PSYCHOLOGY 2012: PHYSICAL CHANGESPSYCHOLOGY 2012: PHYSICAL CHANGES

BIOLOGICAL PERSPECTIVES ON AGINGBIOLOGICAL PERSPECTIVES ON AGING

Biochemical and physiological changes, Biochemical and physiological changes, under genetic influence, interacting with the under genetic influence, interacting with the environment.environment.

Causes? Some theorists see aging as a Causes? Some theorists see aging as a disease that can be cured or prevented!disease that can be cured or prevented!

Non-genetic hypotheses:Non-genetic hypotheses:• wear and tearwear and tear• accumulation of toxinsaccumulation of toxins• accumulation of metabolic waste (e.g. accumulation of metabolic waste (e.g.

lipofuscin)lipofuscin)• collagen changescollagen changes• nutritional deficitsnutritional deficits• accumulation of free radicalsaccumulation of free radicals• damaged DNA can’t repair tissues (damage is damaged DNA can’t repair tissues (damage is

environmental, e.g. sun)environmental, e.g. sun)• cross-linking of cellular proteins and collagen cross-linking of cellular proteins and collagen

(caused by aldehydes)(caused by aldehydes)

Aldehydes: Aldehydes: • by-products of cell metabolism. The more by-products of cell metabolism. The more

fat, calories and animal protein in the diet, fat, calories and animal protein in the diet, the more aldehydes are produced.the more aldehydes are produced.

Genetic hypotheses:Genetic hypotheses:• Hayflick’s limitHayflick’s limit• genes for aging program changes (e.g. genes for aging program changes (e.g.

telomeres)telomeres)

Other physiological hypotheses:Other physiological hypotheses:• aging CV systemaging CV system• endocrine decline (thyroid, pituitary, endocrine decline (thyroid, pituitary,

hypothalamus)hypothalamus)• immunological deficits:immunological deficits:

• less efficientless efficient• autoimmune diseasesautoimmune diseases

THANATOLOGY: STUDY OF DEATHTHANATOLOGY: STUDY OF DEATH

(Thantos: Greek god of death)(Thantos: Greek god of death)

CAUSES OF DEATH:CAUSES OF DEATH:

Until 20Until 20thth century: century:• infectionsinfections• accidentsaccidents• epidemics, pandemicsepidemics, pandemics• parasites (endemic)parasites (endemic)• starvation, severe nutritional deficiencystarvation, severe nutritional deficiency

CAUSES OF DEATH:CAUSES OF DEATH:Twentieth century: lifestyle diseases (1Twentieth century: lifestyle diseases (1stst World) World)

• hypertensionhypertension• hypercholesterolemiahypercholesterolemia• cardiovascular problems: heart attacks cardiovascular problems: heart attacks

and strokesand strokes• cancercancer• immune deficits – AIDSimmune deficits – AIDS• diabetesdiabetes

Causes:Causes:• obesityobesity• sedentary lifesedentary life• fatty foods*fatty foods*• excess foodsexcess foods• smokingsmoking• pollution (harmful chemicals in the pollution (harmful chemicals in the

environment)environment)• radiationradiation

Individual variables related to longevity:Individual variables related to longevity:• geneticsgenetics• personalitypersonality• accidentsaccidents• lifestylelifestyle

Which ones do we have control over?Which ones do we have control over?

PHYSICAL CHANGES AS WE AGE:PHYSICAL CHANGES AS WE AGE:First decade of young adulthood: First decade of young adulthood: • Growth does not stop in adolescenceGrowth does not stop in adolescence• Long bones grow to age 25Long bones grow to age 25• Spine grows to age 30Spine grows to age 30• Skulls grow into old ageSkulls grow into old age• Myelinization and differentiation of CNS to age Myelinization and differentiation of CNS to age

2525Overall, good health, high energy, quick recoveryOverall, good health, high energy, quick recoveryfrom illness. No noticeable effects of unhealthy from illness. No noticeable effects of unhealthy lifestyles. lifestyles. HoweverHowever recently, changes due to recently, changes due tochildhood obesity and environment toxins.childhood obesity and environment toxins.• Past 25-30 a lot depends on lifestyle and Past 25-30 a lot depends on lifestyle and

heredityheredity

Second decade of young adulthood:Second decade of young adulthood:• face linesface lines• weight harder to keep offweight harder to keep off• thinning hair (men)thinning hair (men)• greying hairgreying hair• ““spare tire” (men)spare tire” (men)• hips (women)hips (women)• saggingsagging• changes in menstrual cycle (climacteric)changes in menstrual cycle (climacteric)• tanning: UV rays interfere with DNA production and tanning: UV rays interfere with DNA production and

protein synthesis (tissue damage)protein synthesis (tissue damage)• CV system: past age 20 CV system: past age 20 cardiac outputcardiac output (amount of (amount of

blood pumped in 60 sec.) decreases 1% a year for blood pumped in 60 sec.) decreases 1% a year for sedentary peoplesedentary people

Significant individual differences.Significant individual differences.

