LECTURE 1

GERIATRIC PT
PHTH 415
FALL 2020-2021

BAU – FHS – PTD

IS THERE A “FOUNTAIN OF YOUTH”???
 THEORIES OF AGING
Objectives:
By the end of this subject the student will be able to:
 Define common concepts about scientific theories.
 List common theories of aging process.
 Underline main ideas of each theory of aging process.
 Differentiate between different ideas of the different theories of
aging
 Recognize the reasons for studying theories of aging
 CONTENTS
1- Introduction

2- Definition of terms

3- Aging theories
 INTRODUCTION
Ageing is a progressive, predictable process in which
gradual changes not caused by disease nor accident
occur over time.

Affects both body & mind

Some age-related changes start as early as in the

20 years of age or less; others may not appear
until people are in their 70’s.
 DEFINITION OF TERMS

1- Aging

2- Gerontology

3- Geriatrics

4- Life span

5- Life expectancy

6- Categories of elderly
 1- Aging:
• The time sequential deterioration that occurs including weakness, increased
susceptibility to disease, loss of mobility, loss of agility, and age related
physiological changes.
• It is a syndrome of changes that are deleterious, progressive, universal,
and irreversible.
 Common to all members of a given
species.
 Progressive with time.

 Varies among and within individuals.

 Evidenced by:
 Decline in homeostatic efficiency

 Reaction to injury may not be successful

 2- Gerontology:

Scientific study of the factors impacting

the normal aging process and the effects
of aging.

3- Geriatrics:

Branch of medicine concerned with the

illnesses of old age & their care.
SENESCENCE

The state of being old or the process of

becoming old. The process by which a cell
loses its ability to divide, grow, and
function. This loss of function ultimately
ends in death.
 4- Life span:
• Maximum survival potential.

• In humans : inherent natural life. The length of time for which a

person lives

5- Life expectancy
• Number of years of life expectation from year of birth.

• Women live 6.6 years longer than man.

 6- Categories of the Elderly:
• Young elderly : 65 – 74 ( 60 % of elderly
population).

• Old elderly : ages 75 – 84

• Old & frail elderly : ages > 85

 Demographic Trends

• Over the past three decades, declines in fertility,

improved health care and better socio-economic
conditions in Lebanon have created a compressed
demographic transition together with a rapid increase
towards survival into later life.

• The proportion of older persons, 65 years and over, has

increased from 6.7% in 1996 to 7.4% in 2004, and is
expected to reach 10.2% by 2025; this increase has
gone hand to hand with a decline in the proportion of
the youngsters 0-14 years, from 29.4% in 1996 to 27.3% in
2004 then to an expected 19.5% in 2025.

• This phenomenon has major implications on the social,

economic and health care levels.
 AGING
THEORIES
 Cell mutation
Genetic

Doubling
Biological Hormonal
biologic clock theories

Free radical Immunity

Environmental
theories
 Stress

Despair

Erickson’s Psychological
bipolar theories
 Activity
Social Role

Disengagement Sociological
theories
BIOLOGICAL
THEORIES
 Free Radical Theory
• Free radical are highly unstable and reactive molecules that
are produced by aerobic metabolism, radiation, and other
environmental agents.
• Free radicals disturb DNA and RNA synthesis, protein and
enzyme synthesis, lowering energy levels and preventing
the body from building muscle mass.

• Free radical damage begins at birth and continues until we

die. During youth, the body has extensive repair mechanism
so the effect is minor. However, the accumulated effect of the
free radicals with age cause more damage attacking
collagen and elastin that keep skin moist, smooth, flexible,
and elastic. Also, it may be responsible for other age related
diseases like hypertension and osteoarthritis.
• Substances that prevent the harmful effects of free radicals oxidation
are known as anti-oxidants like vitamins C and E, beta carotene,
omega 3...
 Cross-linking Theory
• With age, protein, DNA, and other molecules develop
inappropriate attachments or cross-links decreasing their
mobility and elasticity and causing problems. Collagen is a
major protein affected by cross-links.
• Young people have few cross-links, but, with age, the
number of cross-links increases causing the skin to shrink
and obstructing the passage of nutrients and waste between
cells.
• High and fluctuating levels of blood sugar react with the
proteins to cause cross-linkage. It is a suggested cause of:
cataract, immune system deficiency, arteriosclerosis, and
damage to the kidneys, blood vessels, lenses of eyes…
• Suggested anti aging procedures: keeping the blood sugars within
range; avoiding cooking with aluminum pans and using excess
baking powder; limiting the use of anti-acids; leading active life style
and following a good healthy diet with less fat and metal ions…
 Wear and Tear Theory
• It suggests that years of damage to the cells, tissues, and
organs eventually wear them out, killing them and then the
body.

