Ch3 Biological Aging and Health Full Test Bank

CHAPTER 3

BIOLOGICAL AGING AND HEALTH

CHAPTER SUMMARY

Chapter 3 is divided into five main sections. The first section on the meaning of longevity defines the concepts of morbidity and mortality and then describes the meaning of life expectancy and life span. Life expectancy can be estimated at any point during the life course (and examples are given both for the U.S. and several other countries), but there is also a description of life expectancy at birth and life expectancy at ages 65 and 75. In the United States, life expectancy at birth increased dramatically from 1900 to 1970 and it continues to edge up gradually. Female infants have a greater life expectancy than male infants do, and European Americans have a greater life expectancy than African Americans do. Life expectancy for those who reach age 65 has increased for both men and women, but there is a gap in favor of women. The gender gap narrows for life expectancy at ages 75 and 85.

Life span is the extreme upper limit of time (maximum longevity) that members of a species can live. For humans, this seems to be approximately 122 years of age. Over the years, the dramatic increases in life expectancy but the relatively constant life span has resulted in a compression of mortality and ultimately in a survival curve that is becoming more and more rectangular.

The second section in the chapter covers the biological aging process, which is broken down into primary and secondary aging. Theories of biological aging are grouped into two general categories: (1) programmed theories, which are more closely tied to primary aging, and (2) stochastic theories, which are more closely tied to secondary aging.

Programmed theories, which postulate that aging is a function of a genetically based program that directs the aging process, include the time-clock theory at the cellular level (and the recent theory that telomere length determines when cell division stops), immune theory, and a more general evolutionary theory.

Stochastic theories, which postulate that aging is the result of damage and random events, include error theory, wear and tear theory (and the variant rate-of-living theory), stress theory, and hypothesis regarding the build-up of damaging substances such as lipofuscin, collagen, and free radicals. Dietary theories also abound, including the possibility that caloric restriction extends life, possibly because it lowers blood glucose and restricts the formation of free radicals.

The third section in the chapter, individual differences in longevity, discusses the possible role of nature (heredity, genetic make-up) and nurture (environmental influences) in the aging process. It is difficult to isolate the effect of nature and nurture, but attempts have been made through the study of naturally occurring phenomena. The Nun Study follows religious sisters whose living environments have been similar over a number of decades.

Marital status has been studied with regard to longevity and marriage seems to be associated with healthy behaviors, especially for men. However, factors related to marriage, such as education and habits, may be more protective than marriage itself, and consistent marriage (to the same person for a long time) may have a stronger association to longevity than does inconsistent marriage (being married more than once).

Scientists have attempted to predict individual longevity by measuring intellectual functioning, but most studies have been retrospective. A steep decline preceding death is called a terminal drop. However, data from the Nun Study suggests that emotional well-being could play a role in longevity. Certain lifestyle practices such as abstention from smoking, limiting fat and sugar in the diet, and adequate exercise hold promise for extending individual longevity.

The fourth section in the chapter discusses physical changes that commonly occur over the course of adulthood as well as the increased frequency of chronic diseases. In general, there is a lower reserve capacity, which means that physical performance may be compromised in stressful and demanding situations. Although aging and disease are not one and the same, some diseases that are more common in older adulthood are osteoarthritis, osteoporosis, Type II Diabetes, atherosclerosis, and hypertension. There are also some age-related changes with regard to the structure and possibly in the functioning of the brain, even with normal aging. Further research is being conducted using imaging techniques, most commonly the fMRI and PET. The field of cognitive neuroscience has taken on increasing importance, and the STAC (Scaffolding Theory of Aging and Cognition) Model has been proposed to account for the possibility of both deficient and preserved performance on cognitive tasks. According to STAC, the aging brain adapts to neural challenges such as atrophy by building alternative neural circuitry, or scaffolds, which can compensate for and offset age-related decline in functioning. The brain’s ability to build scaffolds could be influenced by factors such as maintaining cardiovascular health and engaging in mentally challenging activities. The two leading causes of death in the age 65+ group are heart disease and cancer. Changes in other areas of body functioning (urinary/bowel and sexual) are also discussed.