CHANGES IN VISION:CHANGES IN VISION:• Lens less flexible, doesn’t shed old cells (epithelial) as Lens less flexible, doesn’t shed old cells (epithelial) as

efficiently.efficiently.• Therefore, lens becomes thicker, more compact.Therefore, lens becomes thicker, more compact.• This leads to accommodation being slower and harder.This leads to accommodation being slower and harder.• Affects close range focusing: presbyopiaAffects close range focusing: presbyopia• Also becomes yellowish: need more light to see: Also becomes yellowish: need more light to see:

cataractscataracts• These changes start around 35-45.These changes start around 35-45.• Pupil: less flexible – problems for dark/light adaptation.Pupil: less flexible – problems for dark/light adaptation.• Some eye muscles less effective.Some eye muscles less effective.• Visual acuity decreases around 40-50.Visual acuity decreases around 40-50.• Depth perception decreases at about 50.Depth perception decreases at about 50.• Field of vision shrinks from 50 on, marked after 75.Field of vision shrinks from 50 on, marked after 75.

Retina: after 65 malfunction or destructionRetina: after 65 malfunction or destruction• Senile macular degeneration: gradual Senile macular degeneration: gradual

degeneration of centre of retina, affects both degeneration of centre of retina, affects both eyes. Leads to blindness.eyes. Leads to blindness.

• Disciform macular degeneration: blood leaks to Disciform macular degeneration: blood leaks to the retina. If caught early, can be treated with the retina. If caught early, can be treated with laser photocoagulation. If not: blindness.laser photocoagulation. If not: blindness.

• Glaucoma: intraocular pressure (correlated Glaucoma: intraocular pressure (correlated with hypertension) damages the optic nerve. with hypertension) damages the optic nerve. Beta blockers help. Tonometry diagnostic test Beta blockers help. Tonometry diagnostic test after 50. Leads to blindness.after 50. Leads to blindness.

DRIVING IN OLD AGE:DRIVING IN OLD AGE:• Visual acuity – 20/50Visual acuity – 20/50• 120120° visual field° visual field• RTRT• strengthstrength• coordinationcoordination• range of motionrange of motion• motor skills – speedmotor skills – speed• mental ability:mental ability:

• attention: single, multi, switchingattention: single, multi, switching• memorymemory• problem–solving and decision-makingproblem–solving and decision-making• judgment of distancejudgment of distance• depth perceptiondepth perception• speed of mental processingspeed of mental processing

HearingHearing• Declines after age 13 in industrialized countries.Declines after age 13 in industrialized countries.• Noise pollution.Noise pollution.• Hearing for higher frequency tones goes first.Hearing for higher frequency tones goes first.• Presbycusis: loss of hearing for high pitch tones.Presbycusis: loss of hearing for high pitch tones.• How? Damage to receptor: hair cells, inner ear How? Damage to receptor: hair cells, inner ear

(cochlea)(cochlea)• Also, arthritis of the ossicles possible.Also, arthritis of the ossicles possible.• Also processing slower.Also processing slower.

Loss of hearing can lead to:Loss of hearing can lead to:• social isolationsocial isolation• depressiondepression• paranoiaparanoia

Chemical senses: taste and smellChemical senses: taste and smell• decline too: consequences for nutritiondecline too: consequences for nutrition• poor nutrition can be also due to loneliness and poor nutrition can be also due to loneliness and

isolation, consequences for general health and for isolation, consequences for general health and for CNS functioning. (Vitamin B)CNS functioning. (Vitamin B)

Immune systemImmune system• also declines with agealso declines with age

CNS degenerationCNS degenerationReaction time (RT) as measureReaction time (RT) as measure• loss of neurons (anatomical)loss of neurons (anatomical)• loss of synapses (functional)loss of synapses (functional)

Use it or lose it!!Use it or lose it!!

