Adult Development & Aging PDF - Textbook by Susan Krauss Whitbourne

ADULT DEVELOPMENT & AGING BIOPSYCHOSOCIAL PERSPECTIVES ADULT DEVELOPMENT & AGING BIOPSYCHOSOCIAL PERSPECTIVES Seventh Edition Susan Krauss Whitbourne, Ph.D. University of Massachusetts Boston Stacey B. Whitbourne, Ph.D. VA Boston Healthcare System VP AND EDITORIAL DIRECTOR Veronica Visentin EXECUTIVE EDITOR Glenn Wilson EDITORIAL ASSISTANT Jannil Perez EDITORIAL MANAGER Judy Howarth CONTENT MANAGEMENT DIRECTOR Lisa Wojcik CONTENT MANAGER Nichole Urban SENIOR CONTENT SPECIALIST Nicole Repasky PRODUCTION EDITOR Vinolia Benedict Fernando COVER PHOTO CREDIT Courtesy of Susan K. Whitbourne & Stacey B. Whitbourne This book was set in 9.5/11.5 BerkeleyStd-Book by SPi Global and printed and bound by Quad Graphics. Founded in 1807, John Wiley & Sons, Inc. has been a valued source of knowledge and understanding for more than 200 years, helping people around the world meet their needs and fulﬁll their aspirations. 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Upon completion of the review period, please return the evaluation copy to Wiley. Return instructions and a free of charge return shipping label are available at: www.wiley.com/go/returnlabel. If you have chosen to adopt this textbook for use in your course, please accept this book as your complimentary desk copy. Outside of the United States, please contact your local sales representative. ISBN: 978-1-119-60787-8 (PBK) ISBN: 978-1-119-60939-1 (EVALC) Library of Congress Cataloging-in-Publication Data Names: Whitbourne, Susan Krauss, author. | Whitbourne, Stacey B., author. Title: Adult development and aging : biopsychosocial perspectives / Susan Krauss Whitbourne, e, Ph.D., University of Massachusetts Boston, Stacey B. Whitbourne, Ph.D., VA Boston Healthcare System. Other titles: Adult development & aging Description: Seventh Edition. | Hoboken : Wiley, 2020. | Revised edition of the authors’ Adult development & aging, | Includes bibliographical references and index. Identiﬁers: LCCN 2020004059 (print) | LCCN 2020004060 (ebook) | ISBN 9781119607878 (paperback) | ISBN 9781119609438 (adobe pdf) | ISBN 9781119609377 (epub) Subjects: LCSH: Gerontology. | Older people—Psychology. | Older people—Health and hygiene. | Older people—Social conditions. Classiﬁcation: LCC HQ1061.W48 2020 (print) | LCC HQ1061 (ebook) | DDC 305.26—dc23 LC record available at https://lccn.loc.gov/2020004059 LC ebook record available at https://lccn.loc.gov/2020004060 The inside back cover will contain printing identiﬁcation and country of origin if omitted from this page. In addition, if the ISBN on the back cover differs from the ISBN on this page, the one on the back cover is correct. PREFACE E veryone ages. This very fact should be the scholarly ﬁeld of aging as an undergraduate when she enough to draw you into the subject matter decided to write a paper on personality and adaptation of this course, whether you are the student in a developmental psychology course. At the same time, or the instructor. Yet, for many people, it her father’s professional activities had a profound inﬂuence is difﬁcult to imagine the future in 50, 40, and made the choice of gerontology (the scientiﬁc study of or even 10 years from now. The goal of our aging) a natural one. book is to help you imagine your future and the future It is our hope and belief that you will ﬁnd yourself of your family, your friends, and your society. We have as engrossed in the psychology of adult development and brought together the latest scientiﬁc ﬁndings about aging aging as we are. Not only is everyone around you aging with a more personal approach to encourage you to take but also the issues that researchers in ﬁeld examine range this imaginative journey into your future. all the way from the philosophical to the practical. Why do The seventh edition of Adult Development and Aging: living things age? Is there a way to slow down the aging Biopsychosocial Perspectives incorporates material that we process? How will society deal with the aging of the Baby believe is vital to your understanding of this rapidly devel- Boomers? How will job markets be affected by an aging oping and fascinating ﬁeld of study. Much of what you society? Will the young adults of today age differently will read comes directly from Susan’s classroom teach- than did their parents and grandparents? Bringing it to a ing of the psychology of aging course at the University personal level, as you take the course, you’ll start to ask of Massachusetts Boston. She continues to incorporate her questions about your own life. What challenges await you day-to-day teaching of the course into the text, which keeps as you begin your career? What will it be like to start a the material current, fresh, and engaging. At the same time, family? How will you manage the transition into your early her active involvement in research on the psychology of adulthood as you leave college behind to pursue your own adult development and aging gives her the ability to sift life? All of these, and more, are questions that you will ﬁnd through the available ﬁndings and pull out those that are yourself asking as you explore the many complexities of the central to an understanding of individuals as they change process that causes people to change and grow throughout from the years of early adulthood through late life. life. You will learn not only how people grow older but Stacey was inspired to pursue the ﬁeld of aging after tak- also how to grow older in a way that is healthy and ing her mother’s course at the University of Massachusetts satisfying. Amherst. She continued her graduate work in social and developmental psychology, focusing on cognitive function- THEMES OF THE BOOK ing in later adulthood. Stacey is the program director for a major national initiative that is building a health and The biopsychosocial model emphasized in our text is genomic database for future studies of military veterans. intended to encourage you to think about the multiple Having also taught adult development and aging at Brandeis interactions among the domains of biology, psychology, University and the University of Massachusetts Boston, she and sociology. According to this model, changes in one is also attuned to student needs and interests. area of life have effects on changes in other areas. The We are proud to say that Stacey is the third generation centerpiece of this model is identity, your self-deﬁnition. of her family to be involved in the ﬁeld of gerontology. You interpret the experiences you have through the frame- Theodore C. Krauss, M.D., Susan’s father, was an inno- work provided by your identity. In turn, your experiences vator in geriatric medicine. Susan became interested in stimulate you to change your self-deﬁnition. v vi Preface This is an exciting time to be studying adult devel- given particular attention to new topics and approaches, opment and aging. The topic is gaining increasing media including neuroscience and genetics, as well as continuing attention and tremendous momentum as an academic to bring to students the latest advances in cognition, per- discipline within life span development. The biopsychoso- sonality, relationships, and vocational development as well cial model ﬁts within the framework of contemporary as highlighting sociocultural inﬂuences on development, approaches taking hold in the sciences in general that including race, ethnicity, and social class. emphasize the impact of social context on individuals throughout all periods of life. Entirely new concepts, sets AgeFeed The chapters begin with our very own ‘‘Age- of data, and practical applications of these models are Feed’’ openers to give you an introduction to the topic. resulting in a realization of the dreams of many of the These are in the form of fact versus myth challenges, classic developmental psychologists whose work shaped self-tests, or lists relevant to each chapter that take one the ﬁeld in the early 20th century. of several formats. For AgeFeed openers that involve a Adult development and aging are areas that have no challenge or self-test, the answers are provided for you so national boundaries. Aging is now being recognized as that you can score yourself. Your instructor may decide to a priority for researchers and policy makers around the assign these to tests, so be sure to read them over carefully. world, not only in the United States and Canada. We can We hope you like them! all beneﬁt from this international perspective both for our own countries and for those of citizens around the world. Engaging Figures and Tables All of the ﬁgures and pho- tographs in this seventh edition were redesigned from the previous editions with updated information and for- ORGANIZATION mats. These will help you learn and remember the key If you read the chapters of this book in order from start to information presented in the text. Our selection of these ﬁnish, you will progress from the basics in the ﬁrst three materials connects to the PowerPoint slides that instructors chapters to more complex issues, starting in Chapter 4, that can download from the Wiley website. place relatively more emphasis on the ‘‘bio,’’ the ‘‘psycho,’’ and the ‘‘social.’’ However, not all instructors choose to Contemporary Approach With coauthors literally one proceed in this fashion, and we have designed the book generation apart, it’s been our goal to ﬁnd the balance with this ﬂexibility as an option. We emphasize the biopsy- between the ‘‘professor’’ and the ‘‘student’’ perspectives. chosocial model throughout, in that many of the topics, As a result, you will ﬁnd many current examples relevant regardless of where they appear in the book, span areas as to people in your age group, whether you’re a returning diverse, for example, as driving and diabetes. student or a student of traditional college age. Instructors, We do recommend, though, that the last chapter you too, will ﬁnd material that they can relate to their own read is not the one on death and dying, as is often the case in experiences, whether they are relative newcomers or more other books in the ﬁeld. Our last chapter covers successful seasoned academics. aging. Many students and instructors have shared with us their appreciation of our ending on a ‘‘high note.’’ Even though death is obviously the ﬁnal period of life, we each STUDENT LEARNING AIDS have the potential to live on after our own ending through Glossary Terms We have made a concerted effort in the works we create, the legacies we leave behind, and the this edition to provide a large number of glossary terms, people whose lives we have touched. These are the themes indicated in bold in each chapter, and listed at the end that we would like you to take with you from this book in of the book. Although it may seem like you will have a the years and decades ahead. great many terms to memorize, the fact of the matter is that you will need to learn them anyway, and by having FEATURES them provided in your glossary, you’ll ﬁnd it easier to spot them when it comes time to review for your exams. Up-to-Date Research The topics and features in this text Susan ﬁnds that her students like to study from ﬂashcards are intended to involve you in the ﬁeld of aging from a that they make up, and if you ﬁnd this a useful study scholarly and personal perspective. You will ﬁnd that the tool, the glossary terms will make that process much most current research is presented throughout the text, more straightforward. The majority of these terms relate with careful and detailed explanations of the studies that speciﬁcally to adult development and aging, but where we highlight the most important scholarly advances. We have felt it was helpful for you to review a term that you may Preface vii not have encountered for a while, we also included several Several trends in the literature that are reﬂected in terms of a more general nature. the seventh edition include greater appreciation of the role of social context as an inﬂuence on development Numbered Summaries You will ﬁnd a numbered sum- such as income inequity, variations according to such mary for each chapter that will supplement your studying areas of diversity as race, ethnicity, and sexual orientation. and help you narrow down your reviewing to the chapter’s We also expand our treatment of international variations main points. Together with the glossary terms, these will and include considerable material from the World Health give you a comprehensive overview, though they will help Organization’s focus on ‘‘Active and Healthy Ageing.’’ All you the most if you actually read the chapters themselves. references prior to 2015 have been checked to determine whether newer information is available. Where sections of the text covered topics that have diminished in importance CHANGES IN THE SEVENTH EDITION in the ﬁeld, these have been condensed or eliminated. As The ﬁrst edition of Adult Development and Aging: Biopsy- a result, although the text’s structure remains consistent, chosocial Perspectives was intended to provide a fresh and there are new areas of emphasis reﬂecting the growth of engaging approach to the ﬁeld of the psychology of adult the ﬁeld. development and aging by focusing on three themes: a Our goal is to provide the latest ﬁndings while preserv- multidisciplinary approach, positive images of aging, and ing information of relevance to the ‘‘classic’’ studies in the the newest and most relevant research. We continue this ﬁeld. Students will therefore have the best of all worlds, tradition in the seventh edition because we want you, our with the opportunity to learn about cherished traditions in readers, to feel as connected to the material as possible. adult development and aging but also to learn where this Our thinking is that students will be more motivated to exciting ﬁeld is headed in the coming decades. complete their reading if they like the text and feel that they can relate to it. At the same time, instructors will Supplements Wiley is pleased to offer an online resource ﬁnd their job that much easier because students sitting in containing a wealth of teaching and learning materials at their classrooms will come to class ready to discuss what http://www.wiley.com/college/whitbourne. they’ve read. Instructors who have developed their course based on Website Links References in this edition show the web- earlier editions will not need to change the basic structure sites that students and instructors can consult to gather of their lectures and assignments. However, to reﬂect this updated information on changes in the ﬁeld. ever-changing ﬁeld, we shifted material within the chapters, in some cases deleting topics that by now are no longer considered relevant in order to make room to cover the INSTRUCTOR RESOURCES newer approaches that have come into prominence within the past 3 years. Instructor’s Manual The content in the Instructor’s Man- Although many of the classics remain, we have included ual reﬂects the 45 years of experience that Susan has in over 500 references from the past 3 years, up through teaching this course. You will ﬁnd chapter outlines, key mid-2019. In virtually all cases where we reference pop- terms, learning objectives, and lecture suggestions. We ulation data, we rely on sources from 2018 and 2019. have updated our suggestions for videos, taking advantage We also give expanded coverage to global population and of the new resources available through YouTube, and also health data in keeping with our stated goal of providing an provide instructors with resources for ﬁlms, music, and international perspective. literature. In the sixth edition, we revamped much of the topi- cal organization to be consistent with new developments PowerPoint Slides Prepared for use in lectures, we pro- in theory and research. In the present edition, we have vide you with a complete set of PowerPoint slides tested trimmed some areas that had become outdated even fur- in Susan’s class and designed speciﬁcally for this book. ther in order to be able to cover the emerging literature. Instructors can easily adapt them for their own speciﬁc Additionally, to make the new material consistent with needs. the illustrations, we have provided narratives that will allow readers to understand the main points of each of the Test Bank Instructors have access to a complete down- revamped ﬁgures. These changes came about, in part, as a loadable test bank that includes 50 questions in each result of feedback from students in Susan’s undergraduate chapter that follow the order in which concepts are pre- course in gerontology. sented in the text. Each multiple-choice question is labeled viii Preface according to the concept it tests, along with its difﬁculty to improve your own life and the lives of the older adults level (based on class testing). We include short answer and with whom you may be preparing to work. We hope you essay questions that correspond with each section of the will come away from the course with a positive feeling chapter. Because they are in convenient Microsoft Word about what you can do to ‘‘age better’’ and with a positive format, instructors can adapt them to their own particular feeling about the potentialities of later life. And maybe, needs. just maybe, as has happened on many past occasions with people who read this book and take our courses, you will decide to pursue this ﬁeld and we can welcome you as ACKNOWLEDGMENTS colleagues in the coming years. Our ﬁrst set of acknowledgments goes to our families. Hus- Finally, we would like to comment on the process of bands Richard O’Brien and Erik Gleason have graciously working together as a mother–daughter team. The ﬁrst provided important support that allowed us to spend the author was pregnant with the second author when she many hours we needed over the period of a year to revise embarked on her ﬁrst textbook in the ﬁeld, the precursor the book. Jennifer O’Brien, daughter and sister, is