1. Physical, Cognitive, & Mental Health Issues in Later Adulthood
Chapter 14

2. Demographics of Aging
rapid growth in number of older adults (400% increase in those > 85: )
People > 65 will outnumber others
Developed and developing countries
Profound implications
Marketing, social/political power
Health care services (fewer younger workers)

3. Diversity of Older Adults
Older women > older men
Old among ethnic minorities increasing faster than European
Native American: 65% increase
Asian: 4x increase
Older adults fastest growing segment of African Americans

4. Diversity of Older Adults
Older adults in future will be better educated
Current: 1/2 > 65 have high school diploma, 10% college
2030: 8% high school, 75% college
Better educational opportunities
Greater need for education for occupation

5. Longevity
Average life expectancy: age at which 1/2 people borne in a given year die
Increases in US for 80 years
Declines in infant-labor mortality, medical technology, elimination of diseases
Useful life expectancy: free from debilitating disease/impairment
Maximum life expectancy: oldest one can live
120 due to organ failure

6. Longevity Genes & environment key for lifespan Gender also key
Genes: provide disease resistance, slow aging
Environment: diseases, toxins, SES, lifestyle
Gender also key
Women outlive men by average of 7 years
Men more susceptible to disease?
Women have 2 X chromosomes?
Men have higher BMR?
Women have higher brain-to-body weight ratio?
Women have lower testosterone?

7. Third-Fourth Age Third Age: (young old - 60-80)
Longer, healthier lives
Cognitive, emotional reserves
High levels of well being
Mastery of later life
Fourth Age (oldest-old - > 80)
Losses in cognitive skills
Increases in negative effects of stress
High dementia rates (50% > 90)
Poor quality of life, death issues

8. Biological Theories of Aging
Wear & Tear: body wears out over time
Arthritis but not other aspects of aging
Cellular theories: focus on cell action
Division limitations (fetal tissue: 40-60, adult: 20)
Telomerase: enzyme key for cell replication that declines after each division
Cancer cells may take control of telomerase
Free radicals: chemicals produced in cells produce cumulative damage to cells

9. Biological Theories of Aging
Metabolic theories: higher BMR faster aging
Restricted caloric intake linked w/ longer life
Programmed cell death
DNA of cells ‘tell’ them to die at some point

10. Physiological Changes
Neurons
Neurofibrillary tangles (axons twist)
Dendrites may shrivel up & die
Neuritic plaques (dying neurons around protein core)
Cardiovascular (normative but rate impacted by lifestyle)
Fat deposits in/around heart (begins early)
Arterial stiffening
Increased risk for heart attack, strokes

11. Physiological Changes
Max air from one breath drops 40% (25-85)
Stiffening of ribs and air passages
Destruction of air sacs in lungs
Parkinson’s Disease
Motor dysfunction, tics
Caused by deterioration of dopaminergic neuronal systems
Treated with L-Dopa (raises functional levels of Dop)

12. Physiological Changes
Sensory Changes (vision)
Reduced amount of light passing through eye
Need more light, night vision poor
Increased glare sensitivity, reduced adaption
Lens becomes more yellow impairing color vision
Accomodation reduces
Macular degeneration: retinal cells die (1/5 > 75)

13. Physiological Changes
Sensory Changes (hearing)
Hearing loss common
Cumulative or acute noise exposure
Reduced sensitivity to high pitches (prebycusis)
50% in late 70s
Caused by damage to inner ear
Social, emotional implications
Many types of hearing aids available

14. Sensory Changes (vision)
Sensory changes (assorted)
Taste, touch, pain remain
Smell declines > 70
Balance impaired

15. Health Issues Sleep often disrupted Cancer
2x as long to fall asleep, sleep less/night and feel worse after poor sleep
Cancer
Risk dramatically increases with age
Screening critical

16. Information Processing
Attention
Selective attention: focus & filter irrelevant
Declines with age
Vigilance: attentional maintenance
Link with age unclear
Attentional control: divided, switching

17. Information Processing
Psychomotor speed (reaction time)
Declines with age
Acute with ambiguous information
Decline reduced with practice
Memory
Working memory: (holding, computational processes)
Older adults poor on episodic not semantic

18. Creativity
Ability to produce work that is novel, high in demand and task appropriate
Increases through 20s, plateaus in 30s, declines after
Most important contributions to science made by younger scientists
Old work with young

19. Wisdom Ability to solve difficult real world problems
Post-formal thinking
Deals w/ important/difficult issues of human condition
Superior cognitive processes
Knowledge with scope, depth, balance
Well intended and combines mind & virtue

20. Wisdom Wise people No link with age Experts in basic issues of life
Know how to conduct life, how to interpret events and what life means
No link with age
Do link emotion, thought and behavior in solving a problem
Empathic and compassionate

21. Wisdom Factors leading to wisdom Intelligence Personality
Fluid, crystallized, social
Personality
Creativity
Openness
Growth
Life experience

22. Depression Rate declines with age Diagnosed same way as w/ younger
Cluster of symptoms w/ 2 week duration criterion
Sadness, feeling helpless, tired & physical changes (e.g., appetite changes)
Rule out other causes (e.g., physical health)

23. Depression Causes Treatment
Biological deficiencies (neurotransmitters)
Drugs that impact NT systems are effective
Psychosocial
Negative life events, stress, helplessness
Treatment
Medications
Psychotherapy (behavior & cognitive)

24. Anxiety Disorders Feelings of anxiety for no reason Phobias
Obsessive compulsive disorder
Common in older adults (10% of older women)
Treated with medication, theraoy

25. Alzheimer’s Disease Gradual declines in cognitive functioning
Problems w/ memory, communication
Changes in personality, behavior
Confusion & paranoia common
May not recognize relatives, friends or themselves
Rate varies but faster w/ early onset

26. Alzheimer’s Disease Diagnosis Causes
Long process beginning with progressive change in cognitive functioning
Thorough physical examination and many tests (brain scans) are needed
Causes
Genetic cell death, dysfunction (neurofibrillary tangles)