Section 9: Late Adulthood
Centenarians Centenarians – individuals 100 years and older
Chapter 17: Physical Development in Late Adulthood
Countries with most centenarians: 1. US 2. China 3. Japan 4. England/Wales
Late adulthood 60 to 120 or 125 Longest span – 50 to 60 years
Supercentenarians – individuals 110 years and older “The older you get, the sicker you get” - expectations
1 Longevity
fifty – add 10 sixty – add 2 years
LIFE EXPECTANCY AND LIFE SPAN Life span – maximum number of years an individual can live. Life expectancy – number of years that an average person born in a particular year will probably live.
Differences in Life Expectancy Differences in life expectancies across countries are due to factors such as: 1. Health conditions 2. Medical care LIFE EXPECTANCY ACROSS CULTURES OA W M Japan 82 African-American 73 77 70 Non-Latino Whites 78 81 76 Okinawa 81.2 86 78 80.7 years of age – life expectancy of women 75.4 years of age – life expectancy of men Why can women live longer than men? Social factors such as health attitudes, habits, lifestyles, and occupation are probably important. Leading cause of death in men (in U.S.): 1. Cancer of the respiratory system – due to smoking 2. Motor vehicle accidents 3. Cirrhosis of liver 4. Emphysema – due to smoking 5. Coronary heart disease Why can women live longer than men? - Biological factors: women have more resistance to infections and degenerative diseases, additional X chromosome is associated with the production of antibodies that fight off infections.
NOTE: Centenarians live longer because they have the ability to cope successfully with stress. What chance do you have of living 100? GENES Factors that affect life expectancy: 1. family history 2. marital status 3. economic status 4. physique 5. exercise 6. smoking 7. alcohol 8. disposition 9. education 10. environment 11. sleep 12. temperature 13. health care LIFE EXPECTANCY ACROSS CULTURES OA W M Okinawa 81.2 86 78 Factors that affects life expectancy in Okinawa: 1. Diet – eat heavy on grains, fish and vegetables and low on meat, egg, and dairy products. 2. Low-stress lifestyle – easygoing lifestyle. 3. Caring community – look out for each other and do not isolate or ignore the older adults. 4. Activity – active, engaging in activities such as walking and gardening. 5. Spirituality – finds a sense of purpose. Prayer is commonplace and believed to ease the mind.
THE YOUNG-OLD, THE OLD-OLD, AND THE OLDEST-OLD
2.
Cellular Clock Theory - cells can divide a maximum of 75 to 80, as we age our cells become less capable of dividing. - telomeres (DNA sequences that cap chromosomes) – each time a cell divides, telomeres becomes shorter and shorter until the cell can no longer reproduce. - higher intakes of Vitamin C and E – longer telomeres - injecting telomerase – extends life of cells by 70 to 80 divisions but is linked to cancerous cells and may not produce healthy extensions.
3.
Free Radicals Theory - when cells metabolize energy by-product includes unstable oxygen molecules called free radicals. - free radicals ricochet around the cell, damaging the DNA and other cellular structures. - overeating is linked with increase in radicals - calorie restriction – a diet restricted in calories although adequate in vitamins, proteins, and minerals- reduces oxidative damage.
4.
Mitochondrial Theory - decay of the mitochondria- which are tiny cellular bodies that supplies energy for function, growth, and repair and plays and important role in neural plasticity.
Late adulthood – 60 to 120-125 - longest span (50 to 60 years) Distinguishes into: 1. Young-old – 65 to 74 2. Old-old or old age – 75 years and older 3. Oldest-old – 85 years and older NOTE: Interventions are improving the functioning of the oldest-old. Many experts talk about categories in of functions. Functional age – person’s ability to function. Oldest-old: 1. Sizable losses in cognitive potential and ability to learn. 2. Increase in chronic stress 3. Sizable prevalence of physical and mental disabilities 4. High levels of frailty 5. Increased loneliness 6. Difficulty of dying at older ages with dignity
How does this damage and loss of nutrients occur?
Young-old have substantial potential for: 1. Physical and cognitive fitness 2. Higher levels of emotional being 3. Effective strategies for mastering the gains and losses of old age
According to the mitochondrial theory, the damage caused by free radicals initiates a self-perpetuating cycle in which oxidative damage impairs mitochondrial function, which results in the generation of even greater amounts of free radicals.
