Chapter 1
 Introduction - Notes (Changes and Suggestions in blue and green- 3/6/06)
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 1. Describe the present and anticipated population trends for the elderly and explain the reasons for these trends. (No specific values are needed.)

      - rapid increase in numbers to 2030 with less rapid increases thereafter
      - continued increase in proportion of elders for many decades
      - continued increases in number and proportion of very old elders
      - reasons
          - high birth rates before 1920 and 1946-1964, followed by decreases
          - high number of births 1946-1964
          - declining childhood death rate due to better public health and better medical interventions
          - increase in life expectancy at all ages due to better public health and better medical interventions
     - result is "population bump" of people born 1946-1964 moving up the age scale with "population troughs" before and after them = "baby boomers"

2. Discuss the significance of population trends of elders.

     - economic, health care, social, political, etc. (employment, marketing, career opportunities)

 3. Define or describe the terms developmental change, age change, aging, senescence, biological aging.

      - developmental change = irreversible, normal, universal changes in a natural population as time passes
      - age change = aging = irreversible, normal, universal change as time passes in older individuals
          - senescence = detrimental age changes
      - biological aging = age changes in physical structures and functions that affect either ability to survive or appearance

 4. Describe homeostasis and explain how it is important to the body.

      - homeostasis = proper and fairly stable conditions in the body
      - importance = necessary for "happy" survival of cells and therefore of the person
          - the greater, longer, or more frequent the deviations out of homeostatic range, the greater the risk of illness and death

 5. Describe how homeostasis is maintained, including how negative feedback systems function.

      - maintained by (1) preventing or limiting change through barriers and insulators and avoiding adversity, (2) negative feedback systems, which recognize presence of change and take action to slow or reverse the change, and (3) some positive feedback systems, which recognize presence of change and take action to increase the change
      - steps in negative feedback = (1) detecting (monitoring) (2) communicating and (3) adjusting to limit and reverse change
      - steps in positive feedback = (1) detecting (monitoring) (2) communicating and (3) adjusting to increase change

 6. Describe the overall effects of most age changes on maintaining homeostasis and explain why these effects occur.

      - most aging -> reduced abilities to prevent or limit deviations and to correct them by negative feedback or positive feedback
           - adverse effects on all three steps in negative feedback and positive feedback

 7. Describe the six types of aging (biological, chronological, cosmetic, social, psychological, and economic), and describe interactions among them.

      - biological = age changes in physical structures and functions that affect either ability to survive or appearance
      - chronological = passage of time (from birth)
      - cosmetic = changes in appearance (from biological aging or other factors)
      - social = age changes in interactions among people
      - psychological = age changes in mental processes and behavior
      - economic = age changes in financial status
      - interactions = each type can affect other types except none can affect chronological aging, and complex interaction among many type exist

 8. Describe the advantages and disadvantages of using chronological age and cosmetic aging as indicators or predictors of peoples' status and of the other types of aging.

      - chronological
           - advantages = good for determining average values or trends
           - disadvantages = erroneous for individuals due to increasing heterogeneity with aging
      - cosmetic
           - advantages = good for determining average values or trends
           - disadvantages = erroneous for individuals due to increasing heterogeneity with aging and effects from environment, lifestyle, disease

 9. Describe the distinctions between aging and disease, and explain why many abnormal and disease conditions accompany aging.

      - disease = any of three conditions
              1. inablility to maintain homeostasis when exposed to mild adverse conditions
              2. conditions in part of the body are severe enough to cause some cell injury or cell death
              3. conditions in many or all parts of the body are severe enough to cause widespread cell injury or cell death

      - aging =/= disease, aging not necessarily accompanied by disease, no disease unique to elderly
      - reasons for disease with age
           - decreased ability to maintain homeostasis (barriers, insulators, negative feedback, some positive feedback)
           - decreased reserve capacity to "hide" new disease
           - increased time for chronic disease to eliminate reserve capacity
           - increased time for "slow" disease to develop
           - increased time for exposure to "causes" (number and duration of exposures)

 10. Explain how abnormal and disease changes can be reduced and why doing so is important.

      - (1) prevent occurrence (primary prevention), (2) slow progress (secondary prevention), (3) compensate for or cure (tertiary prevention)
           - avoid risk factors
           - early detection and treatment
      - "prevention" and cure -> increased longevity and improved quality of life

11. Name five main risk factors that promote abnormal and disease conditions that often accompany aging.

      - smoking; stress; poor nutrition; inadequate exercise; exposure to environmental hazards (biological, chemical, physical, sunlight); high blood pressure; high blood cholesterol; genes: poor nutrition

12. Briefly describe cross-sectional and longitudinal methods of studying aging and list three advantages and three disadvantages of each.

