Adult & Aging

average longevity increased ______ through the 20th century
steadily.

-disease and infant mortality decline
-active life vs. dependent life expectancy

Why the variance in a person’s longevity?
-genetic factors (parents)

-environmental factors (some are simple exposure, others are lifestyle choices) (what is cost of allowing or in some cases causing these environmental factors to exist?)

-ethnic differences (African Americans’ life expediencies are lower) than cf. European Americans (-6.5 for men, -4.5 for women), Latino Americans tend to live longer than European Americans even though they have less access to health care)

-Gender differences (women live longer than men in the US (-5+ years) (life expectancy gap narrows over time. That is, as we age, the gender differences in life expectancy gets smaller) (the gap didn’t exist until the early 20th century -why?)

Quality of Life w/Disease and Quality of Life at the end of the Lifespan
-distress from disease/illness, or side effects from treatment, can play a big role
-ability to access basic services and engage in basic functioning is important

How Disease Affects Healthy Aging
IMMUNE SYSTEM!

How does the defense system work?
-some types of cells work to fight off cancerous cells, viruses, infections etc
-it’s not 100% fully understood how this works

Aging is related to how well the system works
-not clear how it’s related, but it is
-immune system takes longer to build up a defense (the cells that fight off illness are not as efficient)
-as we get older it takes longer for the immune system to build up a defense
-can take older adults longer to overcome an illness

in some cases the immune system attacks itself
-called autoimmunity
-leads to onset of several disorders (e.g. rheumatoid arthritis)
– autoimmune disorder disease

Acute Disease
-tend to develop and spread fast
-contagious usually
-examples: strep throat, flu, bronchitis, pneumonia and the common cold
-as you get older you tend to get less acute illnesses (fewer in number but more severe), takes longer to get over and worst side effects

Chronic Disease
-more prolonged and often require long term management
-usually say if it’s 3+ months then it’s chronic but it’s kind of subjective
-examples: arthritis, diabetes, cancer

viral
wait it out, can’t be fixed by antibiotics

bacterial
-antibiotics can treat

women vs men
-women less likely than men to get ill because they have better immune systems
-women who breast feed are sick less

Stress on health
-affects physical health
-affects thoughts and emotions
-review stress chart in notes

-spin stressors into positives helps: “This is a challenge to conquer!”, “I can do this!” vs “I don’t know how I’ll make it.”

Autonomic Nervous Systems (ANS)
– parasympathetic
-sympathetic

Sympathetic Nervous System
– helps body mobilize for stress
-increases heart rate and blood flow
-releases adrenaline
-releases endorphins
– glucose and energy stores are accessed
– fight or flight

Parasympathetic Nervous System
-slows heart rate
-returns body to homeostasis
– without this our bodies would be in constant states of high stress

Coping with stress
-how do you cope with stress?
social support system
working out
entertainment
feeling productive (to-do list)
attain a goal

Lazarus and Folkman’s stress and coping paradigm
-perception of the event’s effect on you

-primary appraisal vs secondary appraisal

primary appraisal
-when you try to categorize stressors in your life
-categorize

secondary apprailsal
-when you evaluate the stressors and whether you view them as a challenge or a threat
-Evaluate

problem focused vs emotion focused coping

Stress effects on family
– tensions surrounding care-giving
– financial obligations
-filial responsibility
-preservation of personal autonomy, rights and dignity of the older individual
-guilt and resentment from other family members

familial responsibility
-the responsibility a child feels toward their parent

Do older or younger adults have more stress?
– older adults tend to report LESS frequent stressors than younger adults (old-old report fewest)

– experience lends better coping
-most common stressors are normative, age-graded

stress effects on health
-short term, we can usually handle it
– long term, the body starts to break down
– release of glucocorticoids – which is toxic to neurons
– weakening immune system
– affects insulin levels (insulin helps with learning and memory and other important body fucntions)
-accelerate cardiovascular system atrophy

-sociocultural effects: do we have access to health care?
– lifespan effects: when does it happen to us? (cancer at 15 vs 65)

cancer incidence
– males tend to get cancer more often than females as they age
– African Americans get cancer more than any other race

Older Adults & Pain
-most common complaint in older adults is pain

How do we treat pain?
-pharmacologically
-what percent of medications are taken by OA’s over 60?

