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Chapter 17
Physical and Cognitive Development
in Late Adulthood

Demographics of Late Adulthood

4 million people in U.S. over 65 today (1 in 8); by 2050, the number will be 18 million (1 in 4)

Fastest growing segment of population is people who are 85 or over.

By 2050, number of adults worldwide over 60 will be more than the number under 15 for the first time in history.

Young old (65-74), old old (75-84), oldest old (85 and older).

Ageism: Confronting the Stereotypes of Late Adulthood

AGEISM, prejudice and discrimination directed at older people, is manifested in several ways.

Negative attitudes about older people, especially about competence & attractiveness.

People talk baby talk to persons in nursing homes.

Job discrimination

Identical behavior by an older person and a younger person is interpreted differently.

Ageism, cont.

Most negative views are based on reverence for youth and misinformation about older people.

Important to remember that the outcomes of aging vary widely from one person to the next. This period of life can bring as much positive change & growth as earlier life periods.

Physical Transitions in Older People

One of the most obvious outward signs of aging is the hair, which becomes thinner, and often turns gray or white.

The face and other parts of the body become wrinkled as the skin loses elasticity and collagen, the protein that forms the basic fibers of body tissue.

Negative stereotypes against appearing old exist for both men and women but are hardest on women, who are most likely to dye their hair or have plastic surgery.

OSTEOPOROSIS: a condition in which the bones become brittle, fragile, and thin, often brought about by a lack of calcium in the diet.

25 % of women over 60 have osteoporosis, largely because of decreased estrogen production.

Osteoporosis is the primary cause of broken bones and may cause people to shrink several inches.

Osteoporosis is largely preventable with sufficient calcium and exercise, and treatable to some extent with medication.

Internal Aging

Significant changes also occur in the internal functioning of the organ systems.

The brain becomes smaller and lighter with age.

There is a reduction of blood flow to the brain, due mostly to reduced capacity of the heart to pump blood.

The space between the skull and the brain doubles from age 20 to 70.

The number of neurons, or brain cells, declines in some parts of the brain, though not as much as was once thought.

Internal Aging, cont.

Because of hardening and shrinking of blood vessels, a 75-year-old's heart pumps less than three-quarters of the blood it pumped during early adulthood.

The efficiency of the respiratory system declines with age.

The digestive system produces less digestive juice and is less efficient in pushing food through the system.

Muscle fibers decrease in size & amount, and become less efficient in using oxygen & storing nutrients.

Slowing Reaction Time

Older adult's reaction time slows significantly.

Peripheral slowing hypothesis vs. generalized slowing hypothesis

It takes older individuals longer to respond.

Decision processes are slowed down.

Older people have more accidents (next slide).

Although it takes individuals longer to respond, the perception of time increases with age.

Time generally seems to rush by faster for older adults than younger ones.

The Senses: Sight, Sound, Taste & Smell

Vision

Lens becomes less transparent and the pupils shrink.

The optic nerve becomes less efficient.

Distant objects are seen less clearly.

More light is needed to see and it takes longer to adjust to a change from light to darkness and vice versa.

Driving at night becomes difficult.

Reading becomes more of a strain and eye strain occurs more easily.

Cataracts, cloudy or opaque areas of the lens of the eye that interfere with passing light, frequently develop.

Cataracts can be surgically removed.

Intraocular lens implants can replace old lens.

 

Glaucoma occurs when pressure in the fluid of the eye increases, either because the fluid cannot drain properly or because too much fluid is produced.

Glaucoma can be corrected with drugs or surgery.

The most common cause of blindness in people over the age of 60 is age-related macular degeneration (AMD) which affects the macula, a yellowish area of the eye located near the retina at which visual perception is most acute.

Sight, Sound, Taste & Smell in Late Adulthood, continued

Hearing

30 % of adults between 65 and 74 have some hearing loss.

50 % of adults between over 75 have hearing loss.

High frequencies are the hardest to hear, making it difficult to hear conversations when there is background noise.

 

Hearing aids would be helpful 75 percent of the time but only 20 percent of people wear them.

They are imperfect and amplify all sounds so it is difficult to discern conversations.

There is a stigma attached to wearing a hearing aid.

Because they cannot hear, some people withdraw from society because they feel left out and lonely.

Sight, Sound, Taste & Smell in Late Adulthood, continued

Taste and smell

Both senses become less discriminating in old age.

Taste buds on tongue decline in number.

Olfactory bulbs in the brain shrink and reduce the ability to smell.

People eat less and get poor nutrition.

Older people may oversalt their food and develop hypertension, or high blood pressure.

Health and Wellness in Late Adulthood

Contrary to popular opinion, most elderly people are in relatively good health for most of old age: ¾ of people 65 and older rate their health as good, very good, or excellent.

Most older people have at least one chronic, long-term condition.

