I. Psychological AspectsJames E. Birren
II. Social AspectsYonina Talmon
III. Economic AspectsEarl F. Cheit
Description and explanation of adult behavior as it evolves over the life-span is the subject matter of the psychology of aging. This includes the study of capacities, perception, learning, problem solving, feelings, emotions, skills, and social behavior as they emerge and change.
Types of age and aging. There are three kinds of aging: biological, psychological, and social. Although the psychology of aging may be studied without regard to biological and social forces, it is best viewed as both a biological and a social science, reflecting the fact that the way in which individuals are transformed over time is a function of a complex field of biological and environmental forces.
Biological age. Biological age refers to the present position of an individual relative to his potential life-span. Research on the biology of aging is concerned with studying the processes that limit the life-spans of species and individuals, or with finding out why species and individual members of species have determinate lengths of life (Verzar 1963; Shock 1960). There is no consensus that the same factors limit the life-spans of different species. Although there is little doubt that the major factors must be genetic, their ultimate nature and the sequence of steps in their expression has yet to be described. The biological age of an individual is closely related to chronological age, but the two are not identical, since they are derived from different concepts as well as different sets of measurements.
Psychological age. Psychological age refers to the position of individuals relative to some population with regard to adaptive capacities as observed or inferred from measurements of behavior. Psychological age may also include subjective reactions to development. Although psychological age is related to both chronological age and biological age, it is not fully accounted for by the combination of these (Birren 1960).
Social age. Social age refers to the social habits and roles of the individual relative to his group or society. An individual’s social age is related to his chronological, biological, and psychological ages, but it is not completely defined by them. Within societies there are often elaborate age-status systems that lead to expectations of how an individual should behave in relation to others. The age-grading of expected behaviors is a long-evolving process in society, and it is only partly determined by the biological and social characteristics of individuals at a given age (Tibbitts 1960).
In all three aspects of aging—biological, psychological, and social—the adult seems to develop or change in characteristically orderly ways. But as a result of many random events, these transitions are uniform but vary around the average trend for some defined population. The idea that individuals develop and age with variations around an average trend was a powerful conceptual innovation of the early nineteenth century.
Historical background. With the growth of science in the nineteenth century it became apparent that how long and how “well” man lived his life were matters for systematic observation. Although profound philosophical views had been set forth earlier, research on the psychology of aging began with the work of Lambert Adolphe Jacques Quetelet in 1835 and was further advanced by Francis Galton in the last quarter of the nineteenth century [see GALTON; QUETELET]. G. Stanley Hall brought attention to the subject by his book Senescence (1922), which is useful as a source of ideas and references. Hall (1922, p. 100) recognized the superficiality in regarding aging as the inverse of development and, despite his specialization in child psychology, struck an independent note, suggesting that older people, like adolescents, have unique psychological processes, which probably exhibit a higher degree of variability than do the functions of youth [see HALL].
Around this time, studies of the spontaneous activity of rats suggested that there was a reduction in drive with age (for references see Birren 1961). The topic aroused less interest in the 1930s, but more recently Anderson (1956) has reasserted the significance of studying age differences in activity level and has suggested the roles of both acquired motivational influences and biological effects.
Mental tests developed just before World War i, used for classifying recruits, showed age differences in test scores that had to be explained if one were going to take seriously what such tests purported to measure. These findings began a continuous line of research to the present day.
In Vienna during the 1930s the work of Charlotte Buhler and Else Frenkel-Brunswik was taking a philosophical turn, an approach that considered man more holistically than did contemporary experimental studies (Buhler 1961). Buhler and her students studied age changes in values and the progression of individuals toward their life goals as revealed by biographical studies. Since 1946 the process and problems of aging have received considerable attention from government and research agencies and from the behavioral sciences.
Approaches and problems. The psychology of aging can be approached as a basic field of knowledge and research; as a way of testing ideas or hypotheses from other areas of special interest, such as perception, learning, or personality; or as an application of psychological knowledge to the problems of older persons, since older persons are in an unfavored position in society and generally after mid-life there is an increase in social and medical problems.
One should distinguish in the older population those characteristics that do not necessarily affect the entire population and those that are so typical of the age range that they can be viewed as developmental, or aging, in nature.
Social problems. The social problems of older persons include income maintenance and employment, housing, medical services, social mobility, and opportunities for compatible interpersonal relations. Aged persons tend to have low incomes and little accumulated wealth and are therefore in a poor position to maintain their standards of food, clothing, housing, and social amenities. In addition, poor health and sensory defects frequently limit social mobility, resulting in a still further lowering of the standard of living.
There tends to be a high interaction on older populations of economic, health, and psychological factors. For example, the young adult who is cured of an illness may return to his original environment with the expectation that he will resume his pattern of living. The older person, discharged from a hospital, more commonly cannot return to his environment with the same expectation that he will resume his previous pattern of living. Many factors, including those of social isolation, transportation, and the need for supporting services (housekeeping and meals), form a complicated matrix of forces in which the older person is embedded and which limit his choices of behavior. Social and medical services are most commonly organized according to patterns that best serve the child or the young to middle-aged adults, although many countries and communities are beginning to organize services for older persons, taking into account the more highly interdependent social, psychological, and physical environment of the older person. The situation is in some respects like that of the young child, although the child’s dependency is focused on the parents. There is often no similar major focus of responsibility for the older adult in relieving the effects of social deprivation and disease.
Health problems. Health statistics define important aspects of the psychological context of older persons. The number of older persons (over 65) classified as deaf or blind is 10 to 50 times greater than in the young adult group. The number of days of restricted activity because of medical problems rises markedly after age 65. One survey by the U.S. Public Health Service (1959) reported that about 13 per cent of those in the 45 to 54 age range have some limitation of activities compared to 55 per cent over the age of 75. More than half the persons over the age of 65 actually have two or more sources of limitation of activity.
Statistics from examinations of men called for military service in World War II show a relation between age and rejection for service. Nearly 18 million men were given examinations for military service by the U.S. forces between 1940 and 1945. If the number of totally disqualified men and men with limited or remediable defects are added together, the total percentage of rejected men 18 to 20 years old was 29.3 per cent, whereas for men aged 38 to 44 the rejection rate was 64.7 per cent (Goldstein 1951).
Not all of the age changes in health and fitness are a result of biological changes of aging. An analysis of selective service statistics suggests the importance of regional and social class differences. Some factors, such as the chronic disability resulting from accidents, vary with exposure, which in turn varies with occupation and social class. Other factors in the social context of the individual not only contribute to the occurrence, but also enlarge upon the consequences, of adverse events because of inability or failure to take remedial steps. The social context of the individual is both a cause of and a result of his biological characteristics and health. The capacity of the older individual to cope with disabilities common to older persons depends upon his educational level, lifelong styles of behavior, and the supportive level of his present environment. Membership in the lowest social classes of society is associated with a higher than average likelihood of joint adverse factors involving physical and mental health, educational opportunity, income, and marital and family relationships.
The number of days of disability for families with incomes under $2,000 was found to be 29.9, compared with only 13.0 days per year for those with incomes of $7,000 or more (U.S. National Center for Health Statistics 1963). Since most persons over 65 have reduced incomes, they must make compromises with their previous standards of living, including that of health maintenance.
Although age is related to vulnerability to adverse environmental circumstances, adverse circumstances may also increase as a function of age. For example, bereavement affects death rates. Death of a spouse apparently significantly hastens the death of the survivor.
The life cycle
Some of the problems facing individuals are characteristic of their age level and may thus be looked upon as “developmental tasks.” The lifespan is marked by familiar epochs, or phases, giving rise to the notion of a normal life cycle of events. As adults move forward in time, they successively make educational and occupational choices, marry, have children, advance in occupation, and retire. It is often difficult to avoid viewing such events as problems, although from a developmental point of view they are part of the normal content of human life. All developmental tasks challenge the individual somewhat. However, with adequate adaptation or resolution of the challenges and dominant concerns of an age level, the individual becomes an increasingly more differentiated and competent person. The principle to be emphasized is that the adult, like the child, is always evolving to become a more differentiated individual.
The analysis of biographical material has suggested to some psychologists that there is a tempo or rhythm to adult life. Buhler (1961) examined biographies for various kinds of information and was led to the opinion that there were clearly demarcated phases through which every adult passes. In general these phases correspond to concepts of construction, culmination, and reduction. The change from striving to withdrawing from life has also been described as a process of “disengagement” (Gumming & Henry 1961). Given a reduction in energy, the individual may become a willing accomplice in the process of separation from active roles in society. Thus, life satisfaction in the very aged may improve with some degree of disengagement. The extent to which all older individuals withdraw from activities and retrench emotionally or affectively is not certain. Probably there are those who would gain in morale from more involved affective and social relationships in late life, just as there are those who gain from moving toward a less involved status. Implied here is the fact that the aging individual is a biological and behavioral system that is interacting with stimulation from a particular social environment. It must be added that the psychological capacities of the individual will limit his effectiveness in adapting to the continually emergent features of his life.