Age changes in how medication works
-absorption
-distribution
-metabolism
-excretion

What doctors often forget
Patient Treatment Context:

-patient characteristics: coping style, traits, expectancies or beliefs

-treatment context moderators: treatment controllability, predictability, or illness severity

Patient Adherence involves all these factors

Health and Disability in Older Adults
– sometimes OA’s aren’t able to do everything they want to because of disability (often due to chronic illness)
-we would all like to experience “compression of morbidity”

How do we characterize disability?
– refer to notes and diagram

Determining “Functional” limitations in health
-frailty
-activities in daily living (ADLs)
-Instrumental activities in daily living (IADLs)

health
state of complete physical, mental and social well being

illness
presence of a physical or mental disease or impairment

Average and Max Longevity
– to calculate the average, they to the age in which half of the individuals are born in a particular year will have died

-to calculate max, they do the oldest possible age you can live

active vs. dependent life expectancy
just living to a healthy old age vs just living a long time

genetic factor in longevity
-having a high threshold for disease

environmental factor in longevity
– disease, toxins, lifestyle and social class
– we’re responsible for most of these

International differences in longevity
– sociocultural, economic, healthcare, disease
– industrial vs developing

valuation of life
degree to which a person is attached to their own life

immune system
-takes longer to build up and fight off illness, not as efficient
-OA more susceptible to infectious disease and cancer

psychoneuroimmunology
-study of the relations between psych, nuero and immunological systems that raise or lower our susceptibility to and ability to recover from disease

men vs women in stress
-men prefer to be alone before a stressful event, women prefer company (oxytocin)

stress and coping paradigm
-stress isn’t an interaction between environment and response, but of persona and event – you reevaluate the situation each time you’re presented with it

Three types of appraisal
– primary: event based on the significance to our well being (ex: irrelevant, benign, or positive and stressful)

-secondary: perceived ability to cope with harm, threat or challenge

-reappraisal: making a new primary or secondary appraisal resulting changes in the situation

coping
-attempts to deal with stressful event (learned)

problem focused coping
-attempts to tackle problems head on

emotion focused
-dealing with one’s feelings involved

Older adult’s narrow life focus
-results in less stressors

arthritis
-common chronic condition
– RA not age-related
-pain – but movement helps
– contractureL freezing of joints

diabietes
-common chronic condition
– when the pancreas produces insufficient insulin
– type 1 develops early in life and requires insulin
– type 2 develops in adulthood and is managed through diet

incontinence
-loss of the ability to control the elimination of urine or feces on an occasional or consistent basis

– 5 reasons: stress (like a cough or sneeze), urge, overflow, functional/environmental (disability or cognitive impairment), latrogenic (medication side effects)

managing pain: pharmacological
-narcotic: mild-mod pain – ibuprofen

-nonnarcotic:severe pain – morphine

managing pain: nonpharmacological
-distraction technique
-massages
-hypnosis
– relaxation

developmental changes with age
1) absorption
2) distribution – depends on cardiovascular system (could easily rise to toxic levels)
3) metabolism (getting rid of the drug/liver) – slower in OA
4) excretion (through urine with kidneys), not as quick (1/3 – 1/2 the dose of adults to OAs – start low, go slow)

disability
– the effect of chronic conditions on people’s ability to engage in activities that are necessary, expected and personally desired in society

