Chapter 18

1. Chapter 18 Physical Development in Late Adulthood

2. “Each of us stands alone at the heart of the earth, pierced through by a ray of sunshine: And suddenly it is evening.” • Salvatore Quasimodo Italian Poet, 20th Century

3. Learning Goals • Discuss the biological aspects of longevity. • Describe how a person’s brain and body change in late adulthood. • Identify health problems in older adults and how they can be treated.

6. Life Expectancy and Life Span • Life span - the upper boundary of life, the maximum number of years an individual can live. • The maximum life span of human beings is approximately 120 years of age. • Life expectancy - the number of years that will probably be lived by the average individual born in a particular year. • The life expectancy of individuals born today in the U.S. is 77 years.

7. Variations in Life Span • Okinawa has the highest life expectancy today (81.2). • Afghanistan and Kenya have very low ones (47years). • Such differences are due to factors including health conditions and medical care. • In the U.S. a 7-year gap exists between life expectancy of Whites (77) and African Americans (70), but the gap is narrowing.

8. Centenarians • In 1980 there were only 15,000 centenarians in the U.S.; in 2000 there were 77,000. • It is projected that this number will increase to 834,000 in 2050. • Research reveals that many centenarians are quite healthy in their old age. • Centenarians are a robust group, as many have had difficult lives. • Such rapid growth in the older population will most likely lead to a variety of societal changes.

9. Sex Differences in Longevity • Today, life expectancy for females is 80, males 74. • Beginning at age 25, females outnumber males, and the gap continues to grow. • By the time adults are 75 years of age, more than 61% of the population is female. • These differences are due to health attitudes, habits, lifestyles, and occupation. • Biological factors play a role, too, as females outlive males in virtually all species.

10. The Young Old, the Old Old, and the Oldest Old • Late adulthood has the longest span of any period of human development—50-60 years. • Developmentalists thus distinguish between subperiods in this stage, although definite age boundaries are not yet agreed upon. • The young old are 65-74 years of age. • The old old are 75 years and older. • Some distinguish the oldest old as 85 years and older. • Many experts prefer to make the distinction based on functioning, rather than age.

11. The Oldest Old • The oldest old are much more likely to be female. • They have a much higher rate of morbidity and a greater incidence of disability than the young old. • They are much more likely to be living in institutions, less likely to be married, and more likely to have low educational attainment. • A substantial portion function effectively, and the majority continue to live in the community. • Forty percent say they have no activity limitation.

12. Biological Theories of Aging • Cellular Clock Theory • Free-Radical Theory • Hormonal Stress Theory

13. Cellular Clock Theory • Leonard Hayflick’s view that cells can divide a maximum of about 75-80 times and that, as we age, our cells become increasingly less capable of dividing. • Recent research has shown that telomeres are DNA sequences that cap chromosomes, and that each time a cell divides, telomeres become shorter and shorter. • Age-related telomere erosion has been found to be linked with an impaired ability to recover from stress and an increased rate of cancer formation.

14. Free-Radical Theory • States that people age because inside their cells normal metabolism produces unstable oxygen molecules known as free radicals. • These molecules ricochet around the cells, damaging DNA and other cellular structures. • This damage can lead to a range of disorders, including cancer and arthritis.

15. Hormonal Stress Theory • Aging in the body’s hormonal system may lower resilience to stress and increase likelihood of disease. • With age, hormones stimulated by stress that flow through the hypothalamic-pituitary-adrenal system remain elevated longer than when we were younger. • These prolonged, elevated levels of stress-related hormones are associated with increased risks for many diseases including heart disease and cancer.