a won- to the present volume. Little did she know that the child derful sounding board for our ideas; as she continues her she was about to have would become a psychologist, much career in clinical psychology, we look forward to continued less a specialist in aging. Indeed, because Susan recently ‘‘collaboration’’ with her. We would also like to thank the relocated to Boston, where Stacey and her family live, we newest members of our family—namely Theodore James have had more opportunities to talk about this revision Gleason, age 8 at the time of this writing, and Scarlett Beth in depth, including some lively debates about several of Gleason, who has just turned 6. Susan is thrilled to be a the topics. The AgeFeeds reﬂect Stacey’s desire to engage grandmother, experiencing the joys of this special status readers with the type of material that students encounter on a ﬁrst-hand basis. in their own informal Web searches and daily online news Throughout the writing of this book, students in the updates. We greatly enjoy writing this book and are proud Mental Health and Aging class at the University of Mas- and happy to be able to share our perspectives with you, sachusetts Boston have provided valuable insights and the reader. observations. As we were revising the book and preparing the lectures, students continued to provide us with fresh Susan Krauss Whitbourne, Ph.D. perspectives. Their good humor, patience, and willingness Stacey B. Whitbourne, Ph.D. to experiment with some new ideas have made it possible January 2020 to add the all-important student viewpoint to the ﬁnished product. We also appreciate the contributions of Susan’s graduate teaching assistants, who serve as sounding boards ABOUT THE AUTHORS in her preparation and review of lecture content. Our ﬁnal thanks go to the reviewers over the years Susan Krauss Whitbourne, Ph.D., is a Professor Emerita who provided helpful comments. Their insightful obser- of Psychological and Brain Sciences at the University of vations and thoughtful proposals for changes helped us Massachusetts Amherst and Adjunct Professor and Faculty tighten and focus the manuscript and enhance the dis- Fellow in Gerontology at the University of Massachusetts cussion of several key areas of interest in the ﬁeld. Boston. She received her Ph.D. in developmental psychol- Thank you to Alex Bishop (Oklahoma State University), ogy from Columbia University in 1974 and completed Sue Burdett-Robinson (Hardin-Simmons University), Alvin a postdoctoral training program in clinical psychology at House (Illinois State University), Gary Montgomery (The the University of Massachusetts at Amherst, having joined University of Texas-Pan American), and Nancy Partika the faculty there in 1984. Her previous positions were (Triton College). We have also beneﬁted from informal as associate professor of education and psychology at the reviews provided by our colleagues who use the book University of Rochester (1975–1984) and assistant profes- in their teaching. We greatly appreciate their helpful sor of psychology at SUNY College at Geneseo. Formerly suggestions. the Psychology Departmental honors coordinator at the In conclusion, we hope that we have given you some- University of Massachusetts Amherst, she was also director thing to look forward to as you venture into the fascinating of the Ofﬁce of National Scholarship Advisement where ﬁeld of adult development and aging and that the subse- she advised students who apply for the Rhodes, Marshall, quent pages of this book will fulﬁll these expectations. We Fulbright, Truman, and Goldwater Scholarships, among aim to present a comprehensive but clear picture of the others. In addition, she was faculty advisor to the Uni- area and hope that you will be able to apply this knowledge versity of Massachusetts Chapter of Psi Chi, a position for Preface ix which she was recognized as the Eastern Regional Out- standing Advisor for the year 2001 and as the Florence Denmark National Faculty Advisor in 2002. She served as eastern region vice president of Psi Chi in 2006–07 and as chair of the program committee for the National Leader- ship Conference in 2009. Her teaching has been recognized with the College Outstanding Teacher Award in 1995 and the University Distinguished Teaching Award in 2001. Her work as an advisor was recognized with the Outstanding Academic Advisor Award in 2006. In 2003, she received the American Psychological Association (APA) Division 20 (Adult Development and Aging) Master Mentor Award and the Gerontological Society of America (GSA) Behavioral and Social Sciences Distinguished Mentorship Award. Over the past 20 years, Dr. Whitbourne has held a variety of elected and appointed positions in APA Division 20 including president (1995–96), treasurer (1986–89), secretary (1981–84), program chair (1997–98), education Her publications include 19 published books, many committee chair (1979–80), Student Awards Committee in multiple editions, and more than 175 journal articles chair (1993–94), Continuing Education Committee chair and chapters, including articles in Psychology and Aging, Psy- (1981–82), and Elections Committee chair (1992–93). She chotherapy, Developmental Psychology, Journal of Gerontology, has chaired the Fellowship Committee and serves as the Journal of Personality and Social Psychology, and Teaching of Division 20 representative to the APA Council (2000–06 Psychology, and chapters in the Handbook of the Psychol- and 2009–14, and 2017–present). She is a fellow of Divi- ogy of Aging, Clinical Geropsychology, Comprehensive Clinical sions 1 (General Psychology), 2 (Teaching of Psychology), 9 Psychology (Geropsychology), the Encyclopedia of Psychology, (Society for the Study of Social Issues), 12 (Clinical Psychol- and the International Encyclopedia of the Social and Behavioral ogy), 20, and 35 (Society for the Psychology of Women). Sciences. She has been a consulting editor for Psychology She served on the APA Committee on Structure and Func- and Aging, serves on the editorial board of the Journal of tion of Council, chaired the Policy and Planning Board in Gerontology, and was a consulting editor for Developmental 2007, served on the APA Membership Board, served on Psychology. She is editor-in-chief of the Wiley-Blackwell the Board of Educational Affairs, chaired Women’s Caucus Encyclopedia of Aging. Her presentations at professional and Coalition of Scientists and Applied Researchers in Psy- conferences number over 250 and include several invited chology, and is now on the Board of Educational Affairs. addresses, among them the APA G. Stanley Hall Lecture In 2011, her contributions were recognized with an APA in 1995, the EPA Psi Chi Distinguished Lecture in 2001, Presidential Citation. and the SEPA Invited Lecture in 2002. In addition to her Dr. Whitbourne is also a fellow of the American professional writing, she writes a blog for Psychology Today Psychological Society and was President of the Eastern Psy- called ‘‘Fulﬁllment at Any Age’’ and has consulted for pub- chological Association (2017–18). She is the Chair of the lications of the National Geographic Society in psychology Behavioral and Social Sciences Section of the Gerontologi- and serves on the Prevention.com health review board. cal Society of America. She is past president of the Council Stacey B. Whitbourne, Ph.D., received her Ph.D. of Professional Geropsychology Training Programs. Having in social and developmental psychology from Brandeis received her Diplomate in Geropsychology in 2015, she University in 2005 where she was funded by a National currently serves as the Treasurer for the ABGERO board of Institute on Aging training fellowship. She completed her the American Board of Professional Psychology. A founding postdoctoral fellowship at the Boston University School of member of the Society for the Study of Human Develop- Public Health, Department of Epidemiology, funded by a ment, she was its president from 2005 to 2007. She is also a National Institute on Aging Grant and a Department of founding member of the Society for the Study of Emerging Veterans Affairs Rehabilitation Research and Development Adulthood. She also served on the Board of Directors of the Service Grant. Currently, she is a research health scientist National Association of Fellowship Advisors. In her home at the Massachusetts Veterans Epidemiology and Research of Amherst, Massachusetts, she served on the Council on Information Center (MAVERIC), a research center housed Aging (2004–07) and was the president of the Friends of within the VA Boston Healthcare System. She serves as the Amherst Senior Center (2007–09). the Program Director of Recruitment and Enrollment for x Preface the Million Veteran Program, a longitudinal health and Membership Committee of Division 20, she has also given genomic cohort funded by the Department of Veteran’s more than 30 presentations at national conferences. As an Affairs Ofﬁce of Research and Development. In addition, undergraduate, she