Late Adulthood

J’Lene George
Life Expectancy and Life Span
• Maximum human life span is 120-125 yrs
• Average life expectancy in the U.S.
▫ Women 81 yrs
▫ Men 78 yrs
• Centenarians
▫ 32% of females and 15% of males have never been
diagnosed with any common age-associated
diseases
▫ Most enjoy life and are have good mental health
The Aging Brain
• The brain loses 5-10% of its weight between age
2 and 90
▫ Neurons lost in frontal lobes, corpus callosum,
cerebellum (balance), glial cells
• The brain continues to adapt throughout the
lifespan
▫ Dendrite growth and change
▫ Decreased lateralization
• There are many individual differences
The Nun Study
• 678 nuns most of whom are from Mankato
Minnesota
• Idea density (a measure of linguistic ability) at 22 is
associated with lower risk for cognitive impairment
in old age
• Positive emotion in early adulthood was linked to
longevity
• Sisters who had taught most of their lives showed
less cognitive decline than those who were engaged
in service-based tasks
▫ Supports the use it or lose it idea
• The immune system declines
• Weight drops
• Muscles mass decreases
▫ Weight training can prevent/improve muscle loss
▫ Older adults move more slowly than younger
adults
▫ Exercise helps maintain and improve mobility in
older adults
Sensory Systems
• Vision
▫ Acuity and color vision decline
 At 60 only 1/3 as much light reaches the retina as at 20
 Adaptation from light to dark becomes slower
 Increased sensitivity to glare –especially 75 and older
 Color vision is affected by yellowing of the lens
 Green-blue-violet
▫ Depth perceptions declines in late adulthood
 Contrast sensitivity due to decreased light may contribute
▫ Diseases including cataracts, glaucoma, macular
degenration
Sensory Systems
• Hearing
▫ Significant loss beginning at 65 in the high
frequencies with some loss in middle frequencies
▫ May be helped by a hearing aid
▫ Worsens over time so that a hearing aid is more
likely to be needed after 75
▫ Men experience hearing loss earlier and to a
greater degree than do women, however, women
are more likely to seek treatment
▫ Caused by degeneration of the cochlea
Changes in Vision and Hearing
Sensory Systems
• Most older adults experience some loss of sense
of taste and touch
▫ May compensate by choosing spicier, sweeter food
• Sensitivity to touch in the lower extremities
decreases slightly
▫ It is rarely a problem
• Decreased sensitivity to pain as well
▫ Can help cope with disease and aging but also can
mask illness or injury
Circulatory System and Lungs
• Cardiovascular disorders increase
▫ 57-80% of older men and 60-81% of older women
have hypertension
▫ High blood pressure should be treated to reduce
risk of heart attack or stroke
• Lung capacity drops by 40% between 20 and 80
▫ Greatest in smokers
▫ Diaphragm strengthening exercises can help
Sexuality
• Many older adults remain sexually active as long
as they are healthy
• Erectile problems increase as men age
▫ ¼ 60-80, ½ over 80
• Adults without a partner are far less likely to be
sexually active
▫ Especially true for women
Health Problems
• Percentage of adults afflicted with a chronic illness
increases with age
▫ Cardiovascular disease
▫ Cancer
▫ Diabetes
▫ Arthritis
▫ Osteoperosis

• ¾ of older adults die of heart disease cancer or

stroke
• Chronic lung disease, pneumonia and flu, and
diabetes are the next 3 most common
• Accidents are 7th leading cause with falls being more
likely in older adults
Exercise, Nutrition and Vitamins
• Exercise has many documented benefits for older
adults
▫ Increased longevity, decreased risk of mental illness,
improved brain and cognitive function, reduced
decline in motor skills, disease prevention and
improvement
• While calorie reduction produces longevity in lab
animals concerns about nutrition cause it to be not
recommended
• Mixed results on vitamins
▫ Some research suggests some benefits for antioxidants
Health Treatment

• Care of older adults needs improvement

▫ Therapies and rehabilitative care can be lacking
▫ Home health is becoming and increasingly popular option
▫ Hospice programs can improve dignity and palliative care
for the dying
• Health and even survival have been linked to a sense of a
control and self-determination
▫ Assertiveness training, and other coping skills training
associated with improved health
▫ Compared to controls who were only assured staff were
committed to their care, patients who were encouraged to
make decisions were happier, healthier and less likely to die
Cognitive Development
• Multidimentionality – there are many aspects to
cognitive development and they can interrelate in
complex ways
• Multidirectionality – while some aspects of cognition
might be declining others may continue to develop
• Similar to crystallized and fluid intelligence there is
some talk of cognitive mechanics and cognitive
pragmatics
▫ Pragmatics stay stable or improve
▫ Mechanics are more likely to show declines
Sensory/Motor and speed of
Processing
• Speed of processing declines as we age
▫ There is considerable variability
▫ While reaction time slows older adults can use
knowledge and experience to compensate
 Reaction time slows but typing speed does not for
good typists
▫ 6 months of aerobic exercise improved
performance in reaction time tasks
▫ A decline in processing speed predicts decline in
memory and spatial ability but not in verbal skills
Attention
• Older adults are less adept at selective attention
than are younger adults
▫ Age differences are minimal on simple search
tasks
• Divided attention tasks show little age difference
if the task is easy but the performance of older
adults declines as task difficulty increases
• No differences on simple and basic sustained
attention vigilance tasks but recent evidence
suggests some declines on more complex tasks
Memory
• Episodic memory –memory for events and
experiences
▫ Younger adults have better episodic memories
than older adults
▫ Older adults think they recall older memories
better but ALL adults recall more recent better
 There is however a reminiscence bump where people
tend to recall things best that occurred in the 2nd and
3rd decades of life
Memory 2

