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Course Syllabus BIOLOGY OF HUMAN AGING Biology/Gerontology 355 M, W, F 2:30-3:30 M3, Winter 2020 Course Description: This course examines the mechanisms of the aging process with special reference to humans, though other organisms may be discussed. The course centers on the major physiological and anatomical changes that occur during aging at all levels of biological organization: organelle, cellular, tissue, organ, organ system and organism. The goal of the course will be to solidify biological concepts and theories that underlie the phenomena of human aging. Throughout the course special effort will be made to differentiate changes during normal healthy aging from late onset age-related deterioration caused by disuse, misuse or abuse and diseases that are associated with increased age (pathology).

Contact Information: Instructor:

Dr. Cheryl Duxbury Dept. of Biology, University of Waterloo Office: ESC 357F Ext. 36450 e-mail: [email protected]

Office Hours:

Tuesdays 2-3, Thursdays 3-4 or by appointment

Resources: Text:

None. Majority of testable material will be derived directly from my course notes. These will be compiled from several different sources

There is no ideal text for this course at a reasonable price. The optional ones we are using give a decent synopsis, and you should make the most of them. The lecture will cover topics that may not be covered in these texts, or add additional detail. Therefore it is important to attend lectures and take notes since you will be responsible for the lecture material whether it is covered in the optional text or not. Course website:

Here you will find course information, course notes for lectures in both ppt and pdf version, links to relevant websites, grades, announcements

Lecture notes:

Lecture slides are absolutely necessary for the successful completion of the course. It is highly recommended to bring the lecture notes to class and use them as a skeleton to add your own comments and information from lecture.

I strongly suggest that you attend the lectures. I frequently give hints regarding important concepts for exam questions. Also, you will get the opportunity to earn 2.5% bonus marks if you attend the lectures (see below). A student should devote at least 3 hours per week to reviewing lecture notes and learning material Student assessment:

Students’ understanding of lecture material will be assessed by one midterm (35% of final grade) and a final exam (65% of final grade). The exams will consist of short answer questions (written format) including definitions, matching, distinguish between type of questions) and some longer “thought” questions (compare, summarize and linking material type questions). Makeup midterm exam: Please read the information regarding missed exams in this syllabus. You are well advised to contact me the day of the exam if possible or definitely by the next day (within 24 hours) by phone or email if you are unable to attend an exam period due to illness. You need to submit a verification of illness (see information re missed exams) and arrange an alternate makeup date with me as soon as possible. You will be given an opportunity to write the missed midterm exam as long as you 1) have a legitimate VIF, 2) follow the directions above for submitting and notifying your illness to me and 3) arrange the alternate within a timely manner of the missed midterm. Note: filing documentation with the Science Undergrad office does NOT automatically excuse the missing of a test. The course instructor will consider the information provided on the VIF (see above) when deciding whether a student should be excused. Students should carefully consider the wisdom of missing a test or exam. A deferral means adding an extra test to a future, already full exam or midterm schedule. Course Marks:

Midterm Exam = 35% Friday, February 28th from 6:30-8:00 Rooms TBA -covers material up to and including Friday, February 14th Final Exam (cumulative) = 65% (TBA) (covers ALL material in the course)

The final exam will be somewhat cumulative meaning it will include all material in the course (i.e., cumulative), but more focus will be on post-midterm material. Both exams will cover material in the course slides and presentation in class. For those participating, clickers represent a “Participation” component of 2.5% up and beyond the weight of the midterm and final exam. This is a great opportunity to improve the overall course grade for a given student. The clicker marks will be accumulated throughout the term and then converted to a mark out of 2.5, which will be added to your final grade in the course. You will not be penalized for answering incorrectly. Clickers: Clickers will typically be used in class to assess progress in reviewing material, and to assess how well students have followed or comprehended lecture material. As described above, clickers are an optional participation component of the course. For each clicker session you will obtain ONE (1) mark for participation (being in class that day) and for EACH question asked you will obtain an additional mark for the correct answer. Incorrect clicker questions are not penalized in any way so relax and enjoy this additional level of learning engagement. So for example if there are two clicker questions in a lecture session you will receive ONE mark for participation and then if you get both questions correct you will receive TWO more marks for a total of 3 bonus marks. I

