1. Chapter Fourteen The Personal Context of Later Life: Physical, Cognitive,and Mental Health Issues

2. The Demographics of Aging
The population of older adults in industrialized nations has been increasing rapidly in the 20th century
Demographers study population trends and use population pyramids to illustrate the changes
Their research predicts that in the year 2030 the number of people over 65 will equal the number in other age groups

3. Caption: Proportion of older adults aged 65 years and over by country.

4. The Diversity of Older Adults
Older women outnumber older men in all ethnic groups in the U.S.
The number of older people in ethnic minority groups in the U.S. is increasing faster than in European Americans
Currently, 50% of people over 65 have high school diplomas and 10% have college degrees. By 2030, 75% will have college degrees

5. Longevity
Longevity is the number of years a person can expect to live

6. Longevity (Cont) Three types of longevity
Average life expectancy is the age at which half the people born in a particular year will have died
Useful life expectancy is the number of years a person is free from debilitating chronic disease
Maximum life expectancy is the oldest age to which any person lives

7. Genetic and Environmental Factors in Life Expectancy
Heredity is a major factor in longevity
Environment plays a role through the effects of disease and toxins
Social class plays a role because certain conditions are related to lack of access to health care

8. Ethnic and Gender Differences in Life Expectancy
Life expectancy is complex and varies among ethnic groups
European American life expectancy is longer than that of African Americans’, but not as long as for Hispanic Americans
Life expectancy varies at different ages

9. Ethnic and Gender Differences in Life Expectancy (Cont)
Women live longer than men by about 7 years. For those who live to 85, the difference is only 1 year
Men are more susceptible to infectious diseases and other conditions that are likely to be fatal
While many explanations have been offered, no consistent finding has been found that supports one theory

10. International Differences in Longevity
Dramatic differences exist between longevity statistics among countries
38 in Sierra Leone
80 in Japan
Genetic, sociocultural, and healthcare factors contribute to the differences

11. Caption: Increase in average longevity at birth in the U.S.

12. The Third-Fourth Age Distinction
Third Age adults are between the ages of 60 to 80
Many advances in knowledge and technology have contributed to the better quality of life for this group
Fourth Age adults are over 80
Few interventions have been developed to hold back cognitive and physiological declines in this group

13. What Makes One Wise?
General personal conditions, such as mental ability
Specific expertise conditions, such as practice or mentoring
Facilitative life contexts, such as education or leadership experiences

14. Depression
Depression is diagnosed based on two changes: Feelings and physical changes
Feelings of sadness are called dysphoria
Physical changes include loss of appetite, insomnia, and trouble breathing
Evaluation of older adults is difficult because some of these changes may be normal

15. What Causes Depression?
Biological and physical causes may include imbalances in neurotransmitters
Internal belief systems may play a role in how people interpret things that happen to them

16. How Is Depression Treated in Older Adults?
Medicines that affect the levels of neurotransmitters, such as heterocyclic antidepressants (HCAs), monamine oxidase inhibiters (MAOIs), and selective seratonin reuptake inhibitors (SSRIs), may be used
Psychotherapy in the forms of behavior therapy or cognitive therapy may be used to learn new behaviors or examine the way patients think about their experiences

17. Anxiety Disorders
Anxiety disorders include phobias and obsessive-compulsive disorder
Anxiety disorders are more common in older adults, partly due to loss of health, relocation of residence, isolation, loss of independence, and other factors
Anxiety disorders can often be successfully treated with psychotherapy and medications

18. Dementia: Alzheimer’s Disease
Dementia is a family of diseases that results in serious behavioral and cognitive impairments. Alzheimer’s disease is one of the more common
Alzheimer’s disease may cause confusion, disability, and dependence
The incidence of Alzheimer’s disease increases with age. Women are at greater risk

19. What Are the Symptoms of Alzheimer’s Disease?
Declines in memory, attention, and judgment
Confusion and difficulties in communication
Changes in personality and decline in hygiene
Incontinence, or the loss of bladder or bowel control

20. How Is Alzheimer’s Disease Diagnosed?
Diagnosis can only be confirmed by autopsy
Diagnosis is made by microscopic analysis of neurons in the brain
The diagnosis of possible Alzheimer’s disease is based on extensive psychoneurological testing and ruling out other causes for symptoms

21. What Causes Alzheimer’s Disease?
The exact cause is not known
Possible explanations have included a slow-acting virus and aluminum deposits in the brain. These have not be confirmed
Genetic research has shown promising results in identifying genetic markers related to specific genes

22. What Can Be Done for Victims of Alzheimer’s Disease?
Though symptoms can be successfully treated, no cure exists
Galantamine appears to help memory loss but does not reverse the deficits
Thioridazine and haloperidol are used to treat severe psychotic symptoms
Antidepressants may be used to treat the depression that often goes along with the disease