Majority of the women oldest-old are: 1. Widow 2. Live alone 3. Institutionalized
The result is that over time the affected mitochondria become so inefficient that they cannot generate enough energy to meet cellular needs.
New England Centenarian Study: 15% - live independent at home 35% - live with family 50% - nursing home
Defects in mitochondria: cardiovascular diseases, degenerative diseases, decline in liver function.
Cognitive impairments – common in oldes-old 5.
BIOLOGICAL THEORIES OF AGING: THEORIES: 1. EVOLUTIONARY THEORY OF AGING – natural selection has not eliminated many harmful conditions and nonadaptive characteristics in older adults. - benefits conferred by the evolutionary theory decline with age because natural selection is linked to reproductive fitness. - Alzheimer’s Disease
Hormonal System Theory - aging in the body’s hormonal system can lower resistance to stress and increase likelihood of diseases. - decline in immune system As people age, the hormones stimulated by stress remain at elevated levels longer. These prolonged, elevated stress is associated with increased risk of cardiovascular diseases, cancer, diabetes, and hypertension.
2 The Course of Physical Development in Late Adulthood THE AGING BRAIN
BRAIN LOSES… Weight - 5 to 10% Volume - 15% CHANGES IN THE BRAIN OCCUR DUE TO: 1. Result from decrease in dendrites 2. Damage of myelin sheath that covers axons 3. Death of brain cells Prefrontal cortex – shrinks with aging linked with decrease in working memory and cognitive activities. Slowing of function in the brain and spinal cord: 1. Physical coordination
2. 3. 4.
No knee jerk Slower reflex
Intellectual performance Timed cognitive tests Reduction in the production of neurotransmitters. a. acetylcholine – decline in memory functioning; associated with memory loss in Alzheimer’s disease b.
c.
dopamine – problems in planning and motor activities; loss of motor control associated with Parkinson’s disease. gamma-aminobutyric acid (GABA) - control the preciseness of signal sent from one neuron to another; decreasing “noise”
Neurotransmitter Acetylcholine Dopamine Gamma-aminobutyric acid (GABA)
Neurogenesis in brain regions: 1. Hippocampus – involved in memory 2. Olfactory bulb – involved in smell NOTE: Grafting of neural stem cells in various regions of the brain might increase neurogenesis.
The Shrinking, Slowing Brain
Above 70 years old Above 90 years old
Neurogenesis – generation of new neurons
Dendritic growth: 40 – 70 years old 90 years old
Dendrites increased No growth
NOTE: Lack of dendritic growth could be due to a lack of environmental stimulation and activity. Aging brain can adapt: 1. As brains age, they can shift responsibilities for a given task from one region to another. o Rewires Compensates what the other lacks 2. Changes in lateralization o Using both hemispheres o Dominant left hemisphere
THE IMMUNE SYSTEM Malnutrition – involving low levels of protein is linked to a decrease in T cells T cells – destroy infected cells Exercise – improve immune system functioning Vaccination against influenza – important in adults
PHYSICAL APPEARANCE AND MOVEMENT Middle age – start of changes in physical appearances
Memory functioning Alzheimer’s Disease Motor activities Parkinson’s disease Control precise of signal sent from one neuron to another
Wrinkles and age spots – are more noticeable Changes: 1. Wrinkles and age spots 2. Shorter due to bone loss in vertebrae 3. Weight drops (60 years) lose muscle bodies a “sagging look”
The Adapting Brain NOTE: Brain loses only a portion of its ability to function, and the activities adults engage in influence the brain’s development. o Aerobic fitness greater volume in hippocampus better memory Exercise + enriched environment new brain cells Stress reduces survival rate
4.
Mobility limitation movements with wide range of difficulty linked to obesity
What they should do: 1. Walking decreases physical disability in adults 2. Exercise and appropriate weight lifting reduce decrease in muscle mass and improves appearances 3. Social activities protects against loss of motor abilities
SENSORY DEVELOPMENT Sensory decline linked to cognitive functioning Sensory acuity, linked to how well others: 1. bathed and groomed themselves, 2. complete household chores, 3. engaged in intellectual activities
3.
