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Old age

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"Old people" redirects here. For the Khmer Rouge term, see New People.
Old Woman Dozing by Nicolaes Maes (1656). Royal Museums of Fine Arts, Brussels

Old age consists of ages nearing or surpassing the life expectancy of human beings, and thus the end of the human life cycle. Euphemisms and terms for old people include, old people (worldwide usage), seniors (American usage), senior citizens (British and American usage), older adults (in the social sciences[1]), the elderly, and elders (in many cultures including the cultures of aboriginal people).

Old people often have limited regenerative abilities and are more prone to disease, syndromes, and sickness than younger adults. The organic process of ageing is called senescence,[2] the medical study of the aging process is gerontology,[3] and the study of diseases that afflict the elderly is geriatrics.[4] The elderly also face other social issues such as retirement, loneliness, and ageism.[5]

The chronological age denoted as “old age” varies culturally and historically. Thus, old age is "a social construct" rather than a definite "biological stage".[6]

Definition

The boundary between senior and old age cannot be defined exactly because it shifts according to context and to society. People can be considered old because of certain changes in their activities or social roles. Examples: people may be considered old when they become grandparents, or when they begin to do less or different work—retirement. Most developed countries have accepted the chronological age of 65 years as a definition of 'elderly' or older person.[7]

German chancellor Otto von Bismarck created the world's first comprehensive government social safety net in the 1880s, providing for old age pensions. In the United States of America, and the United Kingdom, the age of 65 was traditionally considered the beginning of the senior years because, until recently, United States and British people became eligible to retire at this age with full Social Security benefits. In 2003, the age at which a US citizen became eligible for full Social Security benefits began to increase gradually, and will continue to do so until it reaches 67 in 2027. Full retirement age for Social Security benefits for people retiring in 2012 is age 66.[8] Originally, the purpose of old age pensions was to prevent elderly persons from being reduced to beggary, which is still common in some underdeveloped countries, but growing life expectancies and elder populations has brought into question the model under which pension systems were designed.

Marks of old age

The distinguishing marks associated with old age comprise both physical and mental characteristics.[9] The marks of old age are so unlike the marks of middle age that it has been suggested that, as an individual transitions into old age, he/she might well be thought of as different persons “time-sharing” the same identity.[10]

These marks do not occur at the same chronological age for everyone. They, also, occur at different rates and order for different people.[11] Because each person is unique, marks of old age vary between people, even those of the same chronological age.[12]

Physical marks of old age

Physical marks of old age include the following:

  • Bone and joint. Old bones are marked by “thinning and shrinkage.” This results in a loss of height (about two inches by age 80), a stooping posture in many people, and a greater susceptibility to bone and joint diseases such as osteoarthritis and osteoporosis.[13]
  • Digestive system. About 40% of the time, old age is marked by digestive disorders such as difficulty in swallowing, inability to eat enough and to absorb nutrition, constipation, and bleeding.[14]
  • Eyesight. Diminished eyesight makes it more difficult to read in low lighting and in smaller print. Speed with which an individual reads and the ability to locate objects may also be impaired.[15]
  • Falls. Old age spells risk for injury from falls that might not cause injury to a younger person.[16] Every year, about one third of 65 years olds and over half of 80 years old fall.[17] Falls are the leading cause of injury and death for old people.[18]
  • Hair usually becomes thinner and grayer.[19]
  • Hearing. By age 75 and older, 48% of men and 37% of women encounter impairments in hearing. Of the 26.7 million people over age 50 with a hearing impairment, only one in seven uses a hearing aid.[20]
  • Hearts are less efficient in old age with a resulting loss of stamina.[19]
  • Lungs expand less well; thus, they provide less oxygen.[13]
  • Pain afflicts old people at least 25% of the time, increasing with age up to 80% for those in nursing homes.[22] Most pains are rheumatological ormalignant.[23]
  • Sexual activity decreases significantly with age, especially after age 60, for both women and men.[24] However, the sexual drive often continues for men after the cessation of activity.[19]
  • Skin loses elasticity, becomes drier, and more lined and wrinkled.[19]
  • Sleep trouble holds a chronic prevalence of about 50% in old age and results in daytime sleepiness.[25] By age 65, deep sleep goes down to about 5%.[26]
  • Urinary incontinence is often found in old age.[27]
  • Voice. In old age, vocal chords weaken and vibrate more slowly. This results in a weakened, breathy voice that is sometimes called an “old person’s voice.”[28]

