This document summarizes physical, cognitive, and health changes that occur in late adulthood. It discusses how both the young-old (65-84 years old) and oldest-old (85+ years old) are affected differently, with the oldest-old facing greater declines. Key changes include losses in brain and muscle mass, poorer vision and hearing, increased risk of chronic diseases, and slower processing speed and divided attention. However, lifestyle factors like exercise, nutrition, and mental stimulation can help maximize functioning and well-being in late life.
3. Men are more likely than women to die from
most of the leading causes of death such as
cancer of the lungs, motor vehicle accidents,
liver cirrhosis, emphysema and heart disease.
In virtually all species, females outlive the males.
Women have more resistance to infections and
degenerative diseases.
Genes and the ability to cope effectively with
stress are associated with longevity.
Social dynamics, personality, cognition, and
socioeconomic resources and support systems
contribute to the health and quality of life
among older adults, including centenarians.
4. Young-Old and the
Oldest-Old
Young-Old = 65 to 84 yrs. of age
Oldest-Old = 85 and older
Sizable losses in cognitive potential and ability to
learn; increase in chronic stress; a substantial
prevalence of physical and mental disabilities;
high levels of frailty; increased loneliness; and
difficulty of dying with dignity are problems
related to the oldest old.
Young-old have the substantial potential for
physical and cognitive fitness, higher levels of
emotional well-being, and more effective
strategies for mastering gains and losses of old
age.
5. Young-Old and the
Oldest-Old
Majority of the oldest-old
today are females who
are widowed and live
alone. If not, they are
institutionalized.
The majority are also
hospitalized at some
time in the last years of
life and they die alone at
their homes or institution
6. Biological Theories of Aging
Evolutionary Theory of Aging
Natural selection has not eliminated many harmful
conditions and non-adaptive characteristics as it is
merely related to reproductive fitness
Cellular Clock/Telomere Theory
Cells can divide a maximum of 75 to 80 times, and
as we age they are less capable of dividing
Telomere shortening plays a role in aging
Free-radical Theory
People age because when cells metabolize
energy, the by-products include unstable oxygen
molecules
8. Biological Theories of Aging
Mitochondrial Theory
Aging is due to the decay of mitochondria due to
an oxidative damage and loss of critical
micronutrients supplied by the cell
Sirtuin Theory
These family of proteins are linked to longevity,
regulation of mitochondria functioning in energy,
benefits in calorie restriction, stress resistance, and
lower rates of cardiovascular disease, and cancer
10. Biological Theories of Aging
mTOR Pathway
Cellular pathway
involved in the
regulation of growth
and metabolism as key
aspect of longevity
Hormonal Stress Theory
Aging in the body’s
hormonal system can
lower resistance to stress
and increase the
likelihood of disease
11. The Aging Brain
On average the brain loses
5% to 10% of its weight
between ages 20 to 90.
Brain volume also decreases.
In healthy aging, the
decrease is mainly due to
the shrinkage of neurons,
lower number of synapses,
reduced length and
complexity of axons, and
reduced tree-like branching
in dendrites, but only to a
minor extent attributable to
neural loss
12. The Aging Brain
The prefrontal cortex shrinks the most with aging
as implied in decreased working memory and
slower motor behavior.
A general slowing of the functioning of the brain
and spinal cord begins in middle adulthood and
accelerates in late adulthood that it affects both
physical coordination and intellectual
performance.
Demyelination of the brain occurs
Reduced synaptic functioning and production of
some neurotransmitters like acethylcholine,
dopamine, and GABA
13. The Aging Brain
Some studies have documented neurogenesis in
the hippocampus and the olfactory bulb.
Among people in the 90s, dendritic growth no
longer occurred, but may compensate for
possible loss of neurons in the 70s. This may be
accounted for by the lack of environmental
stimulation.
The decrease in lateralization is likely to play a
compensatory role by the means of using both
hemispheres
14. Sleep
50% or more of older adults
complain about difficulty sleeping
Poor sleep is a risk factor for falls,
obesity, lower level cognitive
function, and earlier death.
Excessively long sleep is an indicator
of less effective physical and
cognitive functioning
Strategies to help older adults sleep:
Avoid caffeine
Avoid over-the-counter sleep
remedies
Stay physically active during the
day
Stay mentally active
Limiting naps
15. Physical Appearance and
Movement
Wrinkles and age spots are the most
noticeable changes.
We become shorter as we get older
due to the bone loss in the
vertebrae.
Weight drops after 60 yrs of age
due to muscle loss, which gives a
sagging look
Adequate mobility is an important
aspect of maintaining an
independent and active lifestyle
Regular walking decreases the
onset of physical disability and
reduces functional limitations in
older adults.
