Behavior, Health, and Aging PDF
Preview Behavior, Health, and Aging
Behavior, Health, and Aging Edited by Stephen B. Manuck Richard Jennings Bruce S. Rabin Andrew Baum BEHAVIOR, HEALTH, AND AGING This page intentionally left blank BEHAVIOR, HEALTH, AND AGING lidltrat by Stephen B, Manudfc Richard Jennings Bruce S, Rabin Andrew Baum wtlverslttj of PitwtTurgft VD Psychology Prew X fivnwAnuKbiiSv MEWTOfil! HDVt First published by Lawrence Erlbtwm Associates, ltic , Publishers This edition published 2013 by Psychology Press Psychology Press Psychology Press Tay lor & Francis Gn>up Tay lor & Froncis Group 711 7IlinJ Avenue 27 CliUith Komi New York Hove, Hast Sussex NY 10017 BN3 2FA Psyvholog)' Pros is an fmprim of the Taylor A Francis Group. o>i rfl/rviwi? business Copyright C'2000 by Laurence Krlbaum Associates, Inc. All rights reserved No part of this book may be reproduced in any form, by photostat, microfilm, retrieval system, or any other means, without the prior written permission of the publisher Lawrence Frlh.mm Avsod^tes, Inc,, Publishers 10 Industrial Avenue Mahwah, New Jersey 07430-2262 Library of Congress Calalo&ing-in-Publkation Data Behavior, health, and aging / edited by Stephen Manuck (et al.J p. cm- — (Perspectives in behavioral medicine) Includes bibliographical references and indes ISBN 0-8l>W-3404-4 (doth : alk- paper), I. Aged—Health and hygiene. 2. HeaHh behavior—Age factors 3, Aging, 4- Geriatrics, RA564.B.B43 2000 618.97—dc2l 99-0SS82O 10 9 8 7 6 5 4 3 2 1 Contents Preface Genetics and Aging Gerald E. McClearn and Debra A. Heller Quality Adjusted Life Expectancy for Men and Women in the United States Robert M. Kaplan and Jennifer Erickson Aging Women, Getting Older, Getting Better? Elaine Leventhal Menoupau.se as a Turning Point in Midlife Karen A. Matthews, Rena R. Wing. Lewis H. Knller. Elaine N. Meilahn, and Jane F. Owens Changes in the Immune System During Aging Bruce S. Rabin Effect of Chronic Stress on Immune Function and Health in the Elderly Susan Robinson-Wlielen. Janice K. Kiecolt-Glaser. and Ronald Glaser Neuroimmunc Interactions: Implications for Aging and Innnunosenescence—Rodent Models David A. Padgett, Cathleen M. Dobbs, and John F. Sheridan Immune Functions, Their Psychological Correlates, and Health George F. Solomon and Donna Benton vi CONTENTS 9 Negative Affect and the Disablement Process in Late Life: A Life-Span Control Theory Approach Richard Schulz, Jutta Heckhausen, and Alison O'Brien 119 10 Psychological Factors, Health, and Disease: The Impact of Aging and the Life Cycle Reford B. Williams 135 11 Coping with Chronic Illness Among the Elderly: Maintaining Self-Esteem Vicki S. Helgeson and Kristin Mickelson 153 12 Sex, Psychosocial Stress, and Atherosclerosis: A Monkey Model Michael R. Adams. Steven B. Manuck,./. Koudy Williams, Jay R. Kaplan, and Carol A. Shively 179 13 Comparative Effects of Age and Blood Pressure on Neuropsychological Test Performance: The Framingham Study Merill F. Elias, Penelope K. Elias. Ralph B. D'Agostino, and Philip A. Wolf 199 14 Uncertain Health Effects of Cholesterol Reduction in the Elderly Matthew F. Muldoon, Jay R. Kaplan, and Stephen B. Manuck 225 Author Index 245 Subject Index 263 Preface Millennial events are peculiar for many reasons, particularly when they occur in the context of the millions of years that preceded recorded time keeping and history. They tend to focus attention on long-anticipated out comes as a fitting conclusion to 1,000-year epochs (this occurs at the end of centuries and decades too. but to a lesser extent) and on the changes that the next epoch promises. They are useful as a way of focusing atten tion on changes that occur independent of changes in the calendar, taking advantage of the heightened focus on summarizing where we’ve been and where we are going. So, as a rubric for summarizing changes that may come to dominate our lives in the first 50 to 100 years of the new mil lennium, they serve a useful puipose. One of the most important changes characterizing the new era is the changing nature of our population and its health care demands. Most prominently, our population is aging as people live longer and remain active longer into their lives. As the popu lation ages it becomes more diverse and our knowledge and priorities must change as well. This book deals with aging in the context of health and health care needs. It considers basic changes that accompany aging and some of the more specific problems that accompany it. Several issues are predominant. Genetics has assumed increasing importance, both in terms of the genomic instability we associate with advancing age and in terms of expression of heritable predispositions and exhibition of pre dictable behaviors or disorders. Maclearn and Heller review basic tenets of this evolving field, including some of the methods of looking at heri table differences in health and well-being and some consideration of the implications of discovering genes or polymorphisms that appear to be vii viii PREFACE related to accelerated senescence, systemic disease, or depression. Overall, the genetic bases of differences in how quickly people age and/or lose functional competence are of considerable interest as are the envi ronmental conditions that affect the shape such predispositions assume. The second chapter considers another development that has important