2 types of intervention for diasbility
– extraindividual: environment and healthcare
– intraindividual: personality and behavioral

functional health status
-ADLs: eating, bathroom, walking, dressing
-IADLs: actions that entail some competence and planning (ex: paying bills, taking meds, telephone calls)

overt attention
directly observable, obvious

covert attention
not obvious, more secretive

orienting
overt and covert

where do you orient your attention

selecting
can I select what I want to attend too and block all else out?

divided attention
trying to split attention on more than one thing

multi-tasking

attention switching
going back and forth between tasks

sustained attention
how long can you pay attention?

older adults tend to perform more _______ on attention tasks
poorly

-especially, as demands are increased

Theoretical accounts for why OA’s perform more poorly on attention tasks
– depleted “processing resources” (theory #1)
– inhibition failure (as we get older we lose ability to inhibit irrelevant stimuli as well as we used to) (theory #2)
-slowing (i.e. everything from sense to cognition slows down) (theory #3)

Theory #1: Decline and Processing Resources
– McDowd and Craik (1988)
-Single Task Vs. Dual Task:
– Auditory vs. Visual

Theory #1: Auditory vs. Visual
– auditory: hear words
+ easy: male or female voice?
+ hard: living or nonliving word category

-visual: see alpha numeric figures
+easy: position of the figure (left/center/right)
+hard: odd, even, consonant, vowel character

Theory #1: skill/procedural memory
-doesn’t require much attention
– doesn’t decline with age
-ex: bike, knitting

Theory #1: McDowd and Craik edxpirement
-single task vs complex task
– both older and younger adults are pretty similar in single task conditions
-divided attention tasks that are more complex is where OA suffered more than YA
-say that an OA ran out of processing resources that can help them do two complex tasks, the problem with that is that “processing resources” is not clearly defined or understood, this has subsequently fallen out of favor as a theory

Theory #2: Inhibitory Ability
– OA’s are worse at distractor tasks which measure “selective attention”
-declines with age in most tasks (ex: ignoring distractors)
-not inhibiting what they say

Theory #2: OA’s are more disrupted by distractors
-took them longer to read
– negatively affected their memory for the text
– on the other hand, when the distracting text is related to a problem to be solved, older adults do better

Theory #3: General Slowing/Processing Speed
– everything slows down: sensory decline, slowing of transduction process, slowing of neuronal communication

Theory #3: not generally favored because
-it is highly context specific
– resources needed to decode “muddy” sensory signal can drain

sensory problems
do contribute to cognitive problems

mitigation of age effects on attention
-exercise:
+ executive control studies
-attentional flexibility (ex: task switching)
– time sharing (dual task)
+ random assignment to exercise or control group
+ older exercise differentially
+ found that task switching improved w/exercise (especially with older adults in aerobic exercise: aquatics and walking)

summary of attention
– reliable age decrements in quality of sensory info (previous topic this semester) and attention capacity
-reduction of age differences is possible (physical health plays a role, reliance on context is greater in older adults, later: other knowledge/expertise effects (intelligence or wisdom perhaps))

memory decline with age is
widely documented and subject of frequent complaints

common notion about age and memory
-that brain just gets full
– reach a capacity for memory, no more space for it after a certain point
– NOT TRUE THOUGH
– in fact, the more you know the better

Big ideas to cover
– consider memory mechanisms underlying learning
– consider memory and learning as a self-regulated process

cognitive mechanisms
-short- term memory
– long term memory
– long term

short- term memory
-limited capacity
-impermanent (20 – 30 seconds)

long-term memory
-unlimited capacity
-relatively durable

basic memory processes
– encoding
– storage
– retrieval

memory retrieval
– recall
– recognition

Ex: seven dwarves

types of memory
– episodic
– semantic
– procedural

episodic memory
– has to do with specific events in life
– tends to decline somewhat in old age
– feeling of remembering vs. knowing

semantic memory
– general knowledge and facts
– relatively good into old age (decline is much slower than episodic)
– procedural (ex: riding bike, driving a car)
– better for well trained/well established skills

procedural memory
– better for well-learned/ well-established skills

little evidence that storage of long term memory is a problem
– knowledge does grow over time
– decay rate in memory over time is very gradual
– autobiographical memory (OA can remember quite a bit about their own lives)
– argument against storage memory theory

hypothesis that we remember better big life events
rather than just positive or negative events