Macular degeneration – deterioration of macula of the retina, which correspond to the focal center of the visual field. - can see peripheral but not what right in front of them - factor: smoking - treatment: surgery blindness
Hearing Legally deaf – degeneration of cochlea, primary neural receptor for hearing in the inner ear. Devices that minimize problems linked to hearing loss: 1. Hearing aids – amplify sound to reduce middle earbases conductive hearing loss. 2. Cochlear implants – restore hearing following neurosensory hearing loss 3. Stem cells – alternative to cochlear implants
Vision Visual Acuity Changes: 1. night driving – tolerance for glare diminishes 2. dark adaptation – adults recover longer when going from a well-lighted room to semidarkness 3. area of the visual field becomes smaller – changes suggesting that the intensity in the peripheral area of the visual fields needs to be increased if the stimulus is to be seen 4. visual decline – reduction in the quality and intensity of light reaching the retina
Smell and Taste 60 years of age – starts losing sense of smell and taste
60 years of age 75 Beyond 75 85 Beyond 85
retina 1/3 light Visual perception Worse performance Glare Dark adaptation
Color Vision Changes: color vision – yellowing of the lenses of the eye green-blue-violet part of the color spectrum trouble: navy socks vs black socks Depth Perception Changes: how far or near, high or low street curbs Diseases of the Eyes Diseases: 1. Cataracts – thickening of the lens of the eye that causes vision to become cloudy, opaque, and distorted. - 70 years old – cataract - treatment: glasses surgery to remove 2.
Glaucoma – damage to the optic nerve because of the pressure created by a buildup of fluid in the eye. - treatment: eyedrops destroy vision
Effects of decline: 1. Smell ˃ Taste 2. Reduce enjoyment of food and life satisfaction 3. Reduce the ability to detect smoke 4. Compensate by eating sweeter, spicier, and saltier foods
Touch and Pain Effects: 1. Could detect less in lower extremities ˃ upper extremities 2. Detect in touch not a problem 3. Less sensitive to pain and suffer from it less cope with energy mask injury
THE CIRCULATORY SYSTEM AND LUNGS Cardiovascular disorders – increases in late adulthood Reduce bps above 120/80: 1. Heart attack 2. stroke 3. Kidney disease Rise of blood pressure linked with: 1. Illness
2. 3. 4.
Obesity Stiffening of blood vessels Lack of exercise
2. 3. 4. 5. 6. 7. 8. 9.
Reduce the risk of cardiovascular diseases: 1. Drugs 2. Healthy diet 3. Exercise Walking and exercise capacity – best predictors NOTE: Lung capacity – drops 40 percent between 20 and 80 Effects of smoking, lungs… 1. Loses elasticity 2. Chest shrinks 3. Diaphragm weakens Diaphragm-strengthening functioning
Hypertension Hearing impairments Heart conditions Chronic sinus problems Visual impairments Orthopedic impairments of the back, extremities, etc. Arteriosclerosis diabetes
Chronic conditions associated with the greatest limitation on work: 1. Heart conditions 2. Diabetes 3. Asthma 4. Arthritis Health problems linked to: 1. Conflict in relationships 2. Low income
exercises
–
improve
lung
Causes of Death in Older Adults Leading causes 65 - 74: 1. Cancer 2. Cardiovascular diseases
SEXUALITY Effects: 1. Less frequent orgasm – occurring every second or third attempt direct stimulation is needed 2. Older adults are sexually active as long as they are healthy 3. No sex poor health 4. Good sexual life and interest in sex related to middle and late 5. Sexually active life was longer in men 6. Sexually active women no partner men: dead or with younger women
Decrease in cardiovascular diseases due to: 1. Drugs 2. Decrease in smoking 3. Better diet 4. exercise
Sex education – giving sexual information increased sexual interest, knowledge and activity
Ethnicity – linked with death rates
3 Health HEALTH PROBLEMS Chronic disease – slow onset, long duration - rare increase common Common chronic disorder: 1. Arthritis 2. Hypertension 3. Visual problems - women Hearing problems – men Most prevalent chronic condition: 1. Arthritis
Leading causes 75 - older: 1. Cardiovascular diseases 2. Cancer the older they are the more likely they will die of cardiovascular diseases than cancer
African-American ˃ Asian Americans and Latinos: 1. Stroke 2. Heart disease 3. Lung cancer 4. Breast cancer
