THEORIES IN AGING
 There is no universally accepted definition of aging.
 Aging is best looked at as a series of changes that occur
over time, contribute to loss of function, and ultimately
result in the death of a living organism.
 Like any other organism, human beings age and die.
 The maximum life expectancy of human beings today
appears to be 120 years. Theories of aging have been
considered throughout history, as mankind has sought to
find ways to avoid aging.
 The quest for the ‘fountain of youth’ has motivated
explorers. The search for the extension of youth has led
some people to seek the potions of conjurers which are
often more poisonous than beneficial.
 No one has identified a single unified rationale for why
we age, and why different people live lives of different
lengths. Theories are bound to help explain and give
some logical order to our observations. Observations,
which provide physical and behavioral data, are
collected, and studied to scientifically prove or disprove
their effects on aging.
 Studies of families and identical twins show that there is
a strong correlation in the life expectancies of genetically
related people. Thus, if your grandparents and parents
lived up to 60, 70, 80 or 90 years old, then you are likely
to have a similar lifespan. However, this is not always
the case. Some individuals fail to meet genetic
expectations, while other significantly exceed these
expectations. Biologic and environmental factors are
being studied to these variations.
 Although there is no question that aging is a biologic
process, sociologic and psychological components play
a significant role. All o these areas (genetic, biologic,
environmental and psychosocial) have produced theories
that attempt to explain the changes seen with aging.
 Despite extensive interests in this topic, the specific
causes and processes involved in aging are not
completely understood because we do not have
definitive and reproducible evidence indicating exactly
why we age.
BIOLOGICAL THEORIES IN AGING
 Biologic theories of aging attempt to explain the physical
changes of aging.
 Researchers try to identify which biological factors have
the greatest influence on longevity.
 It is known that all members of a species suffer a gradual,
progressive loss of function overtime because of their
biologic structure. Many of the biologic theories of aging
overlap because most assume that the changes that
caused aging occurs at a cellular level.
 Each theory attempts to describe the processes of aging
by examining various changes in cell structures or
function.
 Some biologic theories looked at aging from a genetic
perspective.
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permission of your instructor.
 The Programmed Theory
o It proposes that everyone has a “biologic clock”
that starts ticking at conception.
o In this theory, everyone has a genetic program
specifying an unknown but predetermined
number of cell divisions. As the program plays
out, the person experiences predictable changes
– such as atrophy of the thymus, menopause,
skin changes and graying of the hair.
 The Runout-of Program Theory
o This theory proposes tat every person has a
limited amount of genetic material that will run
out eventually.
 The Rate of Living Theory
o This theory proposes that individuals have a
finite number of breaths or heartbeats that are
used up over time.
 The Gene Theory
o This theory proposes the existence of one or
more harmful genes that activate over time,
resulting in the typical changes seen with aging,
and limiting the life span of the individual.
 The Molecular Theory
o This theory propose that aging is controlled by
genetic materials that are encoded to
predetermine growth and decline.
 The Error Theory
o This theory proposes that errors in ribonucleic
acid protein synthesis cause errors to occur in
cells in the body, resulting in a progressive
decline in biologic function.
 The Somatic Mutation Theory
o This is like the error theory but proposes that
aging results from deoxyribonucleic acid
(DNA) damage caused by exposure to
chemicals or radiation and that this damage
causes chromosomal abnormalities that lead to
disease or loss of function later in life.
 The Free Radical Theory
o This theory provides one explanation for cell
damage. Free radicals are unstable molecules
produced by the body during the normal
processes of respiration and metabolism or
following exposure to radiation and pollution.
o These Free radicals are suspected to cause
damage to cells, the DNA, and the immune
system. Excessive free radical accumulation in
the body is purported to contribute to the
physiologic changes of aging and a variety of
diseases, such as arthritis, circulatory diseases,
diabetes and arterial sclerosis.
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  The Crosslink to Connective Tissue Theory
o This theory proposes that cell molecules from
DNA and connective tissue interact with free
radicals to cause bonds that decrease the ability
of the tissue to replace itself.
o This results in the skin changes typically
attributed to aging such as dryness, wrinkles,
and loss of elasticity.
