PSYCH- Late Adulthood

Lifespan vs. Life Expectancy

Lifespan (Maximum Lifespan): Greatest age reached by any member of a population or species

•Humans: 120–125 years

Life Expectancy: Average number of years members of a population live

•Global life expectancy (2019): 72.0 years

•Females: 74.2 years, Males: 69.8 years

Age Groups in Late Adulthood

Age Groups in Late Adulthood

• Young-old: 65–74

• Old-old: 75–84

• Oldest-old: 85–99

• Centenarians: 100+

Notes: Based on biological, psychological, social, and chronological differences

Young-Old (65–74)

• Considered “golden years” of adulthood

• Good health, social engagement, knowledge, expertise

• Strong cognitive performance: attention, memory, crystallized intelligence

• Less likely to need long-term care

• High emotional well-being

Old-Old (75–84)

•Often live independently but more chronic illnesses:

• Congestive heart failure, hypertension, cancer

•Half of heart failure cases occur after age 75

•Lifestyle choices influence health outcomes

Oldest-Old (85–99)

• Serious chronic ailments increase with age

• 14% of older U.S. adult population (2015)

• Fastest-growing age group: projected 300% increase worldwide

• More likely female, more chronic illness, higher hospitalization

• About 50% require some assistance with daily activities

Centenarians (100+)

• Centenarians: 100+ years; Supercentenarians: 110+

• Nearly 500,000 worldwide (2015); projected 3.7 million by 2050

• Often healthier than peers; delayed onset of serious illness

• Jeanne Louise Calment: longest-living person, 122 years, 164 days

Physical Changes of Aging – Overview

• Aging affects organs differently; varies by individual (BLSA, 2011)

• Cardiovascular & Respiratory: Heart muscle thickens, arteries stiffen, lung capacity decreases

• Kidneys & Bladder: Less efficient waste removal; reduced urine storage

• Brain: Some loss of neurons, but new ones can be produced

• Body Composition:

  • Loss of lean tissue, muscle, and organ cells after age 30

  • Increase in body fat, especially around the abdomen

  • Sarcopenia: loss of muscle mass leading to weakness and frailty

Physical Appearance & Height/Weight

• Skin: Thinner, less elastic, wrinkles, age spots, slower healing

• Hair & Nails: Hair loss, graying, slower growth; nails thicken and develop ridges

• Height & Weight:

• Height decreases ~½ inch per decade after 40; 1–3 inches total

• Men gain weight until ~55, women until ~65; later weight loss due to muscle loss

• Maintaining Health: Diet, exercise, and strength training help preserve muscle, mobility, and independence

Vision Changes in Late Adulthood

Cataracts

• Clouding of the eye’s lens due to clumping of proteins

• Causes: aging, diabetes, high blood pressure, obesity, smoking, UV exposure, eye trauma, steroids, family history

• Effects: blurry vision, yellow/brown lens tint, difficulty distinguishing dark colors

• Treatment: lens replacement surgery (effective in most cases)

Age-Related Macular Degeneration (AMD)

• Loss of central vision due to deterioration of the macula

• Types:

• Dry (most common): Drusen (fatty deposits) thin macula; no cure; antioxidants may slow progression

• Wet: Abnormal blood vessels leak; may use medication or laser therapy (25% see improvement)

Risk factors: smoking, race (Caucasian > others), high cholesterol, family history

Glaucoma

• Loss of peripheral vision due to optic nerve damage from high eye pressure

• Slowly progressive; can lead to blindness if untreated

• Risk factors: age, African Americans >40, everyone >60, diabetes, family history

• Management: eye drops to lower pressure, regular eye exams

Key Takeaways

• Cataracts: treatable with surgery

• Macular degeneration: central vision loss; limited treatment

• Glaucoma: peripheral vision loss; progression can be slowed with early detection

Hearing and Auditory Changes

Hearing Loss:

• 1 in 4 adults (65–74) and 1 in 2 adults (75+) have disabling hearing loss

• Common signs: trouble on phone, difficulty in group conversations, asking for repeats, turning up TV, difficulty with background noise, cannot hear women/children clearly

Presbycusis:

• gradual, age-related hearing loss affecting both ears; often runs in families

Tinnitus:

• ringing, hissing, or roaring sounds in ears; may worsen over time; higher incidence in males

