Daniel Levinson depicts the late adulthood period as those years that encompass age 65 and beyond. Other developmental psychologists further divide later adulthood into young-old (ages 65–85) and old-old (ages 85 and beyond) stages. Today, 13 percent of the population is over the age of 65, compared with 3 percent at the beginning of this century. This dramatic increase in the demographics of older adulthood has given rise to the discipline of gerontology, or the study of old age and aging.
Gerontologists are particularly interested in confronting ageism, or prejudice and discrimination against older adults.
Aging inevitably means physical decline, some of which may be due to lifestyle, such as poor diet and lack of exercise, rather than illness or the aging process. Energy reserves dwindle. Cells decay. Muscle mass decreases. The immune system is no longer as capable as it once was in guarding against disease. Body systems and organs, such as the heart and lungs, become less efficient. Overall, regardless of people’s best hopes and efforts, aging translates into decline.
Even so, the speed at which people age, as well as how aging affects their outlook on life, varies from person to person. In older adulthood, people experience both gains and losses. For instance, while energy is lost, the ability to conserve energy is gained. Age also brings understanding, patience, experience, and wisdom—qualities that improve life regardless of the physical changes that may occur. Aging in late adulthood profoundly affects appearance, sensation, and motor abilities. An older adult’s appearance changes as wrinkles appear and the skin becomes less elastic and thin.
Small blood vessels break beneath the surface of the skin, and warts, skin tags, and age spots (liver spots) may form on the body. Hair thins and turns gray as melanin decreases, and height lessens perhaps by an inch or two as bone density decreases. The double standard of aging applies to men and women in older adulthood just as it did in middle adulthood. Older men may still be seen as distinguished, while older women are labeled as grandmotherly, over the hill, and past the prime of life. During late adulthood, the senses begin to dull.
With age, the lenses of the eye discolor and become rigid, interfering with the perception of color and distance and the ability to read. Without corrective glasses, nearly half the elderly population would be legally blind. Hearing also diminishes, especially the ability to detect high-pitched sounds. As a result, the elderly may develop suspiciousness or even a mild form of paranoia—unfounded distrustfulness—in response to not being able to hear well. They may attribute bad intentions to those whom they believe are whispering or talking about them, rather than correctly attributing their problems to bad hearing.
Hearing problems can be corrected with hearing aids, which are widely available. The sense of taste remains fairly intact into old age, even though the elderly may have difficulty distinguishing tastes within blended foods. By old age, however, the sense of smell shows a marked decline. Both of these declines in sensation may be due to medications, such as antihypertensives, as well as physical changes associated with old age. In addition to changes in appearance and the dulling of the senses, reflexes slow and fine motor abilities continue to decrease with old age.
By late adulthood, most adults have noticed a gradual reduction in their response time to spontaneous events. This is especially true of older adults who drive. While routine maneuvers on familiar streets may pose fewer problems than novel driving situations, older adults’ reaction times eventually decline to the point that operating a vehicle is too hazardous. However, many elderly are hesitant to give up driving because the sacrifice would represent the end of their personal autonomy and freedom. Generally, older adults score lower overall on tests of manual dexterity than do younger adults.
Older adults may find that their fine motor skills and performance speed decrease in some areas but not in others. For instance, an elderly lifelong pianist may continue to exhibit incredible finger dexterity at the keyboard, but may at the same time find that taking up needlepoint as a hobby is too difficult. Although the average life expectancy is 79 for females and 72 for males, older adulthood can easily extend 20 years or more beyond these figures. As older adults age, most report increasing health problems.
Even so, only about 5 percent of adults over age 65 and 25 percent of those over age 85 live in nursing homes, foster care (where elderly people live with a family licensed by the state to care for aging adults), or other long-term care facilities. With medical advances and continued improvements in health-care delivery, the older population is expected to increase in its numbers and report better health.
Estimates are that within the next 30 years, one out of every five Americans will be an older adult. Although most older adults have at least one chronic health problem, such ilments need not pose limitations on activities well into the adults’ 80s and beyond. The most common medical concerns during older adulthood are arthritis and rheumatism, cancer, cataracts of the eyes, dental problems, diabetes, hearing and vision problems, heart disease, hypertension, and orthopedic injuries. Because the elderly are at greater risk of losing their balance and falling, hip fractures and breakages are particularly common and dangerous in this age group. Contracting colds and flus can have especially serious repercussions for the elderly.