will total the number of points you obtain throughout the term and convert to a mark out of 2.5%. This % (no matter the value) will be added directly onto your final grade for the course! (so winwin situation!) Important: it is essential that students ensure that they register their clicker using the registration folder on LEARN (as soon as possible). If you don’t register the clicker will remain anonymous and a participation mark cannot be credited. So register your clicker! Only valid clicker marks will be used. If you forget your clicker, have not registered it by the first use, or have problems with the clicker during lecture then it will not be recorded even if you are in class. So don’t ask me to give you credit for the marks that were missed. Important: Students using multiple clickers in class is a breach of academic integrity (see be low) and approp riate conseque nces will apply if this is found to occur.

Verification of Illness Form (VIF) and Extenuating Circumstances If students experience an illness that notably interferes with their ability to complete assignments, attend required classes, labs and clinics or write tests, they are to notify the instructor before or within 24 hours of the course element and submit a completed Verification of Illness (VIF) form (issued on or covering the date of the exam) within 48 hours to the Science Undergrad Office (SUO). Exceptions may occur when students are very ill and/or hospitalized. This form is available from the Health Services web site (: https://uwaterloo.ca/campus-wellness/sites/ca.campuswellness/files/uploads/files/VIF-online.pdf). Faculty of Science Winter 2020 Students are to obtain their VIF from Health Services, when it is open - https://uwaterloo.ca/healthservices/about-health-services/hours. There are exceptions to requiring VIFs to come from Health Services: It is closed (weekend and after hours), it is fully booked, students are from out of town, or students are receiving ongoing care from a family physician or specialist. Grand River Hospital Emergency Department no longer provided medical documentation for student visits. VIFs are normally accepted only from physicians; depending on circumstances, statements from dentists and nurses are sometimes considered. For purposes of what constitutes a physician, the person must be registered with the College of Physicians and Surgeons of Ontario or equivalent provincial licensing body. VIFs will not be accepted from traditional medicine/holistic practitioners, acupuncturists, chiropractors, etc . Students must first submit a completed VIF form to the Science Undergraduate Office (STC 2031), where they are catalogued in a database and the instructors for missed course elements are informed by email that a VIF has been received. Students are given a stamped copy of the VIF that must be taken to your instructor; whereas the original is kept in the SUO. Instructors are welcome to view the original VIF. If your VIF is not submitted within 48 hours (if you are well enough to do so) or is not valid nor have you contacted the instructor within 24 hours a grade of zero (0) will be recorded for the missed exam. Student travel plans are not considered acceptable ground for granting an alternative examination time (see http://www.registrar.uwaterloo.ca/exams/finalexams.html). If you miss your final exam due to illness, you will get the opportunity to write the missed exam during the makeup exam period organized by the Science Undergraduate Office after I fill the INC form. I am the only one who can download the INC form and it must be submitted by me when we have agreed on a mutual day and time to write.

Verification of Illness Form (VIF) and Extenuating Circumstances: Summary

If you miss a term test you will receive a grade of zero (0). If the exam was missed due to illness or another valid, documentable reason, you may be granted accommodation (writing an alternate missed exam or transferred weight to final exam) through the following process:  Contact your instructor within 24 hours of the missed exam. Phone messages and emails can be received 24 hours per day.  If you are ill, have yourself examined by a physician at the University of Waterloo Health Services clinic. A UW Verification of Illness Form (VIF) is required for a missed exam completed by a UW Health Services physician that covers the exam date and is not retroactive (i.e. cannot have note completed after the date of the exam-again unless there are extenuating circumstances). VIFs from other clinics will not be accepted if Health Services is open. Note that instructors are under no obligation to accept your medical documentation, and they should not be viewed as a “get out of jail card”, if an instructor has reason to believe you were not actually ill, it can be rejected.  For absences not related to illness (e.g., a death in the family), consult the FAQ on the Science webpage for suggested documentation.  Bring your documentation to the Science Undergraduate Office (STC 2031) within 48 hours (again unless extenuating circumstances would prohibit this) from the exam date and complete their process. An automated Illness Certificate will be sent to your instructor by email. Ask them for a stamped verified photocopy of the VIF to take to your instructor.  Bring the stamped verified photocopy of the VIF to the instructor. If your VIF is not submitted within 48h (unless extenuating circumstances would prohibit) or is not valid a grade of zero (0) will be recorded for the missed exam. Students with disabilities The Accessibility Student Services (ASS), located in Needles Hall, Room 1401, collaborates with all academic departments to arrange appropriate accommodations for students with disabilities without compromising the academic integrity of the curriculum. If you require academic accommodations to lessen the impact of your disability, please register with the ASS at the beginning of each academic term.

