The difference between biological age and passport age. Passport and biological age: heredity or environment? Or do you need a passport for training? Who ages faster - men or women?
October 23, 2012Life on the slope
Don't die before you die! - this motto of the poet is used in their own way by psychotherapists
Leading researcher at the Scientific Center for Mental Health of the Russian Academy of Medical Sciences, Irina Roshchina, answers questions from the executive editor of the “NG-scenarios” application, Yuri Solomonov.
– Irina Fedorovna, one of the writers once said, not without grace: “Every person chooses his own age.” From your point of view, this motto can have a psychotherapeutic effect on those who believe in it?
- I think yes. The fact is that in their practical work psychologists sometimes encounter such phenomena. And it turns out that there are people who have a sense of self of a certain age. It may be greater than your actual age or, conversely, less. The wonderful actress Alla Sergeevna Demidova wrote that throughout her adult life she felt like she was forty years old. I know a man of advanced age who has repeatedly told me: “Surprisingly, I always feel like I’m 38 years old. It seems to me that this is some kind of my base age. When I was younger and when I became older than this age, I still continue to feel myself in this age range.”
Of course, not everyone has this feeling. In any case, a person’s perception of his age in the context of his entire life, unfortunately, has not been sufficiently studied in psychology. Characterization of human age is possible from different positions. Let's say there is a chronological (passport) age - this is the period that you have currently lived. There is biological age, which is determined not by passport data, but by the state of various body systems and the rate of their age-related changes. That is, it is possible to find out the biological age of a person based on a set of biological parameters that reflect the state of the cardiovascular, endocrine and other systems of the body. Different body systems change at different rates with age. For some, changes begin earlier in the endocrine system, for others in the cardiovascular system.
There is also the concept of psychological age, which has been little developed scientifically. This is how a person feels at a given moment in life. So far, the analysis of these states has been reduced to metaphorical descriptions, such as “cheerfulness of spirit,” “clarity of thought,” etc.
To summarize, we can say: if biological age is ahead of chronological age, we are dealing with accelerated aging. If everything looks the other way around, we say that a person ages more slowly and more successfully.
It is important to understand that each of us ages individually. Of course, there are general patterns of this stage of life, but the quality of old age for each of us is personally influenced by how we lived the previous years of our lives. In this context, it is very important how an elderly person uses the experience of previous stages of his life, and how much he has learned to use consciously or unconsciously developed self-regulation strategies to combat the changes that occur in us over the years. If a person finds various ways of self-regulation within himself and for himself and uses them, this leads to a harmonious feeling of himself in old age. Both in youth and in aging, we can be healthy or suffer from illness, which, of course, affects the body, psyche, life expectancy and the feeling of age that you asked about.
– Can we assume that there are national and ethnic characteristics of aging, age, and attitudes towards old age?
- Certainly. Because a person and his psyche are determined by biological, psychological and social factors. And this is a way of life, and habits, rules, stereotypes and even prejudices of the environment in which the life of each of us takes place. All this cannot be discounted. On the other hand, there are biological factors that determine, say, a genetic predisposition to some diseases, and this can ultimately manifest itself both in a resident of a highly developed country and in someone who lives in a less comfortable environment.
But, of course, there is also another thing: a society that cares and responsibly treats the aging of each of its citizens makes people’s old age prosperous, prosperous and, if you like, joyful. Here, both material and moral conditions, as well as the level of psychological culture of society, play a huge role.
In addition, if we talk about national characteristics, we can remember that in eastern cultures (and in Russia such regions are fully represented) the attitude towards old people is traditionally wonderful. In a person who has lived a long life, those around him a priori see a sage, an adviser, a mentor. Hence respect, attention and even obedience. Moreover, this is also observed in relation to those elders who do not at all possess these important qualities for their age and are not the bearer of the wisdom of their people. We can say that with such traditions, both young and mature people feel confident, knowing that in old age they will receive the same respect and understanding.
– Does psychology as a science recognize such a concept as “beautiful old age” and somehow comment on it?
– This concept is connected, of course, not only with the appearance of an old person, but rather is determined by the personality characteristics and deeds and achievements of a person. If a person has developed throughout the previous stages of his existence, consciously worked on himself, then in old age he lives interestingly, actively, looking for some new opportunities, activities, and contacts. This includes expanding the range of interests and achieving new real goals. Of course, a sudden change in lifestyle at a certain age is no longer desirable. But those who have gained wisdom and experience over the years understand this themselves. The main thing is that such people are not led by life, but they are led by it. The fact that personality can develop until the end of life has been proven by all studies. This is the first thing. And secondly, if earlier there was always an equal sign between old age and illness, that is, the prevailing attitude was towards old age as an illness, today this idea is beginning to change in society. Although this process is not easy. For example, strange expediency often comes into play: is it worth making significant efforts to treat those who are already ending their lives anyway?
– Do you want to talk about this?
