Transcript Psychology 3533 Understanding Human Sexuality

PSYCHOLOGY 2012: PHYSICAL CHANGES
BIOLOGICAL PERSPECTIVES ON AGING
Biochemical and physiological changes,
under genetic influence, interacting with the
environment.
Causes? Some theorists see aging as a
disease that can be cured or prevented!
Non-genetic hypotheses:
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wear and tear
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accumulation of toxins
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accumulation of metabolic waste (e.g.
lipofuscin)
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collagen changes
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nutritional deficits
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accumulation of free radicals
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damaged DNA can’t repair tissues (damage is
environmental, e.g. sun)
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cross-linking of cellular proteins and collagen
(caused by aldehydes)
Aldehydes:
• by-products of cell metabolism. The more
fat, calories and animal protein in the diet,
the more aldehydes are produced.
Genetic hypotheses:
• Hayflick’s limit
• genes for aging program changes (e.g.
telomeres)
Other physiological hypotheses:
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aging CV system
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endocrine decline (thyroid, pituitary,
hypothalamus)
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immunological deficits:
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less efficient
autoimmune diseases
THANATOLOGY: STUDY OF DEATH
(Thantos: Greek god of death)
CAUSES OF DEATH:
Until 20th century:
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infections
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accidents
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epidemics, pandemics
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parasites (endemic)
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starvation, severe nutritional deficiency
CAUSES OF DEATH:
Twentieth century: lifestyle diseases (1st World)
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hypertension
hypercholesterolemia
cardiovascular problems: heart attacks
and strokes
cancer
immune deficits – AIDS
diabetes
Causes:
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obesity
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sedentary life
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fatty foods*
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excess foods
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smoking
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pollution (harmful chemicals in the
environment)
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radiation
Individual variables related to longevity:
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genetics
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personality
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accidents
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lifestyle
Which ones do we have control over?
PHYSICAL CHANGES AS WE AGE:
First decade of young adulthood:
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Growth does not stop in adolescence
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Long bones grow to age 25
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Spine grows to age 30
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Skulls grow into old age
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Myelinization and differentiation of CNS to age
25
Overall, good health, high energy, quick recovery
from illness. No noticeable effects of unhealthy
lifestyles. However recently, changes due to
childhood obesity and environment toxins.
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Past 25-30 a lot depends on lifestyle and
heredity
Second decade of young adulthood:
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face lines
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weight harder to keep off
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thinning hair (men)
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greying hair
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“spare tire” (men)
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hips (women)
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sagging
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changes in menstrual cycle (climacteric)
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tanning: UV rays interfere with DNA production and
protein synthesis (tissue damage)
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CV system: past age 20 cardiac output (amount of
blood pumped in 60 sec.) decreases 1% a year for
sedentary people
Significant individual differences.
CHANGES IN VISION:
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Lens less flexible, doesn’t shed old cells (epithelial) as
efficiently.
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Therefore, lens becomes thicker, more compact.
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This leads to accommodation being slower and harder.
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Affects close range focusing: presbyopia
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Also becomes yellowish: need more light to see:
cataracts
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These changes start around 35-45.
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Pupil: less flexible – problems for dark/light adaptation.
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Some eye muscles less effective.
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Visual acuity decreases around 40-50.
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Depth perception decreases at about 50.
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Field of vision shrinks from 50 on, marked after 75.
Retina: after 65 malfunction or destruction
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Senile macular degeneration: gradual
degeneration of centre of retina, affects both
eyes. Leads to blindness.
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Disciform macular degeneration: blood leaks to
the retina. If caught early, can be treated with
laser photocoagulation. If not: blindness.
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Glaucoma: intraocular pressure (correlated
with hypertension) damages the optic nerve.
Beta blockers help. Tonometry diagnostic test
after 50. Leads to blindness.
DRIVING IN OLD AGE:
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Visual acuity – 20/50
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120° visual field
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RT
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strength
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coordination
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range of motion
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motor skills – speed
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mental ability:
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attention: single, multi, switching
memory
problem–solving and decision-making
judgment of distance
depth perception
speed of mental processing
Hearing
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Declines after age 13 in industrialized countries.
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Noise pollution.
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Hearing for higher frequency tones goes first.
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Presbycusis: loss of hearing for high pitch tones.
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How? Damage to receptor: hair cells, inner ear
(cochlea)
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Also, arthritis of the ossicles possible.
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Also processing slower.
