Social phenomena and social practices often exist long before they receive an identifying label. The subsequent act of naming an activity is significant because it allows people to refer to it. The word ageism is a case in point. Until Robert N. Butler introduced the term in 1969, there was no uniform way to refer to the behaviors associated with the practice of ageism, even though the activity ha…
Language comprehension is an important aspect of day to day functioning in adulthood. Comprehension of written and spoken language relies on the ability to correctly process word and phrase meanings, sentence grammar, and discourse or text structure. Difficulties in any of these domains can produce comprehension problems. Age-related memory declines have been reported in many studies comparing you…
Human communication and socialization to a large degree occur through language, which is a symbol system used to represent, convey, and interpret ideas, thoughts, and feelings. Typically one language user (a sender) arranges words or other vocabulary symbols (e.g., gestures, as used in sign language) to express particular intentions or ideas to at least one other language user (a receiver). While …
Although Latin American populations are still fairly young (8 percent were over age sixty in 2000), the countries are aging in a quietly rapid way that could soon overwhelm existing infrastructures. Even as they struggle to develop economically, Latin American populations are aging far faster than those in western Europe, Canada, or the United States, a consequence of past successes in fertility a…
Learning is the process of forming associations that result in a relatively long-lasting change in the organism. Learning that involves relations between events is called associative learning, and the primary forms of associative learning are called classical and instrumental conditioning. Learning and memory are closely associated phenomena because memory occurs as a consequence of learning. Olde…
Leisure is one facet of the quest for meaning that continues throughout life. From earliest cognition to dying breath, meaningful engagement and self-validation appear to be enduring attractors. Two trends speak to the probable importance of leisure. During the course of the twentieth century, there was a vast expansion in access to leisure. At the same time, social demographic changes already app…
C. Wright Mills described the task and promise of the sociological imagination as the ability to "grasp history and biography and the relations between the two." The life course perspective takes this task seriously, providing a theoretical framework, concepts, and analytical tools for examining how lives unfold in historical contexts. This perspective views aging as a life-long proc…
Economists have developed three major theories of consumption and saving behavior: (1) The life-cycle hypothesis (Modigliani and Brumberg, 1954; Modigliani and Ando, 1957; Ando and Modigliani, 1963); (2) the permanent income hypothesis (Friedman, 1957); and (3) the relative income hypothesis (Dusenberry, 1949). All three theories have their conceptual roots in the microeconomic theory of consum…
Life events are defined as discrete experiences that disrupt an individual's usual activities, causing a substantial change and readjustment. Examples of life events include marriage, divorce, illness or injury, and changing or losing a job. In the literature on stress, life events have been traditionally considered as one type of stressor, along with chronic strains (ongoing stressful circ…
Life expectancy is a summary measure of the average number of additional years a group of people can expect to live at a given exact age. Life expectancy figures are derived from a life table. Life table methodology has been developed for human populations to determine average lengths of life, of healthy life, of married life, and of working life. Indeed, life tables have recently been used to det…
Life review is a progressive return to consciousness of memories and unresolved past conflicts for reevaluation and resolution. It is a normal, developmental task of the later years, a private process that differs with each individual. This evaluative process is believed to occur universally in all persons in the final years of their lives, although they may not be totally aware of it and may in p…
Life-span developmental theory provides a framework for understanding human aging. The main purpose of theory in the study of aging is to provide a context for describing and explaining the regular transformations that occur with time to representative organisms living under representative conditions. Theories in general aid the process of articulating meaningful patterns from observations that wo…
Opinions about life-span extension range from the optimistic, fanciful thinking of Ben Bova, a noted science fiction writer, who wrote: "The first immortal human beings are probably living among us today. You may be one of them." (Bova, p. 3), to the realistic views of Steve Austad, a respected researcher on the evolution of aging processes, who wrote: "In Westminster Abbey. .…
The evolutionary origin of control-related behavior lies in the universal strive to achieve outcomes in the environment by one's own activity. Control behavior should be distinguished from perceptions or beliefs about control. Perceived control exclusively addresses mental representations of the degree of control available to the individual. Control behavior, by contrast, encompasses behavi…
