Chapter 17 Late Adulthood: Physical and Cognitive Development

1. Chapter 17 Late Adulthood: Physical and Cognitive Development Development Across the Lifespan

2. Physical Development in Late Adulthood • There are more than 60, 000 people in the United States who are 100 or more years of age! • By the year 2020, there will be over 200,000 • The mean life expectancy of people in Western countries continues to rise • Old age used to be equated with loss: loss of brain cells, loss of intellectual capabilities, loss of energy, loss of sex drive. • This view is changing!

3. GERONTOLOGISTS, specialists who study aging,now see late adulthood as a period of considerable diversity in which people change--growth in some areas, decline in others. • Even the definition of “old” age is changing: • Functional ages are often considered in addition to chronological ages…

4. Functional Age Categories • Young old • Healthy & active • Old old • Some health problems & difficulties with daily activities • Oldest old • Frail & in need of care ~ Chronological age can sometimes predict which group a person is likely to fall into, but it is not a sure thing!

5. Aging: Myth & Reality • Because people are living longer, late adulthood is increasing in length. • Late adulthood is considered to begin at about 60, and ends at death. -- In 1900, only 6 % of the population was age 60 or older. -- By 1990, more than 17 % are 60 or older. -- The number of people over age 85 is projected to increase from 4 to 18 million by 2050! (see next slide)

6. The Flourishing Elderly Think about what factors are contributing to the rise in the population of those over 65.

7. The Demographics of Late Adulthood • Projections into the year 2050 estimate that almost 25 % of the population will be over 65. • The fastest growing segment of the population is what is termed the oldest old, people who are 85 or older. This group's size has nearly doubled in the last 20 years. • This trend is occurring in every developed country in the world.

8. The Elderly Population Worldwide

9. 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 and attractiveness. • Job discrimination • Identical behavior by an older person and a younger person is interpreted differently.

10. People talk baby talk to persons in nursing homes. • Most negative views are based on misinformation about older people (take the myths of aging quiz in your text)  Important to remember that the outcomes of aging vary widely from one person to the next! The autumn & winter of life can bring as much positive change & growth as in earlier life periods.

11. Physical Transitions in Older People: Outward Signs of Aging • Although the physical capabilities of elderly people are not the same as they were in earlier stages of life, many older people remain remarkably agile and physically fit in later life. • One of the most obvious outward signs of aging is the hair. • gray or white • thinner • 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

12. ~ People may shrink as much as 4 inches. • cartilage in backbone becomes thinner • women are most susceptible if they have 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. • Osteoporosis is the primary cause of broken bones. • Osteoporosis is largely preventable with sufficient calcium and exercise.

13. Negative stereotypes against appearing old exist for both men and women • Women, especially in Western cultures, suffer from the double standard for appearance, where women who show signs of aging are judged more harshly than are men. • Women are more likely to dye their hair. • Women are more likely to have plastic surgery.

14. 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. • 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.

15. Because of hardening of the arteries 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 (result = more constipation).

16. Changing Physical Capacities

17. Slowing Reaction Time ~ Older adult's reaction time slows significantly. • The PERIPHERAL SLOWING HYPOTHESIS suggests that overall processing speed declines in the peripheral nervous system (spinal cord and brain). • The GENERALIZED SLOWING HYPOTHESIS is the theory that processing in all parts of the nervous system, including the brain, is less efficient.

18. 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 reason may be changes in the way the brain coordinates it internal time clock (Mangan, 97)

19. Vehicle Fatalities Across the Life Span Drivers over age 70 have a fatal accident record comparable to teens. Why?

20. The Senses: Sight, Sound, Taste & Smell  Old age brings a distinct declining in the sense organs of the body. • Vision • Lens becomes less transparent and the pupils shrink. • The optic nerve becomes less efficient. • Distant objects become less acute. • More light is needed to see and it takes longer to adjust to a change from light to darkness and vice versa.

21. 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

22. 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. • It must be detected early enough. • 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.

23. ( 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.

24. 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.

25. ( Sight, Sound, Taste & Smell in Late Adulthood, continued) • Taste and smell • Both senses become less discriminating in old age. • Due to decline in taste buds on tongue. • 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

26. 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.

27. Common Physical Disorders in Late Adulthood… • 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

28. 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

29. 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. • 1/3 of those over 85 suffer from some sort of dementia

30. The most common form of dementia is ALZHEIMER'S DISEASE,which is a progressive brain disorder that produces loss of memory and confusion. • Alzheimer's kills 100,000 people a year. • If current trends continue, by the year 2040, almost 7 million Americans over 85 will be victims.

31. The symptoms of Alzheimer’s disease appear gradually. • Unusual forgetfulness. • Trouble recalling particular words during conversation. • First recent memory goes, then older memories. • Eventually, total confusion, inability to speak intelligibly or to recognize family and friends. • Toward the end, loss of muscle control and confinement to bed.

32. There is no cure for Alzheimer's. • Biologically, problems with protein production occurs. • The brain shrinks, and several areas of the hippocampus and frontal and temporal lobes deteriorate, certain neurons die, and create a lack of acetylcholine.

33. 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

34. No cure, but symptoms treated… • Several drug treatments appear promising: Tacrine, or Cognex, which are forms of acetylcholine • Only helps about 20 percent. • No drug treatment is totally effective. • Anti-inflammatory drugs promising • Vitamin E and C are currently being investigated as extremely effective at relieving symptoms

35. Because all Alzheimer patients are eventually bedridden, many end their lives in nursing homes • 2/3 of those in nursing homes! ~ People who care for Alzheimer’s often become secondary victims • Stress • Overwhelming care demands ~Therapy & support groups often help a great deal! ~See tips for caring for people with Alzheimer’s Disease in your text.

36. 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

37.  Exercise. • Illness may prevent older people from exercising. • Poor health or nutrition may reduce energy. • Avoid threats to health, such as smoking.

38. A recent study of 7000+ men aged 40-59 found that not smoking, keeping weight down, & exercising can reduce disease. To find your body mass index (BMI, used above), multiply your weight in pounds by 705. Divide the result by your height in inches, then divide by your height again.

39. ~~ Sometimes older people experience unique problems that keep them from following these guidelines… ~~> Getting enough exercise may be problematic --decreased muscle strength & flexibility --illness, weather, poor nutrition

40. ~~> 16-50% of the elderly do not have adequate nutrition ~~ Several million go hungry each day --too poor to buy healthy food --too sick to shop or cook for themselves --lower motivation since cooking for one --declines in earlier taste and smell sensitivity --lifelong patterns

41. 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 - "Use it or lose it." • 2/3 of 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…

42. More than 50% of Americans over age 45 find their partners attractive, and as time goes on, more attractive.

44. 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 (Purdy, 1995, Davey et al., 1997)

45. 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

46. 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.

47. 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. • In 1996, the average life expectancy is 74. • By 2050, the average life expectancy is predicted to be 80.

48. Living to Age 100 If life expectancy continues to increase, it may be common for people to live to be 100 by the end of this century. What implications does this have for society?

49. 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.

50. 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.