 

Arthritis, an inflammation of one or more joints, is common, striking around half of older people.

Approximately one-third of older people have hypertension, or high blood pressure.

The leading causes (three-fourths of all deaths) of death in elderly people are: heart disease, cancer, and stroke.

Psychological & Mental Disorders

15 to 25 % of those over age 65 show some symptoms of psychological malady.

Depression is one of the more common problems for this age group.

Characterized by intense sadness, pessimism, and hopelessness.

May be a result of cumulative losses in life.

Declining health may contribute.

Some psychological problems such as anxiety may be caused by inappropriate drug doses.

 

The most common mental disorder of old people is DEMENTIA, a broad category covering several diseases, each of which includes serious memory loss accompanied by declines in other mental functioning.

Signs are declining memory, lessened intellectual abilities, and impaired judgment.

Less than 2 % of people between the ages of 60 and 65 have it; percentages double every 5 years after 65.

Half of those over 85 suffer from some sort of dementia, primarily Alzheimer’s.

 

The most common form of dementia is ALZHEIMER'S DISEASE, which is a progressive brain disorder that produces loss of memory and confusion.

An estimated 4.5 million Americans have Alzheimer's currently.

10% over 65, nearly 50% over 85.

If current trends continue, by the year 2050, the number could be 11 to 16 million Americans.

The symptoms of Alzheimer’s disease
appear gradually.

Unusual forgetfulness.

Trouble recalling particular words or names.

First recent memory goes, then older memories.

Decreased ability to carry out complex mental tasks.

Eventually, total confusion, inability to speak intelligibly or to recognize family and friends.

May be agitation, paranoia, hallucinations.

Toward the end, loss of muscle control and confinement to bed.

What causes Alzheimer’s?

Biologically, problems with production of beta amyloid precursor protein, a protein that helps the production & growth of neurons

Plaques (amyloid plaques that accumulate outside of cells & deposit in blood vessels of the brain) and tangles (neurofibrillary tangles, clumps of protein inside cells)

The brain shrinks, and several areas of the hippocampus and frontal and temporal lobes deteriorate, certain neurons die, and create a lack of acetylcholine.

 

No known triggers are understood to cause Alzheimer's, but it runs in families.

Genetics clearly play a role.

High blood pressure & diet may increase susceptibility.

Viruses, immune system dysfunction, hormone imbalances being investigated as possible explanations.

Several drug related to acetylcholine appear promising, but only helps about 50 percent of patients & only temporarily.

No drug treatment is totally effective.

Anti-inflammatory drugs promising.

Vitamin E and C are currently being investigated as effective at relieving symptoms.

 

70% live at home, with 75% of care being provided by family & friends.

Because all Alzheimer patients are eventually bedridden, most end their lives in nursing homes, & make up about 2/3 of nursing home patients.

People who care for Alzheimer’s often become secondary victims because of stress & overwhelming care demands.

Annual cost to U.S. society - $100 billion.

Wellness in Late Adulthood

People can do specific things to enhance their physical and psychological well-being and their longevity during old age.

Eat a proper diet.

16 % to 50 % of the elderly do not have adequate nutrition.

It is difficult to shop and cook for oneself.

Little motivation to eat when living alone.

Taste and smell deteriorate and eating is not as enjoyable.

 

Exercise.

Illness may prevent older people from exercising.

Poor health or nutrition may reduce energy.

Avoid threats to health, such as smoking.

Sexuality in Late Adulthood:
Use it or lose it.

Increasing evidence suggests that people are sexually active well into their 80s and 90s.

Good physical and mental health are necessary.

Previous sexual activity increases the desire for sex.

2/3 of married men and women over age 70 had sex with their spouses on average about once a week.

The percentage of people who view their partner as physically attractive increases with age.

There are potential difficulties related to sexual functioning.

It takes men longer to get an erection, and they have a longer refractory period (time following an orgasm during which men are unable to become aroused again).

Women's vaginas sometimes become thin and inelastic, and produce less lubrication.

Despite these physical changes, sexual activity can continue and flourish throughout the lifespan.

Studies: having sex regularly is associated with a lower risk of death.

Theories of Aging

There are 2 major approaches to explain why we age.

GENETIC PREPROGRAMMING THEORIES OF AGING suggest that our body's DNA genetic code contains a built-in time limit for the reproduction of human cells.

May be due to fact that genetic material has a "death gene" that is programmed to direct the body to deteriorate and die.

May be that genetic instructions for running the body can be read only a certain number of times before they become illegible.

 

WEAR-AND-TEAR THEORIES OF AGING argue that the mechanical functions of the body simply wear out with age.

Some subtheories say that the body's constant manufacture of energy to fuel its activities creates by-products, which eventually reach such high levels that they impair the body's normal functioning.

