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
23 October 2012Life on the slope
Don't die before death! - this motto of the poet is used by psychotherapists in their own way
Irina Roshchina, Leading Research Fellow of the Scientific Center for Mental Health of the Russian Academy of Medical Sciences, answers questions from the editor-in-chief of the NG-Scenarios application, Yuri Solomonov.
- Irina Fedorovna, one of the writers once said, not without grace: "Each person chooses his own age." From your point of view, can this motto have a psychotherapeutic effect on the one who believes in it?
- I think yes. The fact is that in 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 can be more than the real age, or vice versa - less. The wonderful actress Alla Sergeevna Demidova wrote that she felt forty years old all her adult life. I know a man of venerable age who told me more than once: “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 whole 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 lived at the moment. There is a 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, by the totality of biological parameters that reflect the state of the cardiovascular, endocrine, and other systems of the body, to find out the biological age of a person. Different body systems change with age at different rates. For someone, changes in the endocrine system begin earlier, for someone in the cardiovascular system.
There is also the concept of psychological age, which is little scientifically developed. This is how a person feels at the moment of life. So far, the analysis of these states has been reduced to metaphorical descriptions, such as "pep," "clarity of thought," and so on.
Summing up, we can say: if the biological age is ahead of the chronological one, we are dealing with accelerated aging. If everything looks the other way around, we are talking about the fact that a person is aging 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 personally, the quality of old age for each of us is influenced by how we lived the previous years of our lives. In this context, it is very important how an older person uses the experience of previous stages of his life, and how much he has learned to use consciously or unwittingly developed self-regulation strategies to deal with the changes that occur in us over the years. If a person finds in himself and for himself various ways of self-regulation and uses them, then this leads to a harmonious feeling of himself in old age. Both in youth and in aging, we can be healthy or suffer from diseases, which, of course, affects the body, psyche, life expectancy and the sense of age that you asked about.
– Can we assume at the same time that there are national, ethnic features of aging, age, 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 certain diseases, and this can eventually manifest itself both in a resident of a highly developed country and in someone who lives in a less comfortable environment for existence.
But, of course, there is something else: a society that treats the aging of each of its citizens with care and responsibility makes the old age of people prosperous, secure and, if you like, joyful. Here a huge role is played by both material and moral conditions, as well as the level of psychological culture of society.
In addition, if we talk about national characteristics, we can recall that in Eastern cultures (and in Russia such regions are fully represented), the attitude towards the elderly is traditionally remarkable. In a person who has lived a long life, others a priori see a sage, adviser, mentor. Hence respect, attention and even obedience. Moreover, this is also observed in relation to those elders who do not at all possess these qualities that are important 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.
- And 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 characteristics of the personality and the deeds and achievements of a person. If a person has been developing all the previous stages of his existence, consciously working on himself, then even in old age he lives interestingly, actively, looking for some new opportunities, activities, contacts for himself. This includes both expanding the circle of interests and achieving new real goals. Of course, a sharp change in lifestyle at a certain age is already undesirable. But those who have gained wisdom and experience over the years understand this themselves. The main thing is that it is not life that leads such people, but they lead it. The fact that a person can develop until the end of life has been proven by all studies. This is first. And secondly, if earlier there was always an equal sign between old age and illness, that is, the attitude towards old age as a disease prevailed, but today this idea is beginning to change in society. Although this is not an easy process. For example, a strange expediency still often works: is it worth it to make significant efforts to treat those who are already ending their lives anyway.
- Do you want to talk about it?
– This, of course, is a fundamentally wrong position. It cannot be justified either professionally or morally. But in our society, it seems to me, with the condemnation of the immorality of such an attitude towards sick old people, things are not in the best way. In addition to the decline in morals, many social problems are affecting, turning older people into outcasts, extra family members, etc.
– But often we can observe the activity of older people in the public field. Take those rallies. It would seem that passionarity, activity disappears over the years, but some older people find some compensators for themselves when they suddenly go to the square to demand or defend something ...
– It all depends on the individual. Understanding the prospects for life in older people is different. It is limited by the duration of the remaining life, and therefore it is necessary to set realistic, achievable goals. But the feeling of duty to relatives, friends, to oneself - it does not disappear anywhere. So it makes some people bring home, family affairs to mind, find meanings and goals in this. And there are those whose consciousness has always been included in the public spheres, and this has not disappeared either. And such old activists can find satisfaction in a rally, a meeting, a meeting with a deputy, in public criticism of the established order of things...
