An article by Fco. Javier Montero Parra, Caridad Gómez Romera,
Jose Antonio Gutierrez Fernandez, Ana Cristina Gomez Romera
and Sergio Salmerón Ríos, from
Our goal is to describe and differentiate what today is considered a normal aging or healthy from pathological aging. It is often confused senescence or normal mental aging with the senilitywhich is pathological aging, that is, it exceeds the involution typical of age and that for various reasons leads to intellectual deterioration and dementia.
Sometimes memory loss is attributed to age, which is to be expected, but is not a fundamental reason to speak of a clear and possible cognitive decline. If it is true that the older you are, the greater the risk of suffering a neurodegenerative pathology. It is estimated that cognitive impairment and dementia would exist between 5-10% of people over 65 years of age. This figure is high but indicates at the same time that more than 90% of men and women of advanced age retain their mental lucidity.
What is indisputable is that over the years, the organism experiences a progressive involution of its vitalityalso affecting the brain, with a greater or lesser degree of neuronal damage, estimating that at the age of 90 there would be a destruction of 30% of the nerve cells.
Aging is not a phase of life that is characterized by a decline, but rather, that nowadays it is proposed that in old age one should not only talk about pathological vs. non-pathological agingtherefore we must differentiate:
1. Normal aging: people without pathologies although at risk of suffering them.
2. Optimal aging: people with a high level of functioning and low risk of suffering from any pathology, which would imply:
- Low probability of disease and disability
- High level of cognitive and functional capacity
- Active involvement with daily life.
Currently, dementia tends to be defined as a loss of intellectual abilities that interfere with the social and occupational functioning of the individual. To diagnose dementia, a loss of cognitive functions in general is not enough, but a global commitment of the personality is required, which translates into the loss of habits and control of instinctive impulses with a significant bankruptcy of self-criticism and disappearing disease awareness.
To explain the variability and heterogeneity of aging, one must take multiple factors into account such as vital, personal, cultural, educational, labor, social, economic history, etc. That is to say, from the different life situations, inter-individual differences related to the level of physical, cognitive and social functioning are observed.
Not having chronic diseases, having a higher level of activity, enjoying a good mood, absence of cognitive deterioration, as well as a higher level of involvement in physical, social and intellectual activities are valued as predictors of successful aging. Hence the great importance of participation with high frequency in individual or group workshops with cognitive intervention programs, which are very effective in maintaining and stimulating intellectual functioning, memory, attention, concentration, etc.
Psychic risk factors for pathological aging
We could synthesize them as follows:
⁃ Events that are experienced as traumatic with the aging process
⁃ Feeling of emptiness, initiating pathological modes of attachment to objects as an attempt to fill said emptiness
⁃ Unelaborated grief stories
⁃ Lack of family or social support network
⁃ Imaginary, symbolic and emotional impoverishment
⁃ Somatizations and behavioral disorders
These conditions of emotional vulnerability They become evident in the behaviors of the subjects from young ages reaching the final destination, which is the psychological risk of pathological aging and that we will detect in multiple symptoms, such as: flexibility, disposition or changes, being reflective, accepting a decrease in performance, limitations, slowdowns, staying self-validating, living until and not towards death, rethinking a unique identity (“I am like that”), establishing self-esteem in the present and not in the past, staying connected with the environment, etc.
There are two very topical issues on the mental agingone determined by cultural factorsthe other by biological factorsand both have experienced the conditions of vulnerability mentioned above.
- First, the cultural ideals of eternal youth and of exaltation of consumption they produce a large number of effects at the level of subjectivity, for the most part depressions of all kinds.
- Secondly, the main threat posed by the passing of the years and which today constitutes one of the most pressing research topics: cognitive decline and Alzheimer’s.
Our challenge, today in the psychogerontology, is the application of these conditions of emotional vulnerability to the triggering of dementia. It is becoming more and more evident that a life of mental and affective poverty and of ties presages pathological aging to a greater extent. In short, a life of representational richness and open to complexity, uncertainty, fluctuations, disorder and non-linear thoughts, capable of carrying out a psychic work of anticipations and resignifications. They will be the psychic conditions that can be built in the course of life as antidotes that will make adversities bearable in order not to break. It is that in the future of the human being build a space between the internal and the external, between past, present and future.