received the Psi Chi National Student she is an instructor of medicine at Harvard Medical School Research Award. In graduate school, she was awarded the and an associate epidemiologist at the Division of Aging Verna Regan Teaching Award and an APA Student Travel at Brigham and Women’s Hospital. The author of several Award. She has received numerous commendations and published articles, she is also a coauthor on a chapter for awards for her work with the Million Veteran Program from the Sage Series on Aging in America. She is a member the Department of Veterans Affairs. She has taught courses of the American Psychological Association Division 20 and on adult development and aging at Brandeis University and the Gerontological Society of America. A member of the the University of Massachusetts Boston. CONTENTS Preface v The Baby Boomers Grow Up: Changes in the Middle-Aged and Older Populations in the United States and the World 16 CHAPTER 1 United States 17 Themes and Issues in Adult Aging Around the World 18 Development and Aging 1 Summary 20 The Biopsychosocial Perspective 3 Four Principles of Adult Development and CHAPTER 2 Aging 4 Models of Development: Nature and Principle 1: Changes Are Continuous Over the Life Nurture in Adulthood 21 Span 4 Principle 2: Only the Survivors Grow Old 5 Models of Individual–Environment Principle 3: Individuality Matters 6 Interactions 23 Principle 4: ‘‘Normal’’ Aging Is Different From Reciprocity in Development 25 Disease 7 Sociocultural Models of Development 26 The Meaning of Age 8 Ecological Perspective 26 Using Age to Deﬁne ‘‘Adult’’ 9 The Life Course Perspective 27 Divisions by Age of the Over-65 Population 10 Ageism as a Social Factor in the Aging Process 29 Functional Age 10 Psychological Models of Development in Personal Versus Social Aging 12 Adulthood 31 Key Social Factors in Adult Development and Erikson’s Psychosocial Theory 31 Aging 14 Piaget’s Cognitive-Developmental Theory 34 Sex and Gender 14 Identity Process Theory 35 Race 14 The Selective Compensation with Optimization Ethnicity 14 Model 38 Socioeconomic Status 15 Biological Approaches to Aging in Adulthood 39 Religion 16 Genes and DNA 39 xi xii Contents Programmed Aging Theories 41 Body Build 72 Random Error Theories 43 Mobility 74 Summary 46 Muscles 74 Bones 75 Joints 76 CHAPTER 3 The Study of Adult Development and Vital Bodily Functions 77 Aging: Research Methods 48 Cardiovascular System 77 Respiratory System 79 Variables in Developmental Research 49 Urinary System 79 Digestive System 81 Descriptive (Single-Factor) Research Designs 49 Age, Cohort, and Time of Measurement 50 Bodily Control Systems 81 Longitudinal Designs 50 Endocrine System 81 Cross-Sectional Designs 54 Immune System 85 Sequential Research Designs 56 Nervous System 86 The Most Efﬁcient Design 56 Central Nervous System 86 Sleep 88 Correlational Designs 57 Temperature Control 89 Simple Correlational Designs 59 Multivariate Correlational Designs 59 Sensation and Perception 89 Vision 89 Types of Research Methods 61 Hearing 91 Laboratory Studies 61 Balance 93 Qualitative Studies 61 Smell and Taste 94 Archival Research 61 Somatosensory System 94 Surveys 62 Epidemiological Studies 62 Summary 95 Case Reports 62 Focus Groups 63 CHAPTER 5 Daily Diaries 63 Observational Methods 63 Health and Prevention 97 Meta-Analysis 63 Key Concepts in Health and Prevention 98 Measurement Issues in Adult Development and Diseases of the Cardiovascular System 98 Aging 64 Cardiac and Cerebrovascular Conditions 99 Ethical Issues in Research 65 Incidence 100 Summary 66 Behavioral Risk Factors 100 Prevention of Heart Disease and Stroke 102 CHAPTER 4 Cancer 102 Risk Factors and Prevention 103 Physical Changes 68 Treatments 105 Appearance 69 Disorders of the Musculoskeletal System 106 Skin 69 Osteoarthritis 106 Hair 71 Osteoporosis 107 Contents xiii Diabetes 108 Everyday Problem-Solving 145 Characteristics of Diabetes 108 Characteristics of Problem-Solving 146 Incidence and Risk Factors 108 Problem-Solving in Adulthood 146 Prevention and Treatment 109 Adult Learners 149 Respiratory Diseases 109 Intelligence 151 Theoretical Perspectives on Adult Intelligence 151 Neurocognitive Disorders 110 Research on Adult Intelligence 152 Alzheimer’s Disease 110 Training Studies 155 Other Forms of Neurocognitive Disorder 115 The Psychology of Wisdom 156 Summary 117 Summary 157 CHAPTER 6 Basic Cognitive Functions: Information CHAPTER 8 Processing, Attention, and Memory 118 Personality 159 Processing Speed and Attention 119 Psychodynamic Perspective 161 Reaction Time 119 Ego Psychology 161 Attention 120 Vaillant’s Theory of Defense Mechanisms 165 Video Games and Attention 122 Adult Attachment Theory 167 Driving and Aging 124 Trait Approaches 168 Memory 126 Research on Aging and the Five-Factor Model 168 Working Memory 126 Health and Personality Traits 170 Effects of Aging on Long-Term Memory in Social Cognitive Approaches 171 Adulthood 127 Psychosocial Inﬂuences on Memory 130 Cognitive Perspective 172 Possible Selves Theory 172 Memory and Health-Related Behaviors 131 Coping and Control 173 Memory Training Studies 133 Identity Process Theory 174 Summary 134 Midlife Crisis Theories and Findings 175 Theory of the Midlife Crisis 175 CHAPTER 7 Critiques and Research on the Midlife Crisis 176 Higher-Order Cognitive Functions 136 Summary 178 Executive Functioning and Its Measurement 138 Intelligence Tests 138 CHAPTER 9 Neuropsychological Assessment 139 Relationships 180 Aging and Executive Functioning 141 Language 142 Marriage and Intimate Relationships 181 Marriage 181 Cognitive Aspects of Language 142 Cohabitation 182 Social Aspects of Language 143 Same-Sex Couples 184 Bilingualism and Aging 145 xiv Contents Divorce and Remarriage 184 CHAPTER 11 Widowhood 186 Mental Health Issues and Treatment 225 Psychological Perspectives on Long-Term Relationships 186 Psychological Disorders in Adulthood 226 Families 189 Major Depressive Disorder 227 Parenthood 189 Bipolar Disorder 228 The Empty Nest 191 Anxiety Disorders 228 Parent–Adult Child Relationships 193 Obsessive-Compulsive and Related Disorders 229 Siblings 196 Trauma and Stress-Related Disorders 229 Grandparents 196 Schizophrenia and Other Psychotic Disorders 230 Friendships 198 Substance-Related Disorders 231 Theoretical Perspectives 198 Personality Disorders 232 Patterns of Friendships 198 Elder Abuse 235 Summary 199 Suicide 236 Treatment Issues in Mental Health Care 237 CHAPTER 10 Assessment 237 Work, Retirement, and Leisure Patterns 201 Treatment 238 Serious Mental Illness 241 Work Patterns in Adulthood 203 Summary 241 Vocational Development 205 Holland’s Vocational Development Theory 206 Super’s Life-Span Life-Stage Theory 207 CHAPTER 12 Occupation as Calling 209 Long-Term Care 243 Variations in Vocational Development 209 Vocational Satisfaction 210 Institutional Facilities for Long-Term Care 244 Intrinsic and Extrinsic Factors 210 Nursing Homes 245 Positive and Negative Moods 211 Residential Care Facilities 246 Person–Environment Correspondence 213 Community-Based Facilities and Services 247 Work Stress 213 Home Health Services 248 Relationships Between Work and Family Roles 214 Day Treatment Services 249 Age and Vocational Satisfaction 215 Community Housing Alternatives 249 Age and Vocational Performance 216 The Financing of Long-Term Care 249 Retirement 217 Medicare 250 Deﬁnitions of Retirement 217 Medicaid 252 Facts About Retirement 218 Legislative Landmarks in the Long-Term Care of The Effects of Retirement on the Individual 220 Older Adults 254 Leisure Pursuits in Later Adulthood 222 1987 Nursing Home Reform Act (NHRA) 254 1998 Nursing Home Initiative 255 Summary 223 Contents xv 2002 National Nursing Home Quality Initiative 255 Bereavement 275 2008 (to Present) CMS Five-Star Quality Summary 278 Ratings 255 The Quality of Long-Term Care 256 CHAPTER 14 Psychological Issues in Long-Term Care 258 Suggestions for Improving Long-Term Care 259 Successful Aging 279 Summary 261 What is Successful Aging? 281 An Overview of Successful Aging 281 Successful Cognitive Aging 282 CHAPTER 13 Factors That Promote Successful Aging 283 Death and Dying 263 Creativity and Aging 287 What Do We Know About Death? 264 What Is Creativity? 287 Medical Aspects of Death 264 Creative Older Adults 288 Death by the Numbers 265 Characteristics of Last Works 289 Biopsychosocial Perspectives on Creativity and Sociocultural Perspectives on Death and Aging 291 Dying 270 Successful Aging: Final Perspectives 293 Psychological Perspectives on Death and Dying 271 Summary 293 Issues in End-of-Life Care 272 Glossary G-1 Advance Directives 272 References R-1 Physician-Assisted Suicide and Euthanasia 274 Author Index I-1 Hospice Care 274 Improving Health Care and Mental Health Services Subject Index I-16 to Dying Patients 275 1 Themes and Issues in Adult Development and Aging At the beginning of each chapter, we invite you to check out ‘‘Age Feed’’ to see top 10 lists, take quizzes, or learn fun facts about the chapter ahead. To get started, as you will learn in Chapter 1, there are many myths about aging. See if you’re able to separate fact from fiction in these statements and check your answers on the next page. 1. All older adults are alike. 