Cognition - Exam 2 reading notes pdf
Cognition - Exam 2 reading notes pdf
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Psych M l 190 Review Topics Weeks 12 0 Compression of Morbidity what is it and how is it related to geriatric medicine Compression of Morbidity is a hypothesis put forth by James Fries Fries hypothesis is that the burden of lifetime illness may be compressed into a shorter period before the time of death if the age of onset of the rst chronic in rmity can be postponed o Modi able behaviors Modifying your behaviors modi es your trajectories Modi able healthy behaviors during the early elderly years including smoking abstinence weight management blood pressure control and regular exercise are linked to enhanced life span in mea as well as to good health and function during older age 0 Cross sectional vs Longitudinal studies age effects vs cohort effects Cross sectional studies compares people at different ages all at one time Disadvantages can t separate cohort and age effects Apparent differences related to affe may be cohort differences Most data on aging is cross sectional Need to be concerned about cohort differences Longitudinal studies compare the attributes of the same people as they change over time Disadvantage Expensive Dif cult to do Time Consuming Selective sampling Selective drop out of participants Retest effects Can t separate age and time effects can t generalize to earlier or later born cohorts who live through different times or through same times at different ages Most ef cient Use both cross sectional and longitudinal sequences Compare longitudinal and cross sectional ndings If ndings are similar closest one can come to age related change If ndings differ look for cohort differencesother factors that might eXplain difference 0 Demographic Transition what is it and how does it change population pyramids three stages Demographic transition looks at the changes in a population s are structure from a young to a middle age to an old population refers to the transition form high birth and death rates to low birth and death rates as a country develops from a pre industrial to an industrialized economic system Shows population from 1900 s gt 21st century Women have longer life eXpectancies which becomes prevalent at older ages Global changes mirror US changes in terms of shape and the women skew Demographic transition in stages happens in the presence of industrialization stages don t occur in countries that are under or non developed I High fertility rateshigh death rates 11 High fertility ratesdeclining death rates 111 Low fertility rateslow death rates Stage II is where we see population shift as it becomes a rst world county and we see increasinghigh fertility rates and death rates declining FERTILITY AND MORTALITY The equation for what affects a population s are structure pyramid l Fertility rates live births in a year women aged 15 44 2 Mortality rates deaths in a year people in a population Psych M l 190 Epidemiological Transition explaining Demographic Transition in terms of what changes how Epidemiological Transition is the study of patterns of mortality and morbidity in populations morbidity any ill health excludes death 1 Explains the demographic transition in terms of changes in causes of death 2 Causes of death change from infectious and malnutrition diseases to chronic diseases Stages of the Epidemiological Transition Changes in leading causes of death I Predominantly infectiousmalnutrition diseases II Decline in malnutritioninfectious diseases Increase in chronic diseases III Predominantly chronic diseases Transitions and Stages Compared Demographic Transition Epidemiological Transition I High fert High mort Infectious malnutrition epidemics famine II High fert Decl mort Declining infectious diseases III Low fert Low mort Increasing chronic diseases heart diseases cancer stroke Epidemiological Transition is a phase of development witnessed by a sudden and stark increase in population growth rates brought about by medical innovation in disease or sickness therapy and treatment followed by a re leveling of population growth from subsequent declines in fertility rates accounts for the replacement of infection diseases by chronic diseases overtime due to expanded public heath and sanitation The epidemiological transition occurs as a country undergoes the process of modernization from developing nation to developed nation status The developments of modern healthcare and medicine like antibiotics drastically reduces infant mortality rates and extends average life expectancy which coupled with subsequent declines in fertility rates re ects a transition to chronic and degenerative diseases as more important causes of death 0 Sex Ratio de nition and how it s changing Sex Ratio is the ratio of males to females in a population There is a gender imbalance Sex ratio applied to adults over 65 years old 1950 90 men in 100 women 2000 60 men in 100 women 0 Age cohorts Society is comprised of age cohorts a group of people born at the same time and thus share