Sleep: Sleep: • more interruptions after 35more interruptions after 35• disturbances due to illness, medication disturbances due to illness, medication

and pain, not to ageand pain, not to age• only differenceonly difference: ½ hr./1 hr. less sleep per : ½ hr./1 hr. less sleep per

night and a few more 3 to 10 minute night and a few more 3 to 10 minute awakeningsawakenings

Temperature regulationTemperature regulation• becomes more difficult: hyper or becomes more difficult: hyper or

hypothermiahypothermia

Consequences of temperature regulation Consequences of temperature regulation

decline:decline:• Both the ability to detect temperature Both the ability to detect temperature

correctly and to adjust diminishcorrectly and to adjust diminish• Hypo and hyperthermia can lead to deathHypo and hyperthermia can lead to death

Touch and pain: danger detection, e.g. hot stoveTouch and pain: danger detection, e.g. hot stove

Reaction timeReaction time: decreases if sedentary. RT good if active, : decreases if sedentary. RT good if active, e.g. tennis player better at 60 than sedentary 25 year e.g. tennis player better at 60 than sedentary 25 year old. Good indicator of nervous system health.old. Good indicator of nervous system health.

Sense of balance impaired after 65Sense of balance impaired after 65: more falls. Coupled : more falls. Coupled with osteoporosis: serious risk.with osteoporosis: serious risk.

Muscle massMuscle mass: atrophy if not used: atrophy if not used

Solution: weight lifting, resistance trainingSolution: weight lifting, resistance training

Endurance better than sheer strength.Endurance better than sheer strength.

What would you test for if you had to grant driving licenses What would you test for if you had to grant driving licenses to over 75s?to over 75s?

SYSTEMS:SYSTEMS:SKELETAL:SKELETAL:• brittle bones, osteoporosisbrittle bones, osteoporosis• calcium losses, complex mechanismcalcium losses, complex mechanism• add visual impairments and loss of sense add visual impairments and loss of sense

of balance: more falls with more serious of balance: more falls with more serious consequencesconsequences

• osteoarthritis: joints degenerate, not osteoarthritis: joints degenerate, not enough cushionenough cushion

• rheumatoid arthritis: progressive tissue rheumatoid arthritis: progressive tissue destruction – autoimmune?destruction – autoimmune?

MUSCLE TISSUE:MUSCLE TISSUE:• use it or lose ituse it or lose it• importance of exerciseimportance of exercise• weight training – also benefits for osteoporosisweight training – also benefits for osteoporosis• endurance holds better than fast surges – snow endurance holds better than fast surges – snow

shovelingshoveling• RT (reaction time): active 65 year olds better RT (reaction time): active 65 year olds better

than inactive 25 year oldsthan inactive 25 year olds• Middle Age: repetitive, automatic tasks overall Middle Age: repetitive, automatic tasks overall

same as youngsame as young• Older Adults: individual differencesOlder Adults: individual differences

HEALTH CHALLENGES AND AGINGHEALTH CHALLENGES AND AGINGYoung adults:Young adults:• back problemsback problems• hearinghearing• hypertension, hypercholesterolemiahypertension, hypercholesterolemia• accidents second leading cause of deathaccidents second leading cause of death• by age 35 cancer and heart disease starts by age 35 cancer and heart disease starts

to appear as important cause of deathto appear as important cause of death• women die more of cancer than of car women die more of cancer than of car

accidentsaccidents

CHRONIC CONDITIONS BY AGE AND GENDER:CHRONIC CONDITIONS BY AGE AND GENDER:Middle age:Middle age:• asthmaasthma• bronchitisbronchitis• diabetesdiabetes• mental disordersmental disorders• arthritis (and rheumatism)arthritis (and rheumatism)• sight and hearingsight and hearing• circulatory, digestive and urinarycirculatory, digestive and urinary• for women, menopausal complaints, for women, menopausal complaints,

hysterectomy and sequelae of hysterectomyhysterectomy and sequelae of hysterectomy

Deaths: cancer and CV, for women cancerDeaths: cancer and CV, for women cancer

CHRONIC CONDITIONS BY AGE AND GENDER:CHRONIC CONDITIONS BY AGE AND GENDER:

Old age:Old age:• arthritis most commonarthritis most common• hypertensionhypertension• CVCV• hearing, visionhearing, vision• leading cause of death: MI, cancers and leading cause of death: MI, cancers and

strokestroke

CHRONIC CONDITIONS BY AGE AND GENDER:CHRONIC CONDITIONS BY AGE AND GENDER:

Old age (cont’d):Old age (cont’d):• In general women more health conscious In general women more health conscious

and knowledgeable than menand knowledgeable than men• Role of marriage. Health gradient from Role of marriage. Health gradient from

better to worse: married, never married, better to worse: married, never married, widowed and divorced. But … effect of widowed and divorced. But … effect of marriage much stronger for menmarriage much stronger for men

• Widowed women healthier than widowed Widowed women healthier than widowed menmen