– This, of course, is a fundamentally wrong position. It cannot be justified either professionally or morally. But in our society, it seems to me that the situation is not the best with condemnation of the immorality of such an attitude towards sick old people. In addition to the decline in morals, there are many social problems that turn older people into outcasts, unnecessary family members, etc.
“But we can often observe the activity of older people in the public sphere. Take the same rallies. It would seem that passion and activity disappears over the years, but some older people find some kind of compensating for themselves when they suddenly go out into the square to demand or defend something...
– It all depends on the individual person. Older people's understanding of life prospects is different. It is limited by the duration of the remaining life, and therefore you need to set realistic, achievable goals for yourself. But the feeling of duty to family, loved ones, to oneself - it does not disappear anywhere. This is what forces some people to bring home and family affairs to their senses, and to find meaning and purpose in this very thing. And there are those whose consciousness has always been included in public spheres, and this also has not disappeared. And such old activists can find satisfaction in a rally, meeting, meeting with a deputy, in public criticism of the current order of things...
– It is clear that your science is not able to improve social conditions for the elderly or raise pensions. But still, what is the role of psychology and psychiatry in maintaining this layer of society in a normal psychological and spiritual state?
– Psychiatrists treat mental illnesses in late life. There is even such a direction in psychiatry - gerontopsychiatry. Psychiatrists treat the full range of mental illnesses in late-life patients. An important feature of the treatment of patients at a late age is an integrated approach to the patient. Because old age is an age when the somatic and mental spheres of a person are in close interaction. Therefore, an exacerbation of any chronic disease (stomach, kidneys, heart) leads to a deterioration in the patient’s mental state. And vice versa - if a chronic somatic disease is treated, the patient’s mental status also improves.
There is, of course, a psychological component to the problems of aging. This means that there are psychologists, although there are clearly not enough of them, who work with elderly patients. They are well aware of the psychological features of normal and pathological aging, master methods for diagnosing variants of normal and painful aging, conduct correctional and rehabilitation classes, train memory and other functions, as well as other forms of supporting the mental health of elderly and old people.
By the way, cognitive training is also necessary for a healthy aging person. This is especially important for those over 50. At this age, training of memory, attention, and thinking is already required. This should be a regular additional load, which Americans figuratively call “brain massage.”
– Phrases from American films like “Did you see your therapist today?” no longer make us laugh. or “Are you having a problem? Do you want to talk about it?"
– I don’t want to say that in this sense our problem of psychological assistance has reached American proportions. But, despite the fact that not everyone has a personal psychologist, even in Moscow, the possibility of receiving psychological help is becoming more and more real. This is expressed primarily in the fact that people are no longer afraid to see a psychologist. Of course, not everyone will go to a psychiatrist for treatment. There remains a fairly persistent and unfair prejudice against psychiatric treatment. But many began to seek psychological help for themselves and for their children.
The situation is more complicated with older people. They are very deprived of psychological help and often come to the clinic for it - to a therapist, a neurologist.
We had a successful scientific program when a special office for elderly people was organized in a regular district clinic, which we, so as not to scare anyone, named it “psychoneurologist.” Therapists and other specialists referred mainly elderly people with mental problems to this office. Psychiatrists and psychologists discovered depressive disorders and other symptoms of mental ill-being in them. Psychiatrists and psychologists worked carefully and carefully with the patients, providing treatment, psychocorrection, and psychotherapy. Elderly patients really liked the way they were treated and noted a significant improvement in their quality of life. But then, unfortunately, this office was closed and the work was interrupted. At the same time, some patients came to us at the NCHC for quite a long time after this for outpatient appointments.
– Was communication important to them?
- Communication too. But the main thing was professional clinical and psychological assistance. We advised them, prescribed medications, psychologists worked with them on cognitive training and other methods of psychotherapy. And the fact that they returned to us and highly appreciated the help they received speaks to the effectiveness of our work and the need to develop an outpatient gerontological service.
- I have no doubt. You are experts. But when there are no such people nearby, their place is taken by charlatans, healers of everything and everyone. Some simply pretend to be miracle doctors, others gain confidence through clever manipulations, and then, you know what happens...
– Yes, it is really widespread. And no one is seriously solving this problem. I can talk about this as a psychologist. This is explained by the fact that many older people have reduced critical capabilities. They become very trusting. Vigilance weakens, faith in miraculous healings and easy ways to win something and get cheap and effective medicine increases. When older people are deprived of the opportunity to receive quality medical care, they, willingly or unwillingly, begin to believe in a miracle pill for all diseases. But it is impossible to convince a reasonable person who is aging actively and critically with such psychological tricks.
– On the other hand, young people also fall for these scams! And all because they are poorly educated and gullible. I have inquisitive students who read a lot of modern literature. Such a student comes with the news: “Did you hear? We have found a cure for aging..."
– And I have to remind you that aging is a complex systemic process of age-related changes in all systems of the body and no miracle pill can slow it down, much less stop it. It is much more correct to say that one must prepare for an active, successful old age from a young age. The level of education received in youth, the ability to achieve set goals, optimism in life - all this determines the quality of old age, which is confirmed by a huge number of examples.