Since the early 1970s, adult literature has been transformed, creating what Constance Rooke has called "a new paradigm of hope." Modern medicine has extended the life span while improving the later years. Editors, publishers, and authors have recognized that a sizable proportion of the reading and writing public is over sixty. A few writers, such as poet Virginia Adair and novelists …
Factors that determine living arrangements over the course of late life are diverse and complex. Living arrangements have important implications for an older adult's emotional, financial, and physical health, and historical changes in elderly living arrangements, the range of housing options available, and factors that predict living arrangements all have consequences for the well-being of …
Reproduction is one of the most important influences on longevity. This influence is both direct, within the life of single individuals, and indirect, through the impact of reproduction on the evolution of longevity, mortality, and related characters. Both effects are considered here. …
One way scientists study a phenomenon is that they change it. In the study of aging, organisms with altered longevity are systems of choice for the unraveling of the biological mechanisms controlling aging. Selection is one of the tools that biologists use to alter the characteristics of organisms, from their size to their shape to their physiology. In this context, it is only natural to strive to…
The population of the United States enjoys one of the highest life expectancies in the world, and throughout the twentieth century the life expectancy of Americans increased remarkably. When the twentieth century began, U.S. newborns could expect to live an average of 47 years (see Figure 1). By 1960, that number had risen to 70 years, and it had increased to 76.7 years by the year 1998 (Anderson;…
Long-term care includes an array of services used by persons who need assistance to perform daily activities that are basic to living independently. These daily activities include self-care activities (e.g., eating, dressing, bathing, and getting around the house) and household tasks (e.g., shopping, preparing meals, managing money, using the telephone, housecleaning, and taking medications). The …
Many older persons today are healthier, better educated, and wealthier than earlier generations. Still, a significant number of older persons are economically and physically vulnerable—especially older women. Long-term care is, in essence, a women's issue. This is because it is predominantly women who need care and provide care. Women make up 75 percent of all nursing home residents …
The rate of population aging across developed countries varies considerably. For example, in the year 2000, the percentage of the total population age sixty-five and older was higher in Japan (17.1 percent), Germany (16.4 percent), the United Kingdom (16 percent), and France (15.9 percent) than in Canada (12.8 percent), the United States (12.5 percent), Australia (12.1 percent), and New Zealand (1…
Long-term care decisions arise for elderly individuals and their families when the elder is no longer able to live independently. The loss of capacity for independent living is typically caused by changes in health that result in a decreased ability to care for oneself in the activities of daily living, such as cooking, eating, bathing, and toileting. These changes in health status can include dem…
The financing of long-term care services comes from a patchwork of funds from the federal, state, and local levels, and from private dollars, primarily paid from the consumer's own pocket. According to data from the Centers for Medicare & Medicaid Services (CMS), almost $115 billion dollars were spent on long-term care (not including Medicaid waiver expenditures) in 1997, with the major…
The feasibility of private long-term care insurance is central to the public policy debate over financing long-term care. The failure of the private market, even with public subsidies, to insure a substantial portion of the population has a bearing on the public sector's role in financing long-term care. The larger the share of the population with adequate private insurance, the less li…
Quality in long-term care requires three steps: (1) defining quality of care; (2) assessing care and services to determine whether quality standards are being met; and (3) correcting quality problems when they are identified. Quality questions in long-term care go beyond the traditional safety and protection issues that have historically dominated the field of tong-term care; policy-makers and reg…
The main function of the respiratory system is to secure gas exchange: oxygen, which fuels metabolism, is transported from the ambient air (which contains 21 percent oxygen) to the pulmonary capillaries, and carbon dioxide is transported from the pulmonary capillaries to the external atmosphere. The oxygen-enriched blood reaches (via the pulmonary veins) the left side of the heart and the peripher…
Good nutritional status is essential to the maintenance of health and quality of life among older people. Normal changes associated with aging, along with physical illness and cognitive or emotional problems, can lead to dietary changes and contribute to undernutrition. Consequently, any deterioration in nutritional status can be considered a major determinant of morbidity and mortality in persons…
