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162-498: Ageing (or aging in American English ) is the process of becoming older . The term refers mainly to humans , many other animals , and fungi, whereas for example, bacteria, perennial plants and some simple animals are potentially biologically immortal . In a broader sense, ageing can refer to single cells within an organism which have ceased dividing , or to the population of a species . In humans, ageing represents
324-707: A cot–caught merger , which is rapidly spreading throughout the whole country. However, the South, Inland North, and a Northeastern coastal corridor passing through Rhode Island, New York City, Philadelphia, and Baltimore typically preserve an older cot–caught distinction. For that Northeastern corridor, the realization of the THOUGHT vowel is particularly marked , as depicted in humorous spellings, like in tawk and cawfee ( talk and coffee ), which intend to represent it being tense and diphthongal : [oə] . A split of TRAP into two separate phonemes , using different
486-652: A Yale School of Public Health study. In a UNFPA report about ageing in the 21st century, it highlighted the need to "Develop a new rights-based culture of ageing and a change of mindset and societal attitudes towards ageing and older persons, from welfare recipients to active, contributing members of society". UNFPA said that this "requires, among others, working towards the development of international human rights instruments and their translation into national laws and regulations and affirmative measures that challenge age discrimination and recognise older people as autonomous subjects". Older people's music participation contributes to
648-429: A brain biopsy to become final, but this is rarely recommended (though it can be performed at autopsy ). In those who are getting older, general screening for cognitive impairment using cognitive testing or early diagnosis of dementia has not been shown to improve outcomes. However, screening exams are useful in 65+ persons with memory complaints. Normally, symptoms must be present for at least six months to support
810-403: A disruption in thought patterns , the most common symptoms of dementia include emotional problems, difficulties with language , and decreased motivation . The symptoms may be described as occurring in a continuum over several stages. Dementia ultimately has a significant effect on the individual, their caregivers , and their social relationships in general. A diagnosis of dementia requires
972-407: A mild or major neurocognitive disorder with varying degrees of severity and many causative subtypes. The International Classification of Diseases ( ICD-11 ) also classifies dementia as a neurocognitive disorder (NCD) with many forms or subclasses. Dementia is listed as an acquired brain syndrome, marked by a decline in cognitive function, and is contrasted with neurodevelopmental disorders . It
1134-520: A pronunciations for example in gap [æ] versus gas [eə] , further defines New York City as well as Philadelphia–Baltimore accents. Most Americans preserve all historical /r/ sounds, using what is known as a rhotic accent . The only traditional r -dropping (or non-rhoticity) in regional U.S. accents variably appears today in eastern New England , New York City , and some of the former plantation South primarily among older speakers (and, relatedly, some African-American Vernacular English across
1296-490: A 2024 new study published in Nature Mental Health. Researchers found that loneliness was associated with a 31% higher likelihood of developing any form of dementia, and it also raised the risk of cognitive impairment by 15%. Symptoms are similar across dementia types and it is difficult to diagnose by symptoms alone. Diagnosis may be aided by brain scanning techniques. In many cases, the diagnosis requires
1458-446: A biological timetable that might be a continuation of inherent mechanisms that regulate childhood growth and development. This regulation would depend on changes in gene expression that affect the systems responsible for maintenance, repair and defense responses. Factors causing errors or damage include internal and environmental events that induce cumulative deterioration in one or more organs . One 2013 review assessed ageing through
1620-475: A common transition faced by the elderly, may have both positive and negative consequences. As cyborgs currently are on the rise some theorists argue there is a need to develop new definitions of ageing and for instance a bio-techno-social definition of ageing has been suggested. There is a current debate as to whether or not the pursuit of longevity and the postponement of senescence are cost-effective health care goals given finite health care resources. Because of
1782-425: A comparable age without dementia; they are three times more likely to have urinary incontinence and four times more likely to have fecal incontinence . The course of dementia is often described in four stages – pre-dementia, early, middle, and late, that show a pattern of progressive cognitive and functional impairment. More detailed descriptions can be arrived at by the use of numeric scales. These scales include
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#17327765897971944-631: A complex phenomenon of "both convergence and divergence": some accents are homogenizing and leveling , while others are diversifying and deviating further away from one another. Having been settled longer than the American West Coast, the East Coast has had more time to develop unique accents, and it currently comprises three or four linguistically significant regions, each of which possesses English varieties both different from each other as well as quite internally diverse: New England ,
2106-447: A consonant, such as in pearl , car and fort . Non-rhotic American accents, those that do not pronounce ⟨r⟩ except before a vowel, such as some accents of Eastern New England , New York City , and African-Americans , and a specific few (often older ones) spoken by Southerners , are often quickly noticed by General American listeners and perceived as sounding especially ethnic, regional, or antiquated. Rhoticity
2268-431: A continuous rate over several stages, and they vary across the dementia subtypes. Most types of dementia are slowly progressive with some deterioration of the brain well established before signs of the disorder become apparent. There are often other conditions present, such as high blood pressure or diabetes , and there can sometimes be as many as four of these comorbidities. Signs of dementia include getting lost in
2430-401: A diagnosis. Cognitive dysfunction of shorter duration is called delirium . Delirium can be easily confused with dementia due to similar symptoms. Delirium is characterized by a sudden onset, fluctuating course, a short duration (often lasting from hours to weeks), and is primarily related to a somatic (or medical) disturbance. In comparison, dementia has typically a long, slow onset (except in
2592-476: A familiar neighborhood, using unusual words to refer to familiar objects, forgetting the name of a close family member or friend, forgetting old memories, and being unable to complete tasks independently. People with developing dementia often fall behind on bill payments; specifically mortgage and credit cards, and a crashing credit score can be an early indicator of the disease. People with dementia are more likely to have problems with incontinence than those of
2754-630: A hot stove; or may not realize that they need to use the bathroom and become incontinent . They may not want to get out of bed, or may need assistance doing so. Commonly, the person no longer recognizes familiar faces. They may have significant changes in sleeping habits or have trouble sleeping at all. Changes in eating frequently occur. Cognitive awareness is needed for eating and swallowing and progressive cognitive decline results in eating and swallowing difficulties . This can cause food to be refused, or choked on, and help with feeding will often be required. For ease of feeding, food may be liquidized into
2916-407: A large extent, is genetically based. For example, numerous perennial plants ranging from strawberries and potatoes to willow trees typically produce clones of themselves by vegetative reproduction and are thus potentially immortal, while annual plants such as wheat and watermelons die each year and reproduce by sexual reproduction. In 2008 it was discovered that inactivation of only two genes in
3078-566: A late stage from HIV infection , and mostly affects younger people. The essential features of HIV-associated dementia are disabling cognitive impairment accompanied by motor dysfunction, speech problems and behavioral change. Cognitive impairment is characterised by mental slowness, trouble with memory and poor concentration . Motor symptoms include a loss of fine motor control leading to clumsiness, poor balance and tremors. Behavioral changes may include apathy , lethargy and diminished emotional responses and spontaneity. Histopathologically , it
3240-446: A loss of appetite leading to poor nutrition. It is suggested that this dysfunction may come about because the olfactory epithelium is exposed to the environment, and the lack of blood–brain barrier protection allows toxic elements to enter and cause damage to the chemosensory networks. Pre-dementia states considered as prodromal are mild cognitive impairment (MCI) and mild behavioral impairment (MBI). Signs and symptoms at
3402-407: A lower mortality rate compared to individuals who are not physically active. The majority of the benefits from exercise are achieved with around 3500 metabolic equivalent (MET) minutes per week. For example, climbing stairs 10 minutes, vacuuming 15 minutes, gardening 20 minutes, running 20 minutes, and walking or bicycling for 25 minutes on a daily basis would together achieve about 3000 MET minutes
