{"id":1515,"date":"2019-01-11T19:36:45","date_gmt":"2019-01-11T19:36:45","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/?post_type=chapter&#038;p=1515"},"modified":"2024-04-30T19:52:03","modified_gmt":"2024-04-30T19:52:03","slug":"health-in-late-adulthood-primary-aging","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/chapter\/health-in-late-adulthood-primary-aging\/","title":{"raw":"Health in Late Adulthood: Primary Aging","rendered":"Health in Late Adulthood: Primary Aging"},"content":{"raw":"<div class=\"textbox learning-objectives\">\r\n<h3>Learning Outcomes<\/h3>\r\n<ul>\r\n \t<li>Describe primary aging, including vision and hearing loss<\/li>\r\n<\/ul>\r\n<\/div>\r\n<h2>Normal Aging<\/h2>\r\nThe Baltimore Longitudinal Study on Aging (BLSA, 2011) began in 1958 and has traced the aging process in 1,400 people from age 20 to 90.\u00a0Researchers from the BLSA have found that the aging process varies significantly from individual to individual and from one organ system to another.\u00a0Kidney function may deteriorate earlier in some individuals. Bone strength declines more rapidly in others.\u00a0Much of this is determined by genetics, lifestyle, and disease.\u00a0However, some generalizations about the aging process have been found:\r\n<ul>\r\n \t<li><span class=\"tight\">Heart muscles thicken with age<\/span><\/li>\r\n \t<li><span class=\"tight\">Arteries become less flexible<\/span><\/li>\r\n \t<li><span class=\"tight\">Lung capacity diminishes<\/span><\/li>\r\n \t<li><span class=\"tight\">Brain cells lose some functioning but new neurons can also be produced<\/span><\/li>\r\n \t<li><span class=\"tight\">Kidneys become less efficient in removing waste from the blood<\/span><\/li>\r\n \t<li><span class=\"tight\">The bladder loses its ability to store urine<\/span><\/li>\r\n \t<li><span class=\"tight\">Body fat stabilizes and then declines<\/span><\/li>\r\n \t<li><span class=\"tight\">Muscle mass is lost without exercise<\/span><\/li>\r\n \t<li><span class=\"tight\">Bone mineral is lost.\u00a0Weight bearing exercise slows this down.<\/span><\/li>\r\n<\/ul>\r\n<div class=\"textbox exercises\">\r\n<h3>Link to Learning<\/h3>\r\nWatch this video clip from the National Institute of Health as it explains the research involved in the\u00a0Baltimore Longitudinal Study on Aging. You'll see some of the tests done on individuals, including measurements on energy expenditure, strength, proprioception, and brain imaging and scans. Watch the\u00a0<a href=\"https:\/\/www.youtube.com\/watch?time_continue=351&amp;v=YqNYZCOPBY4\" target=\"_blank\" rel=\"noopener\">The Baltimore Longitudinal Study of Aging (BLSA)<\/a> here.\r\n\r\n<\/div>\r\n\r\n[caption id=\"attachment_3542\" align=\"alignright\" width=\"487\"]<img class=\"wp-image-3542\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2019\/01\/17152353\/hand-leg-finger-food-produce-care-1028578-pxhere.com_.jpg\" alt=\"younger hands holding an aged hand.\" width=\"487\" height=\"325\" \/> <strong>Figure 1<\/strong>. Primary aging includes inevitable changes such as skin that becomes more wrinkled and less elastic.[\/caption]\r\n<h2>Primary and Secondary Aging<\/h2>\r\nHealthcare providers need to be aware of which aspects of aging are reversible and which ones are inevitable.\u00a0By keeping this distinction in mind, caregivers may be more objective and accurate when diagnosing and treating older patients.\u00a0And a positive attitude can go a long way toward motivating patients to stick with a health regime.\u00a0Unfortunately, stereotypes can lead to misdiagnosis.\u00a0For example, it is estimated that about 10 percent of older patients diagnosed with dementia are actually depressed or suffering from some other psychological illness (Berger, 2005).\u00a0The failure to recognize and treat psychological problems in older patients may be one consequence of such stereotypes.\r\n<h2>Primary Aging<\/h2>\r\nSenescence, or biological aging, is the gradual deterioration of\u00a0<span style=\"color: #333333;\">functional<\/span>\u00a0characteristics<strong>.<\/strong>\u00a0It is the process by which cells irreversibly stop dividing and enter a state of permanent growth arrest without undergoing cell death. This process is also referred to as\u00a0<strong>primary aging<\/strong> and thus, refers to the inevitable changes associated with aging (Busse, 1969). These changes include changes in the skin and hair, height and weight, hearing loss, and eye disease.\u00a0However, some of these changes can be reduced by limiting exposure to the sun, eating a nutritious diet, and exercising.\r\n\r\nSkin and hair\u00a0change with age.\u00a0The\u00a0skin becomes drier, thinner, and less elastic during the aging process. Scars and imperfections become more noticeable as fewer cells grow underneath the surface of the skin. Exposure to the sun, or\u00a0photoaging,\u00a0accelerates these changes.\u00a0Graying hair is inevitable, and hair loss all over the body becomes more prevalent.\r\n\r\nHeight and weight\u00a0vary with age.\u00a0Older people are more than an inch shorter than they were during early adulthood (Masoro in Berger, 2005). This is thought to be due to a settling of the vertebrae and a lack of muscle strength in the back. Older people weigh less than they did in mid-life. Bones lose density and can become brittle.\u00a0This is especially prevalent in women.\u00a0However, weight training can help increase bone density after just a few weeks of training.