ILLNESS AND AGINGILLNESS AND AGING

Issues of quality of life:Issues of quality of life:• individual differences (e.g. reading)individual differences (e.g. reading)• having spousehaving spouse• having children, grandchildrenhaving children, grandchildren• financial self-sufficiencyfinancial self-sufficiency• being in own homebeing in own home• religious comfortreligious comfort• communitycommunity

ILLNESS AND AGINGILLNESS AND AGING• Diseases can be acute or chronicDiseases can be acute or chronic• Acute: rapid onset, reversible, short-term Acute: rapid onset, reversible, short-term

(e.g. ‘flu’)(e.g. ‘flu’)• Chronic: slow onset, irreversible, long-term Chronic: slow onset, irreversible, long-term

(e.g. CV disease)(e.g. CV disease)• As we age, fewer acute illnesses and As we age, fewer acute illnesses and

more chronic ones.more chronic ones.

• Young adults: 20’s not noticeable effects Young adults: 20’s not noticeable effects of abuseof abuse

• 30’s: beginning: more infections, less 30’s: beginning: more infections, less stamina, sleep disorders, GI troubles stamina, sleep disorders, GI troubles • Killers: AIDS, AccidentsKillers: AIDS, Accidents

• 40-60: chronic illness: diabetes, arthritis, 40-60: chronic illness: diabetes, arthritis, rheumatism, sight and hearing, rheumatism, sight and hearing, hypertension, GI, all systems may begin to hypertension, GI, all systems may begin to show problemsshow problems• Killers: heart and cancer lead men more than Killers: heart and cancer lead men more than

womenwomen

• 65+: arthritis most common, hypertension, 65+: arthritis most common, hypertension, CV disease, cataracts, diabetes. Less CV disease, cataracts, diabetes. Less acute illness, more chronic killers: cancer acute illness, more chronic killers: cancer and heart lead.and heart lead.

• Adult onset diabetes: totally linked to dietAdult onset diabetes: totally linked to diet

ILLNESS AND AGINGILLNESS AND AGINGArthritis: painful disease of the jointsArthritis: painful disease of the jointsOsteo and Rheumatoid:Osteo and Rheumatoid:• Osteo: Osteo:

• wear and tear of the joints (injuries, repetitive wear and tear of the joints (injuries, repetitive motion, obesity)motion, obesity)

• bones rubbing together, not protected by bones rubbing together, not protected by serous bags or synovial fluid, mostly over 60serous bags or synovial fluid, mostly over 60

• weight loss, no smoking, gentle exercise weight loss, no smoking, gentle exercise (water)(water)

• use of painkillersuse of painkillers• surgical replacementsurgical replacement

ILLNESS AND AGINGILLNESS AND AGING• Rheumatoid:Rheumatoid:

• autoimmune diseaseautoimmune disease• can appear at any agecan appear at any age

• Remicade, research ongoingRemicade, research ongoing

Arteries:Arteries:• arteriosclerosis: stiffening of arteries due arteriosclerosis: stiffening of arteries due

to less elastin, more collagen and calcium. to less elastin, more collagen and calcium. Appears age related.Appears age related.

• atherosclerosis: plaques of fat and other atherosclerosis: plaques of fat and other debris coat internal arterial walls. Leads to debris coat internal arterial walls. Leads to hypertension. Related to lifestyle. Found in hypertension. Related to lifestyle. Found in children and young adults too (TV, junk children and young adults too (TV, junk food, sedentary life). Heart attacks in food, sedentary life). Heart attacks in young males.young males.

Cardiovascular (CV) System:Cardiovascular (CV) System:• Factors: overeating, fatty foods, refined, Factors: overeating, fatty foods, refined,

processed foods, sedentary, stress, processed foods, sedentary, stress, smoking +++, high salt (processed foods)smoking +++, high salt (processed foods)

• Latest: bacterial (Chlamydia)Latest: bacterial (Chlamydia)• Both arterio and athero cause Both arterio and athero cause

hypertensionhypertension• Heart Attack: myocardial infarctionHeart Attack: myocardial infarction• Stroke: cerebral artery clogged or bursts: Stroke: cerebral artery clogged or bursts:

damage to neuronsdamage to neurons

CANCERCANCER• leading cause of deathleading cause of death• some are eminently preventable: lung (smoking), skin some are eminently preventable: lung (smoking), skin

(sun exposure), colorectal (diet), breast (diet and (sun exposure), colorectal (diet), breast (diet and breastfeeding).breastfeeding).