Loss of hearing can lead to:
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social isolation
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depression
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paranoia
Chemical senses: taste and smell
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decline too: consequences for nutrition
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poor nutrition can be also due to loneliness and
isolation, consequences for general health and for
CNS functioning. (Vitamin B)
Immune system
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also declines with age
CNS degeneration
Reaction time (RT) as measure
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loss of neurons (anatomical)
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loss of synapses (functional)
Use it or lose it!!
Sleep:
• more interruptions after 35
• disturbances due to illness, medication
and pain, not to age
• only difference: ½ hr./1 hr. less sleep per
night and a few more 3 to 10 minute
awakenings
Temperature regulation
• becomes more difficult: hyper or
hypothermia
Consequences of temperature regulation
decline:
• Both the ability to detect temperature
correctly and to adjust diminish
• Hypo and hyperthermia can lead to death
Touch and pain: danger detection, e.g. hot stove
Reaction time: decreases if sedentary. RT good if active,
e.g. tennis player better at 60 than sedentary 25 year
old. Good indicator of nervous system health.
Sense of balance impaired after 65: more falls. Coupled
with osteoporosis: serious risk.
Muscle mass: atrophy if not used
Solution: weight lifting, resistance training
Endurance better than sheer strength.
What would you test for if you had to grant driving licenses
to over 75s?
SYSTEMS:
SKELETAL:
• brittle bones, osteoporosis
• calcium losses, complex mechanism
• add visual impairments and loss of sense
of balance: more falls with more serious
consequences
• osteoarthritis: joints degenerate, not
enough cushion
• rheumatoid arthritis: progressive tissue
destruction – autoimmune?
MUSCLE TISSUE:
• use it or lose it
• importance of exercise
• weight training – also benefits for osteoporosis
• endurance holds better than fast surges – snow
shoveling
• RT (reaction time): active 65 year olds better
than inactive 25 year olds
• Middle Age: repetitive, automatic tasks overall
same as young
• Older Adults: individual differences
HEALTH CHALLENGES AND AGING
Young adults:
• back problems
• hearing
• hypertension, hypercholesterolemia
• accidents second leading cause of death
• by age 35 cancer and heart disease starts
to appear as important cause of death
• women die more of cancer than of car
accidents
CHRONIC CONDITIONS BY AGE AND GENDER:
Middle age:
• asthma
• bronchitis
• diabetes
• mental disorders
• arthritis (and rheumatism)
• sight and hearing
• circulatory, digestive and urinary
• for women, menopausal complaints,
hysterectomy and sequelae of hysterectomy
Deaths: cancer and CV, for women cancer
CHRONIC CONDITIONS BY AGE AND GENDER:
Old age:
• arthritis most common
• hypertension
• CV
• hearing, vision
• leading cause of death: MI, cancers and
stroke
CHRONIC CONDITIONS BY AGE AND GENDER:
Old age (cont’d):
• In general women more health conscious
and knowledgeable than men
• Role of marriage. Health gradient from
better to worse: married, never married,
widowed and divorced. But … effect of
marriage much stronger for men
• Widowed women healthier than widowed
men
ILLNESS AND AGING
Issues of quality of life:
• individual differences (e.g. reading)
• having spouse
• having children, grandchildren
• financial self-sufficiency
• being in own home
• religious comfort
• community
ILLNESS AND AGING
• Diseases can be acute or chronic
• Acute: rapid onset, reversible, short-term
(e.g. ‘flu’)
• Chronic: slow onset, irreversible, long-term
(e.g. CV disease)
• As we age, fewer acute illnesses and
more chronic ones.
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Young adults: 20’s not noticeable effects
of abuse
30’s: beginning: more infections, less
stamina, sleep disorders, GI troubles
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Killers: AIDS, Accidents
40-60: chronic illness: diabetes, arthritis,
rheumatism, sight and hearing,
hypertension, GI, all systems may begin to
show problems
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Killers: heart and cancer lead men more than
women
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65+: arthritis most common, hypertension,
CV disease, cataracts, diabetes. Less
acute illness, more chronic killers: cancer
and heart lead.
Adult onset diabetes: totally linked to diet
ILLNESS AND AGING
Arthritis: painful disease of the joints
Osteo and Rheumatoid:
• Osteo:
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wear and tear of the joints (injuries, repetitive
motion, obesity)
bones rubbing together, not protected by
serous bags or synovial fluid, mostly over 60
weight loss, no smoking, gentle exercise
(water)
use of painkillers
surgical replacement
ILLNESS AND AGING
• Rheumatoid:
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autoimmune disease
can appear at any age
Remicade, research ongoing
Arteries:
• arteriosclerosis: stiffening of arteries due
to less elastin, more collagen and calcium.