This is due, in part, to the reduced capacity of older adults’ body organs and immune system to fight disease. Unfortunate, but not uncommon, is the following scenario: An elderly person falls at home and breaks a hip bone, undergoes successful hip-replacement surgery, and then dies two weeks later from postoperative pneumonia or other infections because of reduced reserve capacity and inability to recover from infection. Inadequate nutrition and the misuse of medication also may be implicated in older adults who suffer from poor health.
By the time adults reach age 65, they need 20 percent fewer calories than they did in their youth, but they still need the same amount of nutrients. This may explain, in part, why so many older Americans are overweight but undernourished. Additionally, cooking becomes a hassle for many older adults, and they find it easier to eat fast food, junk food, or nothing at all. Furthermore, many elderly unintentionally overuse prescription medication or combine medications that, when used together, produce toxic effects.
As the body ages and potentially becomes more sensitive to the effects of prescription medications, drug dosages should be carefully monitored and assessed by a physician. Many elderly who have been hospitalized in near-death condition begin to recover as soon as their medications are reduced or stopped. Life expectancy can be prolonged through exercise. Older adults who have kept active, remained fit, and eaten wholesome foods throughout their lives tend to fare better than those who have not. This should be a lesson to younger adults who have an opportunity to modify their health habits early in life.
The mental, emotional, and behavioral problems typically encountered by older adults are depression, anxiety, and dementia (mental deterioration, also known as organic brain syndrome. Poor nutrition, inadequate sleep, metabolic problems, and strokes may cause dementia, which affects 4 percent of those over age 65. (Dementia due to strokes is sometimes termed multi-infarct dementia. ) Older adults with dementia experience forgetfulness, confusion, and personality changes. Many people use the term senility to refer to dementia, which is incorrect.
Senility does not have a precise or actual medical meaning; it is an overused and nonspecific term, like the word neurosis. Similar in symptoms to dementia is Alzheimer’s disease, an irreversible degenerative brain disorder that can affect as many as 50 percent of older adults over age 85 and eventually results in death. Early symptoms of Alzheimer’s disease include agitation, confusion, difficulty concentrating, loss of memory and orientation, and trouble speaking. Later symptoms include the inability to use or understand language, and total loss of control over bodily functions.
Unfortunately, Alzheimer’s is still a mystery to doctors and other scientists. In fact, the only certain diagnostic procedure for Alzheimer’s disease is the analysis of autopsied brain tissue. The exact causes of Alzheimer’s disease continue to elude researchers, although some suspect that genetics and malfunctions in enzyme activity may play a role. People often fear that aging will cause their intellect to disappear, giving way to cognitive impairment and irrationality. However, intellectual decline is not an inevitable consequence of aging.
Research does not support the stereotypic notion of the elderly losing general cognitive functioning or that such loss, when it does occur, is necessarily disruptive. Older adults tend to learn more slowly and perform less well on tasks involving imagination and memorization than do younger adults, but what older adults may be lacking in terms of specific mental tasks, they make up for in wisdom, or expert and practical knowledge based on life experience. Many older adults complain about not being able to remember things as well as they once could.
Memory problems seem to be due to sensory storage problems in the short-term rather than long-term memory processes. That is, older adults tend to have much less difficulty recalling names and places from long ago than they do acquiring and recalling new information. Practice and repetition may help minimize the decline of memory and other cognitive functions. Researchers have found that older adults can improve their scores on assorted tests of mental abilities with only a few hours of training.
Working puzzles, having hobbies, learning to use a computer, and reading are a few examples of activities or approaches to learning that can make a difference in older adults’ memory and cognitive functions. Recent decades have witnessed older adults’ growing interest in continuing their education. In fact, many colleges and community centers offer classes for free or at a significant discount for senior citizens. Although keeping up with a class of 20 year olds may be a challenge, older adults can learn new information if it is presented clearly, slowly, and over a period of time.
Older adults also can enrich the learning process for others through the insight and wisdom they’ve gained from life experience. Younger students often remark that they appreciate the practical perspective that their older colleagues offer. Older adults who have kept their minds active and fit continue to learn and grow, but perhaps more gradually than their younger colleagues. Patience and understanding (on the part of both the elderly and their significant others), memory training, and continued education are important for maintaining mental abilities and the quality of life in the later years.