Gerontology

Gerontology is derived from two Greek words “geron” which means “old man” and

“logos” which means “discourse” or “study”. Gerontology is the study of the phenomenon of

old age. It is the study of the social psychological and biological aspects of ageing in an adult

person. Gerontology is distinguished from geriatrics which is the branch of medicine that

studies the diseases and care of the elderly person. The elderly adult deserves intensive

medical attention as he continues to grow old. The Oxford Minireference Dictionary defined

gerontology as the study of ageing. The new Websters Dictionary of English Language

(1994) edition, defines gerontology as a study of the phenomenon of old age. Also, the

encyclopedia on ageing (volume 2, 297-298) defined gerontology as the scientific study of

ageing and older population. As the adult advances in age, the need for gerontology becomes

necessary. Contemporary gerontology concerns itself with the ageing population.

Considering the above definitions and explanations, gerontology encompasses the following:

 Studying the physical, mental and social changes in people (adults) as they age.

 Investigating the ageing process itself (biogerontology).

 Investigating the interface of normal ageing and age-related diseases (geroscience).

 Investigating the effects of our ageing population on our society; including the fiscal

effects of pensions, entitlements, life and health insurance and retirement planning.

 Applying knowledge to policies and programmes; including a macroscopic

perspective i.e. (running a nursing home). These five scopes of gerontology can

simply be referred to as multidisciplinary. This is so because there are a number of

sub-fields in it, as well as psychology and sociology. The field of gerontology is

relatively a late developed field of study. This simply means it is a recent field of

study. This made it possible for it to lack structural and institutional support required.
 However, the huge increase in the elderly population in the post industrial western

nations made gerontology to become most rapidly growing field of study. Currently,

gerontology is a well paid field for many all over the world.

Branches of Gerontology:

The following are the branches of gerontology which are embedded in its scope

discussed above.

1. Biogerontology: This is a sub-field of gerontology that studies the biological process

of ageing. It is composed of the interdisciplinary research on biological ageing,

causes, effects and mechanisms in order to better understand human senescence.

Some biogerontologists like Leonard Hayflick, have worked to show that aging is a

biological process which we are far from controlling. They are also known as

conservative biogerontologists. They have predicted that the life expectancy figures

will peak at about the age of 85 (88 for females and 52 for males). Although this

figures are not static. They may continue to rise or decrease.

2. Biomedical gerontology: This is also known as experimental gerontology or life

extension. Life extension is a sub discipline of biogerontology that endeavours to

slow, prevent and even reverse ageing in both humans and animals by curing age-

related diseases and showing the underlying processes of ageing. Some

biogerontologists are at intermediate position, emphasizing the studying of the

ageing process as a means of mitigating ageing – associated diseases. They claim

that maximum life cannot be altered.

3. Medical gerontology: This branch of gerontology studies the biological causes and

effects of ageing, medical and biogerontology are considered by many scientists to

be the most important frontier in ageing research.

 4. Social gerontology: This is a multidisciplinary sub-field of gerontology that

specializes on studying and working with older adults. Social gerontologists are

responsible for educating, researching and advancing the broader causes of ageing in

older adults by giving informative presentations, publishing books and articles that

concerns the ageing population, producing relevant films and television programmes

and producing new graduates in colleges and universities.

The Difference Between Gerontology and Geriatrics

Gerontology is multidisciplinary and is concerned with physical, mental, and social

aspects and implications of aging. Geriatrics is a medical specialty focused on care and

treatment of older persons. Although gerontology and geriatrics have differing emphases,

they both have the goal of understanding aging so that people can maximize their functioning

and achieve a high quality of life.

Physical Changes That Come with Aging:

Physiological changes occur with aging in all organ systems. The cardiac output

decreases, blood pressure increases and arteriosclerosis develops. The lungs show impaired

gas exchange, a decrease in vital capacity and slower expiratory flow rates. The creatinine

clearance decreases with age although the serum creatinine level remains relatively constant

due to a proportionate age-related decrease in creatinine production. Functional changes,

largely related to altered motility patterns, occur in the gastrointestinal system with

senescence, and atrophic gastritis and altered hepatic drug metabolism are common in the

elderly. Progressive elevation of blood glucose occurs with age on a multifactorial basis and

osteoporosis is frequently seen due to a linear decline in bone mass after the fourth decade.

The epidermis of the skin atrophies with age and due to changes in collagen and elastin the
skin loses its tone and elasticity. Lean body mass declines with age and this is primarily due

to loss and atrophy of muscle cells. Degenerative changes occur in many joints and this,

combined with the loss of muscle mass, inhibits elderly patients' locomotion. These changes

with age have important practical implications for the clinical management of elderly

patients: metabolism is altered, changes in response to commonly used drugs make different

drug dosages necessary and there is need for rational preventive programs of diet and

exercise in an effort to delay or reverse some of these changes.

