Chapter 12 - Late Adulthood

Chapter 12 – Section 1

Cultural Beliefs about Late Adulthood

- Begins at about age 65

- Portrayal of late adulthood has often been bleak and grim

- Studies have shown in western countries that older adults often encounter ageism (prejudice

and discrimination based on age)

- Attitudes towards older adults is more negative than younger adults

- Other studies show that older adults experience being ignored or patronized

- Asian, African, & Latin American cultures the view of late adulthood is quite favourable

- Status is based in part on age: the older people become, the more authority and respect they

have

- In the West the depiction of adulthood is becoming more positive in some ways

- An analysis of American television advertisements containing older adults found that 78%

presented them in positive ways

Substages of late Adulthood

- young-old are persons aged 65-74

- Old-old are persons aged 75-84

- Oldest-old are aged 85+

- Declines in functioning are fairly mild in the first two age groups, but much steeper among the

oldest-old

- They are far more likely than the two younger groups to have difficulties performing activities

of daily living (ADLs) (bathing, dressing, food preparation and eating, housekeeping, and paying

bills)

- Gerontologists (researchers on aging) have proposed the concept of functional age to signify

the actual competence and performance of older adults

Global Aging Patterns: The Worldwide Boom in Older Adults

- Old Age Dependency Ratio (OADR) – in population, the ratio of persons age 65 an over to

persons age 20 – 64

- As populations decline due to fertility rates below 2.1, the number of persons in the work force

gradually falls while the number of persons in pension and health care programs gradually rises

as life expectancy increases

- Medical care for older adults is likely to become even more advanced in the decades to come

because vast sums of research funding are being spent on aging research

- Worldwide, at age 65, women have a longer life expectancy than men, usually by about 5 years

Physical Changes

- Primary Aging is the inevitable biological aging that takes place in all members of the human

species, as it takes place in all living organisms

- Secondary Aging is the decline in the physical functioning that takes place due to lifestyle

behaviours such as unhealthy diet, insufficient exercise, and substance use, as well as

environmental influences such as pollution

Changes in Appearance

- Skin continues to wrinkle and sag

- Bones continue to thin, especially In women, and thinning of the bones contributes to a stopped

posture

- Hair becomes thinner on head (it may sprout for the first time in unexpected places)

- Age spots appear (due to years of exposure to sun)

- Height slowly declines about 1 ½ inches for men and 2 inches for women after the age 60, due

to the loss of bone mass in the spinal column

- Teeth become yellower due to loss of enamel from their surface along with the accumulated

effects of food, tea, coffee, & tobacco

- Prior to recent advances of dentistry most people lost most or all of their teeth by late

adulthood

Changes in Senses

Vision

- Declines take place in late adulthood in the functioning of all main part of the visual system:

cornea, lens, retina, and optic nerve

- Older people develop cataracts (a progressive thickening of the lens causing vision to become

cloudy and distorted

Hearing

- Declines in the course of late adulthood for most people and by late seventies 75% most people

report loss of some hearing

- Some older persons have tinnitus (which involves hearing a ringing or buzzing sound with no

external source

- Sometimes hearing loss lead to social withdrawal, it is associated with loneliness and depression

Taste & Smell

- After age 60 the number of taste buds on the tongue declines , the cells in the smell receptor of

the nose diminish and the olfactory bulbs on the brain (process smell) start to shrivel

Changes in Sleep Patterns

- Increases substantially after the age of 60

- However the increase they take longer to fall asleep and wake up often during the night

- With age people come to prefer an earlier bedtime and an earlier wake up time (develop an

increasing preference for morningness over eveningness)

- Sleep Apnea occurs ( a sleep- related respiratory disorder)

- It is especially common among older adults who are obese or who drink alcohol heavily, and it is

substantially more common among men than among women

- Most common treatment is continuous positive airway pressure (CPAP)

Health in Late Adulthood

Chronic Health Problems

Arthritis

- Most common

- It is a disease of the joints that especially affects the hips, knees, neck, hands, and lower back

- No cure for arthritis

- Exercise can help relieve the symptoms of arthritis

Osteoporosis

- For women the decline in bone mass is steepest in the decade following menopause, the

process continues in late adulthood and the risk of osteoporosis continues to rise

- It places older women at higher risk for broken bones and subsequent mortality; about 15% of

women age 65 who experience a major bone fracture die within a year

Hypertension

- Known as high blood pressure

- Secondary aging also contributes to this

- No direct symptoms of hypertension

- However, over time it weakens the circulatory system by putting it under constant strain.