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#17327765897973564-517: A matter of course where dementia is suspected. Many other medical and neurological conditions include dementia only late in the illness. For example, a proportion of patients with Parkinson's disease develop dementia, though widely varying figures are quoted for this proportion. When dementia occurs in Parkinson's disease, the underlying cause may be dementia with Lewy bodies or Alzheimer's disease , or both. Cognitive impairment also occurs in
3726-591: A merger with the THOUGHT ( caught ) set. Having taken place prior to the unrounding of the cot vowel, it results in lengthening and perhaps raising, merging the more recently separated vowel into the THOUGHT vowel in the following environments: before many instances of /f/ , /θ/ , and particularly /s/ (as in Austria, cloth, cost, loss, off, often, etc.), a few instances before /ŋ/ (as in strong, long, wrong ), and variably by region or speaker in gone , on , and certain other words. Unlike American accents,
3888-400: A mixture of old age, high blood pressure, and damage to blood vessels in the brain. Diagnosis of mixed dementia can be difficult, as often only one type will predominate. This makes the treatment of people with mixed dementia uncommon, with many people missing out on potentially helpful treatments. Mixed dementia can mean that symptoms onset earlier, and worsen more quickly since more parts of
4050-630: A new tissue or animal without ageing. Normal human cells however die after about 50 cell divisions in laboratory culture (the Hayflick Limit , discovered by Leonard Hayflick in 1961). A number of characteristic ageing symptoms are experienced by a majority, or by a significant proportion of humans during their lifetimes. Dementia becomes more common with age. About 3% of people between the ages of 65 and 74, 19% of those between 75 and 84, and nearly half of those over 85 years old have dementia. The spectrum ranges from mild cognitive impairment to
4212-636: A nice day , for sure); many are now distinctly old-fashioned (swell, groovy). Some English words now in general use, such as hijacking, disc jockey , boost, bulldoze and jazz , originated as American slang. American English has always shown a marked tendency to use words in different parts of speech and nouns are often used as verbs . Examples of nouns that are now also verbs are interview, advocate, vacuum, lobby, pressure, rear-end, transition, feature, profile, hashtag, head, divorce, loan, estimate, X-ray, spearhead, skyrocket, showcase, bad-mouth, vacation , major, and many others. Compounds coined in
4374-438: A number of mental health issues as older adults deal with challenges such as the death of loved ones, retirement and loss of purpose, as well as their own health issues. Some warning signs are: changes in mood or energy, changes in sleep or eating habits, pain, sadness, unhealthy coping mechanisms such as smoking, suicidal ideations, and others. [1] Older adults are more prone to social isolation as well, which can further increase
4536-480: A process of extensive dialect mixture and leveling in which English varieties across the colonies became more homogeneous compared with the varieties in Britain. English thus predominated in the colonies even by the end of the 17th century's first immigration of non-English speakers from Western Europe and Africa. Additionally, firsthand descriptions of a fairly uniform American English (particularly in contrast to
4698-425: A result of excessive use of alcohol particularly as a substance abuse disorder. Different factors can be involved in this development including thiamine deficiency and age vulnerability. A degree of brain damage is seen in more than 70% of those with alcohol use disorder . Brain regions affected are similar to those that are affected by aging, and also by Alzheimer's disease. Regions showing loss of volume include
4860-493: A safety net that contributes to the postponement of disability and prevention of impoverishment in old age". It has been argued that population ageing has undermined economic development and can lead to lower inflation because elderly individuals care especially strongly about the value of their pensions and savings. Evidence suggests that pensions, while making a difference to the well-being of older persons, also benefit entire families especially in times of crisis when there may be
5022-680: A series of other vowel shifts in the same region, known by linguists as the " Inland North ". The Inland North shares with the Eastern New England dialect (including Boston accents ) a backer tongue positioning of the GOOSE /u/ vowel (to [u] ) and the MOUTH /aʊ/ vowel (to [ɑʊ~äʊ] ) in comparison to the rest of the country. Ranging from northern New England across the Great Lakes to Minnesota, another Northern regional marker
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5184-493: A shortage or loss of employment within households. A study by the Australian Government in 2003 estimated that "women between the ages of 65 and 74 years contribute A$ 16 billion per year in unpaid caregiving and voluntary work. Similarly, men in the same age group contributed A$ 10 billion per year." Due to increasing share of the elderly in the population, health care expenditures will continue to grow relative to
5346-430: A specific age for when an individual is allowed or obliged to do particular activities. These age specifications include voting age , drinking age , age of consent , age of majority , age of criminal responsibility , marriageable age , age of candidacy , and mandatory retirement age . Admission to a movie, for instance, may depend on age according to a motion picture rating system . A bus fare might be discounted for
5508-525: A survey, completed in 2003, polling English speakers across the United States about their specific everyday word choices, hoping to identify regionalisms. The study found that most Americans prefer the term sub for a long sandwich, soda (but pop in the Great Lakes region and generic coke in the South) for a sweet and bubbly soft drink , you or you guys for the plural of you (but y'all in
5670-1025: A thick purée. They may also struggle to walk, particularly among those with Alzheimer's disease . In some cases, terminal lucidity , a form of paradoxical lucidity , occurs immediately before death; in this phenomenon, there is an unexpected recovery of mental clarity. Many causes of dementia are neurodegenerative , and protein misfolding is a cardinal feature of these. Other common causes include vascular dementia, dementia with Lewy bodies, frontotemporal dementia, and mixed dementia (commonly Alzheimer's disease and vascular dementia). Less common causes include normal pressure hydrocephalus , Parkinson's disease dementia , syphilis , HIV , and Creutzfeldt–Jakob disease . Alzheimer's disease accounts for 60–70% of cases of dementia worldwide. The most common symptoms of Alzheimer's disease are short-term memory loss and word-finding difficulties . Trouble with visuospatial functioning (getting lost often), reasoning, judgment and insight fail. Insight refers to whether or not
5832-453: A variation of American English in these islands. In 2021, about 245 million Americans, aged 5 or above, spoke English at home: a majority of the United States total population of roughly 330 million people. The United States has never had an official language at the federal level, but English is commonly used at the federal level and in states without an official language. 32 of the 50 states, in some cases as part of what has been called
5994-466: A week. Exercise has also been found to be an effective measure to treat declines in neuromuscular function due to age. A meta-analysis found that resistance training with elastic bands or kettlebells provided significant improvements to grip strength, gait speed, and skeletal muscle mass in patients with sarcopenia . Furthermore, another analysis found that the positive effects of resistance exercise on strength, muscle mass, and motor coordination reduce
6156-403: Is selected for in evolution. Traits that benefit early survival and reproduction will be selected for even if they contribute to an earlier death. Such a genetic effect is called the antagonistic pleiotropy effect when referring to a gene (pleiotropy signifying the gene has a double function – enabling reproduction at a young age but costing the organism life expectancy in old age) and is called
6318-585: Is a similar case for most Asian countries such as the Philippines, Thailand, Vietnam, Singapore, etc. American English American English , sometimes called United States English or U.S. English , is the set of varieties of the English language native to the United States. English is the most widely spoken language in the United States ; the de facto common language used in government, education, and commerce; and an official language in 32 of
6480-414: Is a type of dementia that primarily affects people in their 80s or 90s and in which TDP-43 protein deposits in the limbic portion of the brain. Hereditary disorders that can also cause dementia include: some metabolic disorders such as lysosomal storage disorders , leukodystrophies , and spinocerebellar ataxias . Persistent loneliness may significantly increase the risk of dementia according to
6642-477: Is about to fall asleep or wake up. Other prominent symptoms include problems with planning (executive function) and difficulty with visual-spatial function, and disruption in autonomic bodily functions . Abnormal sleep behaviors may begin before cognitive decline is observed and are a core feature of DLB. RBD is diagnosed either by sleep study recording or, when sleep studies cannot be performed, by medical history and validated questionnaires. Parkinson's disease