Mental marks of old age

  • Caution marks old age. This antipathy toward “risk-taking” stems from the fact that old people have less to gain and more to lose by taking risks than younger people.[29]
  • Depressed mood.[30] According to Cox, Abramson, Devine, and Hollon (2012), old age is a risk factor for depression caused by prejudice (i.e., “deprejudice”). When people are prejudiced against the elderly and then become old themselves, their anti-elderly prejudice turns inward, causing depression. “People with more negative age stereotypes will likely have higher rates of depression as they get older.”[31] Old age depression results in the over-65 population having the highest suicide rate.[32]
  • Reduced mental and cognitive ability afflicts old age.[33] Memory loss is common in old age due to the decrease in speed of information being encoded, stored, and received. It takes more time to learn new information.[34] Dementia is a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Its prevalence increases in old age from about 10% at age 65 to about 50% over age 85.[35] Alzheimer's disease accounts for 50 to 80 percent of dementia cases. Demented behavior can include wandering, physical aggression, verbal outbursts, depression, and psychosis.[36]
  • Set in one’s ways describes a mind set of old age.[37] A study of over 400 distinguished men and women in old age found a “preference for the routine.”[38] Explanations include old age’s toll on “fluid intelligence” and the “more deeply entrenched” ways of the old.[39]

Demographic changes

In the industrialized countries, life expectancy and, thus, the old age population have increased consistently over the last decades.[40] In the United States the proportion of people aged 65 or older increased from 4% in 1900 to about 12% in 2000.[41] In 1900, only about 3 million of the nation's citizens were 65 or older (out of 76 million total American citizens). By 2000, the number of senior citizens had increased to about 35 million (of 280 million US citizens). Population experts estimate that more than 50 million Americans—about 17 percent of the population—will be 65 or older in 2020.[42]

The number of old people is growing around the world chiefly because of the post–World War II baby boom, and increases in the provision and standards of health care.[43]

The growing number of people living to their 80s and 90s in the developed world has strained public welfare systems and has also resulted in increased incidence of diseases like cancer and dementia that were rarely seen in premodern times. When the United States Social Security program was created, persons older than 65 numbered only around 5% of the population and the average life expectancy of a 65 year old in 1936 was approximately 5 years, while in 2011 it could often range from 10–20 years. Other issues that can arise from an increasing population are growing demands for health care and an increase in demand for different types of services.[44]

Of the roughly 150,000 people who die each day across the globe, about two thirds—100,000 per day—die of age-related causes.[45] In industrialized nations, the proportion is much higher, reaching 90%.[45]

Psychosocial aspects

An elderly Somali woman.

According to Erik Erikson’s "Eight Stages of Life" theory, the human personality is developed in a series of eight stages that take place from the time of birth and continue on throughout an individual’s complete life. He characterises old age as a period of "Integrity vs. Despair", during which a person focuses on reflecting back on his life. Those who are unsuccessful during this phase will feel that their life has been wasted and will experience many regrets. The individual will be left with feelings of bitterness and despair. Those who feel proud of their accomplishments will feel a sense of integrity. Successfully completing this phase means looking back with few regrets and a general feeling of satisfaction. These individuals will attain wisdom, even when confronting death.[46][47][48] Coping is a very important skill needed in the aging process to move forward with life and not be 'stuck' in the past. The way a person adapts and copes, reflects his aging process on a psycho-social level.[49]

Newman & Newman proposed a ninth stage of life, Elderhood. Elderhood refers to those individuals who live past the life expectancy of their birth cohorts. There are two different types of people described in this stage of life. The "young old" are those healthy individuals who can function on their own without assistance and can complete their daily tasks independently. The "old old" are those who depend on specific services due to declining health or diseases. This period of life is characterized as a period of "immortality vs. extinction." Immortality is the belief that your life will go on past death, some examples are an afterlife or living on through one's family. Extinction refers to feeling as if life has no purpose.[50]

Theories of old age

Social theories, or concepts,[51] propose explanations for the distinctive relationships between old people and their societies.