Changes in the psychological capacities of individuals over the adult life-span have been well studied. Occasionally, contradictory results have been obtained, apparently because of differences in the educational level or health status of the groups studied. Disease, particularly cerebrovascular and primary brain disease of late life, can seriously impair mental functioning and limit effective behavior. Presence of such afflicted persons in a sample distorts what may be regarded as the developmental, or normative, changes of aging. What constitutes adequate sampling in studies of aging is difficult to determine, since persons of different ages cannot be matched for many important background characteristics.
Sensory function. The changes in the central nervous system and in the peripheral sensory receptors and their specialized structures result in reduced sensory input with age. Thus, compared with young adults, the older person generally makes discriminations among stimuli of lower intensity. Another effect of the reduced sensory input may be the lowering of the total level of excitation imparted to the nervous system, thereby affecting the level of activity of the individual.
The different types of sensory receptors have in common their essential nature as neural structures or extensions of the nervous system. Thus the tendency toward generally reduced receptor efficiency may be based on the ability of cells of the nervous system to survive and function. In addition to sharing a common primary process of neural aging, receptors may exhibit deterioration in their specialized structures, such as the lens of the eye tending to become opaque (cataract) in many older individuals.
Speed and timing. One of the most distinguishing features of aging persons is their tendency to behave lethargically. Whereas young adults behave quickly or slowly in accord with the demands of the situation, older adults exhibit a generally slower rate of behavior. Slowness in the young adult can be thought of as a function of many factors, such as stimuli or signals that are weak or of low intensity, stimuli that are complex or ambiguous or unfamiliar, stimuli that are unexpected, and stimuli that tend to evoke conflicting responses. Responses that must be made in a sequential manner or responses in which the consequences may be inordinately great may be delayed until the individual feels the conditions are optimum. These factors affect the differential speed of response in older persons, too, but represent an impediment to behavioral speed in addition to a generalized tendency to slowness in the aged.
The generalized slowness of behavior in older persons is looked upon as being most probably an expression of a primary process of general neural aging. Explanations involve the loss of nerve cells, reduced neural excitability, physical-chemical changes at the synapse that limit transmission speed, and a lowered excitation resulting from changes in subcortical centers.
Although much has been learned about psychomotor speed and aging, not much is known about the modifying conditions that maintain an alert organism with a potential for precise and rapid response. Thus, whether continuous high-level stimulation in later life will retard or advance psychomotor slowing is not known.
Slowness can be looked upon as a change dependent upon the more elementary processes in the nervous system, or it can be examined with regard to its consequences for behavior. In the latter view, the slowness of advancing age comes as close as does any identifiable process to being an independent variable. That is, slowness defined as a minimum operations time in the nervous system can be used in turn to explain other psychological phenomena of aging. One consequence of the slowing-down process is that the individual is limited in the amount of activity or the number of behaviors he can emit per unit of time.
To some extent the psychomotor slowness of older persons may be affected by a depressive mood, although a heavy lethargic mood may be superimposed on a pre-existing slowness. Depression of affect is not an adequate explanation for the slowness of advancing age, although it can be a factor that amplifies its consequences.
The older person adapts to his slowness by avoiding situations with unusual time pressures. Slowness itself can be in part a manifestation of adaptation. As the individual becomes less sure of himself in walking, fearing the consequences of a fall, he may tend to slow his movements considerably. Also, with a reduction of activities in later life slowness may accompany adaptation to the level of stimulation of the environment. Long-term adaptation to a characteristic level of activity may result in the speed of response becoming fixed so that increased stimulation will not reinstate the previous limits of behavior. The view that the organism is reacting to a changing environment must be balanced with the view that the organism is also a self-activated system that may change over time and show a reduction in the number of behaviors emitted per unit time. Limiting the number of behaviors that can be emitted per unit time is a function of the central nervous system, a basic process that appears to change with age.
Psychomotor skills. Over the years of employment, individuals develop work methods and by so doing simplify their tasks. The inexperienced worker is apt to be working near the limits of his physiological capacities. With experience, compensations are developed by the individual so that limitations on performance are circumvented or minimized. There is thus no one-to-one or simple relation between complex occupational or athletic skills and specific physical or physiological capacities.
Older workers tend to drift from jobs requiring continuous activity under paced conditions. This confirms the evidence from experimental studies that slowness of perceptual and motor processes is a basic correlate of aging of the nervous system. Over the usual years of employment, there is generally a reduction in accidents resulting from failure of judgment and an increase in accidents involving rapid evasive movements or falls.
Much of the evidence from industrial studies indicates that little change in worker performance is found up to age 60–65. How definitive these facts are is uncertain, since older workers who have managed to survive are a highly selected subpopulation from a total initial population. Except for individuals with cumulative injuries or problems of health, worker performance up to age 60 should be little influenced by physiological changes in aging. Exceptions are instances where time pressures are great.
The individual’s adaptation to his working conditions, as well as his own capacities, is significant for his total effectiveness. Few studies have attempted to measure long-term consequences of practice and experience on psychomotor skills. From laboratory studies and data on athletes, it is known that from about age 40 there is commonly found a reduction in such capacities as strength and sensory acuity and an increase in reaction time. The individual’s limits are not often taxed in occupational performance, however, and tend to be well counterbalanced by experience and better work methods. Capacities change so gradually that adaptation is an almost unconscious process. When dramatic changes in skills occur they are likely to be the result of injury or disease with accompanying neurological damage. It is perhaps only after age 70 that the individual’s skills show a quality of being “old,” primarily because of the slowness of action and the tendency to work according to an internal tempo rather than to an external pace. Some researchers believe that individual differences in skills increase in persons over age 70, so that group averages or norms are less useful than they are for younger persons. Individual differences in rates of aging, specialization of experience and skills over the life-span, and consequences of diseases and injuries, including sensory defects, make the increased range of individual differences a likely and important fact, although there are not many data on the matter.
Learning. The evidence that has been accumulating on both animal and human learning suggests that changes with age in the primary ability to learn are small under most circumstances. When differences do appear, they seem to be readily attributed to processes of perception, set, motivation, and the physiological state of the organism, including disease states, rather than to a change in the primary capacity to learn. There has been a general tendency since the work of Edward L. Thorndike in the 1920s to advance continually the age at which subjects in learning research are regarded as aged. At the present time there is little evidence to suggest that there is an intrinsic age difference in learning capacity over the employed years, i.e., up to age 60. This is not to say that learning of certain psychomotor skills may not show limitations in older persons because of problems of performance or speed limitations, or of lifelong habits that usually elude laboratory study. Clearly, further studies are needed to indicate the optimum conditions for adult learning over the life-span. These include studies on the optimum massing or distribution of practice; the focusing of attention and set; and the re-employment of learning strategies by the older subject, which may have fallen into disuse during the long years since schooling.
Because of the rapid changes in industry, particularly those brought about by automation, occupations change rapidly. Some jobs are eliminated and new jobs are created. Generally, the new jobs emphasize control over production rather than primary productive skills; hence automation brings with it an emphasis on abstract learning rather than on psychomotor skills. Training and retraining is becoming a commonplace characteristic of adult employment. It is expected that increasing information about adult learning and the conditions that best facilitate it will be provided by industrial studies of learning. Attitudes will change still more as training becomes an accepted feature of a work life in which individuals spend more time in training and less time in direct production. Through the work life, years-of-schooling is a more important variable than age in relation to learning.
Intelligence and problem solving. Problem solving involves many component abilities, each with a limit that may change with age. The changes with age in component abilities are both incremental and decremental, and some show almost no change over the adult years. Generally, the amount of information possessed by an individual rises over the life-span. The extent, then, to which a problem contains familiar elements determines whether it will be solved more efficiently by the old adult in comparison with the young. If a problem emphasizes perceptual capacity or retention of instructions, the young adult will probably perform more effectively. It seems plausible that the adult enlarges his repertory of ready-made solutions over a lifetime and becomes more effective by virtue of them. The mode of addressing a problem thus tends with age to be one of searching within the existing repertory of responses rather than one of generating novel approaches. Age, therefore, brings with it not only differential changes in component mental abilities but involves the adaptions of the individual to problem-solving situations.
