrinkles and reduced elasticity. Other contributing factors are nutrition, exposure to the sun, heredity, and hormones. Hair: The hair loses its pigmentation and turns gray. Thinning or hair loss is a part of the aging process too. Nails: The nails become thicker due to reduced blood flow to the connective tissues.

Psychosocial_Aspects_of_Aging.ppt

PSYCHOSOCIAL ASPECTS OF AGING AGING IN AMERICA OLD AGE AND THE ELDERLY HAVE A VARIETY OF EXPECTATIONS AND NAMES. . . .FEW ARE POSITIVE GEEZER BORING OLD BATTLE-AX USELESS OUT OF TOUCH SMELLY SENILE RESPECTED DEMENTED TWILIGHT YEARS EMPTY YEARS GOLDEN YEARS TIME OF OUR LIFE TIME OF LOSS TIME OF PAIN DEPENDENT DEMANDING LOSS OF AUTONOMY THESE CAN ALL REPRESENT ELDERLY PEOPLE WHOM WE KNOW, BUT THEY DONT REPRESENT ALL ELDERLY Elderly are as diverse a group as any other age group The affect of aging on each persons life

is dependent upon that unique individual some generalizations can be made about attitudes of aging based on a persons cultural background. . . . . . . EUROPEAN-AMERICAN CULTURE AND AGING Growing old is generally feared Elderly are not often respected nor revered Nuclear families do not include the elderly Ageism at times is practiced Elderly often seen as sick, senile, and useless ASIAN/AMERICAN CULTURES REACT DIFFERENTLY TO ELDERLY Have great respect for the aged extended families include elderly Big family decisions required everyones input HISPANICS FUNCTION WITHIN STRONG EXTENDED FAMILY UNITS, TOO Very similar to Asian families in their devotion to extended family Elderly have tremendous influence over family decisions AFRICANAMERICAN FAMILIES HAVE DIFFERENT DYNAMICS Grandparents often raise their grandchildren The extended family often includes church members MYTHS OF AGING INVESTIGATING - MYTHS THAT EXIST IN AMERICAN CULTURE MYTH 1: AGE BRINGS ILLNESS AND DISABILITY Over past few decades chronic disease less common 3/4 of those 75 - 84 years old report no disability Twin studies show only 1/3 of elderlys health problems due to heredity Age brings greater risk of disease MYTH 2: CHANGE OF HABITS WHEN ONE IS OLDER RESULTS IN NO PHYSICAL BENEFIT Change in habits adds years Cardiovascular fitness is up 10 - 30% with aerobics Strength of 80 - 90 year olds tripled with body building Exercise cuts death rate 25 - 50% Osteoporosis less with strengthening exercises MYTH 3: AGING MEANS REDUCTION IN MENTAL SHARPNESS 20% of elderly suffer from Alzheimers 50% have some cognitive decline Basic Physiological Changes Associated with Aging The Basic Rule is that by age 70, organ systems and organ functions diminish by 50%. Clinical observations support this basic rule in that pulmonary function, cardiac output, liver function, and kidney function all diminish by age 70 to about 50% of that observed at age 25. Secondary aging increases the rate of diminishing function observed in the basic rule. Aging is a normal process as disease and disability are disruptions. Aging produces a change in the ability to participate in physical activity which is accelerated beginning at approximately age 50. This is due to multiple factors which results in an increased difficulty for delivering oxygen to the tissues of the body. Decreased chest wall elasticity results in the moving of adequate air more difficult, thus more energy is expended to obtain additional oxygen required for exercise. There is decreased ventilation to perfusion ratio. The amount of available blood output from the heart to supply the skeletal muscles is decreased as well. There is an actual decreased in skeletal muscle mass. Weight changes with aging are not totally predictable but in general, a person tends to gain weight up to about age 60 and then weight tends to steadily diminish. There is a change in body composition during this time with a decrease in lean muscle mass and an increase in body fat percentage. This change tends to occur throughout old age. This has implications for use of systemic medications and dosage. This is especially true when coupled with the expected decrease in vital organ function. Katz Index of Independence in Activities of Daily Living (ADL)