“reminiscence bump”
– OA’s remember most what happened to them as YA’s (20-30s)

one secret to good memory
– transform information in your working memory so that it is more meaningful for you
-ex: group two in memory task where they had to rate importance of items if zombie apocalypse occurred

so what goes wrong with aging?
– OAs cannot encode as fast
– organizing information as you take it in is another good way to encode and later remember (deeper level of intake) – AKA mnemonic

so is the problem encoding?
– YES!!
– sort of
– at least partially, many older adults are less likely to do elaborate encoding needed for a more distinctive memory trace
– to organize the material for effective retrieval
– but OA’s can perform these strategies if encouraged

current life status
– YAs are more likely to be pushed to remember and encode (especially college students)
-this could play a role in cohort difference

OA’s can perform these strategies if encouraged
– organization
– “deep” level of semantic encoding
– when learning is incidental, memory tends to be more age equivalent (example of incidental is a pop quiz, when OAs and YAs are tested on incidental the difference between cohorts shrinks. YAs are very used to scheduled intentional tests such as scheduled exams)

“tip of the tongue” phenomenon
– very frequent in OAs
– takes longer for OAs to retrieve words from memory
– they can do it! Just takes them longer

other evidence for retrieval difficulties
– recall harder than recognition
– free vs. cued recall
– false memory occurrence increases with age
– gist vs detail retrieval (as we get older we tend to remember the gist rather than the exact details)

the stage approach
– stability in LT storage
– age deficits: encoding and retrieval

memory is compromised later in life by
reduction in attentional capacity, derived in part (but not wholly) by sensory changes. This, in turn, makes encoding and retrieval less effective

however, it is more complex than that
– social factors may make a difference
– contextual factors of the learning situation may make a difference
– personal learning history may make a difference

It is possible that
– the ability to “self-regulate” your learning behaviors and environment makes a difference
-memory strategies for encoding and retrieval could effect memory efficacy
-effort = outcome?
– degree of control over environment, learned helplessness
– critical period for these factors or successful implementation at any point

short term memory
-is capacity limited
– capacity declines with advancing age

intelligence is
– multidimensional
– multidirectional
– plastic
– varied between individuals (interindividual variability)

– how mental operations work

what is intelligence (one definition)
– mental operations and content that enhance the ability to function in the environment
– from Latin it means “to choose between and make wise choices”

is cognition the same as intelligence
– well what does it mean to have cognition?

to have cognition ability
– reason
– remember
– understand
– solve problems
– make decisions

is this intelligence? some think so. Some would argue that intelligence is cognitive ability

two approaches to study intelligence
– psychometric

– Piagetian

Psychometric
– focus on developing test instruments (metrics) that predict intelligent behavior
– emphasis on product
– test and measurement designs, emphasis on what you put out as a result of the test

Piagetian
– focus on the process of intelligent behavior
– what does intelligent behavior look like?
– named after Piaget, more on the process/steps a person engages in to do a task

Stevenson Mental Inventory
– “IQ” test we took in class meant to prove a point

How intelligence is measured using Psychometric Appraoch
– Wechsler Adult Intelligence Scale (WAIS)
– Primary Mental Abilities (PMA)
– and many more (Stanford Binet, Woodcock-Johnson, etc)
-Stanford Binet was used first for the Army entrance

a big question in testing memory is how MANY components are there to intelligence?
– 5-7 (Thurstone)
– 1 (Spearman)
– 2 (Horn, Cattell)

crystallized intelligence
– pragmatics
-acquired knowledge
– developed intellectual skills
– acquisition of culture
– wisdom?