16. Vision
In late adulthood, the decline in vision
becomes more pronounced
The visual field becomes smaller, a
change suggesting that the intensity
of a stimulus in the peripheral area of
the visual field needs to be increased
if the stimulus is to be seen.
The visual decline can be traced to a
reduction in the quality or intensity of
light reaching the retina.
Adults may have trouble
distinguishing between objects of
closely related objects.
Depth perception declines, which
makes it difficult for them to
determine closeness or height
17. Vision
Cataracts
Thickening of the lens of the eye
that causes a cloudy, opaque,
and distorted vision
Glaucoma
Damage to the optic nerve
because of a pressure from a
buildup of a fluid in the eye
Macular Degeneration
Deterioration of the macula,
which corresponds to the focal
center of the visual field
18. Hearing
Older adults often don’t recognize
that they have a hearing problem,
deny one, or accept it as a part of
getting old.
Hearing loss is linked to declines in
ADLs, cognitive functioning, and
language
19. Smell and Taste
Most older adults lose some
of their sense of taste or
smell, or both
20. Touch and Pain
With aging, individuals could
detect touch less in the lower
extremities than in the upper
extremities,
Presence of pain increases with
age, and women are likely to
report more pain than men
21. Circulatory and
Respiratory Systems
Cardiovascular disorders
increase in late adulthood
A rise in BP with age can be
linked to illness, obesity,
stiffening of blood vessels, stress,
or lack of exercise
Lung capacity drops 40%
between ages 20 and 80, even
when disease is not present as
lungs lose the elasticity, chest
shrinks, and diaphragm
weakens.
Diaphragm-strengthening
exercises may help.
22. Sexuality
Orgasm becomes less frequent
More direct stimulation is
needed to produce erection
Older adults who did not have
a partner were far less likely to
be sexually active than those
who had a partner,
For older adults with a partner
who reported not having sex,
the main reason was poor
health, especially of male
partner’s
A sexually interested older
woman may have problems
23. Health Problems
Probability of having some disease or illness
increases with age.
Chronic diseases with slow onset and long
duration are common in late adulthood
As individual ages during late adult years, they
are likely to die of cardiovascular disease than
cancer.
Falls are the leading cause of injury death for
adults 65+.
24. Health Problems
Arthritis: inflammation of the
joints accompanied by pain,
stiffness, and movement
problems
Osteoporosis: extensive loss of
bone tissue
25. Substance Use and
Abuse
Older adults are taking multiple
medications which can increase
the risks associated with
consuming alcohol or other drugs.
Older adults may abuse
prescription drugs.
There are some benefits to
moderate drinking:
Better physical well-being and
mental performance
Greater openness to social
contacts
Able to assert mastery over one’s
life
26. Exercise, Nutrition, and
Weight
The more active an older adult is, the
more happy they are likely to be.
Gerontologists increasingly
recommend strength training in
addition to aerobic activity and
stretching for older adults.
The average person’s BMI declines
with age about 6.6lbs of lean muscle
are lost each decade and resistance
exercises may help preserve muscle
mass.
Exercise may help prevent adults from
falling down or being institutionalized
Eating a healthy, balanced diet and
taking appropriate vitamins are
important
28. Cognitive Mechanics
Hardware of the mind and reflects the
neurophysiological architecture of the brain that
was developed through evolution.
Decline may begin as soon as early midlife
Cognitive Pragmatics
Culture-based software programs of the mind
May improve at least until an individual becomes
old
29. Speed of Processing
The speed of information processing declines.
Variations in thinking speed appear to be
correlated with the physical aspects of aging.
Slow processing is a predictor of an increased
number of falls.
Accumulated knowledge may compensate for
slower processing speed
Age-related losses may be explained by a
decline in neural connectivity or indirectly
through changes in dopamine
High-intensity aerobic training and processing
speed games may be helpful.
30. Attention
Selective Attention
Focusing on a specific aspect of experience that is
relevant while ignoring the irrelevant
Divided Attention
Concentrating on more than one activity at the
same time
Sustained Attention
Focused and extended engagement with an
object, task, even, or other aspect of the
environment
Executive Attention
Involves planning actions, allocating attention to
goals, detecting and compensating for errors,
monitoring progress on tasks, and dealing with
novel or difficult circumstances
31. Attention
In many contexts, older adults may not be able
to focus on relevant information effectively as
they are less likely be able to ignore distracting
information.
Generally, older adults are less adept at
selective attention than younger adults are.
