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Chapter 17:

Physical Development in Late Adulthood

Learning Goals

Learning Goal 1: Characterize longevity and discuss the biological theories of aging.

A. Define and explain the difference between life span and life expectancy.

B. Describe what is meant by the terms young-old and the oldest-old.

C. Explain the biological theories of aging.

Learning Goal 2: Describe how a person’s brain and body change in late adulthood.

A. Discuss how the brain ages and adapts.

B. Describe sleep patterns in late adulthood.

C. Describe the relationship between the immune system and aging.

D. Discuss the changes in physical appearance and movement.

E. Describe and discuss sensory development/decline in late adulthood.

F. Explain changes in the circulatory system and lungs.

G. Discuss sexuality in late adulthood.

Learning Goal 3: Identify health problems in older adults and describe how they can be

treated.

A. Discuss the health of older adults.

B. Summarize substance use and abuse in late adulthood.

C. Discuss exercise, nutrition, and weight in late adulthood.

D. Describe the trends in health care treatment of the elderly.

 What comes to mind when you hear, “Physical health of late adults?”

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 Life Span: the maximum number of years an individual can live; has remained between 120–125 years

 Life Expectancy: the number of years that the average person born in a particular year will probably live

 Has increased an average of 30 years since 1900  Average life expectancy today is 77.6 years

 Cross-Cultural Differences:  Japan has highest life expectancy (81 years). Why do you believe this to be the case?

Why are we so low on the list here in the US?

 Differences in life expectancy across countries are due to factors such as health conditions and medical care

 Ethnic Differences:  Life expectancy for African Americans is 7 years lower than that of non-Latino Whites

 Females’ ability to outlive males widens beginning in the mid-thirties  Social factors (health, attitudes, habits, lifestyles, occupation)  Biological factors

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 Number of centenarians is increasing by approximately 7% each year  Getting older may not mean getting sicker  Many centenarians are women  Among centenarians, men are more likely to be healthier than women

 Ability to cope successfully with stress seems to be important to longevity

 Other important factors:  Genes and family history  Health, education, personality, and lifestyle

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 Some developmentalists divide late adulthood:  Young-old are aged 65 to 74  Old-old are aged 75 or more  Oldest-old are aged 85 or more

 Important to consider function rather than age. Imagine being oldest-old, but dealing with chronic disease and other health problems. The functioning is a lot poorer than those who are young-old and doing better. Quality of life matters.

 Differences between levels of “old”:  Compared with oldest-old, young-old have a greater potential for physical and

cognitive fitness, higher levels of emotional well-being, and more effective strategies for mastering gains and losses of old age

 The Oldest-Old:  Are mostly female, widowed, and living alone  Are usually hospitalized at some time in last years of life  Die mostly alone in a hospital or institution  Are a heterogeneous, diverse group

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 Cellular Clock Theory: cells can divide a maximum of 75-80 times; this places the maximum human life span at 120–125 years of age

 Telomeres become shorter each time a cell divides

 Free-Radical Theory: people age because when cells metabolize energy, the by-products include unstable oxygen molecules, or free radicals

 Free radicals damage DNA and other cellular structures. Think of all of the berries and other foods out that are antioxidant rich (acai is very popular right now).

 Mitochondrial Theory: aging is due to the decay of mitochondria  Mitochondria: tiny bodies within cells that supply essential energy for function,

growth, and repair

 Hormonal Stress Theory: aging in the body’s hormonal system can lower resistance to stress and increase the likelihood of disease

 Prolonged, elevated levels of stress hormones are associated with increased risks for many diseases

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 On average, the brain shrinks 5% to 10% between the ages of 20 and 90  May result from a decrease in dendrites, damage to myelin sheath, or the death of

brain cells

 Some areas of the brain shrink more than others  Shrinkage of the prefrontal cortex is linked with a decrease in working memory and

other cognitive activities

 A general slowing of function in the brain and spinal cord begins in middle adulthood and accelerates in late adulthood

 Aging has been linked to a reduction in the production of certain neurotransmitters

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 As the brain ages, it adapts in several ways:  Neurogenesis: the generation of new neurons throughout the life span

 Dendrite growth increases from the 40’s to 70’s  Older brains rewire to compensate for losses  Hemispheric lateralization can decrease; may improve cognitive functioning

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 The immune system declines in functioning with age  Extended duration of stress; diminished restorative processes  Malnutrition involving low levels of protein

 Exercise improves the immune system, and influenza vaccination is very important for older adults

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 Wrinkles and age spots become more noticeable  People get shorter with aging due to bone loss in their vertebrae  Weight typically drops after we reach age 60; likely because we lose muscle  Older adults move more slowly than young adults  Appropriate weight lifting can reduce the decrease in muscle mass and improve

appearance.

Changes in Body Composition of Bone, Muscle, and Fat from 25 to 75 Years of Age

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 Vision:  Decline in vision becomes more pronounced  Adaptation to dark and driving at night becomes especially difficult. This is hard for a

lot of my relatives, who are only mid to late 60’s.