Arthritis Arthritis – inflammation of the ts accompanied by pain, stiffness, and movement problems. - affect hips, knees, ankles, fingers and vertebrae - no known cure - symptoms can be reduced Symptoms can be reduced by: 1. Drugs – aspirin 2. Range-pf motion exercises for the afflicted ts 3. Weight reduction 4. Replacement of the crippled t with prosthesis 5. Exercise
Osteoporosis Osteoporosis – chronic condition that involves extensive loss of bone tissue. - why older adults walk with marked stoop - women ˃ men - common in non-Latina White, thin and smallframed
better health + increased longevity lower stress + reduce risk of coronary heart disease Resveratrol – skin of red wine grapes - key role in red wine’s health benefits - increases SIRTI, involved in DNA repair and aging red wine – kills several lines of cancer cells
Related to deficiencies in: 1. Calcium 2. Vitamin D 3. Estrogen 4. Lack of exercise
EXERCISE, NUTRITION AND WEIGHT Exercise Treill tests – determines physical fitness
Prevention: 1. Eat foods rich in Calcium 2. More exercise 3. No smoking 4. Vitamin C supplement
Accidents Accidents – sixth leading cause of death among older adults Common: falls and pneumonia healing and recuperation slower in adults long-term hospital care or home care Tai Chi – a form of balance training, improved the coordination of older adults in challenging situations
SUBSTANCE USE AND ABUSE Sedatives + alcohol impair breathing produce excessive sedative fatal Binge drinking - drinking five or more drinks a day Substance abuse – “invincible epidemic”
Consequences of alcohol abuse erroneously attributed to psychological conditions: 1. Depression 2. Inadequate nutrition 3. Congestive hear failure 4. Frequent falls Late-onset alcoholism – onset of alcoholism after the age of 65 - related to loneliness, loss of a spouse, or disabling condition. Benefits of moderate drinking: 1. Better physical and mental performance 2. More open to social s 3. Able to assert mastery over one’s life Moderate drinking of red wine
Low cardiorespiratory fitness – significant predictor of death Gerontologists recommend: 1. Strength training 2. Aerobic exercise 6.6 pound of lean muscle – lost each decade at 45 accelerate Resistance exercise – increase muscle mass in older adults - reduces muscular weakness Exercise – maintain health Aerobic activity at 60 years of age: 1. 30 minutes of moderately intense activity 2. Five or more days a week 3. Strength training on two or more days Positive effects of exercise: 1. Live independent lives 2. Help prevent falling down 3. Physically fit Physically fit – being able to do the things you want to do, whether you are young or old Discoveries in exercise and aging: 1. Exercise is linked to increased longevity. - systolic blood pressure long-term survival - energy expenditure: 1, 000 calories/week LE by 30% 2, 000 calories/week LE by 50% 2. Exercise is related to prevention of chronic disease. - reduce risk of: cardiovascular diseases type 2 diabetes osteoporosis stroke breast cancer 3. Exercise is associated with improvement in the treatment of many diseases. - improvement in symptoms of: arthritis
pulmonary disease congestive heart failure coronary artery disease hypertension type 2 diabetes obesity Alzheimer’s disease 4. Exercise improves older adult’s cellular functioning. - telomere length was greater in leukocytes when engage in aerobic activity. 5. Exercise improves immune system functioning in older adults. 6. Exercise can optimize body composition and reduce the decline in motor skills as aging occurs. - increase muscle mass and bone mass - decrease bone fragility 7. Exercise reduces the likelihood that older adults will develop mental health problems and can be effective in treatment of mental health problems. 8. Exercise is liked to improved brain and cognitive functioning in older adults. - increase information-processing skills Failure to increase exercise: 1. chronic illness 2. life crises 3. embarrassment 4. “why bother” factor
Nutrition and Weight Two aspects of undernutrition: 1. Vitamin and mineral deficiency 2. Calorie restriction (CR) Effects of CR: 1. Increases life span 2. Delays biochemical alterations 3. Chronic problems appear later 4. Provide neuroprotection for an aging CNR Why does CR increase life span of animals? Lower the free radicals and reduce oxidative stress in cells CR trigger as state of emergency called “survival mode” in which the body unnecessary functions to focus only on staying alive.