The fifth and final section in the chapter covers everyday functioning and health care. There is a distinction between activities of daily living (ADL), which include basic self-care such as dressing and bathing, and instrumental activities of daily living (IADL), which are more complex activities such as housework and shopping. Older adults often need medication to control chronic health problems, but this is not always taken as prescribed. The main source of health insurance for older Americans is Medicare, which has deductibles and co-payments. Another source of health care coverage is from Medicaid, which is means tested so only available to those who fall below a certain income level.

SUGGESTED WEBSITES

National Center for Health Statistics

www.cdc.gov/nchs/

This website provides many statistics on health in the United States. It lists the leading causes of death and information on health care. There is a link to detailed information on agencies that provide home health care and the number of patients receiving it. It has a link to aging where you will find information and tables on trends in healthy aging as well as links to other sites that deal specifically with aging.

Healthy Aging for Older Adults

www.cdc.gov/aging

This website is maintained by the Centers for Disease Control and Prevention Healthy Aging Program. It includes information on the progress and accomplishments of the CDC Healthy Brain Initiative. In addition, there are links to a number of topics related to healthy aging as well as a list of resources and publications.

Health and Age: Live Well, Live Longer

www.healthandage.com

This website provides information on health topics most relevant to older adults. There are links to specific information on various health issues such as Alzheimer’s disease, arthritis, cancer, hearing and vision, memory, osteoporosis, sleep problems, stroke, urinary problems, and so on. There are links to information on men’s health and women’s health, as well as many questions and answers about preventive measures that will lead to healthy and positive aging. However, the site recommends consulting a qualified health care professional to obtain specific advice for individual older adults.

Centers for Disease Control and Prevention

www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html

This is a link in on the CDC website that is of special interest for aging. It reports statistics on falls and hip fractures among older adults and information on the seriousness and cost of such problems. Information includes how often such incidences occur and what the outcomes of falls are likely to be. Also, there is a list of activities designed to prevent falls among older adults.

Medicare

http://www.medicare.gov

This website has information on the federal Medicare program, including the more recent prescription benefits program (Part D). It includes information on the cost of Medicare, the services covered by each Part of the Medicare program, and the facilities and doctors that participate in Medicare.

The Georgia Centenarian Study

http://www.publichealth.uga.edu/geron/research/centenarian-study

This website describes the Georgia Centenarian Study, conducted at the University of Georgia Gerontology Center and funded by the National Institute on Aging (NIA). This study was initiated in 1988 and has been following community-living men and women over the age of 100. The Georgia Centenarian Study collaborates with centenarian studies in the United States and all over the world. A fundamental goal of this study is to determine the biological, psychological, and sociological characteristics of this group that may have enabled them to survive to such a late age.

Center for Vital Longevity

http://vitallongevity.utdallas.edu/

At this center, founded in 2008 and located at the University of Texas at Dallas, a group of distinguished cognitive psychologists and neuroscientists are conducting research focused on cognitive aging and the aging mind. They use cutting edge brain imaging technology to study structural changes in the brain and to determine how neural changes in the brain may affect cognitive abilities and behaviors. Their findings could well lead to the development of interventions that will prevent cognitive decline and allow people to maintain their cognitive functioning at the highest possible level.

New England Centenarian study

www.bumc.bu.edu/centenarian

This website describes the New England Centenarian study, which is located in Boston and directed by Thomas T. Perls, MD, MPH. This study follows a large number of centenarians and their family members. The website describes the individual studies being conducted and the newsletters that have been published. It also posts photos of centenarian study participants.

MULTIPLE-CHOICE QUESTIONS

Select the best answer from the options provided.

1. Morbidity refers to ________, whereas mortality refers to ________.

a. illness; death

b. longevity; disease

c. length of life; quality of life

d. chronic illness; acute illness

2. In the United States, life expectancy at birth________ from 1900 to the present.

a. has stayed the same

b. has decreased

c. has increased

3. In the United States, female babies have ______ life expectancy at birth compared to male babies.

a. a shorter

b. a longer

c. the same

4. Which group of Americans has the lowest life expectancy at birth?

a. African American females

b. African American males

c. European American females

d. European American males

5. With regard to the life expectancy of Americans who reach the age of 65, men have fewer years left than women do.

a. True

b. False

6. Human life span _______________.

a. has increased since 1900

b. has decreased since 1900

c. has stayed the same since 1900

7. In the United States, life expectancy has ______ and life span has ______.

a. been increasing; stayed the same

b. stayed the same; been increasing

c. been decreasing; been increasing

d. stayed the same; been decreasing

8. The term “rectangular survival curve” means that ____________.

a. the life span of the human species is increasing every decade

b. diseases such as AIDS cut life off at an early age for a significant proportion of the population

c. we now have the knowledge to extend human life indefinitely

d. life expectancy is approaching life span for a larger proportion of the population