Emotional and social changes faced by elderly

Male or female, growing older means confronting the psychological issues that come

with entering the last phase of life. Young people moving into adulthood take on new roles

and responsibilities as their lives expand, but an opposite arc can be observed in old age.

Retirement the withdrawal from paid work at a certain age is a relatively recent idea. Up until

the late nineteenth century, people worked about sixty hours a week until they were

physically incapable of continuing. Following the American Civil War, veterans receiving

pensions were able to withdraw from the workforce, and the number of working older men

began declining. A second large decline in the number of working men began in the post-

World War II era, probably due to the availability of Social Security, and a third large decline

in the 1960s and 1970s was probably due to the social support offered by Medicare and the

increase in Social Security benefits (Munnell 2011).

In the twenty-first century, most people hope that at some point they will be able to

stop working and enjoy the fruits of their labor. But do we look forward to this time or fear

it? When people retire from familiar work routines, some easily seek new hobbies, interests,

and forms of recreation. Many find new groups and explore new activities, but others may
find it more difficult to adapt to new routines and loss of social roles, losing their sense of

self-worth in the process.

Each phase of life has challenges that come with the potential for fear. Erik H.

Erikson (1902–1994), in his view of socialization, broke the typical life span into eight

phases. Each phase presents a particular challenge that must be overcome. In the final stage,

old age, the challenge is to embrace integrity over despair. Some people are unable to

successfully overcome the challenge. They may have to confront regrets, such as being

disappointed in their children’s lives or perhaps their own. They may have to accept that they

will never reach certain career goals. Or they must come to terms with what their career

success has cost them, such as time with their family or declining personal health. Others,

however, are able to achieve a strong sense of integrity and are able to embrace the new

phase in life. When that happens, there is tremendous potential for creativity. They can learn

new skills, practice new activities, and peacefully prepare for the end of life. For some,

overcoming despair might entail remarriage after the death of a spouse. A study conducted by

Kate Davidson (2002) reviewed demographic data that asserted men were more likely to

remarry after the death of a spouse and suggested that widows (the surviving female spouse

of a deceased male partner) and widowers (the surviving male spouse of a deceased female

partner) experience their postmarital lives differently. Many surviving women enjoyed a new

sense of freedom, since they were living alone for the first time. On the other hand, for

surviving men, there was a greater sense of having lost something, because they were now

deprived of a constant source of care as well as the focus of their emotional life.

Emotion regulation skills appear to increase during adulthood. Older adults report

fewer negative emotions as well as more emotional stability and well-being than younger

people. Older adults may also be savvier at navigating interpersonal disagreements than

younger people. They may pay more attention to the good and less attention to the bad and
when they experience a negative emotion, they may be able to recover more quickly than

younger people. Thus, at first glance, there seems to be an emotional “mellowing out” with

maturity and an increased and potentially deliberate ability to see the world through rose-

colored glasses. Given these data, it is interesting to learn that older adults may react with

stronger emotions than younger people in some situations.

Indeed, bad events may hit older adults harder than younger ones. In studies in which

researchers try to create a negative mood in their participants, older adults can react with

stronger emotions than younger people. This is particularly true if the investigators use

negative stimuli that are relevant to older adults, such as stimuli about loss or injustice. In

most researches, we find that older adults react to films about loss with greater negativity

than younger adults.

A recent study by Streubel and Kunzmann (2011) suggests that emotional arousal is a

factor that needs more attention in aging research. That is, a focus on positive and negative

emotions and aging may be too limited; rather a focus on the strength of emotions also is

needed. In circumstances in which strong emotions are aroused, older adults may not be able

to regulate their emotions as well as younger people. Indeed, where we see older adults

reacting with stronger negative emotions than younger ones, the films are very powerful and

highly relevant to older people.

Changes in emotions with age are complex. Older adulthood is not simply a time of

emotional well-being and tranquility. Strong emotions exist and reactions to important life

events may increase with age, rather than diminish. More research along these lines is needed

for practitioners to learn how to help older adults navigate emotionally powerful events in

their lives.
 In developing countries, as compared to developed countries, gerontology has drawn

comparatively lesser attention. This is because the increased life expectancy of elderly

resulting in a demographic transition which developing countries are witnessing today has

already been faced by developed countries, several decades back. However, in recent years

with a rising percentage of elderly population, epidemiologists, researchers, demographers

and clinicians have focused their attention towards elderly care health issues and various

problems associated with ageing and numerous implications of this demographic transition.