Appears age related.
• atherosclerosis: plaques of fat and other
debris coat internal arterial walls. Leads to
hypertension. Related to lifestyle. Found in
children and young adults too (TV, junk
food, sedentary life). Heart attacks in
young males.
Cardiovascular (CV) System:
• Factors: overeating, fatty foods, refined,
processed foods, sedentary, stress,
smoking +++, high salt (processed foods)
• Latest: bacterial (Chlamydia)
• Both arterio and athero cause
hypertension
• Heart Attack: myocardial infarction
• Stroke: cerebral artery clogged or bursts:
damage to neurons
CANCER
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leading cause of death
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some are eminently preventable: lung (smoking), skin
(sun exposure), colorectal (diet), breast (diet and
breastfeeding).
only a small percentage of cancers are genetic in origin
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Possible major causes:
• lifestyle
• environmental pollution
• weakened immune system as we age, together with
cumulative exposure to carcinogens
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Carcinogens are pervasive in modern life:
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plastics
synthetic fibers
chemicals to soften or harden susbtances e.g.
phthalates
hormones given to cattle
pesticides, herbicides, preservatives
animal flesh that has incorporated those chemicals
radiation (air travel, medical tests, cell phones?)
treated fabrics (e.g. fire retardant in clothes, carpets,
drapes)
air pollution (e.g. large cities)
second (and third) hand smoke
 Despite
enormous funds for research,
cancer incidence is going up.
 Cancer drugs themselves are
carcinogenic.
 Most funds directed toward detection tests
and chemotherapy drugs.
 Young men: do testicular selfexamination! (imperative if you were born
with cryptorchidia).
 Young women: do BSE and get a yearly
Pap if you are sexually active!
Respiratory system:
• after age 25 vital capacity (amount of
oxygen per breath) decreases if inactive
• smoking +++
Other organs:
• digestive enzymes decrease after 30
• kidneys shrink after 30, filter more slowly
• energy decrement
• intestinal problems
Supplementary notes on health and lifestyle
Until the middle of the 20th century, smoking was mostly a male habit. It was not
seemly for a lady to smoke, although some did in secret, and later in some circles
as a way to flaunt the status quo. Young women also perceived smoking as
sophisticated, since many movie actresses smoked on screen, and as risque and
naughty. Because men smoked and women were not supposed to, smoking was
perceived as a sign of independence and power by many women. Not surprisingly,
men suffered and died from many diseases caused by smoking that hardly touched
women.
In the 1960s, with the second feminist movement gathering momentum,
smoking became acceptable for women. The tobacco companies saw a new, very
lucrative market, and started to target women with very slick ads. The Virginia Slims
advertising campaign is today considered a classic of the advertising world. The
slogan "you've come a long way, baby" became part of the culture. Women were
portrayed as daring, strong, professional, competitive and independent - always
with the picture of a Virginia Slims package prominently displayed next to the
woman. They marketed "feminine" cigarettes: slimmer than the usual cigarette and
with soft paisley prints on the cigarette paper and filter. The packages were also
slimmer. The campaign used two important themes: competing in a man's world,
being more than just a housewife, etc. and losing weight. Millions of women were
lured into smoking with the promise of a more exciting life and a slimmer body. The
model in the ads was always, of course, slim.
Even then, there were segments of the female population that were not
responding to these ads. The advertisers did research and discovered
several female subpopulations, which they targetted separately, including
young adolescents, working class women, rural women, etc. By the 1980s,
smoking was as common among women as among men. And now, more
young women than young men are smokers.
Smoking is highly addictive, at least as addictive as cocaine. Not every
brain responds identically, some individuals will become more easily
addicted than others, but eventually all regular smokers become addicted.
There are receptors in the brain that are very sensitive to nicotine and other
chemicals in cigarette smoke. Smoking is associated with being 'cool' and
grown up amongst adolescents, a way to reach adulthood the easy way.
So what's so bad about smoking? Let me count the ways. Everyone has heard
about lung cancer, and some have heard about emphysema, but these
diseases are only the tip of the iceberg. Over 45,000 Canadians die each year
from smoking-induced causes. These deaths are completely preventable. Let's
take a brief look at the most common effects of smoking:
 COPD: chronic obstructive pulmonary disease. The lungs become so filled
with "gunk" that they gradually shut down. COPD is one of the leading
causes of death and disability.
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Lung cancer: Although there are some rare lung cancers not caused by
smoking, the overwhelming majority are. It takes about 20 years for a
cancerous tumour in the lungs to be detectable, so a young person with no
symptoms could already have the cancer growing without being aware of it.
