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 13 percent of people in the U.S. population are elderly, and most of them are self-sufficient and productive.

  3. Hundreds of theories address the causes of aging. The most common are theories of wear and tear, of genes, and of cellular change. All seem plausible, but none seems sufficient.

  4. One attempt to stop the aging process is calorie restriction. That seems to benefit health and prolong life in many species, but experts are conflicted as to whether it would be useful for people.

Selective Optimization with Compensation

  1. Sexual intercourse occurs less often, driving a car becomes more difficult, and diseases become more common with age. However, selective optimization with compensation can mitigate almost any loss. A combination of personal determination, adjustment by society, and medical research is needed.

    537

  2. Primary aging happens to everyone, reducing organ reserve in body and brain. Secondary aging depends on the individual’s past health habits and genes. Heart disease and osteoporosis are both examples of ways to optimize health, compensate for losses, and achieve compression of morbidity.

The Aging Brain

  1. 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.

  2. 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.

  3. 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.

  4. With age, some new neurons and dendrites grow, more parts of the brain are activated at once, and some types of cognition seem preserved. In daily life, many older people seem as cogent as ever.

Brain Diseases

  1. Neurocognitive disorders, whether they occur in late adulthood or earlier, are diseases that reduce brain functioning. Most people never suffer from a brain disease, but it is devastating when it occurs.

  2. The most common cause of neurocognitive disorder (NCD) in the United States is Alzheimer’s disease, an incurable ailment that becomes more prevalent with age and worsens over time. The main symptom is extreme memory loss.

  3. Also common worldwide is vascular disease (also called vascular or multi-infarct dementia), which results from a series of ministrokes that occur when impairment of blood circulation destroys portions of brain tissue.

  4. Other neurocognitive disorders, including frontotemporal NCDs and Lewy body disease, also become more common with age. Several other types of NCDs 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 significant cognitive decline, particularly in the old.

  5. Major NCD (formerly called dementia) is sometimes mistakenly diagnosed when individuals are suffering from a reversible problem, such as anxiety, depression, brain tumors, and polypharmacy. The elderly take many drugs, sometimes with uncertain side effects.

Older and Wiser

  1. Many people become more interested and adept in creative endeavors, 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.

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