Nutrition and Weight Antioxidants – vitamin C, vitamin E, and beta-carotene - slow the aging process - improve health of older adults - counteract the cell damage caused by free radicals
NOTE: when free radicals cause damage (oxidation) in one cell, a chain reaction of damage follows. Vitamin C and beta-carotene – reduce a person’s risk of becoming frail and sick in the later adult years Uncertainties: 1. Which vitamins 2. Dose 3. Restraints High level of antioxidants less cognitive decline Vitamin B – folate, B6 and B12 - better cognitive performance
HEALTH TREATMENT NOTE: Development of alternative home and communitybased care has decreased the percentage of older adults who live in nursing homes Age nursing homes Important factor related to health and survival in nursing home patient’s feelings control and selfdetermination decide on their own caring nursing home and staff who want to help Self-control or responsible improvement Measured stress-related hormones coping skills, say no, assertive training, time management effect: low levels of cortisol (hormone closely related to stress that has been implicated in a number of diseases)
Chapter 18: Cognitive Development in Late Adulthood Late adulthood 60 to 120 or 125 Longest span – 50 to 60 years
1 Cognitive Functioning in Older Adults MULTIDIMENSIONALITY AND MULTIDIRECTIONALITY Cognitive Mechanics and Cognitive Pragmatics Cognitive Mechanics – “hardware” of the mind and reflect the neurophysical architecture of the brain developed through evolutions. - consists of 1) speed and accuracy of the processes involved in sensory input; 2) attention; 3) visual and motor memory; 4) discrimination; 5) comparison; 6) categorization - because of influence of biology, heredity, and health decline in old age - “fluid mechanics” Cognitive Pragmatics – culture-based “software programs” of the mind. - includes: 1) Reading and writing skills; 2) language comprehension; 3) educational qualifications; 4) professional skills; 5) knowledge about the self and life skills - culture improvement in old age - “crystallized pragmatics” Factors that contribute to the decline in fluid mechanics in late adulthood: 1. Decline in processing speed 2. Working memory capacity 3. Suppressing irrelevant information (inhibition)
Speed of Processing speed of processing – declines in late adulthood due to a decline in functioning of the brain and CNR. health and exercise – influence how much decline in processing speed occurs.
Attention Three aspects: 1. Selective Attention - focusing on a specific aspect of experience that is relevant while ignoring those that are irrelevant - examples: ability to focus on one voice in a crowded room search for a feature 2. Divided Attention - involves concentrating on more than one activity at the same time. 3. Sustained Attention - focused and extended engagement with an object, task, event, or some other aspect of the environment - “vigilance” - examples: Complex laboratory tasks
Memory Note:
Memory does change during aging, but not al memory changes with age in the same way.
Dimensions of memory and aging: 1. Episodic memory - retention of information about where and when of life’s happening. - example: year your sister was born - episodic > semantic 2.
Semantic memory - a person’s knowledge about the world - includes fields of expertise, general academic knowledge, and “everyday knowledge” - independent of an individual’s personal identity with the past - tip-of-the-tongue (TOT) phenomenon, in which individuals can retrieve the information but have the feeling that they should be able to retrieve it.
3.
Cognitive resources a. Working memory – short term memory but places more emphasis on memory as a place for mental work - examples: manipulate and assemble information when making decisions solving problems comprehending written and spoken language b.
Perceptual speed - ability to perform simple perceptual-motor tasks - examples
Deciding whether pairs of two-digit or twoletter strings are the same or different Determining the time required to step on the brakes when the car directly ahead stops Reaction time c.
d.
Explicit memory - memory of facts and experiences that individuals consciously know and can state - “declarative memory” - explicit > implicit Implicit memory - memory without conscious recollection - involves skills and routine procedures that are automatically performed
- focuses on life’s pragmatic concerns and human conditions. Higher-order reasoning activities: 1. Multiple perspectives 2. Allowance for compromise 3. Recognizing the limits of one’s knowledge In regards to wisdom, Bates and is colleagues found that: 1. High levels of wisdoms are rare. 2. The time frame of late adolescence and early adulthood is the main age window for wisdom to emerge. 3. Factors other than age are critical for wisdom to develop to a high level life experiences, values 4. Personality-related factors are better predictors of wisdom than cognitive factors.
4.
Source memory - ability to where one learned something
Triarchic theory of intelligence – wisdom is linked to both practical and academic intelligence
5.