- The heart is forced to work harder, and the arteries develop areas of weakness and

inflammation

Health Care and Health Promotion

- There are medical interventions for nearly all these health problems that can eliminate or at

least reduce them

- Every developed country has a program that provides health care for adults over age 65

Health Effects of Diet

- Eating good diet is even more important in the late adulthood than at earlier ages because it

slows down primary aging and enhances the immune system at a time when risks of a variety of

illnesses and diseases increase

- A poor diet high in fats and sugars places people a risk for a wide range of illnesses and diseases,

with the risks increasing with age

Health Effects of Exercise

- In late adulthood it helps slow the effects of primary aging

- Improves motor coordination and the functioning of the cardiovascular and digestive systems

- Increases muscle and bone mass, and reduces the likelihood of bone fractures

- Lowers the risk of a variety of diseases, like cardiovascular disease, stroke, and osteoporosis,

and reduces the symptoms of diseases such as arthritis and diabetes

- Aerobic exercise such as walking at a rapid pace, jogging or pedaling , enhance the functioning

of the respiratory, cardiovascular, and digestive systems

- Participation in exercise decreases with age throughout adulthood and is lowest in late

adulthood

Automobile Driving in Late Adulthood

- Crashes are a major threat to older adults’ health in developed countries

- In the states, adults over age 75 have car fatality rates nearly as high as for 16 – 20 year-olds

What Not to Do: The Damage from Smoking and Heavy Drinking

- Causes lung cancer which the responsible for more deaths than any other cancer, also it is

among the cancer least susceptible to treatment and cure

- Rates of cigarette smoking is decreasing in developed countries

- A lifestyle that is healthy not only extends life span but it extends people’s active life span, the

number of years their physical functioning is favourable enough for them to enjoy their lives and

perform most of their daily activities without impairment

Chapter 12 – Section 2

Cognitive Changes and Decline

Changes in Attention and Memory

Attention

- Several types of attention decline, including selective, divided, and sustained attention

- Selective attention is the ability to tune out irrelevant information

- Divided attention is the ability to keep track of more than one information source

simultaneously

- Sustained attention is when people are required to concentrate on a task for an extended

period of time, also declines

Memory

- Relatively little decline in procedural memory which is the ability to perform tasks or activities

involving motor skills

- Semantic memory, involving the meaning of words and memory for factual information, also

shows a little decline with age

- Other memories show steeper declines in late adulthood. Working memory, which is the

memory for information currently the focus of your attention declines. So does long term

memory

- Research has shown substantial declines in episodic memory in late adulthood

- Research has also shown, autobiographical memory, shows that people tend to remember past

events in a way that maintains a positive self-image, recalling pleasant events.

- Events within the past decade are easier to recall simply because they are more recent, but the

age 10-30 period may be especially vivid because so many important life events take place

during those years for many people

- Source memory, which is the memory for where a piece of information was acquired declines

also

Brain Changes and Brain Diseases: Dementia & Alzheimer’s Disease

Changes in the Brain

- Brain actually shrinks and total brain mass declines

- The amount of space between brain and skull doubles from age 30 to 70, and spaces within the

brain enlarges as well

- Declines also take place in certain neurotransmitters, most notably acetylcholine (deals with

memory) and dopamine (influences movement and motor coordination)

Diagnosis of Alzheimer’s disease

- Risk rises for experiencing dementia (a condition that entails losses in cognitive functioning

severe enough to interfere with daily life

- Over 70 different kinds of dementia have been identified, but the most common type by far is

Alzheimer’s Disease

- Has to main features: one is that there is an accumulation in the brain of amyloid plaques, which

are deposits of the protein amyloid along with clumps id dead neurons. The other is the

development of neurofibrillary tangles, which are bundles of twisted fibres that appear within

the neurons

Factors Influencing Alzheimer’s

- Studies show that diet is an important factor in the development of Alzheimer’s disease

Treatment and Care for those with Alzheimer’s

- Most current medications seek to limit the loss of acetylcholine, the neurotransmitter that is

involved in memory and that declines sharply in people who have Alzheimer’s

Alternative Views of Cognitive Changes

Wisdom

- Old age is associated with wisdom in the lore of many cultures

- Baltes concluded that wisdom can be defined as “expertise in the conduct and meaning of life”

- Baltes model provides a beginning to investigating the nature of wisdom in relation to age – Are

the responses to hypothetical situations a valid measure of people’s wisdom?

