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Memory Programs for the Elderly

• Programs aimed at enhancing memory, reading, and processing speed in elderly individuals show improvements in specific tasks but lack generalization to broader cognitive abilities (Jarrett, 2015).
• No evidence supports that these programs can delay the progression of Alzheimer’s disease.
• Best brain training methods: physical exercise, learning new skills, and social engagement are considered most effective in building cognitive reserve against aging effects.

Parkinson's Disease

• Characterized by:
  • Motor tremors
  • Loss of balance
  • Poor coordination
  • Rigidity
  • Movement difficulties (Garrett, 2015)
• Affects about 1% of individuals over 60.
• Genetic risk factors include 28 implicated chromosomal areas, environmental factors (e.g., brain injuries) increase risk significantly.
• Symptoms result from the deterioration of the substantia nigra's dopamine-producing neurons impacting motor activity.
• Treatment options include levodopa (crosses blood-brain barrier, converts to dopamine) and deep brain stimulation, evidencing improved motor function.

Sleep in Older Adults

• Recommended sleep duration: 7-9 hours per night. Older adults often experience advanced sleep phase syndrome—falling asleep and waking earlier.
• Insomnia is prevalent in older adults, often caused by:
  • Medications
  • Chronic pain
  • Medical or psychiatric issues
  • Pre-bedtime anxiety about sleep troubles.
• Common sleep disorders in older adults include:
  • Sleep Apnea (can lead to health complications like high blood pressure)
  • Restless Legs Syndrome (unnerving sensations in legs, amplified at night)
  • Periodic Limb Movement Disorder (involuntary jerking during sleep)
  • REM Sleep Behavior Disorder (muscles activate during REM sleep).

Impact of Sleep Problems

• Sleep issues can lead to:
  • Increased accident and fall risks
  • Chronic fatigue
  • Lowered overall life quality
  • Cognitive decline
  • Diminished immune response
  • Depression (Buman, 2013).
• Exercise may enhance sleep quality; 150 minutes/week recommended, including aerobic, resistance, and balance activities.

Sexual Activity in Older Adults

• Elderly individuals often perceived as asexual, which discourages acceptance of their sexuality (Kane, 2008).
• Many older adults express greater sexual satisfaction due to reduced distractions and closer intimacy.
• Statistics show:
  • 72% of men and 45.5% of women aged 52-72 report being sexually active.
  • 20-30% remain sexually involved into their 80s (Schick et al., 2010).

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Sexual Problems in Older Adults

• Chronic illnesses affecting sexual functioning:
  • Arthritis (joint pain)
  • Diabetes (erectile dysfunction)
  • Heart disease (orgasm difficulties)
  • Stroke (can cause paralysis)
  • Dementia (may result in inappropriate behaviors) (National Institute on Aging, 2013).
• Hormonal changes and medications can also impede sexual ability and enjoyment.
• Aspects impacting sexual desire in older adults:
  • Appearance concerns, particularly among women, and fears regarding erectile dysfunction in men may deter sexual activity.
  • Availability of partners varies significantly with men often seeking younger partners post-marriage whereas women often find options limited (Karraker et al., 2011).
  • Marital status changes do not typically affect men's sexual activity as much as women's.

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Enabling Healthy Aging

• Key factors for enhancing life quality among older adults:
  • Staying active (both physically and mentally)
  • Reducing stress
  • Healthy living (reducing smoking and consumption of alcohol)
  • Eating more fruits and vegetables (He et al., 2005).

Cognitive Development in Late Adulthood

Learning Objectives

• Describe memory changes during late adulthood.
• Investigate theories explaining memory changes.
• Examine exaggeration of cognitive losses in older age.
• Understand pragmatic and mechanistic intelligence dynamics.
• Define neurocognitive disorders including Alzheimer's disease.
• Explore retirement dynamics and leisure time management in late adulthood.

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Aging and Information Processing

• Stereotypes of older adults being forgetful are pervasive, but research indicates varied memory and cognition changes:
  • Memory Types:
    • Working memory
    • Long-term memory (semantic, episodic, implicit, prospective).
• Changes noted in:
  • Working Memory:
  • Central executive primarily affected, hampering attention allocation.
  • Long-term Memory:
  • Episodic memory shows pronounced age-related declines compared to semantic memory.
  • Older adults experience more tip-of-the-tongue incidents (Schwartz, 2011).

Attention and Problem Solving

• Older adults show difficulties in selective attention and switching tasks, affecting daily functioning (Jefferies et al., 2015).
• Driving challenges emerge, despite a wealth of experience, due to slower cognitive processing.
• Problem-solving capacities reflect a tendency towards seeking advice from others rather than rapid independent decision-making (Strough et al., 2003).

Cognitive Losses Exaggerated

• Discrepancies in cognitive performance often overemphasized; factors contributing include lack of task relevance, lack of potential skill usage, and sensory decline impacting various cognitive capacities (Garrett, 2015).
• Studies show expertise in familiar tasks can significantly level the playing field for older adults against their younger counterparts (Salthouse, 1984; Charness, 1981).

Intelligence and Wisdom

• Traditional intelligence tests indicate minimal age-related decline in verbal test scores compared to performance tests (Botwinick, 1984).
• Pragmatics of intelligence increase with age while mechanics show decline.
• The emergence of wisdom relates more to experiences and less to age; societal roles provide greater frameworks for wisdom development (Baltes & Kunzmann, 2004).

