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'''Adult development''' refers to the changes that occur in biological, psychological, and interpersonal domains of human life from the end of [[adolescence]] until the end of life. These changes may be gradual or rapid, and can reflect positive, negative, or no change from previous levels of functioning. Changes occur at the cellular level and are partially explained by biological theories of adult development and aging. <ref>Hayflick, L. (1998). How and why we age. Experimental Gerontology, 33, 639-653.</ref>Biological changes influence psychological and interpersonal/social developmental changes, which are often described by stage theories of human development. Stage theories typically focus on “age-appropriate” developmental tasks to be achieved at each stage. [[Erik Erikson]] and [[Carl Jung]] proposed stage theories of human development that encompass the entire life span, and emphasized the potential for positive change even in very late life. Current views on adult development in late life focus on the concept of successful aging, defined as “...low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life.” <ref>Rowe, J., & Kahn, R. (1997). Successful aging. The Gerontologist, 37(4), 433-440. doi:10.1093/geront/37.4.433</ref> Biomedical theories hold that one can age successfully by caring for physical health and minimizing loss in function, whereas psychosocial theories posit that capitalizing upon social and cognitive resources, such as a positive attitude or social support from neighbors and friends, is key to aging successfully. <ref>Bowling, A., & Dieppe, P. (2005). What is successful ageing and who should define it? British Medical Journal,331(7531), 1548-1551. doi:10.1136/bmj.331.7531.1548</ref> [[Jean Louise Calment]] exemplifies successful aging as the longest living person, dying at 122 years old. Her long life can be attributed to her genetics (both parents lived into their 80s) and her active lifestyle and optimistic attitude. She enjoyed many hobbies and physical activities and believed that laughter contributed to her longevity. She poured olive oil on all of her food and skin, which she believed contributed to her long life and youthful appearance.
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== Adult Development ==
==Lifespan Development Theory==
Life span development is an overarching framework that considers individual development ([[ontogency]]) from conception to old age. The framework considers the life-long accumulation of developmental gains and losses, with the relative proportion of gains to losses diminishing over an individual’s life time. According to this theory, life span development has multiple trajectories (positive, negative, stable) and causes (biological, psychological, social, cultural). Individual variation is a hallmark of this theory – not all individuals develop and age at the same rate and in the same manner. <ref> Baltes, P. B., Lindenberger, U., & Staudinger, U. M. (2006). Life span theory in developmental psychology. In R. M. Lerner & W. Damon (Eds.), Handbook of child psychology:Theoretical models of human development (pp. 569-664). Hoboken, NJ: John Wiley.</ref>


===Erik Erikson’s Stages of Psychosocial Development===
Edit.
Erik Erikson's [[Erikson's stages of psychosocial development|stages of psychosocial development]] describe eight stages of life that begin in infancy and end in late adulthood. The last three stages (Early Adulthood, Middle Adulthood, and Late Adulthood) encompass adult development.


=== Anxiety about Aging ===
===Carl Jung’s Stages of Development===
[[Carl Jung]], a Swiss psychoanalyst, formulated four stages of development:
Another Edit.
Childhood: (birth to puberty) Childhood has two substages. The archaic stage is characterized by sporadic consciousness, while the monarchic stage represents the beginning of logical and abstract thinking. The ego starts to develop.
Youth: (puberty until 35 – 40) Maturing Sexuality, growing consciousness, and a realization that the carefree days of childhood are gone forever. People strive to gain independence, find a mate, and raise a family.
Middle Life: (40-60) The realization that you will not live forever creates tension. If you desperately try to cling to youth, you will fail in the process of self-realization. Introverted tendencies are now be explored and people often become religious during this period.
Old Age: (60 and over) Consciousness is reduced. Jung thought that death is the ultimate goal of life. By realizing this, people will not face death with fear, but with a hope for rebirth.


==Goals and Expectations in Successful Adult Development and Aging==
<ref> Blair et al. (2008) </ref>
Aging successfully is dependent upon establishing realistic goals and expectations for one’s own development. There are three primary models that describe goal-setting and realistic expectations for each stage in adult development:

===Selective Optimization with Compensation Model (SOC)===
SOC states that older adults are selective in choosing goals that optimize certain skills, while compensating for the loss of others. For example, an elderly person with fading hearing who loves to read may choose to devote more time and attention to reading, while cutting back on time spent listening to music or going to the opera.