BEST TOOL: The Katz Index of Independence in Activities of Daily Living, commonly referred to as the Katz ADL, is the most appropriate instrument to assess functional status as a measurement of the clients ability to perform activities of daily living independently. Clinicians typically use the tool to detect problems in performing activities of daily living and to plan care accordingly. The Index ranks adequacy of performance in the six functions of bathing, dressing, toileting, transferring, continence, and feeding.

Clients are scored yes/no for independence in each of the six functions. A score of 6 indicates full function, 4 indicates moderate impairment, and 2 or less indicates severe functional impairment. TARGET POPULATION: The instrument is most effectively used among older adults in a variety of care settings, when baseline measurements, taken when the client is well, are compared to periodic or subsequent measures. VALIDITY AND RELIABILITY: In the thirtyve years since the instrument has been developed, it has been modied and simplied and different approaches to scoring have been used. However, it has consistently demonstrated its utility in evaluating functional status in the elderly population. Although no formal reliability and validity reports could be found in the literature, the tool is used extensively as a ag signaling functional capabilities of older adults in clinical and home environments. STRENGTHS AND LIMITATIONS: The Katz ADL Index assesses basic activities of daily living. It does not assess more advanced activities of daily living. Katz developed another scale for instrumental activities of daily living such as heavy housework, shopping, managing nances and telephoning. Although the Katz ADL Index is sensitive to changes in declining health status, it is limited in its ability to measure small increments of change seen in the rehabilitation of older adults. A full comprehensive geriatric assessment should follow when appropriate. The Katz ADL Index is very useful in creating a common language about patient function for all practitioners involved in overall care planning and discharge planning.

The minimental state examination (MMSE) or Folstein test is a brief 30-point questionnaire test that is used to screen for cognitive impairment. It is commonly used in medicine to screen for dementia. It is also used to estimate the severity of cognitive impairment at a specific time and to follow the course of cognitive changes in an individual over time, thus making it an effective way to document an individual's response to treatment Category Orientation to time Orientation to place Registration Attention and calculation Recall Possible points 5 Description From broadest to most narrow. Orientation to time has been correlated with future decline.[4] From broadest to most narrow. This is sometimes narrowed down to streets,[5] and sometimes to floor.[6] Repeating named prompts Serial sevens, or spelling "world" backwards[7] It has been suggested that serial sevens may be more appropriate in a population where English is not the first language.[8] Registration recall

5 3

Language Repetition Complex commands Interpretation

2 1 6

Name a pencil and a watch Speaking back a phrase Varies. Can involve drawing figure shown.

Any score greater than or equal to 25 points (out of 30) is effectively normal (intact). Below this, scores can indicate severe (9 points), moderate (10-20 points) or mild (21-24 points) cognitive impairment.[9] The raw score may also need to be corrected for educational attainment and age.[10] Low to very low scores correlate closely with the presence of dementia, although other mental disorders can also lead to abnormal findings on MMSE testing. The presence of purely physical problems can also interfere with interpretation if not properly noted; for example, a patient may be physically unable to hear or read instructions properly, or may have a motor deficit that affects writing and drawing skills. the Geriatric Depression Scale (GDS) is a 30-item self-report assessment used to identify depression in the elderly. the GDS questions are answered "yes" or "no", instead of a five-category response set. This simplicity enables the scale to be used with ill or moderately cognitively impaired individuals. The scale is commonly used as a routine part of a comprehensive geriatric assessment. One point is assigned to each answer and the cumulative score is rated on a scoring grid. The grid sets a range of 0-9 as "normal", 10-19 as "mildly depressed", and 20-30 as "severely depressed". Clinical Assessment Scales for the Elderly The Clinical Assessment Scales for the Elderly, often abbreviated as CASE, is a diagnostic tool used to deter mine the presence of mental disorders and other conditions in elderly adults.

