Late Adulthood

1. Late Adulthood Ch 17-19 Developmental Psychology Jen Wright

2. The aging process

4. Aging can be beautiful!

5. what ages? • All internal systems • Cardiovascular, respiratory, etc. • Sense organs • Immune system • Muscles, joints, bones • Sexual/reproductive system • Brain • Sleep • Cognitive processing • Physical appearance • Attitudes

6. different kinds of aging • Universal aging • Primary aging • Probabilistic aging • Secondary aging • Chronological aging • Biological aging • Social aging • Ageism • Population aging

7. 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

8. Cellular senescence • It was 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)

9. 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

10. biological theories of aging • Aging clock theory • Telomere theory • Evolutionary theory • Late-acting deleterious mutations not selected against Passing on genes Early-acting disease Middle-acting disease Late-acting disease

11. Wear and tear theory • Error theory • Somatic mutation theory • Free-radical theory • Accumulative waste theory

12. 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

14. 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

16. 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

17. Nun study • http://www.youtube.com/watch?v=nw2lafKIEio

18. Top 4 disease-related deaths • Cancer • Heart disease • Cerebrovascular disease • Pulmonary disease

19. Other diseases that occurs with increasing frequency with age: • Arthritis • Cataracts • Osteoporosis • Type 2 diabetes • Hypertension • Alzheimer’s disease

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

22. Caloric restriction • 60% of required calories • Reduction in Type2 diabetes, cancer • Extension of life in all species tested • Intermittent fasting

23. Erickson’s stages

24. Adolescence: Identity achievement • Young Adulthood:Developed network of intimacy • Mid-life: Generativity vs. Stagnation • Creating/giving vs. “self-absorption” • Late-life: Integrity vs. Despair • Life-review

25. generativity • Creative life projects • 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

26. shift in motivation

27. integrity • Life-review: was one’s life meaningful? • Regrets involve four major themes: • Mistakes and bad decisions • Hard times • Social relationships • Missed educational opportunities • Reminiscence therapy: discussing past activities and experiences with another individual or group • Wisdom • Acceptance of life circumstances • Finding meaning/purpose

28. Dimensions of well-being • Self-acceptance • Purpose in life • Positive relationships • Environmental mastery • Personal growth • Autonomy

29. personality • Conscientiousness predicts lower mortality risk from childhood through late adulthood • Low conscientiousness and high neuroticism predicts earlier death • Older adults characterized by negative affect do not live as long as those characterized by more positive affect

30. volunteerism • Older adults benefit from altruism and engaging in volunteer activities • Helping others may reduce stress hormones, which improves cardiovascular health and strengthens the immune system • Volunteering is associated with a number of positive outcomes • More satisfaction with life • Less depression and anxiety • Better physical health

31. Social networks • Convoy Model of Social Relations: • individuals go through life embedded in a personal network of individuals from whom they give and receive social support • Social Support: • Improves physical and mental health • Reduces symptoms of disease • Increases one’s ability to meet health-care needs • Decreases risk of institutionalization • Associated with lower rates of depression

32. Social Integration • Greater interest in spending time with a small circle of friends and family • Low level of social integration is linked with coronary heart disease • Being a part of a social network is linked with longevity, especially for men • Four-generation families have become more common because of increased longevity • Great-grandparents can transmit family history to future generations

33. Selective Optimization with Compensation • Successful aging is linked with three main factors: • Selection: need to select those activities of most value • Optimization: maintain performance through practice and use of technology • Compensation: find constructive ways to accommodate/work around increasing disability

34. Social aging • Unlike gender/ethnicity • Doesn’t apply for entire life. • (potentially) applies to everyone. • Ageism • Negative stereotypes associated with age negatively influence performance, function, and well-being. • Stereotypes against older adults are often negative • Most frequent form is disrespect, followed by assumptions about ailments or frailty caused by age • Positive stereotypes associated with age positively influence performance, function, and well-being.

37. Development of dementia • Loss of intellectual ability in elderly people has traditionally been called senility. • The pathological loss of brain function is known as dementia—literally, “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

38. Alzheimer’s disease • First described by German psychiatrist • Alois Alzheimer (1906) • Generally diagnosed in people over 65 years • Early-onset (before 65 years) only 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

39. http://www.alz.org/brain/01.asp

40. Dementia and Alzheimer Disease

41. 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

42. 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."

43. Memory problems worsen • STM and LTM • Start of failure to recognize friends/ relatives • Behavioral changes • Wandering • Sundowning • Irritability • Labile affect • Progression is typically 2-10 years

44. 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

45. Plaques • Amyloid-beta proteins • Tangles • Neurofibrillary congestion

46. Causes? • Several competing hypotheses: • Cholingeric hypothesis • Caused by reduced synthesis of acetylcholine • Increase in acetylcholine doesn’t cure dementia • Amyloid hypothesis • Caused by amyloid beta deposits caused by APP (chr21) • Universal development in Down Syndrome by 40 • Gene that leads to excessive deposits in early-onset • Transgenic mice • Weak correlation with neuron loss

47. 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 • Uses APP for transportation • Causes inflammation in brain • HSV1 found in brain cells of Alzheimer’s patients • Cheap available drugs for treatment

48. Risk factors • Obesity • High blood pressure • Head trauma • High cholesterol • Being American! • Higher rates in • Japanese-Americans than Japanese • African-Americans than Africans • Depression • Lower rates in highly educated • Beneficial consequences of learning and memory

49. 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 • Parkinson’s disease, Huntington’s 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

50. 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