Although some strides have been made in treatment, in most cases it's
fatal.
 Emphysema: now under the umbrella of COPD, it is one of the lung
conditions where fluid and scar tissue start to fill the alveoli, the lung
physiological units where the exchange of gases takes place which leads to
oxygenation of the circulating blood. Gradually, smaller portions of the lungs
are functioning, leading to oxygen deprivation. Many disabilities are due to
emphysema and general COPD. Eventually, it's fatal, as it cannot be
reversed.
 Oral cancers: mouth, tongue and jaws can develop cancer due to smoking.
The cancer spreads to the throat, takes de vocal cords and parts of the
neck and, eventually, metastasizes to other body parts.
 Bladder cancer: because many toxic by products of smoke are processed
through the kidneys, they accummulate in the bladder for lengthy periods
of time each day, and cause cancer.
Circulatory system diseases: The chemicals in cigarette smoke (over 2,000 and
counting) promote the formation of plaque through various mechanisms. This
plaque, a sticky substance that adheres to the internal walls of the arteries, is
like a magnet that attracts particles circulating in the blood, until a blood clot
forms. If the clot remains in place and continues to grow, it will eventually
prevent blood from getting through. If it becomes free and is carried in the
blood circulation, it can end up obstructing an important
vessel, such as a coronary artery (which feeds the heart) leading to a heart
attack, or a cerebral artery, leading to a stroke. In both cases, either heart
or brain suffer permanent damage due to oxygen deprivation. Even if plaque
just sits in the arteries, by decreasing the internal space where blood gets
through it leads to hypertension (high blood pressure) one of the most
dangerous (and common) diseases of our time.
Necrosis of the lower limbs: The feet are the most distal body part from
the heart. When circulation is compromised, it is often in the toes. Lack of
circulation leads to necrosis, or tissue death, which spreads quite rapidly
once it begins. Many smokers have had their limbs amputated to stop the
spread of the gangrene. Other conditions, such as diabetes, can also cause
this problem, so a diabetic is at double risk in this regard if they are also
smokers.
Immune system: smoking decreases the capacity of the immune system to
fight infections and other foreign invaders. A smoker is at several times
higher risk of contracting many diseases, including other cancers that are not
directly caused by smoking.
Ulcers: smokers have a higher incidence of duodenal and gastric ulcers.
Cataracts: higher incidence in smokers.
Depression and suicide: a recent longitudinal study determined that
smoking is associated with higher rates of suicidal thoughts and actual
suicide. Although the depression may have preceded the onset of smoking,
those who smoked had a higher rate of suicide than those who did not. This
study was done with people ages 21 to 30.
Low birth weight babies: women who smoke during pregnancy are much more
likely to have babies who are below normal weight, which is associated
with many diseases and problems, including learning disabilities.
Stillbirths: women who smoke during pregnancy have a higher rate of
stillbirths. It appears that smoking, in addition to cutting off the
oxygen supply to the fetus, impairs the functioning of the placenta.
Second hand smoke: chemically, second hand smoke is even worse than what
the smoker initially inhales. People who work in smoking environments are at
much higher risk for lung cancer and COPD, as well as the other diseases. Of
course smokers get both the "fist hand" smoke they inhale and the second
hand smoke they exhale and then breathe in, as it stays in the air around them.
In addition, wives of smokers have a higher incidence of cervical cancer,
although the mechanism is not yet known. In isolated towns where public
smoking has been banned, the rates of heart attacks decreased by 58% in only
six months. Only 30 minutes of exposure to second hand smoke causes
platelets in the blood to become stickier, which is a start for blood clots that
block arteries.
Although both men and women suffer the consequences of smoking,
advertising that targets various subgroups of women very specifically make
smoking a serious issue in women's health. Additionally, we have already seen,
in previous weeks, how smoking is dangerous for women on hormonal
contraceptives and it contributes to osteoporosis in post-menopausal women.
SLEEP DEPRIVATION
In our fast-paced society, two thirds of the adult population do not get
enough sleep. The consequences are fatigue, irritability, depression,
decreased attention span, lack of concentration, lapses in memory,
frequent illnesses and loss of productivity. One of the most serious
consequences for the individual and society is drowsy driving, which
increases the risk for accidents. Sleep-related accidents are most common
among young drivers and shift-workers.
Both caffeine and alcohol taken in the evening can impair sleep. Alcohol
will initially cause drowsiness and lead to sleep, but typically
individuals will awake a few hours later and be unable to go back to
sleep. Sugar can also have a stimulating effect.