life experiences Age cohorts are the changing force of society 0 Lifecourse what is it A life course is de ned as a sequence of socially de ned event and roles that the individual enacts over time Psych M l 190 Life course perspective refers to an approach developed in the 1960 s for analyzing people s lives Within structural social and cultural contexts 0 Stages of physical mental development Lifecourse Theory Development of the individual that occurs With chronological aging Changes in ability to interact With enviornment physically and mentally Stages of physical and mental development gt Infant toddler child adolescent gt Young adult middle age adult older adult gt Achieve developmental milestones gt Order each stage building on the previous 0 Erickson s Stage theory Dilemma and Social Focus First to systematically analyze adult development of the conscious self the ego over the life course Development proceeded in stages Each stage characterized by a speci c developmental dilemma Stage Age Developmental Dilemma Social Focus 1 Birth 12 months Trust vs Mistrust Maternal person 2 18 months 2 years Autonomy vs ShameDoubt Parental persons 3 3 to 6 years Initiative vs Guilt Family 4 6 years to puberty Industry vs Inferiority Neighborhood school 5 Puberty to young adulthood Identity vs Role confusion Peers 6 Young adulthood 2030 Intimacy vs Isolation Partners in friendship sex love 7 Middle adulthood 3060 Generativity vs Stagnation Household Workplace 8 Old age 60 Integritywisdom vs Despair Humankind Main points of Erikson s Stage Theory gt Personality development is not completed in childhood gt The self is dynamic throughout the life cycle gt Personality is shaped by interaction With people in different settings throughout the life cycle gt Resolving each crisis positively sets the stage for future growth 0 Life course as a response to Erickson Controversial aspect of theory b Broad generalizations based on small samples b Descriptive less detailed formulations of processes for resolving developmental dilemmas b Cross cultural validity b Developmental changes vary by sociocultural factors Psych M l 190 b Linear and irreversible order of stages Life course theory incorporates sociocultural and sociohistorical factors that in uence psychosocial development 0 Five principles of Lifecourse Theory 1 2 3 4 5 The principle of life span development The principle of agency The principle of time and place The principle of timing The principle of linked lives 0 Psychosocial theories of successful aging Micro focus on individual Level Theories Three attempts for a grand theory Disengagement theor an inevitable process in which many of the relationships between members of the society are severed and those remaining are altered in quality 1961 Elaine Cumming amp William Henry aging is an inevitable mutual withdrawal or disengagement resulting in decreased interaction bw the aging person and others in the social systems he belongs to A gradual withdrawing from roles due to lessened capabilities and diminished concern Describes changes in aging in terms of high morale Explanation of the physiological psychological and social changes that are associated with the process of normal aging Bene ts both society and individual Severance of ties makes it less likely that individual s death will be disruptive to social system Normative expectation of decreased engagement allows indiv to maintain self worth in the face of declining opportunity and ability for engagement Indiv has time to attend to inner life Fails to consider the cultural shift with old age Equates success with high morale Criticisms of the disengagement theory high morale can be achieved by other means faced criticism since the theory was proposed as innate universal and unidirectional Led to the development of the Activity Theory Activity theory higher activity leads to higher satisfaction optimal aging 1964 Robert Havighurst 1968 Havinghurst Neugarten and Tobin Describes changes in aging Except for the inevitable changes in biology and heath older people are the same as middle aged people and have the same psychologic and social needs Stability of interests throughout life Any observed decrease in social interaction at old age is forced upon the older adult by society against hisher will Role loss is not inevitable To achieve optimalsuccessful aging an older adult should replace his lost activities and roles by new ones Successful aspect of theory roles can be replaced role continuity theories not mutually exclusive Psych M l 190 Criticism It isn t suf cient enough to just partake in higher activity a heightened level of activity is needed but it needs to be engaging and ful lling rather than just busy work Criticism overlooks inequalities in health and economics that hinders the ability for older people to engage in such activities Criticism some older adults do not desire to engage in new challenges Fails to consider maintenance of one s mid life or changes that are made when entering retired or older life Instead maybe another theory needed that