Prospective memory - involves ing to do something in the future - deficits time-based > event-based
Academic intelligence – necessary but not a requirement for wisdom
6.
Beliefs, expectations, and feelings - matters what people tell themselves about their ability to - beliefs or expectancies about their memory skills are related to their actual performance - individuals with low anxiety about their memory skills and high self-efficacy regarding the use of their memory in everyday contexts had better memory performance
Practical knowledge – realities of life is needed for wisdom
7.
Noncognitive factor (health, education, SES) - less education lower cognitive abilities - less education + cognitive activities improve episodic memory - familiar tasks reduces age decrements in memory but does not eliminate them
Common good, balance between: 1. self-interest (intrapersonal) 2. the interest of others (interpersonal) 3. contexts (contextual)
EDUCATION, WORK, AND HEALTH
Lolos and lolas Successive generation
Education Return to college Better educated
Work Manual labor
Health
Cognitively oriented labor
Healthier
Education Conclusion: Some aspects of memory decline in older adults Decline episodic and working memory Decline in perceptual speed linked to memory decline Successful aging reduces memory decline
Decision Making Note:
Older adults preserve decision-making skills. Older adults perform well when decision is not constrained by time pressure and when the decision is meaningful to them.
Wisdom Wisdom – expert knowledge about the practical aspects of life that permits excellent judgment about important matters.
Educational experiences – are positively correlated with scores on intelligence tests and informationprocessing tasks, such as memory Reasons why older adults seek more education: 1. Better understand the nature of their aging 2. Learn more about the social and technological changes 3. Discover relevant knowledge 4. Learn skills to cope with societal and job demands 5. Remain competitive and stay in the workforce 6. Enhance their self-discovery and leisure activities 7. Smoother adjustment to retirement
Work Complex work – linked with higher intellectual functioning in older adults
Health
TRAINING COGNITIVE SKILLS
Hypertension – lower cognitive performance Alzheimer disease – lower physical and cognitive functioning
Lolos and lolas Successive generation NOTE:
Education Return to college Better educated
Work Manual labor
Health
Cognitively oriented labor
Healthier
Two key conclusions: 1. Training can improve cognitive skills 2. Some loss in plasticity Structured experience – improve cognitive skills
Decline in intellectual performance health-related Diseases do not directly cause mental decline. Culprit lifestyles + diseases Examples overeating, inactivity, stress Age-related cognitive decline mood disorders
Lifestyles + exercise – improved cognitive functioning Results of studies: 1. Women with higher physical activity were less likely to experience cognitive decline. 2. Cognitive functioning was assessed by tasked on working memory, planning, and scheduling. Walkers scored higher than stretchers. Aerobic exercise – improve memory and reasoning - get blood and oxygen pumping to the brain, which can help people to think clearly
Training in four groups: 1. Reasoning 2. Memory 3. Speed of processing 4. No training Results: Training effects did not transfer across cognitive domains. Training did not benefit the older adults’ activities of daily living. Senior odyssey – team-based program involving creative problem solving that is derived from the Odyssey of the Mind Mindfulness – involves generating new ideas, being open to new information, and being aware of multiple perspectives.
Depressive symptoms – cognitive decline, poorer memory functionig
Aerobic fitness training improved: 1. Planning 2. Scheduling 3. Working memory 4. Resistance to distraction 5. Processing involving multiple tasks in older adults
Terminal decline – changes in cognitive functioning may be linked more to distance from death or cognition-related pathology rather than birth
NOTE: Cognitive vitality improved through cognitive and physical fitness training
USE IT OR LOSE IT
COGNITIVE NEUROSCIENCE AND AGING
Use it or lose it – significant component of the engagement model of cognitive optimization that emphasizes how intellectual and social engagement can buffer age-related declines in intellectual development
cognitive neuroscience – studies links between brains and cognitive functions - relies on brain imaging techniques to reveal the areas of the brain that are activated when individuals are engaging in certain cognitive activities
Studies that “use it or lose it”: 1. Engagement in cognitively complex activities was linked to faster and more consistent processing speed 2. Those who regularly read books, did crossword puzzles, or exercised their minds were less likely to develop Alzheimer disease. 3. Rading daily was linked to reduced mortality in men in their seventies. 4. Each additional activity the older adult engaged in the onset of rapid memory loss was delayed by .18 years.
