In this 2003 rock song, a man describes his life

extending from ages 15 to 100 as well as his

relationship with the woman he loves. At 15, he
feels he has all the time in the world to dream, but
as time passes by he becomes more aware of his
mortality. He realizes that 100 years isn't all that
much time after all.
https://youtu.be/tR-qQcNT_fY

FIVE FOR FIGHTING- 100 YEARS

PHENOMENON OF AGING
Demographic of Aging
• Longer lifespan
• Available health services

• Theories of Aging
A.Biologic Theories
B.Sociologic Theories
 Demographic of Aging
The demography of aging involves the
investigation of trends in, and
characteristics of, fertility, mortality,
and migration and how these
components of population change
influence, and are influenced by, the
physical and social environments in
which people live.
 Demographic of Aging

Population aging is the 21st century's dominant demographic phenomenon.

Declining fertility
increasing longevity,and
the progression of large-sized cohorts to the older ages (elder shares to rise
throughout the world)
Effect: changes in population needs and capacities, and
potentially significant implications for employment, savings, consumption,
economic growth, asset values, and fiscal balance.

SOURCE: D.E. Bloom, D.L. Luca, in Handbook of the Economics of Population Aging, 2016
 Demographic of Aging

Population aging has profound effects on the demand for long-term care. As life
expectancy increases, the overall value of health increases (Murphy and Topel,
2006)

Some elderly persons live relatively free from chronic illness (Manton et al.,
1997), but others can live for years with chronic illnesses that once proved fatal.
Medical devices improve mobility. The result is not only increased demand but
a wider range of needs.
 Demographic of Aging- transition how it
affects birth & death rates
high birth and low birth and
death rates DEMOGRAPHIC TRANSITION death rates

The reasons for this include improved sanitation and water supply, improved
nutrition, advances in medicine and infectious disease control, and education—
especially education of women.
Women not only acquire more education, but also they tend to marry later and
work more.

Italy & Japan - countries that go through the demographic transition end up with
lower birth and death rates.
 Demographic of Aging
Impact on the labor market
1) the number of people in the standard working ages (20–64) will fall
This is generally accepted as being a cause for concern because, all else equal,
a smaller pool of workers will have to support a larger number of dependents.

2) the proportion of older workers will rise

This is often thought to be a concern based on the assumption that older people
are less productive.

Source: Alan Barrett, in International Encyclopedia of the Social & Behavioral

Sciences (Second Edition), 2015
 DEMOGRAPHIC ISSUES
1. Utilization of Health Care Resources
© Older populations utilize health care
services at rates that are disproportionate
to their overall representation in the
population

© They are hospitalized more frequently,

suffer from more chronic diseases, and
use more medications
 DEMOGRAPHIC ISSUES
2. Other Demographic Issues
© Increasingly diverse ethnically,
racially and culturally

© Poverty is a significant consideration

 Aging Trends....the Philippines

The elderly are expected to comprise 7.7% of total

population in 2025.
The proportion of elderly is small due to the high fertility rate.
Life expectancy averages 63.5 years.
The aged dependency ratio will double from 5.5 elderly per
100 persons aged 15-64 years in 1990 to 10.5/100 in 2025.
Ratio of the population aged 65 and older to population aged 15–64

2005 2010 2015 2020

– Australia 24.1 26.2 30.5 35.3
– Canada 22.6 24.7 29.0 33.8
– Denmark 28.6 31.6 36.5 40.9
– France 37.0 38.9 45.5 51.4
– Germany 37.5 41.2 42.2 45.2
– Ireland 21.2 21.6 23.7 26.1
– Italy 44.3 46.7 50.7 54.5
– Japan 32.0 37.8 45.3 50.5
– Netherlands 25.3 27.6 32.1 35.3
– New Zealand 21.3 23.0 27.0 31.3
– Norway 26.6 27.5 30.6 33.8
– Spain 36.1 37.4 39.7 42.3
– Sweden 33.5 36.7 41.6 45.5
– US 20.9 22.2 25.1 29.1
– UK 29.5 31.2 35.5 38.8
Source: OECD (2006)OECD Factbook 2006: Economic Environmental and Social
Statistics. Paris: Organisation for Economic Co-operation and Development.
TOP 8 MOST PREVALENT CHRONIC CONDITIONS
AMONG OLDER ADULTS