Bibliography
1. Zarebski G. Aging, collective memory and construction of the future. 1st ed. Montevideo: University Psychobooks; 2017.
2. 2. Patti Gelabert V. Normal Aging versus Pathological Aging – Psychology – Neuropsychology. Neuropsicologia.saludyeducacionintegral.com. 2017 . Available in:
Pathological aging, physiology and psychology, psychological profile of the elderly
In it aging biological changes occurboth in the cytoplasm and in the cell nucleus. Alteration of the nuclear and plasma membrane components leads to disturbances in fluidity. The viscosity of the membranes is increased, their functions and the movements of the proteins are altered; so the exchange of information that takes place between them is definitely modified.
The consequences Fundamental of these modifications are: variations in cell excitability, alterations in the transport of molecules and decreased affinity of receptors for certain specific molecules. In it cytoplasm The changes give rise to: a decrease in the number, size and functionality of mitochondria in the body’s cells with the consequent alteration of the respiratory chain. In it cell nucleus transformations occur in the processes of hydration and alteration of genetic information. Biological changes are summarized in Table 1.
Table 1
Aging: Biological changes
cardiovascular system
Decreased heart rate and contractility. Higher prevalence of orthostatic hypotension
Decreased elasticity of the heart valves
respiratory system
Reduced respiratory efficiency. Increased closing volumes
Increased frequency of atelectasis and infections
endocrinological system
Glucose intolerance and hyperinsulinemia. Decreased active thyroid and parathyroid tissue
Estrogen and growth hormone reduction
Increased gonadotropins and cortisol
Liquids and electrolytes
Homeostasis and adaptation less efficient. Tendency to hyponatremia and hyperkalemia
Tendency to dehydration and aqueous intoxication
Increased risk of SIADH
Immune system
Increased production of antibodies. decrease in T cells
Digestive system
Tendency to constipation and malabsorption
Decreased secretion of saliva and gastric juice
Genitourinary system
Decreased renal blood flow, glomerular filtration, and clearance of
creatinine
sense organs
Decreased visual acuity and hearing
Less accommodation capacity. Decreased vibratory and tactile perception
Fur
Paleness and dryness, less elasticity
locomotor apparatus
Rigidity
slowing down of movements
Cardiac rhtyms
REM sleep decreases and wakefulness increases. Rhythms reduced in amplitude
Psychological changes manifest predominantly in memory deficits, alterations in the conceptualization process, loss of flexibility and a general slowing down of activities, to which are added perceptual deficits and psychomotor skills. The way we approach the age-associated cognitive changes and the solutions that society proposes, conditions our attitudes towards aging and the elderly. Some authors suggest that some skills can be acquired for the first time and improved at an advanced age.
- Personality
According to some authors, previous traits are accentuated (caricature of character) and insecurity can lead to dependency. The elderly with paranoid traits isolate themselves more, those with schizoid traits tolerate loss and loneliness better, and those with obsessive traits may have a better adjustment to old age. Personality at this time of life is related to stressful life events suffered during the life cycle, especially losses. - Cognition
Slowing of cognitive functions, abstract reasoning declines. The intelligence quotient remains stable until the age of 80 in the healthy elderly, verbal ability is maintained, psychomotor speed decreases. - memory and attention
The immediate and recent deteriorates and the remote is better preserved. It has been considered that better recall of past events helps the elderly to avoid the painful circumstances of the present and take refuge in a more pleasant past. Attention is hampered by age, especially if there are several simultaneous stimuli. - Adaptation to changes
Social exchanges become more expensive during old age and are less rewarding. Some authors propose reversing the focus of attention, from the outside world to the inside; others the promotion of activity to achieve vital satisfaction and health.
The emotional life of the elderly depends on changes in social status, the decrease in physical and mental faculties, the loss of loved ones, etc. with which a denial of reality and an idealization of the lost object can sometimes be produced
Bibliography
1. HALL, JONHE (2016a). TREATISE OF PHYSICAL PHYSIOLOGY. Recovered from
2. Motor Skills Disorders. (2014). Recovered from
3. AGING AND HEALTH. (2018, February 5). Retrieved October 22, 2018, from
Dr. Fco. Javier Montero Parra
Bachelor of Medicine and Surgery and specialist in Occupational Medicine
Doctor of Ilunion…