• only a small percentage of cancers are genetic in origin only a small percentage of cancers are genetic in origin

Possible major causes: Possible major causes: • lifestyle lifestyle • environmental pollution environmental pollution • weakened immune system as we age, together with weakened immune system as we age, together with

cumulative exposure to carcinogens cumulative exposure to carcinogens

• Carcinogens are pervasive in modern life: Carcinogens are pervasive in modern life: • plasticsplastics• synthetic fibers synthetic fibers • chemicals to soften or harden susbtances e.g. chemicals to soften or harden susbtances e.g.

phthalates phthalates • hormones given to cattle hormones given to cattle • pesticides, herbicides, preservatives pesticides, herbicides, preservatives • animal flesh that has incorporated those chemicals animal flesh that has incorporated those chemicals • radiation (air travel, medical tests, cell phones?) radiation (air travel, medical tests, cell phones?) • treated fabrics (e.g. fire retardant in clothes, carpets, treated fabrics (e.g. fire retardant in clothes, carpets,

drapes) drapes) • air pollution (e.g. large cities) air pollution (e.g. large cities) • second (and third) hand smoke second (and third) hand smoke

Despite enormous funds for research, Despite enormous funds for research, cancer incidence is going up.cancer incidence is going up.

Cancer drugs themselves are Cancer drugs themselves are carcinogenic.carcinogenic.

Most funds directed toward detection tests Most funds directed toward detection tests and chemotherapy drugs.and chemotherapy drugs.

Young men: do testicular self-Young men: do testicular self-examination! (imperative if you were born examination! (imperative if you were born with cryptorchidia).with cryptorchidia).

Young women: do BSE and get a yearly Young women: do BSE and get a yearly Pap if you are sexually active!Pap if you are sexually active!

Respiratory system:Respiratory system:• after age 25 vital capacity (amount of after age 25 vital capacity (amount of

oxygen per breath) decreases if inactiveoxygen per breath) decreases if inactive• smoking +++smoking +++

Other organs:Other organs:• digestive enzymes decrease after 30digestive enzymes decrease after 30• kidneys shrink after 30, filter more slowlykidneys shrink after 30, filter more slowly• energy decrementenergy decrement• intestinal problemsintestinal problems

Supplementary notes on health and lifestyleSupplementary 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 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. 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 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, 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, 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.men suffered and died from many diseases caused by smoking that hardly touched women.

In the 1960s, with the second feminist movement gathering momentum, In the 1960s, with the second feminist movement gathering momentum, smoking became acceptable for women. The tobacco companies saw a new, very lucrative 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 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" 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 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 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 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 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. 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 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.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 Even then, there were segments of the female population that were not responding to these ads. The advertisers did research and discovered responding to these ads. The advertisers did research and discovered several female subpopulations, which they targetted separately, including young adolescents, 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 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.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 Smoking is highly addictive, at least as addictive as cocaine. Not every brain responds identically, some individuals will become more easily brain responds identically, some individuals will become more easily addicted than others, but eventually all regular smokers become addicted. There are receptors in addicted than others, but eventually all regular smokers become addicted. There are receptors in the brain that are very sensitive to nicotine and otherthe brain that are very sensitive to nicotine and otherchemicals in cigarette smoke. Smoking is associated with being 'cool' and grown up amongst chemicals in cigarette smoke. Smoking is associated with being 'cool' and grown up amongst adolescents, a way to reach adulthood the easy way.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 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 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 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: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 COPD: chronic obstructive pulmonary disease. The lungs become so filled with "gunk" that they gradually shut down. COPD is one of the leading with "gunk" that they gradually shut down. COPD is one of the leading causes of death and disability.causes of death and disability.

Lung cancer: Although there are some rare lung cancers not caused by Lung cancer: Although there are some rare lung cancers not caused by smoking, the overwhelming majority are. It takes about 20 years for a 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 nocancerous tumour in the lungs to be detectable, so a young person with nosymptoms could already have the cancer growing without being aware of it.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 Although some strides have been made in treatment, in most cases it's fatal.fatal.

Emphysema: now under the umbrella of COPD, it is one of the lung 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 lungconditions where fluid and scar tissue start to fill the alveoli, the lungphysiological units where the exchange of gases takes place which leads tophysiological units where the exchange of gases takes place which leads tooxygenation of the circulating blood. Gradually, smaller portions of the lungsoxygenation of the circulating blood. Gradually, smaller portions of the lungsare functioning, leading to oxygen deprivation. Many disabilities are due toare functioning, leading to oxygen deprivation. Many disabilities are due toemphysema and general COPD. Eventually, it's fatal, as it cannot be emphysema and general COPD. Eventually, it's fatal, as it cannot be reversed.reversed.

