Download Ch. 17

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Physical and Cognitive Development
in Late Adulthood
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Dr. Kuther's Chalk Talks: Part VIII
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Life Expectancy
• In 2014, infants born in the United States can expect
to live to age 80.
• Some adults live well beyond the expected life span
to a very old age.
• The increase in life expectancy can be attributed to
the influence of contextual factors.
– Health care
– Nutrition
– Sanitation
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Influences on Life Expectancy
• Gender
– Girls born in the U.S. today can expect to live
about 5 years longer than boys.
• Ethnicity
– Mediated by socioeconomic status.
• Nationality
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Centenarians
• Individuals who live past 100 years.
• There were 37,000 centenarians recorded in
the U.S. in 1990 and nearly 54,000 in 2010.
• The longest recorded human life span is 122
years.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Changes in the Nervous System
• Brain volume shrinks as dendrites contract and are
lost, synapses decrease, and glial cells are lost.
• Myelin losses contribute to cognitive declines with
aging.
• A program of aerobic exercise has been shown to
restore brain volume, especially in the
hippocampus (a brain region closely involved with
memory).
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Figure 17.1: Change in Hippocampal
Volume With Aerobic Exercise
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Compensation for Cognitive Declines
• Older adults compensate for cognitive declines by
showing more brain activity and using different brain
areas in solving problems than do younger adults.
• Older adults show brain activity that is spread out over a
larger area, including both hemispheres, compensating
for neural losses.
• Cognitive reserve
– The ability to make flexible and efficient use of available brain
resources that permit cognitive, efficiency, flexibility, and
adaptability.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Figure 17.2: Age Differences in Neural
Activity During a Memory Task
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Neurogenesis
• The process by which new neurons are developed
continues throughout life.
• New neurons are created in the hippocampus and
striatum (a subcortical part of the brain responsible
for coordinating motivation with body movement).
• It is estimated that about 2% of neurons are renewed
each year.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Vision in Late Adulthood
• Virtually all older adults have difficulty seeing objects up
close.
• Many adults develop cataracts, a clouding of the lens
resulting in blurred, foggy vision that makes driving
hazardous and can lead to blindness.
– Cataracts result from hereditary and environmental factors.
• Macular degeneration
– A substantial loss of cells in the center area of the retina,
the macula, causing blurring and eventual loss of central
vision.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Figure 17.3: Age-Related Changes in the Eye
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Hearing in Late Adulthood
• Presbycusis
– Age-related hearing loss.
– Older adults experience difficulty distinguishing highfrequency sounds, soft sounds of all frequencies, and
complex tone patterns.
• Men tend to suffer hearing loss earlier and to a
greater extent than do women.
• About two thirds of older adults experience hearing
loss, which can greatly diminish quality of life and
poses health risks.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Compensation for Hearing Loss
• Many older adults compensate for their hearing loss by
reducing background noise and paying attention to
nonverbal cues such as lip movements, facial
expressions, and body language.
• Use of hearing aids, although they are underused
because:
– Social attitudes that undervalue the importance of hearing.
– Stigma associated with being seen wearing hearing aids.
– Cost.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Cardiovascular Changes in Late Adulthood
• With age, the heart experiences cell loss and becomes more rigid.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Respiratory Changes in Late Adulthood
• The lungs gradually lose cells and elasticity
over the adult years, substantially reducing
the amount of oxygen that enters the system
and is absorbed by the blood.
• Older adults have more trouble breathing, feel
more out of breath during physical exertion,
and have a harder time catching their breath
than younger adults.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Immune System Changes in Late Adulthood
• With age, the immune system becomes less
efficient and adaptive.
• Declines in immune function place older
adults at higher risk of diseases such as flu and
pneumonia, cancers, and autoimmune
diseases such as rheumatoid arthritis.
• Exposure to stress reduces immune function,
and the effects increase with age.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Compression of Morbidity
• Over the past few decades, it has become
increasingly common for older adults in
industrialized nations to age well and delay
disability and disease until the final months or
years of life
• Advances in medicine, improvement in the
standard of living, and increased recognition
of the importance of lifestyle contribute to
compression of morbidity
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Figure 17.5:
Current Health
Status Among
Adults Aged 18
and Over in the
U.S., 2012
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Nutrition
• Losses in muscle mass contribute to weight
loss and a slowed metabolism.
– Therefore, adults require fewer calories and their
diets must be more nutrient dense to meet their
nutritional needs with fewer calories.