One of the theories is the Disengagement Theory proposed in 1961. This theory proposes that in old age a mutual disengagement between people and their society occurs in anticipation of death. By becoming disengaged from work and family responsibilities, according to this concept, people are enabled to enjoy their old age without stress. This theory has been subjected to the criticism that old age disengagement is neither natural, inevitable, nor beneficial.[52] Furthermore, disengaging from social ties in old age is not across the board: unsatisfactory ties are dropped and satisfying ones kept.[53]

In opposition to the Disengagement Theory, the Activity Theory of old age argues that disengagement in old age occurs not by desire, but by the barriers to social engagement imposed by society. This theory has been faulted for not factoring in psychological changes that occur in old age as shown by reduced activity even when available. It has also been found that happiness in old age is not proportional to activity.[54]

According to the Continuity Theory, in spite of the inevitable differences imposed by their old age, most people try to maintain continuity in personhood, activities, and relationships with their younger days.[55]

Socioemotional Selectivity Theory also depicts how people maintain continuity in old age. The focus of this theory is continuity sustained by social networks, albeit networks narrowed by choice and by circumstances. The choice is for more harmonious relationships. The circumstances are loss of relationships by death and distance.[56]

Life expectancy

In most parts of the world, women live, on average, longer than men; even so, the disparities vary between 9 years or more in countries such as Sweden and the United States to no difference or higher life expectancy for men in countries such as Zimbabwe and Uganda.[57]

The number of elderly persons worldwide began to surge in the second half of the 20th century. Up to that time (and still true in underdeveloped countries), five or less percent of the population was over 65. Few lived longer than their 70s and people who attained advanced age (i.e. their 80s) were rare enough to be a novelty and were revered as wise sages. Accidents and disease claimed many people before they could attain old age, and because health problems in those over 65 meant a quick death in most cases. If a person lived to an advanced age, it was due to genetic factors and/or a relatively easy lifestyle, since diseases of old age could not be treated before the 20th century.[citation needed]

Assistance and care

Old man at a nursing home in Norway.

According to the Journal "Demography", there is a rise in the elderly living alone if not with a spouse. Individuals 75 and older have decreased in amount needing help taking care of themselves. Many new assistive devices made especially for the home have contributed greatly to this. Some examples of devices are a medical alert and safety system, shower seat (making it so the person does not get tired in the shower and fall), a bed cane (offering support to those with unsteadiness getting in and out of bed), and an ADL cuff (used with eating utensils for people with paralysis or hand weakness).[citation needed]

However around 25% of individuals 85 and older say that they need help with their activities of daily living. There are many options for long term care to those who require it. There is home based care where a family member, volunteer, or trained professional will aid the person in need and help with daily activities. Another option is community services which can provide the person with transportation, meal plans, or activities in senior centers. A third option is assisted living where 24 hour round the clock supervision is given with aid in eating, bathing, dressing, etc. A final option is a nursing home which provides professional nursing care.[citation needed]