Elderly face various problems and require a multi-sectoral approach involving inputs from

various disciplines of health, psychology, nutrition, sociology and social sciences.

Theories

Disengagement theory (sociological theory)

Disengagement theory was formulated by Cumming and Henry in 1961. States that it

is both normal and inevitable for people to decrease their activity and seek more passive roles

as they age. Disengagement is a mutual withdrawal of the elderly from society and society

from the elderly. The exact time and form of disengagement varies from individual to

individual. The process involves loosening social ties through lessened social interaction.

Knowing that the time preceding death is foreshortened, feeling that the life experience is

narrowing, and sensing a loss of self esteem all signal the onset of disengagement.

Ultimately, society’s need for persons with new energy and skills rather than the wishes of

the older individual, dictates when disengagement occurs. In other words, as people approach

their 70s, they become gradually disengaged from society owing to their declining energy and

their desire for role loss. After an initial period of anxiety and depression, they accept their

new status as disengaged and regain a sense of tranquility and self worth.
Activity theory of aging (sociological theory)

The theory was developed by Robert J. Havighurst in 1961. The theory essentially

asserts a positive relationship between the aged individual's level of participation in social

activity and his/her life satisfaction. This assertion stems from the assumption that the

individual's role, requirements or demands upon self and society remain fairly stable as he

passes from middle to old age except for the inevitable changes in biology and in health,

older people are the same as middle aged with essentially the same psychological and social

needs. There is consequently a natural tendency for the aged individual to seek associations

with others and to participate in group and community affairs, although these tendencies or

needs are often blocked by social norms such as enforced retirement or by physiological

decline This constriction of self enhancing roles, interests and activities produces a crisis in

self evaluation for the individual. The probability that he will develop a negative image of the

self and feel alienated from his environment The Theory proposes that

successful ageing occurs when older adults stay active and maintain social interactions. It

takes the view that the aging process is delayed and the quality of life is enhanced when old

people remain socially active.

Continuity theory (sociological theory)

The continuity theory was formerly proposed in 1971 by Robert Atchley. Continuity

theory maintains that older adults have the ability to adapt positively to change because they

have built up a reservoir of knowledge based on past experiences. Consider the normative

physical decline that accompanies aging; vision and hearing become less acute, the skin

wrinkles, bone density drops and the metabolism slows. As the body naturally loses strength,

vigor and suppleness, the mind gains foresight and wisdom. The theory in short states that

older adults will usually maintain the same activities, behaviors and relationships as they did
in their earlier years of life and older adults try to maintain this continuity of lifestyle by

adapting strategies that are connected to their past experiences. Continuity theory maintains

that human thought and behavior are in continuous evolution. Adaptive change is an example

of positive aging. Social forces within the environment are inseparable throughout the life

course and can reinforce the individual’s personality traits. Continuity is therefore

exemplified in instances where an individual’s attitudes and reactions in old age substantially

reflect the attitudes and reactions of his or her earlier years.

Wear and tear theory (biological theory)

It was first proposed scientifically by German biologist Dr. August Weismann in

1882. The wear and tear theory of aging may also be referred to as simple deterioration

theory or fundamental limitation theory. The theory asserts that the effects of aging are

caused by progressive damage to cells and body systems over time. Essentially, our bodies

"wear out" due to use. Once they wear out, they can no longer function correctly. Cells are

unable to repair damaged DNA. Cells in heart, brain and neurons cannot replace themselves

after they are destroyed by wear and tear.

Common elderly health issues

Getting older can seem daunting, greying hair, wrinkles, forgetting where you parked

the car. All jokes aside, aging can bring about unique health issues. With seniors accounting

for 12 percent of the world’s population¬–and rapidly increasing to over 22 percent by 2050–

it’s important to understand the challenges faced by people as they age and recognize that

there are preventive measures that can place yourself (or a loved one) on a path to healthy

aging.

 Chronic health conditions

 According to the National Council on Aging, about 92 percent of seniors have

at least one chronic disease and 77 percent have at least two. Heart disease, stroke,

cancer, and diabetes are among the most common and costly chronic health

conditions causing two-thirds of deaths each year. The National Center for Chronic

Disease Prevention and Health Promotion recommends meeting with a physician for

an annual checkup, maintaining a healthy diet and keeping an exercise routine to help

manage or prevent chronic diseases. Obesity is a growing problem among older adults

and engaging in these lifestyle behaviors can help reduce obesity and associated

chronic conditions.

 Cognitive health

Cognitive health is focused on a person’s ability to think, learn and remember.