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6804-654: Is also associated with the United States, perhaps mostly in the Midwest and the South. American accents that have not undergone the cot–caught merger (the lexical sets LOT and THOUGHT ) have instead retained a LOT – CLOTH split : a 17th-century distinction in which certain words (labeled as the CLOTH lexical set ) separated away from the LOT set. The split, which has now reversed in most British English, simultaneously shifts this relatively recent CLOTH set into
6966-519: Is also described as a spectrum of disorders with causative subtypes of dementia based on a known disorder, such as Parkinson's disease for Parkinson's disease dementia , Huntington's disease for Huntington's disease dementia, vascular disease for vascular dementia , HIV infection causing HIV dementia , frontotemporal lobar degeneration for frontotemporal dementia , Lewy body disease for dementia with Lewy bodies , and prion diseases . Subtypes of neurodegenerative dementias may also be based on
7128-482: Is also evidence to suggest that exercise of any type may mitigate the degradation of the neuromuscular junction (NMJ) that occurs with age. Current evidence suggests that aerobic exercise causes the most hypertrophy of the NMJ, although resistance training is still somewhat effective. However, further evidence is necessary to identify optimal training protocols for NMJ function and to further understand how exercise affects
7290-604: Is also home to a creole language known commonly as Hawaiian Pidgin , and some Hawaii residents speak English with a Pidgin-influenced accent. American English also gave rise to some dialects outside the country, for example, Philippine English , beginning during the American occupation of the Philippines and subsequently the Insular Government of the Philippine Islands ; Thomasites first established
7452-457: Is another common visual disease that appears in older adults. Glaucoma is caused by damage to the optic nerve, causing vision loss. Glaucoma usually develops over time, but there are variations to glaucoma, and some have a sudden onset. There are a few procedures for glaucoma, but there is no cure or fix for the damage, once it has occurred. Prevention is the best measure in the case of glaucoma. In addition to physical symptoms, aging can also cause
7614-493: Is associated with Lewy body dementia that often progresses to Parkinson's disease dementia following a period of dementia-free Parkinson's disease. Frontotemporal dementias (FTDs) are characterized by drastic personality changes and language difficulties. In all FTDs, the person has a relatively early social withdrawal and early lack of insight. Memory problems are not a main feature. There are six main types of FTD. The first has major symptoms in personality and behavior. This
7776-518: Is called behavioral variant FTD (bv-FTD) and is the most common. The hallmark feature of bv-FTD is impulsive behavior , and this can be detected in pre-dementia states. In bv-FTD, the person shows a change in personal hygiene, becomes rigid in their thinking, and rarely acknowledges problems; they are socially withdrawn, and often have a drastic increase in appetite. They may become socially inappropriate. For example, they may make inappropriate sexual comments, or may begin using pornography openly. One of
7938-448: Is called non-fluent agrammatic variant primary progressive aphasia (NFA-PPA). This is mainly a problem with producing speech. They have trouble finding the right words, but mostly they have a difficulty coordinating the muscles they need to speak. Eventually, someone with NFA-PPA only uses one-syllable words or may become totally mute. A frontotemporal dementia associated with amyotrophic lateral sclerosis (ALS) known as (FTD-ALS) includes
8100-538: Is common in most American accents despite being now rare in England because, during the 17th-century British colonization, nearly all dialects of English were rhotic, and most North American English simply remained that way. The preservation of rhoticity in North America was also supported by continuing waves of rhotic-accented Scotch-Irish immigrants, most intensely during the 18th century (and moderately during
8262-468: Is credited with lowering the risk of heart disease and early death. The major contributors to mortality risk reduction appear to be a higher consumption of vegetables, fish, fruits, nuts and monounsaturated fatty acids, such as by consuming olive oil. As of 2021, there is insufficient clinical evidence that calorie restriction or any dietary practice affects the process of ageing. People who participate in moderate to high levels of physical exercise have
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#17327765897978424-428: Is due to the fact that, historically, brain tissue from patients with the disease could only be studied after the person's death. Brain scans can now help diagnose and distinguish between different kinds of dementia and show severity. These include magnetic resonance imaging (MRI), computerized tomography (CT), and positron emission tomography (PET). However, it is known that one of the first aspects of Alzheimer's disease
8586-419: Is ideal to ensure that advance care planning has occurred to protect the person's wishes. Advance directives exist that are specific to sufferers of dementia; these can be particularly helpful in addressing the decisions related to feeding which come with the progression of the illness. Mild cognitive impairment has been relisted in both DSM-5 and ICD-11 as "mild neurocognitive disorders", i.e. milder forms of
8748-494: Is identified by the infiltration of monocytes and macrophages into the central nervous system (CNS), gliosis , pallor of myelin sheaths , abnormalities of dendritic processes and neuronal loss. Creutzfeldt–Jakob disease is a rapidly progressive prion disease that typically causes dementia that worsens over weeks to months. Prions are disease-causing pathogens created from abnormal proteins. Alcohol-related dementia, also called alcohol-related brain damage, occurs as
8910-494: Is known in linguistics as General American ; it covers a fairly uniform accent continuum native to certain regions of the U.S. but especially associated with broadcast mass media and highly educated speech. However, historical and present linguistic evidence does not support the notion of there being one single mainstream American accent . The sound of American English continues to evolve, with some local accents disappearing, but several larger regional accents having emerged in
9072-490: Is not mainly due to increasing demand from ageing populations, but rather has been driven by rising incomes, costly new medical technology, a shortage of health care workers and informational asymmetries between providers and patients. A number of health problems become more prevalent as people get older. These include mental health problems as well as physical health problems, especially dementia . It has been estimated that population ageing only explains 0.2 percentage points of
9234-561: Is of particular concern, particularly in developed countries, while social protection and old-age pension coverage remain a challenge for developing countries, where a large proportion of the labour force is found in the informal sector." The global economic crisis has increased financial pressure to ensure economic security and access to health care in old age. To elevate this pressure "social protection floors must be implemented in order to guarantee income security and access to essential health and social services for all older persons and provide
9396-420: Is often identified by Americans as a "country" accent, and is defined by the /aɪ/ vowel losing its gliding quality : [aː] , the initiation event for a complicated Southern vowel shift, including a " Southern drawl " that makes short front vowels into distinct-sounding gliding vowels . The fronting of the vowels of GOOSE , GOAT , MOUTH , and STRUT tends to also define Southern accents as well as
9558-445: Is over 80 now in 33 countries. Ageing is a "global phenomenon", that is occurring fastest in developing countries, including those with large youth populations, and poses social and economic challenges to the work which can be overcome with "the right set of policies to equip individuals, families and societies to address these challenges and to reap its benefits". As life expectancy rises and birth rates decline in developed countries,
9720-403: Is overproduction of amyloid . Extracellular senile plaques (SPs), consisting of beta-amyloid (Aβ) peptides, and intracellular neurofibrillary tangles (NFTs) that are formed by hyperphosphorylated tau proteins, are two well-established pathological hallmarks of AD. Amyloid causes inflammation around the senile plaques of the brain , and too much buildup of this inflammation leads to changes in
9882-399: Is reduced, which can lead to isolation and possible depression. Older adults, however, may not experience depression as much as younger adults, and were paradoxically found to have improved mood, despite declining physical health. Macular degeneration causes vision loss and increases with age, affecting nearly 12% of those above the age of 80. This degeneration is caused by systemic changes in
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#173277658979710044-401: Is the mini–mental state examination . Although the greatest risk factor for developing dementia is aging, dementia is not a normal part of the aging process; many people aged 90 and above show no signs of dementia. Several risk factors for dementia, such as smoking and obesity , are preventable by lifestyle changes. Screening the general older population for the disorder is not seen to affect
10206-419: Is the common language at home, in public, and in government. Dementia Dementia is a syndrome associated with many neurodegenerative diseases , characterized by a general decline in cognitive abilities that affects a person's ability to perform everyday activities . This typically involves problems with memory , thinking , behavior , and motor control . Aside from memory impairment and
