Transcript Longevity, Health and Function in Later Life PS 277 – Lecture 15 – Chapter 3

Longevity, Health and
Function in Later Life
PS 277 – Lecture 15 – Chapter 3
Outline
 Longevity: Centenarians and Their Life Course
 Some Chronic Health Problems in Later Life
 Managing Health Problems – Coping Styles
and Religion in Later Life
Nova Scotia Centenarian
I. Longevity and Life
Extension
 Oldest validated life in modern times was 122
years – French woman, Jean Calment (18751997)
 Many legends of earlier times, places where
people lived longer (Bible, explorers, etc.)
 A number of modern theorists argue that
science can extend our expected lifespan at
least by several times – e.g., Aubrey de Grey
Current Research on
Centenarians
 1/10,000 persons in US is over 100; in Canada, it is
1.5/10,000 – functional health is often not bad
 Genetic factors – APOE gene variants linked to longevity
in samples (Alzheimer’s), several genes linked to
cardiovascular diseases also important
 Family members of centenarians are also long-lived – the
Sutherlands – likely more evidence for genetics
 Cognitive factors – dementia increases to age 90, but
then plateaus or declines in 90 -100 yr old samples
Morbidity Profiles of Centenarians
Over Life Course (Evert, Lawler,
Bogan, Perls, 2003)
 New England Centenarian Study
 424 participants, centenarians and sibs
 24% male
 11% smokers, 6% drank daily
 Illnesses: YOU NAME IT!: hypertension, heart failure,
heart attack, cardiac arrhythmia, diabetes, stroke, cancer,
osteoporosis, thyroid condition, Parkinson’s, dementia,
COPD, cataracts
Gender Differences in Group
Profiles
 Survivors = onset of
disease before 80
 Delayers = onset of
disease 80-100
45
40
35
30
Survivors
Delayers
Escapers
25
20
 Escapers = never had
these diseases
15
10
5
0
Males
 Different routes to long
life by gender –
phenotypes linked to
genotypes maybe?
Females
II. Major Functional Problems
in Later Life – Canadian Data
Arthritis as Most Common
Disability
 Two major types: osteoarthritis and rheumatoid
arthritis, neither is “curable,” but must be managed
 Osteoarthritis (10% of population), more a disease of
older age, is due to damage to bones under cartilage in
joints, gradually weakens joints – predicted by age,
obesity, over-use…found in many early human skeletons,
especially after agricultural era
 Rheumatoid arthritis (1-2%) is an autoimmune disorder,
more common in younger people, morning pain and
stiffness, swollen joints, fingers, wrists, ankles – can be
quite destructive over time
Other Major Chronic Disorders
 Diabetes – too little insulin produced by
pancreas: early onset in kids (Type 1),
late onset (Type 2) only as adults –
quite strongly linked to obesity- showing
major and alarming increases in all age
groups
 Heart and Cardiovascular Disease  Cancers – broad family of disorders
III. Stress and Coping – the Lazarus
General Cognitive Model
 Primary appraisal of
event: good, bad,
indifferent
 Secondary appraisal:
evaluating coping
efficacy of various
strategies
 Reappraisal if
situation changes
Major Categories of Coping
Styles
 Problem-focused coping: actively intervening in a
problem, using external behavioral resources, seeking
info, etc.
 Emotion-focused coping: dealing with the feelings
associated with issue, internal resources
 Generally, results suggest that problem-focused coping is
more efficacious for people’s satisfaction and sense of
competence
 However, some chronic, severe problems really do not
lend themselves as easily to problem-focused coping –
e.g., life-threatening illnesses
Coping Patterns: Women and
Breast Cancer (Taylor et al.)
 Life-threatening cancers– emotion-focused patterns
may help
 Finding personal meaning (learned I’m strong)
 Attempting to find control strategies (“optimism, diet
changes, etc. will cure me”)
 Regain self-esteem through downward social
comparisons to worse reference group (“she’s worse off
than me”)
 Some of these strategies can be useful in terms of aging
– e.g., downward comparisons on physical and mental
health, lowering aspirations when can no longer attain
Pessimism, Optimism and Coping in
Cancer by Age Group (Schultz et al.,
1996)
 Recruited 238 people with advanced or recurrent cancers
from hospital treatment
 Mostly having palliative radiation therapy
 Mortality status at 8 months later (70 deceased = 30%)
 Assessed depression, optimism, pessimism as
predictors of mortality
 Interestingly, pessimism was bad for middle aged adults,
but not so bad for older adults
Age Differences in Prediction
of Pessimism for Mortality
Religiosity, Coping and Mortality
(Oman & Reed, 1998)
 Approximately 2000 participants from northern
California, Marin county
 Weekly attendance rates at church were around
25% for each of 4 age groups: 55-64, 65-74,
75-84, 85+
 Studied other factors: health, social support,
psychological variables, and controlled for
these
 Followed up through next 4 years for mortality
Protective Effects of Religious
Attendance in Late Life (Oman,Reed)
Aspects of Religious Coping
 Prayer, religious practice, etc. can provide a
sense of meaning and connection
 Under conditions of stress and loss, religion
may provide several positive features:
 Spiritual support
 Social support and community
 Sense of purpose