Minnesota State University Moorhead



Chapter 15 Physical and Cognitive Development in Late Adulthood

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 Aging and Adaptive Brain

The brain loses volume and weight

Some areas of brain shrink more than others

As brain ages, it adapts

Lack of dendrite growth may be lack of stimulation and activity in brain

Using both hemispheres may improve cognitive functioning

Physical Development

Inevitable if we live to old age

Wrinkles and age spots

Loss of height and weight

Slower movements

Exercise and appropriate weight lifting may help to reduce the decrease in muscle mass and may improve motor functions

Sensory Development

Vision

visual acuity, color vision, and depth perception decline

cataracts -- thickening of lens

glaucoma -- optic nerve damaged by pressure from fluid buildup

macular degeneration -- deterioration of retina

Sensory Development

Hearing

degeneration of cochlea

Smell and taste

most older adults lose some ability to taste and/or smell

Touch and pain

Changes in touch are not problematic

Decreased sensitivity to pain may mask injury and illness

The Circulatory System and Lungs

Blood pressure consistently over 120/80 should be treated to reduce threat of heart attack, stroke, or kidney disease

Lung capacity drops 40 percent between 20 and 80 years even without disease

lungs lose elasticity, chest shrinks, and diaphragm weakens

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

Multidimensionality and Multidirectionality

Speed of processing information declines in late adulthood

Decline in speed is likely due to decline in functioning of brain and central nervous system

Health and exercise may be influencing factors

Memory

Episodic memory -- retention of information about the where and when of life’s happenings

Semantic memory -- person’s knowledge about the world

fields of expertise; general academic knowledge; everyday knowledge of words, places, and things

Both show declines in older adults

Working memory -- closely linked to short-term memory but emphasizes memory as a place for mental work

Perceptual speed -- amount of time it takes to perform simple perceptual-motor tasks

Decline in perceptual speed in older adults is linked to decline in working memory

Explicit memory -- memory of facts and experiences that individuals consciously know and can state

also known as declarative memory

Implicit memory -- memory without conscious recollection; it involves skills and routine procedures that are automatically performed

Implicit memory is less likely to be adversely affected by aging

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

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