Neuropsychology of aging and dementia
Summary
WEEK 1
CH1: INTRODUCTION: OLDER PEOPLE UNDER THE MAGNIFYING
GLASS
1.1 What is Gerontology
Gerontology = study of human aging
Marcus Tullius Cicero – against idea that age is nothing more than
withdrawal from work, reduction in strength, lack of sensual pleasure and
the approach of death.
1.2 What is Old Age?
Being old had multiple aspects
- Biological > physical change (grey hair, wrinkles, hearing problems
etc.)
- Social > withdraw from work at 65 years
- In the past 65 years good marker for health issues as well as
retirement
o Now poor marker for both
Young-old = period of relative freedom and good health (a.k.a. third age)
Old-old = accelerated decline of physical and mental health, the number
of losses in physical health and social relationships exceed the number of
gains (fourth age).
1.3 How Grey is Europe?
Europe is the oldest continent > many older people.
- Many differences in how old people are and how individuals deal
with old age.
o Between and within countries.
- 16% 65 years or older (2009)
- 80 years or older still pretty low (4%)
- All European countries deal with population aging, but different
levels of urgency and visibility.
Differences in how fast population ageing progresses
- More women in higher age groups
- In rural areas faster ageing than in cities
1.4 What Are Older Europeans Like?
Older Europeans present themselves as a rather diverse.
- More women > women live longer and men fight as soldiers in wars.
- Social networks > friends become more important.
- Socia-economic status > wealth of older Europeans high in Belgium,
Switzerland, France.
- Health status – Nordic countries > better health than southern and
eastern countries.
Old Age in Italy
- Third oldest country in the world.
- Highest % of 80+
, - Old age starts at 68 according to Italians
- Elders less engaged in community activities, more in families
Old Age in Sweden
- Lot (70%) of people 55-64 still worked
- Average population aging
- Live longer and longer healthy
- Elders are still productive to a high degree
Old Age in Slovakia
- One of the youngest countries
- Live shorter in good health
- Old age starts at 58 according to Slovakians.
CH2: BIO- AND HEALTH GERONTOLOGY: HOW AGING CHANGES
OUR BODIES
2.1 Summary and Learning Goals
Bio- and health gerontology – investigate physical change during the
aging process.
- Biogerontology – focusses on physical mechanisms of aging.
- Health gerontology – discusses health status in old age and
health care for elders.
Learning goals:
- Give two different definitions of health
- Name three strategies to facilitate healthy aging
- Name four most common diseases among older Europeans
- Give short overview of formal and informational care arrangements
for frail older Europeans.
2.2 What are Bio- and Health Gerontology?
Biogerontology = study the aging process on molecular level, how these
processes affect organs and the entire body.
- Use of flies, worms or rats > generalizable?
- Cells die and are replaced by new cells
Health gerontology = study the bodily changes with age, consequences
of this for daily living and use of health care services
- Two levels of health-related interventions:
o Individual and population level.
2.3 Central theories and concepts in bio- and health gerontology
What is health in old age?
Traditional understanding of health – freedom from disease.
Senescence – process of biological aging
- React to changes more slowly
- Recover more difficult
Two reasons why elders have more health problems
1. Aging causes health decline (heart disease)
2. Diseases simply require a longer period of time to develop > can
only manifest in older ages.
Acute health problems > can be treated to recovery
Chronic health problems > not treated to recovery
,A more positive approach
Health according to WHO – a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity.
Two dimensions to quality of life
- Health related
- Not health related
Active ageing – optimizing opportunities for health, participation and
security to enhance quality of life.
Successful aging – combination of three elements:
1. Absence of disease and risk factors for disease
2. Maintenance of physical and cognitive abilities
3. Engagement in productive activities
- Does not draw attention to quality of life
How can we facilitate healthy ageing?
Three most important approaches for healthy aging:
1. Slow down the ageing process
- Healthy lifestyle at young age
- Anti-ageing medicines > no convincing evidence.
2. Learn from health promotion strategies
- Reduce risk of cardiovascular disease, lung diseases, diabetes
and cancer.
- No smoking, moderating alcohol, good diet, physical activity +
stable psychological and social situation.
3. Preventive medicine
- Targets healthy individuals who are not yet ill
- Makes use of 1 and 2 +:
- Importance of early diagnosis
2.4 What do bio-and health gerontology tell us about the current state of
Europe?