A stable and satisfying marriage can provide an important source of emotional and instrumental support throughout adulthood, and is associated with increased economic well-being, mental health, and physical health. Some of these apparent benefits of marriage may result from improved health behaviors among married people, care and monitoring provided by a spouse, or by selection of the healthiest, …
Throughout history, the formation of marriages has been primarily between young adults, and that remains true in the United States and other modern societies. In late twentieth-century America, however, marital union formation became spread through the adult life span to an unprecedented extent, the average age of those marrying around the end of the century being substantially higher than it was …
Millions of elderly people in the United States have extensive health care needs and expenses, but many have limited incomes or savings to help them cover the cost of care. Virtually all elderly Americans have Medicare, the federal health insurance program for elderly and disabled Americans, to help pay medical bills. However, limits in the scope of benefits, coupled with financial obligations for…
As a discipline and a "worldview," medicine has been one of the most important and powerful forces in the twentieth century. As a paradigm, the biomedical model focuses on individual organic pathology, physiological etiologies, and biomedical interventions. Turner (1987) delineates the medical model as one in which disease is interpreted regarded as a direct result of malfunctions wi…
When Medicare was established in 1965, many of its supporters believed that insuring persons age sixty-five and over was a precursor to a national system of health insurance. The Medicare program was thought to be just the first piece of legislation towards this end. But instead, Medicare has become the largest public program of health insurance, and universal health insurance is a reality only fo…
Prescription drugs are an important part of medical care. Their proper use can lower hospital and nursing home stays and lead to an overall decline in health care expenditures. However, many older individuals lack insurance coverage for such medications. This has led to a national discussion of adding a prescription benefit to Medicare for senior citizens. …
Since the enactment of Medicare in 1965, there has been a market for supplemental insurance designed to fill the gaps in the program's coverage. The possession of supplemental insurance is essential for most Medicare beneficiaries because there are a number of gaps in Medicare coverage, some of which can result in catastrophically high out-of-pocket costs. Under Part A (Hospital Insuranc…
Most people recognize that their memories are changing as they grow older. They have a harder time coming up with names; they have a harder time finding things they need; they have to rely more on external memory cues such as notes or calendars. In fact, research results support these perceptions. The bad news from this research is that memory declines are experienced throughout the adult life spa…
Memory deficits in the adult can develop from lesions that disrupt circuits that interconnect structures involved in encoding and retrieving recently acquired information, as well as from those involved in transferring information to long-term storage. The most important structure of this memory system is the hippocampalentorhinal complex. Other areas involved in memory processes include the amygd…
Everyday memory refers to memory operations that routinely occur in one's daily environment. Examples of everyday memory include remembering names, remembering plans for the day, recalling items that one needs to purchase at the grocery store, remembering to take medications, and remembering telephone numbers, directions, or recent newsworthy events. The hallmark of everyday memory and asso…
Research on the effectiveness of memory training in older adults is important for practical and theoretical reasons. Much of the applied research on this topic is motivated by the aim of trying to identify the techniques that are most effective for improving the memory of older adults. Memory training research also has importance for theories of aging because knowing the potentials and limits o…
Menopause is defined as a mature woman not having a period for one year. The average age of women entering menopause in North America is 51.2 years. Most women will spend more than a third of their lives in menopause. For many, this is a fulfilling time in their lives, as they are relieved from dealing with menstruation and fears of pregnancy; while for some it means dealing with a new set of symp…
The mental health needs of older Americans are a matter of increasing attention, a fact reflected in the growing number of services available since 1975. Even so, the mental health needs of older adults are poorly understood, mental health services are fragmented, and existing services are underutilized. Consequently the older population is especially vulnerable to preventable outcomes: related ph…
Almost everyone is familiar with the idea of going to the doctor for a physical examination for school, employment, a driver's license, or for summer camp. Such an examination includes measurement of pulse and blood pressure, listening to the heart and lungs through a stethoscope, tapping tendons to elicit neurological reflexes, and so on. Everyone may not be aware, however, that the doctor…
