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Gerontology
Chapter 4
• Our bodies are
constantly changing
and most of the time
we don’t even notice
unless these changes
are a result of sudden
or dramatic physical,
psychological or
cognitive events.
• This chapter will focus
on the psychological,
behavioral and
cognitive changes
associated with aging.
Personality
• Each one of us is unique.
• Each of us have character
traits, attitudes, habits, and
emotional tendencies that
distinguish us from the
other.
• The question is : is there a
significant personality
change during old age?
Personality Theories
• Erickson : Integrity versus Despair
• McCrae and Costa : Trait Theory
• Bandura : Self-efficacy
• Erik Erikson:
– 8 stages of psychological development
– final era of life he calls integrity versus despair
– elders either develop a sense of pride in their
past accomplishments and present life, or
experience a feeling of despair because they
believe they do not have enough time left to
improve their sense of life satisfaction
• McCrae and Costa:
– Trait Theory
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neuroticism
extraversion
openness to experience
agreeableness
conscientiousness
– Studies on the elderly found strong stability of
all five traits
• Bandura:
– Self-efficacy relates to the beliefs that each of
us hold about the level of control we have over
the future
– Strength of one’s sense of self-efficacy may be
variable across time
– Studies have shown a decline in health is
significantly correlated to decreased selfefficacy
• There is significant
correlation between a high
level of self-perceived
self-efficacy and positive
health behaviors such as
diet, exercise and nonsmoking.
• Chronic illnesses can
lower the level of
perceived control, which
in turn decreases one’s
motivation to maintain a
healthy lifestyle.
Other Research
• Mitchell and Helson found that people who are
optimistic and managed their lives well at one
stage of life, tended to feel more positive at other
times as well.
• Another study by Erickson indicated that goals,
values, coping styles, and control beliefs are likely
to change over the course of time, peaking at
middle age. Elders have been found to be more
tolerant, patient, and open-minded.
Cognition
• Cognitive impairments
in the elderly are
primarily caused by
disease, aging, and
disuse
• Alzheimer’s disease if
the most common
cognitive disabling
condition of aging
Attention
– Attention: tuned in to the task which is being
completed over a set period of time.
• Divided - paying attention to two or more tasks
simultaneously
• Alternating - quickly alternating concentration
between two or more tasks
• Selective - paying attention to relevant stimuli while
filtering out the noise or unimportant data
• Research:
– divided attention skills decrease with age
– alternating attention decreases with age
– selective attention shows a decline with age
• Health care professionals must take this into
account when working with the elderly
–
Orientation
• Alert or Disorientated
– Retirement
– Medications
• Memory Types
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Primary / Short term
Working
Secondary / Long term
Tertiary / Remote
• Not all types of memory
are affected equally by the
normal aging process.
• Explicit memory tasks that
require concentration and
the motivation for new
learning can be
profoundly affected by
age, where as
subconscious memory
tasks decreases only
slightly with age.
• Research:
– Secondary memory seems to be affected by age
more than primary.
– Working memory declines more sharply with
age than primary or secondary memory.
– If memory skills start to diminish significantly,
compensation and adaptive techniques may be
necessary – what do I mean by that?
World Health Organization
• AACD - aging-associated cognitive decline
– cognitive functioning below age and
educational norms, but above what is expected
for those with dementia
• AAMI - onset of age-associated memory
impairment
– although memory decline is evident, it
often does not interfere with day-to-day
functioning
• Intelligence
– IQ tests show younger
people get higher
scores than their older
counterparts. Why so?
– This is hard research to
study unless over a
course of people’s
lifetimes
Learning - The ability to
learn new
information/skills
Older individuals need
more practice sessions
repeated more often in
order to master a task.
Our brains need to be
motivated to “remain open
for business” use it or
lose it, it’s never too late
to learn
• Perception: defined as the ability to
meaningfully interpret sensory information
– Sensation- visual skills, hearing, taste, smell
• visual skills decrease with age (ex’s)
• hearing tends to decline with age
• ability to detect smells and identifying differing
odors decreases with age, which in turn decreases
the desire for food
• thirst sensation declines with age
• Praxis and Performance
– Praxis: ability to carry out motor functions
• Dyspraxia refers to decreased ability to plan and
execute purposeful movements
• Apraxia refers to the total inability to carry out these
motor plans
– Performance: balance, reaction time, strength
• Reaction time declines
with age along with “less
accurate responses”.
• There is a decline in
balance, coordination and
strength with age, making
falls more prevalent in the
aging population.
• With a decrease in
balance, coordination, and
strength comes a decrease
in praxis.
Quality of life
• Feeling of well being:
– What does that mean?
• Is it affected by health
status?
• The degree of health or
illness has a significant
impact on the level of
quality of life
– Researchers have concluded
that health status was an
excellent predictor of
happiness
• Depression
– Screening criteria on page 132-133 in book
– As many as 1 of 5 people older than age 65 show signs
of clinical depression
– Feeling down and depressed is NOT a natural
consequence of the aging process
• Suicide
– Depression can happen to anyone.
– What would be some suicide signs?
• Death and Bereavement
– Living wills and advanced directives
– When one lives through the death experiences
more often, it doesn’t make bereavement any
easier.
– Kubler-Ross (5 stages of grief)
– Isolation, feeling lost, and sadness, can persist
for years - much longer than is socially
acceptable.
Dementia
• Dementia encompasses multiple cognitive,
psychological, and functional deficits,
including memory impairment.
– Definition:
– Some signs:
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difficulties with understanding or communicating
difficulty with problem solving
behavioral disturbances
impaired visual spatial skills
Alzheimer's’ Disease
• Affects over 4 million people in the United
States (1998 stats)
• Physical symptoms are not common in the
early stages of AD
• AD progresses through three stages:
– mild, moderate, and severe
– progression stages and symptoms on pg.139
• Related disorders
associated with
depression and
dementia:
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malnutrition
stroke
hypothyroidism
failure to thrive
learned helplessness
Summary
• As people age they
tend to:
– move slower and
prefer slower paced
activities
– take longer to learn
new tasks
– become more forgetful
– lose sensory processing
skills
Remember
• These changes are minimal and do not necessarily
interfere with daily functioning
• It is important for individuals to remain active in
order to age well
• As health care professionals we need to encourage
activities and interactions with others and most
importantly show caring, respect and empathy
when caring for the elderly.