2. Most older adults live in nursing homes. AGEFEED 3. Loss of interest in sex and intimacy is a normal part of aging. 4. Most older adults stay socially active. 5. Alzheimer’s disease is an inevitable part of aging. 6. Older adults are unable to learn new skills. ? FACT 7. Memory loss is a normal as people grow older. MY 8. People become more pessimistic in later life. TH ? 9. Creativity peaks early in adulthood and declines after that. 10. As people get older, they need more assistance in daily life. 1 1. All older adults are alike. Myth! The range of ages among older adults spans 5 decades; they differ more than any other age group. AGEFEED 2. Most older adults live in nursing homes....the facts Myth! Only about 5% of older adults in the United States are in nursing homes although this rises to 13% for those 85+. 3. Loss of interest in sex and intimacy is a normal part of aging. Myth! Although the frequency of sexual activity may decrease, most older adults continue to enjoy a fulfilling sex life. 4. Most older adults stay socially active. Fact! Many older adults continue working, volunteer, and are part of a family social network. 5. Alzheimer’s disease is an inevitable part of aging. Myth! Alzheimer’s disease and other forms of cognitive loss occur in a minority of older adults. 6. Older adults are unable to learn new skills. Myth! Learning new skills may take longer, but the ability to learn continues throughout later life. 7. Memory loss is a normal as people grow older. Fact and myth! Short-term memory may be less efficient, but long-term memory is maintained in later life. 8. People become more pessimistic in later life. Myth! Older adults are more likely to feel satisfied with their lives and to be optimistic about getting older. 9. Creativity peaks early in adulthood and declines after that. Myth! There are many examples of famous creative older adults but even ordinary individuals can be creative throughout their lives. 10. As people get older, they need more assistance in daily life. Fact! The need for assistance increases in later adulthood, but only reaches as high as 53% for women aged 85 and older. 2 The Biopsychosocial Perspective 3 Aging affects everyone. Your aging process began the initiate behaviors that can maintain, if not enhance, your moment you were born. If you are of traditional col- everyday functioning. A key goal we have in writing this lege age, you’re undergoing a time of transition that lasts book is to involve you in the progression of your aging from adolescence to adulthood. The concept of being an process and show you ways to be an active part of your adult may be new to you, and the idea of being an older own development. adult may seem far off. Our purpose in writing this book is to help you think about your own aging as well as the aging process more generally. You may have decided to take this course to help you understand your aging family THE BIOPSYCHOSOCIAL members or trends in society and before long, we hope PERSPECTIVE that you also think about what will happen to you as you yourself get older. We organize the book around the biopsychosocial per- Let’s start by asking you what comes to mind when spective, a view of development as a complex interaction of you think of your current age. Is it an important part of biological, psychological, and social processes. Aging is not who you are or do you not think about your actual age? a simple, straightforward progression through time. Your Next, ask yourself whether you consider yourself to be body undergoes biological changes largely inﬂuenced by an adult. What does the word adult mean to you? Is it a your genetics or physiology. At the same time, you change term you would use to describe others who are older than psychologically in ways that reﬂect what’s happening to you are now? Finally, what are your thoughts about the your body that, in turn, affect your body’s changes. All of aging process? When you think of older adults, do you this takes place in a social context. Holding biology and immediately regard them as unable to care for themselves? psychology constant, people age differently depending on What is the ‘‘typical’’ older adult like, in your eyes? where and when they live, whom they interact with, and Just by thinking about these questions, you’ve already what resources they have available to them. started to focus on what age means in terms of your overall Figure 1.1 captures this complex biopsychosocial inter- sense of self. These are the types of questions that we’ll action. Biological processes refer to how the body’s func- explore throughout the book. Even as we discuss in-depth tions and structures change throughout the aging process. the effects of the aging process throughout adulthood, we We cover these changes in the chapters on normal aging will often come back and question how much we really and health. Psychological processes include the individ- know about a person based on age alone. We’ll also show ual’s thoughts, feelings, and behaviors related to growing you that some age distinctions are almost arbitrary. Some- older. We examine these changes in the chapters on one decided that a certain age means you’re in a certain stage of life; from that point forward, people attribute a great deal of meaning to that particular number. In reality, FIGURE 1.1 however, the aging process isn’t completely linked to the The Biopsychosocial Model passage of time alone. Our goal is to encourage you to take personal explo- rations as you gain factual information about the aging Physical Social context So l process. Not only will the material help you in your career changes History ica ci oc regardless of what ﬁeld you go into, but it will also help Genetics Culture og ul ol tu you understand yourself and how you change over time. Bi ra You’ll also learn, perhaps surprisingly, that you don’t have l to sit back and let the aging process passively affect you. There are active steps you can be taking now to make sure that you keep functioning as well as possible for as long as possible throughout your entire life. With a few simple Psychological precautions, you can avoid the illnesses that limit people’s ability to enjoy themselves into their later decades. Cognition If you’re a traditional college-age student heading into Personality your 20s, we hope to help you appreciate that it is never Emotions too early to start incorporating these changes into your According to the biopsychosocial perspective, adult development and lifestyle. And for our readers of nontraditional college aging are understood as involving biological, psychological, and age, we hope to help you see that it’s never too late to sociocultural inﬂuences. 4 Themes and Issues in Adult Development and Aging cognition, personality, and emotions. The social processes FIGURE 1.2 of aging reﬂect the cultural, historical, and interpersonal The Four Principles of Adult Development and Aging inﬂuences on the individual. We cover these in chapters about relationships, family, work, and institutionalization. In Chapter 2, we will explore how life-span development Changes are Only the continuous over survivors grow theories grapple with explaining how these complex pro- the life span old cesses all interrelate. You’ll ﬁnd that there’s a great deal more to aging than you probably imagined when you ﬁrst started reading this chapter. Normal aging is As you can see from the biopsychosocial model, we Individuality different from intend to go beyond ‘‘psychology’’ in teaching you about the matters disease processes involved in adult development and aging. In fact, gerontology, the scientiﬁc study of the aging process, is an interdisciplinary ﬁeld. People who devote their professional lives to the study of gerontology come from many different in a forward direction, the changes throughout life build academic and applied areas—biology, medicine, nursing, upon themselves in a cumulative fashion. If you were hard sociology, history, and even the arts and literature. It’s on your body as a young adult, chances are the changes almost impossible to be a gerontologist without applying you’ll undergo when you’re older will be more negative this integrative view to your work. Knowledge, theories, than if you took good care of yourself. and perspectives from all disciplines contribute importantly The continuity principle also applies to the way that to the study of the individual over time. Gerontology is people think about their own identities. You know that distinct from geriatrics, which is the medical specialty you’re the same person you always were, despite getting in aging. older. Birthdays don’t transform you into a different person. To help put it all together for you as you develop You don’t look the same to others, but you feel