- It is clear that your science is unable to improve social conditions for the elderly, to raise pensions. But still, what is the role of psychology, psychiatry in maintaining this layer of society in a normal psychological, spiritual state?
– Psychiatrists treat mental illness at a later age. There is even such a direction in psychiatry - gerontopsychiatry. Psychiatrists treat the full spectrum of mental illness in patients at a later age. An important feature of the treatment of patients at a later age is an integrated approach to the patient. Because old age is such an age when the somatic and mental spheres of a person are in close interaction. Therefore, the exacerbation of any chronic disease (stomach, kidney, heart) leads to a deterioration in the mental state of the patient. And vice versa - if you treat a chronic somatic disease, then the mental status of the patient improves.
In the problems of aging there is, of course, a psychological component. This means that there are psychologists, although they are clearly not enough, who work with elderly patients. They are well aware of the psychological features of normal and pathological aging, they know the methods of diagnosing variants of normal and painful aging, conduct corrective and rehabilitation classes, train memory and other functions, as well as other forms of mental health support for the 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. From this age line, memory, attention, and thinking training is already required. This should be a regular additional load, which the Americans figuratively call "massage of the brain."
- We no longer cause audience laughter from phrases from American films like “Did you visit your psychotherapist today?” or “Do you have a problem? Do you want to talk about it?"
- I do not want to say that in this sense, the problem of psychological assistance in our country has reached American proportions. But, despite the fact that not everyone has a personal psychologist, even in Moscow, the possibility of obtaining psychological assistance is becoming more and more real. This is expressed primarily in the fact that people are no longer afraid to go to see a psychologist. Of course, not everyone will go to a psychiatrist for treatment. There remains a rather persistent and unfair prejudice against psychiatric treatment. But many began to seek psychological help for themselves and for their children.
The situation is more difficult with older people. They are very deprived of psychological help and often come to the clinic for it - to the therapist, neuropathologist.
We had a successful scientific program, when a special room for the elderly was organized in an ordinary district polyclinic, which we, in order not to frighten anyone, called the sign “psychoneurologist”. Therapists and other specialists sent mainly elderly people with mental problems to this office. They have psychiatrists, psychologists found depressive disorders and other symptoms of mental distress. Psychiatrists and psychologists worked carefully and attentively with patients, were engaged in treatment, psychocorrection, psychotherapy. Elderly patients really liked the attitude towards them, they noted a significant improvement in the quality of their lives. But then, unfortunately, this office was closed, and the work was interrupted. At the same time, some patients came for an outpatient appointment with us at the NCHC for quite a long time after that.
Was communication important to them?
- Communication too. But the main thing was still professional clinical and psychological assistance. We consulted them, prescribed medicines, psychologists did cognitive training with them, and other methods of psychotherapy. And the fact that they came back to us and highly appreciated the help they received speaks of the effectiveness of our work and the need to develop outpatient gerontological services.
- I have no doubt. You are specialists. But when there are none nearby, their place is taken by charlatans, healers of everything and everything. Some simply pretend to be miracle doctors, others, through clever manipulations, ingratiate themselves, and then, you yourself know what happens ...
Yes, it is indeed widespread. And no one seriously solves this problem. I can talk about it as a psychologist. This is due to 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, get a cheap and effective medicine increases. When older people are deprived of the opportunity to receive quality medical care, they voluntarily or involuntarily have faith in a miraculous pill for all diseases. But a reasonable person who is aging actively, critically, cannot be convinced by such psychological tricks.
- On the other hand, young people fall for these frauds! And all because they are poorly educated, gullible. I have inquisitive students who read a lot of modern literature. Such a student comes with the news: “Have you heard? Found a cure for aging ... "
– And I have to remind you that aging is the most complex systemic process of age-related changes in all body systems and no miracle pill can slow it down, let alone stop it. It is much more correct to say that you need to prepare for an active successful old age from a young age. The level of education received in youth, the ability to achieve goals, life optimism - 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, one cannot get around the question that occupies all people: what happens to our memory with age?
