Promoting Functional Health in Midlife and Old Age - Research Paper Example

? Geriatrics of the of the Geriatrics Individuals with healthy lifestyles, during their midlife, ensured a protective effect with respect to their health in later life. These findings hold out great promise, and make it possible to evaluate the combined effect of psychosocial and behavioral factors. Some of these factors are nutrition and diet, reaction to stress and regulation of stress, and religious activity and spirituality (Lachman & Agrigoroaei, 2010, p. 7). Moreover, the major cause of death in the US is on account of heart disease. This is also the principal cause of death among the elderly males and females. Any serious attempt at mitigating the detrimental effects of heart disease on cost and health of the population has to ensure certain interventions (Meng, Wamsley, Eggert, & Van Nostrand, 2007, p. 322). These are the systematic application of primary, secondary, and tertiary prevention strategies to individuals who are at risk of developing heart disease. Tertiary prevention strategies relate to the provision of adequate treatment for heart disease, and this also comprises of reducing the severity of the ailment and occurrence of complications (Meng, Wamsley, Eggert, & Van Nostrand, 2007, p. 322). Furthermore, it has been projected that there could be a substantial increase in the number of people with heart disease in the coming decades, and in this backdrop, it becomes indispensable to adopt these prevention strategies, without any delay. Although, there has been a reduction in the prevalence of disability, the absolute size of the disabled groups has been projected to surpass the 12 million mark, by the year 2030 (Meng, Wamsley, Eggert, & Van Nostrand, 2007, p. 322). The excessive consumption of alcohol has been seen to increase the risk of medical, functional, and psychological disorders to which the older adults are significantly more susceptible. Quite frequently, the excessive consumption of alcohol is a component of other undesirable traits, such as an inadequate diet, smoking, and obesity (Satre, Gordon, & Weisner, 2007, p. 238). This tends to enhance the cumulative risk, with regard to the development of medical problems. Nevertheless, moderate drinking was seen to provide health benefits. With regard to heart disease, moderate drinking had reduced mortality, in comparison to heavy drinking or abstinence. Thus, alcohol can be beneficial to health if consumed in moderate quantities (Satre, Gordon, & Weisner, 2007, p. 238). As shown by the research of Grant and Harford and other scholars, the abuse of alcohol or its consumption in large quantities, and symptoms of depression or major depressive disorder frequently arise in the later stages of life. In addition, a correlation between the abuse of alcohol and depressive symptoms or major depression has also been reported by some research studies (Choi & Dinitto, 2011, p. 860). This relationship has been seen to affect males, as well as females. However, as shown by Blazer, older females develop depressive symptoms to a greater extent than their male counterparts. At this juncture, it has to be emphasized that the older females, have a much greater proclivity to refrain from drinking. On the few occasions that the older females indulge in drink, they have been seen to imbibe much less than the older males. These findings stress the necessity for further examination, in determining the correlation between alcohol use and depressive symptoms (Choi & Dinitto, 2011, p. 860). In addition, smoking enhances the risk of cancer among the elderly people. Abstinence from smoking, proper nutrition, and exercise on regular basis promote good health. These elements are considered as good health behaviors, and have the capacity to reduce the likelihood of hospitalization and the risk of death. Moreover, these habits promote the functional and behavioral performance of people of all ages (Fillenbaum, Burchett, Kuchibhatla, Cohen, & Blazer, 2007, p. 73). As such, these habits promote the wellbeing of individuals and society. Furthermore, it is now abundantly clear that smoking in later life is responsible for a number of well documented hazards. For instance, it has been conclusively established that smoking in the elderly, increases the possibility of premature death, while proving markedly detrimental to their health and quality of life. This is due to the fact that the older people are at a substantially greater danger, in comparison to the non – smoking individuals of their age group. This danger relates to being rendered disabled by cancer, heart disease, respiratory difficulties, circulatory problems, cognitive deterioration, and stroke (Kerr, Watson, Tolson, Lough, & Brown, 2006, p. 572). In addition, smoking has other dangerous effects. For example, it diminishes the effectiveness of medication prescribed for the conditions of the elderly, such as arthritis, diabetes, and hypertension. Furthermore, as shown in the research work conducted by Andrew Irving Associates and the US Fire Administration, smokers among the older people are at great risk of succumbing to household fire. In such accidents, the cause of the fire had been in general, determined to be materials related to smoking (Kerr, Watson, Tolson, Lough, & Brown, 2006, p. 572). As such, smoking in elderly people may lead to cancer, heart disease, respiratory difficulties, circulatory problems, cognitive deterioration, and stroke. However, the cessation of smoking, by those above the age of 65 years, tends to improve their health and longevity, and there is sufficient evidence to support this observation. With