Adults of all ages often wonder about their memory—how it works or does not work, why one remembers some things but not others, and whether memory skills will change over the life course. The term "metamemory" refers to such cognitions about memory—thinking about how, why, and whether memory works. Specific aspects of metamemory include knowledge of memory functioning, …
The southern part of Asia, known as the Middle East, covers an area about the size of the United States and Mexico. The Middle Eastern countries are Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, Turkey, the United Arab Emirates (UAE), the West Bank and Gaza Strip, and Yemen. Although often discussed collectively, they are different in as many ways as they …
One of the most intriguing puzzles of lifespan developmental psychology is the myth of a midlife crisis, a mental health crisis occurring in the midlife years. In 1965, Elliot Jacques proposed the midlife crisis as a normative crisis in early middle adulthood on the basis of a psychoanalytic approach to an awareness of death surfacing in early midlife (the mid-thirties). Although the notion of a m…
If a survey asked respondents what they knew about the geographic distribution and migration patterns of older people in the United States, two observations would be frequently repeated. First, with respect to distribution, respondents would comment on the concentration of older people in Florida. Second, regarding migration, most would report something about retirement migration, with older peopl…
Mitochondria are organelles found in the cytoplasm of all eukaryotic cells. They vary considerably in shape and size, but are all composed of four compartments: a smooth outer membrane, a convoluted inner membrane that forms recognizable structures called cristae, the intermembrane space, and the matrix. Mitochondria are the "powerhouses" of cells; their function is to convert energy…
Molecular biology can be loosely defined as the study of biology at the molecular level. However, the term is usually used in a more limited sense to mean the study of macromolecules such as proteins, DNA, and RNA, and their specific roles in living systems. This use of the term came into being in the 1960s, largely as the result of the elucidation of the structure of DNA in 1953, and the realizat…
Molecular therapy comprises methods to provide a needed gene product to a patient, with the intent to produce a desired effect on health. Genetically engineered viruses can be used to deliver genes to cells in the body, and the cells that receive the gene then synthesize the protein that the gene encodes. Alternatively, in a cell-based form of gene therapy, termed ex vivo gene therapy, the pat…
Genes are the ultimate time travelers. They transcend the bounds of time by hitching a ride in sexually reproducing species such as humans, but then discard the human body later in life as if it was a used car that had passed its warranty period. Once immortality became a fundamental property of deoxyribonucleic acid (DNA), at some time in the distant history of life on earth, the carriers of thes…
Research within the psychology of aging has increased our understanding of old (and very old) age with regard to changes in intellectual functioning, everyday competence, and social relationships, as well as sources of well-being (see Baltes and Mayer, 1999). At the same time, the role of motivational processes in aging has become increasingly important. …
Research in motor control of aging humans has been centered around determining how motor performance is influenced by age, and around efforts to unravel the mechanisms that contribute to declines in motor performance. Changes are often characterized by slower and more variable movements, specifically slower initiation of movement, slower movement durations, declines in coordination of movement, re…
Many seniors enjoy good health and independence well into their ninth and tenth decades. However, some develop illnesses and functional impairments that require intensive or prolonged health care and supportive services at home, in hospitals, or in long-term care facilities. Family, peers, friends, volunteers, and other caregivers provide assistance and support, and in Western countries most senio…
Multiple system atrophy is a group of disorders that share common clinical features, which include Parkinsonism, problems with balance (ataxia), and dysfunction of the autonomic nervous system. It is a sporadic neurodegenerative disease of adult onset. Its cause remains unknown. Parkinsonism is a part of the constellation of symptoms, hence multiple system atrophy also falls within the rubric of d…
There is ample evidence that mutations are causally related to cancer, a prominent age-related disease. Since the 1950s the accumulation of spontaneous mutations in the DNA of organs and tissues has been hypothesized to underlie aging itself (e.g., Failla, 1958). What are mutations, and why are they there? First, it is necessary to distinguish DNA mutations from DNA damage. DNA damage consists of …
Narrative can be situated within the range of speech acts that comprise ordinary communication. At one end, there are relatively brief communications, such as token conversational responses like "umm" or "uh-huh" or short descriptive statements like "I've felt that way all my life." At the other end, where narrative is situated, are more extended an…