 The Clinker Theory
o This theory combines the somatic mutation
theory, free radical theory, and crosslink theory
to suggest that chemicals produced by
metabolism accumulate in normal cells and
cause damage to organs, such as the muscles,
heart, nerves, and the brain.
 The Wear and Tear Theory
o This theory presumes that the body is similar to
a machine, which loses its function when its
parts wear out. As people age, their cells,
tissues, and organs are damaged by internal or
external stressors.
o When enough damage occurs to the body parts,
overall body functioning decreases.
o This theory also proposes that good health
maintenance practices will reduce the rate of
wear and tear resulting in longer and better
body function.
 The Neuroendocrine Theory
o This theory focuses on the complicated
chemical interactions set off by the
hypothalamus of the brain.
o Stimulation or inhibition of various endocrine
glands by the hypothalamus initiates the release
of various hormones from the pituitary and
other glands, which in turn regulate bodily
functions including growth, reproduction and
metabolism.
o With age, the hypothalamus appears to be less
precise in regulating endocrine function leading
to age-related changes such as decreased
muscle mass, increased body fat, and changes
in reproductive function.
o It is proposed that hormone supplements may
be designed to delay or age-related changes.
 The Immunologic Theory
o This theory proposes that aging is a function of
changes in the immune system.
o The immune system, an important defense
mechanism of the body weakens over time,
making an aging person more susceptible to
disease.
o Increase in autoimmune diseases and allergies
seen with aging is caused by changes in the
immune system.
PYCHOSOCIAL THEORIES OF AGING
These set of theories do not explain the physical
changes of aging, rather they have different responses to
the aging process.
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permission of your instructor.
 The Disengagement Theory
o This theory proposes that older people are
systematically separated, excluded, or
excluded, or disengaged from the society
because they are not perceived to be of benefit
to the society.
o Older adults desire to withdraw from the
society as they age. The disengagement is
mutually beneficial.
o Critics of this theory believe that it attempts to
justify ageism, oversimplifies the psychosocial
adjustments to aging, and fails to address the
diversity and complexity of older adults.
 The Activity Theory
o This theory proposes that activity is necessary
for successful aging. Active participation in
physical and mental activities helps maintain
functioning well into old age.
o Purposeful activities and interactions that
promote self esteem improve the overall
satisfaction with life, even at an older age.
o Busy work activities and casual interaction
with others were not shown to improve the self-
esteem of older persons.
LIFE COURSE THEORIES
o These theories trace personality and personal
adjustment throughout a person’s life.
o Many of these theories are specific in
identifying life-oriented tasks for the aging
person.
 Erikson’s Theory of Psychosocial Development
o Erikson’s theory identifies eight stages of
developmental tasks that an individual must
confront throughout the life span.
Erik Erikson’s stages of psychosocial development:
 HOPE: Trust vs Mistrust (Infancy)
 WILL: Autonomy vs Shame/Doubt (early childhood)
 PURPOSE: Initiative vs Guilt (Preschool)
 COMPETENCE: Industry vs Inferiority (School age)
 FIDELITY: Identity vs Role Confusion (Adolescence)
 LOVE: Intimacy vs Isolation (Young Adulthood)
 CARE: Generativity vs Stagnation (Middle Adulthood)
 WISDOM: Ego Integrity and Despair (Late Adulthood)
 Infancy (0-1 year old)
 Existential Question
 “Can I trust the world?”
 Significant Relationship
 Mother
 Important Events
 Feeding
 Focus:
 Believing in caregivers
 Trusting that the world is safe
 Knowing that needs will be met
 How to develop trust?
 Affection: Erikson believed that an
infant's cries communicated an
important message to caregivers.
Such cries indicate an unmet need,
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 and it is up to caregivers to determine
how to fulfill that need.
 Comfort: It is important for
caregivers to provide comfort to an
infant by holding them closely and
securely. This provides both warmth
and physical contact. Feeding,
bathing, and comforting your child
helps them learn to trust that their
needs will be met.
 Food: Erikson also believed that
feeding played a pivotal role in the
development of trust. By feeding an
infant when the child is hungry, they
learn that they can trust their need for
nourishment will be met.