implications for health care in the next epoch, adjustment of life expectancy for quality of life. Most of us are aware of changes in the recognition of and emphasis on quality of life in planning therapeutic interventions for disease or disability and most of us can recognize the importance of factoring such concerns into decision-making and research. Kaplan and Erickson discuss the wisdom and value of quality-adjusted survival analysis and describe the findings of a study of such analyses in a large sample of men and women, reporting differences between men and women in overall quality of life. More significantly, quality adjustments had greater impact on life expectancy among women, negating much of the life expectancy advantages typically afforded them. In contrast to mor tality-based measures of health outcomes that show women with a clear survival advantage, quality-of-life measures suggest advantages for men. Issues associated with gender are also a prominent theme of the third chapter. Here, Leventhal argues that gender differences in symptoms, behaviors, and outcomes affect the physical and psychosocial impact of interventions among the elderly, influencing the emergence of frailty or loss of function and, ultimately, use of the health care system. The impli cations of a view of aging emphasizing multiple systems are considered, and the notion that aging and life span development are really a series of partially independent biological clocks that run at different rates and wind down at different times is discussed. Of necessity, longevity is associated with greater heterogeneity as a variety of factors combine to determine how well people deal with the growth and decline of each of these sys tems. Gender appears to affect many or most of these systems and impli cations for behavior, survival, and psychosocial aging are examined. Chapter 4 continues this focus on gender, focusing on a major life tran sition among aging women. Matthews, Wing, Kuller, Meilahn, and Owens attack the anecdotal nature of reports of menopause, suggesting that despite negative expectations among premenopausal women, menopause is a complex and potentially positive transition for women that does not necessarily unfold as cultural stereotypes would indicate. The chapter comprehensively reviews the biological bases of menopause, its role in increasing risk for cardiovascular disease, and the emotional and biological changes that accompany it. Importantly, Matthews and her PREFACE ix colleagues report evidence that suggests that non-pharmacologic lifestyle interventions may modify risk factors during the menopausal period that reduce potential consequences or health problems later on. The next four chapters deal with various aspects of aging and the immune system. Some of the primary health-related consequences of aging appear to be mediated by the immune system, and the greater vul nerability of older people to infectious illnesses provides prima facia evi dence of declines in immune defenses with age. In chapter 5, Rabin sum marizes our knowledge of immune system changes that occur with aging, including autoimmune responses, T-cell function, cytokine activity, and the role of nutrition in aging of immune defenses. This is followed by Robinson-Whelan, Kiecolt-Glaser, and Glaser’s chapter on chronic stress as an important immunmodulator in the elderly. This discussion is cen tered on chronic stress associated with caregiving and its impact on immu nity, suggesting health implications and possibilities for intervention in this rapidly growing group of older adults. Chapter 7, by Padgett, Dobbs, and Sheridan, explores the concept of immune senescence from a differ ent perspective, using rodent models to evaluate the immune changes thought to accompany aging. These authors offer a very comprehensive review of findings bearing on clear trends toward the progressive decline of immune functions and corresponding increases in vulnerability to infec tious agents. Finally, Solomon and Benton provide a different challenge to the traditional view of immunosenescence. Focusing on healthy behaviors among people doing relatively well in the face of potentially debilitating disease, they found little evidence of substantial immune system decline in a group of healthy older men and women who coped well and maintained good mental health. The implications of this and related findings described in these four chapters are important components of an overall model of health, disease, and outcomes of aging. The last six chapters evaluate some of the psychosocial implications of aging for health and illness, with emphasis on the contributions of these factors to cardiovascular disease. In chapter 9, Schulz, Heckhausen, and O’Brien address the relations between negative emotional experience and disablement and disability in late life, suggesting that adjustment to limita tions on prevailing modes of controlling one's environment is a significant component of the gradual decline many experience. Interventions may address these limitations, facilitating adjustment to them, or may focus on the effects of the disablement process and on secondary prevention. In chapter 10, Williams addresses the dynamic interplay of psychosocial risk factors, biobehavioral mechanisms underlying pathophysiology, and
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