• The DNA that makes up the genes sustains repeated damage

from toxins, radiation, and ultraviolet light.

• The body has the capacity to repair DNA damage, but not all the
repairs are accurate or complete. Thus, the damage progressively
accumulates.
 Waste Accumulation Theory
• During the course of their lifespans, cells produce more
waste than they can properly eliminate.

• The waste can include various toxins which, when

accumulated to a certain level, can interfere with normal cell
functioning, and ultimately killing them.
 Hayflick Limit Theory (Doubling/Biological Clock)

• The aging process is controlled by a biological clock

contained within each living cell.
• Lungs, skin, muscles, and heart have a limited lifespan. They
divide approximately 50 times over the period of years then
suddenly stop.

• Nutrition have an effect on the rate of cell division. Alterations

and degenerations occur within some cells before they reach
their growth limit.

• The most evident changes took place in cell organelles,

membranes, and genetic material. This improper functioning may be
responsible for the effects of aging.
 Genetic Control Theory

• It focuses on the genetic programing encoded within the

DNA that predetermines the tendency to certain types of
physical and mental functioning, and has a great deal to
say how quickly the aging process goes.

• The faulty DNA repair and mutagen damage are responsible

for the observed changes in aging. Also the faults in RNA and
protein synthesis cause the production of unsound cells.

• The timing of this genetic clock is subject to enormous variation

depending on what happens during growing up. DNA can easily be
oxidized and the damage can be accumulated from diet, lifestyle,
toxins, pollution, radiation, and other outside influences.
• Aging is intrinsic to the organism.
• Genes are programed to modulate aging changes and overall
rate of progress
 Individuals vary in the expression of changes (Gray
hair, wrinkles, etc…)
 Polygenic control (multiple genes involved)
 Premature aging syndromes may exist (Progeria)
as an evidence of genetic defective
programming
 Hormonal (Neuroendocrine) Theory

• The hypothalamus (located within the brain) governs the

hormone release from different organs. It responds to the
body’s hormone levels as its guide to regulate hormonal
activity.

• Hormone production is a highly interactive and vital process

for repairing and regulating bodily functions. The drop in
hormone production caused by aging results in a decline in
the body’s ability to repair itself.

• Neurons in the brain center act as pacemakers that regulate the

biological clock during development and aging. A decline in the
relationship between neurological and endocrine systems stimulate
the aging process.
• Aging is attributed to the anterior pituitary hormones that accelerate
aging and result in sleep disturbances, alteration in blood sugar,
inefficient temperature control, decreased muscle strength, impaired
cardiovascular and respiratory function.
 Thymic-Stimulating Theory
• The theory focuses on the thymus as the master gland of the immune
system.
• The size of this gland reduces from 200-250g at birth to around 3g
(three grams) by the age of 60.
• Scientists are investigating whether the disappearance of the thymus
contributes to the aging process by weakening the body's immune
system.
• Thymic hormones play a role in stimulating and controlling the
production of neurotransmitters and brain and endocrine system
hormones.
ENVIRONMENTAL
THEORIES
Aging is caused by accumulation of
insults from the environment

Environmental toxins include : UV, Cross-linking agents (urea-

formaldehyde (UF)), Toxic chemicals ( metal ions, Mg, Zn), Radiation
& Viruses

Result in error in protein synthesis, DNA

synthesis/genetic sequence, cross-
linkage of molecules, mutation.
PSYCHOLOGICAL
THEORIES
 Stress theory:
• Homeostatic imbalances (changes in structural & chemical
composition)

 General adaptation syndrome (Seyle) : initial alarm

reaction , progressing to stage of resistance & exhausting .

 Closely linked to hormonal theory .

 2. Erickson’s bipolar theory:

Integrity: Life is viewed with satisfaction

(productive life, sense of satisfaction, remains
optimistic)

Despair: Life is viewed with despair

(fear of death, feeling of regrets and
disappointment, missed opportunities)
SOCIOLOGICAL
THEORIES
Activity Theory:

Socially active old persons exhibit improved

adjustment to the aging process

Disengagement theory:

Distancing or withdrawal from society leads to

isolation and life dissatisfaction
Role Theory:

Society expects individuals to take certain roles at certain

times in life. In some types of work the peak performance is
reached earlier (dancers, sports players…). Other
influences like returning to school or starting a new career
can affect social age.
Aging is a complex , multifactorial phenomenon
in which some or all of the previous processes
may contribute to the overall aging of an
individual.

Aging cannot be adequately explained by one

single theory