Physical and Cognitive Development in Late Adulthood Chapter 17

Functional Age Actual competence and performance may not match chronological age because some 80 year old appear younger than 65 year olds and vice versa No single biological measure can predict rate of aging

Life Expectancy Life expectancy is increasing in U.S. because of steady decline in infant mortality decrease in adult death rates Life expectancy varies with SES, ethnicity and nationality. As education and income increases so does the length of life Women have 2 to 7 more years in life than men In the USA, a white child is likely to live 3 to 6 years more than an African American child In developing countries with widespread poverty, malnutrition, and disease, the life expectancy is around 55 years compared with the industrialized world.

Variations in Healthy Life Expectancy Japan ranks first: low rates of obesity, heart disease favorable health-care policies U.S. lags behind: lifestyle factors health-care policies In developing nations, reduced by poverty, malnutrition, disease armed conflict

Maximum Lifespan oldest verified age: 122 years Species-specific biological limit: oldest verified age: 122 years Some scientists believe upper limit not yet reached: question: Should maximum lifespan be increased? goal is quality, not quantity, of life

Factors Contributing to Long Life Heredity Environment and lifestyle: healthy diet, normal weight exercise low substance use optimistic toughminded, independent social support community involvement learning

Quality of Life Activities of Daily Living (ADLs): basic self-care tasks bathing, dressing, eating Instrumental Activities of Daily Living (IADLs): conducting business of daily life require some cognitive competence shopping, food preparation, housekeeping, paying bills

Aging and the Nervous System Loss of brain weight accelerates in sixties Neurons lost, especially in prefrontal cortex (executive function) corpus callosum cerebellum (balance) glial cells Autonomic nervous system less efficient How the brain compensates: new fibers, neurons new connections use more parts of brain

Visual Impairments and Aging Lower visual acuity Poor dark adaptation, sensitivity to glare Decreased color, depth perception Cataracts Macular degeneration

Aging Systems of the Body Cardiovascular/respiratory systems: heartbeat less forceful; slower heart rate, blood flow less oxygen delivered to tissues vital lung capacity reduced by half Immune system: effectiveness declines more infectious, autoimmune diseases stress-related susceptibility Healthy diet, exercise help protect immune response

Sleep and Aging consistent bedtime, waking time regular exercise Total sleep needs remain constant Sleep timing changes: earlier bedtime, earlier wakening Sleep difficulties: insomnia nighttime waking Fostering restful sleep: consistent bedtime, waking time regular exercise using bedroom only for sleep

Physical Appearance and Mobility Skin thinner, wrinkled, spotted Ears, nose, teeth, and hair change Lose height and weight after age 60 Muscle strength declines Bone strength drops Flexibility decreases

Adapting to Physical Changes of Aging Subjective age vs. physical age Effective coping strategies: prevention and compensation sense of personal control problem-centered coping Assistive technology and “smart- home” design Person–environment fit

Stereotypes of Aging Assumption that deterioration is inevitable: leads to prejudice, discrimination influenced by culture Stereotype threat: increases physiological response to stress reduces functioning Aging a source of pride in some cultures

Factors in Good Health and Aging Self-efficacy Optimism SES Ethnicity Sex Nutrition Exercise

Nutrition in Late Adulthood Need extra nutrients to protect bones, immune system prevent free radicals Problems with eating: appetite, taste changes chewing, digestive changes shopping, cooking Diet high in nutrients fosters physical, cognitive health

Exercise in Late Adulthood Even sedentary older adults show gains with endurance training Benefits: physical cognitive self-esteem Importance of instilling sense of control

Sexuality in Late Adulthood Sex remains important: decline in frequency; fewer male partners for women healthy couples: continued regular, enjoyable sex Continue patterns of earlier years Factors reducing sexual activity: tobacco, alcohol, prescription drugs may interfere men with erection problems may stop all sexual interaction

Primary and Secondary Aging Primary Aging (Biological Aging) Genetically influenced declines Affects all members of species Occurs even when health is good Secondary Aging Declines due to heredity and environment Effects individualized: major contributor to frailty Illnesses and disabilities: arthritis diabetes unintentional injuries mental disabilities