10368-410: Is the final stage. Pre-dementia includes pre-clinical and prodromal stages. The latter stage includes mild cognitive impairment (MCI), delirium-onset, and psychiatric-onset presentations. Sensory dysfunction is claimed for the pre-clinical stage, which may precede the first clinical signs of dementia by up to ten years. Most notably the sense of smell is lost, associated with depression and
10530-624: Is the increase in the number and proportion of older people in society. Population ageing has three possible causes: migration, longer life expectancy (decreased death rate) and decreased birth rate. Ageing has a significant impact on society. Young people tend to have fewer legal privileges (if they are below the age of majority ), they are more likely to push for political and social change, to develop and adopt new technologies, and to need education. Older people have different requirements from society and government, and frequently have differing values as well, such as for property and pension rights. In
10692-469: Is the variable fronting of /ɑ/ before /r/ , for example, appearing four times in the stereotypical Boston shibboleth Park the car in Harvard Yard . Several other phenomena serve to distinguish regional U.S. accents. Boston , Pittsburgh , Upper Midwestern , and Western U.S. accents have fully completed a merger of the LOT vowel with the THOUGHT vowel ( /ɑ/ and /ɔ/ , respectively):
10854-640: The Cognitive Abilities Screening Instrument (CASI), the Trail-making test , and the clock drawing test . The MoCA ( Montreal Cognitive Assessment ) is a reliable screening test and is available online for free in 35 different languages. The MoCA has also been shown somewhat better at detecting mild cognitive impairment than the MMSE. People with hearing loss , which commonly occurs alongside dementia, score worse in
11016-482: The English-only movement , have adopted legislation granting official or co-official status to English. Typically only "English" is specified, not a particular variety like American English. (From 1923 to 1969, the state of Illinois recognized its official language as "American", meaning American English.) Puerto Rico is the largest example of a United States territory in which another language – Spanish –
11178-622: The Mid-Atlantic states (including a New York accent as well as a unique Philadelphia–Baltimore accent ), and the South . As of the 20th century, the middle and eastern Great Lakes area , Chicago being the largest city with these speakers, also ushered in certain unique features, including the fronting of the LOT /ɑ/ vowel in the mouth toward [a] and tensing of the TRAP /æ/ vowel wholesale to [eə] . These sound changes have triggered
11340-551: The Native American languages . Examples of such names are opossum , raccoon , squash , moose (from Algonquian ), wigwam , and moccasin . American English speakers have integrated traditionally non-English terms and expressions into the mainstream cultural lexicon; for instance, en masse , from French ; cookie , from Dutch ; kindergarten from German , and rodeo from Spanish . Landscape features are often loanwords from French or Spanish, and
11502-665: The blood supply to the brain , typically involving a series of mini-strokes . The symptoms of this dementia depend on where in the brain the strokes occurred and whether the blood vessels affected were large or small. Repeated injury can cause progressive dementia over time, while a single injury located in an area critical for cognition such as the hippocampus, or thalamus, can lead to sudden cognitive decline. Elements of vascular dementia may be present in all other forms of dementia. Brain scans may show evidence of multiple strokes of different sizes in various locations. People with vascular dementia tend to have risk factors for disease of
11664-477: The disposable soma effect when referring to an entire genetic programme (the organism diverting limited resources from maintenance to reproduction). The biological mechanisms which regulate lifespan probably evolved with the first multicellular organisms more than a billion years ago. However, even single-celled organisms such as yeast have been used as models in ageing, hence ageing has its biological roots much earlier than multi-cellularity. The Mediterranean diet
11826-722: The francophile tastes of the 19th century Victorian era Britain (for example they preferred programme for program , manoeuvre for maneuver , cheque for check , etc.). AmE almost always uses -ize in words like realize . BrE prefers -ise , but also uses -ize on occasion (see: Oxford spelling ). There are a few differences in punctuation rules. British English is more tolerant of run-on sentences , called " comma splices " in American English, and American English prefers that periods and commas be placed inside closing quotation marks even in cases in which British rules would place them outside. American English also favors
11988-537: The hard clam (known as quahog in New England) at 508 years, the Greenland shark at 400 years, various deep-sea tube worms at over 300 years, fish like the sturgeon and the rockfish , and the sea anemone and lobster . Such organisms are sometimes said to exhibit negligible senescence . The genetic aspect has also been demonstrated in studies of human centenarians . Life span, like other phenotypes ,
12150-487: The median age rises accordingly. According to the United Nations, this process is taking place in nearly every country in the world. A rising median age can have significant social and economic implications, as the workforce gets progressively older and the number of old workers and retirees grows relative to the number of young workers. Older people generally incur more health-related costs than do younger people in
12312-430: The mini mental state examination (MMSE) is the best studied and most commonly used. The MMSE is a useful tool for helping to diagnose dementia if the results are interpreted along with an assessment of a person's personality, their ability to perform activities of daily living, and their behaviour. Other cognitive tests include the abbreviated mental test score (AMTS), the, "modified mini–mental state examination" (3MS),
12474-502: The type and may, in fact, remain steady throughout most of the human lifespan, dropping suddenly only as people near the end of their lives. Individual variations in the rate of cognitive decline may therefore be explained in terms of people having different lengths of life. There are changes to the brain: after 20 years of age, there is a 10% reduction each decade in the total length of the brain's myelinated axons . Age can result in visual impairment , whereby non-verbal communication
12636-764: The 18th century; apartment , shanty in the 19th century; project, condominium , townhouse , mobile home in the 20th century; and parts thereof ( driveway , breezeway, backyard ) . Industry and material innovations from the 19th century onwards provide distinctive new words, phrases, and idioms through railroading (see further at rail terminology ) and transportation terminology, ranging from types of roads ( dirt roads , freeways ) to infrastructure ( parking lot , overpass , rest area ), to automotive terminology often now standard in English internationally. Already existing English words—such as store , shop , lumber —underwent shifts in meaning; others remained in
12798-546: The 20th century. The use of English in the United States is a result of British colonization of the Americas . The first wave of English-speaking settlers arrived in North America during the early 17th century, followed by further migrations in the 18th and 19th centuries. During the 17th and 18th centuries, dialects from many different regions of England and the British Isles existed in every American colony, allowing
12960-604: The 21st century, one of the most significant population trends is ageing. Currently, over 11% of the world's current population are people aged 60 and older and the United Nations Population Fund (UNFPA) estimates that by 2050 that number will rise to approximately 22%. Ageing has occurred due to development which has enabled better nutrition, sanitation, health care, education and economic well-being. Consequently, fertility rates have continued to decline and life expectancy has risen. Life expectancy at birth
13122-441: The 50 U.S. states . Since the late 20th century, American English has become the most influential form of English worldwide. Varieties of American English include many patterns of pronunciation, vocabulary, grammar and particularly spelling that are unified nationwide but distinct from other English dialects around the world. Any American or Canadian accent perceived as lacking noticeably local, ethnic, or cultural markers
13284-627: The British form is a back-formation , such as AmE burglarize and BrE burgle (from burglar ). However, while individuals usually use one or the other, both forms will be widely understood and mostly used alongside each other within the two systems. While written American English is largely standardized across the country and spoken American English dialects are highly mutually intelligible, there are still several recognizable regional and ethnic accents and lexical distinctions. The regional sounds of present-day American English are reportedly engaged in
13446-413: The East Coast (perhaps in imitation of 19th-century London speech), even the East Coast has gradually begun to restore rhoticity, due to it becoming nationally prestigious in the 20th century. The pronunciation of ⟨r⟩ is a postalveolar approximant [ ɹ̠ ] or retroflex approximant [ ɻ ] , but a unique "bunched tongue" variant of the approximant r sound
13608-705: The Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS or Reisberg Scale), the Functional Assessment Staging Test (FAST), and the Clinical Dementia Rating (CDR). Using the GDS, which more accurately identifies each stage of the disease progression, a more detailed course is described in seven stages – two of which are broken down further into five and six degrees. Stage 7(f)
