Because learning changes everything.

Chapter 17

Physical and Cognitive Development in Late Adulthood

Experience Human Development

FOURTEENTH EDITION
Diane E. PAPALIA
Gabriela MARTORELL

© 2021 McGraw Hill. All rights reserved. Authorized only for instructor use in the classroom.
No reproduction or further distribution permitted without the prior written consent of McGraw Hill.
 Learning Objectives

Discuss the causes and impact of the aging population.

Characterize longevity and discuss biological theories of

aging.

Describe physical changes in late adulthood.

Identify factors that influence health and well-being in late

adulthood.

Describe the cognitive functioning of older adults.

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 Old Age Today

In Japan, old age is a status symbol.

In the United States, aging is generally seen as undesirable.

Stereotypes about aging can become self-stereotypes,

unconsciously affecting older people’s expectations about
their behavior.

Ageism: prejudice or discrimination against a person (most

commonly an older person) based on age.

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 The Graying of the Population

The global population is aging.

Aging populations result from declines in fertility accompanied
by economic growth and improving health.
In the United States, high birthrates and high immigration with
a trend toward smaller families has reduced the relative size
of younger age groups.
• Racial and ethnic minority populations are generally
younger.
• Ethnic diversity among older adults is nonetheless
increasing.

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 FIGURE 1 Percentage of the Population Age 65 and
Older: 2015 and 2050

Source: He, W., D. Goodkind, and P. Kowal. International Population Reports. P95/16-1, An Aging
World: 2015. US Census Bureau, ed. Washington, DC: US Government Publishing Office, 2016.
The growth of the population age 65 and up is projected to increase rapidly in the
coming decades. Growth will be greatest in much of the developing world.
Access the text alternative for slide images.

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 Young Old to Oldest Old 1

Primary aging: gradual, inevitable process of bodily

deterioration throughout the life span.
Secondary aging: processes resulting from disease and bodily
abuse and disuse, often preventable.
Social scientists refer to three groups of older adults:
• Young old: people ages 65 to 74—active, vital, and vigorous.
• Old old: ages 75 to 84.
• Oldest old: age 85 and above, more likely to be frail and
infirm and to have difficulty with activities of daily living
(ADLs)—those activities that are essential in support of
survival.

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 Young Old to Oldest Old 2

A more meaningful classification is functional age: how well a

person functions in a physical and social environment in
comparison with others of the same chronological age.
• A person who is 90 and still living independently may be
functionally younger than a 75-year-old who has dementia.

Gerontology: study of the aged and the process of aging.

Geriatrics: branch of medicine concerned with processes of

aging and medical conditions associated with old age.

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 Longevity and Aging

Life expectancy: age to which a person in a particular cohort

is statistically likely to live, given his or her current age and
health status.

Longevity: length of an individual’s life.

Life span: the longest period that members of a species can

live.

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 Trends and Factors in Life Expectancy 1

A baby born in the United States in 2016 can expect to live to

78.6 years.
• More than 30 years longer than a baby born in 1900.

Women live longer and have lower mortality rates at all ages
then men.
• As the population ages, the ratio of women to men
increases.

The gap in life expectancies between developed and

developing countries is vast.

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 Trends and Factors in Life Expectancy 2

Within the United States, there are wide racial and ethnic
disparities.
• Income and geography also affect life expectancy.

Healthy life expectancy (HLE) looks at the number of years a

person can expect to live in good health, free of disabilities.
• Globally, 62 years for men and 64.8 years for women.

• In the United States, 68.5 years.

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 TABLE 1 Life Expectancy in Years for…

Demographic Group At Birth

Hispanic men 79.3
Hispanic women 84.3
White men 76.3
White women 81.0
African American men 71.9
African American women 78.1

© McGraw Hill Source: Arias, E., and J. Xu. “United States life tables, 2015.” National Vital Statistics Reports 67, no. 7 (2018): 1–64 11
 Why People Age 1

Senescence: period of the life span marked by declines in

physical functioning usually associated with aging.
• Begins at different ages for different people.

Most theories about aging fall into one of two categories:

• Genetic-programming theories; and

• Variable-rate theories.