essentially throughout adulthood, we will pay special attention to the the ‘‘same’’ on the inside. concept of identity. Identity is deﬁned as a composite of When others look at you, however, they don’t neces- how people view themselves in the biological, psycholog- sarily share this perspective. People don’t meet you for the ical, and social domains of life. The interaction of these ﬁrst time and think about what you were like when you domains forms an overall view of the ‘‘self.’’ were younger—they see you as you are now. Unless they are close relatives or friends, they have no way of knowing what you were like when you were in your childhood or teenage years. Anyone meeting you now judges you on the FOUR PRINCIPLES OF ADULT basis of your current appearance because he or she has no DEVELOPMENT AND AGING other data from which to draw. Similarly, when you look at a middle-aged or older We begin our study of adult development and aging by adult, it’s unlikely that you judge that person on the basis sharing a set of four principles that form the foundation of how he or she may have been in the past. You see an of our biopsychosocial approach (see Figure 1.2). As you older woman, perhaps walking with a little difﬁculty, and read the book, you’ll ﬁnd that we return frequently to these don’t stop to think that she might have been a marathon principles, which we highlight when they appear in the runner in her youth. However, that very same older woman chapter. If you begin to understand them now, you will knows that she is the ‘‘same’’ person she’s always been. ﬁnd the course material much easier to master. True, she can no longer compete for a marathon, but this accomplishment is part of her identity. She knows her Principle 1: Changes Are Continuous physical abilities have changed, but to herself she’s still the Over the Life Span Jane, Barbara, or Mary she has been her entire life. There’s an important implication of the continuity First and foremost, changes over the life span happen in a principle for anyone working with older adults. You need continuous fashion. According to the continuity principle, to remember that they would prefer to be treated as the the changes that people experience in later adulthood build people they always were, rather than as ‘‘old people.’’ As on the experiences they had in their earlier years. This we’ll see later, older adults are often stereotyped as weak means we can never isolate the later years of life without and inﬁrm, when in reality, they want to be viewed as considering the years preceding them. Since time moves individuals who possess strengths they have built up over Four Principles of Adult Development and Aging 5 cognitive skills are more likely to attend college which, in turn, provides them with greater economic resources that can sustain their health and well-being. A combination of mental and physical health and adequate resources, plus a dose of good luck, allow them to be with us today. Gerd Altmann/Pixabay Figure 1.3 illustrates the survivor principle. Across the years of adulthood, the population of people born around the same time thins out so that, by the later years, only the hardiest are still alive. Gerontologists must take the survivor principle into account when interpreting the results of their research because it is quite likely that survivors are The principle of continuity is illustrated here, showing that an indi- not like the people born at the same time as they were. vidual may feel the same inside even though their outer appearance They may have been born with greater resilience, but they changes. also likely took care to maintain their health and preserve their longevity. There are so many ways to lose one’s life as you get older, from such causes as terminal illness or their entire lives. They don’t want to be stereotyped on accidents, that to become an older adult, you have to the basis of the way they look to the world right now. possess some incredibly special characteristics. Some nursing home administrators, eager to remind their The survivor principle also impacts the way we under- employees of this fact, display pictures of the residents from stand research on aging. Clearly, all older adults who their younger years on the nameplates outside their doors. participate in research are survivors of the conditions that The residents and their visitors think of them in this way, others did not endure. As time goes by, more and more and it’s helpful if those who work with them are reminded of the older population will die. When they reach age of this fact as well. 90 or 100, they most likely represent a different popula- tion than their now-deceased age mates. The older they get, the more select they become in such key characteris- Principle 2: Only the Survivors Grow Old tics as physical functioning, health, intelligence, and even The survivor principle states that the people who live to personality (Baird et al., 2010). old age are the ones who managed to outlive the many Consequently, when we examine differences between threats that could have caused their deaths at earlier ages. younger and older people, we must keep in mind that older Perhaps this is obvious because clearly, to grow old, you people alive today were a special group when they were have to not die. However, the survivor principle is a bit young. The younger adults have not yet been subjected to more complex than that. Contrary to the Billy Joel song the same conditions that could threaten their lives. Some ‘‘Only the Good Die Young,’’ it’s not the good who die of them will die before they reach old age. Knowing who young, but the ones who fall victim to the forces that cause will be the survivors is almost impossible to predict, of people to lose their lives. Some of these are random, to be course, meaning we may be comparing highly select older sure, such as being killed by someone else in an accident, adults with a wider range of younger adults. Therefore, by an act of war, or in a natural disaster. However, many we cannot conclude that age ‘‘caused’’ the older adults other factors that lead some to survive into old age are to have the characteristics they have now because they nonrandom. Survivors not only manage to avoid random might always have been a special subset of their own causes of their own fatalities but also are more likely to take age group. care of their health, not engage in risky behaviors (such To help illustrate this principle, consider data on the as driving too fast or getting involved in crime), or using psychological characteristic of cautiousness. One of the drugs and alcohol excessively. tried and true ﬁndings in the psychology of adult develop- The survivor principle exempliﬁes the biopsychosocial ment and aging contends that older people are less likely to perspective. The very fact that survivors avoid death until take risks than are younger people. Similarly, older adults late in life suggests that they may have inherited good are less likely to engage in criminal behavior. It’s possible genes or at least managed to maintain their physical abilities that as people age they are better able to avoid behaving (biological factors), are cognitively and emotionally healthy in ways that could bring them harm or get them arrested. (psychological factors), and have surrounded themselves Alternatively, it’s possible that they did not change at all with a good support system (social factors). Furthermore, and are the only ones left standing from their generation. these factors build on each other. People with stronger The people more likely to make risky decisions early on 6 Themes and Issues in Adult Development and Aging FIGURE 1.3 200,000 Expected Survival of Birth Birth Cohort Born in 2020 198,476 18 years 196,372 35 years 189,578 55 years 170,967 70 years 114,801 85 years This ﬁgure shows the expected number 16,449 of people to survive to each age based on calculations for all those born in 100 years 2020. As you can see, those who survive to the age of 85 and older 857 represent an increasingly select group 110 years of the population. in life died at younger ages or were imprisoned. Certainly, years, a point we will continue to focus on throughout those who made poor health decisions would be less likely this book. to have survived into old age. The idea of increasing divergence among older adult As a result of the survivor principle, you need to remind populations does not mean that everyone starts out at yourself continually throughout this book that the older exactly the same point when they’re young. There are adults we study may have become less risky, more honest, always going to be differences within any sample of people or better able to take care of their health. On the other in almost any characteristic you can name. The issue is that hand, they may not have changed at all—only survived as people get older, these differences become magniﬁed. long enough for us to study them. The top-performing person in a