- Changes occur with memory, which are also characteristic of other mental functions. With aging, 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 older person, as a rule, admits that his memory has become worse. Moreover, the memory for the past remains good, but the events that have just occurred are remembered worse. But this does not interfere with normal life. Older people understand that they forget elements of the current life quite quickly. Therefore, they use a variety of compensatory techniques - make notes, put things in a certain place, slow down the pace of activity, train memory. And it is really, within certain limits, amenable to training. But, I repeat, memory for the past practically does not suffer during normal aging. And arbitrary 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 just elements of cognitive training. It is also useful to work with memory for the past: remember events, details, dates. It is also useful to train memory for current events, which is especially susceptible to age-related changes. Therefore, everything related to the current memorization - poems, crossword puzzles, 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 it in reasonable amounts, preferring what you like more (with pleasure!) And what makes sense for the person himself. And everything must be done slowly. You go quieter - you remember more, I would paraphrase a well-known proverb like this. The pace of mental activity decreases with age in everyone. And the impulsive desire for speed leads to mistakes, which, of course, are annoying and can turn away from really useful activities, lower self-esteem, etc.
I want to emphasize that there is definitely active and successful aging. Much depends on how a person lived his life, how he prepared for old age, what he does in 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, is the feeling of the family, the clan. This priority is born from a feeling, an understanding of what else you can do for relatives 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 secure and mentally healthy. The role of the older generation in the mental health of subsequent generations of the family is very important.
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: 4th year student
451 groups
Faculty of VSO
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 used literature………………………………………………...16
Introduction
The aging process of the population puts forward a number of social, hygienic and psychological problems. These include: the most appropriate device for the elderly; 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 from family members. The problem of loneliness, which arises as a result of divorce, the death of loved ones, separation from the family, often entails the fading of interest in life, social isolation. Of considerable importance is the problem of the resettlement of old people, which requires great 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 social and political life and cultural work using the experience, skills, wisdom 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 development by medical workers of the problems of monitoring and treating the elderly and old people.
1. Biological and passport age
Human aging is a natural biological process determined by its individual, genetically determined development program. During the entire existence of a person, aging of some constituent elements of his body and the emergence of new ones occur. 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, the state of the functional systems of the body begins, inevitably leading to a limitation of its adaptive capabilities, an increase in the likelihood of the development of 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. At the same time, 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 organism. This is a high level of adaptive mechanisms that cause the emergence of new compensatory factors that support the vital activity of various systems and organs. The nature and rate of human aging depend on the degree of development and improvement of these compensatory adaptive mechanisms.
Premature aging is observed in most people, characterized by an earlier development of age-related changes than in physiologically aging people, the presence of pronounced heterogeneity in the aging of various systems and organs. Premature aging is largely due to past diseases, the impact of some negative environmental factors. Sharp loads on the regulatory systems of the body associated with stressful situations change the course of the aging process, reduce or distort the adaptive capabilities of the body 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 norms, it is necessary to distinguish between the concepts of CALENDAR (chronological) and BIOLOGICAL age. Biological may precede the calendar, which indicates early, premature aging. The degree of discrepancy between the calendar and biological age characterizes the severity of premature aging, the accelerated pace of development of the aging process. Biological age is determined by a complex characteristic of the functional state of various systems. Determining the biological age of a person and its correspondence to the calendar one is very important for proper diagnosis and therapy, as it allows you 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 shifts 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 that accompanies the descending stage of human development are different concepts. In order to consider a certain stage of human aging physiological and changes in his body as purely age-related, it is necessary to make sure that the subject physiologically went through the entire path of downward 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 drastically change ideas about the timing of the onset of old age.
At a symposium in Leningrad (1962) and an international symposium on problems of gerontology 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, intensive shifts in regulatory mechanisms occur, associated with disturbances in the central mechanisms of regulation of endocrine functions. Changes in the hypothalamic-pituitary-gonadal system are leading in the development of the menopause, which changes complex neuroendocrine relationships. The resulting age-related neurohumoral shifts affect the metabolism and function of tissues, 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 moments and the position of a person in the seventh decade of his life path in society. According to WHO, more than 20 percent of people aged 65 years and older retain their professional ability to work. 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 an organism that has already reached a period of 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 section of scientific gerontology is I. I. MECHNIKOV. His experiments on elucidating 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 a leading role to the 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, the state of reactivity of the body, A. A. Bogomolets believed that the increase with age of metabolic structural changes in these elements inevitably leads to the development of complex and significant changes in the body. In order to prevent premature aging, A.A. Bogomolets suggested 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 body functions, its aging. According to A. A. Nagorny, in the process of self-renewal, protein structures with low metabolism appear, which, not 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 the school of I.P. Pavlov, who laid the foundations of modern ideas about higher nervous activity, revealed the most mobile forms of regulation of the body's adaptation to the environment and established the most important principles of the relationship between the brain and 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, the state of chromatin change, and the rate of renewal of individual proteins decreases. Metabolic and structural changes lead to significant changes in the function of cells, limiting their adaptive capabilities.
