CHAPTER 13

NOTES AND TEST

 

 

The Personal Context of Later Life

 

 

What are older adults like?

1.     The demographics of aging

a.     There is an increase in the number of older adults, especially those over 80

b.    In the future, older adults will be more ethnically diverse and better educated than they are today

 

2.     Life expectancy

a.     This century the average life expectancy has increased dramatically, mainly due to major improvements in health care.

1.     Useful life expectancy, is the number of years an individual has that are free of debilitating disease

2.     Maximum life expectancy is the longest time and individual can live

b.    Genetic factors such as familial longevity and family history of certain diseases influence how long an individual could live

c.     Environmental factors such as acquired disease, toxins, pollutants and life cycle also influence how long an individual could live

d.    Today technological intervention has created a controversy between quantity versus quality of life

e.     Ethnic group differences, are complex and different patterns of life expectancy, and emerge depending on how old people are

f.      Women on the average have a longer life expectancy at birth than men

 

Physical changes and health

1.     Biological theories of aging

a.     There are four major biological theories of aging

1.     The wear and tear theory suggests that aging is caused by body systems simply wearing out

2.     The cellular theories focus on reactions with cells involving free radicals and cross-linking

3.     The metabolic theories focus on reactions with cells involving free radicals and cross-linking

4.     The programmed cell death theories suggest that aging is genetically programmed

b.    Not theory so far has been successful in explaining aging

 

 

2.     Physiological changes

a.     The three most important structural changes in the neuron are

1.     neurofibrillary tangles

2.     dendritic changes

3.     neurotic plaques

 

b.    Each one of these plays an important role in functioning, because they reduce the effectiveness with which neurons transmit information.  With age the levels of neurotransmitters also decline.

c.     The risk of cardiovascular disease increases with age.  Changes in the cardiovascular system include:  build up of fat deposits in the heart and arteries, decrease in the amount of blood the heart is able to pump, weakening of heart muscle tissue, and stiffening of the arteries.  Life style affects most of these changes

d.    Significant cognitive impairment can be caused by stroke and vascular dementia.  The extent and affect of the damage depends on the location of the brain damage

e.     Hard to identify are normative changes in the respiratory system due to the lifetime effects of pollution.  Older adults usually suffer shortness of breath, and their risk of chronic obstructive pulmonary disorder increases

f.      Insufficient levels of dopamine cause Parkinson’s disease, which can be effectively managed with the administration of L-Dopa.  In a few cases dementia develops

g.     Declines in vision and hearing are also reported as a result of aging.  Changes in smell, taste, touch pain and temperament are not as clear

 

Health Issues

1.     Information processing

a.     Research has found that older adults are much slower at visual search unless there is an advance signal

b.    Research also has found that age differences in divided tasks depend on the level of difficulty;  on tasks that are easy there are no differences, but on tasks that are hard young adults perform better.  The psychomotor speed of older adults is also slower, but the amount of slowing becomes less if older adults have practiced the task

c.     Sensory and information processing changes create the problems older drivers have

d.    Working memory also declines with age

 

2.     Memory

a.     Older adults almost always do worse on laboratory memory tasks that require free recall.  These differences are reduced on recognition memory tasks and on some real world memory tasks

b.    Secondary memory also declines with age, but tertiary memory does not

c.     What individuals believe to be true about their memory is related to their performance.  Beliefs about whether cognitive abilities are supposed to change may be most important

d.    Comprehensive evaluations is the way to differentiate memory changes that are associated with aging and those associated to disease

e.     Memory training can be accomplished in a number of ways.  One way is to combine explicit-implicit memory distinctions with external-internal type of memory aids

 

3.     Training intellectual abilities

a.     Training studies have demonstrated that performance on at least some intellectual abilities such as inductive reasoning and spatial orientation, can be significantly improved

 

4.     Creativity and wisdom

a.     Creative output increases until the 30s and then begins to decline.  The age at which creativity peaks varies by discipline

b.    Wisdom is related to being an expert in living, than with the age of the person.

 

Factors that help people become wise are:

a.      general personal conditions

b.     specific expertise conditions

c.     facultative life contexts

 

Mental Health and Intervention

1.     Depression

a.     Key symptom of depression is persistent sadness

b.    Other psychological and physical symptoms occur at that age, but how important they are depends on the age of the person reporting them

c.     Major causes of depression include:

1.     imbalance in neurotransmitters

2.     psychological issues such as loss of internal belief systems

d.    Depression can be treated with medications (heterocyclic antidepressants and MAO inhibitors) and through psychotherapy (behavioral or cognitive therapy)

 

2.     Anxiety disorders

a.     Older adults also suffer from a variety of anxiety disorders, all of which can be treated with either medications or psychotherapy

 

3.     Dementia:  Alzheimer’s disease

a.     Dementia is a family of diseases that causes cognitive impairment

b.    The most common form of irreversible dementia is Alzheimer’s disease

c.     Symptoms of Alzheimer’s disease include:  memory impairment, personality and behavioral changes.  These symptoms get worse, with rates varying across individuals

d.    Definitive diagnosis of Alzheimer’s disease can only be made following brain autopsy.  Diagnosis can be made only after a thorough process during which other possible causes are eliminated

e.     Researchers are now focusing on probable genetic cause for the disease

f.      Alzheimer’s disease for now is incurable, but various therapeutic interventions can be made in order to improve the quality of the patients’ life