\r\n\r\nMuscle loss\u00a0occurs in late adulthood and is most noticeable in men as they lose muscle mass.\u00a0Maintaining strong leg and heart muscles is important for independence.\u00a0Weight-lifting, walking, swimming, or engaging in other cardiovascular and weight bearing\u00a0exercises can help strengthen the muscles and prevent atrophy.\r\n<h3><strong>Vision\u00a0<\/strong><\/h3>\r\nSome typical vision issues that arise along with aging include:\r\n<ul>\r\n \t<li>Lens becomes less transparent and the pupils shrink.<\/li>\r\n \t<li>The optic nerve becomes less efficient.<\/li>\r\n \t<li>Distant objects become less acute.<\/li>\r\n \t<li>Loss of peripheral vision (the size of the visual field decreases by approximately one to three degrees per decade of life.)[footnote]Heiting, Gary. How vision changes as you age. All About Vision. Retrieved from <a href=\"https:\/\/www.allaboutvision.com\/over60\/vision-changes.htm\" target=\"_blank\" rel=\"noopener\">https:\/\/www.allaboutvision.com\/over60\/vision-changes.htm<\/a>.[\/footnote]<\/li>\r\n \t<li>More light is needed to see and it takes longer to adjust to a change from light to darkness and vice versa.<\/li>\r\n \t<li>Driving at night becomes more challenging.<\/li>\r\n \t<li>Reading becomes more of a strain and eye strain occurs more easily.<\/li>\r\n<\/ul>\r\nThe\u00a0majority of people over 65 have some difficulty with vision, but most is easily corrected with prescriptive lenses.\u00a0Three percent of those 65 to 74 and 8 percent of those 75 and older have hearing or vision limitations that hinder activity.\u00a0The\u00a0most common causes of vision loss or impairment are glaucoma, cataracts, age-related macular degeneration, and diabetic retinopathy (He et al., 2005).\r\n<ul>\r\n \t<li><strong>Glaucoma<\/strong> occurs when pressure in the fluid of the eye increases, either because the fluid cannot drain properly or because too much fluid is produced.\u00a0Glaucoma can be corrected with drugs or surgery.\u00a0It must be detected early enough.<\/li>\r\n \t<li><strong>Cataracts<\/strong> are\u00a0<span style=\"font-size: 1rem; text-align: initial;\">cloudy or opaque areas of the lens of the eye that interfere with passing light, frequently develop.\u00a0<\/span>Cataracts can be surgically removed or intraocular lens implants can replace old lenses.<\/li>\r\n \t<li><strong>Macular degeneration<\/strong><span style=\"font-size: 1rem; text-align: initial;\"> is the most common cause of blindness in people over the age of 60. Age-related macular degeneration (AMD) affects the macula, a yellowish area of the eye located near the retina at which visual perception is most acute.\u00a0<\/span>A diet rich in antioxidant vitamins (C, E, and A) can reduce the risk of this disease.<\/li>\r\n \t<li><strong>Diabetic retinopathy<\/strong>, <span style=\"font-size: 1rem; text-align: initial;\">also known as\u00a0diabetic eye disease, is a medical condition in which damage occurs to the\u00a0<\/span>retina<span style=\"font-size: 1rem; text-align: initial;\">\u00a0due to\u00a0<\/span>diabetes mellitus<span style=\"font-size: 1rem; text-align: initial;\">. It is a leading cause of\u00a0<\/span>blindness<span style=\"font-size: 1rem; text-align: initial;\">.\u00a0<\/span><sup id=\"cite_ref-1\" class=\"reference\" style=\"color: #800080; text-align: initial;\"><\/sup>There are three major treatments for diabetic retinopathy, which are very effective in reducing vision loss from this disease: l<span class=\"toctext\">aser photocoagulation, m<\/span><span class=\"toctext\">edications, surgery.<\/span><\/li>\r\n<\/ul>\r\n<h3>Hearing<\/h3>\r\n<strong>Hearing Loss,<\/strong>\u00a0is experienced by 25% of people between ages 65 and 74, then by 50% of people above age 75.[footnote]National Institute on Deafness and Other Communication Disorders. Quick Statistics on Hearing. Retrieved from\u00a0https:\/\/www.nidcd.nih.gov\/health\/statistics\/quick-statistics-hearing.[\/footnote] Among those who are in nursing homes, rates are even higher.\u00a0Older adults are more likely to seek help with vision impairment than with hearing loss, perhaps due to the stereotype that older people who have difficulty hearing are also less mentally alert.\r\n\r\n<strong>Conductive hearing loss<\/strong>\u00a0may occur because of age, genetic predisposition, or environmental effects, including persistent exposure to extreme noise over the course of our lifetime, certain illnesses, or damage due to toxins. Conductive hearing loss involves structural damage to the ear such as\u00a0failure in the vibration of the eardrum and\/or movement of the ossicles (the three bones in our middle ear). Given the mechanical nature by which the sound wave stimulus is transmitted from the eardrum through the ossicles to the oval window of the cochlea, some degree of hearing loss is inevitable.\u00a0These problems are often dealt with through devices like hearing aids that amplify incoming sound waves to make vibration of the eardrum and movement of the ossicles more likely to occur.\r\n\r\nWhen the hearing problem is associated with a failure to transmit neural signals from the cochlea to the brain, it is called <strong>sensorineural hearing loss<\/strong>. This type of loss accelerates with age and can be caused by prolonged exposure to loud noises, which causes damage to the hair cells within the cochlea. <strong>Presbycusis<\/strong> is age-related sensorineural hearing loss resulting from degeneration of the cochlea or associated structures of the inner ear or auditory nerves. The hearing loss is most marked at higher frequencies. Presbycusis is the second most common illness next to arthritis in aged people.