• Semantic memory _memory for facts and

information
▫ Recall may be slower but otherwise this seems to
be unimpaired in older adults
 Older adults are more likely to experience TOT
phenomenon
• Older adults have declines in perceptual speed
which have been linked to declines in working
memory
Memory 3

• Explicit memory is more likely to decline or be

impaired as we age then is implicit memory
▫ Implicit memory –memory of how to do things and other
unconscious processes
▫ Explicit memory –conscious memories of facts and
events
• Source memory, remembering where you learned
something, declines in older adults
▫ Improves when it is important
• Health, education, and SES, and beliefs about memory
can effect memory performance in older adults
Maintaining Cognitive Skills
• “Use It or Lose It” cognitive activity slows
decline
▫ Activities that help include reading, crossword puzzles,
attending lectures and concerts, writing
▫ Part of the engagement model that states that social
and intellectual involvement prevent cognitive decline
• Interventions to teach declining cognitive
abilities have been successful
▫ Training in reasoning and processing speed have had
effects on functioning as well though specific to the
trained area
Cognitive Neuroscience and Aging
• Certain neural circuits in aging adults’ prefrontal cortex
decline, which is linked to performance on complex
reasoning, episodic memory and working memory
• Lateralization decreases as older adults compensate for
cognitive declines
• Patterns of neural difference are larger for retrieval tasks
than for encoding
• Older adults show greater activity in frontal and parietal
areas when engaged in tasks requiring cognitive control
• Walking resulted in increased volume in frontal and
temporal lobes
Nutrition in Late Adulthood

• Need extra nutrients

▫ Protect bones, immune system
▫ Fight free radicals
• Problems eating
▫ Appetite, taste changes
▫ Chewing, digestion
▫ Shopping, cooking
• Supplements, diet changes
may help
Stereotypes of Aging

• Many assume deterioration is inevitable

• Elders experience prejudice, discrimination
• Assumptions affected by culture

• Stereotype threat
• Fear of confirming stereotype
• reduces functioning

• May be changing
• Positive media portrayals
Work
• The percentage of older adults engaged in part-
time work has increased since the 1960’s
▫ Some continue in the same field while others
change fields
▫ Return to work peaks about 4 yrs after retirement
• Cognitively demanding work may help prevent
cognitive decline
• Older workers have lower rates of absenteeism,
fewer accidents, and increased job satisfaction
compared to younger adults
• Many older adults are active volunteers as well
Retirement
• Health, adequate income, education level,
activity level, and social connections contribute
to positive adjustment to retirement
▫ Those who have the resources to do things they
enjoy and find a sense of positive identity and
purpose in doing adjust best
▫ Most were happy with lives prior to retirement
• Poor health, low income, and other adjustments
such as moving or death of spouse make
adjustment more difficult
Mental Health -Depression
• Research indicates depressive symptoms are
about the same or less frequent than in middle
adulthood
▫ It is expected to increase as a problem as the cohort
size increases
• In younger and middle aged adults women are
more likely to be depressed, however, from 60-80
it reverses
• Medication and therapy combination can be
effective treatments in older adults
Mental Health – Substance Abuse
• Late onset substance abuse can occur in older
adults
▫ Prescription medications are more commonly
abused than street drugs
▫ Alcohol may also be used to self medicate pain or
other problems associated with aging
▫ Actual rates are difficult to obtain
Mental Health –Alzheimer disease
• Dementia –global term for any neurological
disorder in which mental function deteriorates
▫ 20% of adults over 80 have dementia
▫ More specific diagnosis is critical for treatment
• Alzheimer’s disease –progressive, irreversible
brain disease that causes gradual deterioration in
memory, reasoning, language and eventually
physical function
▫ Affects 25 million adults (4.5 in the US) but that
may triple as more of the population ages
Alzheimer
• Early onset (younger than 65) comprises 10% of
cases
• Cause death of neurons and decrease in brain
tissue
• amyloid plaques, dense deposits of protein in
blood vessels of the brain
• Neurofibrillary tangles, twisted fibers that build
up in neurons causing pathways for nourishment
and repair to break down resulting in cell death
Alzheimer
• The proportion of adults afflicted doubles every
5 years after age 65
• Family history and genetics increase risk
 apoE may play a role in up to 1/3 of cases and is
associated with development of the disease at a
lower age
 Twin studies also highlight the role of genetics
• More common in individuals with
cardiovascular disease
• Exercise and healthy diets may decrease risk
Alzheimer