• Arthritis
• Hypertension
• Heart Disease
• Respiratory Disease
• Diabetes Mellitus
• Cancer
• Cerebrovascular Disease
• Atherosclerosis
 TOP 10 LEADING CAUSES OF
HOSPITALIZATION AMONG OLDER ADULTS
• Heart Disease
• Cancer
• Cerebrovasular Disease
• Pneumonia
• Fractures
• Bronchitis
• Osteoarthritis
• Diabetes Mellitus
• Disease of the nervous system or sense organs
• Prostate Hyperplasia
 TOP 12 CAUSES OF DEATH AMONG OLDER ADULTS

1. Heart Disease
2. Cancer
3. Cerebrovascular Disease
4. Chronic Obstructive Pulmonary
Disease (COPD) and associated
conditions
5. Pneumonia and Influenza
6. Diabetes Mellitus
 Other characteristics of Elders
• Ethnicity
– Number of minority elders increasing
– Elder Hispanic fastest growing subpopulation

• Socioeconomic
– Women have longer life expectancy
– Men more likely to remarry
– Educational level gradually increasing
– Lower incomes
– Most live in community settings
– Poverty level more likely when living alone
• Health
– Chronic health problems and disabilities increase
– 73% rate health as good, very good, or excellent
– 20% report disability and most have chronic disease

Copyright 2008 by Pearson Education, Inc.

Impact of chronic illness to Philippine
society
A. Affect economic growth –
cost of treatment (ex. Philippines in 2015,
spent Php716M for direct medical
expenses alone)
B. May lead to poverty
- Lost of jobs and cost of chronic
treatment
 Facts and Figures
• Life expectancy in the Philippines (2016)
a. Males – 65.7 years
b. Females – 72.9 years
• NCDs represent 63% of annual deaths in the Philippines
(2017)
a. cardiovascular disease
b. cancer
c. chronic respiratory diseases
d. diabetes
Theories of Aging
 THEORIES

...make sense of phenomena

…provide order and perspective from
which we view facts
Perspectives from the 20th century

A.Biologic Theories
B.Sociologic
Theories
C.Psychologic
Theories
 BIOLOGIC THEORIES
• Genetic Theories
• Wear and Tear Theories
• Immunity Theories
• Cross-linkage Theories
• Free Radical Theory
• Neuroendocrine Theories
• Apoptosis
• Longevity and Senescence Theory
 Biologic Theories of Aging
1. Genetic theories/ Programmed Theory
– life expectancy is pre-programmed
(biologic clock)

- cells divide at limited number of times , then

they start to deteriorate

- Aging as a result of mutation of

somatic cells or alteration in DNA
repair mechanisms
2. Wear and Tear Theory
(use and destruction)
- The body is likened to a machine – can function
well during a period of time but will eventually
wear out
- Longevity can is influenced by the care it
receives and its genetic components
3. Immunity Theory
(Changes in the T- lymphocyte)
• Immunosenescence or immunodeficiency (fewer
defenses against foreign microorganisms)
• High susceptibility to cancer, infections, and autoimmune
diseases
4. Cross Linkage Theory
- a cross-linking agent attaches itself to a single DNA strand and
damages it
- Damage continues as increasing age weakens natural defense
mechanisms that normally repair the damage
- result: formation of collagen-type substances that lead to tissue
organ failure (e.g. atherosclerosis, skin changes)
5. Lipofuscin andFree Radical Theory
- free radicals damage cell membranes because they possess an
extra electric charge
- Normally the body as defense mechanisms (beta-
carotene,vitamins C and E) but protective mechanisms decrease
or free radicals increase with age
- Aging occurs with cumulative damage that interfere with function
- Lipofuscin - a pigmented waste material that is rich in lipids and
proteins whose discovery support the free-radical theory
- led to research on lipid perioxidation with many studies showing
an age-related increase oxidation in of lipids following stress
- Current research focus on developing interventions to modify or
prevent the age-related accumulation of free radicals
6. Neuroendocrine Theories
- changes in the brain and endocrine glands cause
aging
- neurotransmitter theory : proposes that an
imbalance of thought-transmitting chemicals in
the brain interferes with cell division throughout
the body
- numerous alterations of the endocrine system
may actually represent the mechanisms of age-
related changes in organ function
7. Apoptosis theory
(apoptotic program is dysregulated)
= precipitate disability and degeneration
8. Longevity and senescence theories