Social Aspects of Aging ing is an inevitable stage that all people go through. Just like any other stage, this is also one that has several social aspects. If you want to know what they are, continue reading this article because this will provide you with the information you need. In accordance with a study conducted by experts, the needs of old people dont vary much with the needs of people in other age brackets. For them to have that social security, there are several factors that affect it. The following are the social aspects of older people that must reveal their self-worth and assurance in life: hobbies and activities that will make them feel their worth, good relationship with neighbors, family and friends, accessibility of vital services and commodities, good health, financial security and secure housing as well.

But even though diversity is apparent, there is one thing in common in all the nations of the world. That is the government support for the elders. This will make them secure so that their worries will lessen on how to cope with the world and its systems. Manipulative Personality Social Traits Social manipulative personality traits are quite easily spotted once you know what you are looking for and given the right context.Manipulative people follow a pattern of behavior and cling on to their habits more than any other types of persons, because they have a limited insight into their own inner workings and act more out of instinct than anything else. Specialists have identified a number of manipulative personality traits that manipulators possess. Some specialists believe that a person needs to have at least five basic manipulative traits in order to be considered a manipulator. It is not healthy labeling humans so easily, yet, with careful study, it is relatively clear when a person has a manipulative personality and what traits their personality has. Being a socially healthy person means that you interact with others well, with confidence. EFFECTS ON THE CARDIOVASCULAR SYSTEM Some changes that may occur in the cardiovascular system are a decrease in the elasticity of the blood vessels and heart valves, restricted blood flow due to the thickening of the vessel walls and because of the fatty deposits lining the vessels, and a decrease in the ability of the heart to pump out as much blood with each beat. As a result, you may feel fatigued, become short of breath more easily and have less capacity for physical exertion. To counteract some of these effects, maintain a normal weight, exercise regularly, stop smoking, reduce salt, sugar and fatty foods in your diet. If you do this, you will be able to tolerate natural changes more easily and still live a normal life, as well as help to deter the development of heart disease.

EFFECTS ON THE RESPIRATORY SYSTEM Decreased elasticity of the lungs may occur with aging. This may affect your lung's ability to utilize oxygen, as well as your ability to cough and take deep breaths. You may be more prone to fatigue and shortness of breath on exertion, and become more susceptible to infections. Once again, a regular exercise program and quitting smoking will help. Also ask a health adviser about diaphragmatic breathing. You can use these techniques to increase your lung capacity more efficiently. EFFECTS ON THE MUSCULAR SYSTEM

There tends to be a gradual loss of muscle tone, elasticity and strength. In some areas, the muscle is often replaced with fatty tissue leaving you with little rolls or soft, flabby spots. But what is more significant is that your endurance or strength to perform certain tasks may also decrease. A balanced diet and regular exercise may improve muscle tone and strength. Adapt to decreased muscle strength and endurance and do not try to do everything yourself and give yourself more time to accomplish a task.

