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— from approximately age 60 until death

— percentage increasing over time (highest in history)

1900: 6% population over 65 (US)

1990: 17%

2050: 25-30% (estimated)

— complex period

— still many changes occurring

— changes involve both development and decline

— great diversity among individuals

— some become less active/some become more

— some begin to withdraw/some become more interested in contributing

— in this stage development often occurs in reaction to aging

— it can occur to compensate for loss of abilities

— there is also the potential for conflict:

— most want their compensatory behaviours to not be an admission of helplessness

— elderly often fear loss of autonomy (incentive for many behaviours)


1. External

— hair whitens, thins

— skin loses collagen, elasticity

— spinal cartilage thins, leading to a loss of height (loss of height also due to stooped posture)

2. Internal



— shrinks by at least a third

— some cell loss in the brain

— brain also undergoes decreased supply of blood, oxygen, glucose


motor function

— reaction time increases

— need more time for tasks (dressing, preparing meals, etc.)

— explained by two hypotheses:


peripheral slowing hypothesis

— peripheral nervous system processing of info decreases in efficiency

— flow of information to brain becomes slower

— once the information arrives, the brain processing speed itself remains ok

— then, information from brain to periphery also becomes slower


overall, increased reaction time generalized slowing hypothesis

— whole nervous system begins to function more slowely

— brain doesn’t processes information as well as before


sensory function


a) visual abilities decrease



visual acuity light sensitivity ability to adjust for changes in light levels


b) hearing loss

— 30% experience some hearing loss by age 65

— 50% by age 75

— greater loss of high frequency sounds


difficulty hearing conversations when background noise high, etc.


c) taste and smell less sensitive

— decreased number of taste buds, smaller olfactory bulbs

— food now seems less palatable (requires more salt? risk for high blood pressure?)



— cardiac output decreases by 25% from peak

— decreased lung capacity and oxygen uptake by tissues

— decreased size and numbers of muscle fibers

— digestive system becomes less motile, less digestive enzyme activity



— Seattle Longitudinal Study: after 60, there is a decrease in most mental abilities

— especially processing speed, numeric ability

— 1999 study: a separate 4-year longitudianl study

— assessed 900 high-functioning adults over 70 (up to their 90’s)

— all subjects lead independent lives

— tested their cognitive abilities

— most abilities decreased (although the rates of decrease showed great variability)

— some improved in certain abilities

Effect of Sensory Deficits

— 1994 study:

— from 70-100 years, approximately half of the variance in cognitive scores was due to variance in visual or auditory abilities

— if there is less sensory ability, less information can reach the brain in time to be processed

— even in the brain, this could lead to slower processing, less ability to do tasks



Working Memory


— holding, processing new information

— decrease in aging


— ability to remember lists reduced

especially when distracted

— ability to perform tasks while remembering lists also impaired


Long-term Memory


— provides knowledge base

— “everything we know”

— decreases in aging

— but, not all memory equal

a) Explicit Memory

— facts: words, concepts, dates, places, events, etc.

— most people usually able to recall when required

— ability decreases in aging

b) Implicit Memory

— unconscious, automatic

— difficult to retrieve verbally

— recalled through:

— recognition

— performance

— less affected by aging

— 1992 study: learning serial patterns

— shown group of 4 boxes on screen

— when asterisk appears, must push button under box

— asterisk always appears in same serial pattern

— therefore once the pattern is identified, the subject can know which button to press next, even before the asterisk appears above it

— if young subjects are compared to old

— old make less rapid response

— but learn pattern just as quickly

— if asked to identify pattern, less able

— therefore, they learned implicitly

— causes of memory decline:


self-fulfilling prophecy

— aging leads to awareness of memory deficits

— elderly often exaggerate previous abilities, thereby believing that their loss is relatively greater than it is


they then assume a great decline, becomes self-fulfilling prophecy, leads to further declines



— respect for aging associated with abilities in aging

— in China, great respect for abilities of the elderly


memory loss in elderly reported to be 1/5 that of Americans


— for deaf Americans, less aware of attitudes towards aging


memory loss of deaf Americans 1/2 that of hearing Americans prescription drugs

— individuals over 65 y take 1/2 of all prescription drugs

— dosage usually determined in studies for 30 yr-olds


dosage may be too much for elderly


— may lead to memory loss in elderly


i.e., drugs for high blood pressure, Parkinson’s, pain brain cell loss

— found especially in hippocampus

— hippocampus found to have role in memory

— but not strong association


— compensate for losses in abilities

— various forms:


direct compensation

— use aids to improve abilities

— hearing aids, magnifying glasses, etc.

— pill dispensers

— sticks for turning off smoke detectors


selective optimization

— assess abilities and set appropriate goals

— choose small number of tasks

— maintain skill

— i.e., if play musical instrument

— choose particular pieces for ease of play

— then practice, practice, practice


anticipatory behaviours

— engage in behaviour to make upcoming task easier

— write notes to self to aid memory

— drive only in daylight due to deteriorating night vision

— drive route to avoid left-hand turns to avoid requirement for fast reaction speed


take buses at particular times or on particular routes so that seats not occupied, won’t have to stand cogiation

— withdraw from activities for short periods to reflect, consider options, etc.