- Focus on why people live as long as they do

and how life is lived in a functional, productive
and satisfying way
- Adding quality, not just quantity
Observations by Alexander Leaf on three groups of
people who were both healthy and long-lived,
revealed the following significant influences
(1973a, 1973b, 1973c)
1. Genetic factors
2. Physical environment
3. Physical activity throughout life
4. Consumption of moderate amounts of alcohol
5. Sexual activity persisting into advanced years
6. Dietary factors (low animal fat intake)
7. Social environment (acquired status of wisdom and
dignity)
Kohn (1982)
- After doing postmortem studies of 200 people who died at 85
years and older, concluded that:
“had the same degree of disease occurred in middle aged people,
the condition would not have been fatal. Thus, aging itself was
thought to be the actual cause of death of the aged population”
 Conclusions from Biologic Theories
1. Biologic aging affects all living organisms
2. Biologic aging is natural, inevitable, irreversible and progressive with time
3. The course of aging varies from individual to individual
4. The rate of aging for different organs and tissues varies within individuals.
5. Biologic aging process are different from pathologic process
6. Biologic aging increases one’s vulnerability to disease
 Implications to the gerontologic nurse
1. Begin to understand the difference between age-related changes and risk
factors that affect their functional status
2. Concepts gleaned from specific theories guide the nurses plan of care
3. Place equal concern about improving the quality of life
4. Apply holistic approach to care
 Thinking points
Based on the biologic theories
learned, use your case study to
make a mental map of how aging
developed in your case study
participant.
 SOCIOLOGIC THEORIES
- Attempt to explain how society influences it’s old people
and how old people influence their society
- Currently address issues related to the tremendous
diversity of older adults in industrialized and developing
countries
 SOCIOLOGIC THEORIES
• Disengagement theory
• Activity Theory
• Continuity Theory
• Subculture Theory
• Age Stratification and Age Integration
Theory
• Person- Environment Fit Theory
 Sociologic Theories
1. Disengagement theory (Cumming
and Henry)
– Mutual withdrawal between elder
and elder’s environment
– Maintenance of social equilibrium
is achieved by a mutually
beneficial process of reciprocal
withdrawal between society and
older people

Copyright 2008 by Pearson Education, Inc.

2. Activity theory (Havighurst and Albrecht, 1953)
– Best way to age is to stay physically and mentally
active;
– Supposition: older people remain psychologically and
socially fit if they remain active
3. Continuity theory (Neugarten et.al,
1968)

– People maintain adult values,

habits, and behaviors as they age
– A person’s characteristic coping
strategies are in place long before
old age
– The best way to predict how a
person will adjust to being old is to
examine how that person adjusted
to changes throughout life.
4. Subculture Theory(Rose, 1960s)
- states that old people as a group, have their own norms,
expectations, beliefs and habits …therefore, they have
their own subculture
5. Age Stratification Theory
(Riley et. al, 1972)
– Society age in groups
that change and influence
each other showing
interdependence
6. Person- environment fit theory (Lawton)
- considers the relationship between
personal competencies and the
environment
- Person’s competencies change with aging
thus affecting the person’s ability to
interrelate with the environment.
Factors that collectively contribute to the
person’s functional ability:
a. Ego strength
b. Motor skills
c. Biologic health
d. Cognitive capacity
e. Sensory-perceptual capacity
• For each person’s level of competence, there is a level of
environmental press
• The more impaired the person is, the greater the impact
of the environment
 Relevance of Sociologic Theories to
Gerontological Nursing
1. View older adults in relation to their environment, yet sees each
person’s uniqueness.