13770-571: The Inland North. Rather than one particular accent, General American is best defined as an umbrella covering an American accent that does not incorporate features associated with some particular region, ethnicity, or socioeconomic group. Typical General American features include rhoticity , the father–bother merger , Mary–marry–merry merger , pre-nasal "short a " tensing , and other particular vowel sounds . General American features are embraced most by Americans who are highly educated or in
13932-514: The MoCA test, which could lead to a false diagnosis of dementia. Researchers have developed an adapted version of the MoCA test, which is accurate and reliable and avoids the need for people to listen and respond to questions. The AD-8 – a screening questionnaire used to assess changes in function related to cognitive decline – is potentially useful, but is not diagnostic, is variable, and has risk of bias. An integrated cognitive assessment ( CognICA )
14094-608: The Neuropsychiatric Inventory or the Geriatric Depression Scale . Physicians used to think that people with memory complaints had depression and not dementia (because they thought that those with dementia are generally unaware of their memory problems). However, researchers have realized that many older people with memory complaints in fact have mild cognitive impairment the earliest stage of dementia. Depression should always remain high on
14256-475: The Parkinson-plus syndromes of progressive supranuclear palsy and corticobasal degeneration (and the same underlying pathology may cause the clinical syndromes of frontotemporal lobar degeneration ). Although the acute porphyrias may cause episodes of confusion and psychiatric disturbance, dementia is a rare feature of these rare diseases. Limbic-predominant age-related TDP-43 encephalopathy (LATE)
14418-573: The South), sneakers for athletic shoes (but often tennis shoes outside the Northeast), and shopping cart for a cart used for carrying supermarket goods. American English and British English (BrE) often differ at the levels of phonology, phonetics, vocabulary, and, to a much lesser extent, grammar and orthography. The first large American dictionary, An American Dictionary of the English Language , known as Webster's Dictionary ,
14580-528: The U.S. Several verbs ending in -ize are of U.S. origin; for example, fetishize, prioritize, burglarize, accessorize, weatherize , etc.; and so are some back-formations (locate, fine-tune, curate, donate, emote, upholster and enthuse). Among syntactic constructions that arose are outside of, headed for, meet up with, back of, etc. Americanisms formed by alteration of some existing words include notably pesky, phony, rambunctious, buddy, sundae , skeeter, sashay and kitty-corner. Adjectives that arose in
14742-570: The U.S. are for instance foothill , landslide (in all senses), backdrop , teenager , brainstorm , bandwagon , hitchhike , smalltime, and a huge number of others. Other compound words have been founded based on industrialization and the wave of the automobile: five-passenger car, four-door sedan, two-door sedan, and station-wagon (called an estate car in British English). Some are euphemistic ( human resources , affirmative action , correctional facility ). Many compound nouns have
14904-676: The U.S. are, for example, lengthy, bossy, cute and cutesy, punk (in all senses), sticky (of the weather), through (as in "finished"), and many colloquial forms such as peppy or wacky . A number of words and meanings that originated in Middle English or Early Modern English and that have been in everyday use in the United States have since disappeared in most varieties of British English; some of these have cognates in Lowland Scots . Terms such as fall ("autumn"), faucet ("tap"), diaper ("nappy"; itself unused in
15066-530: The U.S. while changing in Britain. Science, urbanization, and democracy have been important factors in bringing about changes in the written and spoken language of the United States. From the world of business and finance came new terms ( merger , downsize , bottom line ), from sports and gambling terminology came, specific jargon aside, common everyday American idioms, including many idioms related to baseball . The names of some American inventions remained largely confined to North America ( elevator [except in
15228-427: The U.S.), candy ("sweets"), skillet , eyeglasses , and obligate are often regarded as Americanisms. Fall for example came to denote the season in 16th century England, a contraction of Middle English expressions like "fall of the leaf" and "fall of the year." Gotten ( past participle of get ) is often considered to be largely an Americanism. Other words and meanings were brought back to Britain from
15390-597: The U.S., especially in the second half of the 20th century; these include hire ("to employ"), I guess (famously criticized by H. W. Fowler ), baggage , hit (a place), and the adverbs overly and presently ("currently"). Some of these, for example, monkey wrench and wastebasket , originated in 19th century Britain. The adjectives mad meaning "angry", smart meaning "intelligent", and sick meaning "ill" are also more frequent in American (and Irish) English than British English. Linguist Bert Vaux created
15552-538: The United States and the United Kingdom suggest that, while spoken American English deviated away from period British English in many ways, it is conservative in a few other ways, preserving certain features 21st-century British English has since lost. Full rhoticity (or "R-fulness") is typical of American accents, pronouncing the phoneme /r/ (corresponding to the letter ⟨r⟩ ) in all environments, including in syllable-final position or before
15714-605: The West and Midwest, and New York Latino English , spoken in the New York metropolitan area . Additionally, ethnic varieties such as Yeshiva English and " Yinglish " are spoken by some American Orthodox Jews , Cajun Vernacular English by some Cajuns in southern Louisiana , and Pennsylvania Dutch English by some Pennsylvania Dutch people. American Indian Englishes have been documented among diverse Indian tribes. The island state of Hawaii , though primarily English-speaking,
15876-555: The accents spoken in the " Midland ": a vast band of the country that constitutes an intermediate dialect region between the traditional North and South. Western U.S. accents mostly fall under the General American spectrum. Below, ten major American English accents are defined by their particular combinations of certain vowel sounds: In 2010, William Labov noted that Great Lakes, Philadelphia, Pittsburgh, and West Coast accents have undergone "vigorous new sound changes" since
16038-478: The accumulated infirmities of old age, bioethicist Ezekiel Emanuel , opines that the pursuit of longevity via the compression of morbidity hypothesis is a "fantasy" and that human life is not worth living after age 75; longevity then should not be a goal of health care policy. This opinion has been contested by neurosurgeon and medical ethicist Miguel Faria , who states that life can be worthwhile during old age, and that longevity should be pursued in association with
16200-438: The accumulation of changes in a human being over time and can encompass physical, psychological, and social changes. Reaction time, for example, may slow with age, while memories and general knowledge typically increase. Ageing is associated with increased risk of cancer, Alzheimer's disease , diabetes , cardiovascular disease , increased mental health risks, and many more . Of the roughly 150,000 people who die each day across
16362-505: The aeronautical sense ], gasoline ) as did certain automotive terms ( truck , trunk ). New foreign loanwords came with 19th and early 20th century European immigration to the U.S.; notably, from Yiddish ( chutzpah , schmooze, bupkis, glitch ) and German ( hamburger , wiener ). A large number of English colloquialisms from various periods are American in origin; some have lost their American flavor (from OK and cool to nerd and 24/7 ), while others have not ( have
16524-460: The annual growth rate in medical spending of 4.3% since 1970. In addition, certain reforms to the Medicare system in the United States decreased elderly spending on home health care by 12.5% per year between 1996 and 2000. Beauty standards have evolved over time, and as scientific research in cosmeceuticals, cosmetic products seen to have medicinal benefits like anti-ageing creams, has increased,
16686-427: The annual plant Arabidopsis thaliana leads to its conversion into a potentially immortal perennial plant. The oldest animals known so far are 15,000-year-old Antarctic sponges , which can reproduce both sexually and clonally. Clonal immortality apart, there are certain species whose individual lifespans stand out among Earth's life-forms, including the bristlecone pine at 5062 years or 5067 years, invertebrates like
16848-430: The attainment of quality of life. Faria claims that postponement of senescence as well as happiness and wisdom can be attained in old age in a large proportion of those who lead healthy lifestyles and remain intellectually active. With age inevitable biological changes occur that increase the risk of illness and disability. UNFPA states that: "A life-cycle approach to health care – one that starts early, continues through
17010-588: The bacterium E. coli may split into distinguishable daughter cells, which opens the theoretical possibility of "age classes" among bacteria. Even within humans and other mortal species, there are cells with the potential for immortality: cancer cells which have lost the ability to die when maintained in a cell culture such as the HeLa cell line, and specific stem cells such as germ cells (producing ova and spermatozoa ). In artificial cloning , adult cells can be rejuvenated to embryonic status and then used to grow