- It's right. But at the same time, we cannot ignore the question that occupies all people: what happens to our memory as we age?
– Changes occur in memory that are also characteristic of other mental functions. As we age, the pace and volume of mental activity decrease, which affects the amount of memorization of new information, and forgetfulness of current events increases. That is, any healthy elderly person, as a rule, admits that his memory has become worse. Moreover, memory for the past remains good, but events that just happened are remembered worse. But this does not interfere with normal life. Older people realize that they forget elements of their current lives quite quickly. Therefore, they use a variety of compensatory techniques - taking notes, putting things in a certain place, slowing down the pace of activity, training their memory. And it really can be trained within certain limits. But, I repeat, memory for the past practically does not suffer during normal aging. And voluntary memory too. When an elderly person sets himself the task of remembering something, he succeeds quite well. Yes, it takes more time and effort, but the result justifies it.
– Some older people, for example, learn poetry...
- Very good. These are precisely the elements of cognitive training. It is also useful to work with memory of the past: remembering events, details, dates. It is also useful to train memory for current events, which is especially susceptible to age-related changes. Therefore, everything that concerns current memorization - poems, crosswords, puzzles, riddles, problem solving, etc. - is undoubtedly beneficial. Writing, reading, counting, memorizing - all this verbal activity with words is extremely useful. The main thing is to do this in reasonable quantities, preferring what you like best (with pleasure!) and what makes sense for the person himself. Moreover, everything must be done slowly. If you drive more quietly, you will remember more, I would paraphrase the famous proverb this way. The pace of mental activity decreases with age for everyone. And the impulsive desire for speed leads to mistakes, which are naturally annoying and can turn you away from truly useful activities, lower self-esteem, etc.
I want to emphasize that, of course, there is active and successful aging. Much depends on how a person lived his life, how he prepared for old age, what he does during it, what threads connect him with others and with himself.
In my opinion, in the scale of values of any outgoing generation, the first place should be and, I am sure, the sense of family and clan. This priority is born from a feeling, an understanding of what else you can do for your family and friends. Much is decided by feelings, of which the main thing is love. Anyone who grows up in an atmosphere of warmth, family harmony, feels the love of not only parents, but also grandparents, grows up psychologically more protected and mentally healthy. The role of the older generation in the mental health of subsequent generations of the family is very great.
MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT
GOU VPO CHITA STATE MEDICAL ACADEMY
FEDERAL AGENCY FOR HEALTH AND SOCIAL DEVELOPMENT
DEPARTMENT OF POLYCLINIC THERAPY WITH A COURSE OF GENERAL MEDICAL PRACTICE
TEST
DISCIPLINE: “Nursing in Geriatrics”
TOPIC: “Biological and passport age, age classification. Risk factors for premature aging"
Completed by: IV year student
451 groups
VSO Faculty
Kurmazova Inessa Valentinovna
Checked:
Introduction……………………………………………………………...………3
1. Biological and passport age…………………………….....……….4
2. Age classification…………………………………………….....……6
3. Mechanism of aging………………………………………………………....….7
4. Aging and disease………………….………………………………………………………....9
5. Factors of premature aging……………………………………...12
Conclusion…….……………………………………………………………………………….....14
List of references………………………………………………………...16
Introduction
The process of population aging raises a number of social, hygienic and psychological problems. These include: the most appropriate arrangement for older people; the position of an elderly and old person in the family and society, especially changing after the end of professional activity and often associated with loneliness, lack of proper attention and support of family members. The problem of loneliness, which arises as a result of divorce, death of loved ones, separation from family, often entails a fading interest in life and social isolation. Of considerable importance are the problem of resettlement of old people, which requires a lot of attention from hygienists and urban planners, the problem of appropriate nutrition, and some changes in the nature of food production.
Modern gerontology aims to ensure a high quality of life for an elderly person in society, his active participation in socio-political life and cultural work using the experience, skills, and wisdom of people of the older generation. The main goal of gerontology is to achieve active and creative longevity.
Attitude towards old people, interest in their destinies, public and state care for them, serves as a criterion for assessing the morality and maturity of any country. One of the indicators of the perfection of medicine and the healthcare system is the mastery by medical workers of the problems of monitoring and treating elderly and old people.
1. Biological and passport age
Human aging is a natural biological process determined by his individual, genetically determined development program. Throughout a person’s existence, some of the constituent elements of his body age and new ones emerge. The general development of man can be divided into two periods - ascending and descending development. The first of them ends with the full maturity of the body, and the second begins at the age of 30-35. From this age, a gradual change in various types of metabolism and the state of the body's functional systems begins, inevitably leading to a limitation of its adaptive capabilities, an increase in the likelihood of developing pathological processes, acute diseases and death.