V.V. Frolkis and other researchers proved that with aging, the reaction of tissues to nervous and humoral influences changes, intracentral ratios, hypothalamic-pituitary influences, hormone metabolism, etc. change.
Modern theories of aging are closely related to the disclosure of the essence of protein biosynthesis and the role of nucleic acids in it. New ideas about the role of nucleic acids led to the assumption that the aging of the body is associated with a change in the process of protein biosynthesis, due to 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 set 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 the fuzzy idea of the age norm, 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 between structural changes found in old age and changes associated with diseases observed in old age.
From the point of view of a physiologist and clinician, old age cannot be identified with illness. A huge range of adaptive capabilities of an aging organism can for a very long time, in many cases up to a very old age, ensure sufficient preservation of the functions that characterize practical health in late ontogenesis.
Old age is a natural and inevitable stage in the development of the body, the disease is a violation of the body's vital functions that can occur at any age. In the development of many diseases in the elderly and old people, a direct genetic connection with naturally occurring age-related changes can be established. The progression of these changes in many people for many years and often until the end of life occurs without pronounced painful phenomena. However, under certain conditions, under the influence of various external factors, they can serve as the basis of the disease. Such factors include loads that are inadequate for an aging organism, requiring sufficient perfection of adaptive 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 "mistakes" in the process of adaptation eventually lead to a violation 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 implementation of 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 need of the elderly and old people for medical care, it is necessary first of all to determine the state of their health. As long as all old people are considered sick, infirm, disabled, rational planning and organization of appropriate medical care for them is 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 the elderly and old people, due to the new qualities of the aging organism, which is very important for the correct diagnosis, national therapy and disease prevention.
The decline in metabolic processes, progressive 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 shifts that occur in an aging organism is a change in its reactions to factors of the internal environment, to external influences, a significant change in compensatory-adaptive mechanisms. The aging process is accompanied by the emergence of new qualities aimed at maintaining compensatory mechanisms, but they only partially support the adaptation processes.
Elderly and old people may suffer from diseases that have arisen in their youth, but the age characteristics of the body cause significant deviations in the course of these diseases. The most characteristic are atypicality, unresponsiveness, 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 proceed sluggishly and protractedly;
during illnesses, their physiological systems capable of combating harmfulness 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 the elderly and senile age, the recovery processes after an acute illness, exacerbation or complications of a chronic pathological process occur more slowly, less completely, which leads to a longer rehabilitation period and often less effective therapy. In this regard, in carrying out the rehabilitation treatment of elderly and senile people in different stages of rehabilitation, great perseverance should be shown and age-related features 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 corresponding to the biological, adaptive and regulatory capabilities of a given human population.
Premature (accelerated) aging is characterized by the earlier development of age-related changes or their greater severity in a particular age period.
The main features that make it possible to distinguish premature aging from physiological age are a significant advance of the passport biological age, a history of chronic diseases, intoxications, rapidly progressive impairments in the body's ability to adapt to changing environmental conditions, adverse neuroendocrine and immunological changes, pronounced unevenness of age-related changes in various organs and aging body systems.
Risk factors for premature (accelerated) aging include:
Adverse environmental factors.
Bad habits.
Physical inactivity.
Irrational nutrition.
Burdened heredity (short life expectancy of parents).
Prolonged and often recurring neuro-emotional overstrain (distress).
They can affect different links in the chain of age-related changes, accelerate, pervert, intensify their usual course.
There is also delayed (retarded) aging leading to an increase in life expectancy, longevity. One of the fundamental issues of gerontology is the issue of age.
In the vast majority, people die not from old age itself, but from diseases that overtake a person in old age, which must and can be treated. To live 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 - oligosymptomatic, latent, with the presence of "masks", but severe, often invalidating.
A great tendency to relapse, the transition of acute forms to chronic ones.
