What Have You Learned?

1. Question 20.1

   What is the connection between senescence and serious disease?

   Although senescence affects every part of the body, and although some parts of the body function less well because of it, senescence does not necessarily cause illness. Serious diseases such as coronary heart disease correlate with hypertension and cholesterol, which correlate with senescence. However, senescence does not direct cause heart disease.

2. Question 20.2

   How often and why do people lose significant brain function before age 65?

   Every adult’s brain slows down with age, but only about 1 percent of individuals under the age of 65 will experience a significant decline in brain functioning. The significant decline in brain functioning may be due to drug abuse, poor circulation, viruses, and genetics.

3. Question 20.3

   What are the visible changes in the skin between ages 25 and 65?

   During adulthood the skin becomes dryer, rougher, thinner, less flexible, and wrinkled.

4. Question 20.4

   What are the visible changes in the hair between ages 25 and 65?

   Hair usually turns gray and thins.

5. Question 20.5

   What are the visible changes in the body shape between ages 25 and 65?

   As adults age, they tend to lose height, specifically in the trunk of the body, and experience an increase in waist circumference. During adulthood muscles typically weaken; pockets of fat settle on the abdomen, upper arms, buttocks, and chin; and adults stoop slightly when they stand.

6. Question 20.6

   How does aging affect nearsightedness and farsightedness?

   Nearsightedness increases gradually in childhood and adolescence, but in midlife the process reverses. Nearsightedness is reduced, but farsightedness increases, because the lens of the eye changes shape.

7. Question 20.7

   Why are hearing losses expected to increase in the next generation?

   Loud music played through headphones or at concerts might damage the hairs of the inner ear. Today’s adolescents and emerging adults wear ear buds much more often than older generations did.

8. Question 20.8

   How are men and women affected by the changes in sexual responsiveness with age?

   Sexual arousal occurs more slowly with age, and orgasm takes longer. For some couples, these slowdowns are counterbalanced by reduced anxiety and better communication, as partners become more familiar with their own bodies and those of their mates. Distress at slower responsiveness seems less connected to physiological aging than to troubled interpersonal relationships and unrealistic fears and expectations. Some adults say that sexual responsiveness may improve with age; arousal and orgasm can continue throughout life. One study found that men and women who were in committed, monogamous relationships were likely to be “extremely satisfied” with sex.

9. Question 20.9

   When a couple is infertile, which sex is usually responsible?

   The cause is in the man about one-third of the time, in the woman another third, and is a mystery in the final third.

10. Question 20.10

    What are the advantages and disadvantages of HRT for women? Are there any advantages/disadvantages for men?

    HRT has been associated with reduced menopausal symptoms such as hot flashes, improved cognition, and a decreased risk for osteoporosis. Despite these advantages, HRT has also been associated with an increased risk for heart disease, stroke, and breast cancer. Because HRT reduces vaginal dryness, men whose wives use it might enjoy the advantage of more frequent sexual intercourse. The disadvantages for men surround the increased risk of illnesses or death of their female partner.

11. Question 20.11

    What are the trends in cigarette smoking in North America?

    In the United States, men have been quitting smoking for decades, which has decreased male lung cancer deaths. While men were quitting smoking, however, the number of women who smoke increased, which has increased female lung cancer rates. Fortunately, cigarette smoking has been declining over the past decade in North America for every gender and age group. In 1970, one-half of U.S. adult men and one-third of women smoked, but by 2010 only 22 percent of men and 18 percent of women did. Women are following the male pattern of quitting, and many offices, homes, and public places are now smoke-free.

12. Question 20.12

    How much alcohol should an adult drink and why?

    Alcohol can be beneficial in moderation—never more than two drinks a day. Alcohol reduces coronary heart disease and strokes. It increases HDL and reduces LDL, reducing the risk of clogged arteries and blood clots. An occasional drink may also lower blood pressure and glucose.

13. Question 20.13

    What factors in the diet affect the rate of obesity?

    Too much meat, fat, and sugar and too little fiber are the main dietary culprits in the rate of obesity.

14. Question 20.14

    What nonfood factors affect the rate of obesity?

    Inadequate physical activity affects the rate of obesity. Less than 50 percent of U.S. adults report that they engage in at least 20 minutes of daily exercise, and one study that used an objective assessment of adult movement found that fewer than 5 percent of U.S. adults get even 30 minutes per day of exercise.

15. Question 20.15

    What diseases and conditions are less likely in people who exercise every day?

    People who exercise are more likely to have lower blood pressure, stronger hearts and lungs, and a reduced risk for the development of almost every disease, including depression, diabetes, osteoporosis, heart disease, arthritis, and cancer.

16. Question 20.16

    What are the advantages and disadvantages of using mortality as a measure of health?

    Mortality statistics are compiled from death certificates, which indicate age, sex, and immediate cause of death. This practice allows valid international and historical comparisons because deaths have been counted and recorded for decades—sometimes centuries. One disadvantage is that to compare health among nations, age-adjusted mortality rates are needed; otherwise, a nation with many people over age 80 will have an artificially high mortality rate.

17. Question 20.17

    What are the advantages and disadvantages of using morbidity as a measure of health?

    Morbidity refers to the rates of illnesses and impairments of all kinds—acute and chronic, physical and psychological—in a given population. As mortality declines, morbidity gives insight into conditions that people are living with. One disadvantage is that screening, drugs, and surgery that have been saving lives appear to have reduced health by contributing to the morbidity of the population.

18. Question 20.18

    How do men and women compare in mortality and morbidity?

    Compared to men the same age, adult women have lower rates of mortality but higher rates of morbidity for almost every chronic disease.

19. Question 20.19

    Why would a disabled person object to measuring DALYs?

    DALYs are one way to measure a person’s degree of impairment due to a disability. The assumption is that a disabled person has somewhat less than a full life. Many disabled people do not like the idea of DALYs; they do not consider their lives diminished.

20. Question 20.20

    What factors would increase a person’s QALYs?

    If people are fully vital, their quality of life is 100 percent, which means that a year of their life equals one QALY. To increase one’s QALY, one would want to live the healthiest, longest life possible.

21. Question 20.21

    Are economic or educational factors more important in the correlation between SES and illness?

    Money and education protect health, but it is not clear whether income or education is the main reason. Perhaps education teaches healthy habits. Or perhaps higher income allows access to better medical care as well as a home far from pollution and crime. Because low income may deprive one of access to education, it could be argued that economic factors are more important.

22. Question 20.22

    Why are there no more diseases of affluence?

    Diseases that were once associated with high income are now associated with low income. Individuals who are poor tend to have poorer eating habits and greater rates of obesity, more stress, bad health habits (e.g., smoking), less access to doctors, and lower-quality medical care.