Developmental Health Psychology

Aging Primary Aging Primary Aging –“normal” senescence Secondary Aging Secondary Aging –“pathological” senescence

Health during old age Most in good health (Stats Can., ’99) Most in good health (Stats Can., ’99) Most common chronic conditions: late adulthood Most common chronic conditions: late adulthood –Arthritis, rheumatism – 42% –High blood pressure – 33% –Allergies – 22% –Back problems – 17% –Heart problems – 16%

Key ideas Women live longer than men Women live longer than men –But more likely to have chronic conditions and limitations in activities of daily living Physical health declines, psychological well-being improves Physical health declines, psychological well-being improves

Determinants of health Determinants of health –Health beliefs, behaviours, social structure, SES –Often can be changed to improve health

Despite attention paid to sickness and treatment, self-care is the most predominant form of care Despite attention paid to sickness and treatment, self-care is the most predominant form of care

Mental Health Attempt to live meaningfully Attempt to live meaningfully –in a particular set of social and environmental circumstances –relying on a particular collection of resources and supports

Self-development self-perception self-perception integration of various roles integration of various roles striving for growth striving for growth possible commitment to something beyond self possible commitment to something beyond self Life satisfaction (self image, self esteem) Life satisfaction (self image, self esteem)

Threats to mental health Epidemiological Catchment Area Study Epidemiological Catchment Area Study –US Nat’l Inst. of Mental Health –18,000 structured interviews –5 regions across US Dispelled 2 major myths: Dispelled 2 major myths: –Women at greater risk. –Older adults at greater risk

Age-Related Trends in Mental Disorders Lower prevalence in older than younger adults Lower prevalence in older than younger adults –all mental disorders (excluding dementias) Younger (18-64 years):11-25% Younger (18-64 years):11-25% Older (65+):6-14% Older (65+):6-14%

Mood disorders (including depression) Mood disorders (including depression) –Younger:3-8% –Older:2-3% Dementia Dementia –Older:6-10% –Possible co-existence and interaction with physical illness

Are Elderly Less Prone to Mental Illness? Diagnostic criteria not “age fair” Diagnostic criteria not “age fair” –depression symptoms different in elderly Elderly typically visit physicians before mental health professionals Elderly typically visit physicians before mental health professionals –physical symptoms mask psychological ones –e.g., difficulty sleeping, changes in diet, heart palpitations (depression)

Myths, stereotypes about aging Myths, stereotypes about aging –must distinguish normal aging from disease –ageism in treatment Cohort effects: “stigma” Cohort effects: “stigma”

Alzheimer’s Disease Progressive, degenerative brain disorder Progressive, degenerative brain disorder Loss of memory, awareness, ability to control body functions Loss of memory, awareness, ability to control body functions

First reported in 1907 First reported in 1907 –Shrinkage of cortex –Large masses of amyloid plaques Spherical protein deposits outside of nerve cells Spherical protein deposits outside of nerve cells –Neurofibrillary tangles Twisted protein filaments inside neurons Twisted protein filaments inside neurons –Spread from bottom (midbrain) to top (cortex)

Plaques, tangles present in normal aging brain Plaques, tangles present in normal aging brain In Alzheimer’s: excessive, interfere with communication between neurons In Alzheimer’s: excessive, interfere with communication between neurons

Prevalence Rare under 50 Rare under % over % over % over % over 85

Symptoms Permanent forgetting of recent events Permanent forgetting of recent events Unable to do routine tasks Unable to do routine tasks Forget simple words Forget simple words Confusion in familiar locations Confusion in familiar locations Forget what numbers mean Forget what numbers mean Put things in inappropriate places Put things in inappropriate places –Watch in fishbowl

Rapid, dramatic mood swings Rapid, dramatic mood swings Loss of language, communication skills Loss of language, communication skills

Causes Very little known Very little known Possibly: Possibly: –Genetic factors (permitting tangles to form) –Environment (sporadic AD – no family history; possible toxins) –Build up of plaques in body, free radicals in brain

Risk Factors Age Age Family history Family history Brain damage (accident) Brain damage (accident) Predictors: Kentucky Nun Study Predictors: Kentucky Nun Study –“richness” of early writing

Treatment Anti-oxidants Anti-oxidants Enzyme-blocking agents (prevent plaques) Enzyme-blocking agents (prevent plaques) Genetic engineering (promote neuron growth) Genetic engineering (promote neuron growth) Respite care: caregiver stress Respite care: caregiver stress Behaviour Modification (activities of daily living) Behaviour Modification (activities of daily living)

Physical activity Physical activity Social involvement Social involvement Good nutrition Good nutrition Calm structured environment Calm structured environment

Coping with AD Patient Patient –Aware of changes –Shame, self image, fear of desertion –Behavioural changes (stages) Caregiver: physical, psychological, social Caregiver: physical, psychological, social –70% family members (female usually) –50% severe stress

Caregiver Stress Caregiver Stress –Physically exhausting: constant vigilance –Psychological effects Grief: adjust to gradual loss Grief: adjust to gradual loss Increasing social isolation Increasing social isolation Stigma: cover-up, try to avoid social interactions Stigma: cover-up, try to avoid social interactions Stress: severity depends on availability of social support (respite care, counselling, support groups) Stress: severity depends on availability of social support (respite care, counselling, support groups)