Balance:

• Inner ear hair cells help maintain balance

• Declines with age → increased risk of balance problems

Musculoskeletal Changes

Arthritis:

• Most common cause of disability among U.S. adults

• 62% of adults with arthritis are 65+; ~50% have mobility limitations (stairs,

walking, grasping)

• Osteoarthritis: cartilage wears away → bone rubs on bone → pain, stiffness, chronic joint issues

• Risk factors: age, genetics, obesity, prior injuries, other medical conditions

Osteoporosis & Kyphosis:

• Weakens bones → fragile fractures, especially hip, spine, wrist

• 1 in 2 women & 1 in 4 men over 50 will experience a fracture

• Kyphosis: hunched posture due to spinal bone loss; can impair walking and sitting

• Prevention: calcium & vitamin D, exercise, limit alcohol, avoid smoking

Respiratory Changes – COPD Chronic Obstructive Pulmonary Disease

• Progressive lung disease: emphysema & chronic bronchitis

• Airways damaged → hard to breathe; lungs lose elasticity, increased mucus

• Leading cause: cigarette smoke; also pipe, cigar, secondhand smoke, environmental/occupational exposures

• Women more susceptible due to smaller lungs & hormonal effects

• Symptoms: shortness of breath, often unnoticed until midlife or late adulthood

• Genetic risk: alpha-1 antitrypsin (AAT) deficiency → higher risk for COPD and liver disease

• No cure; treatments slow progression

Shingles (Herpes Zoster)

• Caused by varicella-zoster virus (same as chickenpox)

• ~1 in 3 adults develop shingles; risk increases with age (50+; especially 60+)

• Symptoms: pain, burning, tingling, rash/blisters (usually one side of body)

• Complications: post-herpetic neuralgia (PHN), eye damage, paralysis, hearing loss

• Prevention: shingles vaccine recommended for adults 50+

Beliefs About Health in Late Adulthood

• Most older adults have at least one chronic illness but rate their health positively

• 65–74: 82% rate health as excellent, very good, or good

• 75+: 73% rate health positively (CDC, 2017)

• Focus on emotional well-being, social relationships, activity, and life satisfaction

• Compare themselves to those worse off (e.g., nursing home residents or deceased peers) → enhances self-perception

• Accept some health deterioration as normal and adapt accordingly

• Positive mental health often aligns with perceived physical health

Brain Plasticity in Late Adulthood

Cognitive Adaptation and Scaffolding:

• The brain remains highly plastic; practice and training can compensate for age-related changes

Scaffolding Theory of Aging & Cognition:

• Brain adapts to neural atrophy by forming alternative neural connections (“scaffolding”)

• Supports continued high cognitive performance

• Older adults performing memory tasks may use both prefrontal areas, whereas younger adults rely mainly on the right prefrontal cortex

• Reduced lateralization enhances cognitive skills in aging adults

Parkinson’s Disease

• Characteristics: motor tremors, rigidity, poor coordination, balance loss, difficulty moving

• Prevalence: ~1% of adults over 60; <10% familial cases

• Causes/Risk Factors:

• Genetic: 28 chromosomal areas implicated

• Environmental: brain injury (concussion increases risk), toxins, industrial chemicals, herbicides/pesticides, carbon monoxide

• Mechanism: deterioration of substantia nigra → less dopamine → impaired motor control

• Treatment:

• Medications (e.g., Levodopa/L-dopa)

• Deep brain stimulation (electrical stimulation improves motor function)

Long-Term Memory Changes in Late Adulthood

Semantic Memory (facts & knowledge):

• Shows little decline; retrieval speed often similar to younger adults

• Older adults may outperform younger adults on vocabulary, history, or general knowledge

• Tip-of-the-tongue events are more common

Episodic Memory (events & experiences):

• Declines more with age than semantic memory

• Harder to encode/retrieve due to both “what” and “when/where” components

• Decline more pronounced with complex tasks

Implicit Memory (skills & habits):

• Shows minimal decline

• Includes procedural memory and priming (e.g., completing words based on recent exposure)

Remembering Future Tasks

• Prospective Memory: remembering to do things in the future (e.g., appointments, medication)

• Decline Factors:

• More likely under time-based tasks (remembering at a specific time) than event-based tasks (remembering when an event occurs)

• Declines more when working memory is busy with competing tasks

• Examples:

• Time-based: take medication at 8:00 PM, attend a 10:00 AM doctor’s appointment

• Event-based: give a message when seeing a friend, mail a letter when passing the mailbox

• Older adults often perform well in real-world settings by focusing on meaningful tasks

• Strategy: prioritize important activities and reduce multitasking

Alzheimer’s Disease

• Prevalence & Impact:

• ~5.4 million Americans diagnosed (2016); ~1 in 9 aged 65+

• Projected 13.8 million by 2050

• 6th leading cause of death in the U.S.; 5th for ages 65+

• No current cure, prevention, or way to slow progression

• Symptoms & Progression:

• Early: subtle memory loss, personality changes, confusion

• Middle: language, problem-solving, and personality deterioration

• Late: loss of physical coordination, self-care, conversation, environmental response, movement control

• Survival & Risk Factors:

• Average survival: 8 years (up to 20)

• Greatest risk factor: age

• Other risks: genetic factors (familial Alzheimer’s), traumatic brain injury, obesity, hypertension, high cholesterol, diabetes

Employment Trends and Capabilities of Older Adults

Employment Rates:

•1994: 12% of employed adults were 65+ → 2016: 18%

•60s: 40% still working | 70s: 14% | 80+: 4%

•Fastest projected growth: 65–74 and 75+ age groups

Education & Gender:

•Higher education → higher likelihood of working

•60+ with bachelor’s degree or more: 37% employed

•Some college: 31%; high school or less: 21%

•Men 60+ more likely to work than women (33% vs. 24%)

Work Performance:

•Older adults excel in jobs requiring social skills, experience, and accumulated knowledge

•Lower absenteeism and higher investment in work

•Earning growth for older workers is higher than other age groups

Transitioning into Retirement

Retirement is a Process: not a single event (Quinn & Cahill, 2016)

Common Paths:

•Bridge jobs: ~60% move to part-time work between career and full retirement

•Encore careers: ~15% take new jobs post-retirement, often in a different field

•Phased retirement: ~10% reduce hours gradually

Retirement Age Trends:

•Average age declined from 70 (1910) → 63 (1980s) → 65 (today)

•18.5% over 65 still working (2012) vs. 12% in 1990

Influences on Retirement Timing:

•Laws (Age Discrimination in Employment Act)

•Social Security & Medicare benefits

•Personal health and finances

Delayed Retirement & Stages

Reasons for Delayed Retirement:

•Economic: supplement income, insufficient pension, Social Security not full income

•Psychological: maintain social contacts, purpose, health benefits

•Health & Longevity: delaying retirement linked to longer life; forced retirement linked to negative outcomes

Phases of Retirement (Atchley, 1994):

1.Remote pre-retirement: fantasizing about retirement

2.Immediate pre-retirement: making concrete plans

3.Actual retirement

4.Honeymoon phase: travel, new activities

5.Disenchantment phase: emotional let-down

6.Reorientation phase: adjustment and routine

Key Point: Retirement is a gradual process with multiple stages

Understanding Ageism

Definition: Prejudice or discrimination based on age; stereotypes assume aging automatically leads to poor physical and mental health (Nelson, 2016).

Cultural Impact:

• Negative stereotypes common in media, conversations, greeting cards

• U.S. culture often mocks aging; other cultures (e.g., China) hold more positive views

Effects on Older Adults:

• Stereotype threat: internalizing stereotypes can worsen memory, physical performance, and self- efficacy (Levy, 2009)

• Reduced engagement in preventative health behaviors

• Slower recovery from illness and increased stress

• Attributing health problems to age → higher mortality

Positive Views:

• Optimistic perceptions of aging → better physical and mental health, longer life

• Challenging societal stereotypes can improve older adults’ well-being

Erikson – Integrity vs. Despair

Stage Overview:

•Last stage of Erikson’s psychosocial theory

•Focus on reflecting on one’s life and finding meaning (Erikson, 1982)

Integrity:

•Acceptance of life’s accomplishments and limitations

•Feeling content and at peace

•Leads to wisdom in late life

Despair:

•Regret over missed opportunities

•Bitterness or unresolved conflicts

•Leads to hopelessness and dissatisfaction

Modern Implications:

•Promotes the importance of staying healthy, active, and socially engaged

•Encourages older adults to remain vital members of society

Staying Active in Late Adulthood

Activity Theory:

•Life satisfaction is higher for older adults who remain active (Lemon et al., 1972)

•Staying busy helps replace lost roles with new opportunities

Benefits of Staying Active:

•Improved physical and mental health

•More positive views on aging

•Stronger social connections

Opportunities for Engagement:

•Community and faith-based organizations

•Volunteering

•Social clubs and group activities

Connection to Erikson:

•Generativity continues into late adulthood through mentoring, volunteering, and contributing to society

Generativity in Late Adulthood

Generativity Beyond Midlife:

•Older adults remain concerned with future generations

•Activities include working, volunteering, and raising grandchildren

Volunteering:

•Peaks in middle adulthood, remains high in 60s, declines in late 70s

•Common settings: religious organizations, hospitals, environmental groups

•African-American older adults volunteer at higher rates due to religious involvement

Benefits of Volunteering:

•Increased social contact, life satisfaction, lower depression/anxiety

•Linked to better health and lower mortality rates

Virtual Volunteering:

•Enables engagement from home

•Examples: mentoring teens, online community support, global connections

Social Networks in Late Adulthood

Definition: Social networks = family, friends, acquaintances

Changes with Age:

•Less close relationships decrease

•Close, meaningful relationships persist

Convoy Model of Social Relations:

•Innermost circle (spouse, family) = stable

•Peripheral relationships (coworkers, neighbors, acquaintances) = more vulnerable to change

•Social support exchanges decrease in peripheral relationships

Socioemotional Selectivity Theory:

•Older adults prioritize emotionally meaningful relationships

•Focus on positive interactions, avoid negativity

•Motivated by limited perceived time and emotional satisfaction

Widowhood in Late Adulthood

Prevalence:

•~1 in 3 women 65+ widowed

•~1 in 10 men 65+ widowed

Biggest Challenge: Loneliness

Factors Affecting Adjustment:

•Extroversion & high self-efficacy → better adjustment

•Positive support from adult children → fewer depressive symptoms

Emotional Context:

•Mixed emotions if spouse had a prolonged illness (relief + guilt)

Health Risks:

•Widowhood Mortality Effect → higher risk of death post-loss

•Men generally at higher risk of mortality and suicide

•Predictability of death can reduce mortality risk

Divorce and Remarriage

Challenges and Implications of Divorce

• Trends:

  • Divorce rates among adults 65+ are rising, but still lower than younger age groups

• Gender Differences:

  • Women: more financial difficulties, more likely to remain single

  • Men: better financial outcomes, more likely to remarry

• Family Support:

  • Adult children often provide more care and support to divorced mothers than fathers

Remarriage & Cohabitation in Late Adulthood

• Remarriage:

  • More stable than marriages in younger adults

  • Emotional maturity → realistic expectations → greater stability

  • Companionship often more important than starting a family

• Cohabitation:

  • Increasing among older adults as an alternative to marriage

  • Offers companionship without legal/marital obligations

  • Often preferred to protect family wealth and avoid child-rearing responsibilities

• Trends:

  • In 2014, ~2% of adults 65+ were cohabitating

Match the age categories in late adulthood with appropriate person.

Meredith suffers from Alzheimer's and cannot go places on her own.

•  oldest-old

Jasmine dances every Friday night and loves to go shopping for her grandkids.

•  young-old

Greg lives in a vibrant retirement community on his own and uses a walker to get around.

•  old-old

The ability to cope effectively with stress has allowed centenarians to live a long life.

being able to hold having to use the bathroom is not a physical change of aging

Match the appropriate vision change with the description

signs of cloudiness in the lens ut doesn't typically interfere with vision

•  cataracts

the peripheral visual field deteriorates toward the center field of vision

•  glaucoma

loss of clarity in the center field of vision

•  age-related macular degeneration

You had to of had chickenpox to get shingles.

Older adults have lower rates of absenteeism and greater investment in their work compared to younger adults.

Older adults who have considerable emotional support from their friends were less likely to seek romantic relationships.

Jackson regrets not traveling the world when he was able to.  This is an example of DESPAIR

match the prospective memory type with the example

Ruthie knows that the weekly movie at the center starts at 6pm.

 

time-based

Jerome forgot to call his brother until he saw someone on the phone in the store.

 

event-based