NOTE: Changes in the brain can influence cognitive functioning and changes in cognitive functioning can influence the brain. Links between aging + cognitive neuroscience: 1. Neural circuits in specific regions of the brain’s PFC is linked to poorer performance by older adult’s on complex reasoning tasks, working memory, and episodic memory tasks. 2. Both hemispheres compensate for aging declines. 3. Functioning of the hippocampus declines. 4. Patterns of neural decline with aging are larger for retrieval than encoding.
5. 6. 7.
Adults show greater activity frontal and parietal regions. Worse connectivity between brain regions. Brain activations frontal + occipital + hippocampal Increasing number of cognitive and fitness training assess the results of training on brain functioning.
Waking 1hr/day/3x a week for six months - increase volume in frontal and temporal lobe Neurocognitive scaffolding view Increase activation in the PGC adaptive brain. Adaptive brain compensates challenges of declining neural structures and function, and declines in various aspects of cognition Scaffolding – use of complementary, neural circuits to protect cognitive functioning in aging brain. - strengthen by cognitive engagement and exercise
2 Language Development What: 1. 2.
3. 4.
5.
6.
7.
8.
Maintain or improve their word knowledge and word meaning. Language-related complaints a. Difficulty in retrieving words for conversation b. Understanding spoken language TOT phenomenon when you something but just can’t quite retrieve it. Difficulty in understanding speech: a. Rapid speech b. Competing stimuli c. Can’t see conversation partner d. Hearing loss Phonological skills: a. Lower in volume b. Less articulate c. Less fluent – more pauses, fillers, repetitions, and corrections Conflicting information about changes in discourse (extended verbal expression in speech or writing). a. Retelling a story b. Giving instructions Nonlanguage factors a. Slower info-processing speed b. Decline in working memory Adults with Alzheimer a. Word finding b. Generating difficulties c. More grammatical errors
3 Work and Retirement WORK NOTE: 1. Retirees partially retire a. Part time b. Change career 2. Adults maintain productivity Continued employment: 1. Good health 2. Strong physiological commitment to work 3. Distaste for retirement 4. Educational attainment 5. Working spouse Reciprocal relation – higher cognitive ability work intellectual functioning
RETIREMENT IN THE UNITED STATES AND IN OTHER COUNTRIES Retirement in the United States Less clear life path: 1. Not retire continue 2. Retire new job 3. Retire volunteer 4. Postretirement go another 5. In and out of workforce 6. Disability retirement 7. Laid off “retirement” Why: 1. 2. 3.
Financial Stay busy “give back”
Retirement in the United States Reasons given by people regariding when they expect to retire from work: 1. Continue as long as possible 2. Retire when I am old enough to receive my pension 3. Retire when I am eligible for early retirement 4. Retire when my employer forces me to 5. Retire when my friends/colleagues do
Japanese US Germans Chinese Turkish
WORK Miss Less Least Most Most
MONEY Least Less -Least Most
Work: 1. 2. 3. 4.
