Chapter 15Physical and Cognitive Development in Late Adulthood
Longevity
Life span -- maximum number of years an individual can live
120–125 years; remains unchanged
Life expectancy -- number of years that the average person, born in a particular year, will probably live
has increased 31 years since 1900
average U.S. life expectancy = 78 years
Differences in Life Expectancy
International differences due to health conditions, medical care, etc.
Sex differences
women outlive males an average of 5 years
due to health attitudes, habits, lifestyles, occupation
biological factors -- females outlive males across species
Centenarians
Increasing numbers
15,000 in 1980
55,000 in 2008
Genes play a role
Also family history, health, exercise, education, personality, and lifestyle
Biological Theories of Aging
Evolutionary Theory of Aging
Natural selection has not eliminated many harmful conditions and nonadaptive characteristics in older adults
Natural selection is linked to reproductive fitness
Cellular Clock Theory
as we age, cells become less capable of dividing
telomeres -- DNA sequences that cap chromosomes
as cells divide, telomeres become shorter and eventually cells can no longer divide
Free Radical Theory -- people age because as cells metabolize energy, the by-products include unstable oxygen molecules known as free radicals
free radicals damage DNA
resulting damage can lead to range of disorders such as cancer and arthritis
Hormonal Stress Theory -- aging in the body’s hormone system can lower resistance to stress and increase likelihood of disease
prolonged elevation of stress-related hormones associated with risk of chronic disease
The Nun study
Sexuality
Sexuality can be life-long
Aging changes sexual performance, especially in males
orgasm less frequent
erectile dysfunction
education may help deal with these issues
Health Problems
As we age, probability of illness increases
Arthritis and hypertension are most common chronic disorders
Low income is strongly related to health problems in late adulthood
Approximately three times as many poor as non-poor older adults report that chronic disorders limit their activities
Causes of Death in Older Adults
Nearly 60 percent of U.S. adults aged 65–74 die of cancer or cardiovascular disease
In the 75–84 and 85-and-over age groups, cardiovascular disease is still the leading cause of death
Arthritis
Arthritis -- inflammation of the joints, accompanied by pain, stiffness, and movement problems
Incurable disorder that affects hips, knees, ankles, fingers, and vertebrae
Symptoms reduced by drugs, range-of-motion exercises, weight reduction, and joint replacement
Osteoporosis
Osteoporosis -- extensive loss of bone tissue
Women are especially vulnerable; it is the leading cause of broken bones in women
More common in non-Latina White, thin, and small-framed women
Related to deficiencies in calcium, vitamin D, estrogen, and lack of exercise
Accidents
Accidents are the sixth-leading cause of death among older adults
Falls are the leading cause of injury deaths in those 65 and older
Participation in an exercise class once a week for three years reduced the fall risk and the number of falling incidents
Exercise
Gerontologists recommend strength training in addition to aerobic activity for older adults
Weightlifting can preserve muscle mass
Exercise helps people maintain independence and prevents institutionalization
Increases longevity
Nutrition and Weight
Leaner adults live longer, healthier lives
Calorie restriction works to increase life span of animals but human connection is not specifically known
Health Treatment
Quality of health treatment for older adults needs improvement
Geriatric nurses can be helpful
Quality of nursing homes varies and costs are escalating
Concerns focus on patient’s medical care, right to privacy, access to medical information, safety and lifestyle freedom
Alternatives to Nursing Home Care
Home health care
Day-care centers
Preventive medicine clinics
Alternatives are potentially less expensive and less likely to depersonalize the patient
Patients perform better cognitively
Wisdom
Wisdom -- expert knowledge about the practical aspects of life that permits excellent judgment about important matters
practical knowledge
development of coping skills
High levels of wisdom are rare
Factors other than age are critical for wisdom to develop
Training Cognitive Skills
Training can improve the cognitive skills of many older adults
There is some loss of plasticity in late adulthood, especially in those older than 85 years
Cognitive vitality can be improved with training
Cognitive neuroscience -- field of study that links brain and cognitive functioning
Changes in brain can influence cognitive functioning, and changes in cognitive functioning can change brain
Lack of use of working memory may cause neural connections in prefrontal lobes to atrophy
Work
Older adults increasingly work part-time in retirement
Probability of employment also was positively correlated with educational attainment and being married to a working wife
Older workers have a lower rate of absenteeism, fewer accidents, and increased job satisfaction
Adjustment to Retirement
Best adjustment for those who are
healthy
have adequate income
active
educated
have an extended social network
satisfied with life before retirement
Depression
Major depression -- mood disorder in which the individual is deeply unhappy, demoralized, self-derogatory, and bored
Predictors of depression: earlier symptoms, poor health, death of a spouse, and low social support
Insomnia is a risk factor for depression in older adults
Depression is a treatable condition
Dementia
Dementia -- global term for any neurological disorder in which the primary symptoms involve a deterioration of mental functioning
Loss of ability to care for themselves and recognize familiar surroundings and people
Alzheimer’s Disease
Alzheimer’s Disease -- a progressive, irreversible brain disorder characterized by gradual deterioration of memory, reasoning, language, and eventually physical function
Early- (younger than 65) and late-onset (older than 65)
Formation of amyloid plaques -- deposits of protein accumulating in blood vessels
Neurofibrillary tangles -- twisted fibers that build up in neurons
Causes of Alzheimer’s Disease
No certain scientific proof of causes
Age is a risk factor
Genetic links seem to exist
Lifestyle factors
Lack of exercise
Mild cognitive impairment represents a transitional state between the cognitive changes of normal aging and very early Alzheimer disease and dementias
Care for Individuals with Alzheimer’s Disease
Family members and other care providers can become physically and emotionally drained
Need for respite care -- services that provide temporary relief to caregivers
Parkinson’s Disease
Parkinson’s disease -- a chronic, progressive disease characterized by muscle tremors, slowing of movement, and partial facial paralysis
Onset is triggered by degeneration of neurons that produce dopamine in the brain
Dopamine -- neurotransmitter necessary for normal brain functioning