2. With continuity theory, nurses can identify activity patterns and

coping mechanisms from the past and help them find ways that
contribute to self-fulfillment.
Relevance of Sociologic Theories to
Gerontological Nursing
3. Age integration theories – broadening
environments to include pets and
intergenerational activities
4. Person-environment fit theory
- appreciate of importance environmental
adaptations as interventions
- consider both environmental and psychosocial
factors
- interventions can be directed to improve
personal competency and decrease
environmental demands
Imagine that you are 84 years old and have
been retired for 15 years. Create an image
of yourself at that age , making sure that you
incorporate some changes that are likely to
occur as you grow older.

1. Identify the people who are part of your life

2. Identify the activities that you do in the
following areas: leisure, physical activity,
intellectual stimulation, emotional growth,
social interaction, spiritual nurturing
3. Will you be part of an organization (ex.
volunteer)
4. What would be your health and functioning
be and where will you be living?
Based on that image of yourself at 87 years old, answer the
following questions

ANSWER TWO (2) OF THE FOLLOWING

QUESTIONS:
1. How would you apply either the activity
theory or the disengagement theory to your
life at 84 as it compares to your life at
present?
2. *What aspects of your life at 84 years old
could be explained by the continuity theory?
3. *....concepts of the subculture, age
stratification or age integration theories?
4. *….person-environment fit theory?
 PSYCHOLOGIC THEORIES
• Address questions about the behavioral
and developmental aspects of later
adulthood
• Acknowledge psychological aging as
influenced by biologic and social factors
• Psychological aging involves use of
adaptive capacities for behavioral control
and self-regulation
Adaptive capacities include:
1. Learning memory
2. Feelings
3. Intelligence
4. Motivation
 Psychologic Theories
Erik Erikson (1963)
• Integrity VS Despair ( 65- death)
(-) Sense of loss, contempt for others

• The greater the task achievement, the

healthier the personality
• Failure influences the person’s ability to
achieve the next task.
• Failure to resolve the crisis is damaging to
the ego Copyright 2008 by Pearson Education, Inc.
ROBERT PECK (1968)
• Ego differentiation vs. work role preoccupation
- Occupational work is not the basis for self
definition and worth

• Body transcendence vs. body preoccupation

-The inner self- not the body is viewed as
the basis for satisfaction, happiness and
morale

• Ego transcendence vs. ego preoccupation

- Acceptance without undue fear and anxiety
of death; active involvement in a future
beyond morality
 (65-75 years)- Havighurst
• Adjusting to
– decreasing physical strength
– retirement
– lower and fixed income
– death of parents, spouses and friends
– new relationships with adult children
– leisure time
– slower physical and cognitive responses
• Keeping active and involved
• Making satisfying living arrangements
Copyright 2008 by Pearson Education, Inc.
 Additional Developmental Tasks
(75 years and older) - Havighurst
• Adjusting to
– living alone
– possibility of moving into a nursing home
– one’s own death

• Safeguarding physical and mental health

• Remaining in touch with other family
members
• Finding meaning in life
Copyright 2008 by Pearson Education, Inc.
Carl Jung (1960)

- personalities are either introvert or extrovert

- A balance of the two is essential for mental
health
- Younger years – tend to be extrovert
- 40 years above – tend to be introvert
• Successful aging is dependent on accepting one’s
diminishing capacity and increasing losses
• Later adulthood is a time where a person looks backward
rather than forward and is responsible for devoting
serious attention to self.
THANK YOU!!