Rigidity is a descriptive term referring to a tendency to hold to a particular point of view and to resist change when the situation suggests that change is appropriate. In older adults most rigidity in problem solving seems to lie not in attitudes per se but in changes in abilities. Rigid behavior can result from disease and brain damage occurring with age. Thus, a population of individuals over the age of 65 years is a mixture of those who have limitations of mental abilities because of somatic disease affecting the brain and those who are relatively healthy. Up to about age 65 the number of years of education shows, in the relatively healthy, a greater relation to mental abilities than does chronological age. Furthermore, healthy individuals over the age of 65 will tend to perform better than young adults on certain mental tests, such as vocabulary, comprehension of verbal statements, and arithmetic operations, and they will perform more poorly than young adults on tests involving spatial perception and rapid decoding of information. Because of these differential changes with age no simple answer can be given to the question of whether problem solving and intellectual capacity rise or fall over the adult years.
Longitudinal studies of mental abilities indicate that some individuals decline rapidly in abilities over a short period of time, reflecting changes in health. If many such persons are included in a sample, the averages will show gradual decline, when in fact the results are a mixture of two populations: those who are stable in their abilities and those who decline abruptly and seriously. In statistical terms this means that changes in ability in later life are not randomly distributed, but that, with age, there is an increasingly skewed distribution of abilities.
Several studies show that the likelihood of survival is related to mental-test performance. The probability of survival is less in the persons showing drops in test performance. This seems reasonable, since the performance of psychological tests is a function of complex activity in the nervous system. Such activity may be particularly sensitive to disturbances in blood flow to the brain, arteriosclerosis, and loss of cells in senile brain disease. A new field of research is emerging, concerned with behavioral measurements that identify persons who have latent or active somatic disease and that show the relations of mental abilities to brain damage in later life.
Tests of mental ability have been criticized as being inappropriate for use with older adults because much of their content was developed for young adults and children. Intelligence tests for children are used mostly in school-like situations for the prediction of school success. No such simple criterion of adult intelligence can be agreed upon, and in general adult intelligence is difficult to define. The term has meaning in a particular context, such as occupational training, vocational guidance, or medical diagnosis and therapy. Measurements of behavior will increasingly have to indicate the extent to which particular areas of the nervous system and the body are involved in a disease process limiting social effectiveness.
As progress is made in research on the analysis of logical problem-solving behavior of persons over a wide age range, it will be possible to specify the individual differences in the sequence between some problem input and the resulting solution, or behavioral output. These sequences will no doubt be found to differ with age between the healthy person of high initial ability, with good education and supporting environment, and an individual of poor health, of low initial ability, with poor education and an unsupporting environment. At present there are only intimations about the nature of these efforts.
With advancing age there are reductions in drive level, including spontaneous physical activity and sexual behavior. Studies of many kinds of activities have shown a tendency toward declining social activities and interpersonal relationships. This has given rise to concepts of psychological and social disengagement. To some extent social role decline is initiated by the environment placing the individual in a less engaged position, e.g., retirement or the death of the spouse. In addition, there is an affective detachment from the environment, in which older persons have less ego involvement in their roles and activities. Students of personality and aging have described this as partially a consequence of a reduced “ego energy.”
Generally, personality traits are more variable over the adult years than are mental abilities; however, some traits, like those of personal values and vocational interests, are relatively stable, whereas self-regarding attitudes change markedly. Studies of personality traits in relation to age and intelligence indicate that age is less important than intelligence in the personality adaptations over adult life. An important qualification must be made, however, in that nonverbal intelligence becomes highly correlated with psychomotor speed in older adults. Reflected in these three aspects of the individual—psychomotor speed, nonverbal intelligence, and personality adaptations—may be a factor of central nervous system change. What the student of personality observes at one level and calls “ego energy” may at another level be measured as psychomotor speed.
The possibility exists that there is physiological registration of the effects of psychological events of later life, just as there are physiological or somatic changes with behavioral consequences. This does not imply either a complete persistence or a complete fluidity of behavior. There are relative fixations of habit systems and physiological adaptations that make the older adult a more differentiated organism than the child. Changes with age in the environment and within the individual continually provoke further differentiation of behavior. There is always some environment that is optimum for the age and state of a particular organism.
Changes in interests and activities of adults reflect the changing position of the older adult in his environment as well as his motivations and long-established patterns of behavior. The habit systems that are built up in the individual over time impose controls over the behavior elicited in response to somatic changes in internal drives and external stimulation. One stable element in the choices of behavior is personal values, although these too may be modified or superseded if the cognitive load placed on the individual becomes excessive, or if the values are in dramatic conflict with the changes and drift in the content of the individual’s life. The adaptive person modifies his behavior over time, thus “aging successfully.” The internal habit systems that promote adaptation are not fully known. Apparently, successful adaptation may be brought about by quite different and almost opposite types of personality organization.
The attitudes of an aged person toward “old people” may be differentiated from his attitude toward himself in growing old. In general, the selfconcepts of older subjects contain negative feelings of self-worth, although older persons living independently may regard themselves somewhat less negatively than do the institutionalized aged. This suggests that the personal circumstances of the individual over the age of 60 tend to be more important in determining his attitudes and his level of functioning than is his chronological age.
There are many issues to be explored more fully in relation to aging, such as what happens in late life to the early-life compulsive neurotic. It has been shown that schizophrenic patients may develop senile mental disorders; the superimposition of aging and senile brain changes upon early-life psychosis may reveal something about the basic processes of each. Similarly, it will be useful to know what happens to the homosexual in late life, as drives slacken, and to know what happens in late life to those men and women who have had excessively strong sexual drives, erotomania. Improvements in research methods can now lead to better distinctions between the transient emotional states and moods and persistent symptoms that appear in such regular form that they are found to constitute a syndrome. It seems likely that new syndromes will be identified in the older population as the normal psychology is better defined and understood and as more detailed attention is given to older deviant individuals. Knowledge in this area is far from static, and it is to be expected that finer discriminations will continually be made among the mental problems associated with advancing age.
Maladjustment. Many forms of deviant behavior and mental illness change in their frequency with age. The changes in the relative frequencies of forms of socially deviant behavior suggest that with age there are shifts in the motivation to act as well as in the controls over behavior. Rape tends to be a young man’s crime; only 7 per cent of men arrested for rape are over 40. Arrests for exhibitionism, by contrast, are greater with age. In terms of arrests, younger men steal automobiles and older men deal in stolen property or engage in embezzlement and forgery. Property offenses tend to be related to unemployment, but unemployment affects younger and older men differently: crime in the 25 to 35 age group rises with unemployment and declines in those over 35 (U.S. Federal Bureau of Investigation 1963).
Suicide rates rise greatly and consistently with age in men; it is higher for whites than nonwhites. A sex difference is also seen, with women’s suicide rates showing a slight rise in the middle years and then a decline after 60. Illness and physical infirmity seem to play a precipitating role in suicides. The large age, sex, and white-nonwhite differences in suicide rates indicate that the social environment as well as personal values is of major importance. The violent modes of suicide chosen by older men leave little doubt of their serious intent, in contrast to more ambivalent suicide attempts of younger persons.
Although patients with mental diseases associated with later life constitute the largest group of first admissions to mental hospitals, they do not constitute the largest group in the hospitals, for their death rates are high. Schizophrenic patients tend to remain in hospitals longer (average 10 years) than do senile patients (average 2.5 years), most of whom die in the hospital. Relative to the total population, few persons over 65 become mental hospital patients—only about 1 to 2 per cent (Confrey & Goldstein 1959). This figure, however, does not fully represent the frequency of mental disorder in the older population. Populations differ in their capacity to tolerate the older deviant person, although in general the community is more permissive with deviant behavior of older than of younger persons. The widowed, single, and divorced occupy many more beds in institutions than do married persons. Thus, social isolation is a factor in the likelihood of institutionalization.
Circulatory impairment and senile brain deterioration occur both separately and together in older patients. Studies indicate that advancing age is not necessarily related to a reduction in blood flow to the brain. Other studies show that the type of brain deterioration is related to the kind of symptoms shown by a patient, but that mixtures of organic and functional factors are frequently found. Diagnosis tends to be multiple in the older person, with interaction taking place between somatic and mental illness and the social environment throughout the course of the illness. Physical factors are being increasingly recognized as having functional consequences in older persons, not only in depressive affect, which may lead to suicide, but also as factors in precipitating mental disorder.
More emphasis is being given to mixed etiology in mental illness in older persons, and fewer persons have symptoms that are regarded categorically as either functional or organic in background. It is expected that additional disease patterns in the older population will be defined as research methods now available are applied to representative samples of the populations as well as to selected clinical groups. As more knowledge of the normal psychology of aging is acquired, the treatment of the older patient will become more specific and more rationally based.
As the average life-span of modern man has increased, the amount of time spent outside the labor force has increased more than the amount of time spent in it. The length of time prior to entering employment has increased, but more dramatic has been the increase in the length of retirement, which has doubled. This creates a special problem; the individual must earn a sufficient income during the work life to provide for a longer retirement. Since retirement incomes are generally low, the standard of living drops, and the need for income to subsist and maintain previous activities is a primary concern for most older persons. It is not likely that there will be a reversal of the trend toward decreasing employment of older persons, for their employment would in many instances necessitate competition for jobs with young adults.