– Older adults are less likely to get all of their
nutritional needs met through their diet and are
therefore at risk for a nutritional deficiency.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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VIDEO CASE
Aging and Physical Development
Elsie and Margaret describe the physical changes that accompany aging
and how they adapt to those changes. Note the variability in
experiences.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Diet Suggestions for Older Adults
• Nutritious foods (fruits, whole grains, low-fat
dairy products, leafy green vegetables, and
healthy sources of protein).
• Supplements for vitamins A, B6, B12, C, and E.
• Antioxidants and omega-3.
– Important preventative effects for age-related
declines in cognitive functions and
neurodegenerative disorders.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Exercise
• Exercise offers powerful health benefits to older adults.
– Individuals as old as 80 who begin a program of
cardiovascular activity show gains similar to those of much
younger adults.
– Weight-bearing exercise begun as late as 90 years of age can
improve blood flow to the muscles and increase muscle size.
• Throughout the adult years, moderate physical activity is
associated with improved physiological function, a
decreased incidence of disease, and reduced incidence of
disease, and reduced incidence of disability.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Psychological Benefits of Exercise
• Exercise offers older adults stress relief, protects
against depression, and is associated with higher
quality of life.
• Older adults who are physically active show less
neural and glial cell losses throughout their
cortex and less cognitive decline than do those
who are sedentary.
• Exercise is associated with increased
hippocampal volume.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Chronic Illness: Arthritis
• A degenerative joint disease
• Osteoarthritis (most common)
– Affects joints that are injured by overuse.
– Results in loss of movement and pain.
– Aging is the most prominent risk factor; it may first
appear in middle adulthood but becomes more
common and worsens in severity during older
adulthood.
• Rheumatoid arthritis (not age- or use-related)
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Chronic Illness: Diabetes
• Diabetes is a disease marked by high levels of blood
glucose.
• About one fourth of older adults over the age of 60
have diabetes.
• Diabetes is the leading cause of death among people
age 65 and over.
• Diabetes is influenced by heredity and lifestyle factors.
– Ethnicity
– Diet and exercise
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Risks of Diabetes
• Increased risk of heart attack, stroke, circulation
problems in the legs, blindness, and reduced
kidney functions.
• Serious cognitive and neurological effects
– Brain aging, including declines in executive function,
processing speed, memory, and motor function.
• Psychosocial functioning
– Depression
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Preventing Diabetes
• Maintaining a healthy weight through diet and
exercise.
• Individuals can successfully manage the
disease by adopting a diet that carefully
controls the amount of sugar entering the
bloodstream as well as engaging in regular
exercise.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Injuries
• Deaths from unintentional injuries account for
61.5 deaths per 100,000 in 65-year-old adults,
and a striking 361.9 in adults aged 85 and
older.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Injuries: Motor Vehicle Accidents
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Injuries: Falls
• One out of three U.S. adults over the age of 65 and
one half of those over the age of 80 fall each year.
• Factors associated with increased risk of falls among
older adults:
– Changes in vision, hearing, motor skills, and cognition.
• Falls are a serious hazard for older adults because of
the natural loss of bone and high prevalence of
osteoporosis increase the risk of bone fractures.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Dementia
• Dementia refers to a progressive deterioration
in mental abilities due to changes in the brain
that influence higher cortical functions such as
thinking, memory, comprehension, and
emotional control.
• Reflected in impaired thought and behavior
• Interferes with the older adult’s capacity to
engage in every day activities.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Figure 17.9: Projected Growth in Dementia Prevalence: LowIncome vs. High-Income Countries, 2013–2050 (projected)
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Alzheimer’s Disease
• The most common cause of dementia.
• A progressive neurodegenerative disorder.
• It progresses from general cognitive decline, to
include personality and behavior changes, motor
complications, sever dementia, and death.
• The risk of Alzheimer’s disease grows exponentially
with age, doubling approximately every five to six
years in most Western countries.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Figure 17.10: Projected Prevalence of Alzheimer’s
Disease in the U.S. Population, 2010-2015 (projected)
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Description of Alzheimer’s Disease
• Widespread brain deterioration and the
presence of amyloid plaques and
neurofibrillary tangles in the cerebral cortex.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Diagnosis of Alzheimer’s Disease
• Alzheimer’s disease is diagnosed in living
patients through exclusion: by ruling out all
other causes of dementia.