Physiological old age is characterized by the preservation of mental and physical health, a certain capacity for work, contact, and interest in modernity. In this case, changes in all physiological systems gradually and evenly develop in the body with adaptation to its reduced capabilities. Physiological old age cannot be considered only as a process of reverse development of the body. This is also a high level of adaptive mechanisms that determine the emergence of new compensatory factors that support the vital functions of various systems and organs. The nature and pace of human aging depend on the degree of development and improvement of these compensatory adaptive mechanisms.
Premature aging is observed in most people and is characterized by an earlier development of age-related changes than in physiologically aging people, the presence of pronounced heterogeneity of heterochthony in the aging of various systems and organs. Premature aging is largely due to past diseases and exposure to certain negative environmental factors. Sharp loads on the body's regulatory systems associated with stressful situations change the course of the aging process, reduce or distort the body's adaptive capabilities and contribute to the development of premature aging, pathological processes and diseases that accompany it.
Due to the fact that the aging process in people occurs very individually and often the state of the body of an aging person does not correspond to age standards, it is necessary to distinguish between the concepts of CALENDAR (chronological) and BIOLOGICAL age. Biological may precede calendar, which indicates early, premature aging. The degree of discrepancy between calendar and biological age characterizes the severity of premature aging and the accelerated rate of development of the aging process. Biological age is determined by a complex characteristic of the functional state of various systems. Determining a person’s biological age and its correspondence to the calendar age is very important for correct diagnosis and therapy, as it allows one to find out what changes in well-being, what degree of changes in organs and systems, restrictions on their functions are a manifestation of age-related changes and what is caused by the disease, pathological process and is subject to treatment.
Old age as a certain stage of existence and aging as a dynamic process accompanying the descending stage of human development are different concepts. In order to consider a certain stage of human aging and changes in his body as purely age-related as physiological, it is necessary to make sure that the subject has physiologically gone through the entire path of descending development, reached physiological old age, active longevity.
2. Age classification
Age periodization is largely determined by the average life expectancy of a person, changes in which dramatically change ideas about the timing of old age.
At a symposium in Leningrad (1962) and an international symposium on problems of gerontology WHO in Kiev (1963), an age classification was adopted, according to which it is recommended to distinguish three chronological periods in late human ontogenesis:
Average age - 45-59 years;
Old age - 60-74 years;
Senile - 75 years and older.
In middle age, intense changes occur in regulatory mechanisms associated with disturbances in the central mechanisms of regulation of endocrine functions. Changes in the hypothalamic-pituitary-gonad system are leading in the development of the menopausal period, changing complex neuroendocrine relationships. The resulting age-related neurohumoral changes affect the metabolism and function of tissues and can determine the development of dystrophic and degenerative processes in the tissues and organs of an aging organism, its adaptation to new conditions of existence.
The second period of late ontogenesis is old age. It is hardly possible to call it a period of early old age, and people of this age are elderly people or people of advanced age. This is dictated by both psychological factors and the position of a person in the seventh decade of his life in society. According to WHO, more than 20 percent of people aged 65 years and older retain their professional working capacity. This makes it possible to perceive the physiological old age of a person no earlier than 75 years.
3. Mechanism of aging
The biology of human aging, elucidation of the physiological characteristics of an aging organism or one that has already reached old age, its reaction to environmental factors, both pathogenic and therapeutic, are of great importance for a correct understanding of the origin and development of diseases characteristic of the second half of a person’s life, for the correct construction of therapy . Age-related changes in an aging organism are often the background, often the basis on which a chronic pathological process develops.
The founder of the biology of aging as the main branch of scientific gerontology is I. I. MECHNIKOV. His experiments to determine the effect on the animal body of toxic substances formed during putrefactive fermentation in the intestines were the first attempt to obtain an experimental model of old age.
A.A. BOGOMOLETS is the founder of Soviet gerontology. Assessing age-related changes at the cellular and systemic levels, he attached leading importance to connective tissue in the mechanisms of aging. Based on his ideas about the role of connective tissue elements in nutrition, the metabolism of parenchymal cells, and the state of reactivity of the body, A. A. Bogomolets believed that the increase in metabolic structural changes in these elements with age inevitably leads to the development of complex and significant changes in the body. In order to prevent premature aging, A.A. Bogomolets proposed stimulating both specific cells and connective tissue elements.
A.V. Nagorny put forward a hypothesis about the gradual attenuation of the process of self-renewal of proteins, leading to a decrease in the functions of the body and its aging. According to A. A. Nagorny, in the process of self-renewal, protein structures with low metabolism appear, which, without participating in metabolism, contribute to a gradual decrease in energy production.
Of great importance in the study of age-related changes were the works of I.P. Pavlov’s school, which laid the foundations for modern ideas about higher nervous activity, revealed the most flexible forms of regulation of the body’s adaptation to the environment, and established the most important principles of the relationship between the brain and the endocrine glands. The role of functional disorders of higher nervous activity in pathological processes and premature aging has been proven.
A number of our scientists have shown that with aging, the intensity of RNA renewal, the connection of DNA with histones, and the state of chromatin change, and the rate of renewal of individual proteins decreases. Metabolic and structural changes lead to significant changes in cell function, limiting their adaptive capabilities.