Travel and the final examination period Student travel plans are not considered acceptable grounds for granting an alternative examination time (see http://www.registrar.uwaterloo.ca/exams/finalexams.html ). The final exam schedule is usually posted about 5 or 6 weeks into the term; start checking in the middle of February for the final exam date/time /place.

Expectation of Academic Integrity Academic Integrity: In order to maintain a culture of academic integrity, members of the University of Waterloo community are expected to promote honesty, trust, fairness, respect and responsibility.

Grievance: A student who believes that a decision affecting some aspect of his/her university life has been unfair or unreasonable may have grounds for initiating a grievance. Read Policy #70, Student Petitions and Grievances, Section 4. http://www.adm.uwaterloo.ca/infosec/Policies/policy70.htm

Discipline: A student is expected to know what constitutes academic integrity, to avoid committing academic offenses, and to take responsibility for his/her actions. A student who is unsure whether an action constitutes an offense, or who needs help in learning how to avoid offenses (e.g., plagiarism, cheating) or about “rules” for group work/collaboration should seek guidance from the course professor,

academic advisor, or the Undergraduate Associate Dean. For information on categories of offenses and types of penalties, students should refer to Policy #71, Student Discipline, http://www.adm.uwaterloo.ca/infosec/Policies/policy71.htm

Appeals: Concerning a decision made under Policy #70 (Student Petitions and Grievances) (other than petitions) or Policy #71 (Student Discipline) a student may appeal the finding, the penalty, or both. A student who believes he/she has a ground for an appeal should refer to Policy #72 (Student Appeals) http://www.adm.uwaterloo.ca/infosec/Policies/policy72.htm The Faculty of Arts has an excellent website on “Avoiding Academic Offences” – (http://arts.uwaterloo.ca/arts/ugrad/academic_responsibility.html). Refer students to this site as most of it is very applicable to Science students as well, regardless of the courses they are in.

Tentative Course Outline: The first part of the course will focus on molecular and cellular aspects of aging, and the second part will deal mostly with age-related changes and age-related dysfunctions in selected body systems.

Topic 1: Basic Concepts in the Biology of Aging (Introduction Material) 1.1: overview of the aging process, definitions, myths, common terms related to aging 1.2: intrinsic and extrinsic factors that play a role in aging process 1.3: types of aging: chronological vs. physiological age etc. 1.4: define aging from a physiological viewpoint (importance of homeostasis) 1.5: biological aging is distinct from the diseases of old age 1.6: the role of aging in disease (or role of disease in aging)

Topic 2: Aging by Numbers: Demographics of Aging 2.1: define life expectancy and life span 2.2: analysis of human life span (population trends) 2.3: factors that affect human longevity (survivorship)

Topic 3: Basic Cell Review of Structure and Function 3.1: review of the body’s organization as organs, tissues and cells

Topic 4: Theories of Aging: An overview 4.1: evolutionary theories of aging 4.2: genetic/environmental interactions in aging 4.3: molecular, cellular, and system level theories 4.4: programmed theories of aging vs. wear and tear theories 4.5: envision biological clocks as a concept

Topic 5: Cellular Aging 5.1: programmed theories:  cell cycle and Hayflicks Limit (Biological Clock Theory)  tissue cultured cells and replicative senescence  longevity genes and death genes  telomeres, apoptosis  diseases that mimic premature aging: the progerias 5.2: wear and tear theories  DNA repair, free radical damage (diet), lipofuscins, mitochondria  Cross-linkage theory of aging (AGE products, diabetes) 5.3: specific cellular changes that occur during aging 5.4: genetics of aging in various model systems (i.e. SIR2 pathway in S. Cerevisiae, DAF-2 receptor in C. elegans, insulin-like signaling pathways in M. musculus)