– Brain imaging can help physicians rule out other,
potentially treatable, causes of dementia, such as
a tumor or stroke.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Progression of Alzheimer’s Disease
1. Memory problems (episodic memory)
– May look like absentmindedness
2. Impairments in attentional control
3. Severe problems with concentration and short-term memory;
confusion
4. Vocabulary and speech impairments
5. Personality changes
6. Become unable to care for themselves
7. Inability to recognize objects and familiar people
8. Final stages – lose the ability to comprehend and produce
speech, to control bodily functions, and to respond to stimuli
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Risk Factors for Alzheimer’s Disease
• Gender
– Women are at greater risk than men.
• Age
• Ethnicity
– African Americans and Hispanic older adults are more
likely to have Alzheimer’s disease and other
dementias.
• Genetics
• Same factors that contribute to cardiovascular
risk.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Protective Factors Against Alzheimer’s Disease
• Education
– The process of learning promotes neural activity
and increases connections among neurons,
thickening the cortex and boosting cognitive
reserve.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Vascular Dementia
• Also known as multi-infarct dementia.
• The second most common form of dementia and loss
of mental ability in older adulthood, worldwide.
• Caused by strokes, or blockages of blood vessels in the
brain.
– With each small stroke, brain cells die, and an immediate
loss of mental functioning occurs.
– As time passes, individuals tend to show improvement
because the brain’s plasticity leads other neurons to take
on functions of those that were lost.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Risk Factors for Vascular Dementia
• Genetic and environmental factors
– Obesity and overweight in middle-age adults.
– People who are at risk for cardiovascular disease.
– Gender – men are more likely to suffer early
vascular dementia.
– Heavy alcohol use, smiling, inactivity, stress, and
poor diet (all more prevalent in men).
– Cross-cultural differences.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Preventing Vascular Dementia
• Factors that prevent cardiovascular disease,
such as physical activity, also prevent and slow
the progression of vascular dementia.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Parkinson’s Disease
• The most common cause of subcortical dementia.
• A brain disorder that occurs when neurons in a part
of the brain called the substantia nigra die or become
impaired.
– Neurons in this part of the brain produce the
neurotransmitter dopamine, which enables coordinated
function of the body’s muscles and smooth movement.
– Symptoms appear when at least 50% of the nerve cells in
the substantia nigra are damaged.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Symptoms of Parkinson’s Disease
• Motor symptoms
–
–
–
–
–
Tremors
Slowness of movement
Difficulty initiating movement
Difficulty with balance
Shuffling walk
• Cognitive symptoms
– Those with larger cognitive reserves and more synaptic
connections among neurons show a slower progression of
neurological changes before dementia appears.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Risk Factors for Parkinson’s Disease
• Genetic, environmental, and lifestyle
influences:
– Epigenetics.
– No gender, ethnic, social, economic, or
geographical boundaries.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Reversible Dementia
• Dementia caused by psychological and
behavioral factors that can be reversed.
• Common causes:
– Poor nutrition and dehydration.
– Prescription and nonprescription drugs and drug
interactions.
– Symptoms of depression and anxiety in older
adults.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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VIDEO CASE
Caring for Ill Older Adults
Elsie, a certified nurse’s assistant, discusses her experiences working
with older adults.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Working Memory
• Age-related declines in working memory span from
young through older adulthood.
• The greater the number of tasks and demands, the worse
the performance.
• Reduced sensory capacity contributes to older adults’
difficulty with working memory.
• Multitasking is challenging in older adulthood.
• Older adults show a significant information processing
bias toward positive versus negative information.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Long-Term Memory
• Age-related changes in working memory
contribute to changes in long-term memory.
• Semantic memory (memory for factual
material) shows little age-related decline.
• Episodic memory (autobiographical memory)
and memory for experiences tends to
deteriorate with age.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Figure 17.11: Age
and Cohort
Differences in
Cognitive Aging
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Age-Related Changes in Language
• Sensory and cognitive changes influence older
adults’ capacities for language.
– Age-related hearing loss and reductions in
attention and processing speed mean that
following rapid speech and understanding speech
when there is background noise require more
effort with age.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Problem Solving
• Problem-solving skills in everyday settings
show that people remain efficient decision
makers throughout adulthood.
• Older adults are better at matching their
strategies to their goals than are young adults.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Wisdom
• Expertise in the conduct and meanings of life.
• Characterized by emotional maturity and the
ability to show insight and apply it to
problems.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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Cognitive Changes
• Fluid intelligence declines in older adulthood.
• Crystallized intelligence remains the same or
improves.
• Cognitive abilities tend to remain stable,
relative to peers, over the life span.
• Differences in experience and lifestyle can
account for many differences in cognitive
change over adulthood.
Kuther, Lifespan Development. © 2017, SAGE Publications.
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