— avoid distractions, etc.




according to Erikson, late middle adulthood is period of crisis of integrity vs. despair

— attempt to unify personal history and experience with experience of larger community

— attempt to maintain continuity through offspring, etc.

— either experience satisfaction/contentment or despair/sense of wasted opportunities




tendency to stereotype people of advanced chronological age

two forms:





— expectancies that person will show signs of dementia, helplessness,




— emphasize lapse of memory in the elderly, reduced ability to react in timely fashion, etc.

— denigrate attempts to compensate for age as further proof of increasing vulnerability

— problems:


such behaviour leads to a greater risk of decrease in communication


— elderly may become afraid to admit to vulnerabilities

— could refuse to admit to health, financial problems





— by speaking to elderly using “baby talk”


loud, simple sentences


— could discriminate against elderly directly ( when they apply for


jobs, volunteer positions, etc.)


— by ignoring need for privacy, need for autonomy, etc.


Challenges to Identity


foundations of identity throughout most of life:


physical appearance physical health employment/responsibilities autonomy/agency




no longer tenable in late life

lead to loss of identity?

coping strategies developed


identity assimilation

— no change in identity

— new experiences assimilated into previous identity

— denial of change

— can be adaptable, but lead to problems if extreme:

— increased hostility to others

(due to maintenance of false reality)


— risk to health

— ignore own limitations

identity accomodation

— adapt to new reality by changing self-concept

— again, can be adaptable but could lead to problems if extreme:

— can lead to sense of loss (of self)

— increased self-doubt

— sense that previous values, beliefs, selves unimportant, wrong

require balance of each



Gender Differences

difference in lifespan (women live longer)

difference increases over time

women comprise 2/3 of the population over 65 (North America)

— but comprise 3/4 of elderly poor

— if over 64, 4X as many widows as widowers

policies favour men?


— pension plans often based upon full-time employment

— women most likely caregivers through life


— now responsible for ailing husbands

— negative effect on health


effect of death of spouse


— for women:


2 yrs after death of spouse, more likely to be happier than unhappy


— for men:


— more likely to be unhappy

— more likely to remarry (more chances)


— women more likely to prepare for death of spouse


more likely to be caregiver during spouses last months


effects of divorce


— women:

— do well in late adulthood

— if reared children as single parent, then greater satisfaction

— closer to children

— independent (employed)

— increasing number of widows means that they now enjoy being part of a larger social group

— men:

— do less well

— less contact with children

— less contact with old friends (wives usually social co-ordinator)

— diverced elderly men report increased physical and psychological. problems (compared to non-divorced men)



sexual activity continues in 90’s

after 70 y:


— 2/3 men and women still have sex with spouse


if have sex, once/week (average)


— 43% men and 33% women masturbate




— males: erections more difficult


refractory period longer


— females: less lubrication of vagina

if individual was sexually active throughout life, they are more likely to remain so in late adulthood

— if elderly stop having sex for several months, they become less likely to restart



— study of health in the elderly very complex due to


death and/or illness inevitable (not true for any other age group)



because many of the changes associated with aging are natural, it’s


difficult to assess whether some changes are natural or part of a disease

institutionalization of many elderly creats certain health problems, affects


certain treatment decisions, etc. elderly have less autonomy, agency

— less of these is associated with poorer health

Loss Of Intellectual Function

— some loss normal

— often due to disease

— generally classified as category of dementia

— includes more than 70 diseases

— chronic, degenerative (most)

— if temporary, called delirium




most common (comprises 50% dementia cases in world)

leads to abnormalities in cerebral cortex

— involves protein called beta-amyloid

— can form plaques outside brain cells

— can form tangles inside brain cells

— usually begin in hippocampus (site of memory)



— by 65, 1/100


rate approximately doubles every 5 yrs.


— if over 80, 1/5





noticeable forgetfulness




sometimes, no advance (for more than 10 y) generalized confusion

— unaware of problems




— may have mood changes


emphasis of prior moods



debilitating memory loss


— less able to recognize people, places

— dangerous, risk of accidents

— under home care if possible



full-time care


no recognition/normal response



no response/emotion/communication


eventually, death


Multi-infarct Dementia


2nd leading cause of dementia

series of strokes


— blockages of cerebral blood vessels

— lack of oxygen to tissue leads to tissue damage

— restricted to immediate area

symptoms varied (type and severity)

— often:

— blurred vision

— slurred speech

— localized paralysis

— confusion (can be specific)

— usually, some recovery over time (neural compensation)

— as number of infarcts increases, more severe symptoms occur until

dementia results

associated with lifestyle, nutrition, smoking, etc.


Subcortical Dementias


damage in subcortical regions

intellectual function not impaired Parkinson’s disease


damage to neurons producing dopamine


loss of motor control Multiple sclerosis

— loss of myelin in brain