In periods of high technological change, older persons and those with less education tend to be dropped from employment. Industrial trends are such that education and continuing training through the employed life are becoming characteristic. The distinction between working and training is less clear than it once was. Previously, the worker trained before entering the labor market; now, there is continuing on-the-job training as industrial processes are modified. Older workers tend to have obsolete skills, and the basis for unemployment among older workers is technological change rather than the worker’s lack of capacity. Because of the work orientation of society, the transition to free-time activities is not easy. Along with the expansion of leisure-time activities there exists a need for a reorientation in attitudes toward the uses of time; the meaningful use of free time in retirement can be a major problem of personal values.
Past generations of scientists and scholars tended to show peak productivity in the age range 30 to 40 years. Major contributions to mathematics, chemistry, and physics tend to come earlier in life than do those in medicine and philosophy. While sustained productivity in most learned fields occurs over the life-span, the most notable works appear to be produced by individuals in their thirties. Not much is known about scientific and artistic achievement by women, because few women entered these fields until recently and women often do not indicate their ages in their biographies.
Athletic achievement in sports declines by age 45 to a level not reached until age 70 in the sciences. There seems some basis for accepting the general view that physical capacities develop and decline earliest and that psychological capacities develop later and permit high-level achievements during most of the usual employed life-span. Social skills mature latest and in individuals in good health in a favorable environment are maintained at a high level throughout the life-span.
Total family income is at peak in the mid-fifties, suggesting that income trails somewhat the age of maximum productivity and the age of maximum need. What effects the current emphasis on education and research will have on productive careers and life achievement are not apparent. The effects of age and social climate probably differ, depending on whether the motives underlying employment are income, recognition, achievement, or desire for knowledge. A change in the social climate is giving increasing emphasis to maximum self-development, particularly through education, in contrast to the older ethic of work, which held that it was more moral to “work” hard than to study hard. Because of conflicts with earlier formed attitudes, older adults necessarily show some lag in responding to evolving attitudes toward education, work, and the uses of free time.
Last stages of life
At the end of life, early-life events may be evoked with surprising recall. Some time before the terminal stages of life an individual may become involved with a review of his life. Individuals react differently to the stimulus provided by the indications that life may be ending: some may deny it, some may react passively, and others may welcome it without reflection. Many people become involved in varying degrees in reexamining their lives in the face of an uncertain future. The life review is an active or purposeful examination of the events of one’s life accompanying an impression of impending death. The intent of the life review is to reconcile one’s values with the behaviors of one’s life and to leave behind an acceptable image.
At present there is not much systematic research on reminiscing and the life review, so it is not possible to contrast individuals and experiences in a quantitative manner. This facet of the psychology of aging will, no doubt, become increasingly recognized. As more information becomes available, professional services for the aged will become more constructive.
Meeting and coping with frequent bereavement is one of the particular tasks of old age. Individuals learn to manage their grief by many devices— some by diverting their thoughts or avoiding provocative situations, others by developing abstractions of life principles.
The experience of loss is, of course, lifelong, and one of the elements of maturity is the management of the reactions to loss and the resumption of acceptable behavior.
The dying person has four tasks: (1) managing his reactions to the symptoms of his terminal state and altered physiology; (2) reacting to the impending separation from loved ones and friends; (3) reacting to a transition to an unknown state; and (4) adjusting his perception of his life.
Because of the frequency of deviant reactions in later life and the dramatic circumstances surrounding the end of life, the late years of life tend to be clouded in an aura of pathology, somatic and psychic. Terminal decline should be separated conceptually from the normal adaptations to living in the later years. Centenarians need not be debilitated but often have reasonably good health and mental lucidity. The normal psychology of later life is becoming understood, leading to expectations for successful adaptations for most persons. As further research is done on the relations of psychological, physiological, and social changes in later life, the characteristics which promote optimum adaptations should become better known.
The psychology of aging has as long a history as other areas of psychology, but the impetus to research and the organization of information did not come until recent years, with the increase in the percentage of older persons in Western societies. The subject is one of basic research and of application. Surveys indicate that older persons tend to be in a disadvantageous position in society with regard to income and services. Much of current research shows an awareness of the fact that aging is jointly a psychological, biological, and social problem. It seems very likely that most countries will increasingly organize social and medical services for older persons, taking into account the fact that biological, social, and psychological problems show greater interdependence in older than in younger adults.
The pattern or scope of research that is most relevant to aging is multidisciplinary, having an emphasis somewhat contrary to research in other areas of psychology, which tend to stress segmentation of problems within narrow conceptual systems. One deterrent to the study of the psychological aspects of aging has been the wide scope and complexity of variables that are relevant to how long and how well individuals live.
A recent development in the field is the reporting of longitudinal studies of adults; longitudinal data have even been collected on senescent oneegg twins. Although the major approaches and ideas in the psychology of aging have in the past come from other areas of research, there is evidence that theory and methods special to the psychology of aging are emerging.
The individual life with its contents and processes is the basic unit of reference for psychology as a science. In the past little recognition was given by investigators in other areas that age is one of the most pervasive of variables, and research was done on a hypothetical age-constant organism. Probably no psychological law can be properly stated without qualification in terms of the reference group in mind. One of the contributions of the psychology of aging to general psychology and the social sciences is that of providing a context within which to fit diverse research findings, i.e., a developmental psychology of the life-span.
James E. Birren
Anderson, John E. (editor) 1956 Psychological Aspects of Aging. Washington: American Psychological Association.
Birren, James E. (editor) 1960 Handbook of Aging and the Individual: Psychological and Biological Aspects. Univ. of Chicago Press.
Birren, James E. 1961 A Brief History of the Psychology of Aging. Gerontologist 1:69–77, 127–134. → Contains a bibliography.
Birren, James E. 1964 The Psychology of Aging. Englewood Cliffs, N.J.: Prentice-Hall.
Buhler, Charlotte 1961 Meaningful Living in the Mature Years. Pages 345–387 in Robert W. Kleemeier (editor), Aging and Leisure. New York: Oxford Univ. Press.
Confrey, E. Q.; and Goldstein, M. S. 1959 The Health Status of Aging People. Pages 165–207 in C. Tibbitts (editor), Handbook of Social Gerontology. Univ. of Chicago Press.
Gumming, Elaine; and Henry, W. E. 1961 Growing Old. New York: Basic Books.
France, Centre National de la Recherche Scientifique 1961 Le vieillissement des fonctions psychologiques et psychophysiologiques. Colloques internationaux, No. 96. Paris: Éditions du Centre. → Contains English translations of the papers, and summaries in both French and English.
Goldstein, M. S. 1951 Physical Status of Men Examined Through Selective Service in World War II. Public Health Reports 66:587–609.
Hall, G. Stanley 1922 Senescence: The Last Half of Life. New York: Appleton. → Contains a discussion of early philosophical views about aging.
Havighurst, Robert J.; and Albrecht, Ruth 1953 Older People. New York: Longmans.
Journal of Gerontology. → Published quarterly since 1946 by the Gerontological Society. Contains current psychological research on aging.
Kuhlen, Raymond G. (editor) 1963 Psychological Backgrounds of Adult Education. Papers presented at a Syracuse University conference, October 1962. Chicago: Center for the Study of Liberal Education for Adults.
Kutner, Bernard et al. 1956 Five Hundred Over Sixty: A Community Survey on Aging. New York: Russell Sage Foundation.
Lehman, Harvey C. 1953 Age and Achievement. Princeton Univ. Press.
Shock, Nathan W. (editor) 1960 Aging: Some Social and Biological Aspects. Symposia presented at the Chicago meeting of the American Association for the Advancement of Science, Dec. 29–30, 1959. Washington: The Association.
Tibbitts, Clark (editor) 1960 Handbook of Social Gerontology: Societal Aspects of Aging. Univ. of Chicago Press.
Tibbitts, Clark; and Donahue, Wilma T. (editors) 1962 Social and Psychological Aspects of Aging. New York: Columbia Univ. Press.
U.S. National Center for Health Statistics 1963 Family Income in Relation to Selected Health Characteristics, United States. Vital and Health Statistics, Series 10, No. 2. Prepared by Robert R. Fuchsberg. Washington: Government Printing Office.
U.S. Public Health Service, National Health Survey 1959 Impairments by Type, Sex, and Age; United States, July 1957–June 1958. Health Statistics, Series B, No. 9. Prepared by Louise E. Bollo. Washington: Government Printing Office.
Verzar, Frigyes 1963 Lectures on Experimental Gerontology. Springfield, 111.: Thomas.
Welford, A. T. 1958 Ageing and Human Skill Oxford Univ. Press.