17172-404: The blood vessels , such as tobacco use , high blood pressure , atrial fibrillation , high cholesterol , diabetes , or other signs of vascular disease such as a previous heart attack or angina . The prodromal symptoms of dementia with Lewy bodies (DLB) include mild cognitive impairment , and delirium onset. The symptoms of DLB are more frequent, more severe, and earlier presenting than in
17334-437: The brain that cannot be controlled, leading to the symptoms of Alzheimer's. Several articles have been published on a possible relationship (as an either primary cause or exacerbation of Alzheimer's disease) between general anesthesia and Alzheimer's in specifically the elderly . Vascular dementia accounts for at least 20% of dementia cases, making it the second most common type. It is caused by disease or injury affecting
17496-443: The brain will be affected. Chronic inflammatory conditions that may affect the brain and cognition include Behçet's disease , multiple sclerosis , sarcoidosis , Sjögren's syndrome , lupus , celiac disease , and non-celiac gluten sensitivity . These types of dementias can rapidly progress, but usually have a good response to early treatment. This consists of immunomodulators or steroid administration, or in certain cases,
17658-405: The cases of a stroke or trauma), slow decline of mental functioning, as well as a longer trajectory (from months to years). Some mental illnesses , including depression and psychosis , may produce symptoms that must be differentiated from both delirium and dementia. These are differently diagnosed as pseudodementias , and any dementia evaluation needs to include a depression screening such as
17820-421: The circulation of waste products and by the growth of abnormal vessels around the retina. Other visual diseases that often appear with age are cataracts and glaucoma. A cataract occurs when the lens of the eye becomes cloudy, making vision blurry; it eventually causes blindness if untreated. They develop over time and are seen most often with those that are older. Cataracts can be treated through surgery. Glaucoma
17982-406: The country), though the vowel-consonant cluster found in "bird", "work", "hurt", "learn", etc. usually retains its r pronunciation, even in these non-rhotic American accents. Non-rhoticity among such speakers is presumed to have arisen from their upper classes' close historical contact with England, imitating London's r -dropping, a feature that has continued to gain prestige throughout England from
18144-614: The diverse regional dialects of British English) became common after the mid-18th century, while at the same time speakers' identification with this new variety increased. Since the 18th century, American English has developed into some new varieties, including regional dialects that retain minor influences from waves of immigrant speakers of diverse languages, primarily European languages. Some racial and regional variation in American English reflects these groups' geographic settlement, their de jure or de facto segregation, and patterns in their resettlement. This can be seen, for example, in
18306-742: The double quotation mark ("like this") over the single ('as here'). Vocabulary differences vary by region. For example, autumn is used more commonly in the United Kingdom, whereas fall is more common in American English. Some other differences include: aerial (United Kingdom) vs. antenna, biscuit (United Kingdom) vs. cookie/cracker, car park (United Kingdom) vs. parking lot, caravan (United Kingdom) vs. trailer, city centre (United Kingdom) vs. downtown, flat (United Kingdom) vs. apartment, fringe (United Kingdom) vs. bangs, and holiday (United Kingdom) vs. vacation. AmE sometimes favors words that are morphologically more complex, whereas BrE uses clipped forms, such as AmE transportation and BrE transport or where
18468-693: The economy in coming decades. This has been considered as a negative phenomenon and effective strategies like labour productivity enhancement should be considered to deal with negative consequences of ageing. In the field of sociology and mental health, ageing is seen in five different views: ageing as maturity , ageing as decline, ageing as a life-cycle event, ageing as generation, and ageing as survival. Positive correlates with ageing often include economics, employment, marriage, children, education, and sense of control, as well as many others. The social science of ageing includes disengagement theory, activity theory, selectivity theory, and continuity theory. Retirement,
18630-891: The elimination of the causative agent. A 2019 review found no association between celiac disease and dementia overall but a potential association with vascular dementia. A 2018 review found a link between celiac disease or non-celiac gluten sensitivity and cognitive impairment and that celiac disease may be associated with Alzheimer's disease, vascular dementia, and frontotemporal dementia . A strict gluten-free diet started early may protect against dementia associated with gluten-related disorders . Cases of easily reversible dementia include hypothyroidism , vitamin B 12 deficiency , Lyme disease , and neurosyphilis . For Lyme disease and neurosyphilis, testing should be done if risk factors are present. Because risk factors are often difficult to determine, testing for neurosyphilis and Lyme disease, as well as other mentioned factors, may be undertaken as
18792-416: The emergence of the fungal/animal kingdoms approximately a billion years ago, and the evolution of seed-producing plants 320 million years ago. The sexual organism could henceforth pass on some of its genetic material to produce new individuals and could itself become disposable with respect to the survival of its species. This classic biological idea has however been perturbed recently by the discovery that
18954-520: The first signs. As dementia progresses, initial symptoms generally worsen. The rate of decline is different for each person. MMSE scores between 6 and 17 signal moderate dementia. For example, people with moderate Alzheimer's dementia lose almost all new information. People with dementia may be severely impaired in solving problems, and their social judgment is often impaired. They cannot usually function outside their own home, and generally should not be left alone. They may be able to do simple chores around
19116-517: The following two centuries) when this ethnic group eventually made up one-seventh of the colonial population. Scotch-Irish settlers spread from Delaware and Pennsylvania throughout the larger Mid-Atlantic region, the inland regions of both the South and North, and throughout the West: American dialect areas that were all uninfluenced by upper-class non-rhoticity and that consequently have remained consistently rhotic. While non-rhoticity spread on
19278-457: The frontal, temporal, and parietal lobes, as well as the cerebellum, thalamus, and hippocampus. This loss can be more notable, with greater cognitive impairments seen in those aged 65 years and older. More than one type of dementia, known as mixed dementia, may exist together in about 10% of dementia cases. The most common type of mixed dementia is Alzheimer's disease and vascular dementia. This particular type of mixed dementia's main onsets are
19440-479: The genus Hydra have a regenerative ability by which they avoid dying of old age. Early life forms on Earth, starting at least 3.7 billion years ago, were single-celled organisms. Such organisms ( Prokaryotes , Protozoans , algae ) multiply by fission into daughter cells; thus single celled organisms have been thought to not age and to be potentially immortal under favorable conditions. However, evidence has been reported that aging leading to death occurs in
19602-839: The globe, about two-thirds die from age-related causes. Certain lifestyle choices and socioeconomic conditions have been linked to ageing. Current ageing theories are assigned to the damage concept, whereby the accumulation of damage (such as DNA oxidation ) may cause biological systems to fail, or to the programmed ageing concept, whereby the internal processes (epigenetic maintenance such as DNA methylation ) inherently may cause ageing. Programmed ageing should not be confused with programmed cell death ( apoptosis ). Human beings and members of other species, especially animals, age and die. Fungi, too, can age. In contrast, many species can be considered potentially immortal : for example, bacteria fission to produce daughter cells, strawberry plants grow runners to produce clones of themselves, and animals in
19764-944: The hospital , BrE to hospital ; contrast, however, AmE actress Elizabeth Taylor , BrE the actress Elizabeth Taylor ). Often, these differences are a matter of relative preferences rather than absolute rules; and most are not stable since the two varieties are constantly influencing each other, and American English is not a standardized set of dialects. Differences in orthography are also minor. The main differences are that American English usually uses spellings such as flavor for British flavour , fiber for fibre , defense for defence , analyze for analyse , license for licence , catalog for catalogue and traveling for travelling . Noah Webster popularized such spellings in America, but he did not invent most of them. Rather, "he chose already existing options on such grounds as simplicity, analogy or etymology." Other differences are due to
19926-539: The house but not much else, and begin to require assistance for personal care and hygiene beyond simple reminders. A lack of insight into having the condition will become evident. People with late-stage dementia typically turn increasingly inward and need assistance with most or all of their personal care. People with dementia in the late stages usually need 24-hour supervision to ensure their personal safety, and meeting of basic needs. If left unsupervised, they may wander or fall; may not recognize common dangers such as
