Physical Development in Late Adulthood

The aging process often results in a loss of memory, deteriorated intellectual function, decreased mobility, and higher rates of disease.

LEARNING OBJECTIVE[ edit ]

Review the physical and neurological changes characteristic of late adulthood

KEY POINTS[ edit ]

During late adulthood the skin continues to lose elasticity, reaction time slows further, muscle strength and mobility diminishes, hearing and vision decline, and the immune system weakens.
The aging process generally results in changes and lower functioning in the brain, leading to problems like decreased intellectual function and neurodegenerative diseases such as Alzheimer's.
Many of the changes in the bodies and minds of older adults are due in part to a reduction in the size of the brain as well as loss of brain plasticity.
Memory degenerates in old age, so older adults have a harder time remembering and attending to information. In general, an older person's procedural memory tends to remain stable, while working memory declines.
TERMS[ edit ]

cerebellum
Part of the hindbrain in vertebrates; in humans it lies between the brainstem and the cerebrum and plays an important role in sensory perception, motor output, balance, and posture.

Alzheimer's disease
A disorder involving loss of mental functions resulting from brain-tissue changes; a form of senile dementia.

corpus callosum
In mammals, a broad band of nerve fibers that connects the left and right hemispheres of the brain.

neurodegenerative
Of, pertaining to, or resulting in the progressive loss of nerve cells and of neurologic function.


Physical Changes
Late adulthood is the stage of life from the 60s onward; it constitutes the last stage of physical change. Average life expectancy in the United States is around 80 years; however, this varies greatly based on factors such as socioeconomic status, region, and access to medical care. In general, women tend to live longer than men by an average of five years. During late adulthood the skin continues to lose elasticity, reaction time slows further, and muscle strength diminishes. Hearing and vision—so sharp in our twenties—decline significantly; cataracts, or cloudy areas of the eyes that result in vision loss, are frequent. The other senses, such as taste, touch, and smell, are also less sensitive than they were in earlier years. The immune system is weakened, and many older people are more susceptible to illness, cancer, diabetes, and other ailments. Cardiovascular and respiratory problems become more common in old age. Seniors also experience a decrease in physical mobility and a loss of balance, which can result in falls and injuries.

Changes in the Brain
The aging process generally results in changes and lower functioning in the brain, leading to problems like memory loss and decreased intellectual function. Age is a major risk factor for most common neurodegenerative diseases, including mild cognitive impairment, Alzheimer's disease, cerebrovascular disease, Parkinson's disease, and Lou Gehrig's disease.

While a great deal of research has focused on diseases of aging, there are only a few informative studies on the molecular biology of the aging brain. Many molecular changes are due in part to a reduction in the size of the brain, as well as loss of brain plasticity. Brain plasticity is the brain's ability to change structure and function. The brain's main function is to decide what information is worth keeping and what is not; if there is an action or a thought that a person is not using, the brain will eliminate space for it.




Alzheimer's disease (AD) is a neurodegenerative disease and is the most common form of dementia in older adults.
Brain size and composition change along with brain function. Computed tomography (CT) studies have found that the cerebral ventricles expand as a function of age in a process known as ventriculomegaly. More recent MRI studies have reported age-related regional decreases in cerebral volume. The brain begins to lose neurons in later adult years; the loss of neurons within the cerebral cortex occurs at different rates, with some areas losing neurons more quickly than others. The frontal lobe (which is responsible for the integration of information, judgement, and reflective thought) and corpus callosum tend to lose neurons faster than other areas, such as the temporal and occipital lobes. The cerebellum, which is responsible for balance and coordination, eventually loses about 25 percent of its neurons as well.

Changes in Memory
Memory also degenerates with age, and older adults tend to have a harder time remembering and attending to information. In general, an older person's procedural memory stays the same, while working memory declines. Procedural memory is memory for the performance of particular types of action; it guides the processes we perform and most frequently resides below the level of conscious awareness. In contrast, working memory is the system that actively holds multiple pieces of transitory information in the mind where they can be manipulated. The reduced capacity of the working memory becomes evident when tasks are especially complex. Semantic memory is the memory of understanding things, of the meaning of things and events, and other concept-based knowledge. This type of memory underlies the conscious recollection of factual information and general knowledge about the world, and remains relatively stable throughout life.



Source: Boundless. “Physical Development in Late Adulthood.”

Theories

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Nursing Theory of Aging

Nursing Theory of Aging 

• Miller (2004) has developed the functional consequences theory.
• Older adults experiences functional consequences because of age related changes and additional risk factors.
• Without interventions, many functional consequences are negative; with them, however functional consequences can be positive.
• The role of regent logic nurse is to identify the factor that causes negative functional consequences and to initiate  interventions that will result in positive ones.
• Normal age related changes and factors may negatively interfere with patients activity and quality of life.
• The nurse must differentiate between normal age related changes that can be reversed and risk factors that can be modified.