EFFECTS ON THE SKELETAL SYSTEM The skeletal system gradually changes over the years until it is porous and brittle, as the bones lose calcium and also their density. This may be more pronounced in women. As a result, you may become more prone to fractures, notice a decrease in height or even develop a stoop in your posture. To retard this process, eat a diet high in calcium and vitamin D. Ask your doctor whether you would benefit from calcium and vitamin D supplements. Also, moderate amounts of exercise such as walking and exercising on a stationary bicycle are helpful and prove to be very enjoyable. EFFECTS ON THE METABOLIC SYSTEM There may be a gradual decline in the activity of the thyroid gland, as well as decline in the ability of the pancreas to produce insulin. As a result, there is a decrease in the body's ability to use fats and sugars and to convert them into energy. You may note an increase in weight, an increased blood sugar level when you go to the doctor, who may tell you that you have adult onset diabetes. You may find a decrease in energy as well as decrease in your ability to handle stress. Reduce your caloric intake, avoid junk food, reduce your sugar and fat intake, and exercise regularly. EFFECTS ON THE DIGESTIVE SYSTEM The digestive tract is a very resilient system, but there are some changes that occur which may cause you some distress. There is a gradual slowing of the system as well as a decrease in the secretion of saliva and enzymes which are necessary for digestion. As a result, there may be problems with indigestion, elimination and adequate absorption of nutrients. Eat a balanced diet, high in fibre and fluids. Avoid eating heavy meals. In fact, small, frequent meals eaten slowly enhance the digestive process. EFFECTS ON THE NEUROLOGICAL SYSTEM What happens here is, the messages take a slightly longer time to pass from the nerves to the muscles, and the muscles take a slightly longer time to react to these messages. So take this into consideration while doing things that require a quick response. Also, there may be a decrease in the perception of pain and an increase in the time to react to it. This may seem like a blessing at times; after all, it would be nice for injuries and aches not to hurt so much. Problems may arise, however, if you put off going to the doctor for something that hurts you because it does not seem too bad.

Become attuned to your body and what you are feeling and have anything unusual checked out by a doctor. There is also a change in the wake-sleep cycle. You may find yourself not sleeping as much at night. This may be nothing to worry about. You may sometimes need to rest during the day and need less, deep sleep at night. EFFECTS ON THE GENITOURINARY SYSTEM The ability of the kidneys to filter and reabsorb may also decrease. Also, men show a tendency towards prostate enlargement while women have hormonal changes that may cause vaginal itching and burning, making intercourse uncomfortable. Frequent check-up and contact with your doctor when symptoms appear are important. EFFECTS ON THE SENSORY SYSTEM There is a gradual decrease in the overall sensual acuity of the body. Your sense of touch is decreased, as is your ability to hear some high-pitched sounds. You may notice a decrease in the ability to smell and a loss of some of the sweet and salty taste buds. The lenses of your eyes lose some of their ability to accommodate, so you may find yourself reading at arm's length. The size of the pupil also decreases, sometimes making it harder to adapt to dim light. There may also be a yellowing of the lens, and decrease in colour perception. Simply ask people to speak slower and in a lower tone. Add colour, variety, and seasonings besides salt to your food to make your meals more appealing. Decreasing the glare while increasing the light helps you to see more clearly. If colour differentiation has become a problem or if things look rather dull, try adding touches of bright colours, such as oranges and reds to your home and wardrobe. EFFECTS ON THE HAIR, SKIN AND FACE Turning grey is one of the most obvious changes that occur with age. Most people past thirty express some dissatisfaction if not dismay with what is happening to their hair. Amongst men and women, the hair begin to grey in the late twenties and thirties. Almost everyone has grey hair by the age of forty, although, as with every other aspect of aging, there are distinct variations within the family and ethnic groups. One possibility is to dye your hair with one of the safe, vegetable based dyes or rinses now available in the market. This is preferred to aniline (coal tar) based dyes, as prolonged use over the years may cause bladder cancer or leukaemia. Vision As you age, the ability of your eye to refract light changes as the aging process gradually changes the curve of the lens and the retina. Common vision problems that generally start to occur by your mid-40s or early 50s include presbyopia, or an inability to read small print or objects close to your eyes. Joints As you age, your joints may cause you pain and stiffness. This is because the ends of your bones wear down over time and often rub together. Padding-like connective tissues, sacs and discs found between many joints in the body, including the spinal vertebrae, the knees and the fingers simply wear out and

don't protect the joints anymore. Medical conditions like arthritis and osteoporosis are common joint conditions experienced by older people whose joints become swollen, painful, still and inflamed