The latent period of the disease is shortened.
Complications of the disease are becoming more frequent.
The terms of joining complications are reduced, in particular, functional decompensation of the affected system.
The life expectancy of the patient is reduced.
Diagnostic features:
Alertness and a targeted search are necessary, based on the structure of morbidity.
It is necessary to verify the information received from the patient.
It is important to use adequate paraclinical research methods.
Minor symptoms must be considered.
Patient monitoring is required.
In assessing the results of studying the patient, one must proceed from the criterion of the age norm.
Features of prevention:
Preceding age-related risk factors increase the role of primary and secondary prevention.
In addition to the generally accepted preventive measures, it is necessary to use methods and means to increase the tolerance to harmful substances that is reduced in an old person (geroprotectors, rational motor mode, rational geriatric nutrition, climate therapy, etc.).
Treatment features:
A 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 principle of low impact.
Potentiation of the effectiveness of therapeutic measures by including geroprotectors, adaptogens, an active motor regimen, effective oxygen therapy, etc. into 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 honey. universities. - Samara: Publishing house GUP "Perspektiva", 2004. - 504 p.
3. L.I. Dvoretsky "Iatrogeny in Geriatrics". – Clinical gerontology №4, 1997
4. A.N. Okorokov. "Diagnosis of diseases of internal organs". -M.: Medical literature, 2000
5. Zhuravleva T.P., Pronina N.A. Nursing in geriatrics. - M.: ANMI, 2005. - 438 p.
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Age- the duration of the period from the moment of birth to the present or any other point in time. Anatomical and physiological age - age determined by the totality of metabolic, structural, physiological, regulatory processes. This age may not correspond to the 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- this is the true age of the human body, showing how old a person really is. Biological age shows the age of the human body (how old the body really is). The age of the human body usually does not coincide with the calendar age. The "wear and tear" of the body is not expressed in the same way for all people and does not occur at the same speed for everyone. The body of a 40-year-old person can correspond in health reasons to the body of a 20-30-year-old.
Biological age may 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. In a significant proportion of children, the biological and chronological (calendar) age coincide. However, there are children and adolescents whose biological age is ahead of chronological or behind it.
Why can people of the same calendar age look completely different? We all met such "adult" people, when even in the presence of this person - your peer, you feel like a teenager, compared to him.
The viability 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, old cells are renewed - the body exists.
From a biological point of view, the aging process of an organism is a very slow process. Death most often occurs not from the natural aging of the body itself, but from the accompanying diseases.
The concept of biological age arose as a result of awareness of uneven development, maturity and aging.
One of the most important patterns of ontogenesis is the unevenness of age-related changes. This phenomenon is the reason for the discrepancy between the chronological and biological age of the organism.
The introduction of the concept of "biological age" is explained by the fact that the calendar (passport, chronological) age is not a sufficient criterion for the health and working capacity of an aging person.
Biological age is the level of development of morphological structures and related functional phenomena of the organism's vital 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 on the basis of the development of secondary sexual characteristics);
Skeletal maturity (estimated by the timing and degree of ossification of the skeleton);
Dental maturity (estimated by the timing of eruption of milk 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 on the basis of 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 start schooling.
The assessment of morphological maturity is based on the change 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 signs used to assess biological age must satisfy a number of requirements. First of all, they should reflect clear age-related changes that can be described or measured.
The method of assessing these changes should not harm the health of the subject and cause him discomfort. Finally, it must be suitable for screening a large number 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.
For a correct assessment of biological age, it is desirable to use several indicators in combination. However, in practice, during mass surveys, biological age has to be judged by some individual indicators that fairly well reflect the development of the child.
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 in different people. This is manifested, for example, in the study of groups of people of the same passport age. For example, in the group of 10-year-old girls, 50% of those surveyed for biological development will correspond to the "typical", average variant, the rest will deviate within 1-2 years in one direction or another, i.e. their biological age will correspond to 11-12 years or 8-9 years.
Biological age is determined by a combination of metabolic, structural, functional, regulatory features and adaptive capabilities of the body. The assessment of the state of health by the method of determining the 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 strongly in morpho-functional status, that is, biological age. Younger than their age are usually those who have a favorable daily lifestyle combined with positive heredity.
ZPR options.
ZPR of constitutional origin.