V.V. Frolkis and other researchers have proven that with aging, the reaction of tissues to nervous and humoral influences changes, intracentral relationships, hypothalamic-pituitary influences, hormone metabolism, etc. change.
Modern theories of aging are closely related to the discovery of the essence of protein biosynthesis and the role of nucleic acids in it. New ideas about the role of nucleic acids have led to the assumption that the aging of the body is associated with changes in the process of protein biosynthesis, caused by disturbances in the genetic apparatus that increase during ontogenesis. According to V.V. Frolkis (1970), age-related changes develop earlier in regulatory genes and later in structural ones. The aging process of a cell is mainly due to the accumulation of metabolites in it with age, which can form large inactive complexes with protein molecules that disrupt the normal function of cells. Thus, aging is a complex complex of metabolic changes in cells and shifts in the nervous and humoral regulation of the body.
4. Aging and disease
Aging and disease are concepts that are difficult to separate in medical practice, mainly due to a vague idea of the age norm and the frequent combination of physiological aging processes with phenomena typical of age-related pathology.
From the point of view of a pathologist, the body of an old person always has a substrate characteristic of the pathological process, and it is not possible to distinguish structural changes found in old age from changes associated with diseases observed in old age.
From the point of view of a physiologist and clinician, old age cannot be identified with disease. The huge range of adaptive capabilities of an aging organism can ensure sufficient preservation of functions that characterize practical health in late ontogenesis for a very long time, in many cases until very old age.
Old age is a natural and inevitable stage in the development of the body; disease is a disruption of the body’s vital functions that can occur at any age. In the development of many diseases in elderly and old people, a direct genetic connection can be established with naturally occurring age-related changes. The progression of these changes in many people over many years and often until the end of life occurs without significant painful phenomena. However, under certain conditions, under the influence of various external factors, they can serve as the basis for the disease. Such factors include loads that are inadequate for an aging body, requiring sufficient perfection of adaptation mechanisms, often leading to somatic and mental decompensation. Age-related changes are often a background that facilitates the development of the pathological process. There is an opinion that in the process of aging, adaptation becomes more and more imperfect, that numerous “errors” in the adaptation process ultimately lead to a disruption of homeostasis, and then it is very difficult to differentiate between age-related and pathological. But this aging process is not pathological.
Eliminating the idea of old age as a disease is important not only for the correct approach of medical personnel to patients of older age groups, but also for the expedient construction of geriatric care. In order to understand the health care needs of older and older people, it is necessary first to determine their health status. As long as all old people are considered sick, infirm, and disabled, rational planning and organization of appropriate medical care for them will be impossible.
Nevertheless, there are several important provisions of geriatrics, confirmed by practice, and which should be taken into account. Firstly, this is the multiplicity of pathological processes, since the number of diagnosed diseases in the same patient increases with age. Secondly, it is necessary to take into account the peculiarities of the development and course of diseases in elderly and old people, due to the new qualities of the aging organism, which is very important for the correct diagnosis, national therapy and prevention of diseases.
The decline in metabolic processes that progresses with age (after 35 years) is the basis for the gradual development of involution, strophic processes developing in the parenchyma of organs, and regenerative processes in bradytrophic tissues. The result of the changes occurring in the aging organism is a change in its reactions to factors of the internal environment, to external influences, and a significant change in compensatory and adaptive mechanisms. The aging process is accompanied by the emergence of new qualities aimed at preserving compensatory mechanisms, but they only partially support adaptation processes.
Elderly and old people may suffer from diseases that arose in their youth, but the age-related characteristics of the body cause significant deviations in the course of these diseases. The most characteristic features are atypicality, unresponsiveness, and smoothness of clinical manifestations.
Summarizing the features of the manifestation and course of diseases in the elderly, N.D. Strazhesko noted:
the symptoms of various diseases in old age are much poorer than in adulthood;
all illnesses in old people are sluggish and protracted;
during illnesses, their physiological systems capable of fighting harm are more quickly depleted;
The protective apparatus is not able to ensure the rapid development of humoral and tissue immunity during infection and, together with the vascular system and metabolic organs and tissues, cannot guarantee the course of energy processes in various diseases at such a height as in adulthood.
In elderly and senile age, the processes of recovery after an acute illness, exacerbation or complication of a chronic pathological process occur more slowly, less completely, which determines a longer period of rehabilitation and often less effective therapy. In this regard, in carrying out rehabilitation treatment for elderly and senile people at different stages of rehabilitation, great persistence should be shown and age-related characteristics of the physical and mental state should be taken into account.
5. Factors of premature aging
Natural aging is characterized by a certain pace and sequence of age-related changes that correspond to the biological, adaptive and regulatory capabilities of a given human population.
Premature (accelerated) aging is characterized by an earlier development of age-related changes or their greater severity in a particular age period.