 Toddlerhood (1-3 years old)
 Existential Question
 “Can I do things myself”
 “Am I reliant on the help of others?”
 Significant Relationship
 Parents
 Important Events
 Toilet Training
 Clothing themselves
 Focus:
 Toilet training (learning to control
one’s body functions leads to a
feeling of control and a sense of
independence).
 Gaining more control over food
choices, toy preferences, and
clothing selection.
 How to develop autonomy?
 Provide opportunities for children to
be independent. Allow them to make
food, clothing, and toy choices and
provide reassurance that they have
done a good job.
 Be supportive during potty training,
but not punitive for accidents.
 Offer safe outlets where children can
play independently with the support
and guidance of a trusted caregiver.
 Preschool (3-5 years old)
 Existential Question
 “Am I good or bad?”
 “Is it okay for me to do, move, and
act?”
 Significant Relationship
 Family
 Important Events
 Exploration
 Play
 Focus:
 Attempt new tasks
 Join or come up with activities with
friends
 Use new skills in play.
 How to develop initiative?
 At this stage, play and imagination
take on an important role.
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permission of your instructor.
 Being given the freedom and
encouragement to play helps a child
feel excited about exercising some
control over what they're doing.
 Children need to begin asserting
control and power over the
environment by taking initiative:
planning activities, accomplishing
tasks, and facing challenges.
 School Age (6-12 years old)
 Existential Question
 “Can I make it in the world of people
and things?”
 "How can I be good?"
 Significant Relationship
 Neighbors
 School
 Important Events
 School
 Focus:
 A child's social world expands
considerably as they enter school and
gain new friendships with peers.
 Through social interactions, children
begin to develop a sense of pride in
their accomplishments and abilities.
 How to develop industry (and competence)?
 It is important for both parents and
teachers to offer support and
encouragement. Adults should be
careful not to equate achievement
with acceptance and love
 Unconditional love and support from
adults can help all children through
this stage, but particularly those who
may struggle with feelings of
inferiority.
 Children who are overpraised, on the
other hand, might develop a sense of
arrogance.
 Adolescence (12-18 years old)
 Existential Question
 “Who am I?"
 “Who can I be?”
 Significant Relationship
 Peers
 Role Model
 Important Events
 Social relationships
 Focus:
 Commitment: Resolving the crisis at
this stage of development involves
committing to a particular identity.
This might involve committing to a
career path, deciding what social
groups to associate with, and even
developing a sense of personal style.
 Self-confidence: Those who are able
to develop a strong sense of identity
are better able to have self-
confidence, or a sense of trust in their
abilities, qualities, and judgements.
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  Sense of independence: Those who
receive proper encouragement and
reinforcement through personal
exploration will emerge from this
stage with a strong sense of self and
a feeling of independence and
control. Those who remain unsure of
their beliefs and desires will remain
insecure and confused about
themselves and the future.
 Fidelity: Those who are successful
develop fidelity, a psychological
virtue characterized by the ability to
relate to others and form genuine
relationships. This ability plays an
important role in the upcoming stage
known as intimacy versus isolation.
 How to help people develop a self-identity?
 Do not compare them with their
siblings or their peers.
 Teach them to act as confident
people.
 Make them feel better about
themselves.
 Expose them to less media influence.
 Young adulthood (18 to 40 years old)
 Existential Question
 “Can I love?”
 “"Will I be loved, or will I be alone?"
 Significant Relationship
 Friends
 Partner(s)
 Important Events
 Romantic Relationships
 Focus:
 Strong and deep romantic
relationships
 Close relationships with friends and
family
 Strong social support network
 How to build intimacy?
 Being intimate: This is more than
just engaging in sex; it means forging
emotional intimacy and closeness.
Intimacy does not necessarily have to
be with a sexual partner. People can
also gain intimacy from friends and
loved ones.
 Caring for others: It is essential to
be able to care about the needs of
others. Relationships are reciprocal.
Getting love is important at this
stage, but so is giving it.
 Making commitments: Part of
being able to form strong
relationships involves being able to
commit to others for the long term.
 Self-disclosure: This involves
sharing part of the self with others,
while still maintaining a strong sense
of self-identity.