20088-407: The impact on health care demand. The large number of suggestions in the literature for specific interventions to cope with the expected increase in demand for long-term care in ageing societies can be organized under four headings: improve system performance; redesign service delivery; support informal caregivers; and shift demographic parameters. However, the annual growth in national health spending
20250-614: The industry has also expanded; the kinds of products they produce (such as serums and creams) have gradually gained popularity and become a part of many people's personal care routine. The increase in demand for cosmeceuticals has led scientists to find ingredients for these products in unorthodox places. For example, the secretion of cryptomphalus aspersa (or brown garden snail) has been found to have antioxidant properties, increase skin cell proliferation, and increase extracellular proteins such as collagen and fibronectin (important proteins for cell proliferation). Another substance used to prevent
20412-674: The influence of 18th-century Protestant Ulster Scots immigrants (known in the U.S. as the Scotch-Irish ) in Appalachia developing Appalachian English and the 20th-century Great Migration bringing African-American Vernacular English to the Great Lakes urban centers. Any phonologically unmarked North American accent falls under an umbrella known as General American. This section mostly refers to such General American features. Studies on historical usage of English in both
20574-438: The late 18th century onwards, but which has conversely lost prestige in the U.S. since at least the early 20th century. Non-rhoticity makes a word like car sound like cah or source like sauce . New York City and Southern accents are the most prominent regional accents of the country, as well as the most stigmatized and socially disfavored. Southern speech, strongest in southern Appalachia and certain areas of Texas,
20736-450: The lens of the damage theory, proposing nine metabolic "hallmarks" of ageing in various organisms but especially mammals: There are three main metabolic pathways which can influence the rate of ageing, discussed below: It is likely that most of these pathways affect ageing separately, because targeting them simultaneously leads to additive increases in lifespan. The rate of ageing varies substantially across different species, and this, to
20898-418: The list of possibilities, however, for an elderly person with memory trouble. Changes in thinking, hearing and vision are associated with normal ageing and can cause problems when diagnosing dementia due to the similarities. Given the challenging nature of predicting the onset of dementia and making a dementia diagnosis clinical decision making aids underpinned by machine learning and artificial intelligence have
21060-457: The maintenance of interpersonal relationships and promoting successful ageing. At the same time, older persons can make contributions to society including caregiving and volunteering. For example, "A study of Bolivian migrants who [had] moved to Spain found that 69% left their children at home, usually with grandparents. In rural China, grandparents care for 38% of children aged under five whose parents have gone to work in cities." Population ageing
21222-415: The major neurocognitive disorder (dementia) subtypes. Kynurenine is a metabolite of tryptophan that regulates microbiome signaling, immune cell response, and neuronal excitation. A disruption in the kynurenine pathway may be associated with the neuropsychiatric symptoms and cognitive prognosis in mild dementia. In the early stage of dementia, symptoms become noticeable to other people. In addition,
21384-399: The meaning of objects as well. For example, a drawing of a bird, dog, and an airplane in someone with FTD may all appear almost the same. In a classic test for this, a patient is shown a picture of a pyramid and below it a picture of both a palm tree and a pine tree. The person is asked to say which one goes best with the pyramid. In SV-PPA the person cannot answer that question. The other type
21546-785: The mechanisms that cause NMJ degradation. A meta-analysis showed that loneliness carries a higher mortality risk than smoking. Different cultures express age in different ways. The age of an adult human is commonly measured in whole years since the day of birth. (The most notable exception— East Asian age reckoning —is becoming less common, particularly in official contexts.) Arbitrary divisions set to mark periods of life may include juvenile (from infancy through childhood , preadolescence , and adolescence), early adulthood , middle adulthood , and late adulthood . Informal terms include " tweens ", "teenagers", "twentysomething", "thirtysomething", etc. as well as "denarian", "vicenarian", "tricenarian", "quadragenarian", etc. Most legal systems define
21708-427: The mid-nineteenth century onwards, so they "are now more different from each other than they were 50 or 100 years ago", while other accents, like of New York City and Boston, have remained stable in that same time-frame. However, a General American sound system also has some debated degree of influence nationwide, for example, gradually beginning to oust the regional accent in urban areas of the South and at least some in
21870-410: The most common signs is apathy , or not caring about anything. Apathy, however, is a common symptom in many dementias. Two types of FTD feature aphasia (language problems) as the main symptom. One type is called semantic variant primary progressive aphasia (SV-PPA). The main feature of this is the loss of the meaning of words. It may begin with difficulty naming things. The person eventually may lose
22032-617: The most formal contexts, and regional accents with the most General American native features include North Midland, Western New England, and Western accents. Although no longer region-specific, African-American Vernacular English , which remains the native variety of most working- and middle-class African Americans , has a close relationship to Southern dialects and has greatly influenced everyday speech of many Americans, including hip hop culture . Hispanic and Latino Americans have also developed native-speaker varieties of English. The best-studied Latino Englishes are Chicano English , spoken in
22194-559: The much longer lives of even small mammals, such as the mouse (around 3 years). A model organism for the study of ageing is the nematode C. elegans – having a short lifespan of 2–3 weeks – enabling genetic manipulations or suppression of gene activity with RNA interference , and other factors. Most known mutations and RNA interference targets that extend lifespan were first discovered in C. elegans . The factors proposed to influence biological ageing fall into two main categories, programmed and error-related . Programmed factors follow
22356-425: The neurocognitive deficits may sometimes show improvement with treatment of the causative medical condition. Diagnosis of dementia is usually based on history of the illness and cognitive testing with imaging . Blood tests may be taken to rule out other possible causes that may be reversible, such as hypothyroidism (an underactive thyroid), and to determine the dementia subtype. One commonly used cognitive test
22518-425: The neurodegenerative diseases of Alzheimer's disease , cerebrovascular disease , Parkinson's disease and Lou Gehrig's disease . Furthermore, many types of memory decline with ageing , but not semantic memory or general knowledge such as vocabulary definitions. These typically increase or remain steady until late adulthood (see Ageing brain ). Intelligence declines with age, though the rate varies depending on
22680-451: The observation of a change from a person's usual mental functioning and a greater cognitive decline than might be caused by the normal aging process. Several diseases and injuries to the brain, such as a stroke , can give rise to dementia. However, the most common cause is Alzheimer's disease , a neurodegenerative disorder. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) , has re-described dementia as
22842-461: The other dementia subtypes. Dementia with Lewy bodies has the primary symptoms of fluctuating cognition, alertness or attention; REM sleep behavior disorder (RBD); one or more of the main features of parkinsonism , not due to medication or stroke; and repeated visual hallucinations. The visual hallucinations in DLB are generally vivid hallucinations of people or animals and they often occur when someone
23004-417: The outcome. Dementia is currently the seventh leading cause of death worldwide and has 10 million new cases reported every year (approximately one every three seconds). There is no known cure for dementia. Acetylcholinesterase inhibitors such as donepezil are often used and may be beneficial in mild to moderate disorder, but the overall benefit may be minor. There are many measures that can improve
23166-402: The past forms of a few verbs (for example, AmE/BrE: learned / learnt , burned / burnt , snuck/sneaked , dove/dived ) although the purportedly "British" forms can occasionally be seen in American English writing as well; different prepositions and adverbs in certain contexts (for example, AmE in school, BrE at school ); and whether or not a definite article is used, in very few cases (AmE to
23328-441: The person realizes they have memory problems. The part of the brain most affected by Alzheimer's is the hippocampus . Other parts that show atrophy (shrinking) include the temporal and parietal lobes . Although this pattern of brain shrinkage suggests Alzheimer's, it is variable and a brain scan is insufficient for a diagnosis. Little is known about the events that occur during and that actually cause Alzheimer's disease. This
23490-585: The physical manifestations of ageing is onobotulinumtoxinA, the toxin injected for Botox. In some cultures, old age is celebrated and honoured. In Korea, for example, a special party called hwangap is held to celebrate and congratulate an individual for turning 60 years old. In China, respect for elderly is often the basis for how a community is organized and has been at the foundation of Chinese culture and morality for thousands of years. Older people are respected for their wisdom and most important decisions have traditionally not been made without consulting them. This