17. McArthur Studies of Successful Aging • Studied women and men 70-79 years old • Physical performance did decline with age, but there was considerable individual variation • The physical performance of older adults in poor health from low-income backgrounds was less than that of their higher-income, health counterparts. • A majority of older adults maintained their physical performance over a 3-year period

18. The Aging Brain • General Slowdown in Central Nervous System Functioning • Decreased Brain Lateralization • Changes in Neurons • The Mankato Nuns • Preventing and Treating Brain Diseases

19. General Slowdown in Central Nervous System Functioning • A general slowdown of function characterizes the central nervous system, which begins in middle adulthood and increases in late adulthood. • This slowdown can affect physical coordination and intellectual performance. • After age 70, many adults no longer show a knee-jerk reflex and by age 90 most reflexes are virtually gone.

20. Decreased Brain Lateralization • The decrease in lateralization in older adults might play a compensatory role in the aging brain. • Both hemispheres may improve cognitive functioning of older adults. • Support for the decrease in differentiation is found in the higher intercorrelations of performance on cognitive tasks in older adults than in younger adults.

21. Changes in Neurons • Recent research has shown that adults continue to grow new brain cells throughout their lives. • Even in late adulthood, the brain has remarkable repair capability. • Growth of dendrites has been observed to continue through the 70s. • Brain activity of older and younger people were compared; it was observed that older brains literally rewired themselves to compensate for losses.

22. The Mankato Nuns • The nuns are the largest group of brain donors in the world. • Examination of the nuns’ donated brains, as well as others, has led neuroscientists to believe that the brain has a remarkable capacity to change and grow, even in old age.

23. Preventing and Treating Brain Disease • The more educated people are, the less likely they are to develop Alzheimer’s. • This probably occurs because intellectual activity develops surplus brain tissue that compensates for tissue damage by the disease. • Older individuals may recover better from strokes. • Even when areas of the brain are damaged by stroke, new message routes can be created to get around the blockage or to resume the area function.

24. Physical Appearance and Movement • The changes that take place in middle adulthood become more pronounced in late adulthood. • The changes are most noticeable in the form of facial wrinkles and age spots. • We get shorter when we get older. • Our weight usually drops after we are 60, most likely due to muscle loss, which causes us to look “saggy.”

27. Sensory Development • Vision • Hearing • Smell and Taste • Touch and Pain

28. Vision • Any decline in vision that began in early or middle adulthood becomes more pronounced. • Night driving is particularly difficult. • Dark adaptation is slower. • Visual field becomes smaller. • A recent study discovered that sensory acuity, especially in vision, was related to whether and how well elderly adults bathed and groomed themselves, completed chores, engaged in intellectual activities and watched TV.

29. Other Vision Problems • Cataracts • Glaucoma • Macular Degeneration

30. Hearing • Hearing impairment may begin in middle age, but doesn’t become an impediment until late adulthood. • Seventy-five percent of individuals aged 75-79 experience some type of hearing problem. • Fifteen percent of those over 65 is legally deaf. • This hearing loss is usually due to the degeneration of the cochlea, the primary neural receptor for hearing in the inner ear.

31. Smell and Taste • Most older adults lose some of their sense of smell, taste, or both. • Smell and taste losses often begin around 60 years of age. • Many older adults often prefer highly seasoned foods to compensate for their diminished senses. • This may lead to eating more nonnutritious, highly seasoned junk food.

32. Touch and Pain • Studies have shown that with aging, individuals could detect touch less in the lower extremities than in the upper extremities. • For most older adults, this decline is not a problem. • Older adults are less sensitive to pain and suffer from it less than younger adults. • This can be harmful if it masks injury and illness that need to be treated.

33. The Circulatory System • When heart disease is absent, the amount of blood pumped through the heart is the same regardless of an adult’s age. • Some experts argue that the healthy heart may even become stronger as we age through the adult years, with capacity increasing, not decreasing. • Illness, obesity, anxiety, stiffening of blood vessels, or lack of exercise may cause blood pressure to rise with age. • High blood pressure should be treated.

34. The Respiratory System • Lung capacity drops 40% between the ages of 20 and 80, even without disease. • Lungs lose elasticity, the chest shrinks, and the diaphragm weakens. • Diaphragm-strengthening exercises can improve lung functioning.