The present challenge of research on aging is to maintain or even accelerate the trend of declining disability and disease rates in the context of the anticipated rise in the number of older people. Demographic projections show that the U.S. population will begin to age rapidly after 2011, the year the first baby boomers turn sixty-five. Between 2000 and the year 2030, the number of people over si…
Although research initiatives on normal aging of the human brain are still in their infancy, experimental studies have revealed a discrete spectrum of structural, physiological, and neuropsychological alterations that accompany the senescent changes that occur in other organ systems. While neuronal atrophy is the most consistent and pervasive change associated with the aging process, investigation…
None of the billions of nerve cells, or neurons, in the human brain functions alone. To process information, neurons must form circuits and must communicate with each other rapidly and with great precision. Within a neuron, the electrical impulses that carry information are propagated by rapid changes in membrane potential that arise from the controlled opening and closing of ion channels. These p…
Neurodegenerative diseases represent a diverse spectrum of chronic neurological disorders, of possible genetic etiology, that are associated with the progressive loss of motor, sensory, and perceptual functions and associated cognitive and behavioral deficits. These disorders are characterized by disease-selective profiles of adult-onset neuronal cell loss within areas of the cerebral cortex, basa…
A substantial volume of scientific evidence has been accumulated demonstrating that biological aging is associated with functional deficits at the cellular, tissue, organ, and system levels. Although several theories have been proposed to explain these changes, as well as the increased risk of disease with age, no single explanation has adequately accounted for the diversity of physiological chang…
Information in the brain is transmitted from neuron to neuron through specialized connections called synapses. A synapse between two neurons is made up of presynaptic and postsynaptic terminals, which are separated by a synaptic cleft. The presynaptic terminal is filled with small vesicles containing chemical neurotransmitters, and the postsynaptic terminal consists of receptors specific for these…
Neuropsychology is a scientific field concerned with understanding relationships between the human brain, behavior, and mind, and applying this understanding to the assessment, clinical management, and rehabilitation of persons with neurological disease and injury. Mind includes both conscious (that of which the person is aware) and unconscious (that of which the person is unaware) mental contents…
The idea that nerve cells function as independent units and form a physical contact to facilitate intercellular communication was first proposed by neurobiologists at the turn of the twentieth century. This concept, termed the neuron theory of brain function, is based on the knowledge that the nervous system is not made up of a contiguous labyrinth of intertwining processes but instead represents …
Nurse practitioners play an increasingly important role in providing health care in the United States. Nurse practitioner Marilyn Graham (left) prepares to give three-month-old Donovan Washington a check-up in Arlington, Texas on August 30, 2000. (AP photo Donna McWilliam.) Health care demands are often the driving force behind the emergence of new and modified positions within the field. I…
The practice of nursing home administration has been embodied in five domains of practice developed in the 1980s by the National Association of Boards of Examiners for Long Term Care Administrators: (1) organizational management, (2) personnel, (3) financial management, (4) environmental management, and (5) resident care. These five domains are updated every five years. A license issued by a state…
Nursing facilities, commonly called nursing homes, serve a small percentage of older adults. These facilities continue to be in the public-policy spotlight because of efforts to redefine their position in the long-term care system and because of ongoing efforts to enhance the quality of care they provide to their residents. Nursing facilities are defined here as facilities with three or more beds…
Every year over 1.5 million people (of all ages) in the United States spend some time in a nursing home (McKnight's; Kassner and Bectel). Although many return home after a brief stay, others spend their last years as nursing home residents. Whether one plans to stay for a few weeks or a few years, choosing a nursing home is a difficult decision. Nursing homes vary in services provided, amen…
In the twenty-first century, nursing homes have become a standard form of care for the most aged and incapacitated persons. Nearly 6 percent of older adults are sheltered in residential facilities that provide a wide range of care. Yet such institutions have not always existed; rather, their history and development reflect relatively recent demographic and political realities that shape the experi…
A movement to establish dementia special care units (SCUs) began in the United States in the 1960s. The movement gained momentum, becoming widespread in 1980s and 1990s. This growth was fueled by the recognition that Alzheimer's disease and other progressive dementias represent a serious public health problem, and by the advocacy of the Alzheimer's Disease and Related Disorders Assoc…