===Socioemotional Selectivity Theory (SST)===
SST suggests that as adults begin to perceive that time is limited, perhaps as early as midlife, they become increasingly selective in how they spend their time and resources, devoting more of each to emotionally meaningful goals. <ref>Ouwehand, C., De Ridder, D., & Bensing, J. (2007). A review of successful aging models: Proposing proactive coping as an important additional strategy. Clinical Psychology Review, 27, 873-884. Retrieved from http://dx.doi.org/10.1016/j.cpr.2006.11.003</ref> For example, researchers have found that older adults are more attracted to advertisements appealing to close-knit bonds rather than exploration and adventure, which appeals more to younger adults. This extends to a significant preference for positive over negative information in attention and memory among older adults.This preference for positive information over negative is known as the [[positivity effect]].<ref>Reed, A. E., & Carstensen, L. L. (2012). The theory behind the age-relatedpositivity effect. Frontiers in Psychology, 3. doi: 10.3389/fpsyg.2012.00339</ref> Over time, adults shift their goal focus away from mastering new information or skillsets and towards maintaining physical and socio-emotional wellbeing.<ref>Cavanaugh, J., & Blanchard-Fields, F. (2015). Chapter 8 - social cognition. In Adult development and aging, 7th edition (pp. 216-244). Stamford, CT: Cengage Learning.</ref>

Physical and cognitive declines associated with [[aging]] create challenges to one’s sense of [[personal control]] and [[autonomy]]. The degree to which one believes that one has control and autonomy influences one’s behavior, relationships, physical health, and cognitive functioning, and goal setting. Preservation of personal control can be achieved via assimilative activities, accommodations, and immunizing strategies.<ref>Cavanaugh, J., & Blanchard-Fields, F. (2015). Chapter 8 - social cognition. In Adult development and aging, 7th edition (pp. 216-244). Stamford, CT: Cengage Learning.</ref>

==Physical Aging==
Physical aging includes changes at the biological level ([[senescence]]) and larger organ and musculoskeletal levels. Sensory changes and degeneration begin to be common in midlife. Degeneration can include the break down of muscle, bones and joints, leading to physical ailments such as [[sarcopenia]] or [[arthritis]].<ref>Lawrence, R. C., Helmick, C. G., Arnett, F. C., Deyo, R. A., Felson, D. T., Giannini, E. H., ... Wolfe, F. (1998). Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis & Rheumatism, 41(5), 778-799. </ref>

At the sensory level, changes occur to vision, hearing, taste, touch, and smell, and taste. Two common sensory changes that begin in midlife include our ability to see close objects and our ability to hear high pitches.<ref>Gates, G. A., & Mills, J. H. (2005). Presbycusis. The Lancet, 366(9491), 1111-1120.</ref><ref>Glasser, A., & Campbell, M. C. (1998). Presbyopia and the optical changes in the human crystalline lens with age. Vision Research, 38(2), 209-229.</ref> Other developmental changes to vision might include [[cataracts]], [[glaucoma]], and the loss of central visual field with [[macular degeneration]] . <ref>Nusbaum, N. J. (1999). Aging and Sensory Senescence. Southern Medical Journal, 92(3), 267-275.</ref> Hearing also becomes impaired in midlife and aging adults, particularly in men. In the past 30 years, hearing impairment has doubled.<ref>Strawbridge, W. J., Wallhagen, M. I., Shema, S. J., & Kaplan, G. A. (2000). Negative Consequences of Hearing Impairment in Old Age: A Longitudinal Analysis. The Gerontologist, 40(3), 320-326.</ref> Hearing aids as an aid for hearing loss still leave many individuals dissatisfied with their quality of hearing. [[Olfaction]] can co-occur with changes in sense of taste. “Olfactory dysfunction can impair quality of life and may be a marker for other deficits and illnesses” and can also lead to decreased satisfaction in taste when eating. Losses to the sense of touch are usually noticed when there is a decline in the ability to detect a vibratory stimulus. The loss in sense of touch can harm a person’s fine motor skills such as writing and using utensils. The ability to feel painful stimuli is usually preserved in aging, but the process of decline for touch is accelerated in those with diabetes.<ref>Nusbaum, N. J. (1999). Aging and Sensory Senescence. Southern Medical Journal, 92(3), 267-275.</ref>
Physical deterioration to the body begins to increase in midlife and late life, and includes degeneration of muscle, bones, and joints. [[Sarcopenia]], a normal developmental change, is the degeneration of muscle mass, which includes both strength and quality.<ref>Leeuwenburgh, C. & Marzetti, E. (2006). Skeletal Muscle Apoptosis, Sarcopenia and Frailty at Old Age. Experimental Gerontology, 41(12), 1234-1238./ref> This change occurs even in those who consider themselves athletes, and is accelerated by physical inactivity.<ref>Roubenoff, R. (2000). Sarcopenia and its implications for the elderly. European Journal of Clinical Nutrition, 54(6). S40-S47.</ref> Many of the contributing factors that may cause sarcopenia include neuronal and hormonal changes, inadequate nutrition, and physical inactivity.<ref>Leeuwenburgh, C. & Marzetti, E. (2006). Skeletal Muscle Apoptosis, Sarcopenia and Frailty at Old Age. Experimental Gerontology, 41(12), 1234-1238.</ref> [[Apoptosis]] has also been suggested as an underlying mechanism in the progression of sarcopenia. The prevalence of sarcopenia increases as people age and is associated with the increased likelihood of disability and restricted independence among elderly people. Approaches to preventing and treating sarcopenia are being explored by researchers. A specific preventative approach includes progressive resistance training, which is safe and effective for the elderly.<ref>Baumgartner et al. (1997). Epidemiology of sarcopenia among the elderly in new mexico. American Journal of Epidemiology, 147 (8), 755-763.</ref>