See also

References

  1. ^ Publication Manual of the American Psychological Association, 6th edition (American Psychological Association, 2009) ISBN 1433805618
  2. ^ http://www.thefreedictionary.com/senescence
  3. ^ http://www.thefreedictionary.com/gerontology
  4. ^ http://www.thefreedictionary.com/geriatrics
  5. ^ http://www.bbc.co.uk/news/uk-politics-24572231
  6. ^ Oxford Dictionary of Sports Science & Medicine, s.v. "old age". Online at http://www.oxfordreference.com/view/10.1093/acref/9780198568506.001.0001/acref-9780198568506-e-4834?rskey=7F4W2c&result=4834. Accessed December 05, 2013.
  7. ^ "WHO""Definition of an older or elderly person".
  8. ^ "Age To Receive Full Social Security Retirement Benefits". U.S. Social Security Administration. Retrieved 6 June 2011.
  9. ^ http://www.ncbi.nlm.nih.gov/pubmed/1891555. Accessed November 19, 2013.
  10. ^ Richard A. Posner, Aging and Old Age (University of Chicago, 1997), 86-87.
  11. ^ “When Does Someone Attain Old Age?” at http://ohioline.osu.edu/ss-fact/0101.html. Accessed November 20, 2013
  12. ^ “Ageing: Myth and Reality” (The Department of Communities, Child Safety and Disability Services, Australia, 2012) 12-13 at http://www.communities.qld.gov.au/resources/communityservices/seniors/publications/ageing-myth-reality.pdf. Accessed November 18, 2013.
  13. ^ a b “The Normal Aging Process” at http://wahsa.org/agingprocess.pdf and http://www.documbase.com/The-Normal-Aging-Process.pdf. Accessed December 1, 2013.
  14. ^ “Your Aging Digestive System,” www.JohnsHopkinsHealthAlerts.com. Accessed December 1, 2013.
  15. ^ American Psychological Association, “Older Adults' Health and Age-Related Changes” at http://www.apa.org/pi/aging/resources/guides/older.aspx
  16. ^ Center for Healthy Aging: Falls Prevention Awareness Day
  17. ^ “How Often Falls Occur” at http://www.learnnottofall.com/content/fall-facts/how-often.jsp. Accessed November 4, 2013.
  18. ^ “Falls Among Older Adults: An Overview” at http://www.cdc.gov/homeandrecreationalsafety/Falls/adultfalls.html.
  19. ^ a b c d “Healthy Aging - Normal Aging” at http://www.webmd.com/healthy-aging/tc/healthy-aging-normal-aging. Accessed November 30, 2013.
  20. ^ American Psychological Association, “Older Adults' Health and Age-Related Changes” at http://www.apa.org/pi/aging/resources/guides/older.aspx. Accessed November 3, 2013
  21. ^ “The Immune System in the Elderly: A Fair Fight Against Diseases?” at http://www.medscape.com/viewarticle/780507_2. Accessed November 8, 2013.
  22. ^ S. A. King, “The challenge of geriatric pain,” Psychiatric Times, 26:7, July 2009. http://www.psychiatrictimes.com/articles/challenge-geriatric-pain
  23. ^ Gary McCleane and Howard Smith, editors, Clinical Management of the Elderly Patient in Pain (CRC Press, 2006). 150.
  24. ^ “Sexual function in the elderly” at ” http://www.ncbi.nlm.nih.gov/pubmed/2297288. Accessed December 1, 2013
  25. ^ Jana R. Cooke, MD, “Sleep Disorders in the Elderly,” Psychiatric Times 25.4 (2008).
  26. ^ Julie K. Silver, M.D., “Aging and Energy: Why Energy Levels Go down as We Get Older” (2008) at http://www.gather.com/viewArticle.action?articleId=281474977424338
  27. ^ Joseph G. Ouslander, “Urinary Incontinence in the Elderly.” Western Journal of Medicine 135(6): 482–491. Online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1273322/
  28. ^ NBC News Health, “The wavery, shaky 'old person's voice,' explained.” http://www.nbcnews.com/health/wavery-shaky-old-persons-voice-explained-1C8119298
  29. ^ Richard A. Posner, Aging and Old Age (University of Chicago, 1995), 112, 116.
  30. ^ Kennedy G.J. The epidemiology of late-life depression. In: Kennedy G. J, editor. Suicide and depression in late life: Critical issues in treatment, research and public policy. New York: John Wiley and Sons; 1996. pp. 23–37.