Adequate research plays a crucial role in preserving the health status and functional independence of older adults. Conversely, malnutrition is associated with an increased rate of morbidity, mortality, and a failure to thrive in the elderly population. …
The first work that linked caloric restriction to an extension of life span was published in 1935 by Clive McCay and his colleagues, nutritionists at Cornell University in Ithaca, New York. Their studies showed that restricting the food intake of rats soon after weaning increases their length of life. Since then, this finding has been confirmed many times in rats, mice, and hamsters. In most of th…
Although Americans have long been consuming vitamin and mineral supplements, it was only in the 1980s and 1990s that a direct relationship between diet and health (and, therefore, the potential beneficial role for nutrient supplements beyond the minimum amounts required to avoid deficiency) became apparent. The elderly population is the most diverse and heterogeneous of any age group, and determin…
Obesity refers to the presence of excess total body fat (i.e., increased adipose tissue, or increased adiposity). Obesity is assessed by many different methods, and its exact definition varies widely. The so-called gold standard for the measurement of adiposity (degree of fatness) is underwater weighing, in which a subject is placed in a tank of water with only the head above the water line. The a…
The primary focus of occupational therapy is enabling individuals to participate actively and meaningfully in their day to day lives. Occupation is defined as any meaningful activity a person may do throughout the course of a day, including taking care of one's self (self care), contributing to society through paid and unpaid work (productivity), and simply enjoying life (leisure). Individu…
The Older Americans Act (OAA) is the principal piece of federal legislation designed to provide a range of community services to adults age sixty and above. The law was enacted in 1965, during a time when the federal government was inaugurating a broad range of domestic social policies. The overarching goal of the OAA—to promote the independence of older Americans— has remained large…
As many nations of the world experience aging populations, attention is increasingly turning to changes within the older population itself, especially changes in the age structure of this older population. As a general statement, over time the elderly population is likely to become older; such a phenomenon is important because there are likely to be important differences among age groups within th…
Osteoporosis is a bone disease that affects over ten million Americans and 1.4 million Canadians. Persons with this disease have low bone mass and structural deterioration of bone tissue. This causes the bone to become more fragile and An elderly woman with a Dowager's hump caused by osteoporosis. (Corbis photo by Lester V. Bergman.) more likely to fracture. Osteoporosis is often r…
Pain is an unpleasant sensation induced by a noxious stimulus, and is transmitted along special nerve pathways to the brain. Many older adults state that it is the experience of chronic pain, more than anything else, that alters their individual sense of themselves, making them finally "feel old." While many age-related conditions give rise to pain, the experience of pain itself is n…
A report released by the Institute of Medicine's Committee on Care at the End of Life states that individuals often suffer needlessly at the end of life. According to this report, the organization of the health care delivery system in the United States impedes delivery of good end-of-life care, and, in addition, physicians and nurses lack the basic training necessary to provide good end-of-…
A panel study is defined as a study that collects information on the same individuals at different points in time. The various data collections are often called waves. A panel study is therefore a longitudinal study; it differs from other studies that collect information over time, such as time series and cohort studies, in that it studies the same persons longitudinally. Major panel studies for s…
Eddie Jean Roberts (left) visits her mother, 111-year-old Jewel Roberts (right), every day to assist with meals and basic care at the elder Roberts's new home, which was donated by Habitat for Humanity. (AP photo by Donna McWilliam.) Parents of grown children can find themselves in ambiguous situations in our highly technical society. Young adults need many years of education to find…
Throughout recorded history, there has been an interest in understanding the causes and consequences of the complex relationship between parents and children. Despite frequently expressed worries about the weakening of inter-generational ties, the evidence has demonstrated the continued intensity and influence of these ties. In fact, recent research has shown that the intensity of the bond retains…
Parkinsonism is a term that describes a group of disorders in which patients present with varying combinations of tremor, muscle rigidity, slowed movements (bradykinesia), and postural disturbances, including falls. In addition to these signs (not all of which need to be present), patients with parkinsonism also exhibit other neurological symptoms. Parkinsonism needs to be distinguished from idiop…
Except in a hypothetical individualistic and primitive society, where each person produces for his or her own consumption, everyone depends for survival, at least in part, on an allocation of goods and services produced by others. This allocation can be based on trade, perhaps facilitated by money, or made in accordance with a perceived obligation. For persons with reduced productivity resulting f…