We are talking about the so-called harmonic infantilism, in which the emotional-volitional sphere is, as it were, at an earlier stage of development, in many respects resembling the normal structure of the emotional make-up of younger children. Such children are characterized by bright, but superficial and unstable emotions, the predominance of game motivation, an increased mood background, and immediacy.
Difficulties in learning in the lower grades are associated with the predominance of game motivation over cognitive, 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 due to hereditary factors, which allows us to see in it one of the types of normative psychophysical development. Sometimes it is also associated with the peculiarities of intrauterine development, in particular, multiple pregnancies.
ZPR of somatogenic origin.
This type of mental delay 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, due to a number of neurotic layers - insecurity, timidity, capriciousness associated with a sense of one's physical inferiority.
ZPR of psychogenic origin.
This type of violation is associated with unfavorable conditions of upbringing, which arose early and lasted for a long time. ZPR of this type occurs in three main cases:
Lack of care, neglect. This is the most common option. In such cases, the child has an abnormal development of personality according to the type of 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. There are features of immaturity of the emotional-volitional sphere, namely: affective lability, impulsiveness, increased suggestibility. There is also a lack of basic knowledge and ideas 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.
overprotection, or upbringing according to the type of "family idol". Most often happens to anxious parents. They "attach" the child to themselves, 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, not initiative, self-centered, not capable of long-term volitional effort, overly dependent on adults. Personal 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, tyranny, aggression towards the child, other family members are allowed. The child may develop obsessions, neuroses, or neurosis-like states. An emotionally immature personality is formed, which is characterized by fears, an increased level of anxiety, indecision, lack of initiative, and a syndrome of learned helplessness is also possible. The intellectual sphere suffers, since all the activity of the child is 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 with a simple answer: "I was born in 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 much thought. The same will happen if you saw any "Vasin" document, such as a passport.
Now think about how you will answer if you have not seen his passport, and he himself did not say anything about his age? You will have to think: "Vasya is my classmate - he means about the same as me ... Although, no, there are geeks and eternal students ... He dresses like a teenager, and he has such a sparse beard growing - he is probably younger ... Although he is so strong and muscular, like a 40-year-old man ... Yes, and he is always so serious. No, apparently, he is still older ... ". This can go on indefinitely until you sort through all the possible social, psychological and biological characteristics that our perception correlates with the concept of age. But, it would seem, 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 him, the most heterogeneous features (signs) correlate 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 in the course of life. As a result, estimates of the age of the poor fellow "Vasya" made by us and other people can differ significantly. The same will happen if specialists (psychologists, anthropologists, etc.) express their opinion. Their judgment (peer review) 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 figure that a person has in his passport and which he himself can tell.
No less important is the fact that we will determine how old this particular person looks from the point of view of biology, psychology, etc., and this definition - 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 a person was born to this particular moment is called chronological, or passport, age. When asking a person about age, we are interested in this figure.
The age of a person, estimated by the degree of development (or maturity) of individual signs and systems of signs, 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 characteristics, 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. Rokhlin and P.N. Sokolov (30-40 years of 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 one can speak, for example, of psychological age, its criteria, and so on.
Above, we have considered ontogeny periodization schemes that reflect our understanding of the normality of the growth process. Indeed, in the average group of people, say, in the period from 8 to 12 years in boys and in 8-11 years in girls, most of the permanent teeth erupt, the development of secondary sexual characteristics begins, characteristic changes in the psyche take place, etc. However, all together these "typical" changes are typical only for 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 lesser part of individuals deviate from this average developmental option:
their biological age lags behind the passport one - retardation occurs (slowdown in 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.
From this it follows that the age status of a given individual is determined by the degree of proximity 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, it can be noted for 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 organism is affected by a general or leading factor, in the second - by a factor that acts only on a specific system of the body. These phenomena are the basis for a differentiated study of developmental factors, as well as a way for individual prevention, rehabilitation and treatment.
If the growth rates of different body systems differ greatly from each other (departure from the broad group reaction norm), 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 can help.
Thus, one of the most important practical functions of studying biological age is to control the pace of development of individual body systems, to search for correspondences between them and to determine those that we consider normal. Considering in these studies a variety of endo- and exogenous parameters, we are as close as possible to understanding the action of specific factors that determine ontogenetic variability. Finally, the determination of biological age is the only possible assessment in paleoanthropological studies and in forensic identification.