The more difficult the competing tasks are, the
less effectively older adults divide attention.
On a simple vigilance and sustained attention
task, older adults usually perform as well as
younger adults unlike in complex vigilance tasks
wherein their performance drops
Older adults had deficiencies in executive
attention
32. Attention
The more active and physically fit
older adults are better be able to
allocate attention when
interacting with the environment
The Lumosity program sessions
focus on problem solving, mental
calculation, working memory,
and attention.
Yoga practice that included
postures, breathing, and
meditation improved the
attention and information
processing of older adults
33. Memory
Explicit/Declarative Memory
Memory of facts and experiences that individuals
consciously know and can state
Implicit Memory
Memory without conscious recollections, which
includes skills and routine procedures
automatically performed
Episodic Memory
Retention of information about details of life’s
happenings
Semantic Memory
Person’s knowledge about the world
34. Memory
Implicit memory is less likely to be adversely
affected by aging than explicit memory is
Younger adults have better episodic memory
than older adults have both for real and
imagined events as the older the memory, the
less accurate it is.
Older adults often take longer to retrieve
semantic information, but usually they can
retrieve it.
The ability to retrieve very specific information
usually declines in older adults.
Tip-of-the-Tongue Phenomenon
A common memory error which individuals cannot
quite retrieve familiar information but have the
feeling that they should be able to retrieve it.
35. Memory
Working Memory
The mental workbench that allows people to
manipulate and assemble information when
making decisions, solving problems, and
comprehending written and spoken language
Source Memory
Ability to remember where on learned something
Prospective Memory
Remembering to do something in the future
36. Memory
Working memory declines is explained by their
less efficient inhibition and increased
distractibility.
Training on working memory can improve fluid
intelligence.
Imagery strategy training help improve working
memory
Perceptual speed declines is related to working
memory declines
Failures of source memory increases with age.
Referenced encoding helps improve their source
memory is
37. Memory
As people get older, they get more selective in
how they use their resources.
Prospective memory played an important role in
older adults’ successful management of
medications they needed to take as well as
keeping appointments
38. SUMMARY
• Most but not all aspects of memory decline during
late adulthood.
• The decline occurs primarily in explicit, episodic, and
working memory, not in semantic or implicit memory.
• A decline in perceptual speed is associated with
memory decline.
• Successful aging does not mean eliminating
memory decline altogether, but reducing and
adapting to it
39. Executive Function
Prefrontal cortex shrinks with aging and it
decreases working memory and other cognitive
functions.
Executive function skills therefore decline in older
adults
Older adults are less effective in cognitive control
Aerobic exercises may help improve cognitive
function
40. Decision Making
Many older adults preserve decision-making skills
reasonably well
Age-related decreases in memory impair
decision making
Older adults often perform well when decision
making is not constrained by time pressures,
when it is meaningful for them, and when it does
not involve high risks.
41. Metacognition and
Mindfulness
Older adults tend to overestimate memory
problems that they experience on a daily basis
that they seem to be more aware of memory
failures.
Mindfulness-based stress reduction program
involving meditation improved older adults’
memory and inhibitory control
42. Wisdom
Expert knowledge about the practical aspects of
life that permits excellent judgment about
important matters.
This practical knowledge involves exceptional
insight into human development and life matters,
good judgment, and an understanding of how
to cope with difficult life problems.
The time frame of late adolescence and early
adulthood is the age window for wisdom to
emerge
Personality-related factors such as openness to
experience, generativity, and creativity are
better predictors of wisdom than cognitive
factors such as intelligence
43. Wisdom
Knowledge of Life
Prosocial Values
Self Understanding
Acknowledgement of
Uncertainty
Emotional balance
Tolerance
Openness
Spirituality
Sense of Humor
44. Use It or Lose It
Mental activities that likely benefit the
maintenance of cognitive skills in older adults
include reading books, doing crossword puzzles,
and going to lecture and concerts.
Intellectual and social engagement can buffer
age-related declines in intellectual development
45. Language Development
Vocabulary continues to increase until late
adulthood
Among the most common language-related
concerns among older people are difficulty in
retrieving words to use or problems
understanding.
Older adults’ speech is typically lower in volume,
slower, less precisely articulated, and less fluent.
Older adults’ speech skills are adequate for
everyday communication
46. Work and Retirement
Cognitive ability is one of the best predictors of
job performance
A cognitively stimulating work environment
promotes successful aging
Early retirement policies were introduces during
1970s and 1980s
47. Work and Retirement
Retirement is a process
Men had higher morale when they retired within
the last 2 years
Retired married and remarried women reported
more being satisfied with their lives than those
who are widowed, separated, divorced, or
never been married.