looks at the lifespan instead of just older age Continuity theory Older adults attempt to preserve existing internal structure self self esteem identity and external structures activities role relationships and environments when they adapt to changes Describes changes in aging individuals who age successfully continue habits preferences lifestyle and relationships through midlife and later 1989 Robert Atchely Developed in response to both disengagement and activity theory Continuity coherence or consistency of patterns over time adaptive strategy for successful aging Continuity of personality preserve self in the face of other changes Continuity of activities prevent offset or minimize other effects of aging Continuity of relationship preserve social support system Criticism de nition of normal aging distinguishes normal aging from pathological aging neglecting older adults with chronic illness consider people who have unhealthy habits preferences and the like in their middle age these people are aging poorly in their midlife and will continue to deteriorate in older age with their poor lifestyle Weakness fails to demonstrate how social institutions impact the individuals and the way they age Role Theory perspective that considers most of everyday activity to be the acting out of socially de ned categories and role transformations Each social role is a set of rights duties expectations norms and behaviors that a person has to ful ll Roles de ne our social and self identities Eligibility for some roles determined by chronological age The appropriateness of roles is evaluated by chronicle age Social expectations about methods of role enactment is shaped by chronological age Role Transformations Role adoption Role loss Role discontinuity Role exit Later adulthood as a roleless role gt de ne those that view roles that were meaningful to them eg spouse friend are gone Age norm informal rules that specify age appropriate roles and behavior socialized Psych M l 190 Social clock prescriptive timetable for the timing of major life events 9 6 9 6 too young too old to act you age age appropriate Age Norms for major life events comparing 1960 1998 increased avg age Socialization lifelong process by which individuals learn to perform roles adjust to changing roles relinquish old ones and learn the appropriate timing of roles Mezzo interface of individual and society Level Theories person environment interactions concerned with Social Phenomenology socialized perspective of aging Symbolic Interaction perspective interactions bw individuals and their environment shape individuals perceptions of the aging process and themselves proposes that age is socially constructed and determined by symbols resembling social interactions proposes being deemed old or young is a social construction as an elder shape views of yourself as younger shape views of elder Policies and programs can modify both individuals needs and societal constraints Cooley Mead Thomas Social Exchange Theory social constructionism explains interaction of aging individuals with others in society Economic Theory Social interaction bw individual is based on rational calculation People seek to maximize rewards and minimize costs gains gt pains Individuals will continue to engage in exchange as long as the bene ts outweigh the costs Hypothesis social interactions bw young and old degrease because older people have fewer resources to bring to the exchange Declining resources strain the possibility for continued interaction w others Makes having relationship harder bc resources often unequal and individuals will only continue to engage in exchange resources if bene t of relationship outweigh cost of exchange Critique theory fails to recognize distinction bw immediate exchange strategies and deferred exchange strategies where Immediate exchanges of goods amp services that occur at one point in time Deferred exchanges that occur over the life course support bank multigenerationally e g parents take care of you when you where sick so you feel the need to care for them Social Constructivist Theories The individual and the social system explains individual processes of aging as in uenced by the social construction of age and aging and the social meanings of age as organized by the context within which they take place The world is composed of meanings and not of things Individual understanding of age affected by social context Social Phenomenology of Aging how is our understanding of aging in uenced by social de nitions and social structures Post modernist theories of aging take this concept to the extreme objective truth is impossible Psych M l 190 Macro truth is variable Age and Social Status Level Theories Modernization Theory with increasing modernization the status of the aged relative to the non aged in the society declines 1974 Cow gill given the constant rapid change that characterize modernization the young have to be socialized for an unknown future and therefore the older generation looses its earlier socializing role as their experiences become