This is a more optimistic theory, which suggests that longevity can be extended by eliminating the toxins produced by the body.

Life Expectancy: How Long Have I Got?

LIFE EXPECTANCY, the average age of death for members of a populations, has been steadily increasing.

In 1776, the average life expectancy was 35.

In 1900, the average life expectancy was 47.

Now, the average life expectancy is 75.

By 2050, the average life expectancy is predicted to be 80.

Reasons for increases in life expectancy.

Health conditions are better.

Many diseases are wiped out or better controlled through medicine.

People's working conditions are better.

We are working on improving environmental conditions.

 

The maximum possible human life span is believed to hover around 120.

To extend the maximum life span would probably take genetic alterations.

Figures for life expectancy mask individual gender, race, and ethnic disparities.

The average Caucasian in the U.S. is likely to live 76 years.

The average African-American is likely to live 71 years.

The average Japanese is likely to live 79 years.

The average Gambian is likely to live less than 45 years.

 

A male born in the U.S. is most likely to live 73 years.

A female born in the U.S. is most likely to live 80 years.

Possible reasons women live longer:

Women's hormones (estrogen and progesterone) protect them from heart attacks.

Women may eat more healthy diets than men.

Women experience less stress in the workforce than men (?)

 

Cognitive Development in Late Adulthood

The idea that older people become less cognitively adept comes from misinterpretations of research evidence.

Cross sectional research does not take cohort effects into account (influences attributable to growing up in a particular time period/era).

Longitudinal studies suffer from practice effects and sample attributions.

Recent research (by Schaie) used cross-sequential methods, which combine cross-sectional and longitudinal methods.

Included 500 subjects (aged 20-70)

Tested every 7 years

More subjects added (to total 5,000)

Results show no uniform pattern of adult age-related changes across intellectual abilities.

Some abilities decline beginning at age 25 (fluid intelligence--ability to deal with new situations.)

Some stay steady or increase (crystallized intelligence--acquired store of information, skills, strategies).

There were some individual differences in the patterns of change…

For some, intellectual skills began to decline in the 30’s.

Others showed NO decline until the 70’s.

1/3 in their 70’s scored higher than the average young adult.

Why? Certain environmental and cultural factors are related to greater or lesser intellectual decline.

Environmental and cultural factors related to greater or lesser intellectual decline, continued.

Lesser declines:

Good health.

Higher SES.

Involvement in an intellectually stimulating environment.

A flexible personality.

Being married to a bright spouse.

Feeling satisfied with one’s accomplishments in earlier periods of late adulthood.

Schaie & Willis taught people whose reasoning and spatial skills had declined a variety of skills. More than half showed a significant improvement.

This plasticity (modifiability of behavior) suggests that there is nothing fixed about the changes that may occur in intellectual abilities during late adulthood ("use it or lose it").

Memory in Late Adulthood

Cross-cultural memory research shows that in societies where older people are held in high esteem, people are less likely to show memory losses than in societies where they are held in less regard.

Memory in Late Adulthood, continued

When memory declines that can be directly attributed to aging do occur, they are limited primarily to episodic memory.

Episodic memory relates to specific life experiences.

Other types of memory are mostly unaffected by age.

Semantic memories (general knowledge & facts).

Implicit memories (memories that people are not consciously aware of).

Memory in Late Adulthood, continued

The capacity for new memories does change during late adulthood.

Short-term memory loss is gradual until age 70, and then becomes more pronounced.

Information presented quickly and verbally is forgotten sooner.

New information is more difficult to recall, perhaps because it is not processed as efficiently.

Memory in Late Adulthood, continued

In late adulthood, people are subject to some of the same principals of recall as younger people.

In both groups, autobiographical memory (memories of information about one’s own life) frequently follows the Pollyanna Principle.

Pleasant memories are more likely to be recalled than unpleasant memories.

Memory in Late Adulthood, continued

People in all stages of adulthood also are more likely to recall things that fit with their current self-view.

Particular periods of life are remembered more easily than others for adults.

70-year olds recall their 20s and 30s best.

50-year olds recall their teenage years and 20s best.

Explanations of memory changes in late adulthood tend to fall into 3 main categories

Environmental Factors

Certain things that cause declines in memory may be more common among older people:

Drugs

Retirement

Lower motivation in testing situations

2) Information Processing Deficits

Inability to inhibit irrelevant information and thought declines.

Difficulty paying attention and organizing info.

Processing speed declines.

Less efficient memory retrieval.

 

Biological Factors

Brain and body deterioration.

Accelerated frontal lobe deterioration.

Continuation of education in late adulthood can improve cognitive skills.

Learning in Late Life: Never Too Late

Elderhostel is one of many educational opportunities for older adults.

Public colleges sometimes provide free tuition.

Retirement communities near college campuses provide educational opportunities.

Older adults can hold their own with younger students in college classes.