Flexibility is a key factor in adjusting to retirement
48. Mental Health
MAJOR DEPRESSION:
Feeling unhappy, demoralized, self-derogatory, and
bored
Increases among the oldest-old, which is frequently
among women
Medication + Psychotherapy works well
ECT was more effective than antidepressants
Males who live alone are likely to commit suicide
49. Mental Health
ALZHEIMER DISEASE
Gradual deterioration of memory,
reasoning language, and eventually
physical function.
Women are likely than men to
develop Alzheimer
Deficiency in acetylcholine
Formation of amyloid plaques and
neurofibrillary tangles
Older adults with Alzheimer are likely
to have cardiovascular disease
Aricept, Razadyne, Exelon, and
Cholinesterase inhibitors improve
memory and other cognitive functions
Namenda regulates glutamate
Namzatric improves cognition and
overall mental ability
Family is an important support system,
but it may have costs related
50. Mental Health
PARKINSON DISEASE
Muscle tremors, slowing of movement, and partial
facial paralysis
Degeneration of dopaminergic neurons
Dopamine agonists and L-dopa are administered,
but these drugs lose efficacy over time
Deep brain stimulation can also help
51. Religion and Spirituality
In many societies around the world,
older adults serve as spiritual
leaders in their churches and
communities
Religious service attendance was
stable in middle adulthood,
increased in late adulthood, and
declined in older adult years
Individuals over 65 years of age are
more likely to say that religious faith
is an important influence in their
lives.
Religion and spirituality can meet
some important psychological
needs, help face impending death,
find meaning in life, and accept
inevitable losses
Religious community may serve as
social support system
53. Erikson’s Theory
The integrity versus despair stage involves reflecting on
the past and either piecing together a positive review or
concluding life was not well spent.
There are chances for pain, anger, guilt, and grief, but
there are opportunities for resolution and celebration,
for affirmation and hope, for reconciliation and personal
growth
54. Activity Theory
The more active and involved older adults are,
the more likely they are to be satisfied with their
life
55. Socioemotional
Selectivity Theory
Older adults become more selective about their
social networks as they grow older s they place high
value on emotional satisfaction, older adults spend
more time with familiar individuals that they have had
rewarding relationships
56. Selective Optimization with
Compensation Theory
People can produce new resources and
allocate them effectively to tasks they want to
master
Loss is a common dimension of old age although
there is a wide variation of losses involved.
Specific forms depend on life history, pattern of
interests, values, health, skills, and resources
57. Personality, Self, and Society
Older adults are more conscientious and agreeable
Self-esteem among males was higher than females, but
in the 70s and 80s, self-esteem of males and females
converged
Some aspects of their lives require continued support for
self-esteem
Self-control is accounted for better quality of life
The aging society raise policy issues for the well-being of
older adults
Status of the economy
Health care
Eldercare
Generational inequity
Income
Living arrangements
Technology
58. Family and Social
Relationships
Individuals who are in a
marriage or partnership are
happier, less distressed, and live
longer
Retirement alters couple’s
lifestyle and adaptation that
they shall adjust by becoming
egalitarian
Married individuals are likely to
find themselves having to care
for a sick partner with a limiting
health condition
59. Family and Social
Relationships
The majority of divorced older adults are
women
Men are more likely to remarry
Older adults who had been married for
many years, who had better marital
quality, who owned a home, and who
were wealthy were less likely than others
to become divorced
Divorce can weaken kinship ties
Older adults who cohabited had more
positive, stable relationships
60. Family and Social
Relationships
Parent-child relationships in later
life differ from earlier in the life
span
They are influenced by a lengthy
joint history and extensive shared
experiences and memories
Adult children are important part
of the aging parent’s social
network
Adult daughters are likely than
sons to be involved in the lives of
their aging parents
61. Family and Social
Relationships
At the turn of the 20th Century, three-generation
family was common, but now the four-
generation family is common
New friendships are less likely to be forged
although some older adults seek new friendships
after the death of spouse
Convoy Model of Social Relations
Individuals go through life embedded in a
personal network of individuals to whom they give
and from whom they receive social support
62. Family and Social
Relationships
Older adults are more altruistic
When older adults volunteer, they have better
health, better cognitive functioning, and are less
lonely
63. Successful Aging
Being active and engaged are especially
important
Older adults who exercise regularly, attend
meetings, participate in church activities, and go
on trips, are more satisfied.
Older adults who engage in challenging
cognitive activities are more likely to retain
cognitive skills for a longer period of time
Successful aging involves perceive control over
the environment