• Early detection is important

▫ Mild cognitive impairment is a risk factor
▫ Episodic memory deterioration is an early sign
▫ FMRI and other brain scans can detect the disease
• Cholinerase inhibitors have been approved for
treatment of Alzheimer disease
▫ Improve memory and other function by increasing
acetylcholine levels
▫ Slow progression in early stages but are not
approved for late stages
Arthritis
Osteoarthritis
• Deteriorating cartilage in
frequently used joints
• Common, related to wear and
tear
Rheumatoid
Arthritis
• Autoimmune response, affects
whole body
• Inflamed connective tissues
▫ Membranes in joints
• Cartilage grows
▫ Can deform joints
▫ Lost mobility
Adult-Onset Diabetes
• Too little insulin or cells insensitive to
insulin
• Increases in late adulthood
▫ Genetics
▫ Inactivity, abdominal fat
• Risk of long-term damage
▫ Circulatory system
▫ Eyes, kidneys, nerves
• Treatment
▫ Lifestyle changes
▫ Medicine
Selective Optimization
with Compensation
• Select
▫ Choose personally valued
activities, avoid others
• Optimize
▫ Devote diminishing
resources to valued
activities
• Compensate
▫ Find creative ways to
overcome limitations
Social Emotional
Erikson’s Theory:
Ego Integrity versus Despair
Ego Integrity
• Feel whole, complete,
satisfied with achievements
• Serenity and contentment
• Associated with psychosocial
maturity
Despair
• Feel many decisions were
wrong, but now time is too
short
• Bitter and unaccepting of
coming death
• Expressed as anger and
contempt for others
Peck: Three Tasks of
Ego Integrity

• Ego differentiation versus

work-role preoccupation
• Body transcendence versus
body preoccupation
• Ego transcendence versus ego
preoccupation
Gerotranscendence

• Beyond ego integrity

• Cosmic, transcendent perspective
• Directed beyond self
▫ Forward and outward
• Heightened inner calm
• Quiet reflection
Emotional Expertise

• Cognitive-affective complexity
▫ Declines for many
• Affect optimization improves
▫ Maximize positive emotions, dampen negative
ones
• More vivid emotional perceptions
▫ Make sure of own emotions
▫ Use emotion-centered coping
Reminiscence and Life Review
Reminiscence Life Review
• Telling stories about people, • Considering the meaning of
events, thoughts and feelings past experiences
from past • A form of reminiscence
▫ Self-focused: can deepen • For greater self-understanding
despair • Can help adjustment
▫ Other-focused: solidifies
relationships
▫ Knowledge-based: helps solve
problems
 Social Theories of Aging
Disengagement
Mutual withdrawal of elders and society
Theory
Social barriers cause declining
Activity Theory
interaction
Continuity Strive to maintain consistency between
Theory past and future
Social networks become more selective
Socioemotional
with age; extends lifelong process
Selectivity
• Emphasize emotion-regulating
Theory
functions of social contact
Age-Related Changes in Number of
Social Partners
Marriage in Late Adulthood

• Satisfaction peaks in late adulthood

▫ Fewer stressful responsibilities
▫ Fairness in household tasks
▫ Joint leisure
▫ Emotional understanding,
regulation
• If dissatisfied,
harder for women
Long-Term
Gay and Lesbian Partnerships

• Most happy, highly fulfilling

• Coping with oppression may strengthen
skill at coping with physical aging
 Face legal, health care issues
Divorce, Remarriage,
Cohabitation
Few divorces in late adulthood, but
Divorce increasing
 Hard to recover; especially women
Rates low; decline with age
Remarriage  Higher for divorced than widowed
 Late remarriage stable
Growing trend
Cohabitation  Financial and family reasons
 Relationships stable
Widowhood

• Most stressful event of life for many

• Few remarry; most live alone
▫ Must cope with loneliness
• Reorganizing life harder for men
▫ More likely to remarry
• Sources of support include friends, family,
senior centers, support groups, religion,
volunteer activities
Never-Married, Childless Elders
• About five percent in
North America
• Develop alternative
meaningful relationships
▫ Youths
▫ Friends
▫ Relatives
• Men more likely to be lonely
Changes in Aid Among Siblings
Relationships with
Adult Children
• Quality of relationship affects elders’ physical,
mental health
• Assist each other
▫ Direction changes toward children helping as
parents age
▫ Closeness affects willingness to help
▫ Emotional support most often
 Parents try to avoid dependency
Age Changes in Volunteering
Elder Maltreatment

• Physical abuse
• Physical neglect
• Psychological abuse
• Sexual abuse
• Financial abuse
Risk Factors for
Elder Maltreatment
• Dependent victim
• Dependent perpetrator
 Emotionally or financially
• Psychological disturbance,
stress of perpetrator
• History of family violence
• Greater risk in low-quality
nursing homes