 Middle Adulthood (40 to 64 years old)
 Existential Question:
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permission of your instructor.
 “Can I Make My Life Count?”
 “How can I contribute to the world?”
 Significant Relationship
 Household
 Workmates
 Important Events
 Parenthood
 Work
 Focus:
 Making a mark in the society
 Guiding the Next Generation
 Creating a comfortable home
 Being proud of the accomplishments
 Taking care of aging parent
 Use leisure time creatively
 Conflict:
 Generativity-is developed when one feels
he can contribute to the society and his
family.
 Stagnation- is developed when one unable
or unwilling to help society move forward.
 How to promote Generativity?
 Developing relationships with family.
 Making commitments to other people.
 Mentoring others.
 Contributing to the next generation.
 Late Adulthood (65 years old to death)
 Existential Question:
 “Is it Okay to Have Been Me?”
 “Did I live a meaningful life?”
 Significant Relationship
 Mankind (my kind)
 Important Events
 Reflecting back on life
 Focus:
 Contemplating on one’s achievements
 Evaluation of how one lived his/her life
 Conflict:
 Ego Integrity- is achieved if a person
perceives himself to have lived a happy and
productive life.
 Despair- is developed if a person has not
achieved his life goals, or has been
dissatisfied with his life.
 How to Improve Integrity?
 Start early: The things you do during
middle age will play a role in your feelings
about life as you age. Focus on doing
things that will support your emotional
wellness as you grow older, such as getting
involved in your community and
strengthening relationships to ensure you
have a strong social support network.
 Seek meaningful relationships: High-
quality relationships with people you care
about and who care about you are
important. Focus on those relationships
and work on making peace with
relationships that may not be as strong.
 Reframe your thinking: Rather than
ruminating over regrets or wishing you can
change the past, focus on reframing how
you think about those events. For example,
you might focus on what you learned from
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 those experiences rather than dwelling on
what you wish you could do differently.
 Practice gratitude: Focus on the positive
aspects of your life rather than paying
excessive attention to the negative.
 The Additional 9th stage completed by Joan Erikson,
after Erik Erikson’s death.
 Experienced by older adults in their 80’s and 90’s.
 At this stage, all of the previous 8 stages happen at the
same time, where the negative pole now takes the
dominant role over the positive.
 MISTRUST VS TRUST
 Because of the decrease in physical abilities,
elders often begin to mistrust themselves and
the environment.
 SHAME/DOUBT VS AUTONOMY
 Older adults develop shame for losing control
of their own body.
 They doubt the autonomy of their own body.
 GUILT VS INITIATIVE
 Some may develop a sense of guilt for being a
burden to a family member or the society.
 INFERIORITY VS INDUSTRY
 They start feeling inferior for not having
enough energy and driving force that they used
to have.
 ROLE CONFUSION VS IDENTITY
 They lose their sense of place and develop
confusion on their own role to the family
 ISOLATION VS INTIMACY
 They start feeling Isolated and alone as they
lose their sense of place. Loss of intimacy is
heightened after the death of a spouse.
 STAGNATION VS GENERATIVITY
 Having less energy and being unable to become
productive makes older people feel stagnant.
 DESPAIR VS INTEGRITY
 Instead of back at their achievements, they start
looking forward to what body part will stop
working next, or what special friend may be
gone tomorrow. This will lead to despair and
hopelessness.
 Havighurst Theory
o This theory details the process of aging and
defines specific tasks for late life.
o These tasks include:
 Adjusting to decreased physical
strength and health
 Adjusting to retirement and decreased
income
 Adjusting to the loss of a spouse
 Establishing a relationship with one’s
age group.
 Adopting to the social roles in a
flexible way.
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permission of your instructor.
 Establishing satisfactory living
arrangements.
 Newman’s Theory
o Newman's theory identifies the task of aging as
coping with the physical changes of aging,
redirecting energy to new activities and roles
including retirement, grand parenting and
widowhood accepting one's own life; and
developing a point of view about death.
o Newman's theory asserts that every person in
every situation, no matter how disordered and
hopeless it seems, is part of the universal
process of expanding consciousness.