\r\n\r\nOne disease that results in sensorineural hearing loss is <strong>M\u00e9ni\u00e8re's disease<\/strong>. Although not well understood, M\u00e9ni\u00e8re's disease results in a degeneration of inner ear structures that can lead to hearing loss, tinnitus (constant ringing or buzzing), <strong>vertigo<\/strong> (a sense of spinning), and an increase in pressure within the inner ear (Semaan &amp; Megerian, 2011). This kind of loss cannot be treated with hearing aids, but some individuals might be candidates for a cochlear implant as a treatment option. <strong>Cochlear implants<\/strong> are electronic devices\u00a0consisting of a microphone, a speech processor, and an electrode array. The device receives incoming sound information and directly stimulates the auditory nerve to transmit information to the brain.\r\n\r\nBeing unable to hear causes people to withdraw from conversation and others to ignore them or shout.\u00a0Unfortunately, shouting is usually high pitched and can be harder to hear than lower tones.\u00a0The\u00a0speaker may also begin to use a patronizing form of \u2018baby talk' known as\u00a0<strong>elderspeak<\/strong>\u00a0(See et al., 1999). This language reflects the stereotypes of older adults as being dependent, demented, and childlike.\u00a0Hearing loss is more prevalent in men than women.\u00a0And it is experienced by more white, non-Hispanics than by Black men and women.\u00a0Smoking, middle ear infections, and exposure to loud noises increase hearing loss.\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Nutrition and Aging Research<\/h3>\r\n<span style=\"color: #333333;\">The\u00a0<a style=\"color: #333333;\" title=\"Jean Mayer\" href=\"https:\/\/en.wikipedia.org\/wiki\/Jean_Mayer\" target=\"_blank\" rel=\"noopener\">Jean Mayer<\/a>\u00a0Human Nutrition Research Center on Aging\u00a0(HNRCA), located in\u00a0<a class=\"mw-redirect\" style=\"color: #333333;\" title=\"Boston, Massachusetts\" href=\"https:\/\/en.wikipedia.org\/wiki\/Boston,_Massachusetts\" target=\"_blank\" rel=\"noopener\">Boston, Massachusetts<\/a>, is one of six human nutrition research centers in the United States supported by the\u00a0<a style=\"color: #333333;\" title=\"United States Department of Agriculture\" href=\"https:\/\/en.wikipedia.org\/wiki\/United_States_Department_of_Agriculture\" target=\"_blank\" rel=\"noopener\">United States Department of Agriculture<\/a>\u00a0and\u00a0<a style=\"color: #333333;\" title=\"Agricultural Research Service\" href=\"https:\/\/en.wikipedia.org\/wiki\/Agricultural_Research_Service\" target=\"_blank\" rel=\"noopener\">Agricultural Research Service<\/a>. The goal of the HNRCA, which is managed by\u00a0Tufts University, is to explore the relationship between nutrition, physical activity, and healthy and active aging.<sup id=\"cite_ref-1\" class=\"reference\"><\/sup><sup id=\"cite_ref-2\" class=\"reference\"><\/sup><\/span>\r\n\r\n<span style=\"color: #333333;\">The HNRCA\u00a0has made significant contributions to U.S. and international nutritional and physical activity recommendations, public policy, and clinical healthcare.<sup id=\"cite_ref-usda.gov_7-0\" class=\"reference\"><\/sup>\u00a0These contributions include advancements in the knowledge of the role of dietary calcium\u00a0<sup id=\"cite_ref-8\" class=\"reference\"><\/sup><sup id=\"cite_ref-9\" class=\"reference\"><\/sup>and vitamin D in promoting nutrition and bone health,\u00a0<sup id=\"cite_ref-10\" class=\"reference\"><\/sup>the role of nutrients in maintaining the optimal immune response, the\u00a0prevention of infectious diseases, the role of diet in prevention of cancer, obesity research,\u00a0<sup id=\"cite_ref-12\" class=\"reference\"><\/sup>modifications to the Food Guide Pyramid,\u00a0<sup id=\"cite_ref-13\" class=\"reference\"><\/sup>contribution to USDA nutrient data bank, advancements in the study of\u00a0<a style=\"color: #333333;\" title=\"Sarcopenia\" href=\"https:\/\/en.wikipedia.org\/wiki\/Sarcopenia\" target=\"_blank\" rel=\"noopener\">sarcopenia<\/a>, heart disease,\u00a0<sup id=\"cite_ref-14\" class=\"reference\"><\/sup>vision, brain and cognitive function,\u00a0<sup id=\"cite_ref-15\" class=\"reference\"><\/sup>front of packaging food labeling initiatives,\u00a0<sup id=\"cite_ref-16\" class=\"reference\"><\/sup>and research of how genetic factors impact predisposition to weight gain<sup id=\"cite_ref-usda.gov_7-1\" class=\"reference\"><\/sup>\u00a0and various health indicators.\u00a0<\/span><span style=\"color: #800080;\"><span style=\"color: #333333;\">Research clusters within the HNRCA address four specific strategic areas: 1) cancer, 2) cardiovascular disease, 3) inflammation, immunity, and infectious disease and 4) obesity.<\/span><\/span>\r\n\r\n<\/div>\r\n<div class=\"textbox examples\">\r\n<h3>WAtch IT<\/h3>\r\nResearch done by T. Colin Campbell M.D., Michael Greger M.D., Neal Bernard M.D. and others have demonstrated the impact of diet upon longevity and quality of life. As discussed in the video below, consumption of less animal based protein has been linked with the slowing of degradation of function which was traditionally seen as part of the normal aging process.