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 Why People Age 2

Genetic-programming theories: biological aging results from

a genetically determined developmental timeline.
• Programmed senescence theory: aging results from the
sequential switching on and off of certain genes.
• Endocrine theory: biological clocks act through hormones to
control the pace of aging.
• Hayflick limit: genetically controlled limit on the number of times
cells can divide in members of a species.
• Immunological theory: a programmed decline in immune
function leads to increased vulnerability to infectious
disease.
• Evolutionary theory: genes that promote reproduction are
selected at higher rates than genes that extend life.
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 Why People Age 3

Variable-rate theories: biological aging results from damage

to biological systems that varies from person to person.
• Wear-and-tear theory: cells and tissues have vital parts that
wear out.
• Free-radical theory: accumulated damage from oxygen
radicals causes cells and eventually organs to stop
functioning.
• Free radicals: unstable, highly reactive atoms or molecules, formed
during metabolism, that can cause bodily damage.
• Rate-of-living theory: the greater an organism’s rate of
metabolism, the shorter its life span.
• Autoimmune theory: the immune system becomes
confused and attacks its own body cells.
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 How Far Can the Life Span Be Extended? 1

Survival curve: a curve on a graph showing the percentage

of people or animals alive at various ages.

In people who live to be very old, morbidity—or being in a

state of disease—is being compressed.
• They reach old age in relatively good health but then
deteriorate very quickly.
• The process of aging itself seems to have been postponed.

The longevity riddle: Can we postpone aging even more, delay

aging until even later, and thus increase the life span?

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 How Far Can the Life Span Be Extended? 2

One line of research is on dietary restriction.

• Calorie restriction has been found to have beneficial effects
on human aging and life expectancy.
Because a very-low-calorie diet takes great discipline and is
unrealistic for most people, there is increasing interest in
developing drugs that mimic the effects.

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 Physical Changes

Some typical changes are readily observable:

• Paler, less elastic skin.

• Wrinkles.

• Varicose veins.

• Thinning hair.

• Shorter stature as disks between the spinal vertebrae

atrophy.

Other changes are less visible but equally important.

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 Organic and Systemic Changes

Though highly variable, certain declines are typical.

• Lungs become less effective.
• Immune system functioning declines, exacerbated by stress.
• Heart health suffers.
• Arrhythmia (irregular heartbeat) becomes more likely.
• Changes in the heart result in impaired capacity.
• Low-grade inflammation related to chronic stress increases
vulnerability to disease.
• Digestive system issues increase the risk of malnutrition.
• Reserve capacity: ability of body organs and systems to put
forth 4 to 10 times as much effort as usual under acute stress.

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 The Aging Brain

With age, there are declines in the brain’s ability to process

information rapidly, in executive functioning, and in episodic
memory.
• These changes are generally subtle because the brain
retains a significant degree of plasticity and can
compensate.
Other changes in late adulthood, including decreasing volume
and weight of the brain, make cognitive declines increasingly
likely.
Not all changes in the brain are destructive.
• Older brains can grow new nerve cells from stem cells.

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 Sensory and Psychomotor Functioning 1

Vision problems are common.

• Cataracts: cloudy or opaque areas in the lens of the eye,
which cause blurred vision.
• Age-related macular degeneration: the center of the
retina gradually loses its ability to discern fine details.
• Glaucoma: irreversible damage to the optic nerve caused
by increased pressure in the eye.

Hearing impairments also increase with age.

Both can deprive older people of social relationships and

independence.

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 Sensory and Psychomotor Functioning 2

Generally, aging results in a variety of changes related to

physical abilities.
• Increases in body fat.

• Declines in muscle strength, aerobic capacity, flexibility, and

agility.
• Increased risk of falls.

Functional fitness: the ability to perform the physical

activities of daily living.

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 Sleep

Older people tend to sleep and dream less.

Poor sleep quality or chronic insomnia can contribute to

depression, neurodegenerative disorders, and cognitive
declines.
• Too much sleep and too little sleep are associated with an
increased risk of mortality.

Cognitive behavioral therapy is recommended as the first line

of defense.