 Carl Jung’s Theory
o This theory proposes that development
continues throughout life by a process of
searching, questioning, and setting goals that
are consistent with the individual’s personality.
o Carl Jung saw mid-life as one of those critical
transition periods in our adulthood.
o The first half of life is the stage in which we
receive our education, choose our careers, begin
a family, acquire the trappings of success such
as a home, a car, and establish our persona(s).
o The second half of life is less about acquiring
things and knowledge, and more about finding
meaning. We are faced with questions such as
‘What is the point of my life?’ or ‘What makes
me feel I am useful in this world?’ As we
ponder these questions, we often realize that life
has not turned out the way we expected it to.
 The Theory of Gerotranscendence
o Developed by Lars Tornstam, a Swedish
Sociology professor.
o Assumptions:
 The individual becomes less self-
occupied and at the same time more
selective in the choice of social and
other activities.
 There is an increased feeling of
affinity with past generations and a
decreased interest in superfluous
social interaction.
 The individual might also experience
a decrease in interest in material
things and a greater need for solitary
"meditation." Solitude becomes more
attractive
 There is also often a feeling of
cosmic communion with the spirit of
the universe, and a redefinition of
time, space, life and death.
o Major Dimensions of the theory:
 THE COSMIC DIMENSION
o Time. As one ages, one becomes able
to transcend through time.
o Example: The case for the
old woman who had been
mistreated by her mother as a
child, and who now
understood her troubled
mother in a new way and was
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 able to reconcile with her, 20
years after her death.
o Connection to Earlier Generations.
As one ages, one understands his role
as a link between generations.
o Example: A person no longer
focuses on his self as part of
a generation but focuses on
creating a new generation.
o Life and Death. Most people become
less afraid of death as they get closer
to it.
o Example: One informant
talked about how much she
loves life and how much
pleasure life gives, and at the
same time explained that if
she were to die tomorrow it
would not matter.
 THE SELF DIMENSION
o Self-confrontation. An individual
looks back on himself at earlier phases
in life and discovers hidden aspects of
the self – both good and bad.
o Example: At age 80
discovered she had the gift to
write such good poetry that
she published her first book
of poems at that age.
o Decrease in Self-centeredness. The
individual experiences a new
awareness of the fact that he or she is
not the center of the universe.
o Example: People letting go of
elevated self-esteem and
started taking themselves less
seriously than earlier.
o Body Transcendence. A new
awareness develops of how to take
good care of the body without being
obsessed with it.
o Example: Elderly people’s
earlier obsession with their
body and beauty has been
replaced with pleasing
acceptance, which has
resulted in greater
satisfaction.
o Self-transcendence. The focus on
one's own needs has gradually been
transcended and replaced with a focus
on the needs of others - in particular
the needs of children and
grandchildren.
 SOCIAL AND PERSONAL
RELATIONSHIPS DIMENSION
o Interpersonal transcendence. The
interest in participating in superficial
kinds of socializing fades away.
o Example: A person’s earlier
interest in mingling at
cocktail parties has given
way to being with a
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permission of your instructor.
particular friend or staying
at home contemplating.
o Emancipated innocence. The
individual develops a new skill to
transcend needless conventions,
norms, and rules, which earlier in life
had curtailed freedom to express the
self.
o Example: the woman who
nowadays enjoys bicycling
around with torn stockings
and giggling, breaking the
futile rule of not wearing torn
stockings - a rule she was a
captive of in younger days.
o Modern ascetism. Adopting the
concepts that last part of the journey
through life is easier and more joyful
if one is carrying light luggage.
Material things started to mean less,
and material possession that are
beyond one’s needs are better given
away to family and friends.
o Example: Some individuals
start giving away things to
children, grandchildren, and
others.
Applying Gerotranscendence In Patient Care
o A less invasive way of using the theory of
Gerotranscendence is to make staff members aware of
this developmental possibility and of how to behave so
as not to misinterpret or block care recipients who
exhibit signs of gerotranscendent development.
o Wadensten (2003) has translated the theory into
guidelines for staff members.
o The Preamble of these guidelines is to accept signs of of
gerotranscendence as possibly normal signs of the aging
process.
o Examples of other guidelines are:
 Understand and respect that older people can have
a different perception of time, such that the
boundaries between past, present and future are
transcended.