sample of young adults may be 10 points higher than the next highest performer. By the time, this person reaches his or her 70s or 80s, Principle 3: Individuality Matters these differences may grow by a factor of two, three, or more. In part, this is a statistical ﬂuke. As you’ll learn in A long-held myth regarding development is that as people Chapter 3, it’s difﬁcult to ﬁnd a sample of older adults age, they all become alike. This view is refuted by the who are as close in age as are the young adults researchers principle of individuality, which asserts that as people tend to study (who are often within 2 or 3 years of each age, they become more different from each other. This other). If age is related to performance, then the odds are divergence occurs in people’s physical functioning, psy- that the older group will differ simply because they differ chological performance, relationships, interest in work, more in age. economic security, and personality. However, the increasing variation among older adults In one often-cited study, still considered relevant, isn’t just a statistical artifact. Even if you had a sample researchers examined a large number of studies of aging of older adults who were exactly the same age, it’s likely to compare the divergence among older versus younger that they would differ more among themselves than they adults on measures of the same characteristics (Nelson & would have when they were younger because they’ve lived Dannefer, 1992). Research continues to underscore the through more experiences affecting everything from their notion that individuals continue to become less alike from health to their psychological well-being. Those experiences each other with age. Such ﬁndings suggest that diversity have cumulative effects, causing them to change at different becomes an increasingly prominent theme during the adult rates and to differing degrees. Four Principles of Adult Development and Aging 7 FIGURE 1.4 Inter- and Intraindividual Differences in Development 60 Individual age 55 outperforms both Interindividual age 35-year-olds 50 differences in performance 40 Scores 30 20 l 10 ry ica la ills tor ledge ory bu hs k i s H ow m ca t Me Vo Ma kn 0 Individual 1 (age 35) Individual 2 (age 35) Individual 3 (age 55) These illustrative data from a theoretical study on cognition show how people of the same age show different levels of performance on different tasks (intraindividual variability) but also that on particular tasks, such as vocabulary, older individuals can perform better than younger individuals (interindividual variability). Consider what’s happened to you and the people you same person (Baltes & Graf, 1996), a concept known as grew up with by this point in your life. You have made the multidirectionality. decision to go to college, while others in your age group Figure 1.4 illustrates interindividual and intraindi- may have enlisted in military service. You may meet your vidual differences by showing scores of two 35-year-old future spouse in college, while your best friend remains individuals and one 55-year-old individual on four psy- on the dating scene for years. Upon graduation, some chological tests. These illustrative data from a theoretical may choose to pursue graduate studies as others enter study on cognition show how people of the same age show the workforce. You may or may not choose to start a different levels of performance on different tasks (intrain- family, or perhaps have already begun the process. With dividual variability) but also that on particular tasks, such the passage of time, your differing experiences build upon as vocabulary, older individuals can perform better than each other to help mold the person you become. The younger individuals (interindividual variability). many possibilities that can stem from the choices you make help illustrate that the permutations of events in Principle 4: “Normal” Aging Is Different people’s lives are virtually endless. Personal histories move From Disease in increasingly idiosyncratic directions with each passing day, year, and decade of life. The principle that normal aging is different from disease There are actually two types of differences that come means that growing older doesn’t necessarily mean growing into play when we talk about individuality. Interindividual sicker. It is important for both practical and scientiﬁc differences are differences between people. Intraindivid- reasons to distinguish between normal aging and disease. ual differences refer to the variations in performance Health care specialists who work with middle-age and within the same individual. In other words, not all sys- older adults need to recognize and treat the onset of a tems develop at the same rate within the person. Some disease rather than dismiss it simply as ‘‘getting older.’’ functions may increase over time, others decrease, and For example, an 80-year-old man exhibiting symptoms of others stay the same. Even within a construct such as depression can be successfully treated, assuming that the intelligence, an individual may show gains in one area, clinician does not write his symptoms off as a feature of losses in another, and stability in yet another domain. normal aging. Personality development in adulthood does Intraindividual differences illustrate the fact that devel- not inevitably lead to the depressive symptoms of lowered opment can proceed in multiple directions within the self-esteem, excessive guilt, changes in appetite, or lack of 8 Themes and Issues in Adult Development and Aging interest in activities. Older adults may experience some loss, aging can also involve gains. The term optimal aging moderation in personality qualities such as becoming a refers to age-related changes that improve the individual’s bit less judgmental in relation to others. However, the functioning. Changes due to optimal aging may reﬂect the development of psychological disorders for the ﬁrst time in preventative or compensatory measures that adults take later life is not typical. Clinicians who mistakenly think that to counter the toll that aging would normally take on their these symptoms are part of the normal aging process won’t physical and psychological functioning. However, some take the proper course of treatment that could alleviate the individuals do not even make special efforts to alter their depressed person’s suffering. own aging, but for reasons not always entirely clear, seem Gerontologists translate the principle that normal aging to age at a slower rate than their peers. They may be the is different from disease into terms that distinguish these ones who never seem to get sick right until the very end processes. Primary aging (or normal aging) refers to the of their lives, when a sudden illness leads to their death. normal changes over time that occur due to universal, Throughout life, age-related losses due to primary, sec- intrinsic, and progressive alterations in the body’s systems. ondary, and tertiary aging occur contemporaneously, as Changes over time leading to impairment due to disease we show in Figure 1.5. Thus, even while optimal aging rather than normal aging are referred to as secondary or can slow the deleterious changes of primary and secondary impaired aging. These changes are not due to universal, aging, eventually tertiary aging takes over and the individ- intrinsic processes but are a function of an abnormal set of ual’s life comes to an end. Remember that, according to the changes afﬂicting a segment rather than the entirety of the principles of intraindividual and interindividual variabil- older population (Aldwin & Gilmer, 1999). Skin wrinkling ity, the rates of each type of aging vary within individuals and discoloration represent primary aging but skin cancer and from person to person. represents secondary aging. The third type of aging process sets in toward the very end of life, when individuals experience a rapid loss THE MEANING OF AGE of functions across multiple areas of functioning. This precipitous decline is called tertiary aging (Gerstorf et al., The study of aging implies that age is the major variable 2013). Representing the impact of disease on perhaps of interest. However, the scientiﬁc study of aging faces a already compromised areas of functioning, tertiary aging challenge in that age carries with it a number of problems deserves mention in its own right as distinct from primary as that major variable of interest. To be sure, there is or even secondary aging. value in categorizing individuals in later life based on Primary, secondary, and tertiary aging refer to pro- their age. At the same time, attaching a numerical value cesses that, over time, accumulate, and in the absence of to people on the basis of their date of birth carries with accident or injury, cause the individual’s death. Gerontol- it a certain arbitrariness. Chronological age is a number ogists believe that despite changes in the body that lead to based on measures of the Earth’s