Leading Causes of Death in Late Adulthood

Arthritis Osteoarthritis Deteriorating cartilage in frequently used joints Common, related to wear and tear Rheumatoid Arthritis Autoimmune response Involves whole body Inflammation of connective tissue Cartilage tissue grows: deformed joints loss of mobility

Adult-Onset Diabetes heredity inactivity, abdominal fat Too little insulin or cells insensitive to insulin Incidence rises with age as a result of heredity inactivity, abdominal fat Risk of long-term damage to circulatory system eyes, kidneys, nerves brain Treatment: diet, exercise, weight loss

Accidents in Late Adulthood Motor vehicle Vision problems, slower reactions Falls Vision, balance, strength problems Risk of hip fracture Limits mobility, social contact

ALZ.ORG https://www.youtube.com/watc h?v=ROTZxvil66A&feature=yout u.be As you read the facts: Pick 1 or 2 that strike you as particularly surprising.

Short Clip “My Name is Lisa” https://www.youtube.com/watc h?v=ZiRHyzjb5SI As you watch the short film think about the intersections of development occurring here. As an adolescence As a person in Middle Adulthood with Early onset Alzheimer’s Disease.

Mental Disabilities in Late Adulthood Dementia: impairments of thought and behavior that disrupt everyday life: Alzheimer’s disease cerebrovascular dementia: result of strokes Misdiagnosed or reversible dementia: depression medication side effects

Alzheimer’s Disease Incidence Higher with age: nearly 45% over age 85 Symptoms Forgetting, disorientation, personality change, depression, motor problems, delusions, speech problems, infections Brain Changes Neurofibrillary tangles, amyloid plaques in cerebral cortex, synapse deterioration Risk Factors Genetic predisposition High-fat diet Lifestyle factors Protective Factors Education, active lifestyle Mediterranean diet Active social life

Help for Caregivers of Elders with Dementia Knowledge about disease, available resources Coping strategies Caregiving skills Respite Intervention programs

Long-Term Care in Late Adulthood More common with advanced age: severe disorders loss of support network Varies by SES, ethnic group Alternatives: home care by family assisted living home-helper systems

Selective Optimization and Compensation Choose personally valued activities, avoid others Devote diminishing resources to valued activities Compensate Find creative ways to overcome limitations

Deliberate vs. Automatic Memory Episodic memory lapses: slower cognitive processing poor attention to context Recall declines: harder to remember source of information temporal memory suffers Automatic Recognition easier than recall: environmental supports Implicit memory better than explicit memory: depends on familiarity, not conscious awareness

Associative Memory Deficit in Late Adulthood Difficulty in creating or retrieving links between pieces of information Helpful strategies: memory cues elaboration

Remote and Prospective Memory Very long-term recall Autobiographical memory for both remote and recent events Reminiscence bump for events of adolescence, early adulthood Prospective Remembering to engage in planned actions Event-based easier than time- based Risk of repetition of actions Reminders can help

Language Processing in Late Adulthood Little change in comprehension Losses in retrieval of words from long-term memory (tip-of-the-tongue state) ability to plan what to say and how to say it Compensatory techniques: speak more slowly, using more sentences, but shorter ones

Problem Solving in Late Adulthood Real vs. hypothetical problems: family relationships managing activities of daily living Extend adaptive strategies of middle adulthood: use experience to decide quickly when able consult family members and others collaborate to generate strategies

Wisdom Breadth and depth of practical knowledge Ability to reflect on, apply knowledge to improve life Ability to listen, evaluate others’ concerns Transmission of useful knowledge, reflections to younger people

What Contributes to Wisdom? Life experience: human-service training and practice leadership positions Age: no guarantee of wisdom helpful when combined with life experience History of overcoming adversity Education, physical health

Factors Related to Cognitive Change Modest genetic contribution Mentally active life: education, stimulating leisure, community participation, flexibility Health status Retirement: both positive and negative effects Distance to death: terminal decline Cognitive interventions: ADEPT: Adult Development and Enrichment Project, ACTIVE Advance Cognitive Training for Independent and Vital Elderly

Lifelong Learning Road Scholar Osher Lifelong Learning Institutes Increased participation in continuing education: Road Scholar Osher Lifelong Learning Institutes community senior centers Benefits: new ideas, skills, friends broader world perspective improved self-image rise in use of computers and Internet