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Neurocognitive Disorders

• Alzheimer’s Disease:
  • Most prevalent neurocognitive disorder affecting 5.4 million Americans as of 2016; estimated to reach 13.8 million by 2050.
  • Gradual onset characterized by memory loss, confusion, and difficulties across cognitive tasks (Alzheimer’s Association, 2016).
  • Neuronal death and formation of amyloid plaques and tau tangles disrupt mental functioning (Erber & Szuchman, 2015).
  • Important research indicates sleep plays a role in processing amyloid and tau; poor sleep may exacerbate Alzheimer's symptoms (Shokri-Kojori et al., 2018; Holth et al., 2019).

Vascular Neurocognitive Disorder and Lewy Body Disorders

• Vascular Neurocognitive Disorder presents sudden declines in cognitive abilities and is linked to blockages in cerebral blood vessels; risk factors include hypertension and strokes.
• Neurocognitive Disorder with Lewy Bodies features protein deposits affecting cognition and movement simultaneously, experiencing symptoms similar to Parkinson’s Disease and includes sleep and visual disturbances (Erber & Szuchman, 2015).

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Work and Retirement

• Work among older adults is increasing, projected labor force changes emphasize continued productivity into later years (McEntarfer, 2019).
• Transition to retirement considered incremental, often Jan ringing part-time bridge jobs (Quinn & Cahill, 2016).
• Economic factors, social security laws, and health insurance motivations influence retirement timing.

Delayed Retirement

• Economic necessity is a significant reason for delaying retirement as many individuals address financial instability from insufficient pensions or savings.
• Psychological benefits arise from continued social engagement and the positive impact on health when slightly extending working life (Wu et al., 2016).

Retirement Stages

• Atchley’s Phases of Retirement:
  1. Remote pre-retirement: Fantasizing future endeavors.
  2. Immediate pre-retirement: Establishing concrete plans.
  3. Actual Retirement: Transition to retired status.
  4. Honeymoon Phase: Joyful engagement in newfound leisure.
  5. Disenchantment Phase: Facing emotional challenges post-retirement.
  6. Reorientation Phase: Adjusting to new lifestyles.

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Post-Retirement Life

• Seniors who actively engage socially and seek post-retirement productive engagement report greater satisfaction and positive health outcomes (Kaskie et al., 2008).

Elder Education

• Continuing education aids older adults in staying active mentally and socially, as noted in numerous programs for seniors.

Leisure Activities

• Average leisure time remains approximately 7 hours daily with an increasing reliance on screens (Livingston, 2019).

Psychosocial Development in Late Adulthood

Learning Objectives

• Explain stereotypes regarding older adults and their implications.
• Summarize Erikson’s final psychosocial challenge of integrity versus despair.
• Explore self-esteem and self-concept as influential factors.
• Discuss relationships with children and family in late adulthood.
• Describe marital, singlehood, and cohabitation arrangements among older adults.
• Analyze issues of loneliness and mental health evident in this demographic.

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Ageism and its Impact

• Ageism, or prejudicial attitudes reflected in societal perceptions of older adults, may exacerbate cognitive decline due to stereotype confirmation.
• Research suggests stronger positive perceptions of aging correlate with better cognitive performance in older individuals (Nelson, 2016).

Minority Status and Poverty in Elderly

• Older minority populations face compounded stresses due to ageism and racism, exacerbating health disparities.
• The poverty rate is notably higher among older women compared to men, particularly in minority groups.

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Living Arrangements

• The majority of older adults (65+) live with a partner or spouse rather than alone; multigenerational households are becoming increasingly common (Cohn & Passel, 2018).

Erikson’s Integrity vs. Despair

• Erikson’s final developmental stage emphasizes reflection on life satisfaction and the reconciliation of regrets to foster a sense of integrity in late adulthood.

Staying Active in Late Adulthood

• The Activity Theory promotes active engagement as essential for improving quality of life among older adults.

Generativity in Late Adulthood

• Continuing contributions to society, such as mentoring younger generations and volunteering, underpin a sense of generativity as vital in old age.

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Social Relations

• The Convoy Model and Socioemotional Selectivity Theory explore shifts in social interactions among older adults, focusing on maintaining meaningful relationships over broader networks.

Relationship Dynamics with Adult Children

• Many older adults provide emotional and financial support to their adult children, with variations impacting overall life satisfaction based on the nature of the relationships.

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Loneliness and Health

• Loneliness significantly affects older adults’ physical and mental health, with community engagement being a protective factor against social isolation.

Marriage and Widowhood

• The highest marital status among older adults is common, and loss of a spouse greatly impacts psychological and physical well-being, posing risks such as increased mortality.

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Divorce and Dating in Late Adulthood

• Older adults face unique challenges with increasing divorce rates, and dating dynamics reflect tangible shifts due to social media engagement and changing societal norms.

Gay and Lesbian Elders

• Significant health disparities exist among LGBT elders; they often rely more heavily on non-familial social networks for support.

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Elder Abuse

• Acknowledging forms of elder abuse is crucial; awareness surrounding it can mitigate risk and enhance protective resources.

Substance Abuse in the Elderly

• Substance misuse poses a growing challenge for aging populations; understanding unique factors in this demographic's tendency toward substance dependency is essential.

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Successful Aging

• Rowe & Kahn's criteria for successful aging include avoiding disease, maintaining high functioning, and engaging in productive activity, providing a framework for interventions in late adulthood.

The Impact of COVID-19 on Older Adults

• COVID-19 has placed older adults at disproportionate risk, largely due to comorbidities and inherent age-related immune system deficiencies.