Chinese, Turkish Japanese US Germans
Money: 1. Turkish 2. US 3. Chinese, Japanese
High percentage of early retirement: 1. 2. South Korea 3. HK
ADJUSTMENT TO RETIREMENT NOTE: 1. Satisfied lived and better health: remarried women > not married women 2. adjust best to retirement: a. healthy b. have adequate income c. active d. educated e. extended social network f. satisfied with lives 3. most difficult to adjust: a. inadequate income b. poor health c. added stress 4. difficulty in adjusting to retirement had: a. strong attachment to work b. lack of control c. low self-efficacy 5. improve adaptation by: a. cultivating interests 6. workers: a. not confident about pension benefits b. count on benefits that won’t be there when they retire c. don’t heed advice about retirement d. overestimate long-term care coverage e. savings are modest f. know little about social security income Flexibility – factor to adjusting in retirement
4 Mental Health Mental disorder – increasingly dependent on the help and care of others Effects of mental health disorder: 1. loss in dollars 2. loss of human potential 3. suffering
DEPRESSION Major depression – mood disorder in which the individual is deeply unhappy, demoralized, derogatory and bored - “common cold” of mental disorders - treatable medications and psychotherapy + spiritual involvement Person: 1. does not feel well, 2. loses stamina easily 3. has poor appetite 4. listless 5. unmotivated Lower frequency of depressive symptoms: 1. fewer economic hardships 2. fewer negative social interchanges 3. increased religiosity 4. engage in regular exercise Depressive symptoms in oldest-old: 1. women 2. more physical disability 3. cognitive impairment 4. lower SES Predictors of depression in older adults: 1. earlier depressive symptoms 2. poor health 3. disability 4. loss events 5. low social Result of depression: sadness suicide Insomnia – overlooked risk factor of depression
DEMENTIA, ALZHEIMER DISEASE, AND OTHER AFFLICTIONS Mental disorders: 1. Dementia – a global term for any neurological disorder in which the primary symptoms involve a deterioration of mental functioning - lose the ability to: care for themselves, recognize familiar surroundings
2. Alzheimer Disease - form of dementia - progressive, irreversible disorder characterized by deterioration of memory, reasoning, language, and eventually physical function - deficiency in acetylcholine – important in memory
- note: As the disease progresses, the brain shrinks and deteriorates. Deterioration amyloid plaques – dense deposits of proteins that accumulate in blood vessels neurofibrillary tangles – twisted fibers that build up in neurons Oxidative stress occurs when the body’s antioxidant defenses don’t cope with the freeradical attacks and oxidation in the body. Causes: Genes (identical twins) Age Apolipoprotein E (apo E) – linked to increasing presence of plaques and tangles. Lifestyles Risk factors: Obesity Smoking Atherosclerosis High cholesterol Lipids - 2 types: a. early-onset – initially occurring in individuals younger than 65 years of age - rare b. late-onset – initially occurring in individuals 65 years of age and older - important agenda: bio and envi factors development of preventive strategies maintenance Mild Cognitive Impairment (MCI) – represents a traditional state between the cognitive changes of normal aging and Alzheimer disease - provides a break away from the burden of providing chronic care.
3. Multi-Infract dementia - sporadic and progressive loss of intellectual functioning caused by repeated temporary obstruction of blood flow in cerebral arteries - results series of mini strokes - note: Infract – temporary obstruction of blood vessels - men with a history of HBD - symptoms: Confusion Slurring of speech Writing impairment
Numbness on one side of the face, arm and leg - quick recovery - recommend Exercise Improved diet Appropriate drugs
4. Parkinson’s Disease - chronic, progressive disease characterized by muscle tremors, slowing of movement and partial face paralysis - degeneration of dopamine - treatment: ister L-dopa converted by the brain into dopamine Deep brain stimulation (DBS) – implantation of electrodes within the brain stimulated by a pacemaker-like device Dance (tango) Stem cell transplantation Gene therapy
CAUSES Dementia Alzheimer disease
TREATMENTS
Deterioration due to amyloid plaques – dense deposits of proteins that accumulate in blood vessels neurofibrillary tangles – twisted fibers that build up in neurons
Multi-infract dementia
Parkinson’s disease
Oxidative stress temporary obstruction of blood flow in cerebral arteries degeneration of dopamine
Exercise Improved diet Appropriate drugs L-dopa converted by the brain into dopamine Deep brain stimulation (DBS) – implantation of electrodes within the brain stimulated by a pacemaker-like device Dance (tango) Stem cell transplantation Gene therapy
FEAR OF VICTIMIZATION, CRIME, AND ELDER MALTREATMENT
Fear of being a victim of a crime - serious offenses robbery - nonviolent crimes fraud, vandalism, purse snatching, harassment How often does it occur? Carried out by: family , spouse Involve: Neglect Psychological abuse Physical abuse Institutional abuse – involves maltreatment of older adults living in facilities such as nursing homes, hospitals, longterm care - rough handling, hitting, slapping patients, inappropriate treatment, psychological abuse, isolation and threats
5 Religion Spirituality: 1. lower depression 2. derives a sense of meaning in life 3. higher levels of life satisfaction, 4. higher levels of self-esteem, 5. higher levels of optimism 6. sense of well being 7. better health 8. slower rates of cognitive decline 9. reduction in mortality 10. provide psychological needs a. help face impending death b. find meaning c. find significance d. accept losses e. social activities f. social g. leadership roles prayer and meditation - reduce stress and dampen body’s production of stress hormones