\r\n\r\nhttps:\/\/www.youtube.com\/watch?time_continue=206&amp;v=dwJASNFy9XQ\r\n\r\nYou can <a href=\"https:\/\/oerfiles.s3-us-west-2.amazonaws.com\/Lifespan+Development\/Transcriptions\/CalorieRestrictionVsAnimalProteinRestriction_transcript.txt\" target=\"_blank\" rel=\"noopener\">view the transcript for \"Caloric Restriction vs. Animal Protein Restriction\" here (opens in new window)<\/a>.\r\n\r\n<\/div>\r\nPrimary aging can be compensated for through exercise, corrective lenses, nutrition, and hearing aids. Just as important,\u00a0by reducing stereotypes about aging, people of age can maintain self-respect, recognize their own strengths, and count on receiving the respect and social inclusion they deserve.\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/2a47e075-a35f-4693-971b-55d02ba7a745\r\n\r\n<\/div>\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Glossary<\/h3>\r\n<div><\/div>\r\n<div>\r\n\r\n[glossary-page]\r\n[glossary-term]cochlear implant:[\/glossary-term]\r\n[glossary-definition]electronic device that consists of a microphone, a speech processor, and an electrode array to directly stimulate the auditory nerve to transmit information to the brain[\/glossary-definition]\r\n\r\n[glossary-term]conductive hearing loss:[\/glossary-term]\r\n[glossary-definition]failure in the vibration of the eardrum and\/or movement of the ossicles[\/glossary-definition]\r\n\r\n[glossary-term]M\u00e9ni\u00e8re's disease:[\/glossary-term]\r\n[glossary-definition]results in a degeneration of inner ear structures that can lead to hearing loss, tinnitus, vertigo, and an increase in pressure within the inner ear[\/glossary-definition]\r\n\r\n[glossary-term]presbycusis:[\/glossary-term]\r\n[glossary-definition]age-related sensorineural hearing loss resulting from degeneration of the cochlea or associated structures of the inner ear or auditory nerves[\/glossary-definition]\r\n\r\n[glossary-term]primary aging:[\/glossary-term]\r\n[glossary-definition]aging that is irreversible and is due to genetic predisposition[\/glossary-definition]\r\n\r\n[glossary-term]secondary aging:[\/glossary-term]\r\n[glossary-definition]refers to changes that are caused by illness or disease[\/glossary-definition]\r\n\r\n[glossary-term]sensorineural hearing loss:[\/glossary-term]\r\n[glossary-definition]failure to transmit neural signals from the cochlea to the brain[\/glossary-definition]\r\n\r\n[glossary-term]temporal theory of pitch perception:[\/glossary-term]\r\n[glossary-definition]sound\u2019s frequency is coded by the activity level of a sensory neuron[\/glossary-definition]\r\n\r\n[glossary-term]vertigo:[\/glossary-term]\r\n[glossary-definition]spinning sensation[\/glossary-definition]\r\n[\/glossary-page]\r\n\r\n<\/div>\r\n<\/div>","rendered":"<div class=\"textbox learning-objectives\">\n<h3>Learning Outcomes<\/h3>\n<ul>\n<li>Describe primary aging, including vision and hearing loss<\/li>\n<\/ul>\n<\/div>\n<h2>Normal Aging<\/h2>\n<p>The Baltimore Longitudinal Study on Aging (BLSA, 2011) began in 1958 and has traced the aging process in 1,400 people from age 20 to 90.\u00a0Researchers from the BLSA have found that the aging process varies significantly from individual to individual and from one organ system to another.\u00a0Kidney function may deteriorate earlier in some individuals. Bone strength declines more rapidly in others.\u00a0Much of this is determined by genetics, lifestyle, and disease.\u00a0However, some generalizations about the aging process have been found:<\/p>\n<ul>\n<li><span class=\"tight\">Heart muscles thicken with age<\/span><\/li>\n<li><span class=\"tight\">Arteries become less flexible<\/span><\/li>\n<li><span class=\"tight\">Lung capacity diminishes<\/span><\/li>\n<li><span class=\"tight\">Brain cells lose some functioning but new neurons can also be produced<\/span><\/li>\n<li><span class=\"tight\">Kidneys become less efficient in removing waste from the blood<\/span><\/li>\n<li><span class=\"tight\">The bladder loses its ability to store urine<\/span><\/li>\n<li><span class=\"tight\">Body fat stabilizes and then declines<\/span><\/li>\n<li><span class=\"tight\">Muscle mass is lost without exercise<\/span><\/li>\n<li><span class=\"tight\">Bone mineral is lost.\u00a0Weight bearing exercise slows this down.<\/span><\/li>\n<\/ul>\n<div class=\"textbox exercises\">\n<h3>Link to Learning<\/h3>\n<p>Watch this video clip from the National Institute of Health as it explains the research involved in the\u00a0Baltimore Longitudinal Study on Aging. You&#8217;ll see some of the tests done on individuals, including measurements on energy expenditure, strength, proprioception, and brain imaging and scans. Watch the\u00a0<a href=\"https:\/\/www.youtube.com\/watch?time_continue=351&amp;v=YqNYZCOPBY4\" target=\"_blank\" rel=\"noopener\">The Baltimore Longitudinal Study of Aging (BLSA)<\/a> here.<\/p>\n<\/div>\n<div id=\"attachment_3542\" style=\"width: 497px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-3542\" class=\"wp-image-3542\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2019\/01\/17152353\/hand-leg-finger-food-produce-care-1028578-pxhere.com_.jpg\" alt=\"younger hands holding an aged hand.\" width=\"487\" height=\"325\" \/><\/p>\n<p id=\"caption-attachment-3542\" class=\"wp-caption-text\"><strong>Figure 1<\/strong>. Primary aging includes inevitable changes such as skin that becomes more wrinkled and less elastic.<\/p>\n<\/div>\n<h2>Primary and Secondary Aging<\/h2>\n<p>Healthcare providers need to be aware of which aspects of aging are reversible and which ones are inevitable.