      - cross-sectional study = individuals grouped into age categories, parameters measured for groups -> correlations between differences for parameters and differences in ages of groups -> conclusions about aging "causing" differences = age changes
           - advantages = fast, inexpensive, many readings, little "period effect"
           - disadvantages = no measurement of age changes, infer correlations = causation, birth cohort effect, differential mortality effect bias, no measurements of changes in any individuals

      - longitudinal study = repeat measurements of parameters on same individuals over extended period
           - advantages = actually measure age changes, measure changes in individuals, can detect changes in rates of change, can detect changes caused by non-age factors {e.g., disease, accident}, can make predictions based on extant conditions
           - disadvantage = take long time -> problems with participants, researchers, techniques; expensive; have few subjects; have "period effect"; have birth cohort effect; practice effect in subjects

13. Briefly describe the time lag method of studying aging and list advantages and disadvantages.

     - like cross-sectional study but repeated in intervals of several or many years
         - advantages = same as cross sectional studies plus identifying birth-cohort effects
         - disadvantages = same as cross sectional study plus need for more time -> problems with researchers and techniques

14. Briefly describe advantages and disadvantages of using non-human and cell studies to learn about human aging.

      - advantages = better genetic homogeneity; better control of environmental factors; take less space; less expensive; quicker; less ethical and psychological complications; fewer complications from diseases and medical treatments
      - disadvantages = non-human genes and diseases; non-human physiology {e.g., hormones}; non-human responses to conditions; can only infer to humans

15. Describe general patterns of biological aging (age of onset, trends over time, age of appearance, types of variability).

      - onset = variable but beginning at age 20, trends = no plateau period, variable decline with occasional periods of improvement in some parameters, appearance = well after onset from {1} reserve capacity, {2} compensatory strategies, {3} changes in lifestyles and goals
      - types of variability = (1) among individuals for age of onset in one body part, (2) among individuals for rates for a given body part, (3) among individuals for parts that age fastest, (4) among individuals, general average differences, (5) among body parts in one individual, (6) among rates at different ages for one body part
      - variability due to (1) intrinsic and non-modifiable differences {e.g., genes, gender), (2) extrinsic and modifiable factors {e.g., accident, disease, education, diet, occupation, air quality}

16. Describe heterogeneity as age increases and explain its significance.

      - increase heterogeneity within and among individuals as age increases -> (1) increased importance for individualization rather than stereotyping or "lumping", (2) no set age for becoming "old"

17. Describe the meaning, usefulness and difficulty in determining a person's "biological age".

     - meaning = appearance and ability to maintain homeostasis relative to the average of others at specific ages
     - usefulness = better understand aging; evaluate methods for altering aging; develop individualized care plans; evaluate treatments; identify non-age changes; predict future status of individuals
     - difficulties = lack of agreement about methods and criteria to be used

18. Describe maximum longevity, mean longevity, and life expectancy, and describe past, current, and future trends in these parameters.

      - maximum longevity = age of oldest individual ever
      - mean longevity = life expectancy = average age of death in a population
      - different for different populations (e.g., male vs female, between races, at different ages)
      - no change in human maximum longevity possible yet
      - mean longevity increased, is increasing, and is expected to continue to increase
       - present and future increases due mostly to increases for adults, not children
        Go to https://www.biologyofhumanaging.com/activit.htm#Life Expectancy:Assignment  for activities related to determining life expectancy for an individual.

19. Name two non-modifiable and four modifiable factors that influence mean longevity and explain their relationships to quality of life.

      - non-modifiable = genes (?), race, gender, family history, intelligence, personality
      - modifiable = education, social relationships, nutrition, exercise, housing, health care, employment, marital state, stress, quality of physical environment, diseases, accidents
      - improving factors -> increased longevity and increased quality of life

20. Explain concepts of quality of life and their importance.

     - concepts vary
          - external quantitative measures by others of health, performance of tasks, psychological status, economic status, social abilities
          - internal self-evaluation including personal sense of identity, independence, efficacy, control of environment, satisfaction
     - important for establishing and evaluating programs, policies, and individual choices involving life style; for optimizing conditions for elders and for society

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