14.6 Summary

Prejudice and Predictions

1. Contrary to ageist stereotypes, most older adults are happy, quite healthy, and active. Benevolent as well as dismissive ageism reduces health and self-image, as elderspeak illustrates.

2. An increasing percentage of the population is older than 64, but the numbers are sometimes presented in misleading ways. Currently, about 14 percent of people in Canada are elderly, and most of them are self-sufficient and productive.

3. Gerontologists distinguish the young-old, the old-old, and the oldest-old, according to each age group’s relative degree of dependency. Only 10 percent of those over age 64 are dependent on others for basic care, and those “others” are usually relatives, not unrelated taxpayers.

4. Sexual intercourse occurs less often, driving a car becomes more difficult, and all the senses become less acute with age. However, selective optimization with compensation can mitigate almost any loss. A combination of personal determination, adjustment by society, and technological devices is needed.

Cognition

5. Brain scans and measurements show that the speed of processing slows down, parts of the brain shrink, and more areas of the brain are activated in older people.

6. Memory is affected by aging, but specifics vary. As the senses become dulled, some stimuli never reach the sensory memory. Working memory shows notable declines with age because slower processing means that some thoughts are lost.

7. Control processes are less effective with age, as retrieval strategies become less efficient. Anxiety may prevent older people from using the best strategies for cognitive control. Ecologically valid, real-life measures of cognition are needed.

Aging and Disease

8. Primary aging happens to everyone, reducing organ reserve in body and brain. Secondary aging depends on the individual’s past health habits and genes. The combination of primary and secondary aging eventually causes morbidity, disability, and mortality.

Neurocognitive Disorders

9. Neurocognitive disorders (NCDs), formerly (and now informally) called dementia, are characterized by cognitive loss—at first minor lapses, then more serious impairment, and, finally, such major losses that even recognition of family members, or remembering how to eat or talk, may fade.

10. The most common cause of cognitive loss among the elderly is Alzheimer’s disease, an incurable ailment that worsens over time, as plaques and tangles increase.

11. Vascular neurocognitive disorders result from a series of ministrokes (transient ischemic attacks, or TIAs) that occur when impairment of blood circulation destroys portions of brain tissue.

12. Other NCDs, including frontal lobe disorders and Lewy body disease, also become more common with age. Several other types of neurocognitive disorder can occur in early or middle adulthood. One is Parkinson’s disease, which begins with loss of muscle control. Parkinson’s disease can also cause neurocognitive problems, particularly in the old.

13. Neurocognitive disorder is sometimes mistakenly diagnosed when individuals are suffering from a reversible problem, such as anxiety, depression, and polypharmacy.

New Cognitive Development

14. Many people become more interested and adept in creative endeavours, as well as more philosophical, as they grow older.

The life review is a personal reflection that many older people undertake, remembering earlier experiences, putting their entire lives into perspective, and achieving integrity or self-actualization.

15. Wisdom does not necessarily increase as a result of age, but some elderly people are unusually wise or insightful.

16. It was once believed that many people in certain parts of the world lived long past 100 as a result of moderate diet, exercise, hard work, and respect for the aged. Such reports are now thought to have been exaggerated.

17. The number of centenarians is increasing, and many of them are quite healthy and happy. The personality and attitudes of the very old suggest that long-term survival may be welcomed more than feared.