obsolete Residential segregation due to geographic mobility Generational competition due to increased longevity Education disadvantages due to mass education Modernization process of transformation of a total society which includes interrelated processes 1974 Cowgill application of health technology urbanization and geographic mobility increased productivity and modern economic technology industrialization rising levels of education Age Strati cation Theory 1988 Riley Foner and Waring explains that every society is strati ed by age and that age is an organizer of social structure and social interaction Society is comprised of age cohorts Age cohort a group of people born same time and thus share life experiences Age cohorts are the changing force of society Age Segregated Institutions Young adults at school Middle aged at work Older adults leisure 0 Biological Theories of aging free wear and tear cellular aging immunological theory cross linkage radical mitochondrial DNA mutation Focus on the cellular level wear and tear cell membranes become more viscous with age cellular aging immunological theory immune system is programmed to decline over time leads to increased vulnerability to infectious diseases amp thus aging and death cross linkage excess glucose causes cross linking of proteins an accumulation of cross linked proteins damages cells and tissues slowing down bodily processes resulting in aging Recent studies show that cross linking reactions are involved in the age related changes in the studied proteins Psych M l 190 free radical superoxide amp other free radicals cause damage to the macromolecular components of the cell giving rise to accumulated damage causing cells and eventually organs to stop functioning mitochondrial DNA mutation DNA mutations build up in non dividing cells and accumulate With increasing age causing cells to deteriorate and malfunction Damage to mDNA might lead to mitochondrial dysfunction Therefore aging results from damage to the genetic integrity of the body s cells aging cells get less exible due to changes in fat rafting stiffening up cell membrane around receptor protein break down fat in ammation fall apart worn down Easily oxidized fats causes massive immune response atherosclerosis hardening and loss of integrity in ammation gtk250 g carbsday lead to diabetes by end of year Long term effects poor lipid metabolism insulin levels spike and stay high 0 Telomeres and Telomerase Telomere shorten With each successive cell division play role in aging by adjusting cellular response to stress and growth stimulation on the basis of pervious cell divisions and DNA damage Telomerase restore telomeres to the end of chromosome the level of telomerase activity is important in determining telomere length in aging cells and tissues present in gt85 of tumors high in stem germs and activated immune cells End replication problem very end of chromosome isn t completely copied during cell division 0 Replicative Senescence stop replicating Senescence aging o Hay ick Limit human cells ability to divide is limited to approx 50 times after Which they simply stop dividing related to life span of species may be related to shortening of telomeres probably evolved as anti cancerous Fibroblasts Why are they important in context of senescence as well as cancer 0 Antagonistic pleiotropy Markers of aging that are similar to some changes in HIV 0 Progression of Cancers several things needed for cell to become cancer 0 Largest risk factor for cancer Other carcinogens things that play a role in cancer 0 How big a problem is cancer in elders A leading cause of death What types Modi able or non modi able risk factors in cancers 0 PSA tests What do they test for Why is there controversy for these tests 0 Immune system and cancer 0 Ethical issues of treating cancerSensory systems What are they Why are they important Psych M l 190 What are transduction areas of vision What are a couple ways it fails What other changes occur in the eye vision Glaucoma vs Cataracts vs AMD AMD wet vs dry What might be a cause of tinnitus Different role of inner and outer hair cells Risks of changes in taste and smell Language laterality and long term risks of langauge loss with stroke How does growth hormone change with age What is osteoporosis Osteopenia What hormones are involved Down regulation suppression of endogenous hormones with supplementation Sarcopenia changes in lipid water skeletal muscle mass Changes in skin with aging Cardovascular changes in aging Atherosclerosis vs Arterioslcerosis Role of cholesterol in Atherosclerosis Stages of Atherosclerosis Myelination throughout the lifecourse Big neurotransmitter changes ACh DA Brain control of motor systems where Hyper Hypo movement Parkinson39s etiology and general sympoms Huntinton39s genetic component EEG vs ERP vs QEEG How does EEG change with age What effect does this have EEG in different stages of sleep SWS vs REM Paradoxical sleep Circadian changes later in life Strategies for re regulating sleep
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