  31. ^ Cox, William T. L.; Abramson, Lyn Y.; Devine, Patricia G.; Hollon, Steven D. (2012). "Stereotypes, Prejudice, and Depression: The Integrated Perspective". Perspectives on Psychological Science. 7 (5): 427–449. doi:10.1177/1745691612455204.
  32. ^ Laura E. Berk, Development Through the Lifespan, (Allyn & Bacon, 2010), 610.
  33. ^ Salthouse, Timothy A. (2009). "When does age-related cognitive decline begin?". Neurobiology of Aging 30 (4): 507–514. doi:10.1016/j.neurobiolaging.2008.09.023. ISSN 01974580. PMC 2683339. PMID 19231028.
  34. ^ “Memory loss and aging” and “Mild cognitive impairment” by the Mayo Clinic staff. Online at http://www.mayoclinic.com/health/memory-loss/HQ00094. Accessed November 4, 2013
  35. ^ Susan Jacoby, Never Say Die (Vintage, 2011) 12.
  36. ^ “Alzheimer's disease” by Mayo Clinic Staff. Online at http://www.mayoclinic.com/health/alzheimers-disease/DS00161. Accessed November 14, 2013.
  37. ^ George P. Moschis, Marketing to Older Consumers (Praeger, 1992), 102.
  38. ^ Martin S. Lindauer, Aging, Creativity, and Art (Springer, 2003), 55-56.
  39. ^ Richard A. Posner, Aging and Old Age (University of Chicago, 1995), 116.
  40. ^ "Table 26: Life expectancy at birth, at 65 years of age, and at 75 years of age by race and sex: United States, selected years, 1900 - 2005" (PDF). Centers for Disease Control and Prevention. Retrieved 26 August 2010.
  41. ^ Meyer, Julie (2001). "Census 2000 Brief, C2KBR/01-12, U.S." (PDF). "Washington, DC": "Census Bureau". Retrieved 2009-03-17.
  42. ^ ”Number of old Americans” at http://www.agingstats.gov/Main_Site/Data/2012_Documents/Population.aspx. Accessed December 1, 2013.
  43. ^ United Nations, “World Population Ageing: 1950-2050" at http://www.un.org/esa/population/publications/worldageing19502050/
  44. ^ http://www.ssa.gov/policy/docs/ssb/v66n1/v66n1p1.html. Accessed November, 2013.
  45. ^ a b Aubrey D.N.J, de Grey (2007). "Life Span Extension Research and Public Debate: Societal Considerations" (PDF). Studies in Ethics, Law, and Technology. 1 (1, Article 5). doi:10.2202/1941-6008.1011. Retrieved August 7, 2011.
  46. ^ Erikson, E.H. (1968). Identity: Youth and Crisis. New York: Norton.
  47. ^ Erikson, E.H. (1963). Childhood and Society. (2nd ed.). New York: Norton.
  48. ^ Carver, C.S. & Scheir, M.F. (2000). Perspectives on Personality. Needham Heights, MA: Allyn & Bacon
  49. ^ Yolanda Griffiths and Andrea Thinnes, “Psychological Aspects of Aging” at http://ot.creighton.edu/community/OT_FOR_ELDERS/3rd_Edition_Chapters/Proofs/Padilla_Chapter_04_main.pdf.
  50. ^ Barbara M. Newman, Philip R. Newman, Development Through Life: A Psychosocial Approach: A Psychosocial Approach (Cengage Learning, 2011), Ch 13 “Later Adulthood (60-75 Years)” and Ch 14, “Elderhood (75 until death).”
  51. ^ “Theory: A conception . . . of something to be done, or of the method of doing it.” Oxford English Dictionary Online . December 2013.
  52. ^ Michael Totten, “An Overview of Cumming and Henrys Social Disengagement Theory,” http://www.sciences360.com/index.php/an-overview-of-cumming-and-henrys-social-disengagement-theory-3750/.
  53. ^ Laura E. Berk, Development Through the Lifespan, (Allyn & Bacon, 2010), 613.
  54. ^ Laura E. Berk, Development Through the Lifespan, (Allyn & Bacon, 2010), 614.
  55. ^ Laura E. Berk, Development Through the Lifespan, (Allyn & Bacon, 2010), 614.
  56. ^ Laura E. Berk, Development Through the Lifespan, (Allyn & Bacon, 2010), 614-615.
  57. ^ de Blij, Harm. The power of place. Geography, Destiny, and Globalization's Rough Landscape. Oxford University Press. London:2009. p161ff
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Preceded by Stages of human development
Old age 		Succeeded by
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