\u00a0By keeping this distinction in mind, caregivers may be more objective and accurate when diagnosing and treating older patients.\u00a0And a positive attitude can go a long way toward motivating patients to stick with a health regime.\u00a0Unfortunately, stereotypes can lead to misdiagnosis.\u00a0For example, it is estimated that about 10 percent of older patients diagnosed with dementia are actually depressed or suffering from some other psychological illness (Berger, 2005).\u00a0The failure to recognize and treat psychological problems in older patients may be one consequence of such stereotypes.<\/p>\n<h2>Primary Aging<\/h2>\n<p>Senescence, or biological aging, is the gradual deterioration of\u00a0<span style=\"color: #333333;\">functional<\/span>\u00a0characteristics<strong>.<\/strong>\u00a0It is the process by which cells irreversibly stop dividing and enter a state of permanent growth arrest without undergoing cell death. This process is also referred to as\u00a0<strong>primary aging<\/strong> and thus, refers to the inevitable changes associated with aging (Busse, 1969). These changes include changes in the skin and hair, height and weight, hearing loss, and eye disease.\u00a0However, some of these changes can be reduced by limiting exposure to the sun, eating a nutritious diet, and exercising.<\/p>\n<p>Skin and hair\u00a0change with age.\u00a0The\u00a0skin becomes drier, thinner, and less elastic during the aging process. Scars and imperfections become more noticeable as fewer cells grow underneath the surface of the skin. Exposure to the sun, or\u00a0photoaging,\u00a0accelerates these changes.\u00a0Graying hair is inevitable, and hair loss all over the body becomes more prevalent.<\/p>\n<p>Height and weight\u00a0vary with age.\u00a0Older people are more than an inch shorter than they were during early adulthood (Masoro in Berger, 2005). This is thought to be due to a settling of the vertebrae and a lack of muscle strength in the back. Older people weigh less than they did in mid-life. Bones lose density and can become brittle.\u00a0This is especially prevalent in women.\u00a0However, weight training can help increase bone density after just a few weeks of training.<\/p>\n<p>Muscle loss\u00a0occurs in late adulthood and is most noticeable in men as they lose muscle mass.\u00a0Maintaining strong leg and heart muscles is important for independence.\u00a0Weight-lifting, walking, swimming, or engaging in other cardiovascular and weight bearing\u00a0exercises can help strengthen the muscles and prevent atrophy.<\/p>\n<h3><strong>Vision\u00a0<\/strong><\/h3>\n<p>Some typical vision issues that arise along with aging include:<\/p>\n<ul>\n<li>Lens becomes less transparent and the pupils shrink.<\/li>\n<li>The optic nerve becomes less efficient.<\/li>\n<li>Distant objects become less acute.<\/li>\n<li>Loss of peripheral vision (the size of the visual field decreases by approximately one to three degrees per decade of life.)<a class=\"footnote\" title=\"Heiting, Gary. How vision changes as you age. All About Vision. Retrieved from https:\/\/www.allaboutvision.com\/over60\/vision-changes.htm.\" id=\"return-footnote-1515-1\" href=\"#footnote-1515-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/li>\n<li>More light is needed to see and it takes longer to adjust to a change from light to darkness and vice versa.<\/li>\n<li>Driving at night becomes more challenging.<\/li>\n<li>Reading becomes more of a strain and eye strain occurs more easily.<\/li>\n<\/ul>\n<p>The\u00a0majority of people over 65 have some difficulty with vision, but most is easily corrected with prescriptive lenses.\u00a0Three percent of those 65 to 74 and 8 percent of those 75 and older have hearing or vision limitations that hinder activity.\u00a0The\u00a0most common causes of vision loss or impairment are glaucoma, cataracts, age-related macular degeneration, and diabetic retinopathy (He et al., 2005).<\/p>\n<ul>\n<li><strong>Glaucoma<\/strong> occurs when pressure in the fluid of the eye increases, either because the fluid cannot drain properly or because too much fluid is produced.\u00a0Glaucoma can be corrected with drugs or surgery.\u00a0It must be detected early enough.<\/li>\n<li><strong>Cataracts<\/strong> are\u00a0<span style=\"font-size: 1rem; text-align: initial;\">cloudy or opaque areas of the lens of the eye that interfere with passing light, frequently develop.\u00a0<\/span>Cataracts can be surgically removed or intraocular lens implants can replace old lenses.<\/li>\n<li><strong>Macular degeneration<\/strong><span style=\"font-size: 1rem; text-align: initial;\"> is the most common cause of blindness in people over the age of 60. Age-related macular degeneration (AMD) affects the macula, a yellowish area of the eye located near the retina at which visual perception is most acute.\u00a0<\/span>A diet rich in antioxidant vitamins (C, E, and A) can reduce the risk of this disease.<\/li>\n<li><strong>Diabetic retinopathy<\/strong>, <span style=\"font-size: 1rem; text-align: initial;\">also known as\u00a0diabetic eye disease, is a medical condition in which damage occurs to the\u00a0<\/span>retina<span style=\"font-size: 1rem; text-align: initial;\">\u00a0due to\u00a0<\/span>diabetes mellitus<span style=\"font-size: 1rem; text-align: initial;\">. It is a leading cause of\u00a0<\/span>blindness<span style=\"font-size: 1rem; text-align: initial;\">.