 Do encourage the older person to recall and talk
about childhood and old times, and how they have
developed during life.
 Do let older people decide for themselves whether
they want to be alone or participate in ''activities.''
 Do not always start a conversation with a routine
health question like ''how do you feel today.''
 In the morning you can instead ask what dreams
the old person has had, and start a discussion
about what message might be inherent in the
dream.
 Disengagement Theory
o Formulated by Cumming and Henry in1961 in
the book Growing Old, and it was the first
theory of aging that social scientists developed.
o Cumming and Henry provided 9 postulates:
 Postulate 1: Everyone expects death,
and one's abilities will likely deteriorate
over time. As a result, every person will
lose ties to others in his or her society.
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  Postulate 2: Because individual
interactions between people
strengthen norms, an individual who
has fewer varieties of interactions has
greater freedom from the norms
imposed by interaction. Consequently,
this form of disengagement becomes a
circular or self-perpetuating process.
 Postulate 3: Because men have a
centrally instrumental role in America,
and women a socioemotional one,
disengagement differs between men
and women.
 Postulate 4: The individual's life is
punctuated by ego changes. For
example, aging, a form of ego change,
causes knowledge and skill to
deteriorate. However, success in an
industrialized society demands certain
knowledge and skill. To satisfy these
demands, age-grading ensures that the
young possess sufficient knowledge
and skill to assume authority and the
old retire before they lose their skills.
This kind of disengagement is affected
by the individual, prompted by either
ego changes or the organization—
which is bound to organizational
imperatives—or both.
 Postulate 5: When both the individual
and society are ready for
disengagement, complete
disengagement results. When neither
is ready, continuing engagement
results. When the individual is ready
and society is not, a disjunction
between the expectations of the
individual and of the members of this
social systems results, but engagement
usually continues. When society is
ready and the individual is not, the
result of the disjunction is usually
disengagement.
 Postulate 6: Man's central role is
work, and woman's is marriage and
family. If individuals abandon their
central roles, they drastically lose
social life space, and so suffer crisis
and demoralization unless they
assume the different roles required by
the disengaged state.
 Postulate 7: This postulate contains
two main concepts.
 Readiness for disengagement
occurs if:
An individual is aware of
the shortness of life and
scarcity of time.
Individuals perceive their
life space decreasing.
A person loses ego energy.
 Each level of society grants
individuals permission to
disengage because of the
following:
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Requirements of the rational
legal occupational system in
an affluent society
The nature of the nuclear
family.
The differential death rates.
 Postulate 8: Fewer interactions and
disengagement from central roles lead
to the relationships in the remaining
roles changing. In turn, relational
rewards become more diverse, and
vertical solidarities are transformed to
horizontal one.
 Postulate 9: Disengagement theory is
independent of culture, but the form it
takes is bound by culture.
 Activity Theory
o Also known as the “implicit theory of aging”,
“normal theory of aging”, and “lay theory of
aging”.
o Was developed by Robert J. Havighurst in
1961.
o Proposes that successful ageing occurs when
older adults stay active and maintain social
interactions.
o Asserted that satisfaction in old age depended
on active maintenance of personal relationships
and endeavors.
o It takes the view that the aging process is
delayed, and the quality of life is enhanced
when old people remain socially active.
o Activity theory reflects the functionalist
perspective that the equilibrium that an
individual develops in middle age should be
maintained in later years.
 Continuity Theory
o The continuity theory was formerly proposed in
1971 by Robert Atchley in his article
"Retirement and Leisure Participation:
Continuity or Crisis?" in the journal The
Gerontologist.
o States that older adults will usually maintain the
same activities, behaviors, relationships as they
did in their earlier years of life.
o Older adults try to maintain this continuity of
lifestyle by adapting strategies that are
connected to their past experiences
o The internal structure of an individual such as
personality, ideas, and beliefs remain constant
throughout the life course.
o The external structure of an individual such as
relationships and social roles provides a support
for maintaining a stable self-concept and
lifestyle.
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Prepared by Prof. Huemer O. Uy DSN(CAR), MSN, RN, USRN