fluid intelligence
– ability to identify and understand realtionships
-mental mechanics
-ability to identify and understand relationships
-ability to transform information to get solutions
-contribution from genetic program controlling senescence

everyone has
mental mechanics

data suggests that there’s some decline over time but
– over one year most stayed stable in terms of fluid ability

Schaie and The Seattle Longitudinal Study
Dr. K. Warner Schaie began the Seattle Longitudinal Study (SLS) in 1956 in cooperation with the Group Health Cooperative of Puget Sound (GHC). Dr. Sherry L. Willis became principal co-investigator of the study in 1983. The purpose of this research project is to study various aspects of psychological development during the adult years. Originally, in 1956, five hundred GHC members were randomly selected. They ranged in age from their early 20s to late 60s.

The study has continued in seven-year intervals since 1956: 1963, 1970, 1977, 1984, 1991, 1998, and 2005. At each interval, all persons who had previously participated in the study were asked to participate again. In addition at each seven-year interval until 1998, a new group of people randomly selected from the Group Health membership have been asked to participate. Approximately 6000 people have now participated at some time in this study. Of the original participants, 26 people remain who have now been in the study for 50 years.

Current participants range in age from 22 to 101 years. In addition to the main study, we have collected data in 1989/90, 1996/97, and 2003/04 from many adult children as well as sisters and brother of our main study participants in order to determine the extent of family similarity in mental abilities and other psychological characteristics. Many of these relatives were studied again in 1996/97 and in 2003/04. In 2002, grandchildren of our main study also began to participate, making the SLS the first three-generation study of cognitive abilities ever conducted in this country.

Some of our study participants aged 64 years and older also received cognitive training designed to slow or remediate cognitive age changes. Three training studies were conducted in 1983/84, 1990/91, and in 1997/98.

The Seattle Longitudinal Study is considered to be one of the most extensive psychological research studies of how people develop and change through adulthood. Dr. Schaie and his colleagues have written two monographs and over 300 articles and chapters in scientific publications on findings from this study. Dr. Schaie has testified before congressional committees regarding findings from the study, and study results have been used in legal proceedings on age discrimination in employment as well as in policy discussions regarding mandatory retirement practices in the United States and Canada.

many different aspects of fluid intelligence
– each may decline differently and at different rates

age-related changes in primary abilities
-data from Schaie’s Seattle Longitudinal Study (SLS) of more than 5000 individuals from 1956-1998 in six testing cycles

-people tend to improve on primary abilities until late 30s or early 40s
– scores stabilize until mid-50s and early 60s
– by late 60s consistent declines are seen
– nearly everyone shows a decline in one ability, but few show decline on four or five abilities

Are IQ scores hereditary?
– perhaps partially
– DEFINITELY not wholly

data by cohort
-if there was no cohort effect then all cohorts should all do the same
– there were cohort effects thought!
-see increase in performance by generation
-is this due to education differences?

generation you’re from can influence
intellectual ability

aspects of fluid intelligence, such as how we process things, might
have a causal relationship with crystallized intelligence

what moderates changes in intellectual abilities?
– cohort (earlier slide)
– information processing (speed of processing and working memory)
– lifestyle and socioeconomic factors

lifestyle and socioeconomic factors
-education, socioeconomic status
-personality (internal focus of control – stronger perception of abilities)
– health (esp. cardiovascular illness)
– cognitive training (plasticity)

plasticity: can we get better?
-training studies by Willis
– focus on introductive reasoning, speed, memory training
– called ACTIVE trials
– improved performance over time
– limited or narrow transfer of training tasks to general “everyday” tasks

motivation factor
– OA’s come into the lab and are super motivated to do well
– test well
– but in the real world where daily tests aren’t seen as important motivation, they may not do well

some studies find no age differences in training effects, others find young benefit more, but virtually all
find task-specific benefits of training for all ages