23652-468: The potential to enhance clinical practice. Various brief cognitive tests (5–15 minutes) have reasonable reliability to screen for dementia, but may be affected by factors such as age, education and ethnicity. Age and education have a significant influence on the diagnosis of dementia. For example, Individuals with lower education are more likely to be diagnosed with dementia than their educated counterparts. While many tests have been studied, presently
23814-599: The prodromal stage may be subtle, and the early signs often become apparent only in hindsight. Of those diagnosed with MCI, 70% later progress to dementia. In mild cognitive impairment, changes in the person's brain have been happening for a long time, but the symptoms are just beginning to appear. These problems, however, are not severe enough to affect daily function. If and when they do, the diagnosis becomes dementia. The person may have some memory problems and trouble finding words, but they can solve everyday problems and competently handle their life affairs. During this stage, it
23976-884: The quality of life of a person with dementia and their caregivers. Cognitive and behavioral interventions may be appropriate for treating the associated symptoms of depression. The signs and symptoms of dementia are termed as the neuropsychiatric symptoms —also known as the behavioral and psychological symptoms—of dementia. The behavioral symptoms can include agitation , restlessness, inappropriate behavior, sexual disinhibition, and verbal or physical aggression. These symptoms may result from impairments in cognitive inhibition . The psychological symptoms can include depression, hallucinations (most often visual), delusions, apathy, and anxiety. The most commonly affected areas of brain function include memory , language , attention , problem solving , and visuospatial function affecting perception and orientation. The symptoms progress at
24138-476: The reproductive years and lasts into old age – is essential for the physical and emotional well-being of older persons, and, indeed, all people. Public policies and programmes should additionally address the needs of older impoverished people who cannot afford health care." Many societies in Western Europe and Japan have ageing populations. While the effects on society are complex, there is a concern about
24300-445: The risk for physical and mental conditions such as anxiety, depression, and cognitive decline. [2] A distinction can be made between "proximal ageing" (age-based effects that come about because of factors in the recent past) and "distal ageing" (age-based differences that can be traced to a cause in a person's early life, such as childhood poliomyelitis ). Ageing is among the greatest known risk factors for most human diseases . Of
24462-595: The risk of falls in the elderly, which is a key factor for living a longer and healthier life. In terms of programming, there is no one-size-fits-all approach. General recommendations for improvements to gait speed, strength, and muscle size for reduced fall risk are resistance training programs with two to three 40-60 minute workouts per week, consisting of 1-2 sets of 5-8 repetitions of 2-3 different exercises for each major muscle group, but individual considerations must be taken due to differences in health status, motivation, and accessibility to exercise facilities. There
24624-416: The roughly 150,000 people who die each day across the globe, about two-thirds--100,000 per day--die from age-related causes . In industrialized nations, the proportion is higher, reaching 90%. In the 21st century, researchers are only beginning to investigate the biological basis of ageing even in relatively simple and short-lived organisms, such as yeast . Little is known of mammalian ageing, in part due to
24786-400: The single-cell bacterium Escherichia coli , an organism that reproduces by morphologically symmetrical division. Evidence of aging has also been reported for the bacterium Caulobacter crescintus . and the single cell yeast Saccharomyces cerevisiae . Ageing and mortality of the individual organism became more evident with the evolution of eukaryotic sexual reproduction , which occurred with
24948-1010: The symptoms begin to interfere with daily activities, and will register a score on a mini–mental state examination (MMSE). MMSE scores are set at 24 to 30 for a normal cognitive rating and lower scores reflect severity of symptoms. The symptoms are dependent on the type of dementia. More complicated chores and tasks around the house or at work become more difficult. The person can usually still take care of themselves but may forget things like taking pills or doing laundry and may need prompting or reminders. The symptoms of early dementia usually include memory difficulty, but can also include some word-finding problems , and problems with executive functions of planning and organization. Managing finances may prove difficult. Other signs might be getting lost in new places, repeating things, and personality changes. In some types of dementia, such as dementia with Lewy bodies and frontotemporal dementia , personality changes and difficulty with organization and planning may be
25110-646: The symptoms of FTD (behavior, language and movement problems) co-occurring with amyotrophic lateral sclerosis (loss of motor neurons). Two FTD-related disorders are progressive supranuclear palsy (also classed as a Parkinson-plus syndrome), and corticobasal degeneration . These disorders are tau-associated. Huntington's disease is a neurodegenerative disease caused by mutations in a single gene HTT , that encodes for huntingtin protein. Symptoms include cognitive impairment and this usually declines further into dementia. The first main symptoms of Huntington's disease often include: HIV-associated dementia results as
25272-570: The traditional standard accent of (southern) England, Received Pronunciation (RP), has evolved a trap–bath split . Moreover, American accents preserve /h/ at the start of syllables, while perhaps a majority of the regional dialects of England participate in /h/ dropping , particularly in informal contexts. However, General American is also innovative in a number of its own ways: The process of coining new lexical items started as soon as English-speaking British-American colonists began borrowing names for unfamiliar flora, fauna, and topography from
25434-650: The underlying pathology of misfolded proteins, such as synucleinopathies and tauopathies . The coexistence of more than one type of dementia is known as mixed dementia . Many neurocognitive disorders may be caused by another medical condition or disorder, including brain tumours and subdural hematoma , endocrine disorders such as hypothyroidism and hypoglycemia , nutritional deficiencies including thiamine and niacin , infections, immune disorders, liver or kidney failure, metabolic disorders such as Kufs disease , some leukodystrophies , and neurological disorders such as epilepsy and multiple sclerosis . Some of
25596-417: The verb-and-preposition combination: stopover, lineup, tryout, spin-off, shootout , holdup, hideout, comeback, makeover , and many more. Some prepositional and phrasal verbs are in fact of American origin ( win out, hold up, back up/off/down/out, face up to and many others). Noun endings such as -ee (retiree), -ery (bakery), -ster (gangster) and -cian (beautician) are also particularly productive in
25758-775: The word corn , used in England to refer to wheat (or any cereal), came to denote the maize plant, the most important crop in the U.S. Most Mexican Spanish contributions came after the War of 1812 , with the opening of the West, like ranch (now a common house style ). Due to Mexican culinary influence, many Spanish words are incorporated in general use when talking about certain popular dishes: cilantro (instead of coriander), queso, tacos, quesadillas, enchiladas, tostadas, fajitas, burritos, and guacamole. These words usually lack an English equivalent and are found in popular restaurants. New forms of dwelling created new terms ( lot , waterfront) and types of homes like log cabin , adobe in
25920-721: The workplace and can also cost more in worker's compensation and pension liabilities. In most developed countries an older workforce is somewhat inevitable. In the United States for instance, the Bureau of Labor Statistics estimates that one in four American workers will be 55 or older by 2020. Among the most urgent concerns of older persons worldwide is income security. This poses challenges for governments with ageing populations to ensure investments in pension systems continues to provide economic independence and reduce poverty in old age. These challenges vary for developing and developed countries. UNFPA stated that, "Sustainability of these systems
26082-409: The young or old. Each nation, government, and non-governmental organization has different ways of classifying age. In other words, chronological ageing may be distinguished from "social ageing" (cultural age-expectations of how people should act as they grow older) and "biological ageing" (an organism's physical state as it ages). Ageism cost the United States $ 63 billion in one year according to
26244-469: Was written by Noah Webster in 1828, codifying several of these spellings. Differences in grammar are relatively minor, and do not normally affect mutual intelligibility; these include: typically a lack of differentiation between adjectives and adverbs, employing the equivalent adjectives as adverbs he ran quick / he ran quickly ; different use of some auxiliary verbs ; formal (rather than notional) agreement with collective nouns ; different preferences for
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