regard to heart disease, stroke and other such conditions, the benefits of discontinuing smoking are almost immediate. Moreover, stopping smoking drastically diminishes the risk and even ends the development of chronic obstructive pulmonary disease. After a decade of abstention from smoking, the risk of developing lung cancer reduces to that of non – smokers (Kerr, Watson, Tolson, Lough, & Brown, 2006, p. 572). Abstention from smoking results in reduced risk of lung cancer in elderly people. Nevertheless, functional health in the US has shown some improvement. However, this has been accompanied by an increase in the disability levels. This unwelcome increase in disability constitutes a major public health problem that assumes alarming proportions in later life. Individuals who entertain and inculcate health risk factors, such as smoking, having alcohol problems, and being overweight, and people with chronic health problems are headed towards developing poor functional health (Lachman & Agrigoroaei, 2010, p. 1). As such, it has now been decidedly established that smoking substantially increases the risk of developing several ailments. Keeping this important fact in view, the Medicare Stop Smoking Program was implemented, with the express objective of helping the elderly adults to give up smoking. Several levels of intervention were adopted in this process, and their effectiveness was assessed (Coberley, Rula, & Pope, 2011, pp. S – 49). These levels of intervention were usual care; reimbursement for counseling from a health care provider; reimbursement for provider counseling with bupropion or a nicotine patch; and counseling over the telephone, in addition to the use of a nicotine patch. The best results, after a year of these interventions, were witnessed with regard to the telephonic help and nicotine patch intervention, and this was of the order of 19.3%. The results of usual care, on the other hand, were just 10.2% (Coberley, Rula, & Pope, 2011, pp. S – 49). Nevertheless, smoking causes long term damage, which is not eradicated entirely, on giving it up. For instance, former smokers had thicker blood vessels than those who had never smoked. In one study, variables, such as age, gender, diabetes, alcohol and hypotension were controlled. However, it was discovered that wall volume thickness remained significant (Sullivan, 2006, p. 9). Moreover, the arterial lumen was seen to dilate with exercise and other risk modification strategies. In the conference, sponsored by the American Stroke Association, Agarwal brought these important facts to the forefront. It was also shown that the cessation of smoking did not ensure the expansion of the arterial lumen. This disturbing discovery prompted Agarwal to sound a warning note, by stating that smoking had to be stopped as soon as possible, as it would have an adverse effect on the rest of the life of the smoker (Sullivan, 2006, p. 9). In addition, smoking adds a decade to the age of the smoker, with regard to risk of death from all causes. Thus, a 50 year old smoker is at the same risk of death from all causes as a non – smoking individual of 60 years. The single largest cause of death for people who have never smoked is on account of heart disease death (Woloshin, Schwartz, & Welch, 2008, p. 845). Once, such people cross the age of 50 years, the possibility of their demise due to heart disease exceed the chances of death from cancer of the colon, lung, and prostate combined. Smokers are at risk of dying from lung cancer to the same degree as dying from heart disease. Once the half century mark has been crossed, smokers are ten times more likely to die of lung cancer than cancer of the colon or prostate (Woloshin, Schwartz, & Welch, 2008, p. 845). Among smokers who are older than 50 years, lung cancer will be a more prevalent than the other ailments, such as colon or prostate cancers. As such, smoking is very damaging to health and this has been established by several studies. For instance, in a study conducted by LaCroix et al., the correlation between smoking and death from all causes among 7178 persons was examined. These persons were 65 years or older, and none of these persons had been afflicted with cancer, myocardial infraction, or stroke (Andrawes, Bussy, & Belmin, 2005, p. 870). This study discovered that current smokers were at greater risk of cardiovascular mortality than the individuals who had never smoked. With regard to former smokers who had not been smoking from 2 decades, this study found that their mortality was the same as those who had never smoked (Andrawes, Bussy, & Belmin, 2005, p. 870). This provides emphatic evidence and inducement to cease smoking, regardless of the age of the individual concerned. Furthermore, the importance of aerobic fitness has been chiefly demonstrated in cardiovascular and heart failure populations. In these groups, exercise testing constitutes a clinical standard of care. Consequently, evaluating aerobic fitness assumes substantial significance. This assessment could even be deemed the most important predictor of the long – term health of chronic cardiac populations. Moreover, a major intervention with such patients is to bring about their fitness (Lavie, Arena, Church, & O'Keefe, 2012). In addition, a very interesting discovery made with regard to the elderly was that their emotional health and wellbeing improved with age. This was notwithstanding the deterioration in their physical health. Several wellness programs have provided evidence that the emotional health of the elderly can be improved by programs that concentrate on improving the physical health of seniors (Coberley, Rula, & Pope, 2011, pp. S – 49). However, a major impediment to promoting the health of the aged is provided by social exclusion. In fact, the data provided by the English Longitudinal Study of Ageing (ELSA) project has disclosed that social exclusion constitutes an intricate, dynamic and multidimensional target. Thus, social exclusion has to be addressed by means of a sophisticated combination of measures and initiatives at both the local and national levels (Toofany, 2008, p. 19). The risk of stroke and heart disease is reduced to an appreciable extent, by decreasing the blood pressure. This is reduction in risk is independent of the initial blood pressure of the individual concerned. For instance, it has been shown that a 5mm of Hg reduction in blood pressure reduces the risk of stroke by 34%. With regard to ischemic heart disease, the reduction in risk from a pre – treatment level was seen to be 21% (Jenkins, Baker, & White, 2009, p. 34). These figures are significant and clearly depict the importance of reducing the blood pressure in individuals at risk. Several socio – demographic variables have a tangible influence on functional health, and these include gender, race, and economic status. All the same, there is evidence to demonstrate that disability and physical limitations at any age can be limited and controlled by changing one’s lifestyle, avoiding risk factors, and adopting protective or health promoting behavior (Lachman & Agrigoroaei, 2010, p. 1). The majority of the studies in this area have focused on identifying the risk factors related to negative outcomes, such as morbidity and mortality. However, there have been significant endeavors to evaluate the effects of health promoting factors for preserving good health. In other words, these efforts have concentrated on what should be done rather than what should be avoided. This is a positive approach, and it has demonstrated its usefulness, by being more effective in transforming behavior and effecting the promotion of health (Lachman & Agrigoroaei, 2010, p. 1). Several research studies have provided substantial evidence to establish that there are specific social, physical, and psychological factors that have an overwhelming effect on ensuring better health in later life. Some of these factors like control beliefs, social support, and physical exercise have been clearly identified as predictors of functional health. In addition, a vast array of studies has shown that these factors can be subjected to modification and therefore can be employed with benefit in reducing disability and improving functional health (Lachman & Agrigoroaei, 2010, p. 1). Physical exercise, on being regularly engaged in, has the capacity to prevent or reduce disability. This is the result of the beneficial effect of physical exercise on muscle mass, bone density, cardiovascular and pulmonary functioning, among other areas. However, it is to be borne in mind that maintaining a regular regimen of physical exercise can prove to be an onerous task. Furthermore, it has not been conclusively demonstrated that physical exercise has long – term benefits (Lachman & Agrigoroaei, 2010, p. 2). Furthermore, a study was conducted with individuals in the age range of 70 to 79 years, and the results were published in Neurology. The number of people studied was around 2,500, and it was shown that the educated, non – smoking, physically and socially active members of this group had a much better chance of retaining their cognitive skills (American Academy of Neurology, 2009). Moderate to vigorous exercise, at least once a week, was seen to improve the maintenance of cognitive function, to the extent of 30%, in comparison to those who did not indulge in physical exercise. Individuals with a minimum of high school education were three times more likely to retain the acuity of their mental processes than those with lesser education. With regard to non – smokers it was noticed that these individuals were likely to be twice as perspicacious as the smokers were. Moreover, working people and individuals not living in solitude were 24% more likely to maintain cognitive function (American Academy of Neurology, 2009). In a study by Tikkanen et al., 679 participants with an average age of 80.8 years were examined. Among these 58.8% had been physically active at the age of 20 to 64 years. This had the salutary effect of enabling them to walk 1300 feet independently in their old age. In addition, these people depicted better walking speed and grip strength, in comparison to the physically inactive men (Tikkanen, et al., 2012, p. 905). In fact, smoking and physical exercise are behaviors that can be transformed. As per the above discussion, it can be concluded that, engaging in adequate exercise and abstaining from smoking and alcohol can help tremendously in preventing the development of many health hazards like cancer, stroke, respiratory problems and dementia in the older individuals. List of References American Academy of Neurology. (2009, June 8). Staying Sharp: New Study Uncovers How People Maintain Cognitive Function in Old Age. Retrieved November 24, 2012, from http://www.aan.com/press/index.cfm?fuseaction=release.view&release=740 Andrawes, W. F., Bussy, C., & Belmin, J. (2005). Prevention of Cardiovascular Events in Elderly People. Drugs & Aging, 22(10), 859 – 876. Choi, N. G., & Dinitto, D. M. (2011). Heavy/binge drinking and depressive symptoms in older adults: gender differences. International Journal of Geriatric Psychiatry, 26(8), 860 – 868. Coberley, C., Rula, E. Y., & Pope, J. E. (2011). Effectiveness of Health and Wellness Initiatives for Seniors. 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