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Chapter Fourteen
The Personal Context of Later
Life: Physical, Cognitive,and
Mental Health Issues
The Demographics of Aging
• The population of older adults in
industrialized nations has been increasing
rapidly in the 20th century
• Demographers study population trends and
use population pyramids to illustrate the
changes
• Their research predicts that in the year 2030
the number of people over 65 will equal the
number in other age groups
The Diversity of Older Adults
• Older women outnumber older men in all
ethnic groups in the U.S.
• The number of older people in ethnic minority
groups in the U.S. is increasing faster than in
European Americans
• Currently, 50% of people over 65 have high
school diplomas and 10% have college
degrees. By 2030, 75% will have college
degrees
Longevity
• Longevity is the number of years a person
can expect to live
Longevity
(Cont)
• Three types of longevity
– Average life expectancy is the age at which
half the people born in a particular year will
have died
– Useful life expectancy is the number of
years a person is free from debilitating
chronic disease
– Maximum life expectancy is the oldest age
to which any person lives
Genetic and Environmental Factors in
Life Expectancy
• Heredity is a major factor in longevity
• Environment plays a role through the effects
of disease and toxins
• Social class plays a role because certain
conditions are related to lack of access to
health care
Ethnic and Gender Differences in Life
Expectancy
• Life expectancy is complex and varies among
ethnic groups
• European American life expectancy is longer
than that of African Americans’, but not as
long as for Hispanic Americans
• Life expectancy varies at different ages
Ethnic and Gender Differences in Life
Expectancy
(Cont)
• Women live longer than men by about 7
years. For those who live to 85, the
difference is only 1 year
• Men are more susceptible to infectious
diseases and other conditions that are likely
to be fatal
• While many explanations have been offered,
no consistent finding has been found that
supports one theory
International Differences in Longevity
• Dramatic differences exist between longevity
statistics among countries
– 38 in Sierra Leone
– 80 in Japan
• Genetic, sociocultural, and healthcare factors
contribute to the differences
The Third-Fourth Age Distinction
• Third Age adults are between the ages of 60
to 80
– Many advances in knowledge and
technology have contributed to the better
quality of life for this group
• Fourth Age adults are over 80
– Few interventions have been developed to
hold back cognitive and physiological
declines in this group
What Makes One Wise?
• General personal conditions, such as mental
ability
• Specific expertise conditions, such as
practice or mentoring
• Facilitative life contexts, such as education or
leadership experiences
Depression
• Depression is diagnosed based on two
changes: Feelings and physical changes
– Feelings of sadness are called dysphoria
– Physical changes include loss of appetite,
insomnia, and trouble breathing
– Evaluation of older adults is difficult
because some of these changes may be
normal
What Causes Depression?
• Biological and physical causes may include
imbalances in neurotransmitters
• Internal belief systems may play a role in how
people interpret things that happen to them
How Is Depression Treated in Older
Adults?
• Medicines that affect the levels of
neurotransmitters, such as heterocyclic
antidepressants (HCAs), monamine oxidase
inhibiters (MAOIs), and selective seratonin
reuptake inhibitors (SSRIs), may be used
• Psychotherapy in the forms of behavior
therapy or cognitive therapy may be used to
learn new behaviors or examine the way
patients think about their experiences
Anxiety Disorders
• Anxiety disorders include phobias and
obsessive-compulsive disorder
• Anxiety disorders are more common in older
adults, partly due to loss of health, relocation
of residence, isolation, loss of independence,
and other factors
• Anxiety disorders can often be successfully
treated with psychotherapy and medications
Dementia: Alzheimer’s Disease
• Dementia is a family of diseases that results
in serious behavioral and cognitive
impairments. Alzheimer’s disease is one of
the more common
• Alzheimer’s disease may cause confusion,
disability, and dependence
• The incidence of Alzheimer’s disease
increases with age. Women are at greater
risk
What Are the Symptoms of Alzheimer’s
Disease?
• Declines in memory, attention, and judgment
• Confusion and difficulties in communication
• Changes in personality and decline in
hygiene
• Incontinence, or the loss of bladder or bowel
control
How Is Alzheimer’s Disease
Diagnosed?
• Diagnosis can only be confirmed by autopsy
• Diagnosis is made by microscopic analysis of
neurons in the brain
• The diagnosis of possible Alzheimer’s
disease is based on extensive
psychoneurological testing and ruling out
other causes for symptoms
What Causes Alzheimer’s Disease?
• The exact cause is not known
• Possible explanations have included a slowacting virus and aluminum deposits in the
brain. These have not be confirmed
• Genetic research has shown promising
results in identifying genetic markers related
to specific genes
What Can Be Done for Victims of
Alzheimer’s Disease?
• Though symptoms can be successfully
treated, no cure exists
• Galantamine appears to help memory loss
but does not reverse the deficits
• Thioridazine and haloperidol are used to treat
severe psychotic symptoms
• Antidepressants may be used to treat the
depression that often goes along with the
disease