Williams, Richard H.; Tibbitts, Clark; and Donahue, Wilma (editors) 1963 Processes of Aging: Social and Psychological Perspectives. 2 vols. New York: Atherton.
Old age is the last phase of the life cycle. The timing of this phase, its impact on role relationships, and the meaning attached to it vary in different societies and in different subgroups within any given society. Differentiation in this sphere is effected by a complex combination of demographic, economic, social, and cultural factors. In industrial societies, falling death rates and decreasing birth rates have resulted in a considerable aging of the population. While the maximum span has changed very little, if at all, and the range of variation of the percentages of old people in various countries is still wide, there is a strong over-all upward trend in the average length of human life (Sauvy 1963).
Paradoxically, there is an inverse relationship between the demographic weight of aging people and their position in society. In most societies with a low proportion of old people, the aged are revered, whereas steady increases in the population of the aged impose an increasing burden on the younger age groups and engender a negative image of aging. However, the effect of demographic weight is not wholly negative; the growing proportion of old people in the population enhances their political importance.
There is a direct relationship between a society’s level of productivity and the welfare of its aged. Societies that live at the edge of starvation find it difficult to maintain old people and often revert to the solution of abandoning them or putting them to death. At the other extreme, only highly productive systems can allow early retirement and provide adequate pensions. It should be noted, however, that when we shift the emphasis to the usefulness of their working capacity, the relationship between productivity and the position of the aged is reversed: low productivity tends to preserve the marginal utility of increments of labor, whereas high productivity and technological advance engender a labor surplus and older workers become increasingly redundant.
In economic systems where ownership rights are vested in the aged, the aged control to a considerable extent the life chances of the young and thereby command their assistance and deference. The time and the manner in which property rights are transferred from one generation to the other have far-reaching repercussions on the relations between old and young. Limitation of property rights, separation between ownership and control, and the proliferation of open opportunities for the young undermine the authority and autonomy of the old.
The extent of development of a market economy and the extent of bureaucratization also affect the position of the aged. Recruitment to work in a premarket economy is ascriptive, whereas the policy of recruitment in a market economy is based on tests of competence and competition that put the partly disabled older worker at a disadvantage. Nonbureaucratic institutions are flexible and can adapt their internal division of labor to suit the changes in capacities and needs of the available workers. Bureaucratic organizations have standardized and highly coordinated work routines and find it hard to vary their job requirements in order to adjust them to personal capacities and needs.
The impairment of skills by age does not proceed at the same rate for all occupations. Other things being equal, the capacity to perform tasks requiring a high degree of physical strength or coordination begins to decline much earlier in life than the capacity for decision making and administration; indeed, the seasoned executive is likely to be at his best around middle age. Yet the strain of executive life is bound to have a more or less corrosive effect. Far better suited to the capacities of aging people is the performance of such “integrative” societal roles as that of judge or religious functionary, since these involve concern with long-run considerations and guardianship of cultural traditions. It should be noted, however, that the developmental patterns of the different capacities are not determined solely by physiological processes and that health care and continuous training can maintain a high level of capacity and postpone gross disability considerably.
Finally, the function of the aged as bearers and transmitters of the techniques, knowledge, and skills of their society depends to a large extent on the rate of technological and social change in their society. Slow change puts a premium on accumulated knowledge and long experience; it makes possible an age-graded role allocation, which shifts older people to positions that are less arduous and exacting and yet are of central importance in their society. Conversely, rapid and pervasive change undermines their importance.
The position of the aged is strongest, and they are best protected, in kincentered societies. Corporate kin groups are based on lineal intergenerational continuity; within them, the old occupy positions of authority and serve as crucial intermediary links. Intergenerational living arrangements supply them with direct contact with the young. Yet another factor is the extent of community integration of the aged, which depends on the localization and connectedness of the network of social relations and on the continuity of contacts over the life cycle. Thus lifelong, overlapping, and mutually reinforcing ties with kin, neighbors, friends, and former colleagues integrate old people into the community as a whole. The accessibility of significant persons and service institutions is an important feature of such communities. Since old people become increasingly dependent on their immediate environment, they are usually at a disadvantage in urban communities, where the networks of informal relations are typically loose and where vital associations usually lie outside the local neighborhood.
Closely related to the factors discussed so far, but partly independent of them, are certain basic orientations and value premises that affect the predominant view of the aged in any society (Parsons 1960). First, the extent to which old age is valued in any society depends partially on its dominant time orientation. In past-oriented societies, the aged are meaningful links to tradition and ensure historical continuity. Their role is particularly important in societies where continuity has a religious connotation; they serve as direct links to or even as incarnations of divine powers in societies based on ancestor worship. A presentorientation centers on short-range concerns and devalues old age. An even more radical devaluation of old age is inherent in a forward-looking orientation, which stresses innovation and progress.
Partly independent of the location of the dominant time dimension is the extent of differentiation of the phases of the life cycle. Life may be viewed as an orderly succession of distinct phases, each posing its distinctive developmental dilemmas and tasks and each involving more or less clear, phasespecific normative injunctions and rewards. On the other hand, the view of life may be “fixated” on one of the life cycle phases, while the other phases are considered devoid of intrinsic interest or value of their own. A conception of life that is based exclusively on youth or middle age puts aging people at a serious disadvantage. Devaluation of old age coupled with lack of unequivocal normative standards undermines the ability of the elderly to adjust to the role transitions involved in aging.
Yet another important factor is an “otherworldly” versus a “this-worldly” orientation. An otherworldly orientation mitigates the onset of decline and the finality of death by projection to an afterlife or by an emphasis on a purely spiritual, nonterrestrial salvation; radical world rejection leads to glorification of death as the true goal of life. The awareness of time running short and the regret over physical deterioration are more acute when the prevalent culture emphasizes sensual enjoyment of material things and does not offer the consolation of life in the hereafter (Jeffers et al. 1962). Of crucial importance is the distinction between an emphasis on detachment or release versus an emphasis on active mastery. Adjustment to the role loss and contraction of activity entailed in aging is easiest when the dominant orientation encourages a passive and contemplative attitude toward the world and values highly detached meditation. Aging can be accepted with relative equanimity when the prevalent values legitimize release from duties, relaxation, and ego-gratification. On the other hand, adjustment to old age is most difficult and involves a serious reorientation when the value system puts the main stress on active striving and mastery of external reality; under these circumstances aging signifies being cut off from productivity and utility. Similarly, a cultural emphasis on achievement rather than ascription reduces the importance of seniority; social status becomes a function of ability, not of age. In an ascriptively oriented society, on the other hand, age progression is a major criterion of role allocation (Eisenstadt 1956).
Collectivism and individualism are also major orientations affecting treatment of the aged. The isolated individual is confined within the narrow limits of his life span and cannot see beyond it. The collectivistic orientation emphasizes the unity and continuity of the group as it evolves from generation to generation; thus the time perspective of the aging person is extended—the future of the group is also his future. The tendency toward individualism or collectivism affects the position of the aged in yet another way. The collectivistic orientation stresses the welfare of the group as a whole and emphasizes the interdependence of all its members. It fosters a binding sense of obligation toward those in need of support and encourages mutual aid and group action. Individualism stresses independence and fosters self-centeredness and self-sufficiency. It undermines the sense of moral duty toward the aged and hampers attempts to solve their problems by concerted action.
The position of the aged is thus dependent on a very complex combination of factors. One or another factor may be dominant in a given situation, but all of them have to be considered. Comparative research in this field has just begun; here it must suffice to say that the optimal balance between the forces that enhance the position of the aged and the factors that undermine it is in fact reached both in primitive societies that are well beyond the mere struggle for survival and in traditional agrarian societies (Fortes 1949). The most important mechanism operating in such societies is the transfer of the aged to the political and religious sphere; the young take over responsibility for work and welfare, but the old maintain over-all control. The injunctions to respect parents and old people in general are the pivot of the moral, jural, and religious systems. By contrast, processes of development in modern society have, on the whole, undermined the position of the aged. Aging leads to loss of status and control, and the prevailing negative image of old age is shared by both young and old (Tuckman & Lorge 1953; Barron 1953). However, there are many counteracting factors, and the balance is by no means wholly negative.
Aging and the modern kinship system
Demographic analysis of the family cycle reveals that the postparental stage has lengthened considerably and now lasts an average of 16 years (Click 1957; Nimkoff 1962). The relationship between spouses is determined by the key events which punctuate the process of aging: termination of child-rearing tasks, retirement, and dissolution of the marital bond by death. In the first phase of aging the main burden of adjustment falls on the wife, who loses her cardinal role while her husband is at the peak of his career. During the second phase the main burden falls on the husband, who loses his major role as a member of the occupational system and has to redefine his relationship with his wife. The process of aging therefore brings about a shift in the basis of solidarity between husband and wife, who move into a more equalitarian relationship with each other and with the world around them (Gumming & Henry 1961). The data suggest that couples react to this shift either by a rapprochement or by increasing estrangement. The departure of the children is sometimes followed by a period of renewal and intensification of attachment that is experienced as a second honeymoon. It should be noted, however, that the pattern of estrangement predominates. Examination of marital satisfaction over time in a large sample of families in Detroit (Blood & Wolfe 1960) indicates that marital satisfaction reaches a low point at the stage of unlaunched adult children, rises somewhat in the beginning of the postparental stage, but declines again after retirement.