Developmental changes to various organs and organ systems occur throughout life. These changes affect responses to stress and illness, and can compromise the body’s ability to cope with demand on organs.<ref>Evers, B. C., and Thompson, J. (1994). Organ physiology of aging. The Surgical Clinics of North America, 74(1), 23-39.</ref> The altered functioning of the heart, lungs, and even skin in old age can be attributed to factors like cell death or endocrine hormones. There are changes to the reproductive system in midlife adults, most notably [[menopause]] for women, the permanent end of fertility. In men, hormonal changes also affect their reproductive and sexual physiology, but these changes are not as extreme as those experienced by women.<ref>Hermann, M., Untergasser, G., Rumpold, H., and Berger, P. (2000). Aging of the male reproductive system."Experimental Gerontology 35(9-10), 1267-1279.</ref>

==Non-normative Aging: Cognitive Impairments==
[[Dementia]] is characterized by persistent, multiple cognitive deficits in the domains including, but not limited to, memory, language, and visuospatial skills and can result from central nervous system dysfunction.<ref>Kempler, D. Neurocognitive Disorders in Aging. Thousand Oaks: Sage, 2005.</ref><ref>Bayles, Kathryn, and Cheryl Tomoeda. The ABC’s of Dementia. 2nd ed. Phoenix: Canyonlands, 1995. </ref><ref>Borda, C. Alzheimer’s Disease and Memory Drugs. Ed. David J. Triggle. New York: Chelsea, 2006. </ref> Two forms of dementia exist: degenerative and nondegenerative. The progression of nondegenerative dementias, like head trauma and brain infections, can be slowed or halted but degenerative forms of dementia, like Parkinson’s disease, Alzheimer’s disease, and Huntington’s are irreversible and incurable.

===Alzheimer’s disease===
[[Alzheimer's disease]] (AD) was discovered in 1907 by [[Alois Alzheimer|Dr. Alois Alzheimer]], a German neuropathologist and psychiatrist. Physiological abnormalities associated with AD include neurofibrillary plaques and tangles. Neuritic plaques, that target the outer regions of the cortex, consist of withering neuronal material from a protein, [[amyloid-beta]]. Neurofibrillary tangles, paired helical filaments containing over-phosphorylated [[tau protein]], are located within the nerve cell. Early symptoms of AD include difficulty remembering names and events, while later symptoms include impaired judgment, disorientation, confusion, behavior changes, and difficulty speaking, swallowing, and walking. After initial diagnosis, a person with AD can live, on average, an additional 3 to 10 years with the disease.<ref>Zanetti, O., Solerte, S.B., & Cantoni F. (2009). Life expectancy in Alzheimer’s disease (AD). Archives of Gerontology and Geriatrics, 49, 237-243.</ref> In 2013, it was estimated that 5.2 million Americans of all ages had AD.<ref>Alzheimer’s Association. (2013). 2013 Alzheimer’s disease facts and figures. Alzheimer’s and Dementia. 9(2), 1-68.</ref> Environmental factors such as head trauma, high cholesterol, and [[type 2 diabetes]] can increase the likelihood of AD.<ref>Kelly, Evelyn B. Alzheimer’s Disease. New York: Chelsea, 2008. Print.</ref>

===Huntington’s disease===
[[Huntington's Disease]] (HD) named after [[George Huntington]] is a disorder that is caused by an inherited defect in a single gene on [[chromosome 4]], resulting in a progressive loss of mental faculties and physical control.<ref>http://www.alz.org/dementia/huntingtons-disease-symptoms.asp</ref><ref>http://www.hdsa.org/images/content/1/3/13699.pdf</ref> HD affects muscle coordination (involuntary writhing) and leads to cognitive decline and psychiatric issues.<ref>http://en.wikipedia.org/wiki/Huntington%27s_disease</ref> Symptoms usually appear between the ages of 30-50 but can occur at any age, including adolescence.<ref>http://www.hdsa.org/images/content/1/3/13699.pdf</ref> There is currently no cure for HD and treatments focus on managing symptoms and quality of life. Current estimates claim that 1 in 10,000 Americans have HD, however, 1 in 250,000 are at-risk of inheriting it from a parent.<ref>http://www.webmd.com/parkinsons-disease </ref> Most individuals with HD live 10 to 20 years after a diagnosis.