9. With compression of morbidity, more and more people __________.

a. will be ill only immediately prior to death

b. will suffer from illness early in life but not later

c. will no longer suffer from illness at all

d. will suffer from illness throughout life

10. Primary aging refers to age-related changes that ____________.

a. come from outside the organism

b. affect all members of the species

c. are attributable to lack of exercise

d. occur because of smoking and excessive use of alcohol

11. Secondary aging refers to age-related changes that ___________.

a. are universal in the species

b. result from disease, disuse, and abuse

c. that are intrinsic, coming from within the organism

d. that imply the ticking of a biological time clock

12. Programmed theories of aging have more in common with secondary aging than they do with primary aging.

a. True

b. False

13. Some researchers think that ______, which are protective caps at the tail ends of chromosomes located in each cell, lose some of their length. When they become too short the cell cannot divide any longer, and this could affect the longevity of the organism.

a. collagen

b. telomeres

c. cross-links

d. lipofuscin

14. Which of the following is NOT considered a stochastic theory of biological aging?

a. Wear-and-tear theory

b. Free radical theory

c. rate-of-living theory

d. Immune theory

15. Compared to programmed theories of biological aging, stochastic theories are better able to explain how lifestyle factors affect an individual person’s rate of aging and chances of living a long life.

a. True

b. False

16. When people are exposed to conditions of stress, their physiological responses are associated with an increase in the level of stress-related hormones. When the stressful conditions return to normal, the elevated hormone levels do too. A return to normal, or baseline, levels of stress hormones ______________.

a. takes more time for young adults than it does for older adults

b. takes the same amount of time for young and older adults

c. takes less time for young adults than it does for older adults

17. __________ are the molecular fragments formed as a by-product of the body’s metabolic processes that unite with other molecules and interfere with their functioning.

a. Telomeres

b. Collagen

c. Free radicals

d. Lipofuscin

18. Compared to rats on unrestricted diets, rats fed a diet nutritionally adequate diet but a reduced number of calories ______________.

a. look less sleek but live the same amount of time

b. look more sleek but live the same amount of time

c. look less sleek but die earlier

d. look more sleek and have greater longevity

19. Obesity has become a public health issue in the United States, but, fortunately, it is extremely rare in adults ages 65 and older.

a. True

b. False

20. Genetic make-up can fully account for how long a person will live.

a. True

b. False

21. Men who reach the ninth decade of life are often better off mentally and physically than women are.

a. True

b. False

22. Tucker and her colleagues studied the relationship between marital status at midlife and longevity in a sample of men and women in the Terman Life-Cycle longitudinal study initiated in 1921. They found that _______________.

a. those who had never married had a higher mortality risk than those who were married

b. those married to the same person at midlife years had a lower mortality risk than those married more than once

c. those who were separated or divorced at midlife had a higher mortality rate than those who were married

d. marital status at midlife had no relationship to mortality risk

23. “Terminal drop” specifically refers to the fact that ___________.

a. there is a decline in cognitive ability test scores prior to death

b. older adults often experience falls prior to death

c. older adults often experience a drop in blood pressure

d. some older adults experience a decline in life satisfaction

24. One study described in Chapter 3 found that individuals who have faster reaction times in their 50s live ______________ compared to individuals who have slower reaction times.

a. more years

b. fewer years

c. the same number of years

25. According to findings from the Nun Study, it is possible to predict longevity on the basis of the level of positive emotional expression found in autobiographies that the nuns wrote when they were entering the convent as young adults.