movement around the JEGAT MAXIME/MaxPPP/Newscom An example of optimal aging is Charles Eug- ster, shown here on the far left. Beginning his ﬁtness program when he was 85 years old, he broke world records for masters ath- letes, winning more than 100 ﬁtness awards prior to his death at age 97. The Meaning of Age 9 Losses Gains FIGURE 1.5 Age-Related Losses and Gains Primary aging Optimal aging Normal age-related Changes that improve changes the individual’s functioning Secondary aging Disease-related impairments Normal aging is also referred to as primary aging, which is different from secondary aging related to disease and tertiary aging, which includes the rapid loss Tertiary aging of function before death. There are also gains associated Rapid decline shortly with aging referred to as ‘‘optimal aging’’ in which before death people become better with age in certain functions. sun; however, we don’t know how much the changes in perhaps the synonym of ‘‘mature’’ comes to mind. This, in the physical universe relate to what goes on inside the body turn, may conjure up images of a person reaching a certain in any kind of precise fashion. level of accomplishment or growth. Consider, for example, Consider what happens when people’s ages change at a the term ‘‘mature’’ in reference to an apple. A mature apple major birthday such as reaching the age of 40. The crossing is one that is ready to be eaten, and you can judge that by from an age that ends in 9 to an age that ends in 0 may examining the apple’s color, size, and texture. An apple’s lead people to engage in self-scrutiny just because we’ve maturity level is relatively easy to measure compared to all been socialized to believe that 40 means something judging the maturity of humans. The complexity of the important. This belief is reinforced by birthday cards that biopsychosocial processes that occur within us are far invoke the ‘‘over the hill’’ metaphor. In truth, your body more difﬁcult to quantify. does not change in discrete ﬁts and starts when you pass a You might think that the most logical deﬁnition of particular birthday. maturity should be based on physical development. Yet, The body does keep time in a cycle that approximates you also know that girls and boys who have passed through a 24-hour period, but there is no evidence at the moment puberty in their teenage years would, in contemporary to suggest that this time pacemaker is related to aging. Western society, be regarded as anything but an adult. To say that chronological age (or time) ‘‘means’’ anything Although their physical attributes deﬁne them as adults, with regard to the status of the body’s functioning is, the psychological and social standards would not. based on current evidence, questionable. The popularity Perhaps a standard based on ability is a better option. of such phrases as ‘‘30 being the new 20’’ and ‘‘60 the Consider 16 years, the age when most people can legally new 50’’ capture the difﬁculty of deﬁning people’s aging drive. Or, alternatively, consider age 18, when U.S. society processes based solely on a number. Chronological age ordains the person with the right to vote. Using the age of does have some value in describing a person, but like other 21 presents another possible point of entry into adulthood. descriptive features of a person, such as gender or eye Because it is the age when American adults can legally drink color, it is the social meaning attached to chronological alcohol, for many, the turning of 21 represents a deﬁning age that often outweighs any intrinsic usefulness. As we mark of the beginning of adulthood. However, the United have already discussed, people of the same age can vary States is in a small minority of nations that set the drinking substantially from one another, and people of different ages age at 21. Some Canadian provinces set the drinking age at can be more similar to each other than their differing age 19 (though it is 18 in most); countries such as Germany, might lead you to expect. Barbados, and Portugal set it at 16. These conﬂicting age demarcations for even such a seemingly concrete behavior as drinking alcohol show that deciding when a person is Using Age to Define “Adult” an adult on this basis has very limited utility. Now that we have you thinking about the meaning of age, Parenthetically, the variations in the legal drinking we will move on to the next challenge—the meaning of the age shown from country to country (and even within a word ‘‘adult.’’ Earlier, we asked you to decide whether you country) illustrate the interaction of biological and socio- consider yourself an adult. When you think of that word, cultural factors in setting age-based parameters around 10 Themes and Issues in Adult Development and Aging human behavior. People in Canada who are 18 years old Divisions by Age of the Over-65 are, on average, not all that physiologically distinct from Population 18-year-olds who live in the U.S. For that matter, they are probably not even psychologically different. It’s the culture Traditionally, 65 years of age has been viewed as the entry that distinguishes whether they’re able to drink alcohol point for ‘‘old age.’’ The origins of this age of retirement without getting arrested. can be traced to Germany when, in 1889, the German If you’re like many students, the age of 25 may hold Chancellor Otto von Bismarck proposed an old-age social special importance for you. This is the age where, in the insurance program. Although the original age in Germany United States, you can rent a car without having to pay a was 70 years, it became changed in 1916 to age 65, and tremendous surcharge. This age has no inherent meaning, now this is the age traditionally associated with ‘‘old age.’’ but it is used by car rental companies because the chances Gerontologists recognized long ago that not only was of having an auto accident are lower after the age of 25. It’s 65 an arbitrary number for deﬁning old age, but that it also possible that a switch is ﬂicked on a person’s 25th birthday resulted in people being placed into too broad of a category so that the unsafe driver now has become a model of good when deﬁned as older adults. All other things being equal, behavior on the road. However, the odds are statistically a 65-year-old faces very different issues than someone who higher that people under age 25 are more likely to engage is 85 or 90. There are certainly 65-year-olds in very poor in the risky combination of drinking and driving, which is health and 95-year-olds who have no serious ailments. what leads to the higher insurance premiums. But because, on average, 65-year-olds are so different than Another set of criteria related to the age of adulthood those who are 20 or more years older, we use a convention pertains to when people can marry without the consent of to break the 65-and-older category into subgroups. their parents. There again, we ﬁnd huge variation. Within The subgroups most frequently used in gerontology the United States alone, the age of consent varies from state are young-old (ages 65 to 74); old-old (ages 75 to 84); to state from 16 to 18 years of age, though the age at which and oldest-old (ages 85 and older). We shouldn’t place individuals can legally consent to sex may be younger. In too much credence on numbers, as we’ve already said, but South Carolina, for example, 14-year-old girls are consid- these are good approximations for roughly categorizing the ered old enough to consent to having sex with partners who 65-and-older population. Bernice Neugarten, one of the are 18 or older. Moreover, the age when people actually early pioneers in psychological gerontology, proposed these marry reﬂects factors such as the health of the economy; in distinctions in the mid-1970s, and they have remained in bad economic times, the median age of marriage goes well use to this day even though 85 may be the ‘‘new’’ 65 above the age of consent. During these times, people in with the oldest-old being in better health than they were their 20s (or older) may ﬁnd they’re forced to move back 50 years ago (Neugarten, 1974). in with their parents because they aren’t earning sufﬁcient With more and more people living to the oldest-old income to rent or buy their own place. Does that mean that category as deﬁned in this manner, gerontologists are reex- people become less ‘‘adult’’ when the economy lags? amining the divisions of the 65+ age group. Speciﬁcally, Given these contradictory deﬁnitions of ‘‘adult,’’ it people over the age of 100, known as centenarians, are might be wise to recommend that we set the threshold becoming more and more commonly represented in the into adulthood based on the individual’s having reached population, as we will show later in the chapter. It will the chronological age associated with the expectations and not be long before the very highest age cat

Adult Development & Aging PDF - Textbook by Susan Krauss Whitbourne

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