In Willis study
-OA’s came in twice a week for 5 weeks
-trying to train them to get better in inductive reasoning
-wasn’t a ton of success
-pre-test and post-test
– with 10 hours of training there was improvement in lab
– no improvement in real world application
– a lot of tasks are context specific rather than context general

fluid and crystallized abilities develop
differently

cross-sectional differences in fluid and crystallized abilities
are both a consequence of both age-graded and history-graded influences

there is not a lot of evidence that
disuse causes declines; other factors seem to predict declines more strongly

we may be able to “selectively optimize” (a Baltes would day) to maintain
good functioning within certain areas

research shows that intelligence and creativity are necessary
but not the only criteria for what seems to define genius

geniuses
– enjoy finding problems
-are often obsessive and enthusiastic about gaining knowledge and learning
-critical mass of knowledge about the topic
-often report combining multiple models to excel (ex: genius painters often report experiencing sounds as visual symbols)
-Terman did a lot of “giftedness studies”

Terman’s study of giftedness
-1500 people starting in 1921 as children
-all had IQ scores of 135+ by age 10
-tracked them over 60 years
-very few became truly “creative geniuses” by the criteria we just reviewed, however, only 11 failed high school, 97 got Ph.D.s, 92 got law degrees and 57 got M.D.s
-as a whole they lived longer than the general population and were physically and mentally healthier

motivation vs cognitive ability
– both play a role
– is it 50/50 or 90/10

Piagetian Approach to Intelligence
-wisdom
-focus on the process of intelligence
-gaining knowledge: how do we do it?
– intelligence is an adaptation of knowledge (to take experience and shift things in some way)
– knowledge is restructured in response to experience

Piaget’s theory
-sensorimotor period
-preoperational period
-concrete operations period
-formal operations period

sensorimotor period
-object permanence

preoperational period
– egocentrism

concrete operations period
-classification
-conservation
-mental reversing
-most adults stay here and don’t progress to formal operations period

formal operations period
-abstract thought: reasoning about past/present/future
-occurs around adolescence

ex: thinking about peace, morality, etc etc or how the past/present/future effects each other

Neo-Piagetian Approach
-wisdom is not simply knowledge about facts and figures
– real adult problem-solving

real adult problem solving
older adults are more likely to:
-use multiple frameworks (perspectives)
-realize possibility of more than one “good situation”
-understand reality constraints (“practical wisdom”)

postformal/dialectical thought
-blanchard-fields (1986)
-conflictual accounts (ex: grandparent visit)
-probes:
what was the conflict about and what happened?
were the two accounts different Could they both be right?

scoring for Blanchard-Fields
-level 1: absolutist
-level 3
-level 6

level 1: absolutist
– only one correct account of the event is acknowledged; no distinction between event and interpretation

level 3
recognition of multiple perspectives, but belief in truth

level 6
multiple perspectives fully acknowledged; individual as interpreter; equal weight to discrepant sources of info

level of reasoning increases
with age

older adults are better at
reasoning unexpected events in life

as we get older we might
have some advantages in solving/reasoning nonnormative life events

summary of wisdom in OAs
-intelligence goes beyond logic
-some evidence that we become more skilled
-wisdom is not an isolated object//domain specific skill

evidence that we become more skilled
-at reconciling multiple perspectives
– at being logical and emotional at the same time
– about conditions of life and its variations
– about strategies of judgment and advice
– understanding life-span contextualism
– understanding relativism: knowledge about differences in values, goals and priorities
– about life’s unpredictability and ways to manage

areas of intellectual growth as we age
-general knowledge
– wisdom (though operationally defining it is difficult)
– expertise in specific domains (although expertise is largely task-specific, rather than generalizable to similar tasks that tap into the same cognitive abilties

can we build cognitive reserve?
-education early in life span is associated with reduced risk of AD later
-Nun study
-leisure engagement is predictive of longevity and reduced risk of AD