SENIOR YEARS-- OLDER ADULTS:
- Late adulthood: Demographics
- More elderly adults (living longer) and fewer young in all developed countries.
- In Japan & much of Europe: population already older than in U.S.
- Families having fewer children-- approaching "Zero Population Growth"
(This is world-wide, but in U.S. immigration slows this trend a bit)
- Social consequences: More resources needed for elder care (hospitals, nursing care);
fewer resources needed for schools, etc.
Aging Populations
- Longevity:
- Avg. longevity increasing everywhere (more retired people, fewer wage earners)
- Maximum longevity increasing-- more nursing and elder care facilities needed
- Also: Healthier elderly-- more cruise ships, golf, etc.
- If you have long-lived parents and grandparents, your chances of living longer are increased.
- Women generally live longer than men (~5 yrs on average); ethnic groups vary
- Internationally: Abkhazia*, Switzerland: older adults stay active, so they live longer!
*Autonomous, mountainous region in western Republic of Georgia, east of Black Sea
Staying active >60 is important; mountainous terrain helps (Tibet, parts of Peru, too)
Japan, Spain, Italy, etc.: older adults more respected, encouraged to stay
socially engaged and healthy, so they live longer!
- Age 60-80 sometimes called "Third age"-- healthier physically, help families, emotional well-being valued, also cognitive wisdom
- Age 80+ called "Fourth age"-- more frail, more dependent (burden on many families), more cancer, more Alzheimer's disease
| Notable people professionally active past age 80
| | Name | Dates | Active until-- | Lived until..
| | Frank Sinatra, singer | 1915-1998 | Performed until age 80 | 83
| | Maurice Chevalier actor, singer | 1888-1972 | Performed until age 82 | 84
| | Irving Berlin, song writer | 1888-1989 | Composed untoil age 83 | 101
| | Georgia O'Keefe, painter | 1887-1986 | Painted until age 85 | 99
| | Julie Andrews, actress, singer | 1935-now | Still performing | 85+
| | Bea Arthur, actress | 1922-2009 | Performed until age 86 | 87
| | Jane Goodall, primatologist | 1934-now | Still lecturing | 86+
| | Arturo Toscanini, conductor | 1867-1957 | Conducted until age 87 | 90
| | Arthur Rubinstein, pianist | 1887-1982 | Performed until age 89 | 95
| | Pablo Casals, cellist | 1876-1973 | Composed and
performed until age 94 | 97
| | Betty White, actress | 1922-now | Still acting | 98+
| | Sewall Wright, geneticist | 1889-1988 | Published until age 99 | 99
|
Interviewer: "How do you feel about growing old?
Maurice Chevalier: "It's very nice, when you consider the alternative." |
- Biological theories of aging:
- Telomeres on ends of chromosomes shorten with each cell division; this eventually limits cell repair
(unless "telomerase" is present, as in embryonic cells or in cancer)
- "Free radicals" (molecules with unpaired electrons) cause genetic damage. Diet rich in antioxidants lowers cancer risks & prolongs life.
- Physiological changes:
- Brain and nervous system:
- Neurons with less sprouting
- Buildup of beta-Amyloid protein leads to Alzheimer's disease; also neurofibrillary tangles inside nerve cells causes them to die
- Cell damage leads to loss of some neurotransmitters (e.g., Parkinsonism)
- Neuroimaging shows: Brain tissue shrinks, brain cavities (vesicles) may enlarge.
- Cardiovascular system:
- Atherosclerosis (fat deposits, which may calcify): higher risk of strokes, heart disease
- Arteriosclerosis: lining of arteries harden and become less elastic
- Transient Ischemic Attacks ("mini-strokes"): interrupted blood flow; early sign of impending larger stroke
- Vascular dementia: many small strokes in brain
- Heart attacks (myocardial infarction =death of heart muscle tissue)
- Respiratory system: COPD (Emphysema & Chronic bronchitis)-- much more in former smokers or those exposed to air pollution
- Vision loss:
- Presbyopia (near-sightedness): need reading glasses, don't see as well at night
- Cataracts-- opaque spots in lens tissue
- Glaucoma-- lens gets stiffer, less ability to focus
- Macular degeneration-- loss of retinal cells, often leads to blindness
- Diabetic retinopathy-- death of cells from blood vessel damage in retina
- Hearing loss: Sensitivity to high-pitched tones declines the most (presbycusis)
- Chronic diseases:
- Diabetes (especially type 2)
- More cancers
- Frequent declines in sleep
- Nutritional deficiencies from eating less
Advice: Eat less, but keep up vitamins, fiber (fruits, vegetables, whole grains), & fish
Mediterranean and DASH diets emphasize low-fat proteins (like fish, yogurt, cottage cheese), healthy fats*, lots of fruits, grains, and vegetables
*includes omega-3 fatty acids (fish, nuts) and monounsaturated
fatty acids (olive oil), but avoid saturated fats (red meats)
- Attitudes of others is important; important to remain socially engaged
(if no longer employed, then volunteer, get active in church or community group, etc.)
- Cognitive decline (proceeds faster if poor cardiovascular health):
- Slower reaction time (driving can become a problem)
- Multitasking skill declines (more easily distracted, which causes forgetting)
- Memory loss:
- Working (short-term) memory-- remembering a phone number long enough to dial
Test with random words; "digit span"-- Can you repeat a list of 5 digits? 8 digits?
- Implicit memory = unconscious (often kinesthetic): tying a bow, using a can-opener
- Explicit memory = deliberate, conscious (often verbal)
- Episodic memory = memory or past events
- Semantic memory = meanings of words
- Autobiographical memory = memory of events from one's distant past
- Some memory loss in normal, but abnormal if it impairs daily functioning
- Memory aids-- "E I E I O":
E=Explicit memory I=Implicit memory
E=External aid I=Internal aid
O="Oh, now I remember!"
- Explicit, external-- grocery list, appointment book, pill organizer (with compartments)
- Implicit, external-- color-coded maps, doors, signs
- Explicit, internal-- mental imagery, rote rehearsal, mnemonics, tunes
- Implicit, internal-- learned associations (conditioning): I live in the yellow house; turn left at the brown door;
go just past the fire extinguisher
- Creativity (of artists, composers) peaks in 30s and 40s; it declines with age (but not always)
- Wisdom-- not always age-related but more more revered
Older people remember more examples; Tell more stories to young; Have more patience
- Mental health:
- Loneliness-- living with family is best; even pets; keeping in touch often
- Depression (dysphoria) is less common in elderly
- Treatment in elderly (when needed):
- Behavior therapy (encourage more social contacts), or
- Cognitive therapy (learn to recognize negative thoughts, substitute positive ones)
- Anxiety disorders MORE common in elderly:
Treatments include psychotherapy; benzodiazepine drugs like Valium, Librium, Paxil (but beware of overdoses)
- Dementia incl. Alzheimer's: Hard to treat; some drugs can slow progress but not reverse
- Brain changes: APO-ϵ4 allele; β-amyloid (especially small 'oligomers', then clumps or 'plaques');
then phosphorylation of tau protein, causing neurofibrillary tangles
- Symptoms include forgetting names of loved ones, losing sense of place (lost in places once familiar), etc.
- Progressive disease: can slow but never reverse
- Diagnosis p. 494-- many other causes to rule out
- Incontinence (loss of bladder control): adult diapers used
- Parkinson disease: loss of cells in basal ganglia of brain; loss of dopamine that they secrete
--starts with tremors; shuffling gait; hard to initiate movement or lift feet
- Chronic Traumatic Encephalopathy (CTE): from repeated brain injuries (often in football, boxing)
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