Systemic and Organism Aging -each system will start with a general introduction to the anatomy of the system to be discussed, and how this system works in a normal, young person. -this will be followed by any normal age-related changes that occur in that system, followed by age-related dysfunctions (disease related changes). Not necessarily in this order

Systems A. Skin:  

   

Anatomy of skin and Accessory Structures Age related changes to skin (hair, nails, glands (sebaceous and sweat)  Common skin conditions (Lentigo. Purpura, Angiomas, senile pruritus, Senile Keratosis, Sebjorrheic Keratosis, Herpes Zoster, Decubitus Ulcers (pressure sores)  Connective tissue and subcutaneous layer  Vitamin D production and effects with age  Sensory changes and burns  Immune changes in skin and infection (wound healing)  Body temperature regulation with age.  Cullulitis  Fingernail and toenail conditions Skin cancers (UV-B effects) (basal, Squamous and Malignant melanoma (causes, symptoms and treatments in elderly) Pharmacology (treatments for infections of nails skin etc) Treatments for pressure ulcers Treatments for skin cancers

B. Skeletal and Joints:   

Anatomy of bone and joints Age related changes to bone and cartilage  Effects of menopause on bone Age-related dysfunctions  Bursitis, Arthritis  Osteroarthritis, Rheumatoid arthritis, Gouty arthritis  Osteoporosis (type 1 and type 2)  Vertebral fractures, hip fractures  Falls in elderly (types of fractures)  Pagets disease  Ankylosing spondylitis  Cancer of the bone  Diagnostic tests and treatment a. DEXA scan b. Bone scan c. Blood tests d. RF e. Synovial fluid analysis  Pharmacology and treatments  Risk factors for osteoporosis

C. Muscular System:  

Anatomy of muscle (skeletal, smooth and cardiac) Organization of skeletal muscle

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Nerve-muscle interaction Age related changes to muscle Age related dysfunctions  Parkinson’s disease, Myasthenia gravis  Muscle cramps  Polymyositis  Polymyalgia rheumatica  Senile myosclerosis Exercise and aging, mobility and safety

D. Nervous System: Cells of nervous system Organization of NS (central and peripheral) Pathways (reflexes, sensory, motor etc) Brain and parts of brain Receptors, skin, smell, taste Age related changes  Nerves (motor, reflexes, autonomic)  brain and memory, thinking, vocabulary, personality  sleep (biorhythms)  effects of aging on neural plasticity  Age related dysfunctions  Decreased reflex  Declining autonomic  Insomnia, Depression, delirium  Dementia (learning, memory)  Alzheimers a. Vascular, Lewy body, frontotemporal  Multi-infarction dementia (stroke)  Parkinsons disease  Stroke (cerebrovascular accident)-move from CV  TIA’s, cerebral aneurysms  Seizures (epilepsy)  Peripheral neuropathy  Brain tumors  Herniated disc (here or in joints and cartilage)  Treatment options (pharmacologic) etc      

E. Special Senses (eye, ear and smell)   



Review of anatomy of each organ Age related change to each organ Age related dysfunction to eye  Presbyopia, Blindness, Glaucoma  Diabetic retinopathy  Cataracts  Macular degeneration  Detached retina Age related dysfunction to ear  Presbycusis, Tinnitus  Deafness (hearing aids), Dizziness and vertigo

F. Mouth and oral cavity (taste) 

Anatomy of mouth, tongue and teeth

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Age related changes to each Age related dysfunction  Edentulous (not teeth)  Periodontal disease  Caries (cavities)  Xerostomia (dry mouth)  Oral cancer and stomatitis (sores in mouth)

G. The Circulatory System:    

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Anatomy of Heart and blood vessels (arteries and veins) Blood and Lymph Age related changes to each Age related dysfunction  Atherosclerosis, Hypertension, Hypotension (blood pressure)  Hyperlipidemia, Aneurysms, Embolism  Varicose veins  Coronary Artery disease  Myocardial infarction (heart attach)  Angina pectoris, Cardiac arrhythmias  Congestive heart failure  Risk factors for each  Prevention and intervention  Valvular disorders  Peripheral vascular disease (arterial disease) Risk factors involved in each, treatments, medical intervention and drugs. Nonpharmacological treatments.

H. The Digesti...