The main signs that make it possible to distinguish premature aging from physiological aging are a significant advance of the biological age, a history of chronic diseases, intoxications, rapidly progressing impairments in the body’s ability to adapt to changing environmental conditions, unfavorable neuroendocrine and immunological changes, pronounced unevenness of age-related changes in various organs and systems of the aging body.
Risk factors for premature (accelerated) aging include:
Adverse environmental factors.
Bad habits.
Physical inactivity.
Poor nutrition.
Burdened heredity (short life expectancy of parents).
Long-term and frequently recurring neuro-emotional stress (distress).
They can influence different links in the chain of age-related changes, accelerate, distort, and intensify their normal course.
There is also delayed (retarded) aging, leading to increased life expectancy and longevity. One of the fundamental questions of gerontology is the question of age.
The vast majority of people die not from old age itself, but from diseases that overtake a person in old age, which are necessary and possible to treat. Living long, maintaining health and creative activity is the natural place of every person.
From the above, the following conclusion should be drawn. Features of the clinical picture:
The course of the disease is usually atypical - asymptomatic, latent, with the presence of “masks”, but severe, often disabling.
Greater tendency to relapse, transition from acute to chronic forms.
The latent period of the disease is shortened.
Complications of the disease are becoming more frequent.
The timing of complications, in particular functional decompensation of the affected system, is reduced.
The patient's life expectancy is reduced.
Diagnostic features:
Alertness and targeted search are required, based on the morbidity structure.
Verification of the information received from the patient is necessary.
It is important to use adequate paraclinical research methods.
Minor symptoms need to be taken into account.
Dynamic monitoring of the patient is necessary.
When assessing the results of studying a patient, one must proceed from the criterion of the age norm.
Features of prevention:
Previous age-related risk factors increase the role of primary and secondary prevention.
In addition to generally accepted preventive measures, it is necessary to use methods and means of increasing the reduced tolerance to harmful substances in an old person (geroprotectors, rational motor regimen, rational geriatric nutrition, climate therapy, etc.).
Features of treatment:
Clear implementation of the principle of high humanism.
Compliance with the principle of reasonable sparing of the patient’s long-term habits.
Strict adherence to the low impact principle.
Potentiating the effectiveness of therapeutic measures by including geroprotectors, adaptogens, active motor mode, effective oxygen therapy, etc. in the therapeutic complex.
Bibliography
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2. Nursing, volume 2. Ed. G.P. Kotelnikov. Textbook for students of faculties of higher nursing education. universities - Samara: Publishing house State Unitary Enterprise "Perspective", 2004. - 504 p.
3. L.I. Dvoretsky "Iatrogenesis in geriatrics." – Clinical gerontology No. 4, 1997
4. A.N.Okorokov. "Diagnostics of diseases of internal organs." -M.: Medical literature, 2000.
5. Zhuravleva T.P., Pronina N.A. Nursing in geriatrics. - M.: ANMI, 2005. - 438 p.
6. L.B. Lazebnik, V.P. Drozdov “Genesis of polymorbidity”. - Clinical gerontology No. 1-2, 2001
Age- the duration of the period from the moment of birth to the present or any other point in time. Anatomical and physiological age is age determined by the totality of metabolic, structural, physiological, and regulatory processes. This age may not correspond to calendar age.
Age chronological (passport)- the period of time from the moment of birth to the present or any other moment of calculation. It means how many years a person has lived.
In addition, there is the concept biological age is the true age of the human body, showing how old a person really is. Biological age shows the age of a person's body (how old the body has truly aged). The age of a person's body usually does not coincide with calendar age. The “wear and tear” of the body is not expressed equally in all people and does not occur at the same rate in all people. The body of a 40-year-old person can correspond in health to the body of a 20-30-year-old.
Biological age can be ahead or behind chronological age.
The formulation of the concept of “biological age” is of great importance, since for many practical purposes it is important to group children not only by calendar (passport) age, but by the degree of their development. For a significant proportion of children, biological and chronological (calendar) ages coincide. However, there are children and adolescents whose biological age is ahead of or behind their chronological age.
Why can people of the same calendar age look completely different? We have all met such “adult” people, when even in the presence of this person - your peer, you feel like a teenager in comparison with him.
The vitality of our body is determined not by the years lived, but by the degree of wear and tear of the body. As long as the internal organs and systems work normally and interact with each other, a balanced metabolism is maintained, and old cells are renewed, the body exists.
From a biological point of view, the aging process of the body is a very slow process. Death most often occurs not from the natural aging of the body itself, but from diseases accompanying it.
The concept of biological age arose as a result of the awareness of uneven development, maturity and aging.
One of the most important patterns of ontogenesis is the unevenness of age-related changes. This phenomenon causes a discrepancy between the chronological and biological age of the organism.
The introduction of the concept of “biological age” is explained by the fact that calendar (passport, chronological) age is not a sufficient criterion for the state of health and working capacity of an aging person.
Biological age is the level of development of morphological structures and associated functional phenomena of the body’s life activity achieved by an individual, determined by the average chronological age of the group to which he corresponds in terms of his level of development.