35. Sexuality • In a study of elderly people, almost 30% had participated in sexual activity in the past month. • In the absence of disease, sexuality can be lifelong, though aging does induce some changes. • Orgasm becomes less frequent in males, and more direct stimulation is needed for erection. • From 65-80, approximately 1 out of 4 men has serious problems getting/keeping erections. • When intercourse is impaired by infirmity, closeness and sensuality needs persist.

37. Health Problems • Causes of Death in Older Adults • Arthritis • Osteoporosis • Accidents

38. Health Problems • Lifestyle, social, and psychological factors are linked with health in older adults. • Engaging in physical activity had a protective effect on health in virtually every group of older adults assessed. • Emotional support was linked with better functionality in individuals with cardiovascular disease and self-efficacy was a protective factor for individuals with a history of cancer.

39. Causes of Death in Older Adults • Heart Disease • Cancer • Stroke • Pneumonia • Influenza • Diabetes

40. Arthritis • Inflammation of the joints accompanied by pain, stiffness, and movement problems. • Arthritis is especially common in older adults. • This disorder can affect hips, knees, ankles, fingers, and vertebrae. • There is no known cure for arthritis, but symptoms can be reduced by drugs, range-of-motion exercises, weight reduction, joint replacement, and in extreme cases, replacement of the crippled joint with a prosthesis.

41. Osteoporosis • An aging disorder involving extensive loss of bone tissue. • The main reason many older adults walk with a marked stoop. • Women are especially vulnerable to osteoporosis, the leading cause of broken bones in women. • Afflicts two-thirds of women over age 60. • Related to deficiencies in calcium, vitamin D, estrogen depletion, and lack of exercise.

42. Prevention and Treatment • Eat foods rich in calcium, get more exercise, and avoid smoking. • Estrogen replacement therapy may also be recommended for high-risk individuals, except those with a history of breast cancer. • Certain drugs can be used to reduce the risk. • Older women should also get bone density checks.

43. Accidents • The seventh leading cause of death for older adults. • Injuries resulting from a fall at home or during a traffic accident are common. • Each year, approximately 200,000 adults over the age of 65 fracture a hip in a fall. • Half of these adults die within 12 months, frequently from pneumonia. • One study showed an exercise program reduced the risk of falls in elderly adults.

44. The Robust Oldest Old • The oldest old are a heterogenous group, a diversity that is just now being recognized. • A large portion of the oldest old not only do not require personal assistance on a daily basis, but also are physically robust. • In one study, about three-fourths of the robust older adults had no hospitalizations and had fewer than six doctor visits in the previous 12 months. • The majority of the oldest old live in the community and remain independent.

45. Exercise • Older adults are healthier and happier the more active they are. • In a study of over 10,000 men and women, sedentary participants were more than twice as likely to die during the 8-year study as moderately fit participants. • Another study showed that starting a moderately vigorous sports activity from the 40s through the 80s was associated with a 23% lower risk of death. • Gerontologists recommend strength training too.

47. Nutrition and Weight • Evidence shows food restriction in lab animals can increase life span. • Animals fed restricted diets live as much as 40% longer than animals given unlimited food access. • Diet restrictions also delay biochemical alterations that contribute to poorer health and aging. • Leaner men live longer, healthier lives. • Current research is exploring the link between body mass index and longevity in women.

48. The Growing Vitamin and Aging Controversy • Research shows antioxidants—vitamin C, vitamin E, betacarotene—help slow the aging process and improve the health of older adults. • Antioxidants counteract the cell damage caused by free radicals. • No evidence shows antioxidants can increase the life span, but some experts believe they can reduce one’s risk of becoming frail and sick in later years. • Recent research has concluded that taking B vitamins is positively related to cognitive performance in older adults.

49. Health Treatment • Care Options • Giving Options for Control and Teaching Coping Skills • The Older Adult and Health-Care Providers