 Decline may be the result of a reduction in the quality or intensity of light reaching the retina

 Color vision may decline as a result of the yellowing of the lens of the eye  Depth perception declines in late adulthood  Decrease in contrast sensitivity

Rates of Decline in Visual Functioning Related to Glare in Adults of Different Ages

 Diseases of the Eye:

 Cataracts: a thickening of the lens of the eye that causes vision to become cloudy, opaque, and distorted

 Glaucoma: damage to the optic nerve because of the pressure created by a buildup of fluid in the eye

 Macular Degeneration: deterioration of the macula of the retina, which corresponds to the focal center of the visual field

 Hearing:

 Hearing impairments are typical in late adulthood  15% of the population over age 65 is legally deaf  Usually due to degeneration of the cochlea

 Some (but not all) hearing problems can be corrected by hearing aids

 Smell and Taste:  Smell and taste losses typically begin about age 60  Less decline in healthy older adults  Often leads to a desire for more seasoned foods

 Touch and Pain:  Slight decline in touch sensitivity with age  Older adults are less sensitive to pain

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 Cardiovascular disorders increase in late adulthood

 Rise in blood pressure can be linked with illness, obesity, anxiety, stiffening of blood vessels, or lack of exercise

 Lung capacity drops 40% between the ages of 20 and 80, even without disease

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 Orgasm becomes less frequent in males with age  Many older adults are sexually active as long as they are healthy  Older adults who do not have a partner are far less likely to be sexually active than

those who have a partner

 Various therapies have been effective for older adults who report sexual difficulties

Many older people continue to enjoy an active sex life.

While disease or social prejudice may prevent some older people from having sex, many

continue to remain active. Of course, they may have to make adjustments to take into

account the fact that older men have more difficulty achieving an erection, while for women;

vaginal dryness can pose a problem, though there are solutions available.

Many older people have a need for a good sexual relationship.

With the many psychological, economic, social, and physical changes that come as people

grow into old age, a healthy sexual relationship may be very helpful.

Social attitudes are often a source of frustration.

Further, there is a tendency in society at large to assume that because an older woman is no

longer fertile, she becomes asexual. This, quite simply, is not true, and older women, as well

as men, should be allowed to embrace their sexuality without being made to feel ashamed

of it.

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 Probability of having some disease or illness increases with age  Arthritis is the most common  Hypertension is the second most common

 Older women have a higher incidence of arthritis, hypertension, and visual problems than older men

 Older men are more likely than women to have hearing impairments  Lifestyle and social and psychological factors are linked to health in older adults

 Nearly 75% of older adults die from heart disease, cancer, or cerebrovascular disease (stroke)

 Ethnicity is linked with death rates of older adults  African Americans have high death rates for stroke, heart disease, lung cancer, and

female breast cancer

 Asian Americans and Latinos have low death rates for these diseases

 Arthritis: an inflammation of the joints accompanied by pain, stiffness, and movement problems

 Common in older adults  Symptoms can be reduced with:  Use of some drugs like aspirin

 Range-of-motion exercises  Weight reduction  Joint replacement in extreme cases

 Osteoporosis: extensive loss of bone tissue  Affects women more often than men  Can be prevented by:  Eating calcium-rich foods and vegetables  Having a regular exercise program  Medication

 Accidents: 7th leading cause of death in older adults  Healing and recuperation are slower in older adults  Exercise programs can reduce risks

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 Medications can increase the risks associated with consuming alcohol or other drugs  Majority of U.S. adults 65 and older completely abstain from alcohol  Substance abuse among older adults may be an “invisible epidemic”  Late-Onset Alcoholism: onset of alcoholism after the age of 65  Often related to loneliness, loss of a spouse, or a disabling condition

 Moderate drinking of red wine is linked to better health and increased longevity

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 Exercise:  Active adults are healthier and happier  Benefits:  Linked to increased longevity  Related to prevention of common chronic diseases (diseases that start out

slowly but last a long time)

 Associated with improvement in the treatment of many diseases  Can optimize body composition and reduce the decline in motor skills as aging

occurs

 Reduces the likelihood that older adults will develop mental health problems  Linked to improved brain and cognitive functioning

 Nutrition and Weight:  Some older adults restrict their dietary intake in a way that may be harmful to their

health

 Decreased snacking between meals may contribute to harmful weight loss  Calorie restriction has been proven to extend the life span of certain animals, but it is

not known if this works in humans

 New research suggests that antioxidants may help slow the aging process and possibly prevent some diseases

 Other factors such as exercise, better health practices, and good nutritional habits may be actual cause of positive correlation between vitamin intake and slower aging, but more research needs to be done

 There is now more interest in the possible link between vitamins and cognitive performance in older adults

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 Some studies show older adults in the U.S. receive the recommended medical care only half the time

 Probability of being in a nursing home or other extended-care facilities increases with age  The quality of these facilities varies and is a source of concern  Over 33% fail to meet minimum federal standards

 Many specialists recommend alternatives, such as home health care, day-care centers, and preventative medicine clinics

 Patient’s feelings of control and self-determination are important for health and survival in nursing homes

 Coping skills may reduce stress-related hormones, improving overall health

Perceived Control and Mortality

 What are your largest concerns regarding physical changes in late adulthood?  What steps can you can take now to affect these changes?

Here are some good websites related to this chapter:

Elderly Healthcare

http://www.ahrq.gov/research/elderix.htm

Gerontology Society of America

http://www.geron.org/

Healthy Aging for Older Adults

http://www.cdc.gov/aging/