Oral cancers: mouth, tongue and jaws can develop cancer due to smoking. 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 The cancer spreads to the throat, takes de vocal cords and parts of the neck and, eventually, metastasizes to other body parts.neck and, eventually, metastasizes to other body parts.

Bladder cancer: because many toxic by products of smoke are processed Bladder cancer: because many toxic by products of smoke are processed through the kidneys, they accummulate in the bladder for lengthy periods through the kidneys, they accummulate in the bladder for lengthy periods of time each day, and cause cancer.of time each day, and cause cancer.

Circulatory system diseases: The chemicals in cigarette smoke (over 2,000 and Circulatory system diseases: The chemicals in cigarette smoke (over 2,000 and counting) promote the formation of plaque through various mechanisms. This counting) promote the formation of plaque through various mechanisms. This plaque, a sticky substance that adheres to the internal walls of the arteries, is 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 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 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 prevent blood from getting through. If it becomes free and is carried in the blood circulation, it can end up obstructing an importantcirculation, it can end up obstructing an importantvessel, such as a coronary artery (which feeds the heart) leading to a heartvessel, such as a coronary artery (which feeds the heart) leading to a heartattack, or a cerebral artery, leading to a stroke. In both cases, either heartattack, or a cerebral artery, leading to a stroke. In both cases, either heartor brain suffer permanent damage due to oxygen deprivation. Even if plaque 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 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 through it leads to hypertension (high blood pressure) one of the most dangerous (and common) diseases of our time.dangerous (and common) diseases of our time.

Necrosis of the lower limbs: The feet are the most distal body part from 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 ofthe heart. When circulation is compromised, it is often in the toes. Lack ofcirculation leads to necrosis, or tissue death, which spreads quite rapidlycirculation leads to necrosis, or tissue death, which spreads quite rapidlyonce it begins. Many smokers have had their limbs amputated to stop the 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 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 alsothis problem, so a diabetic is at double risk in this regard if they are alsosmokers.smokers.

Immune system: smoking decreases the capacity of the immune system to Immune system: smoking decreases the capacity of the immune system to fight infections and other foreign invaders. A smoker is at several timesfight infections and other foreign invaders. A smoker is at several timeshigher risk of contracting many diseases, including other cancers that are not higher risk of contracting many diseases, including other cancers that are not directly caused by smoking.directly caused by smoking.

Ulcers: smokers have a higher incidence of duodenal and gastric ulcers.Ulcers: smokers have a higher incidence of duodenal and gastric ulcers.Cataracts: higher incidence in smokers.Cataracts: higher incidence in smokers.

Depression and suicide: a recent longitudinal study determined that Depression and suicide: a recent longitudinal study determined that smoking is associated with higher rates of suicidal thoughts and actual smoking is associated with higher rates of suicidal thoughts and actual suicide. Although the depression may have preceded the onset of smoking, 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. Thisthose who smoked had a higher rate of suicide than those who did not. Thisstudy was done with people ages 21 to 30.study was done with people ages 21 to 30.

Low birth weight babies: women who smoke during pregnancy are much more Low birth weight babies: women who smoke during pregnancy are much more likely to have babies who are below normal weight, which is associated likely to have babies who are below normal weight, which is associated with many diseases and problems, including learning disabilities.with many diseases and problems, including learning disabilities.

Stillbirths: women who smoke during pregnancy have a higher rate of Stillbirths: women who smoke during pregnancy have a higher rate of stillbirths. It appears that smoking, in addition to cutting off the stillbirths. It appears that smoking, in addition to cutting off the oxygen supply to the fetus, impairs the functioning of the placenta.oxygen supply to the fetus, impairs the functioning of the placenta.

Second hand smoke: chemically, second hand smoke is even worse than what Second hand smoke: chemically, second hand smoke is even worse than what the smoker initially inhales. People who work in smoking environments are atthe smoker initially inhales. People who work in smoking environments are atmuch higher risk for lung cancer and COPD, as well as the other diseases. Ofmuch higher risk for lung cancer and COPD, as well as the other diseases. Ofcourse smokers get both the "fist hand" smoke they inhale and the second 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. 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, In addition, wives of smokers have a higher incidence of cervical cancer, although the mechanism is not yet known. In isolated towns where public 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 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 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 platelets in the blood to become stickier, which is a start for blood clots that block arteries.block arteries.