===Parkinson’s Disease===
[[Parkinson's Disease]] (PD) was first described by [[James Parkinson]] in 1817. It typically affects people over the age of 50. PD is related to damaged nerve cells that produce [[dopamine]].<ref>de Lau, L., & Breteler, M. (2006). Epidemiology of parkinson's disease. The Lancet Neurology, 5(6), 525-535.</ref> Common symptoms experienced by people with PD include trembling of the hands, arms, legs, jaw, or head; rigidity (stiffness in limbs and the midsection); [[bradykinesia]]; and postural instability, leading to impaired balance and/or coordination.<ref>Chou, K. L., Taylor, J. L., & Patil, P. G. (2013). The mds−updrs tracks motor and non-motor improvement due to subthalamic nucleus deep brain stimulation in parkinson disease. Parkinsonism & Related Disorders, 19(11), 966-969.</ref> PD cannot be cured, but diagnosis and treatment can help relieve symptoms. Treatment options include medications like Carbidopa/[[Levodopa]] (L-dopa), that reduce the severity of motor symptoms in patients.<ref>Hauser, R. A., et al.. (2013). Extended-release carbidopa-levodopa (ipx066) compared with immediate-release carbidopa-levodopa in patients with parkinson's disease and motor fluctuations: a phase 3 randomised, double-blind trial. The Lancet Neurology, 12(4), 346-356.</ref> Alternative treatment options include non-pharmacological therapy. Surgery ([[pallidotomy]], [[thalamotomy]]) is often viewed as the last viable option.<ref>Lang, P. E., & Obeso, J. A. (2004). Challenges in parkinson's disease: restoration of the nigrostriatal dopamine system is not enough. The Lancet Neurology, 3(5), 309-316. </ref>

==Mental Health==
Older adults represent a significant proportion of the population, and this proportion is expected to increase with time.<ref>Zarit, S. H., & Zarit, J. M. (1998). Mental disorders in older adults: Fundamentals of assessment and treatment. New York: Guilford Press.</ref> Mental health concerns of older adults are important at treatment and support levels, as well as policy issues. The prevalence of suicide among older adults is higher than in any other age group.

===Depression===
is one of the most common disorders that presents in old age and is [[comorbid]] with other physical and psychiatric conditions, perhaps due to the stress induced by these conditions.<ref>Alexopoulos, G. S. (2005). Depression in the Elderly. The Lancet, 365(9475), 1961-1970.</ref> In older adults, depression presents as impairments already associated with age such as memory and psychomotor speed. Research indicates that higher levels of exercise can decrease the likelihood of depression in older adults even after taking into consideration factors such as chronic conditions, body mass index, and social relationships.<ref>Strawbridge, W. J. (2002). Physical Activity Reduces the Risk of Subsequent Depression for Older Adults. American Journal of Epidemiology, 156(4), 328-334. doi: 10.1093/aje/kwf047</ref> In addition to exercise, behavioral rehabilitation and prescribed antidepressants, which is well tolerated in older adults, can be used to treat depression.<ref> Alexopoulos, G. S. (2005). Depression in the Elderly. The Lancet, 365(9475), 1961-1970.</ref>

===Anxiety===
[[Anxiety]] is a relatively uncommon diagnosis in older adults and it difficult to determine its prevalence.<ref>Scogin, F. R. (1998). Anxiety in Old Age. 205-209. Retrieved March, 2014, from http://psycnet.apa.org/books/10295/018.pdf</ref> Anxiety disorders in late life are more likely to be under-diagnosed because of medical comorbidity, [[cognitive decline]], and changes in life circumstances that younger adults do not face. However, in the [[Epidemiological Catchment Era Project]], researchers found that 6-month prevalence rates for anxiety disorders were lowest for the 65 years of age and older cohort. A recent study found that the prevalence of general anxiety disorder (GAD) in adults aged 55 or older in the United States was 33.7% with an onset before the age of 50.<ref>Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A., & Craske, M. G. (2010). Anxiety disorders in older adults: A comprehensive review. Depression and Anxiety, 27(2), 190-211. doi: 10.1002/da.20653</ref>

===Attention Deficit Hyperactivity Disorder (ADHD)===
[[ADHD]] is generally believed to be a children’s disorder and is not commonly studied in adults. However, ADHD in adults results in lower household incomes, less educational achievement as well as a higher risk of marital issues and substance abuse.<ref>Brod, M., Schmitt, E., Goodwin, M., Hodgkins, P., & Niebler, G. (2012). ADHD burden of illness in older adults: A life course perspective. Quality of Life Research, 21(5), 795-799. doi: 10.1007/s11136-011-9981-9</ref> Activities such as driving can be affected; adults who suffer from inattentiveness due to ADHD experience increased rates of car accidents.<ref>Reimer, B., D’Ambrosio, L. A., Gilbert, J., Coughlin, J. F., Biederman, J., Surman, C., ... Aleardi, M. (2005). Behavior differences in drivers with attention deficit hyperactivity disorder: The driving behavior questionnaire. Accident Analysis & Prevention,37(6), 996-1004. doi: 10.1016/j.aap.2005.05.002</ref> Adults with ADHD tend to be more creative, vibrant, aware of multiple activities, and are able to multitask when interested in a certain topic.<ref>Brod, M., Schmitt, E., Goodwin, M., Hodgkins, P., & Niebler, G. (2012). ADHD burden of illness in older adults: A life course perspective. Quality of Life Research, 21(5), 795-799. doi: 10.1007/s11136-011-9981-9</ref>