The main criteria for biological age are:
Maturity (assessed based on the development of secondary sexual characteristics);
Skeletal maturity (assessed by the timing and degree of skeletal ossification);
Dental maturity (assessed by the timing of the eruption of primary and permanent teeth, tooth wear);
Indicators of maturity of individual physiological systems of the body based on age-related changes in the microstructures of various organs;
Morphological and psychological maturity.
Morphological maturity is assessed based on the development of the musculoskeletal system ─ muscle strength, static endurance, frequency and coordination of movements. School maturity is closely related to morphological and physiological maturity, which means the degree of psychophysiological and morphological maturity sufficient to begin schooling.
Assessment of morphological maturity is based on changes in body proportions, resulting from the fact that the growth of the head and neck slows down, but the growth of the limbs accelerates.
The characteristics used to estimate biological age must satisfy a number of requirements. First of all, they must reflect clear age-related changes that can be described or measured.
The method for assessing these changes should not harm the health of the subject or cause him discomfort. Finally, it must be suitable for screening large numbers of individuals. These are the so-called bone age, dental age, sexual development, general morphological development, physiological maturity, mental and mental development and some others.
To correctly assess biological age, it is advisable to use several indicators in combination. However, in practice, during mass examinations, biological age has to be judged by some individual indicators that fairly well reflect the child’s development.
The “biological age” of a person differs from the “passport” (chronological) age. It reflects the rate of individual growth, development, maturation and aging of the body. All primates have individual differences in growth processes. The growth rate, the combination of growth and development rates at different stages of ontogenesis can vary significantly among different people. This manifests itself, for example, when studying groups of people of the same passport age. For example, in a group of 10-year-old girls, 50% of those examined in terms of biological development will correspond to the “typical”, average variant, the rest will deviate within 1-2 years in one direction or the other, i.e. their biological age will correspond to 11-12 years or 8-9 years.
Biological age is determined by the totality of metabolic, structural, functional, regulatory features and adaptive capabilities of the body. Assessment of health status by the method of determining biological age reflects the influence of external conditions on the body and the presence (absence) of pathological changes.
Biological age, in addition to heredity, largely depends on environmental conditions and lifestyle. Therefore, in the second half of life, people of the same chronological age can differ especially greatly in morpho-functional status, that is, biological age. Those who have a favorable daily lifestyle combined with positive heredity are usually younger than their age.
ZPR options.
ZPR of constitutional origin.
We are talking about the so-called harmonious infantilism, in which the emotional-volitional sphere is, as it were, at an earlier stage of development, in many ways reminiscent of the normal structure of the emotional makeup of younger children. Such children are characterized by bright, but superficial and unstable emotions, a predominance of play motivation, heightened mood, and spontaneity.
Difficulties in learning in the early grades are associated with the predominance of play motivation over cognitive motivation, immaturity of the emotional-volitional sphere and the personality as a whole. In such cases, all of the above qualities are often combined with an infantile body type. This combination of mental and physical traits is often caused by hereditary factors, which allows us to see it as one of the types of normative psychophysical development. Sometimes it is also associated with the characteristics of intrauterine development, in particular, multiple births.
ZPR of somatogenic origin.
This type of mental retardation is due to the influence of various severe somatic conditions suffered at an early age (surgeries with anesthesia, heart disease, low mobility, asthenic conditions). Often there is a delay in emotional development - somatogenic infantilism, caused by a number of neurotic layers - uncertainty, timidity, capriciousness associated with a feeling of physical inferiority.
ZPR of psychogenic origin.
This type of disorder is associated with unfavorable upbringing conditions that arose early and lasted for a long time. ZPR of this type occurs in three main cases:
Insufficient care, neglect. This is the most common option. In such cases, the child experiences abnormal personality development such as mental instability. The child does not develop forms of behavior associated with active inhibition of affect. The development of cognitive activity and intellectual interests is not stimulated. Features of immaturity of the emotional-volitional sphere are observed, namely: affective lability, impulsiveness, increased suggestibility. There is also a lack of basic knowledge and understanding necessary for mastering the school curriculum. This type of mental retardation should be distinguished from the phenomena of pedagogical neglect, which are not a pathological phenomenon, but a limited deficit of knowledge and skills due to a lack of intellectual information.
Hyperprotection, or upbringing according to the “family idol” type. Most often occurs in anxious parents. They “tie” the child to themselves, while at the same time indulging his whims, and force the child to act in the most convenient and safe way for the parent. Any obstacles or dangers, both real and imaginary, are removed from the child’s environment. The child is not independent, lacks initiative, is self-centered, incapable of sustained volitional effort, and is overly dependent on adults. Personality development follows the principle of psychogenic infantilism.
Personality development according to the neurotic type observed in families with very authoritarian parents or where constant physical violence, rudeness, despotism, aggression towards the child and other family members are allowed. The child may experience obsessions, neuroses or neurosis-like conditions. An emotionally immature personality is formed, which is characterized by fears, an increased level of anxiety, indecision, lack of initiative, and a possible syndrome of learned helplessness. The intellectual sphere suffers, since all the child’s activities are subordinated to the motive of avoiding failure, and not achieving success, therefore, such children, in principle, will not do anything that could once again confirm their failure.
