Late Adulthood

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Late Adulthood

• Ch 23-25
• Developmental Psychology
• Jen Wright

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Health and aging

• Positives
• Less susceptibility to colds and allergies
• Frequency of accidental deaths drops dramatically
• Negatives
• Natural aging process
• Increased disability
• Increased vulnerability to disease
• Decreased capacity to respond to stress
• And, even in the absence of these things, death.

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The aging process
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what ages?

• Sense organs
• All internal systems
• Cardiovascular, respiratory, etc.
• Immune system
• Muscles, joints, bones
• Sleep
• Brain
• Sexual reproductive system
• Physical appearance
• Attitudes

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Aging can be beautiful!
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different kinds of aging

• Universal aging
• Primary aging
• Probabilistic aging
• Secondary aging
• Chronological aging
• Biological aging
• Social aging
• Ageism
• Population aging

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universal/biological aging

• Senesence
• The universal biological processes of a living
  organism approaching an advanced age.
• Oganismal senescence
• Increasing homeostatic instability
• Declining ability to respond to stress
• Increasing risk of disease, dysfunction,
  disability

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• Cellular senescence
• Once believed that normal cells were in principle
  immortal
• Environmental factors responsible for cell death
• Now we know that most (but not all) cells die
• Hayflick limit
• Number of times a cell will divide before dying
• 52 times in 20 oxygen (normal air)
• 70 times in 3 oxygen (human internal conditions)

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What controls cell division?

• Cells possess molecular clocks
• Telomeres
• Non-coding appendix on ends of DNA
• Shortened by mitosis
• At certain length, cell will no longer divide
• Protective mechanism against chromosome
  destruction, mutation, and cancer
• Other forms of programmed cell death
• E.g. apoptosis
• Triggered by mitochondria

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Biological theories of aging

• Aging clock theory
• Telomere theory
• Wear and tear theory
• Evolutionary theory
• Late-acting deleterious mutations not selected
  against
• Somatic mutation theory
• Error accumulation theory
• Free-radical theory
• Mitochondrial hormesis
• Accumulative waste theory

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• How long is a normal life?
• maximum life span
• the oldest possible age that members of a species
  can live
• under ideal circumstances for humans
• approximately 122 years
• average life expectancy
• the number of years the average newborn in a
  particular population group is likely to live

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aging prevention

• Artificial extension of telomeres
• Trade-off between aging and cancer
• Vitamin D naturally lengthens
• Increased sirtuins repair damage to DNA
• Caloric restriction
• Intermittent fasting
• Organ/tissue repair and rejuvenation
• Free-radical therapy
• Stem cells
• Organ/tissue replacement
• Artificial and cloned organs/tissue

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• Increasing morbidity (disease)
• Increasing mortality (death)
• Top 4 disease-related deaths
• Cancer
• Heart disease
• Cerebrovascular disease
• Pulmonary disease
• Effects of gender?
• Effects of SES?

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• Other diseases that occurs with increasing
  frequency with age
• Arthritis
• Cataracts
• Osteoporosis
• Type 2 diabetes
• Hypertension
• Alzheimers disease

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• Distinguish between normal aging and pathology
• Identify risks
• Increased complications for minor illnesses and
  accidents
• Vulnerability to major diseases
• Healthy vs. unhealthy lifestyles
• Diet
• Exercise
• Preventative care
• Other habits

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poor health habits tobacco

• in all its forms contains harmful drugs
• nicotine is the most addictive
• Dramatically decreases lung capacity
• death from lung cancer is down by 20 from 1980
  1995
• Still in top 10 killers

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poor health habits alcohol

• In moderation (no more than two moderate-sized
  drinks a day) can increase lifespan
• reduction in coronary heart disease
• alcohol increases high-density lipoprotein (HDL),
  the good cholesterol and reduces low-density
  lipoprotein (LDL), the bad cholesterol that
  causes clogged arteries and blood clots
• Heavy drinking increases risk of death
• 27,000 death from liver disease/year
• Increased risk from many other diseases
• Brain damage, decreases fertility, osteoperosis
• Associated with other bad habits overeating,
  smoking
• Increased risk of other forms of death suicide,
  homocide, accidental

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poor health habits inactivity

• Lack of exercise

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good health habits

• Leisure time -- vacations
• 12,338 men between 35 57 years
• 21 less likely to die over 9 years
• 32 less likely to die of coronary heart disease
• Social involvement
• Engagement
• Activity
• Continuity

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Ericksons stages

• Identity certainty
• Developed network of intimacy
• Generativity vs. stagnation (mid-life)
• Integrity vs. despair (late life)

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generativity

• Feeling needed by people
• Helping younger generation develop
• Influence in community or area of interest
• Productivity and effectiveness
• Appreciation/awareness of older generation
• Broader, more global perspective
• Interest in things beyond family

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integrity

• Wisdom
• Acceptance of life circumstances
• Finding meaning
• Dimensions of well-being
• Self-acceptance
• Purpose in life
• Positive relationships
• Environmental mastery
• Personal growth
• Autonomy

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centenarians

• People living to be 100 years old
• 55,000 in US in 2005
• 1 in 50 women, 1 in 200 men
• 30,000 in Japan
• Okinawans 5x more likely
• 450,000 world-wide
• Super-centenarians 110 years

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• Reviewing lives of different centenarians
• Many differences in lifestyles
• Yet, they were similar in four ways
• diet was moderate
• work continued throughout life
• family, friends, community ties were important
• exercise and relaxation were part of daily
  routine

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Social aging

• Unlike gender/ethnicity
• Doesnt apply for entire life.
• (potentially) applies to everyone.
• Ageism
• Negative stereotypes associated with age
  negatively influence performance, function, and
  well-being.
• Positive stereotypes associated with age
  positively influence performance, function, and
  well-being.