\u00a0<\/span><sup id=\"cite_ref-1\" class=\"reference\" style=\"color: #800080; text-align: initial;\"><\/sup>There are three major treatments for diabetic retinopathy, which are very effective in reducing vision loss from this disease: l<span class=\"toctext\">aser photocoagulation, m<\/span><span class=\"toctext\">edications, surgery.<\/span><\/li>\n<\/ul>\n<h3>Hearing<\/h3>\n<p><strong>Hearing Loss,<\/strong>\u00a0is experienced by 25% of people between ages 65 and 74, then by 50% of people above age 75.<a class=\"footnote\" title=\"National Institute on Deafness and Other Communication Disorders. Quick Statistics on Hearing. Retrieved from\u00a0https:\/\/www.nidcd.nih.gov\/health\/statistics\/quick-statistics-hearing.\" id=\"return-footnote-1515-2\" href=\"#footnote-1515-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a> Among those who are in nursing homes, rates are even higher.\u00a0Older adults are more likely to seek help with vision impairment than with hearing loss, perhaps due to the stereotype that older people who have difficulty hearing are also less mentally alert.<\/p>\n<p><strong>Conductive hearing loss<\/strong>\u00a0may occur because of age, genetic predisposition, or environmental effects, including persistent exposure to extreme noise over the course of our lifetime, certain illnesses, or damage due to toxins. Conductive hearing loss involves structural damage to the ear such as\u00a0failure in the vibration of the eardrum and\/or movement of the ossicles (the three bones in our middle ear). Given the mechanical nature by which the sound wave stimulus is transmitted from the eardrum through the ossicles to the oval window of the cochlea, some degree of hearing loss is inevitable.\u00a0These problems are often dealt with through devices like hearing aids that amplify incoming sound waves to make vibration of the eardrum and movement of the ossicles more likely to occur.<\/p>\n<p>When the hearing problem is associated with a failure to transmit neural signals from the cochlea to the brain, it is called <strong>sensorineural hearing loss<\/strong>. This type of loss accelerates with age and can be caused by prolonged exposure to loud noises, which causes damage to the hair cells within the cochlea. <strong>Presbycusis<\/strong> is age-related sensorineural hearing loss resulting from degeneration of the cochlea or associated structures of the inner ear or auditory nerves. The hearing loss is most marked at higher frequencies. Presbycusis is the second most common illness next to arthritis in aged people.<\/p>\n<p>One disease that results in sensorineural hearing loss is <strong>M\u00e9ni\u00e8re&#8217;s disease<\/strong>. Although not well understood, M\u00e9ni\u00e8re&#8217;s disease results in a degeneration of inner ear structures that can lead to hearing loss, tinnitus (constant ringing or buzzing), <strong>vertigo<\/strong> (a sense of spinning), and an increase in pressure within the inner ear (Semaan &amp; Megerian, 2011). This kind of loss cannot be treated with hearing aids, but some individuals might be candidates for a cochlear implant as a treatment option. <strong>Cochlear implants<\/strong> are electronic devices\u00a0consisting of a microphone, a speech processor, and an electrode array. The device receives incoming sound information and directly stimulates the auditory nerve to transmit information to the brain.<\/p>\n<p>Being unable to hear causes people to withdraw from conversation and others to ignore them or shout.\u00a0Unfortunately, shouting is usually high pitched and can be harder to hear than lower tones.\u00a0The\u00a0speaker may also begin to use a patronizing form of \u2018baby talk&#8217; known as\u00a0<strong>elderspeak<\/strong>\u00a0(See et al., 1999). This language reflects the stereotypes of older adults as being dependent, demented, and childlike.\u00a0Hearing loss is more prevalent in men than women.\u00a0And it is experienced by more white, non-Hispanics than by Black men and women.\u00a0Smoking, middle ear infections, and exposure to loud noises increase hearing loss.<\/p>\n<div class=\"textbox key-takeaways\">\n<h3>Nutrition and Aging Research<\/h3>\n<p><span style=\"color: #333333;\">The\u00a0<a style=\"color: #333333;\" title=\"Jean Mayer\" href=\"https:\/\/en.wikipedia.org\/wiki\/Jean_Mayer\" target=\"_blank\" rel=\"noopener\">Jean Mayer<\/a>\u00a0Human Nutrition Research Center on Aging\u00a0(HNRCA), located in\u00a0<a class=\"mw-redirect\" style=\"color: #333333;\" title=\"Boston, Massachusetts\" href=\"https:\/\/en.wikipedia.org\/wiki\/Boston,_Massachusetts\" target=\"_blank\" rel=\"noopener\">Boston, Massachusetts<\/a>, is one of six human nutrition research centers in the United States supported by the\u00a0<a style=\"color: #333333;\" title=\"United States Department of Agriculture\" href=\"https:\/\/en.wikipedia.org\/wiki\/United_States_Department_of_Agriculture\" target=\"_blank\" rel=\"noopener\">United States Department of Agriculture<\/a>\u00a0and\u00a0<a style=\"color: #333333;\" title=\"Agricultural Research Service\" href=\"https:\/\/en.wikipedia.org\/wiki\/Agricultural_Research_Service\" target=\"_blank\" rel=\"noopener\">Agricultural Research Service<\/a>. The goal of the HNRCA, which is managed by\u00a0Tufts University, is to explore the relationship between nutrition, physical activity, and healthy and active aging.