===Other Mental Disorders===
The impact of mental disorders such as [[schizophrenia]], other forms of [[psychosis]], and [[bipolar disorder]] in adulthood is largely mediated by the environmental context. Those in hospitals and nursing homes differ in risk for a multitude of disorders in comparison to community-dwelling older adults.<ref>Zarit, S. H., & Zarit, J. M. (1998). Mental disorders in older adults: Fundamentals of assessment and treatment. New York: Guilford Press.</ref> Differences in how these environments treat mental illness and provide social support could help explain disparities and lead to better knowledge of how these disorders are manifested in adulthood.

==Personality in Adulthood==


== Jane Berry Theory ==
== Psyc 315 ==
== Richmond Hall ==




Revision as of 03:54, 27 March 2014

Adult development refers to the changes that occur in biological, psychological, and interpersonal domains of human life from the end of adolescence until the end of life. These changes may be gradual or rapid, and can reflect positive, negative, or no change from previous levels of functioning. Changes occur at the cellular level and are partially explained by biological theories of adult development and aging. [1]Biological changes influence psychological and interpersonal/social developmental changes, which are often described by stage theories of human development. Stage theories typically focus on “age-appropriate” developmental tasks to be achieved at each stage. Erik Erikson and Carl Jung proposed stage theories of human development that encompass the entire life span, and emphasized the potential for positive change even in very late life. Current views on adult development in late life focus on the concept of successful aging, defined as “...low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life.” [2] Biomedical theories hold that one can age successfully by caring for physical health and minimizing loss in function, whereas psychosocial theories posit that capitalizing upon social and cognitive resources, such as a positive attitude or social support from neighbors and friends, is key to aging successfully. [3] Jean Louise Calment exemplifies successful aging as the longest living person, dying at 122 years old. Her long life can be attributed to her genetics (both parents lived into their 80s) and her active lifestyle and optimistic attitude. She enjoyed many hobbies and physical activities and believed that laughter contributed to her longevity. She poured olive oil on all of her food and skin, which she believed contributed to her long life and youthful appearance.

Lifespan Development Theory

Life span development is an overarching framework that considers individual development (ontogency) from conception to old age. The framework considers the life-long accumulation of developmental gains and losses, with the relative proportion of gains to losses diminishing over an individual’s life time. According to this theory, life span development has multiple trajectories (positive, negative, stable) and causes (biological, psychological, social, cultural). Individual variation is a hallmark of this theory – not all individuals develop and age at the same rate and in the same manner. [4]

Erik Erikson’s Stages of Psychosocial Development

Erik Erikson's stages of psychosocial development describe eight stages of life that begin in infancy and end in late adulthood. The last three stages (Early Adulthood, Middle Adulthood, and Late Adulthood) encompass adult development.

Carl Jung’s Stages of Development

Carl Jung, a Swiss psychoanalyst, formulated four stages of development: Childhood: (birth to puberty) Childhood has two substages. The archaic stage is characterized by sporadic consciousness, while the monarchic stage represents the beginning of logical and abstract thinking. The ego starts to develop. Youth: (puberty until 35 – 40) Maturing Sexuality, growing consciousness, and a realization that the carefree days of childhood are gone forever. People strive to gain independence, find a mate, and raise a family. Middle Life: (40-60) The realization that you will not live forever creates tension. If you desperately try to cling to youth, you will fail in the process of self-realization. Introverted tendencies are now be explored and people often become religious during this period. Old Age: (60 and over) Consciousness is reduced. Jung thought that death is the ultimate goal of life. By realizing this, people will not face death with fear, but with a hope for rebirth.

Goals and Expectations in Successful Adult Development and Aging

Aging successfully is dependent upon establishing realistic goals and expectations for one’s own development. There are three primary models that describe goal-setting and realistic expectations for each stage in adult development:

Selective Optimization with Compensation Model (SOC)

SOC states that older adults are selective in choosing goals that optimize certain skills, while compensating for the loss of others. For example, an elderly person with fading hearing who loves to read may choose to devote more time and attention to reading, while cutting back on time spent listening to music or going to the opera.