The health status of older Europeans
- Varies widely based on your country.
- Lowest life-expectancies at birth > eastern Europe
- Generally, the number of people with limitations in their activities
increases with age but also country specific > no clear geographical
pattern.
Frailty = condition marked by weight loss, exhaustion, weakness, slow
walking, low activity.
- Makes older adults more vulnerable to health problems
- Risk > smoking, low physical activity.
Leading health issues
- Cardiovascular diseases > primary cause of death, followed by
cancer and diabetes.
- Mental health issues > depression and cognitive decline
o Dementia increases sharply with age
Care for frail older Europeans
, Two main types of care
1. Informal care – unpaid, usually by family or friends.
- Declining birth rate > eases burden on middle aged caregivers.
- Northern Europe > more healthy elders who help unhealthy
elders.
2. Formal care – paid professionals.
- More in northern Europe (also more long-term)
Variation in care spending in resources in Europe.
- Higher spending in northern and continental
2.5 Current debate in bio- and health gerontology: is a longer life
desirable?
Two hypotheses about the relation between health problems (morbidity)
and longer lives:
- Compression of morbidity – most severe health problems are
concentrated in the last years of life
- Expansion of morbidity – number of life years in poor health
increases with increasing life-span.
COLLEGE 1 - AGING PART ONE
Introduction
- More elderly in developed countries than less developed.
o But more older people expected in less developed countries
as well as developed.
- Life expectancy at birth is also increasing
- Number of children per women is decreasing
Definitions of age
- Chronological age = time that has elapsed since birth
- Biological age = where people stand relative to the number of
years they will live
- Functional age = competence in completing tasks (muscle
strength)
- Psychological age = how well person adapts to changing
conditions (flexibility)
- Social age = what individuals in a chronological age group should
do and how they should behave.
What is old?
- Chronological
o Age of 65 is arbitrary
o Young old – 65-74
o Old old – 75-84
o Oldest old – 85+
- Functional
o Third age – between retirement and start of age-imposed
limitations
o Fourth age – cognitive and physical impairments interfering
with everyday functioning.
Summary
WEEK 1
CH1: INTRODUCTION: OLDER PEOPLE UNDER THE MAGNIFYING
GLASS
1.1 What is Gerontology
Gerontology = study of human aging
Marcus Tullius Cicero – against idea that age is nothing more than
withdrawal from work, reduction in strength, lack of sensual pleasure and
the approach of death.
1.2 What is Old Age?
Being old had multiple aspects
- Biological > physical change (grey hair, wrinkles, hearing problems
etc.)
- Social > withdraw from work at 65 years
- In the past 65 years good marker for health issues as well as
retirement
o Now poor marker for both
Young-old = period of relative freedom and good health (a.k.a. third age)
Old-old = accelerated decline of physical and mental health, the number
of losses in physical health and social relationships exceed the number of
gains (fourth age).
1.3 How Grey is Europe?
Europe is the oldest continent > many older people.
- Many differences in how old people are and how individuals deal
with old age.
o Between and within countries.
- 16% 65 years or older (2009)
- 80 years or older still pretty low (4%)
- All European countries deal with population aging, but different
levels of urgency and visibility.
Differences in how fast population ageing progresses
- More women in higher age groups
- In rural areas faster ageing than in cities
1.4 What Are Older Europeans Like?
Older Europeans present themselves as a rather diverse.
- More women > women live longer and men fight as soldiers in wars.
- Social networks > friends become more important.
- Socia-economic status > wealth of older Europeans high in Belgium,
Switzerland, France.
- Health status – Nordic countries > better health than southern and
eastern countries.
Old Age in Italy
- Third oldest country in the world.
- Highest % of 80+
, - Old age starts at 68 according to Italians
- Elders less engaged in community activities, more in families
Old Age in Sweden
- Lot (70%) of people 55-64 still worked
- Average population aging
- Live longer and longer healthy
- Elders are still productive to a high degree
Old Age in Slovakia
- One of the youngest countries
- Live shorter in good health
- Old age starts at 58 according to Slovakians.
CH2: BIO- AND HEALTH GERONTOLOGY: HOW AGING CHANGES
OUR BODIES
2.1 Summary and Learning Goals
Bio- and health gerontology – investigate physical change during the
aging process.