The most common cognitive health issue facing the elderly is dementia, the loss of

those cognitive functions. Approximately 47.5 million people worldwide have

dementia—a number that is predicted to nearly triple in size by 2050. The most

common form of dementia is Alzheimer’s disease with as many as five million people

over the age of 65 suffering from the disease in the United States. According to the

National Institute on Aging, other chronic health conditions and diseases increase the

risk of developing dementia, such as substance abuse, diabetes, hypertension,

depression, HIV and smoking. While there are no cures for dementia, physicians can

prescribe a treatment plan and medications to manage the disease.

 Mental health

According to the World Health Organization, over 15 percent of adults over

the age of 60 suffer from a mental disorder. A common mental disorder among

seniors is depression, occurring in seven percent of the elderly population.

Unfortunately, this mental disorder is often underdiagnosed and undertreated. Older

 adults account for over 18 percent of suicides deaths in the United States. Because

depression can be a side effect of chronic health conditions, managing those

conditions help. Additionally, promoting a lifestyle of healthy living such as

betterment of living conditions and social support from family, friends or support

groups can help treat depression.

 Physical injury

Every 15 seconds, an older adult is admitted to the emergency room for a fall.

A senior dies from falling every 29 minutes, making it the leading cause of injury

among the elderly. Because aging causes bones to shrink and muscle to lose strength

and flexibility, seniors are more susceptible to losing their balance, bruising and

fracturing a bone. Two diseases that contribute to frailty are osteoporosis and

osteoarthritis. However, falls are not inevitable. In many cases, they can be prevented

through education, increased physical activity and practical modifications within the

home.

 Sensory impairments

Sensory impairments, such as vision and hearing, are extremely common for

older Americans over the age of 70. According to the CDC, one out of six older adults

has a visual impairment and one out of four has a hearing impairment. Luckily, both

of these issues are easily treatable by aids such as glasses or hearing aids. New

technologies are enhancing assessment of hearing loss and wearability of hearing aids.

 Bladder control and constipation

Incontinence and constipation are both common with aging, and can impact

older adults quality of life. In addition to age-related changes, these may be a side

effect of previous issues mentioned above, such as not eating a well-balanced diet and

suffering from chronic health conditions. The Mayo Clinic suggests maintaining a
 healthy weight, eating a healthy diet and exercising regularly to avoid these elderly

health issues. There are often effective medical treatments, and older adults should not

be embarrassed to discuss with their physicians.

Death

Death is marked by the end of blood circulation, the end of oxygen transport to organs

and tissues, the end of brain function, and overall organ failure. The diagnosis of death can

occur legally after breathing and the heartbeat have stopped and when the pupils are

unresponsive to light. The two major causes of death in the United States are heart disease

and cancer. Other causes of death include stroke, accidents, infectious diseases, murder, and

suicide. While most of these phenomena are understood, the concept of stroke may be

unclear. A stroke occurs when blood supply to part of the brain is impaired or stopped,

severely diminishing some neurological function. Some cases of dementia result from several

small strokes that may not have been detected.

Some people seek to thwart aging and death through technologies such as the

transplantation of organs, cosmetic surgery, and cryopreservation (deep-freezing) of the

recently deceased in the hope that a future society will have found the means to revitalize the

body and sustain life.

Consultation on Global Strategy and Action Plan on Ageing and Health

 Commitment to Healthy Ageing. Requires awareness of the value of Healthy Ageing

and sustained commitment and action to formulate evidence based policies that

strengthen the abilities of older persons.

 Aligning health systems with the needs of older populations. Health systems need to

be better organized around older people’s needs and preferences, designed to enhance

older people intrinsic capacity, and integrated across settings and care providers.
 Actions in this area are closely aligned with other work across the Organization to

strengthen universal health care and people-centred and integrated health services.

 Developing systems for providing long-term care. Systems of long-term care are

needed in all countries to meet the needs of older people. This requires developing,

sometimes from nothing, governance systems, infrastructure and workforce capacity.

WHO’s work on long-term care (including palliative care) aligns closely with efforts

to enhance universal health coverage, address non-communicable diseases, and

develop people-centred and integrated health services.

 Creating age-friendly environments. This will require actions to combat ageism,

enable autonomy and support Healthy Ageing in all policies and at all levels of

government. These activities build on and complement WHO’s work during the past

decade to develop age-friendly cities and communities including the development of

the Global Network of Age Friendly Cities and Communities and an interactive

information sharing platform Age-friendly World.

 Improving measurement, monitoring and understanding. Focused research, new

metrics and analytical methods are needed for a wide range of ageing issues. This

work builds on the extensive work WHO has done in improving health statistics and

information, for example through the WHO Study on global aging and adult health.