Socioemotional Selectivity Theory (SST)

SST suggests that as adults begin to perceive that time is limited, perhaps as early as midlife, they become increasingly selective in how they spend their time and resources, devoting more of each to emotionally meaningful goals. [5] For example, researchers have found that older adults are more attracted to advertisements appealing to close-knit bonds rather than exploration and adventure, which appeals more to younger adults. This extends to a significant preference for positive over negative information in attention and memory among older adults.This preference for positive information over negative is known as the positivity effect.[6] Over time, adults shift their goal focus away from mastering new information or skillsets and towards maintaining physical and socio-emotional wellbeing.[7]

Physical and cognitive declines associated with aging create challenges to one’s sense of personal control and autonomy. The degree to which one believes that one has control and autonomy influences one’s behavior, relationships, physical health, and cognitive functioning, and goal setting. Preservation of personal control can be achieved via assimilative activities, accommodations, and immunizing strategies.[8]

Physical Aging

Physical aging includes changes at the biological level (senescence) and larger organ and musculoskeletal levels. Sensory changes and degeneration begin to be common in midlife. Degeneration can include the break down of muscle, bones and joints, leading to physical ailments such as sarcopenia or arthritis.[9]

At the sensory level, changes occur to vision, hearing, taste, touch, and smell, and taste. Two common sensory changes that begin in midlife include our ability to see close objects and our ability to hear high pitches.[10][11] Other developmental changes to vision might include cataracts, glaucoma, and the loss of central visual field with macular degeneration . [12] Hearing also becomes impaired in midlife and aging adults, particularly in men. In the past 30 years, hearing impairment has doubled.[13] Hearing aids as an aid for hearing loss still leave many individuals dissatisfied with their quality of hearing. Olfaction can co-occur with changes in sense of taste. “Olfactory dysfunction can impair quality of life and may be a marker for other deficits and illnesses” and can also lead to decreased satisfaction in taste when eating. Losses to the sense of touch are usually noticed when there is a decline in the ability to detect a vibratory stimulus. The loss in sense of touch can harm a person’s fine motor skills such as writing and using utensils. The ability to feel painful stimuli is usually preserved in aging, but the process of decline for touch is accelerated in those with diabetes.[14]

Physical deterioration to the body begins to increase in midlife and late life, and includes degeneration of muscle, bones, and joints. Sarcopenia, a normal developmental change, is the degeneration of muscle mass, which includes both strength and quality.Cite error: A <ref> tag is missing the closing </ref> (see the help page). Many of the contributing factors that may cause sarcopenia include neuronal and hormonal changes, inadequate nutrition, and physical inactivity.[15] Apoptosis has also been suggested as an underlying mechanism in the progression of sarcopenia. The prevalence of sarcopenia increases as people age and is associated with the increased likelihood of disability and restricted independence among elderly people. Approaches to preventing and treating sarcopenia are being explored by researchers. A specific preventative approach includes progressive resistance training, which is safe and effective for the elderly.[16]

Developmental changes to various organs and organ systems occur throughout life. These changes affect responses to stress and illness, and can compromise the body’s ability to cope with demand on organs.[17] The altered functioning of the heart, lungs, and even skin in old age can be attributed to factors like cell death or endocrine hormones. There are changes to the reproductive system in midlife adults, most notably menopause for women, the permanent end of fertility. In men, hormonal changes also affect their reproductive and sexual physiology, but these changes are not as extreme as those experienced by women.[18]

Non-normative Aging: Cognitive Impairments

Dementia is characterized by persistent, multiple cognitive deficits in the domains including, but not limited to, memory, language, and visuospatial skills and can result from central nervous system dysfunction.[19][20][21] Two forms of dementia exist: degenerative and nondegenerative. The progression of nondegenerative dementias, like head trauma and brain infections, can be slowed or halted but degenerative forms of dementia, like Parkinson’s disease, Alzheimer’s disease, and Huntington’s are irreversible and incurable.

Alzheimer’s disease

Alzheimer's disease (AD) was discovered in 1907 by Dr. Alois Alzheimer, a German neuropathologist and psychiatrist. Physiological abnormalities associated with AD include neurofibrillary plaques and tangles. Neuritic plaques, that target the outer regions of the cortex, consist of withering neuronal material from a protein, amyloid-beta. Neurofibrillary tangles, paired helical filaments containing over-phosphorylated tau protein, are located within the nerve cell. Early symptoms of AD include difficulty remembering names and events, while later symptoms include impaired judgment, disorientation, confusion, behavior changes, and difficulty speaking, swallowing, and walking. After initial diagnosis, a person with AD can live, on average, an additional 3 to 10 years with the disease.[22] In 2013, it was estimated that 5.2 million Americans of all ages had AD.[23] Environmental factors such as head trauma, high cholesterol, and type 2 diabetes can increase the likelihood of AD.[24]

Huntington’s disease

Huntington's Disease (HD) named after George Huntington is a disorder that is caused by an inherited defect in a single gene on chromosome 4, resulting in a progressive loss of mental faculties and physical control.[25][26] HD affects muscle coordination (involuntary writhing) and leads to cognitive decline and psychiatric issues.[27] Symptoms usually appear between the ages of 30-50 but can occur at any age, including adolescence.[28] There is currently no cure for HD and treatments focus on managing symptoms and quality of life. Current estimates claim that 1 in 10,000 Americans have HD, however, 1 in 250,000 are at-risk of inheriting it from a parent.[29] Most individuals with HD live 10 to 20 years after a diagnosis.