As in earlier stages, segregation between aging husband and wife varies directly according to the connectedness of their social network and is most marked in couples with close-knit kin and community ties (Bott 1957). A study of a working-class suburb in London (Young & Willmott 1957) indicates sharp segregation and growing estrangement between aging spouses; the close relationship of the wife with her children and kin takes clear precedence over her relationship with her husband, and retirement of the husband engenders considerable tension. In an attenuated form, estrangement also appears among more mobile middle-class couples. Research on a primarily middle-class sample in Kansas City reveals that there is surprisingly little emphasis on the relationship with the spouse and that, especially for the wife, the parent-child and sibling bonds seem to override it (Cumming & Henry 1961). There is considerable evidence that in spite of the fact that widows face more serious economic problems than widowers and in spite of the greater centrality of the familial role for the wife, aging women overcome the shock of bereavement more easily than men (Townsend 1957; Marris 1958; Cumming & Henry 1961).
The parent-child relationship
Recent research indicates that in spite of the considerable intergenerational discontinuity brought about by processes of accelerated change, the parent-child bond is of crucial importance during the process of aging. Scrutiny of actual living arrangements suggests that, although the prevalent ideology emphasizes separation and independence, about a third of the people over 65 who have children live with one of them. The over-all trend, however, is one of decline in the number of such joint households; increases in some countries were caused by the postwar housing shortage (Schelsky 1953). The emergent pattern is that of living near children rather than living with or far away from them.
There is evidence that joint living engenders considerable strain and that it is easier to maintain amicable relations when the parents live in proximate but separate dwellings (Tartler 1961; Robins 1962). The highest proportion of joint households has been found among peasants, small craftsmen, and tradesmen. Living arrangements based on close proximity are typical of the nonmobile working class and of minority ethnic groups during the initial stages of their acculturation; such arrangements are less prevalent in families of people employed in professional and bureaucratic careers but do not disappear altogether. A typical pattern in such families is that of a two-phased movement— a period of dispersion is followed by a period of family coalescence. Adult children may go far afield in search of career openings, but the aging of the parents often brings about a reunion (Young & Geertz 1961).
During the later stages of aging, the parents, who have hitherto given more to their children than they have received from them, gradually become the main beneficiaries of the exchange. Although the importance of supporting parents in the economic sense is declining with the development of public and private pension schemes, there is considerable evidence that this trend has not undermined the filial sense of responsibility (Schorr 1960). Most assistance in such tasks as housekeeping, personal care, and nursing during periods of illness comes from children. In general, daughters are much more involved in the relationship than sons; the mother-daughter bond is particularly strong and persists throughout the process of aging, especially in working-class families.
Recent research also indicates that inherent strains are involved in the parent-child bond. Although there is a considerable congruence between the norms of aging parents and children in this sphere (Streib 1958), the relationship is basically asymmetrical (Reiss 1962): aged parents seem more attached to their children than vice versa. Most children have a more or less strong sense of duty toward their aging parents, but the intensity of such a commitment varies according to the nature of the affective bonds between them, compatibility of values and style of life, and the possibilities of reciprocal services. There is also some evidence that there is an inverse relationship between the urgency of the need of the parents and the children’s readiness to help (Dinkel 1944).
Reaching grandparenthood is one of the key events in the onset of aging, and it occurs early in the process; there is a strong likelihood of becoming a grandparent well before one’s fiftieth birthday (Click 1957). There is evidence that grandparenthood is accepted with considerable ambivalence (Winch 1952). Grandchildren are tangible reminders of the passage from adulthood to old age, and they start to arrive at a time when such an awareness is still alien to the self-image. One of the most important factors affecting the position of grandparents in modern societies is the change in the patterns of familial authority. Comparative data on grandparents in primitive and traditional societies reveal that they perform either of two alternative roles (Apple 1956). In some societies they are typically strict and remote figures at the apex of the familial authority structure; in others they are permissive and easygoing and counteract the rigorous discipline imposed by parents. Grandparents are no longer authority figures in modern societies, and since parents have become much more permissive toward their children, there is also less need for grandparents to offer nurturance and tension release. Hence there has been a decline in the significance of grandparents in the life of their grandchildren, even though close contacts are often maintained through childhood and adolescence (Townsend 1957). The emergent pattern is based on intermittent contact, informality, and playfulness. The emphasis is on giving the grandchildren treats and having fun together rather than on transmission of values or nurturance (Neugarten & Weinstein 1964).
More distant kin
Aging people maintain contact and some interchange with a variety of more distant kin. Consanguinal kin tend to be more important than affinal ones and the wife’s relatives more important than the husband’s. Interaction among kin emphasizes ritual activities, friendliness, and sociability more than mutual aid (Gumming & Schneider 1961). There is a considerable amount of regular communication and visiting among kin, which provides aged people with their most important links with the outside world. Large family gatherings are less frequent than they used to be, but they have not disappeared; old people are often at the center of elaborate family rituals that draw relatives from far and wide (Albrecht 1962). Aging people serve as repositories of family lore and knowledge about kinsmen and are important connecting links in the kinship network (Young & Geertz 1961).
It should be noted that at times secondary and tertiary relatives replace and substitute for primary ones. When aging parents have sons but no daughters they see more of their daughters-in-law. When they have no children, they have more contact with and get more assistance from nieces and nephews (Townsend 1957; Rosenmayr & Köckies 1963). Dormant ties are often reinvoked and reactivated. The obligations toward more distant kin are less binding than the obligations toward primary ones, but they are often strong enough to form a second line of defense around the aging person. In case of unavailability of closer relatives, they may step in and close the gap. Thus, kinship provides a field of actual and potential sources of support and aid.
Considerable interaction between aging people and their kin occurs in most sectors and strata of modern society. In certain subcategories of the population—in the nonmobile working class, among the self-employed in the lower middle class, in the upper class, and in certain ethnic groups—the kin bond is anchored in traditional obligations that persist and are reinforced by social and cultural intergenerational continuity. In other subcategories, pre-eminently among those employed in bureaucratic and professional careers, the kin network is loose, more elective, and more flexible but persists in spite of considerable geographical and occupational mobility. Although the majority of old people get considerable emotional support and aid from kin, this fact should not obscure the inherent limitations of the familial system of care. The emerging pattern of family relations in industrialized countries is not set by unequivocal norms, and much depends on personal relations and personal choice. A certain percentage of old people are neglected and isolated, either because they do not reach a modus vivendi with their kin or because they have few kin. Furthermore, families find it extremely difficult to cope with severely disabled old people. There is a sizable minority of old people who require a considerable amount of extrafamilial aid.
Aging and the occupational system
The proportion of old people in the labor force has declined considerably in all industrialized countries; except for the period of World War II, this trend has been steady and cumulative. In the United States about two-thirds of the men past 65 were working in 1900, as compared to one-third today (only 18 per cent of them full time). Almost half of those still working are self-employed, primarily in agriculture, small businesses, and the independent professions. Inasmuch as long-range trends of limitation of opportunities for selfemployment continue, the labor force participation rates of older people will continue to decline. Increases in the average length of life, together with decreases in employment opportunities for the aged, result in great increases in the length of retirement (Kreps 1963; Michigan, Univ. of, 1963). It should be noted that there are considerable differences between men and women in this respect. While the participation of men past 65 in the labor force has declined, the participation of women in this age range has increased. Withdrawal from the occupational system is the major problem for aging men, whereas it is far less important for working women (Gumming & Henry 1961).
Patterns of retirement
Four major patterns of reaction emerge from research on aging in the sphere of work (Schneider 1962). The pattern of full engagement is based on the assumption that a man should not relinquish his work role or relax his efforts in this sphere until he dies; at the other extreme, full disengagement entails abrupt and total cessation of work. In between these extremes there are the patterns of gradual disengagement from the work role and of disengagement and reengagement. Many men “practice” for retirement by giving up work, starting again, and changing their status several times before finally retiring for good.
There is considerable variation with respect to the timing of retirement (Clark & Dunne 1956; Michigan, Univ. of, 1963; Wilensky 1960). Dropping out of the work force is already observable in the age span of 45–55. The most important reason for early retirement is ill health; another important factor is fluctuation in the economic situation. In most cases, retirement regulations set the limit at 60 for women and 65 for men. Although the majority of workers discontinue work either before or after the prevalent retirement age, there is a growing tendency to view it as the “normal” age of retirement.