- a related question is whether the wisdom of elders might be valued differently depending on

culture’s rate of social change

Responding to Cognitive Decline

- Some of the decline if cognitive functioning that takes place in late adulthood is due to primary

aging

- In developed countries most people have retired from work by the time they reach late

adulthood. This means that they do not receive the daily cognitive stimulation that is part of

performing most work tasks

Late-Life Learning

- It seems clear that in the some way regular physical exercise enhances physical functioning and

slows primary aging in late adulthood, regular mental exercise enhances mental abilities and

slows the cognitive decline that takes place with primary aging

Selective Optimization with Compensation

- Declines eventually takes place due to primary aging for both physical and cognitive abilities

- Selective optimization with compensation (SOC) – successful aging involves selecting valued

activities that can still be done well enough to be enjoyed, and dropping activities that have

become too strenuous

- By reducing the range of activities in this way, optimizing performance in the remaining

activities becomes more likely because all the person’s energy and attention can be focused on

them

Chapter 12 – Section 3

Emotional and Self-Development

- Numerous Studies have shown that late adulthood is a time of exceptionally favourable

emotional and self-development

Positive Emotions and Self Concept

- Late adulthood is more often a time of contentment and peace

- But depressive symptoms are lower, including periods of enduring sadness, guilt, and suicidal

thoughts

Theories on Emotions in Late Adulthood

- Erik Erikson’s theory proposes that late adulthood is time to reflect on one’s life and

socioemotional selectivity theory proposes that satisfaction with the life depends on limiting

one’s emotional and social contacts to those that are enjoyed the most

Erikson’s theory

- Ego integrity versus despair

- Ego integrity means looking back on one’s life and accepting the outcome of it – including the

choices that turned out well along with the mistakes and disappointments – and concluding that

overall it was a life well lived

- In contrast despair in late adulthood entails regrets and bitterness about the course of one’s life,

and a bitter conclusion that it has not gone well and now cannot be changes

- Bernice Neugarten’s term integrated personality, the person who accepts becoming older and

looks at the past, present, and future with contentment

- People who experience hearing or visual problems in late adulthood are also more likely to

report depressive symptoms

Socioemotional Selectivity Theory

- According to Carstenssen’s socioemotional selective theory – older adults maximize their

emotional well-being by becoming increasingly selective in their social contacts

- Rather than having a wide variety of social contacts, older adults prefer to withdraw from

relationships that are not emotionally rewarding and focus on the relationships that mean the

most to them

- One key reason for increasing socioemotional selectivity in late adulthood is that there are

changes in the goals people have for their relationships

- The goals are often knowledge-based

- Relationship goals become more emotion-based. Older adults seek to maintain and develop

relationships that are low in conflict and high in mutual enjoyment and drop the rest

The Social and Cultural Contexts of Late Adulthood

Family Relationships

Relations with Adult Children

- most people continue to have close relationships with their children

- in contrast, the dominant tradition in Western cultures is that parents and children live in

separate households once children reach adulthood

- by late adulthood, the direction of the obligation has reversed and children take care of their

parents

Relations with Grandchildren and Great-Grandchildren

- most people become grandparents for the first time in middle adulthood

- in developed countries, about half of adults over age 65 have at least one grandchild who is at

least 18 years old

Living Arrangements in Late Adulthood

- if older adults can neither love on their own nor with a child, there is a variety of other possible

living arrangements

- assisted living facilities have separate apartments for each person, but residents are provided

with meals in a common dining area, housekeeping services, transportation for shopping and

medical appointments, and social activities.