Parkinson’s Disease

Parkinson's Disease (PD) was first described by James Parkinson in 1817. It typically affects people over the age of 50. PD is related to damaged nerve cells that produce dopamine.[30] Common symptoms experienced by people with PD include trembling of the hands, arms, legs, jaw, or head; rigidity (stiffness in limbs and the midsection); bradykinesia; and postural instability, leading to impaired balance and/or coordination.[31] PD cannot be cured, but diagnosis and treatment can help relieve symptoms. Treatment options include medications like Carbidopa/Levodopa (L-dopa), that reduce the severity of motor symptoms in patients.[32] Alternative treatment options include non-pharmacological therapy. Surgery (pallidotomy, thalamotomy) is often viewed as the last viable option.[33]

Mental Health

Older adults represent a significant proportion of the population, and this proportion is expected to increase with time.[34] Mental health concerns of older adults are important at treatment and support levels, as well as policy issues. The prevalence of suicide among older adults is higher than in any other age group.

Depression

is one of the most common disorders that presents in old age and is comorbid with other physical and psychiatric conditions, perhaps due to the stress induced by these conditions.[35] In older adults, depression presents as impairments already associated with age such as memory and psychomotor speed. Research indicates that higher levels of exercise can decrease the likelihood of depression in older adults even after taking into consideration factors such as chronic conditions, body mass index, and social relationships.[36] In addition to exercise, behavioral rehabilitation and prescribed antidepressants, which is well tolerated in older adults, can be used to treat depression.[37]

Anxiety

Anxiety is a relatively uncommon diagnosis in older adults and it difficult to determine its prevalence.[38] Anxiety disorders in late life are more likely to be under-diagnosed because of medical comorbidity, cognitive decline, and changes in life circumstances that younger adults do not face. However, in the Epidemiological Catchment Era Project, researchers found that 6-month prevalence rates for anxiety disorders were lowest for the 65 years of age and older cohort. A recent study found that the prevalence of general anxiety disorder (GAD) in adults aged 55 or older in the United States was 33.7% with an onset before the age of 50.[39]

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is generally believed to be a children’s disorder and is not commonly studied in adults. However, ADHD in adults results in lower household incomes, less educational achievement as well as a higher risk of marital issues and substance abuse.[40] Activities such as driving can be affected; adults who suffer from inattentiveness due to ADHD experience increased rates of car accidents.[41] Adults with ADHD tend to be more creative, vibrant, aware of multiple activities, and are able to multitask when interested in a certain topic.[42]

Other Mental Disorders

The impact of mental disorders such as schizophrenia, other forms of psychosis, and bipolar disorder in adulthood is largely mediated by the environmental context. Those in hospitals and nursing homes differ in risk for a multitude of disorders in comparison to community-dwelling older adults.[43] Differences in how these environments treat mental illness and provide social support could help explain disparities and lead to better knowledge of how these disorders are manifested in adulthood.