The demand for mandatory retirement is rooted in both organizational and personal needs and thus is gaining the upper hand. The over-all trends are toward curtailment and standardization of the work span. Yet since the majority of aging workers are reluctant to retire and many are forced by adverse economic circumstances to seek work, there is considerable pressure to increase substitute employment opportunities. Attempts to solve this problem have developed in two major directions (Donahue 1955; Townsend 1957). First, there has been some exploration of marginal possibilities of employment in existing enterprises. For example, retired company directors and experts often act as consultants in their own or in other firms; in the lower echelons of the occupational ladder there are “old men jobs,” such as watchman and janitor. Second, sheltered and partly subsidized enterprises have been developed for those who can no longer earn a living any other way.
Effects of retirement
Retirement has far-reaching repercussions on most aspects of life. In the first place, it usually brings about a noticeable fall in the standard of living. However, the most important aspect of retirement is the loss of what is to most men their cardinal role (Blau 1956). The society’s emphasis on productivity and achievement leads to a fixation on the occupational role, which becomes the core of personal identity. Cessation of work also disrupts basic life routines. No less problematic is the blurring of status position; past occupational history can fully articulate the family to the social structure only in cases in which the accomplishments of the retired men are cumulative or not easily forgotten. Yet another source of strain is the disruption of peer-group solidarity with colleagues, which is for the majority of men the main source of companionship outside the family. Thus the combined effects of retirement usually lead to serious disorientation. Many retired workers experience feelings of deprivation, boredom, and isolation, and in some cases retirement leads to sudden physical and mental degeneration.
However, such negative features are not universally associated with retirement. Lowered morale stems in many cases mainly from ill health and economic deprivation. The higher the retirement income, the more closely it approximates living costs, and the smaller the gap between preretirement and postretirement income, the more optimistic is the old person’s evaluation of retirement and the easier his adjustment to it. Yet another key factor is the ideological premise that shapes the institutionalization of retirement (Donahue et al. 1960). The reaction to retirement is much more favorable where the old-age pension is defined as an inalienable right of every old person rather than as a degrading grant-in-aid for the needy. Work-centered values prevent the legitimation of retirement and engender serious problems, even when cessation of work is not accompanied by economic difficulties or ill health (Talmon 1961). The more positive view of retirement that is gradually emerging in affluent industrialized societies is an outcome of the transition from the emphasis on production to an emphasis on consumption and the concomitant legitimation of leisure and immediate gratification (Wilensky 1961a).
Participation in formal organizations
The peak of overfall organizational participation in voluntary associations occurs during middle age, followed by a slight decline that becomes definite around 65 (Wilensky 1961&). There is a certain variation of the participation cycle by sex (Havig-hurst 1957; Cumming & Henry 1961). Women react to the early loss of their child-rearing role by a temporary expansion of their organizational activity, whereas in the case of men the loss of their cardinal role is accompanied by cumulative withdrawal. Middle-class people are more active than members of the working class, both before and after the onset of aging. And, of course, individual organizational activity varies according to the opportunities and stimulus provided by the community of residence.
Attendance at church services and churchsponsored functions is the most prevalent form of organizational participation of the aging. Attendance rises during the age range of 50-65 and then decreases with age. There is some evidence that religious piety and especially belief in an afterlife have a similar developmental pattern, rising at the age when crises such as retirement and widowhood occur and then subsiding.
Examination of patterns of participation throughout the life cycle underlines the importance of preaging patterns. In general, people who were inactive before aging usually remain inactive; however, not all who were active remain active. Even those who continue their activity, and even enhance it, tend to relinquish it when they approach advanced old age. The key determinants seem to be the relationships between the interlocking cycles of family life, work, and organizational participation. The fact that the role loss of the woman occurs while her husband is still at the peak of his career engenders in her a quest for substitute roles outside the orbit of the nuclear family. Although the majority of women turn to cultivation of informal relations, a sizable minority enhance their organizational affiliation and participation. The withdrawal of both husband and wife after the retirement of the husband stems from the fact that much voluntary participation is career-connected.
In and by itself, similarity of age does not provide an adequate basis for the development of group consciousness and identification. Aging people are widely dispersed geographically, and the age category is subdivided by crosscutting kinship affiliations and by ethnic, religious, and class allegiances. The emergence of group consciousness and identification is also hindered by the stigma attached to aging; pride, denial, and apathy are often stronger than collective interests.
There are, however, a number of factors that enhance age-group consciousness and, under certain conditions, lead to group organization and action (Rose 1962). Economic deprivation, ill health, and status insecurity engender resentment and a sense of common lot. The issues of pensions and medical care have led to the emergence of the aging as a voting bloc, sometimes with a leadership that acts as a political pressure group. Recent research into a pension movement that has organized about a quarter of all pensioners in California (Pinner et al. 1959) reveals certain characteristics that may be typical. This movement did not develop effective over-all leadership from within; the leader is middle-aged and is, in addition, marginal in the community. Communication runs directly from the leader to a loosely connected audience. While there is a considerable core of devoted, hardworking, and self-sacrificing members, the majority are passive, and their participation is fluctuating and very unstable. Yet another important characteristic of the movement is the narrowness and specificity of goals; members are in favor of radical measures with regard to provision for the aged but take a conservative position with regard to most other issues. The main motive for enrollment and participation was found to be status anxiety: most members are from the slightly privileged aged rather than from the most underprivileged. It seems that those who have some hold on the material and social foundations of respectability are more likely to resent their loss of status and are more amenable to political organization.
Yet another type of age-segregated organization is the old-age club or day center that is set up by various bodies, such as municipalities, trade unions, and religious organizations. Such clubs may put the main emphasis on organization of special interest groups and on providing facilities and instruction for the development of hobbies, or they may concentrate on providing a congenial atmosphere for sociability. Only a small proportion of those above 65 patronize the centers in metropolitan areas (Kutner et al. 1956; compare Townsend 1957). Participation in club activities is much greater among aged people living in retirement housing and retirement communities (Hoyt 1954). Most of these clubs are set up for rather than by old people and are managed by professionally trained directors.
During the period of aging, there is a gradual thinning out of the number of people surrounding the individual and a lessening of the amount and intensity of interaction; the majority of aged people do not wish to maintain extensive social contacts. There is considerable similarity in the developmental trends in formal and informal participation. However, since primary relations are less affected by the withdrawal from the major institutional roles than secondary relations, the level of interaction with the informal network remains higher than that of interaction within formal organizations.
Evidence on the developmental pattern of informal relations during the aging process—which is unsatisfactory and often contradictory (Townsend 1957; Cumming & Henry 1961)—gives the general impression that the dominant pattern for men is the continuation of preaging level of interaction and then decline, while the pattern typical of women is upsurge and decline. Since the main emphasis in the feminine role is expressive and inasmuch as the wife is the main mediator between the family and its network of informal relations, she finds it easy to enhance and revoke such relationships; an increasingly important source of companionship and diversion is the growing peer group of widows (Blau 1961). By contrast, since the man’s role is mainly instrumental, he finds it difficult to shift from goal-oriented relationships to sociability for its own sake.
The durability of informal relations during the process of aging is affected by several factors. Bonds based on long association and common memories are more durable than short-range ones. Moreover, diffuse and comprehensive ties, such as those with kin and close friends, are more ageresistant than the more specific and limited ties that exist, for instance, between colleagues. Ascriptive bonds stand the test of deterioration and dependency better than more selective relations, and close kin are more important than close friends during the later stages of aging; the most persistent friends are those who through long service as substitute kin have become quasi relatives.
Another important factor operating in this process is accessibility. With the decline of physical mobility comes a gradual increase in the importance of neighbors. However, research clearly indicates that social interaction between the aged and their young and middle-aged neighbors is very limited and that the large majority of closer as well as the more superficial ties of old people are within their own age group (Aldridge 1959). The social distance between members of different age groups who are not tied by kinship bonds reflects the tendency to age-graded interaction that is dominant in modern societies (Neugarten & Peterson 1957).
Although old age usually entails a more or less marked contraction of the social world of the individual, research indicates that in the majority of cases it does not lead to extreme isolation or loneliness. It is significant that the extent of loneliness is not directly related to the extent of isolation (Kutner et al. 1956; Townsend 1957); it stems, rather, from a gap between desired and actual interaction. The intensity of loneliness experienced by the aged individual is a reaction to a discrepancy between his past and present patterns of association.
The majority of aging people spend at least part of their day doing nothing whatsoever, and the amount of time spent in semisomnolent idleness increases with age (Beyer & Woods 1963). The problem is not so much the increase of the quantity of unobligated time as the shift in its function and significance. During adulthood leisure is delimited and patterned to a large extent by work; once the rhythm of work and leisure is upset, free time is often experienced as unstructured.