Relativity of age. Biological and chronological age
"How old are you?" - an elementary question that has a simple answer: “I was born in the year YY. XX years have passed since then. I am XX years old.”
“And how old is Vasya (Petya, Masha...)?” If you are familiar with this “Vasya” and he told you how old he is, then you will answer without thinking too much. The same will happen if you saw some kind of “Vasin” document, for example a passport.
Now think about how you will answer if you haven’t seen his passport, and he himself didn’t say anything about his age? You will have to think: “Vasya is my classmate - he means about the same age as me... Although, no, there are child prodigies and eternal students... He dresses like a teenager, and he has such a sparse beard growing - he’s probably younger... Although he is as strong and muscular as a 40-year-old man... And he is always so serious. No, apparently, he is still older..." This can go on indefinitely until you go through all the possible social, psychological and biological characteristics that our perception correlates with the concept of age. But it would seem that the question was similar.
The whole difference was that we asked you to estimate the age of another person, and each of us has an individual stereotype of age perception. According to it, the most diverse traits (signs) are correlated with a certain level of development (status), which we consider typical, that is, corresponding to a particular age. Moreover, this stereotype depends on our personal experience, that is, it changes over the course of life. As a result, estimates of the age of poor fellow "Vasi" made by us and other people may differ significantly. The same will happen if specialists (psychologists, anthropologists, etc.) express their opinions. Their judgment (expert assessment) will be closer to the truth than ours, and it will be more reasonable. All together, we will get an interval estimate of age and, most likely, we will approximately guess the number that is in a person’s passport and which he himself can tell about.
It is equally important that we determine how old this particular person looks from the point of view of biology, psychology, etc., and this determination - a judgment about the pace of individual development - will also be justified.
The period of time that has passed in absolute terms (that is, in years, months, days, etc.) from the moment of a person’s birth to this specific moment is called chronological, or passport age. When asking a person about his age, we are interested in this figure.
The age of a person, assessed by the degree of development (or maturity) of individual characteristics and systems of characteristics, is called biological age. In other words, biological age is the level of morphofunctional maturation achieved by the body, which we obtain by comparing development according to different criteria. Among them are the degree of somatic and skeletal maturity, the dental system, indicators of the reproductive system, physiological and biochemical signs, etc. It is logical that the more criteria are considered, the more accurate our integral assessment of the morphofunctional status becomes.
The introduction of the term “biological age” into scientific circulation is associated with the names of V.G. Shtefko, D.G. Rokhlina and P.N. Sokolov (30-40s of the XX century). Biological age reflects the main characteristics of ontogenetic development and, above all, the heterochrony of growth, maturation and aging at different levels of organization. It is clear that this category is not only a biological reality, and we can talk, for example, about psychological age, its criteria, etc.
Above, we examined the schemes for the periodization of ontogenesis, reflecting our idea of the normality of the growth process. Indeed, in the average group of people, say, in the period from 8 to 12 years old in boys and in 8-11 years old in girls, the majority of permanent teeth erupt, the development of secondary sexual characteristics begins, characteristic changes in the psyche occur, etc. However, all together, these “typical” changes are characteristic only of the “average” child from this group, that is, those boys or girls in whom the process of growth and development of individual body systems is most integrated (balanced or normal).
Usually, no less a minority of individuals deviate from this average development option:
their biological age lags behind the passport age - retardation occurs (deceleration of development according to these characteristics);
on the contrary, their morphofunctional status corresponds to large values of chronological age - that is, development is accelerated and acceleration is characteristic.
It follows from this that the age status of a given individual is determined by the degree of closeness with the average values of the corresponding criterion among chronological peers belonging to the same population group, anthropological sample or population (for more details, see: Vlastovsky V.G., 1976; Pavlovsky O. M., 1987).
Acceleration or retardation can be general, that is, observed in all indicators of biological age, or it can be private - when the development of individual parameters is disproportionately accelerated or slowed down. In the first case, the body experiences the influence of a general or leading factor, in the second - a factor acting only on a specific system of the body. These phenomena are the basis for a differentiated study of development factors, as well as a path for individual prevention, rehabilitation and treatment.
If the growth rates of different body systems differ greatly from each other (a departure from the broad group norm of reaction), there is a real threat of disharmony of all further development. The integration of regulation is disrupted, and even if the leading factor is eliminated, no catch-up growth may help.
Thus, one of the most important practical functions of studying biological age is monitoring the rate of development of individual body systems, searching for correspondences between them and determining those that we consider normal. By considering a wide variety of endo- and exogenous parameters in these studies, we are getting as close as possible to understanding the action of specific factors that determine ontogenetic variability. Finally, determination of biological age is the only possible assessment in paleoanthropological studies and in forensic identification.
