There are many ways of considering ageing and the perspective taken has an influence on how we consider and explain the process. These ways of considering have been termed models and theories of ageing.
There are many ways of considering ageing and the perspective taken has an influence on how we consider and explain the process. These ways of considering have been termed models and theories of ageing. For the purposes of your study in this unit these terms will be used interchangeably.
In this module we are going to look at three models of health that have been applied to Ageing.
1. Biomedical
2. Biopsychosocial
3. Sociocultural
We will begin by viewing two lectures. The first contrasts a Biomedical and Biopsychosocial model in relation to Angina. This video is not specific to ageing but does illustrate the two models. The second discusses Ageing from a Sociocultural perspective.
We will then read a summary of each model.
WATCH:
Gill Furze Biomedical vs. Biopsychosocial treatments: The example of Angina
Age aging and growing old: Socio-cultural perspectives
Biomedical models of ageing
Biomedical Model of Ageing
Biomedical models focus on biological factors and exclude psychological environmental and social factors in discussions of illness health and ageing. Physiology pathology and biochemistry are core areas of investigation. As such biomedical models form the basis of traditional western medicine and the model under which most health professionals continue to primarily be taught and practice. Within a biomedical model disease is considered to be an organic condition that may be eradicated or cured by medical intervention targeted at physiology pathology and biochemistry.
Disease is something that is experienced by a person that person then becomes the object of treatment by the medical professional. As treatment is provided after symptoms appear we can consider traditional western medicine under a biomedical model to be primarily reactive rather than preventative. Treatment is typically provided in a medical environment (hospital or Drsoffice) out of the context of the persons own personal environment.
Biomedical models have in the past and continue to make an enormous contribution to health and well-being. It is through a biomedical model that we have been able to map and understand the anatomical and neurophysiological structures of the body and to explore genetics. However the model does not come without its shortfalls. Failing to consider the impact of individual differences life circumstance environmental and psychological impacts on health and well-being the biomedical model is insufficient in facilitating well-being and global quality of life is insufficient in providing holistic treatment is insufficient in targeting public health and global health issues and insufficient in promoting healthy active and successful ageing across the lifespan.
Under a biomedical model a distinct power imbalance is also seen between the object of treatment (people patients consumers) and the provider of treatment (the health professional). Here we have an emphasis on people as passive recipients of care provided by the health professional with the knowledge to tell us what is best what we need. Without consideration of factors outside of physiology pathology and biochemistry the opinion concerns and circumstances surrounding the illness are not given equal weighting.
Here are some topics currently under discussion within the Biogerontology field that are consistent with a biomedical model of ageing.
Telomeres
The shortening of telomeres has been described as the molecular clock of ageing. A link has in fact been found between the age and telomere length such that shorted telomeres are associated with shorter life expectancy.
Mitochondrial damage
Changes in mitochondrial Fe homeostasis cause a decline in mitochondrial function. Decline in mitochondrial function causes neuromuscular degenerative disease and tissue dysfunction.
Micronutrient inadequacy
Inadequate micronutrient intake leads to metabolic changes that can increase the chance of DNA damage leading to increased risk of cancer immune dysfunction cognitive decline and accelerated ageing due to mitochondrial decay.
Immunological Point of view
Change in immune system function is a key characteristic of ageing and one key reason why older people are more prone to chronic and degenerative health conditions. Reactivity of dendritic cells to self-antigens can be characteristic of ageing this over-reactivity may then induce lymphocyte T proliferation leading to higher risk of autoimmune diseases
WHAT DO THESE CHANGES MEAN FOR US?
Have a look at this animation of for a quick and very simplistic but effective summary of changes to our body we can expect as we age. We will also briefly summarise some below:
Eyesight
As we age our eyesight does decline for some this decline may result in no noticeable functional loss of vision. Others may be aware that they must hold the newspaper a little further away to read may need to read larger print or notice it takes longer to focus on smaller objects. Conditions impacting vision common in older people include presbyopia cataracts and macular degeneration.
Hearing
Hearing loss related to ageing is called presbyacusis and results in a loss of hearing across all frequencies. Your ability to detect changes in pitch reduces listening in background noise becomes harder wax production reduces your eardrum thickens the bones (ossicles) that transfer sounds to your inner ear may move less easily you have also accumulated a lifetime of damage to your inner hair cells that transmit sounds as nerve impulses to your brain for processing causing issues with the perception of sounds particularly complex sounds such as speech.
Ageing and Taste
Taste receptors detect sweet. salty bitter and sour tastes. Saliva helps us to dissolve food and drinks and therefore release the flavour producing chemicals and substances in food the odours from these chemicals and substances waft up to your nose where you then smell your food. Whilst the taste receptors on your tongue are quite resilient with age your sense of smell declines and as this occurs so does your ability to taste. In addition many older people experience loss of saliva production which in turn reduces our ability to breakdown our food and release those flavour producing stimulants. It also reduces our ability to ingest and digest our food. Many medications commonly used by older people can also impact on taste sensation including blood pressure and arthritis medication chemotherapy and radiation treatments.
Metabolic Changes
Gaining weight as we age whilst common is NOT inevitable. Body fat starts to increase from around 25 years of age however muscle mass and body water decrease. Hence you may gain weight or lose muscle tone. What does happen as you age is that you have a lower basal metabolic rate so in short you burn less calories. Our nutrition needs change as we age. If we still eat in our older years what we did when we were 17 it is likely we will gain weight.
Respiratory Changes
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