Chapter 23 What Have You Learned?

1. Question 23.1

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   Ageism, racism, and sexism are all forms of prejudice. Ageism is the idea that age determines who you are. Racism is the idea that race determines who you are. Sexism is the idea that sex determines who you are. They are all forms of stereotyping, which makes them social diseases that cause groups to treat each other based on superficial cues (i.e. skin color, sex, or age) rather than on personal qualities. All of them can lead to members of the stereotyped group accepting the stereotypes, to their own detriment. That can produce self-fulfilling prophecies and stereotype threat.

2. Question 23.2

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   While racism and sexism are not considered acceptable, ageism is not recognized as readily as racism or sexism even though it should be just as unacceptable. Parents protect their children from racism via racial socialization, teaching them to recognize and counter bias while encouraging them to be proud of who they are. However, when children express an ageist thought, few people teach them otherwise. Later on, their long-standing prejudice is “extremely resistant to change,” undercutting their own health and intellect.

3. Question 23.3

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   Ageism often seems complimentary or solicitous. However, the effects of ageism, whether benevolent or not, are insidious, seeping into and eroding the older person’s feelings of competence. The resulting self-doubt fosters anxiety, morbidity, and even mortality.

4. Question 23.4

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   An ageist culture assumes that the patterns of the young are ideal. Added to the problems caused by the ageism of the culture is self-imposed ageism, which reduces movement.

5. Question 23.5

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   Elderspeak, like baby talk, uses simple, short sentences, slower talk, higher pitch, louder volume, and frequent repetition. It may include patronizing terms such as “honey” and “dear,” or may use nicknames (e.g., Billy) instead of surnames (e.g., Mr. White).

6. Question 23.6

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   Instead of a pyramid, with a wider base (more infants, children, and teenagers) and a smaller top (fewer people 64 and older), the pyramid is becoming a rectangle. The age groups are becoming equal in numbers.

7. Question 23.7

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   The young-old, typically aged 65 to 75, are healthy, active, financially secure, and independent. Few people notice them or realize their age. The old-old, typically aged 75 to 85, suffer some losses in body, mind, or social support, but they can still care for themselves. Only the oldest-old, typically over 85, are dependent, and they are the most noticeable.

8. Question 23.8

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   Primary aging: With age the heart pumps more slowly and the vascular network is less flexible, increasing the risk of stroke and heart attack. Secondary aging: A high allostatic load can increase the likelihood of heart disease.

9. Question 23.9

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   Primary aging does not directly cause illness, but it makes almost every disease more likely. Secondary aging: A high allostatic load and genetic factors such as being female can increase the likelihood of type 2 diabetes.

10. Question 23.10

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    For most of human history, when people died at much younger ages, most died of acute illness—e.g., heart attack, blood poisoning, and typhoid. Chronic illness is the major medical challenge facing the elderly now.

11. Question 23.11

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    The day–night circadian rhythm diminishes with age. Many older people wake before dawn and are sleepy during the day. Compared to younger adults, older adults spend more time in bed, take longer to fall asleep, and wake more frequently during the night. They also are more likely to nap.

12. Question 23.12

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    New tests need to be designed that test judgment, reaction time, and peripheral vision. A national panel recommends simulated driving via a computer and video screen, with the prospective driver seated with a steering wheel, accelerator, and brakes. The results of this test could allow some 80-year-olds to renew their licenses, some to have their licenses revoked, and many to recognize that they are less proficient than they thought.

13. Question 23.13

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    Morbidity is the reduction of sickness before death. Ideally, a person is in good health for decades after age 65, and then, within a few days or months, experiences serious illnesses that lead to death. Years of frailty are avoided. Morbidity has been compressed even as mortality is postponed.

14. Question 23.14

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    Compression of morbidity is good for society and individuals because healthier people remain alert and active and do not become dependent and burden the healthcare system. Improved prevention, diagnosis, and treatment mean less pain, more mobility, better vision, stronger teeth, sharper hearing, clearer thinking, and enhanced vitality.

15. Question 23.15

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    Due to osteoporosis, a fall that would have merely bruised a young person may result in a broken wrist or hip in an elder. The fall then leads to morbidity, sometimes for months, especially when hospitalization and weeks or months of limited movement cause infections and stress.

16. Question 23.16

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    Only 10 percent of people of either sex over age 65 see well without glasses, but selective optimization allows almost everyone to use their remaining sight quite well. Changing the environment—brighter lights, large and darker print—is a simple first step. Corrective lenses and magnifying glasses help. For those who are totally blind, dogs, canes, and audio devices have for decades allowed mobility and cognition.

17. Question 23.17

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    Hearing impairment increases dramatically with age, and deafness is far more common in men than in women. Unfortunately, ageism leads elders to avoid hearing aids, leaving them to mishear until deafness is imminent. Ageism affects whether a society provides technological help. A dramatic improvement in the ability of deaf people to enjoy concerts, plays, museums, and so on results from a “hearing loop,” a small device in a room that enables people with hearing aids to hear the words or music they want, without the distracting clatter. Installing a loop requires someone to realize that it is worth the cost.

18. Question 23.18

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    Less sensitive touch in fingers and toes can lead to an elder overlooking injuries such as ingrown toenails and finger pricks until they become infected. Reduced bitter and sour taste reception can lead to excessive use of salt to boost the flavor of food, and a dampened sense of smell can prevent elders from smelling a gas leak, for example.

19. Question 23.19

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    The wear-and-tear theory does not account for many facts. Some body functions benefit from use. Exercise improves heart and lung functioning; tai chi improves balance; weight training increases muscle mass; sexual activity stimulates the sexual-reproductive system; foods that require intestinal activity benefit the digestive system. Thus, although the wear-and-tear theory applies to some body parts, few scientists now believe it explains aging overall.

20. Question 23.20

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    The genetic theory of aging does not provide a maximum human lifespan, but instead indicates that the genetic clock set in each person’s DNA determines, in conjunction with environmental factors, their personal lifespan. Genes seem to bestow on every species an inherent maximum lifespan, which in humans under ideal circumstances is 122 years.

21. Question 23.21

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    Common genes seem to trigger an early death. Almost every illness of secondary aging tends to occur in families, suggesting a genetic link. Hundreds of genes hasten the aging of one body part or another. Certain alleles directly accelerate aging and death. Secondary aging is part of the disease process, and many bad health habits correlate with specific genes that seem to push people to drink, drug, overeat, and so on.

22. Question 23.22

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    Societies need young adults to reproduce the generation and then need elders to die (leaving their genes behind) so that scarce resources can be devoted to the reproduction and rearing of the new generation.

23. Question 23.23

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    Toxins damage cells over time, so minor errors in copying accumulate. Eventually, the organism can no longer repair every cellular error, resulting in senescence. The longer that cells are exposed to toxins, the more they break down.

24. Question 23.24

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    The job of the cells of the immune system is to recognize pathogens and destroy them, but the immune system weakens with age as well as with repeated stresses and infections. Eventually the organism can no longer repair every cellular error, resulting in senescence.

25. Question 23.25

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    People might lie in order to gain attention for being a centenarian.

26. Question 23.26

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    Prejudice about late adulthood is common among people of all ages, including young children and older adults. There is no other group like the elderly about which we feel free to openly express stereotypes and even subtle hostility. Most of us believe that we aren’t really expressing negative stereotypes or prejudice, but merely expressing true statements about older people when we utter our stereotypes.