Personality in Adulthood

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  3. ^ Bowling, A., & Dieppe, P. (2005). What is successful ageing and who should define it? British Medical Journal,331(7531), 1548-1551. doi:10.1136/bmj.331.7531.1548
  4. ^ Baltes, P. B., Lindenberger, U., & Staudinger, U. M. (2006). Life span theory in developmental psychology. In R. M. Lerner & W. Damon (Eds.), Handbook of child psychology:Theoretical models of human development (pp. 569-664). Hoboken, NJ: John Wiley.
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  6. ^ Reed, A. E., & Carstensen, L. L. (2012). The theory behind the age-relatedpositivity effect. Frontiers in Psychology, 3. doi: 10.3389/fpsyg.2012.00339
  7. ^ Cavanaugh, J., & Blanchard-Fields, F. (2015). Chapter 8 - social cognition. In Adult development and aging, 7th edition (pp. 216-244). Stamford, CT: Cengage Learning.
  8. ^ Cavanaugh, J., & Blanchard-Fields, F. (2015). Chapter 8 - social cognition. In Adult development and aging, 7th edition (pp. 216-244). Stamford, CT: Cengage Learning.
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  10. ^ Gates, G. A., & Mills, J. H. (2005). Presbycusis. The Lancet, 366(9491), 1111-1120.
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  14. ^ Nusbaum, N. J. (1999). Aging and Sensory Senescence. Southern Medical Journal, 92(3), 267-275.
  15. ^ Leeuwenburgh, C. & Marzetti, E. (2006). Skeletal Muscle Apoptosis, Sarcopenia and Frailty at Old Age. Experimental Gerontology, 41(12), 1234-1238.
  16. ^ Baumgartner et al. (1997). Epidemiology of sarcopenia among the elderly in new mexico. American Journal of Epidemiology, 147 (8), 755-763.
  17. ^ Evers, B. C., and Thompson, J. (1994). Organ physiology of aging. The Surgical Clinics of North America, 74(1), 23-39.
  18. ^ Hermann, M., Untergasser, G., Rumpold, H., and Berger, P. (2000). Aging of the male reproductive system."Experimental Gerontology 35(9-10), 1267-1279.
  19. ^ Kempler, D. Neurocognitive Disorders in Aging. Thousand Oaks: Sage, 2005.
  20. ^ Bayles, Kathryn, and Cheryl Tomoeda. The ABC’s of Dementia. 2nd ed. Phoenix: Canyonlands, 1995.
  21. ^ Borda, C. Alzheimer’s Disease and Memory Drugs. Ed. David J. Triggle. New York: Chelsea, 2006.
  22. ^ Zanetti, O., Solerte, S.B., & Cantoni F. (2009). Life expectancy in Alzheimer’s disease (AD). Archives of Gerontology and Geriatrics, 49, 237-243.
  23. ^ Alzheimer’s Association. (2013). 2013 Alzheimer’s disease facts and figures. Alzheimer’s and Dementia. 9(2), 1-68.
  24. ^ Kelly, Evelyn B. Alzheimer’s Disease. New York: Chelsea, 2008. Print.
  25. ^ http://www.alz.org/dementia/huntingtons-disease-symptoms.asp
  26. ^ http://www.hdsa.org/images/content/1/3/13699.pdf
  27. ^ http://en.wikipedia.org/wiki/Huntington%27s_disease
  28. ^ http://www.hdsa.org/images/content/1/3/13699.pdf
  29. ^ http://www.webmd.com/parkinsons-disease
  30. ^ de Lau, L., & Breteler, M. (2006). Epidemiology of parkinson's disease. The Lancet Neurology, 5(6), 525-535.
  31. ^ Chou, K. L., Taylor, J. L., & Patil, P. G. (2013). The mds−updrs tracks motor and non-motor improvement due to subthalamic nucleus deep brain stimulation in parkinson disease. Parkinsonism & Related Disorders, 19(11), 966-969.
  32. ^ Hauser, R. A., et al.. (2013). Extended-release carbidopa-levodopa (ipx066) compared with immediate-release carbidopa-levodopa in patients with parkinson's disease and motor fluctuations: a phase 3 randomised, double-blind trial. The Lancet Neurology, 12(4), 346-356.
  33. ^ Lang, P. E., & Obeso, J. A. (2004). Challenges in parkinson's disease: restoration of the nigrostriatal dopamine system is not enough. The Lancet Neurology, 3(5), 309-316.
  34. ^ Zarit, S. H., & Zarit, J. M. (1998). Mental disorders in older adults: Fundamentals of assessment and treatment. New York: Guilford Press.
  35. ^ Alexopoulos, G. S. (2005). Depression in the Elderly. The Lancet, 365(9475), 1961-1970.
  36. ^ Strawbridge, W. J. (2002). Physical Activity Reduces the Risk of Subsequent Depression for Older Adults. American Journal of Epidemiology, 156(4), 328-334. doi: 10.1093/aje/kwf047
  37. ^ Alexopoulos, G. S. (2005). Depression in the Elderly. The Lancet, 365(9475), 1961-1970.
  38. ^ Scogin, F. R. (1998). Anxiety in Old Age. 205-209. Retrieved March, 2014, from http://psycnet.apa.org/books/10295/018.pdf
  39. ^ Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A., & Craske, M. G. (2010). Anxiety disorders in older adults: A comprehensive review. Depression and Anxiety, 27(2), 190-211. doi: 10.1002/da.20653
  40. ^ Brod, M., Schmitt, E., Goodwin, M., Hodgkins, P., & Niebler, G. (2012). ADHD burden of illness in older adults: A life course perspective. Quality of Life Research, 21(5), 795-799. doi: 10.1007/s11136-011-9981-9
  41. ^ Reimer, B., D’Ambrosio, L. A., Gilbert, J., Coughlin, J. F., Biederman, J., Surman, C., ... Aleardi, M. (2005). Behavior differences in drivers with attention deficit hyperactivity disorder: The driving behavior questionnaire. Accident Analysis & Prevention,37(6), 996-1004. doi: 10.1016/j.aap.2005.05.002
  42. ^ Brod, M., Schmitt, E., Goodwin, M., Hodgkins, P., & Niebler, G. (2012). ADHD burden of illness in older adults: A life course perspective. Quality of Life Research, 21(5), 795-799. doi: 10.1007/s11136-011-9981-9
  43. ^ Zarit, S. H., & Zarit, J. M. (1998). Mental disorders in older adults: Fundamentals of assessment and treatment. New York: Guilford Press.
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