<sup id=\"cite_ref-1\" class=\"reference\"><\/sup><sup id=\"cite_ref-2\" class=\"reference\"><\/sup><\/span><\/p>\n<p><span style=\"color: #333333;\">The HNRCA\u00a0has made significant contributions to U.S. and international nutritional and physical activity recommendations, public policy, and clinical healthcare.<sup id=\"cite_ref-usda.gov_7-0\" class=\"reference\"><\/sup>\u00a0These contributions include advancements in the knowledge of the role of dietary calcium\u00a0<sup id=\"cite_ref-8\" class=\"reference\"><\/sup><sup id=\"cite_ref-9\" class=\"reference\"><\/sup>and vitamin D in promoting nutrition and bone health,\u00a0<sup id=\"cite_ref-10\" class=\"reference\"><\/sup>the role of nutrients in maintaining the optimal immune response, the\u00a0prevention of infectious diseases, the role of diet in prevention of cancer, obesity research,\u00a0<sup id=\"cite_ref-12\" class=\"reference\"><\/sup>modifications to the Food Guide Pyramid,\u00a0<sup id=\"cite_ref-13\" class=\"reference\"><\/sup>contribution to USDA nutrient data bank, advancements in the study of\u00a0<a style=\"color: #333333;\" title=\"Sarcopenia\" href=\"https:\/\/en.wikipedia.org\/wiki\/Sarcopenia\" target=\"_blank\" rel=\"noopener\">sarcopenia<\/a>, heart disease,\u00a0<sup id=\"cite_ref-14\" class=\"reference\"><\/sup>vision, brain and cognitive function,\u00a0<sup id=\"cite_ref-15\" class=\"reference\"><\/sup>front of packaging food labeling initiatives,\u00a0<sup id=\"cite_ref-16\" class=\"reference\"><\/sup>and research of how genetic factors impact predisposition to weight gain<sup id=\"cite_ref-usda.gov_7-1\" class=\"reference\"><\/sup>\u00a0and various health indicators.\u00a0<\/span><span style=\"color: #800080;\"><span style=\"color: #333333;\">Research clusters within the HNRCA address four specific strategic areas: 1) cancer, 2) cardiovascular disease, 3) inflammation, immunity, and infectious disease and 4) obesity.<\/span><\/span><\/p>\n<\/div>\n<div class=\"textbox examples\">\n<h3>WAtch IT<\/h3>\n<p>Research done by T. Colin Campbell M.D., Michael Greger M.D., Neal Bernard M.D. and others have demonstrated the impact of diet upon longevity and quality of life. As discussed in the video below, consumption of less animal based protein has been linked with the slowing of degradation of function which was traditionally seen as part of the normal aging process.<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Caloric Restriction vs. Animal Protein Restriction\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/dwJASNFy9XQ?start=206&#38;feature=oembed\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>You can <a href=\"https:\/\/oerfiles.s3-us-west-2.amazonaws.com\/Lifespan+Development\/Transcriptions\/CalorieRestrictionVsAnimalProteinRestriction_transcript.txt\" target=\"_blank\" rel=\"noopener\">view the transcript for &#8220;Caloric Restriction vs. Animal Protein Restriction&#8221; here (opens in new window)<\/a>.<\/p>\n<\/div>\n<p>Primary aging can be compensated for through exercise, corrective lenses, nutrition, and hearing aids. Just as important,\u00a0by reducing stereotypes about aging, people of age can maintain self-respect, recognize their own strengths, and count on receiving the respect and social inclusion they deserve.<\/p>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"assessment_practice_2a47e075-a35f-4693-971b-55d02ba7a745\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/2a47e075-a35f-4693-971b-55d02ba7a745?iframe_resize_id=assessment_practice_id_2a47e075-a35f-4693-971b-55d02ba7a745\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<div class=\"textbox key-takeaways\">\n<h3>Glossary<\/h3>\n<div><\/div>\n<div>\n<div class=\"titlepage\">\n<dl>\n<dt>cochlear implant:<\/dt>\n<dd>electronic device that consists of a microphone, a speech processor, and an electrode array to directly stimulate the auditory nerve to transmit information to the brain<\/dd>\n<dt>conductive hearing loss:<\/dt>\n<dd>failure in the vibration of the eardrum and\/or movement of the ossicles<\/dd>\n<dt>M\u00e9ni\u00e8re&#8217;s disease:<\/dt>\n<dd>results in a degeneration of inner ear structures that can lead to hearing loss, tinnitus, vertigo, and an increase in pressure within the inner ear<\/dd>\n<dt>presbycusis:<\/dt>\n<dd>age-related sensorineural hearing loss resulting from degeneration of the cochlea or associated structures of the inner ear or auditory nerves<\/dd>\n<dt>primary aging:<\/dt>\n<dd>aging that is irreversible and is due to genetic predisposition<\/dd>\n<dt>secondary aging:<\/dt>\n<dd>refers to changes that are caused by illness or disease<\/dd>\n<dt>sensorineural hearing loss:<\/dt>\n<dd>failure to transmit neural signals from the cochlea to the brain<\/dd>\n<dt>temporal theory of pitch perception:<\/dt>\n<dd>sound\u2019s frequency is coded by the activity level of a sensory neuron<\/dd>\n<dt>vertigo:<\/dt>\n<dd>spinning sensation<\/dd>\n<\/dl>\n<\/div>\n<\/div>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-1515\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Psyc 200 Lifespan Psychology. <strong>Authored by<\/strong>: Laura Overstreet. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"http:\/\/opencourselibrary.org\/econ-201\/\">http:\/\/opencourselibrary.org\/econ-201\/<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><li>Human Nutrition Research Center on Aging. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Human_Nutrition_Research_Center_on_Aging\">https:\/\/en.wikipedia.org\/wiki\/Human_Nutrition_Research_Center_on_Aging<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Presbycusis. <strong>Provided by<\/strong>: Wikimedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Presbycusis\">https:\/\/en.wikipedia.org\/wiki\/Presbycusis<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Image of hands. <strong>Provided by<\/strong>: pxhere. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/pxhere.com\/en\/photo\/1028578\">https:\/\/pxhere.com\/en\/photo\/1028578<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/cc0\">CC0: No Rights Reserved<\/a><\/em><\/li><li>Caloric Restriction vs. Animal Protein Restriction. <strong>Authored by<\/strong>:  NutritionFacts.org. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?time_continue=206&#038;v=dwJASNFy9XQ\">https:\/\/www.youtube.com\/watch?time_continue=206&#038;v=dwJASNFy9XQ<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><li><strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Information on diabetic retinopathy. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Diabetic_retinopathy#cite_note-1\">https:\/\/en.wikipedia.org\/wiki\/Diabetic_retinopathy#cite_note-1<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Information on glaucoma. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Glaucoma\">https:\/\/en.wikipedia.org\/wiki\/Glaucoma<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Information on cataracts. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Cataract\">https:\/\/en.wikipedia.org\/wiki\/Cataract<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Information on macular degeneration. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Macular_degeneration\">https:\/\/en.wikipedia.org\/wiki\/Macular_degeneration<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-1515-1\">Heiting, Gary. How vision changes as you age. All About Vision. Retrieved from <a href=\"https:\/\/www.allaboutvision.com\/over60\/vision-changes.htm\" target=\"_blank\" rel=\"noopener\">https:\/\/www.allaboutvision.com\/over60\/vision-changes.htm<\/a>. <a href=\"#return-footnote-1515-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-1515-2\">National Institute on Deafness and Other Communication Disorders. Quick Statistics on Hearing. Retrieved from\u00a0https:\/\/www.nidcd.nih.gov\/health\/statistics\/quick-statistics-hearing. <a href=\"#return-footnote-1515-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":29,"menu_order":5,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Psyc 200 Lifespan Psychology\",\"author\":\"Laura Overstreet\",\"organization\":\"\",\"url\":\"http:\/\/opencourselibrary.org\/econ-201\/\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Human Nutrition Research Center on Aging\",\"author\":\"\",\"organization\":\"Wikipedia\",\"url\":\"https:\/\/en.wikipedia.org\/wiki\/Human_Nutrition_Research_Center_on_Aging\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Presbycusis\",\"author\":\"\",\"organization\":\"Wikimedia\",\"url\":\"https:\/\/en.wikipedia.org\/wiki\/Presbycusis\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Image of hands\",\"author\":\"\",\"organization\":\"pxhere\",\"url\":\"https:\/\/pxhere.com\/en\/photo\/1028578\",\"project\":\"\",\"license\":\"cc0\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Caloric Restriction vs. Animal Protein Restriction\",\"author\":\" NutritionFacts.org\",\"organization\":\"\",\"url\":\"https:\/\/www.youtube.com\/watch?time_continue=206&v=dwJASNFy9XQ\",\"project\":\"\",\"license\":\"other\",\"license_terms\":\"Standard YouTube License\"},{\"type\":\"cc\",\"description\":\"\",\"author\":\"\",\"organization\":\"\",\"url\":\"\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Information on diabetic retinopathy\",\"author\":\"\",\"organization\":\"Wikipedia\",\"url\":\"https:\/\/en.wikipedia.org\/wiki\/Diabetic_retinopathy#cite_note-1\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Information on glaucoma\",\"author\":\"\",\"organization\":\"Wikipedia\",\"url\":\"https:\/\/en.wikipedia.org\/wiki\/Glaucoma\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Information on cataracts\",\"author\":\"\",\"organization\":\"Wikipedia\",\"url\":\"https:\/\/en.wikipedia.org\/wiki\/Cataract\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Information on macular degeneration\",\"author\":\"\",\"organization\":\"Wikipedia\",\"url\":\"https:\/\/en.wikipedia.org\/wiki\/Macular_degeneration\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"}]","CANDELA_OUTCOMES_GUID":"6d7e596d-5dd2-4023-9b5f-0157372d4326, d6f0cd97-c4a0-446a-b12f-83595c652bc8","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-1515","chapter","type-chapter","status-publish","hentry"],"part":372,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters\/1515","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/users\/29"}],"version-history":[{"count":48,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters\/1515\/revisions"}],"predecessor-version":[{"id":7850,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters\/1515\/revisions\/7850"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/parts\/372"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters\/1515\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/media?parent=1515"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapter-type?post=1515"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/contributor?post=1515"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/license?post=1515"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}