Sleeping pills and tranquilizers disrupt the normal sleep cycle, as they
impede REM sleep. REM (rapid eye movement) sleep is associated with
dreaming and is necessary several times throughout the night, in short
periods. When a person misses REM sleep for one night or more, there is a
rebound effect that results in too many REM periods the first night the sleep
aid is not taken, causing restlessness and fatigue the next day.
Stress is one of the main reasons for inability to sleep well. There are
several methods to deal with stress without resorting to medication.
Other causes of sleeplessness are a full stomach (or a really empty one),
light, which will prevent the release of the hormone melatonin, necessary for
sleep, noise and uncomfortable temperature in the room (too hot or too cold).
Although both men and women in modern societies tend to be sleep deprived,
women are at higher risk because of the double shift. This is the situation
where women with a family work 8 hours or more at their paid work, and come
home to another few hours of intense homemaking and childcare work.
Because so many women have to juggle these responsibilities, they are more
likely to also lay awake once they do get to bed and review all the tasks that
were left undone and the new ones that need to be done the next day. Women
also tend to be prescribed more psychotropic drugs by their doctors, which put
them at risk for a vicious cycle of sleeplessness and of addiction
Diabetes
Metabolic disorder due to problems in either
• production of insulin or
• utilization of insulin
Insulin: pancreatic hormone essential for
metabolizing glucose (sugar)
Diabetes
Two types of diabetes:
Type I and Type II
Type I (juvenile or early onset):
• Either genetic or intrauterine causes
• Appears in infancy/childhood
• Pancreas does not produce sufficient
insulin
• Treatment: insulin injections for life, diet
Diabetes
Type II: adult onset
• Although there could be genetic predisposition,
it’s overwhelmingly a lifestyle disease
• 90-95% of total # of diabetics are type II
• 85% are overweight/obese
• The other 10% have faulty diets
• Used to appear in late middle-age/old age but
appearing earlier:
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40’s: 40% increase in last 8 years
30’s: 70% increase
teens: also on the rise
Diabetes
Pancreas produces enough insulin initially but diet
high in carbohydrates causes strong insulin spikes
• eventually tissues do not respond to insulin
• a lot of glucose (2-3 times normal) stays in blood
• this causes even more insulin production,
pancreas overwhelmed, insulin production slows
• eventually, insulin shots needed
• also insulin spikes cause hunger and cravings
Diabetes
• weight goes further up – vicious cycle
• since glucose not metabolized, no energy
for cells, muscle and neurons slow down:
lethargy, lack of energy and irritability
• high glucose in blood causes damage to
capillaries, especially eyes and feet:
blindness and gangrene
• meanwhile, liver keeps sending more
glucose into blood because cells are
starved – so, even more glucose in blood.
Diabetes
Damage caused by diabetes:
• leading cause of blindness in ages 20-74
• kidney damage: dialysis
• CV disease
• impotence in men
• vaginal and UT infections in women
• nerve damage
• gangrene of feet/legs: amputation
• shortened lifespan
Diabetes
Treatment:
• diet: foods with low glycemic index,
balanced: protein and fat slow down carb
absorption
• weight loss
• exercise
• if severe, insulin, drugs that stimulate
insulin production, drugs that sensitize
tissues to insulin
SUNDRY ITEMS:
Diabetes: distinction between early (insulin
dependent) and late onset (non-insulin
dependent) becoming blurry.
Important: diet crucial, both during pregnancy
(can “program” baby for later onset) and during
lifespan: as sugar consumption increased this
century, diabetes increased in the same
proportion.
SES: Socio-economic status. Most important
variable for all other variables studied in adult
development. Income and educational level.
SUNDRY ITEMS (Cont’d):
Cardiovascular disease: besides factors
discussed, recent evidence that chlamydia, a
bacterium, implicated – can be treated with
antibiotics.
Breast cancer: Besides factors mentioned in
text, one overlooked variable is breastfeeding:
BRCA has higher incidence in nonbreastfeeders. As the number of years
breastfeeding increases, the incidence of
BRCA decreases (negative correlation)
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Ninety percent of breast cancer is not genetic in
origin.
Research and funding has been concentrated
on finding a "cure", rather than in understanding
the factors in breast cancer. Emphasis on
detection and treatment, rather than on
prevention.
There is a positive correlation between Western
lifestyle and diet and breast cancer incidence.
Many environmental chemicals have effects that
can lead to cancer.
Positive correlation reported between BMI (fat
ratio) and incidence of BRCA.