- Biogerontology – focusses on physical mechanisms of aging.
- Health gerontology – discusses health status in old age and
health care for elders.
Learning goals:
- Give two different definitions of health
- Name three strategies to facilitate healthy aging
- Name four most common diseases among older Europeans
- Give short overview of formal and informational care arrangements
for frail older Europeans.
2.2 What are Bio- and Health Gerontology?
Biogerontology = study the aging process on molecular level, how these
processes affect organs and the entire body.
- Use of flies, worms or rats > generalizable?
- Cells die and are replaced by new cells
Health gerontology = study the bodily changes with age, consequences
of this for daily living and use of health care services
- Two levels of health-related interventions:
o Individual and population level.
2.3 Central theories and concepts in bio- and health gerontology
What is health in old age?
Traditional understanding of health – freedom from disease.
Senescence – process of biological aging
- React to changes more slowly
- Recover more difficult
Two reasons why elders have more health problems
1. Aging causes health decline (heart disease)
2. Diseases simply require a longer period of time to develop > can
only manifest in older ages.
Acute health problems > can be treated to recovery
Chronic health problems > not treated to recovery
,A more positive approach
Health according to WHO – a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity.
Two dimensions to quality of life
- Health related
- Not health related
Active ageing – optimizing opportunities for health, participation and
security to enhance quality of life.
Successful aging – combination of three elements:
1. Absence of disease and risk factors for disease
2. Maintenance of physical and cognitive abilities
3. Engagement in productive activities
- Does not draw attention to quality of life
How can we facilitate healthy ageing?
Three most important approaches for healthy aging:
1. Slow down the ageing process
- Healthy lifestyle at young age
- Anti-ageing medicines > no convincing evidence.
2. Learn from health promotion strategies
- Reduce risk of cardiovascular disease, lung diseases, diabetes
and cancer.
- No smoking, moderating alcohol, good diet, physical activity +
stable psychological and social situation.
3. Preventive medicine
- Targets healthy individuals who are not yet ill
- Makes use of 1 and 2 +:
- Importance of early diagnosis
2.4 What do bio-and health gerontology tell us about the current state of
Europe?
The health status of older Europeans
- Varies widely based on your country.
- Lowest life-expectancies at birth > eastern Europe
- Generally, the number of people with limitations in their activities
increases with age but also country specific > no clear geographical
pattern.
Frailty = condition marked by weight loss, exhaustion, weakness, slow
walking, low activity.
- Makes older adults more vulnerable to health problems
- Risk > smoking, low physical activity.
Leading health issues
- Cardiovascular diseases > primary cause of death, followed by
cancer and diabetes.
- Mental health issues > depression and cognitive decline
o Dementia increases sharply with age
Care for frail older Europeans
, Two main types of care
1. Informal care – unpaid, usually by family or friends.
- Declining birth rate > eases burden on middle aged caregivers.
- Northern Europe > more healthy elders who help unhealthy
elders.
2. Formal care – paid professionals.
- More in northern Europe (also more long-term)
Variation in care spending in resources in Europe.
- Higher spending in northern and continental
2.5 Current debate in bio- and health gerontology: is a longer life
desirable?
Two hypotheses about the relation between health problems (morbidity)
and longer lives:
- Compression of morbidity – most severe health problems are
concentrated in the last years of life
- Expansion of morbidity – number of life years in poor health
increases with increasing life-span.
COLLEGE 1 - AGING PART ONE
Introduction
- More elderly in developed countries than less developed.
o But more older people expected in less developed countries
as well as developed.
- Life expectancy at birth is also increasing
- Number of children per women is decreasing
Definitions of age
- Chronological age = time that has elapsed since birth
- Biological age = where people stand relative to the number of
years they will live
- Functional age = competence in completing tasks (muscle
strength)
- Psychological age = how well person adapts to changing
conditions (flexibility)
- Social age = what individuals in a chronological age group should
do and how they should behave.
What is old?
- Chronological
o Age of 65 is arbitrary
o Young old – 65-74
o Old old – 75-84
o Oldest old – 85+
- Functional
o Third age – between retirement and start of age-imposed
limitations
o Fourth age – cognitive and physical impairments interfering
with everyday functioning.