Importance to Nurses 
1. Each theory provides framework and insight into the differences among elderly patients.
2. Nurses play a significant role in helping aging person experience health fulfillment and sense of well being.
3. Nurses attitude towards aging can have an enormous impact on patients.
4  It makes the nurse aware whether the changes are related to aging or disease condition.
5. It helps to provide specific care keeping in mind about the various changes in their biological and psychological aspect.
6. It helps to differentiate normal aging from the abnormal one.
7. It can be tested, changed or used to guide research or to provide base for evaluation.
8. It guides the nurses in helping the old people adapt to various changes.
9. It helps the older people on re-balancing the relationship.

Natural changes during older adulthood 

Ageing is a natural process. It should be regarded as a normal inevitable biological changes which are incident to old age is gerontology. Care of aged is called geriatrics.

Old people have limited regenerative capabilities and are more prone to disease, syndromes, and sickness than other age groups. There is often a common physical decline, and people become less active. Old age can reason, along with other things:

• Hair loss
• Changes of hair color to gray or white 
• Wrinkles and liver spots on the skin.
• Agility and slower reaction times 
• Reduced ability to clear thinking 
• Lessened hearing 
• Diminished eyesight 
• Difficulty recalling memories 
• Lessening or termination of sex, sometimes because of physical symptoms such as erectile dysfunction in men, but often simply a decline in libido.
• Greater weakness to bone disease such as osteoarthritis 

Some myths and facts related to aging are given below:

Myths:
1. Ageing is the time of tranquility and that ageing is synonymous with senility.
2 Old age is time of reduced activity.
3. Older person are thought to be resistant to change.
4. Ageing is a uniform process that progresses at the same rate and with the same results for all.

Facts:
1. Many older people retain their mental faculties well beyond the ninth decade of life.
2. Societal factors may limit opportunities for older adults to demonstrate their productivity but many older adults remain productive throughout life.
3. resistant to changes tends to be lifelong characteristics, not one developed with advancing age.
4. Ageing affects each individual differently and the outcomes of ageing may be different from one individual to another.


Nursing care of older adults is challenging and they should be cared for according to their level of understanding because all older adults are not the same. For example, some may be physically active, intelligent and productive members of the community whereas others may not be aware of these differences.  

Theories

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Psychological theories

1. Disengagement theory: One of the earliest theories 

• Developed by Elaine cumming and Willaim Henry (cumming and Henry 1961)
• This theory viewed aging as a process through which society and the individual gradually withdraw or disengage from each other.
• Nobody grows old merely by living a number of years. We grow old by deserting our ideas . Years may wrinkle the skin but to give up enthusiasm wrinkles the soul. - Samuel Ullman.

2. Activity theory : Proposed by Havighrust (1963)

• Suggest that aged people should continue an active middle-aged lifestyle and should remain as active as possible.
• It suggests that obstacles are to be resisted and that problems involving declining health, loss of roles and responsibilities, reduction in income and diminishing circle of friends are to be overcome.
• It suggests many ways for older people to maintain an active life.
• For most elderly people when physical activity is much reduced, intellectual activities should be emphasized.
• when old friends and relatives are dying or otherwise lost, the establishment of new friendship would be encouraged.

3. Continuity theory: Negatron, 1964

• In spite of aging process, personality and basic patterns of behavior are considered to be constant in the individual.
• Patterns and activity levels develop over a life time will largely determine whether an individual remain engaged and active or disengaged and inactive as they age.
• This theory encourages young people to consider their own future aging process.

4. Social Exchange theory :

• Postulates that social interaction between individuals and groups continues as long as everyone profits from the interaction.
• When there is no longer profit from the social exchange, imbalance occurs in the interaction and one individual is perceived as having more power than the over.
• The decrease in the social interaction of the aged is the result of exchange relationship that gradually erodes the power of the aged.

Environmental Theories :

• The elements in the environments have been considered by the researchers to have an effect on aging phenomena.
• Biologists have considered the effects of the environment on the cellular structure of the human organism.

1. Radiation Theory: Excessive exposure to the suns radiation puts the skin at risk during the somatic mutation process.

2. Stress Theory: According to Perlman (1954), Human aging is a disease syndrome arising from a struggle between environmental stress and biological resistance and relative adaptation to the effects of stress or agents. These stress or agents might include air, pollutants, chemical and psychological and sociological events.

Developmental Theory : 

• Erikson (1963) theorized that person's life consists of eight stages.
• Each stage represents a crucial turning point in life stretching from birth to death, with its own developmental conflicts to be resolved.
• According to him, the major developmental task of old age is either to achieve ego integrity or to suffer despair.

Theories

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