Although both men and women suffer the consequences of smoking, Although both men and women suffer the consequences of smoking, advertising that targets various subgroups of women very specifically makeadvertising that targets various subgroups of women very specifically makesmoking a serious issue in women's health. Additionally, we have already seen, smoking a serious issue in women's health. Additionally, we have already seen, in previous weeks, how smoking is dangerous for women on hormonal in previous weeks, how smoking is dangerous for women on hormonal contraceptives and it contributes to osteoporosis in post-menopausal women. contraceptives and it contributes to osteoporosis in post-menopausal women.

SLEEP DEPRIVATION SLEEP DEPRIVATION

In our fast-paced society, two thirds of the adult population do not get In our fast-paced society, two thirds of the adult population do not get enough sleep. The consequences are fatigue, irritability, depression, enough sleep. The consequences are fatigue, irritability, depression, decreased attention span, lack of concentration, lapses in memory, decreased attention span, lack of concentration, lapses in memory, frequent illnesses and loss of productivity. One of the most serious frequent illnesses and loss of productivity. One of the most serious consequences for the individual and society is drowsy driving, which consequences for the individual and society is drowsy driving, which increases the risk for accidents. Sleep-related accidents are most common increases the risk for accidents. Sleep-related accidents are most common among young drivers and shift-workers.among young drivers and shift-workers.

Both caffeine and alcohol taken in the evening can impair sleep. Alcohol Both caffeine and alcohol taken in the evening can impair sleep. Alcohol will initially cause drowsiness and lead to sleep, but typically will initially cause drowsiness and lead to sleep, but typically individuals will awake a few hours later and be unable to go back to individuals will awake a few hours later and be unable to go back to sleep. Sugar can also have a stimulating effect.sleep. Sugar can also have a stimulating effect.

Sleeping pills and tranquilizers disrupt the normal sleep cycle, as they Sleeping pills and tranquilizers disrupt the normal sleep cycle, as they impede REM sleep. REM (rapid eye movement) sleep is associated with impede REM sleep. REM (rapid eye movement) sleep is associated with dreaming and is necessary several times throughout the night, in short 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 aperiods. When a person misses REM sleep for one night or more, there is arebound effect that results in too many REM periods the first night the sleeprebound effect that results in too many REM periods the first night the sleepaid is not taken, causing restlessness and fatigue the next day.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 Stress is one of the main reasons for inability to sleep well. There are several methods to deal with stress without resorting to medication.several methods to deal with stress without resorting to medication.

Other causes of sleeplessness are a full stomach (or a really empty one),Other causes of sleeplessness are a full stomach (or a really empty one),light, which will prevent the release of the hormone melatonin, necessary forlight, which will prevent the release of the hormone melatonin, necessary forsleep, noise and uncomfortable temperature in the room (too hot or too cold).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,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 situationwomen are at higher risk because of the double shift. This is the situationwhere women with a family work 8 hours or more at their paid work, and come 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. home to another few hours of intense homemaking and childcare work. Because so many women have to juggle these responsibilities, they are more 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 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 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 also tend to be prescribed more psychotropic drugs by their doctors, which put them at risk for a vicious cycle of sleeplessness and of addictionthem at risk for a vicious cycle of sleeplessness and of addiction

DiabetesDiabetes

Metabolic disorder due to problems in eitherMetabolic disorder due to problems in either• production of insulin orproduction of insulin or• utilization of insulinutilization of insulin

Insulin: pancreatic hormone essential for Insulin: pancreatic hormone essential for metabolizing glucose (sugar)metabolizing glucose (sugar)

DiabetesDiabetes

Two types of diabetes:Two types of diabetes:

Type I and Type IIType I and Type II

Type I (juvenile or early onset):Type I (juvenile or early onset):• Either genetic or intrauterine causesEither genetic or intrauterine causes• Appears in infancy/childhoodAppears in infancy/childhood• Pancreas does not produce sufficient Pancreas does not produce sufficient

insulininsulin• Treatment: insulin injections for life, dietTreatment: insulin injections for life, diet

DiabetesDiabetes

Type II: adult onsetType II: adult onset• Although there Although there couldcould be genetic predisposition, be genetic predisposition,

it’s overwhelmingly a lifestyle diseaseit’s overwhelmingly a lifestyle disease• 90-95% of total # of diabetics are type II90-95% of total # of diabetics are type II• 85% are overweight/obese85% are overweight/obese• The other 10% have faulty dietsThe other 10% have faulty diets• Used to appear in late middle-age/old age but Used to appear in late middle-age/old age but

appearing earlier:appearing earlier:• 40’s: 40% increase in last 8 years40’s: 40% increase in last 8 years• 30’s: 70% increase30’s: 70% increase• teens: also on the riseteens: also on the rise

