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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