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 Sexual Functioning

A sizeable number of adults remain sexually active late into

adulthood.
Both men and women do report a decline in sexual desire.
• This may be a negative influence of ageism and
stereotypes.
With age, men typically take longer to develop an erection and
to ejaculate; and women report more difficulties with becoming
aroused and experiencing orgasm.
• Health problems are more likely to affect women.
• Poor mental health and relationship dissatisfaction are
associated with sexual dysfunction in both men and women.

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 Health Status

Poor health is not an inevitable consequence of aging.

• About 78% of U.S. adults age 65 and older consider
themselves in good to excellent health.

Poverty is strongly related to poor health and to limited

access to and use of health care.

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 Chronic Conditions and Disabilities 1

The six top leading causes of death in the United States in

2016 were chronic conditions:
• Heart disease;
• Cancer;
• Chronic lower respiratory disease;
• Stroke;
• Alzheimer’s disease; and
• Diabetes.
Many of these deaths could be prevented through healthier
lifestyles.
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 Chronic Conditions and Disabilities 2

The proportion of people who have difficulty with functional

activities rises sharply with age.
• Approximately 34% of people age 65 to 74 have functional
impairments.

In the presence of chronic conditions and loss of reserve

capacity, even a minor illness or injury can have serious
repercussions.

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 Lifestyle Influences on Health and Longevity

A lifelong program of exercise may prevent many physical

changes once associated with normal aging.
• In addition, it may improve mental alertness and cognitive
performance, help relieve anxiety and depression, and
enhance feelings of well-being.
• Inactivity contributes to disease and disability.

Nutrition plays a large part in susceptibility to chronic

illnesses; and a healthy diet is associated with a higher
quality of life in older adults.
• Periodontal disease is related to cognitive declines and
cardiovascular disease.
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 Mental and Behavioral Problems 1

Estimates are that 20% of nursing home residents have some

form of mental or behavioral problem, but only 3% seek
professional help.
• The primary reason is difficulty accessing support services.

Depression plays a pervasive role in mental functional status,

disability, and quality of life.
• Vulnerability seems to be influenced by multiple genes
interacting with environmental factors.
• Treatments include antidepressant drugs and
psychotherapy.

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 Mental and Behavioral Problems 2

Dementia: the general term for deterioration in cognitive and

behavioral functioning due to physiological causes.
• The vast majority are caused by Alzheimer’s disease: a
progressive, irreversible, degenerative brain disorder
characterized by cognitive deterioration and loss of control
of bodily functions, leading to death.
• Parkinson’s disease: a progressive, irreversible
degenerative neurological disorder, characterized by
tremor, stiffness, slowed movement, and unstable posture.
• Alzheimer’s and Parkinson’s together with multi-infarct
dementia (MD) account for at least 8 out of 10 cases of
dementia, all irreversible.
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 Mental and Behavioral Problems: Alzheimer’s Disease 1

Alzheimer’s disease (AD) gradually robs patients of

intelligence, awareness, and the ability to control bodily
functions—and finally kills them.
• It affected more than 50 million people in 2018, and the
number is expected to more than triple by 2050.
• Personality changes tend to occur early in development.
• Accumulation of an abnormal protein called beta amyloid
peptide appears to be the main culprit.
• Neurofibrillary tangles: twisted masses of protein fibers found in
brains of persons with AD.
• Amyloid plaque: waxy chunks of insoluble tissue found in brains of
persons with AD.
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 Photo: Art by Esther Lipman Rosenthal

Esther Lipman Rosenthal’s battle with Alzheimer’s disease is evident in her

artwork. She created the picture on the left, showing her husband golfing, at age
55 and the picture on the right, showing him on cross-country skis, at age 75,
during the early and middle stages of her disease.

© McGraw Hill Photos courtesy of Linda Goldman. 31

 Mental and Behavioral Problems: Alzheimer’s Disease 2

Other influences include:

• The breakdown of myelin.
• Genetics.
• Some general lifestyle factors.
Neuroimaging is showing promise as a diagnostic tool.
• Another approach has focused on three biomarkers: tau
proteins, amyloid plaques, and neurofilament light chains.
No cure has been found, but early diagnosis and treatment
can slow the progress of the disease and improve the quality
of life.

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 Photo: PET scans

These PET (positron emission tomography) scans show significant decrease of

glucose cerebral metabolism and reduced activity (left) in a patient with Alzheimer’s
disease, compared to the greater activity levels seen in a normal brain (right).