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• cognitive decline is rooted not in the older
  persons body and brain but in the surrounding
  social context
• cultural attitudes can lead directly to age
  differences in cognition
• does most harm when individuals internalize other
  peoples prejudices and react with helplessness
• if the elderly fear losing their minds because
  they have internalized the idea that old age
  always bring dementia, that fear may become a
  stereotype threat, undermining normal thinking

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• Ageism among scientists
• scientists measure age differences in memory in
  the same way they studied memory in generalin
  laboratories
• these factors work against older adults, who tend
  to perform best in familiar settings

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population aging

• Increased age of population
• Two causal factors
• Rising life expectancy
• Declining fertility
• Asia/Europe face severe population aging
• Average age approaching 50
• Economic implications
• More savings/less spending
• Increased health care
• Less education
• Retirement/social security

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Population aging
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Development of dementia

• Loss of intellectual ability in elderly people
  has traditionally been called senility.
• The pathological loss of brain function is known
  as dementialiterally, out of mind, referring
  to severely impaired judgment
• dementia
• irreversible loss of intellectual functioning
  caused by organic brain damage or disease
• becomes more common with age, but it is abnormal
  and pathological even in the very old

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Alzheimers disease

• First described by German psychiatrist
• Alois Alzheimer (1906)
• Generally diagnosed in people over 65 years
• Early-onset before 65 years
• 5-10 of patients
• Several genetic causes
• 4.5 million American suffer from it
• 5 of 65-74 years
• Nearly 50 of 85
• 1 in 6 women over 55 1 in 10 men over 55

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• http//www.alz.org/brain/01.asp

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Symptoms of Pre-dementia

• Early symptoms similar to age-related or
  stress-induced memory loss
• Difficulty remembering recently learned facts
• Subtle cognitive difficulties
• Executive function of attentiveness
• Planning, flexibility
• Abstract thinking
• Impairment in semantic memory
• New memory formation
• Mild confusion
• Apathy
• As early as 5-10 years (some say 20 years) before
  official diagnosis

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Moderate stages

• Hindering of independence
• Paraphasias
• Phonemic paraphasia - Mispronunciation, syllables
  out of sequence. e.g. "I slipped on the lice
  (ice) and broke my arm."
• Verbal paraphasia - Substitution of words
• Semantic paraphasia - The substituted word is
  related to the intended word. e.g. "I spent the
  whole day working on the television, I mean,
  computer."
• Remote paraphasia - The substituted word is not
  really related to the intended word. e.g. "You
  forgot your lamp, I mean, umbrella."

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• Memory problems worsen
• STM and LTM
• Failure to recognize close relatives
• Behavioral changes
• Wandering
• Sundowning
• Irritability
• Labile affect
• Progression is typically 2-10 years

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Advanced stages

• Complete dependence
• Significant language impairment
• Eventual loss of speech
• Apathy, exhaustion
• Loss of mobility, ability to feed oneself
• External causes of death
• Progression is typically 1-5 years

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Causes?

• Several competing hypotheses
• Cholingeric hypothesis
• Caused by reduced synthesis of acetylcholine
• Increase in acetylcholine doesnt cure dementia
• Amyloid hypothesis
• Caused by amyloid beta deposits caused by APP
  (chr21)
• Universal development in Down Syndrome by 40
• Transgenic mice
• Weak correlation with neuron loss

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• Tau hypothesis
• Caused by tau protein abnormalities
• Formation of neurofibrillary tangles
• Herpes simplex virus (HSV1) hypotheis
• Cold sore virus
• May be responsible for up to 60 of cases
• Promotes formation of beta amyloid plaques
• HSV1 found in brain cells of Alzheimers patients
  
• Cheap available drugs for treatment

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Risk factors

• Obesity
• High blood pressure
• High cholesterol
• Higher rates in
• Japanese-Americans than Japanese
• African-Americans than Africans
• Depression
• Lower rates in highly educated
• Beneficial consequences of learning and memory

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Other forms of dementia

• The second most common cause of dementia is a
  stroke
• Vascular dementia (VaD), also called
  multi-infarct dementia (MID)
• a form of dementia characterized by sporadic, and
  progressive, loss of intellectual functioning
  caused by repeated infarcts, or temporary
  obstructions of blood vessels, which prevent
  sufficient blood from reaching the brain
• Subcortical Dementias
• Forms of dementia that begin with impairments in
  motor ability and produce cognitive impairment in
  later stages
• Parkinsons disease, Huntingtons disease, and
  Multiple Sclerosis are subcortical dementias
• Reversible Dementia
• dementia caused by medication, inadequate
  nutrition, alcohol abuse, depression, or other
  mental illness can sometimes be reversed