This section discusses the historical development of employer-provided private pensions, both internationally and in the United States. It also considers the historical development of the normal retirement age. …
The U.S. retirement income system is analagous to a three-legged stool. The first leg is the public Social Security system, which covers virtually all workers and provides benefits based on lifetime earnings at sixty-five, and reduced benefits at sixty-two. The second leg consists of employer-provided supplementary pensions, which cover roughly half the workforce. These tax-subsidized plans are sp…
Various criteria are used to assess a person's level of health. Objective measures can be noted and counted by a trained observer, while subjective measures of health depend exclusively on a person's self-evaluation. Objective measures include the presence of a disease or disorder, measuring of blood pressure, days spent in bed or in the hospital, or observation of the ability of the…
"Personal care" is one of several terms used to describe one-on-one assistance provided to individuals of any age who need help with daily living tasks on a long-term basis. The term can be used generically to describe assistance with daily living tasks regardless of the residential setting in which the care is provided, whether or not the provider of care and the care recipient are …
"Personality" is a broad term that refers to a person's characteristic behaviors, actions, emotions, and thoughts. It is the distinctive way one approaches the world, as manifested in the typical actions, feelings, and cognitions that distinguish one person from another. Historically, scholars have conceptualized personality in three main ways: the trait, cognitive-behavioral,…
Pet ownership and animal companionship have become increasingly prevalent in the United States. In 1996, there were 111.9 million cats and dogs in the United States, with these animals living in nearly 60 percent of American households. In addition, more than 4.5 million homes had pet birds and 6.3 percent of homes had pet fish. Less common pets, such as rabbits, ferrets, hamsters, gerbils, turtle…
Physical therapy has an important role in health care delivery, and is connected with maximizing function, preventing decline, decreasing pain, and treating physical illnesses. For elderly individuals, who often have decreased physical reserve, any medical illness can lead to decline. Inactivity and bedrest, a common consequence of illness, contributes to and intensifies muscle weakness, causing d…
It is evident even from casual observation of physical activities, such as walking, that elderly people exhibit a deterioration of physiological processes. Moreover, the inability of athletes to continue peak performance when they reach their thirties or forties indicates that deterioration begins at a relatively young age and progresses in severity from that point on. Indeed, many studies have…
Fibroblasts have been used since the 1960s as a cell-culture model for the aging of organisms. Fibroblasts are cells that produce and maintain the connective elements, or stroma, of most tissues. The stroma provides structure and regulatory signals to the functional cells of tissues (the parenchyma). Fibroblast cultures have provided a wealth of information about basic cellular processes, such as …
The cardiovascular system undergoes a large number of changes with advancing age, some of which occur in the apparent absence of disease; and many of which are either caused by, or exacerbated by, disease. Cardiovascular diseases comprise a group that accounts for nearly one-half of all deaths in the United States. The incidence of noncongenital cardiovascular maladies, e.g., congestive heart fail…
Forty percent of the body mass is made up of some three hundred and fifty skeletal muscles with each muscle composed of hundreds of thousands of cells, termed fibers. Each fiber consists of overlapping thick and thin protein filaments organized longitudinally in repeating patterns. Muscle fibers have the unique capacity to utilize energy in the form of adenosine triphosphate (ATP) to force the thi…
The process of aging is controlled by a variety of cellular and molecular mechanisms. This process is a continuum of events that are initiated during embryonic development, are genetically determined, and continue throughout all of life. There is a genetic program that controls how and where arms and legs form in the embryo, how much these appendages grow after birth and how much bone will be lost…
For at least a century, the term plasticity has been used in a variety of circumstances pertaining to the scholarly study of human development. Although varying in certain conceptual aspects and practical applications, the fundamental meaning of the term may be found in its numerous appearances across several developmental literatures and historical decades. In its most enduring and generalized se…
Pneumonia is an infection involving the lungs. It may be caused by bacteria, viruses, or parasites. There are more than one hundred microbial causes of pneumonia. However, most cases of pneumonia are due to the following bacteria: Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and Morayella (Branhamella) catarrhalis. Clinically, pneumonia is characterized by a variety o…
