Late Adulthood JLene George Life Expectancy and Life

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Late Adulthood J’Lene George

Late Adulthood J’Lene George

Life Expectancy and Life Span • Maximum human life span is 120 -125 yrs

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

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 •

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 ▫

• 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

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

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

Changes in Vision and Hearing

Sensory Systems • Most older adults experience some loss of sense of taste and

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

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

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

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 7 th leading cause with falls being more likely in older adults

Exercise, Nutrition and Vitamins • Exercise has many documented benefits for 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

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

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 ▫

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

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

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 2 nd and 3 rd decades of life

Memory 2 • Semantic memory _memory for facts and information ▫ Recall may be

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

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 ▫

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,

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 ▫

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

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 parttime work has increased since

Work • The percentage of older adults engaged in parttime 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

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

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 6080 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

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 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

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

Alzheimer • The proportion of adults afflicted doubles every 5 years after age 65 • Family history and genetics increase risk apo. E 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

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

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

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 •

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

Social Emotional

Erikson’s Theory: Ego Integrity versus Despair Ego Integrity • Feel whole, complete, satisfied with

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 •

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 ▫

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 ▫

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 • Telling stories about people, events, thoughts and feelings

Reminiscence and Life Review Reminiscence • Telling stories about people, events, thoughts and feelings from past ▫ Self-focused: can deepen despair ▫ Other-focused: solidifies relationships ▫ Knowledge-based: helps solve problems Life Review • Considering the meaning of past experiences • A form of reminiscence • For greater self-understanding • Can help adjustment

Social Theories of Aging Disengagement Mutual withdrawal of elders and society Theory Activity Theory

Social Theories of Aging Disengagement Mutual withdrawal of elders and society Theory Activity Theory Social barriers cause declining interaction Continuity Theory Strive to maintain consistency between 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

Age-Related Changes in Number of Social Partners

Marriage in Late Adulthood • Satisfaction peaks in late adulthood ▫ ▫ Fewer stressful

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

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 Divorce Few divorces in late adulthood, but increasing § Hard to

Divorce, Remarriage, Cohabitation Divorce Few divorces in late adulthood, but 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

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

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

Changes in Aid Among Siblings

Relationships with Adult Children • Quality of relationship affects elders’ physical, mental health •

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

Age Changes in Volunteering

Elder Maltreatment • Physical abuse • Physical neglect • Psychological abuse • Sexual abuse

Elder Maltreatment • Physical abuse • Physical neglect • Psychological abuse • Sexual abuse • Financial abuse

Risk Factors for Elder Maltreatment • Dependent victim • Dependent perpetrator Emotionally or financially

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