Health Status Assessment for Elderly Patients

1. A brief but systematic assessment of functional status should be incorporated into the routine medical management of elderly patients, because of its demonstrated usefulness. 2. Future research should emphasize the development of detailed clinical information about the natural history, differential diagnosis, and management of functional disability. 3. Undergraduate and postgraduate medical programs should teach diagnostic and patient management skills related to functional disability to all physicians. 4. Reimbursement mechanisms to pay for performance of functional status assessments should be developed. Health status has been assessed on the basis of the following epidemiological parameters: information on illness and health problems, hospitalisation, disability, mobility, and body weight, depression, limited life enthusiasm, assessment of satisfaction resulting from contacts with other persons, identification of problems connected with ageing. Activity has been assessed on the basis of responses to the open and closed questions. The statistic tests: Chi 2, logistic regression, Pearson's correlation were used.

Memory Loss in Elderly

memory loss associated with the aging process normally begins with an awareness of being forgetful and progresses gradually. The alterations in memory develop as a consequence of diminishing nerve cell activity in the brain. Memory problems can remain mild with no change in the ability to manage daily living functions.

Mild Cognitive Impairment

Another common disorder in the elderly, referred to as mild cognitive impairment, has the primary symptoms of mild memory loss. Those with the disorder continue to function well with daily activities, require a little extra time to recall memories and maintain the ability to learn new skills. Problems with serious memory loss or development of dementia are not associated with mild cognitive impairment.

A more serious memory problem is one that affects a persons ability to carry out everyday life activities such as driving a car, shopping or managing money. Some of the signs are:

Alzheimers is the #1 Cause of Memory Loss in the Elderly

With Alzheimers disease, the signs begin slowly and get worse over time. Some of the early signs are:

simple forgetfulness; difficulty with understanding directions; asking the same questions.

Visual impairment limits the elderly Visual impairment is an important cause of activity limitation and disability among the elderly. Approximately 1.8 million noninstitutionalized elderly report some difficulty with basic activities such as bathing, dressing, and walking around the house, in part because they are visually impaired. Visual impairment increases the risk of falls and fractures, making it more likely that an older person will be admitted to a hospital or nursing home, be disabled, or die prematurely. Cataracts were most prevalent among older women Cataracts, a clouding of the lens of the eye, are a leading cause of visual impairment in the elderly. According to the National Eye Institute, over half of all Americans aged 65 years and older have cataracts. In the early stages, they do not seriously impair vision. Then as vision begins to worsen, corrective lenses can often be used to improve vision. If vision becomes too impaired, cataract removal surgery is performed. Glaucoma was twice as common among black elderly as it was among white elderly Glaucoma is irreversible damage to the optic nerve caused by increased pressure in the eye. It is an insidious, slow-progressing disease that if left untreated can cause irreversible blindness. In 1984, about 5 percent of the non-institutionalized elderly population reported having glaucoma. In 1995, the rate had risen to approximately 8 percent. The National Eye Institute (NEI) estimates that half the people who have glaucoma are unaware of their condition. Hearing impairment also limits the elderly Like visual impairment, hearing impairment diminishes the quality of life for older individuals. 6,7 Uncorrected hearing impairment can lead to social isolation,8 cognitive decline,9 and decreased mobility. Hearing loss can be caused by:

Exposure to loud noises over long periods of time Smoking11 A history of middle ear infections12

Certain chemicals. For example, long duration of exposure to trichloroethylene has been linked to hearing loss.

This study showed that elderly persons with age-related macular degeneration were more than three times more likely to have an age-related hearing loss than others!

Chronic illness among elderly

Coronary heart disease, osteoporosis and dementia are just some of the conditions that more and more people will be battling with in later years, according to data from the charity Help the Aged.

Serious chronic illnesses are a major health issue in modern society. Any illness is called "chronic" if it is long-lasting or even lifelong. The opposite of chronic is "acute", referring to diseases that come on quickly and often do not last long (if they last, they are said to become "chronic"). In the USA, more than 90 million people have a chronic illness, and the top 5 chronic illnesses (heart disease, cancer, stroke, COPD, and diabetes) together cause more than two-thirds of all deaths