Theories of Aging 30/1/2011

“Everyman desires to live long, but no man would be old.”

THEORIES OF AGING Prior to the middle of the twentieth century, the cause of death listed on many older adults’ death certificates was old age. It was thought that at some later point in life, the body just gave out. The growth in scientific medical and gerontological knowledge over the past century has challenged this popular view. At the 55 th annual meeting of the Gerontological Society of America, a presentation by Butler and Olshansky (2002) continued to debate, “Has anyone ever died of old age?”

Despite the continuing debate, the question remains: in the absence of illness, why do people die? The results of efforts to answer this question are derived from theories of aging.

Biological Theories Explain that the reason people age and die is because of changes in the human body. Two of the main biological categories are feature and defect theories. Feature theory is consistent with the work of Hayflick (2007) commonly known as the “Hayflick limit.” The Hayflick limit essentially states that cells will divide for a finite number of times, and once they have reached this limit, the cells shrink, disperse, and eventually die, resulting in death of the body. The Hayflick limit relies heavily on the science of “programmed cell death” or “apoptosis.” In other words, theorists who support this theory believe that how a person ages is genetically predetermined.

Consistent with this theory, little can be done to alter the aging process, despite interventions taken to promote health and prevent illness. The main purpose of aging, according to feature theory, is to improve or perfect human beings. Supporters of the feature theory look to the wide variation in lifespan among people in similar environments to support the theory. For example, two people who grow up and live their lives in the same town, performing similar jobs and having similar families may die at vastly different ages as a result of their genetic make-up.

The defect theory is a biological theory that is somewhat the opposite of feature theory. According to the defect theory, the breakdown and losses that occur with aging are accidents or mistakes. Defect theories lead researchers to believe that the cause of death of older adults generally results from a wearing out of the body, or an accumulation of mutations in DNA that can no longer be withstood.

In contrast to feature theory, defect theory supports the work of health promotion and illness treatment and management as an important manner in which to prolong life. Examples of defect theory in action are seen among the large numbers of older adults who survive years after treatment for aggressive cancers or cardiac disease.

Recent work related to the defect theory shows great support for the influence of caloric restriction on the aging process ( Caloric restriction (Anti-aging diet) was originally conceived by Pearl (1928) as a manner in which to optimize metabolism to expand life. This theory, which has repeatedly been tested, revealed that when mice and rats were fed a calorie-restricted but nutritious diet, they lived about 50% longer than rats fed regular diets. Moreover, the study showed that the study rats were more active and youthful. This translates to about a 30% increase in longevity for human beings or 10 to 15 years of added human life.

Psychological Theories Support the idea that an older adult’s life ends when they have reached all of their developmental milestones. For example, Maslow’s Hierarchy of Needs states that a person’s final stage is self- actualization. From a psychological viewpoint, once an older adult reaches self-actualization, they approach the end of life.

Other theories within the psychological dimension include Erikson’s stages of development (1997). Erikson theorizes that within each stage of life, individuals must successfully encounter and resolve a problem or crisis in order to move on to the next stage. Within the final stage, ego integrity versus despair, the older adult must successfully master changes in health, loss of loved ones, and resolution of role changes such as no longer being a parent, employee, or friend.

Moral/spiritual theories Moral/spiritual theories support the idea that once an older individual finds spiritual wholeness, this transcends يتجاوز) (the need to inhabit a body, and they die. Theories that fall within this category include Kohlberg’s stages of moral development (Lind, Hartman, &Wakenhut, 1985). Kohlberg’s theory of moral development states that an individual goes through a series of moral reasoning activities that become progressively more sophisticated throughout life.

Sociological Theories Sociological theories explain that aging results as older adult’s usefulness in roles and relationships changes or declines.

Disengagement theory states that as relationships change or end for older adults, either through the process of retirement, disability, or death, a gradual withdrawing of the older adult is evidenced. Less involvement in activities is seen. Activity theory. This theory states that social activity is an essential component of successful aging. Consequently, when social activity is halted because of death of loved ones, changes in relationship, or illness and disabilities that affect relationships, aging is accelerated and death becomes nearer.

The focus of activity theory is the relationship between activity and self concept. In other words, social activity and role relationships are integral to the self- concept and harmful when disrupted or stopped. To avoid this, new roles must be developed to replace lost roles. For example, within this theory, the loss of job roles through retirement could be replaced with appropriate recreational or volunteer activities to avoid the harmful effects of the job loss on self- concept.

Nursing Implications Nurses who consider aging as a progressive decline ending in death may view old age as a depressing, useless period and foster hopelessness and helplessness in older patients. Nurses can promote joy and a sense of purpose in the elderly by viewing old age as an opportunity for continued development and satisfaction.

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