- Nursing homes provide all of these services as well as extensive medical care and most residents

are afflicted with dementia or other serious health problems

Love and Sexuality

Marriage, Widowhood, and Remarriage

- In general, marital satisfaction increases from middle adulthood to late adulthood and reaches

its highest point of the entire life span

- Older couples tend to have fewer major daily responsibilities that cause stress and inspire

conflict between marital partners, such as caring for young children and working in demanding

jobs

- Most people have retired or cut back on work by late adulthood, older couples have more time

to enjoy joint leisure activities that strengthen the marital bond

- Older couples are more likely to solve their disagreements calmly, without becoming angry

- Women are more likely to become widows than men

- Past age 85 about 80% of women are widows and only about one-third of men are widowers

- Grief in the aftermath of the spouse’s death may endure as depressive symptoms that last for

years afterwards

- Men take the loss of a spouse especially hard. They are more likely than women to become

depressed after a spouse dies, and they take more years to recover to previous levels of mental

health, especially if they don’t remarry

- Loneliness is common in the years following the death of a spouse, even after depression fades

- Rates of remarriage in late adulthood are relatively low

- Remarriages tend to be more successful in late adulthood than at earlier life stages

Sexuality I Late Adulthood

- Sexual activity in late adulthood depends not only on the availability of a partner but on physical

health

- There is also physical changes specific to sexuality in late adulthood

- In women, the decline in vaginal lubrication that began in middle adulthood continues into late

adulthood, making intercourse more painful and less pleasurable

- In men, testosterone levels decline by about 1/3 from the forties to the seventies, and one

consequences is that erections take longer to achieve and are more difficult to maintain

Work and Retirement

- Even as recently as a century ago, retirement was rare

- Today the median retirement age is 60-63 across developed countries, and life expectancies

range from the mid-seventies to the mid-eighties

The Decision to Retire

- Although most older adults welcome retirement and adjust well to it, about one-fourth have

adjustment problems of one kind or another

Working Part-Time

- Increasingly, retirement is not a single event where a person goes from working full-time to not

working at all, but rather a years-long process of gradually reducing work hours or moving from

full-time work to a series of part-time jobs punctuated by periods of not working

- Money is an obvious reason fro working beyond the traditional “retirement age,” but for most

older adults it is not the main reason

Life outside Work and Home: Leisure, Community, Religion, and Media Use

Leisure Activities

- People have a lot more time to devote to leisure activities. Sometimes people take up activities

they have never done before, such as painting

- Longer average retirement period than ever before, and because as a group they now have

more money than ever before

- Travel is one common form of leisure among older adults

- Exploritas sponsors “learning adventures” throughout the world, in which older adults travel to

an attractive location and enjoy the sights while also spending time on a college campus

learning more about the sights they are seeing

Community Service and Civic Engagement

- Some remain engaged in community and religious activities

- Religious organizations are the main setting fro volunteer work

- High rates of volunteering in late adulthood show how generativity extends into late adulthood

for many people

- Self-related health, lower rates of disability, lower risk of mortality

- Late adulthood is also a time of being highly involved in civic organizations of various kinds, from

book clubs to garden clubs to religious congregations to political action groups

- Civic activities includes voting, contributing to a political candidate, and writing a letter to local

newspaper

Religious Involvement

- Religious participation is the most common type of civic engagement for Americans in late

adulthood

- Attention tends to decline after age 80, for reasons of health and transportation, not wanting

beliefs

- Not only religious participation but a wide range of religious beliefs and practices are highest in

late adulthood

- Religiosity in late adulthood promotes self-esteem, life satisfaction, overall happiness, and a

sense of meaning

Media Use

- Older adults spend a lot of time on media because most of them have a lot of leisure time to

spend; they no longer have work, child care, or other daily responsibilities that demand their

time

- Television is by far the most-used media form in late adulthood. In fact, watching television is

the most frequently reported daily activity in late adulthood

- Television has been asserted to be a major force on globalization, and there is evidence that this

is as true among older adults as it is at younger ages

- The elders also believed that TV affected them through its influence on the young

- Their adult children, inspired by television to pursue a better lifestyle and more opportunities,

were migrating to the cities and leaving the elders to care for their grandchildren

- Another media is the internet, older adults are the least likely to use the internet of any age

group

- They can learn to use the internet in a variety of ways that enhance their health and their

quality of life.

- Medical practitioners in a variety of developed countries are now advocating e-health (the use

of the internet and electronic devices to enhance communication between health providers and

patients