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 Intelligence and Processing Abilities 1

Wechsler Adult Intelligence Scale (WAIS): intelligence test

for adults that yields verbal and performance scores as well
as a combined score.
• In the classic aging pattern, older adults do not perform as
well as young adults, but the difference is primarily in
processing speed and nonverbal performance.
• Scores on the verbal scale—particularly vocabulary,
information, and comprehension—fall only slightly.

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 Intelligence and Processing Abilities 2

In the Seattle Longitudinal Study, perceptual speed tended to

decline earliest and most rapidly.
• Cognitive decline in other areas was slower and more
variable.
• Those most likely to show declines were men with limited
education, dissatisfaction with their success, and a
significant decrease in flexibility of personality.
• Some health-related variables were important, especially
hypertension and diabetes.
Engaging in activities that challenge cognitive skills promotes
the retention or growth of those skills and appears to protect
against dementia.
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 Intelligence and Processing Abilities 3

Much research has not found everyday problem solving to

decline as much as measures of intelligence on tests.
• Declines with age are more evident with instrumental
problems than with interpersonal problems.
In many older adults, there is a general slowdown in speed of
processing and in switching attention from one task to
another.
• Many older adults naturally compensate.
There appears to be some link between psychometric
intelligence and how long and in what condition adults will
live—but the exact relationship is still being explored.

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 Memory and Aging 1

In assessments of short-term memory, a person is asked to

repeat a sequence of numbers in digit span forward order or
in the reverse—digit span backward.
• Digit span forward, which relies on sensory memory, holds
up much better with age.
• Sensory memory: initial, brief, temporary storage of
sensory information.
• Working memory: short-term storage of information being
actively processed.
Tasks that require only rehearsal show very little decline,
while tasks that require reorganization or elaboration show
greater falloff.
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 Memory and Aging 2

Information-processing researchers divide long-term memory

into three major systems:
• Episodic memory: specific experiences or events, linked
to time and place.
• Semantic memory: general factual knowledge, social
customs, and language.
• Procedural memory: motor skills, habits, and ways of
doing things, which can be recalled without conscious
effort.
• Episodic memory is not as accessible to older adults.
• Sematic memory and procedural memory remain relatively
unaffected.
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 Speech and Memory: Effects of Aging

As people become older, they often begin to have minor

difficulties with language, and these are considered memory
problems.
• The core language processes remain relatively unchanged.

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 Why Do Some Memory Systems Decline? 1

Neurological change is one explanation.

• A disorder that damages a particular brain structure may
impair the type of memory associated with it.
• Dysfunction in the frontal lobes and hippocampus may
cause false memories.
• The hippocampus is also broadly important for memory
processes.
• The brain often compensates for age-related declines in
specialized regions by tapping other regions to help.

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 Why Do Some Memory Systems Decline? 2

Another approach looks at problems in encoding, storage,

and retrieval.
• Older adults seem to have greater difficulty encoding new
episodic memories.
• Material in storage may deteriorate to the point where
retrieval becomes difficult or impossible.
• Memories that contain an emotional component are more
resistant to the effects of decay.

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 Wisdom

Wisdom is the ability to navigate the messiness of life.

• People who are wise are also comfortable with uncertainty
and understand that different people have different
viewpoints and sometimes there is no right answer.

Wisdom is not necessarily a property of old age.

• A variety of factors affect the propensity to be wise.

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 Research in Action: The Oldest Old

One characteristic shared by the oldest old is resilience

against disease.

Genetics appears to explain about 25% of the variation in

human longevity.

Lifestyle factors are also key influencers—the most important

of which is exercise.

Successful aging also has much to do with psychosocial

factors such as positive affect, education, better cognitive
functioning, and family contact.

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 Window on the World: Elder Care Worldwide

As the world ages, one pressing need is for elder care.

• Both the number of older people and the duration of their
elder years are growing.

Switzerland tops the Global Age Watch Index, which ranks

countries based on how well older people are doing.
• It has many programs promoting health, capability, and
activity for the aging population, plus universal health care
and pension plans for all citizens.

Inequality in health care, income, education, and

opportunities is apparent between the top- and bottom-
ranked countries.
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 Questions?

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