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Chapter 15

Physical and Cognitive Development in Late Adulthood

PowerPoints developed by Nicholas Greco IV, College of Lake County, Grayslake, IL

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Life Span and Life Expectancy

Life span -- maximum number of years an individual can live120–125 years; remains unchanged

Life expectancy -- number of years that the average person, born in a particular year, will probably livehas increased 31 years since 1900average U.S. life expectancy = 78 years

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Differences in Life Expectancy

International differences due to health conditions, medical care, etc.

Sex differences women outlive males an average of 5 yearsdue to health attitudes, habits, lifestyles,

occupationbiological factors -- females outlive males

across species

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Centenarians

Increasing numbers15,000 in 198055,000 in 2008

Genes play a role Also family history, health, exercise,

education, personality, and lifestyle

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Biological Theories of Aging

Evolutionary Theory of AgingNatural selection has not eliminated many

harmful conditions and nonadaptive characteristics in older adults

Natural selection is linked to reproductive fitness

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Biological Theories of Aging

Cellular Clock Theoryas we age, cells become less capable of

dividingtelomeres -- DNA sequences that cap

chromosomesas cells divide, telomeres become shorter and

eventually cells can no longer divide

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Biological Theories of Aging

Free Radical Theory -- people age because as cells metabolize energy, the by-products include unstable oxygen molecules known as free radicalsfree radicals damage DNAresulting damage can lead to range of

disorders such as cancer and arthritis

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Biological Theories of Aging

Hormonal Stress Theory -- aging in the body’s hormone system can lower resistance to stress and increase likelihood of diseaseprolonged elevation of stress-related

hormones associated with risk of chronic disease

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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

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Physical Development

Inevitable if we live to old ageWrinkles and age spotsLoss of height and weightSlower movementsExercise and appropriate weight lifting may

help to reduce the decrease in muscle mass and may improve motor functions

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Sensory Development

Visionvisual acuity, color vision, and depth

perception declinecataracts -- thickening of lensglaucoma -- optic nerve damaged by

pressure from fluid buildup macular degeneration -- deterioration of

retina

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Sensory Development

Hearingdegeneration of cochlea

Smell and tastemost older adults lose some ability to taste

and/or smell Touch and pain

Changes in touch are not problematicDecreased sensitivity to pain may mask injury

and illness

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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 diseaselungs lose elasticity, chest shrinks, and

diaphragm weakens

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Sexuality

Sexuality can be life-long Aging changes sexual performance,

especially in malesorgasm less frequenterectile dysfunctioneducation may help deal with these issues

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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 adulthoodApproximately three times as many poor as

non-poor older adults report that chronic disorders limit their activities

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Causes of Death in Older Adults

Nearly 60 percent of U.S. adults aged 65–74 die of cancer or cardiovascular disease

Cancer is now the leading cause of death In the 75–84 and 85-and-over age groups,

cardiovascular disease is still the leading cause of death

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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

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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

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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

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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

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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

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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

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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

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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

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Attention Selective attention -- focusing on a specific

aspect of experience that is relevant while ignoring others that are irrelevant

Divided attention -- concentrating on more than one activity at the same time

Sustained attention -- state of readiness to detect and respond to small changes occurring at random times in the environmentalso known as vigilance

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Memory

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

Semantic memory -- person’s knowledge about the worldfields of expertise; general academic

knowledge; everyday knowledge of words, places, and things

Both show declines in older adults

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Memory

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

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Memory Explicit memory -- memory of facts and

experiences that individuals consciously know and can statealso 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

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Wisdom

Wisdom -- expert knowledge about the practical aspects of life that permits excellent judgment about important matterspractical knowledgedevelopment of coping skills

High levels of wisdom are rare Factors other than age are critical for

wisdom to develop

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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

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Cognitive Neuroscience and Aging

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

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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

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Adjustment to Retirement

Best adjustment for those who arehealthyhave adequate incomeactiveeducatedhave an extended social networksatisfied with life before retirement

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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 supportInsomnia is a risk factor for depression in

older adults Depression is a treatable condition

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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

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Alzheimer’s Disease Alzheimer’s Disease -- a progressive,

irreversible brain disorder characterized by gradual deterioration of memory, reasoning, language, and eventually physical functionEarly- (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

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Causes of Alzheimer’s Disease

No certain scientific proof of causesAge is a risk factorGenetic links seem to existLifestyle factorsLack of exercise

Mild cognitive impairment represents a transitional state between the cognitive changes of normal aging and very early Alzheimer disease and dementias

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Estimated Risks for Developing Alzheimer Disease at Different Ages for

Women and Men

INSERT FIGURE 15.7 HERE

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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

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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