DiabetesDiabetes

Pancreas produces enough insulin initially but diet Pancreas produces enough insulin initially but diet

high in carbohydrates causes strong insulin spikeshigh in carbohydrates causes strong insulin spikes• eventually tissues do not respond to insulineventually tissues do not respond to insulin• a lot of glucose (2-3 times normal) stays in blooda lot of glucose (2-3 times normal) stays in blood• this causes even more insulin production, this causes even more insulin production,

pancreas overwhelmed, insulin production slowspancreas overwhelmed, insulin production slows• eventually, insulin shots neededeventually, insulin shots needed• also insulin spikes cause hunger and cravingsalso insulin spikes cause hunger and cravings

DiabetesDiabetes• weight goes further up – vicious cycleweight goes further up – vicious cycle• since glucose not metabolized, no energy since glucose not metabolized, no energy

for cells, muscle and neurons slow down: for cells, muscle and neurons slow down: lethargy, lack of energy and irritabilitylethargy, lack of energy and irritability

• high glucose in blood causes damage to high glucose in blood causes damage to capillaries, especially eyes and feet: capillaries, especially eyes and feet: blindness and gangreneblindness and gangrene

• meanwhile, liver keeps sending more meanwhile, liver keeps sending more glucose into blood because cells are glucose into blood because cells are starved – so, even more glucose in blood.starved – so, even more glucose in blood.

DiabetesDiabetes

Damage caused by diabetes:Damage caused by diabetes:• leading cause of blindness in ages 20-74leading cause of blindness in ages 20-74• kidney damage: dialysiskidney damage: dialysis• CV diseaseCV disease• impotence in menimpotence in men• vaginal and UT infections in womenvaginal and UT infections in women• nerve damagenerve damage• gangrene of feet/legs: amputationgangrene of feet/legs: amputation• shortened lifespanshortened lifespan

DiabetesDiabetes

Treatment:Treatment:• diet: foods with low glycemic index, diet: foods with low glycemic index,

balanced: protein and fat slow down carb balanced: protein and fat slow down carb absorption absorption

• weight lossweight loss• exerciseexercise• if severe, insulin, drugs that stimulate if severe, insulin, drugs that stimulate

insulin production, drugs that sensitize insulin production, drugs that sensitize tissues to insulintissues to insulin

SUNDRY ITEMS:SUNDRY ITEMS:

DiabetesDiabetes: distinction between early (insulin : distinction between early (insulin dependent) and late onset (non-insulin dependent) and late onset (non-insulin dependent) becoming blurry.dependent) becoming blurry.

Important: diet crucial, both during pregnancy Important: diet crucial, both during pregnancy (can “program” baby for later onset) and during (can “program” baby for later onset) and during lifespan: as sugar consumption increased this lifespan: as sugar consumption increased this century, diabetes increased in the same century, diabetes increased in the same proportion.proportion.

SESSES: Socio-economic status. Most important : Socio-economic status. Most important variable for all other variables studied in adult variable for all other variables studied in adult development. Income and educational level.development. Income and educational level.

SUNDRY ITEMS (Cont’d):SUNDRY ITEMS (Cont’d):

Cardiovascular diseaseCardiovascular disease: besides factors : besides factors discussed, recent evidence that chlamydia, a discussed, recent evidence that chlamydia, a bacterium, implicated – can be treated with bacterium, implicated – can be treated with antibiotics.antibiotics.

Breast cancerBreast cancer: Besides factors mentioned in : Besides factors mentioned in text, one overlooked variable is breastfeeding: text, one overlooked variable is breastfeeding: BRCA has higher incidence in non-BRCA has higher incidence in non-breastfeeders. As the number of years breastfeeders. As the number of years breastfeeding increases, the incidence of breastfeeding increases, the incidence of BRCA decreases (negative correlation)BRCA decreases (negative correlation)

Ninety percent of breast cancer is not genetic in Ninety percent of breast cancer is not genetic in origin. origin.

Research and funding has been concentrated Research and funding has been concentrated on finding a "cure", rather than in understanding on finding a "cure", rather than in understanding the factors in breast cancer. Emphasis on the factors in breast cancer. Emphasis on detection and treatment, rather than on detection and treatment, rather than on prevention. prevention.

There is a positive correlation between Western There is a positive correlation between Western lifestyle and diet and breast cancer incidence. lifestyle and diet and breast cancer incidence.

Many environmental chemicals have effects that Many environmental chemicals have effects that can lead to cancer. can lead to cancer.

Positive correlation reported between BMI (fat Positive correlation reported between BMI (fat ratio) and incidence of BRCA. ratio) and incidence of BRCA.