Older people generally resemble young and middle-aged adults in their political attitudes, partisan attachments, and behavior. There are more differences within age groups than between them. When age group differences do appear, they may reflect common traits and interests developed through the life-course processes of aging; or they may originate in the historical circumstances affecting a partic…
There were 420 million people in the world age sixty-five and older as of the year 2000, according to United Nations estimates (United Nations, 1998). If they all lived together under one flag, they would represent the third largest nation in the world. As a fraction of the total world population, the older population accounts for 7 percent, but this percentage varies considerably from one part of…
In 1999, in the United States, 3.2 million people age sixty-five and over, representing 9.7 The suit and tie might hide the fact that this elderly man is homeless and lives in poverty. (Library of Congress) percent of the older population, were officially classified as poor, that is, their income (or that of their families) fell below the income threshold defined by the Census Bureau as t…
Skin ulcerations caused by pressure and/or shearing stress are known under a variety of names, including decubitus ulcers, pressure ulcers, pressure sores, and bedsores. They are caused by impaired blood flow (perfusion) through the affected area, which reduces tissue oxygenation. This process is termed ischemia and results in partial or total tissue death. It occurs when there is concentrated ex…
Nonhuman primates provide valuable experimental models for many aspects of aging research. These include diseases of aging (such as diabetes, cardiovascular dysfunction, and osteoporosis), reproductive senescence, neurobiological aging and related cognitive decline, and interventions to alleviate age-related deterioration. The choice of species is dependent on the purpose of the investigation and …
Adult performance in intellectually demanding real-life situations has received increasing attention in the cognitive and psychological research literatures since the 1970s. The ability of adults to solve cognitive problems encountered in daily life has frequently been referred to by several terms, including everyday problem solving, practical problem solving, everyday cognition, pragmatics of int…
Social problem-solving therapy (PST) is a cognitive-behavioral intervention that is an efficacious treatment for depression. According to this model, depression is multifaceted, the result of an interaction between daily stress, major life events, weak coping skills, and depressive affect (Nezu: see Figure 1). People most vulnerable to depression either have inadequate problem-solving skills or pr…
In the formative years of gerontology as a field of study, considerable attention was paid to the frailties and limitations associated with the advancing years of older people. This attention to both the physical and psychosocial aspects of aging provided the essential foundation for an understanding of the challenges facing an aging society. Older adults were often viewed as a "deserving p…
More than a thousand age-based organizations exist in the United States at the national, state, and local levels. A number of such groups have emerged in other countries, such as Canada, as well as at the international level. These organizations are nonprofit collective entities with the betterment of persons age sixty and older as their objective (Liebig). However, not all have a professional ori…
In the Western tradition, at least since the time of the ancient Greeks, physicians, philosophers, and lay practitioners have advocated diverse means to obtain a long and healthy life. Although they hardly formed a unified group, or advocated a single method or approach, the authors together voiced a recurring belief in the idea of prolongevity: that, following specific regimes and methods, indiv…
The prostate gland, the seminal vesicles, and the bulbourethral gland constitute the male accessory sex tissues. These tissues are responsible for the production of the secretions that form the major component of the ejaculate (semen). This function, as well as their growth and development, requires continued function of the testes to supply testosterone. Though the ejaculate components may not co…
Formerly, psychiatrists were termed alienists, as though they dealt with strange, alien phenomena that had nothing to do with the rest of us. People with psychiatric disease were either ignored, sometimes tolerated, but more often dealt with by incarceration in large institutions away from cities. The kind of mental illnesses found in these hospitals were the severe variety. Today we call them the…
Assessment pervades nearly every aspect of psychological or psychotherapeutic work with older adults. Thorough evaluation of the psychological status of an older person is an important but oftentimes complex and daunting process, even for experienced clinicians. In general, psychological assessment techniques are designed to evaluate a person's cognitive, emotional, social, and personality …
Psychotherapy involves individual or group meetings with a therapist trained to use various techniques to treat psychopathology. Psychiatrists, psychologists, nurses, social workers, and counselors can provide psychotherapy interventions to older adults with psychiatric disorders. Review of the literature suggests that psychotherapy is an effective treatment intervention, either alone or in conjun…