a. True

b. False

26. Harris surveyed adults from a wide range of ages on their attitudes toward the use of age concealment techniques such as coloring hair or getting a facelift. Harris found that the people in her survey were least likely to be favorably viewed when such techniques were used by _______.

a. men

b. women

c. themselves

d. They were equally disapproving of all of the above

27. Reserve capacity is the extra capacity needed when stressful or demanding situations require more than the normal capacity. With increasing age, the level of this reserve capacity __________.

a. is lower

b. is higher

c. stays the same

28. Deterioration of the bone structure (brittle and porous bones) is found most commonly in________, who suffer in great numbers from ______.

a. Hispanic American women; rheumatoid arthritis

b. African American men; atherosclerosis

c. Native American men; bone marrow disease

d. European American women; osteoporosis

29. The build-up of plaque that can restrict blood flow is called __________.

a. osteoporosis

b. rheumatoid arthritis

c. atherosclerosis

d. Alzheimer’s disease

30. Which disease is associated with high blood glucose levels and can lead to complications such as stroke and blindness?

a. Arthritis

b. Osteoporosis

c. Diabetes

d. Cancer

31. Which technique is used to monitor changes in brain activity as individuals engage in cognitive tasks?

a. CT scans

b. X-rays

c. fMRI

d. Video monitoring

32. As age increases from middle to older adulthood, the volume of the brain _____.

a. increases

b. remains stable

c. decreases

33. Which area of the brain seems to be the most affected by the aging process as far as having tangles, plaques, and widened sulci?

a. The occipital lobe

b. The parietal lobe

c. The frontal lobe

d. All of the above are equally affected by the aging process.

34. Compared with the brains of old rats that live in standard cages with little stimulation, the brains of old rats that live in a complex toy-filled environment ___________.

a. have more extensive dendritic branching of neurons.

b. have the less extensive dendritic branching of neurons.

c. have the same amount of dendritic branching of neurons.

35. According to the Scaffolding Theory of Aging and Cognition (STAC), the brain cannot adapt to the neural changes that occur with aging and thus shows greater and greater slippage in functioning as time goes by.

a. True

b. False

36. According to the Scaffolding Theory of Aging and Cognition (STAC), __________.

a. the extent of scaffolding in the brain is not affected by environmental factors

b. scaffolding in the brain compensates for age-related decline in the brain’s neural circuitry

c. new circuitry resulting from scaffolding is commonly associated with a greater degree of differentiation in brain activation

d. All of the above

37. Which of the following is the leading cause of death for people age 65+ in the United States?

a. Heart disease

b. Diabetes

c. Alzheimer’s disease

d. Acute infectious diseases

38. As a cause of death, diabetes is ______ among European American older adults than it is among African American older adults.

a. more frequent

b. equally frequent

c. less frequent

39. Which of the following is the best example of an activity of daily living (ADL)?

a. Shopping

b. Bathing

c. Cooking

d. Driving

40. Which of the following is the best example of an instrumental activity of daily living (IADL)?

a. Bathing

b. Eating

c. Dressing

d. Cooking

41. The federal health insurance program that covers most Americans as long as they are ages 65 and older is called _________.

a. Medicaid

b. Medicare

c. Welfare

d. Senior Citizen Health Access

42. Which of the following is true about Medicaid?

a. It is a federal health insurance program administered by individual states.

b. It is a means-tested health insurance program.

c. It covers lengthy nursing home stays in some cases.

d. All of the above.

SHORT ANSWER QUESTIONS

1. What is meant by life expectancy at birth and how has it changed in the United States from 1900 to the present time?

2. Describe any gender differences in life expectancy in the United States.

3. What is meant by life span? For humans, has it changed over the past number of decades?

4. What does the rectangular survival curve signify about life expectancy, life span, and the compression of mortality?

5. What is the difference between primary aging and secondary aging?

6. How are programming and stochastic theories of biological aging different? Give an example of each and explain why it falls into the category it does.

7. Describe how both nature and nurture relate to individual differences in longevity.

8. What is terminal drop?

9. What is reserve capacity? How does it change with increasing age?

10. Describe some of the changes that take place in the aging brain?

11. Distinguish between activities of daily living (ADL) and instrumental activities of daily living (IADL).

12. Explain the difference between Medicare and Medicaid.