After retirement, activities that were fully absorbing and gratifying throughout adulthood often lose much of their meaning. Solitary hobbies, for instance, may provide a much needed respite from the hectic interaction during working hours, but the same hobbies do not necessarily facilitate adjustment to retirement and may even have a confining or isolating effect. Similarly, leisure-time activities that are part of a full-fledged family life may lose much of their attraction after the onset of aging, when the children have homes of their own. There is also the problem of the synchronization of leisure; the retired are free at times when most other members of the community are occupied, and this may increase aging people’s feelings of alienation from the community.
Development of variegated leisure-time interests during adulthood facilitates the shift of dominant emphasis from work to free time (Havighurst 1954). Usually, however, these preaging patterns cannot be carried over into old age without a reassessment and at least some restructuring. During the early phases of aging there is an increase in recreational activities outside the home—activities such as visiting, traveling, fishing, and gardening. During the later phases recreation becomes increasingly centered on and confined to the home. Card games, handicrafts, reading, and above all television watching become the main preoccupations. A small but significant minority emphasize creativity and culture (Riesman 1954). But the majority of aging people cling to their preaging patterns (Dumazedier & Ribert 1963); there is some restructuring and change of pace, but little experimentation with new pursuits. It should be noted, however, that a certain proportion of aging people manage to develop new interests and to branch out into new spheres of activity (Riesman 1954). In such cases there is a redirection of involvement and a discovery of hitherto untapped personal abilities. A central characteristic of many of the activities that serve as focuses of re-engagement is that in one way or another they constitute a bridge between work and recreation. These pursuits are taken on voluntarily and felt to be genuine expressions of self, yet they require self-imposed obligations and self-discipline. Thus, re-engagement involves cumulative gains in understanding, knowledge, or proficiency which counterbalance the sense of over-all decline.
Major issues in the study of aging
The sociological study of aging centers on two major issues: the competition between the “engagement” and “disengagement” theories of aging and the controversy between the adherents of “community integration” and those of “age-group segregation.”
The study of aging was dominated for a long time by a theory of engagement (see, for example, Cavan et al. 1949), which assumed that old age does not differ much from middle age. It asserted that most aging people resent the role loss imposed on them by society and resist the shrinkage of their social world. According to this view, the best way to avoid the adverse effects of aging is to continue to maintain the level of activities and the associates of middle age as long as possible and to find suitable substitutes when forced to relinquish preaging patterns. The keys to optimal aging are activity, outgoingness, and involvement.
The theory of disengagement, developed recently by Cumming and Henry (1961), discards the view of old age as an extension of middle age. Aging leads to a triple withdrawal from society: a loss of roles, a contraction of relationships, and a decline in commitment to norms and values. Thus the aging person becomes increasingly egotistical— relaxation, comfort, and self-gratification are his main preoccupations. Cumming and Henry argue that disengagement is an intrinsic developmental process inherent in aging as such and not just a result of external social pressures. Withdrawal is seen as functional for the individual as well as for society, in that it prepares the aging person for his approaching final withdrawal and minimizes the effect of his death on the social system.
These two theories of aging are based on competing ideologies, and the transition from one to the other reflects the value reorientation occurring in affluent industrial societies. The engagement theory expresses the high evaluation of active mastery of external reality, whereas the disengagement theory reflects the emergent emphasis on release and gratification. A critical examination of the data leads to the conclusion that both theories are inadequate and require modification (Rose 1964).
Our analysis of the process of aging indicates that there is a considerable difference between the first and the last stages of aging. The onset of aging is often accompanied by an upsurge of activity and involvement, whereas the downward trend dominates during the later stages. Also, as has been noted above, there are considerable differences in the reaction to aging in different spheres of participation. Aging is, in many cases, a restruc-turing of roles and relationships and a change in their relative significance, rather than mere decline.
Identification with values is partly independent of participation and may persist in spite of the decline in activity and interaction. There is some evidence that aged people are less pious, less conformist, and less concerned about moral issues and about matters of principle (Gumming & Henry 1961). However, there is considerable evidence that the aging identify with the central values of their society and do not differ much from other age groups as far as their conceptions of the good life are concerned (Rosow 1963). We find little to substantiate the contention that old people abandon the interests and causes that occupied the center of their life in order to become late-day hedonists. It seems that lifelong commitments can persist in spite of the weakening of institutional supports and controls, and there are some indications that the growing distance from everyday affairs may enhance rather than undermine the concern with ultimate values (Talmon 1963).
We turn now to the concept of optimal aging. Although not all old people fit the mold of “good adjustment” recommended by the engagement theory, it is true that the large majority of studies report a very strong correlation between engagement and morale. Furthermore, this correlation does not decline with age. Successful aging seems to depend to a large extent on a flexible combination of disengagement and engagement; adjustment is easiest when the aging person accepts the withdrawal from his central roles and reorients himself to other spheres.
The theories of engagement and disengagement have evolved out of research in industrialized countries, yet they purport to have universal application. The limitations of both theories become even more apparent if we try to apply them to primitive or traditional societies. The withdrawal and alienation of the aging in modern society are a reaction to the strains inherent in its structure and value orientations, and thus they cannot be assumed to be intrinsic to old age as such. The disengagement theory admits that the process of aging takes different forms in different societies and in different subgroups in any given society, but it has not spelled out the structural and ideological determinants that affect this process in a systematic way. There is great need for a wide-ranging and rigorous comparative analysis.
Classification of living arrangements of old people from the point of view of their opportunity for contact with members of other age groups and with each other yields a continuum ranging between maximal residential integration to maximal residential segregation. Scrutiny of the literature reveals that there is a fairly widespread rejection of the two extreme solutions: three-generation households are regarded as incompatible with the values and structure of the modern family, while there is growing opposition to closed and isolated homes for the aged.
However, we find controversy with regard to the intermediate patterns. Two seemingly opposed viewpoints have emerged in this sphere. Upholders of the age-heterogeneous pattern continue to put the main emphasis on intergenerational community integration (Mumford 1956; Townsend 1957). They hold that intergenerational relationships with kin are the main axis of the social integration of the aged. Living on their own in a “mixed” neighborhood in which they are long-term residents, with children or other close kin within easy reach, is considered to be the optimal solution.
Advocates of this view can cite a recent survey of old-age institutions in Britain (Townsend 1962), which has revealed that the majority of residents deplored their transfer to an old-age home and that it had an adverse effect on their morale. Furthermore, more than half of the residents were able to take care of themselves with either no assistance or very little; an additional fifth could live on their own if they were provided with considerable aid. The results of this survey have led to a demand to abolish all old-age institutions and to transfer the care of the aged to the community, where they can maintain partial independence with the help of community and domiciliary services.
Advocates of semi-segregated residential settings (Rosow 1961) hold that relationships with age peers are the major axis of social integration of the aged. They point out that the semi-integrated pattern works only in cases in which the aging person is a long-term resident in a relatively homogeneous and stable neighborhood and as long as his network of informal relations is localized and fairly intact. A partly segregated age-homogeneous setting maximizes opportunities for contacts with peers and protects the aged from invidious evaluation yet at the same time does not cut them off from outside contacts. Research on different types of semi-segregated settings reveals extensive social participation and intensive use of the variegated facilities provided by the management (Kleemeier 1954; Hoyt 1954).
Those recommending semi-segregated arrangements have also pointed to certain practical difficulties involved in the anti-institutional position. Given the shortage of personnel and equipment, institutionalization of a certain proportion of relatively isolated or severely disabled aged seems imperative (Fiske 1964). Furthermore, comparative analysis of different types of institutions for the aged indicates that homes that are not isolated from the community and allow their residents as much privacy and independence as possible neither cut them off from outside contacts nor produce the other adverse effects of isolated and highly bureaucratic institutions. It seems clear that aging people placed in different economic and social circumstances and at different stages of the aging process may require different solutions. There is also the need to take account of variations in temperament and value orientations. The intermediate patterns that combine contact and segregation, dependence and independence, are complementary rather than alternative solutions.
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Since the end of World War II, mortality rates in Asia, Africa, and Latin America have begun to warrant the expectation of long life for the people of those areas, a hope realized by a growing number of Europeans and Americans for more than half a century. But the twentieth century has not yet contrived economic circumstances that will furnish the majority of those who reach old age the means to solve its accompanying problems. To be sure, money alone does not assure independence, self-esteem, and good health. It is a facilitating condition, however; and the overriding economic fact about the aged—those age 65 and over —is that most of them are still living on considerably less than an adequate income. According to United States census figures for 1960, aged persons living alone had a median yearly income of $1,055. For two-person families it was $2,530. Included in the 16.5 million aged were over thirty thousand persons who that year reported a taxable income of $50,000 or more, and over two million men and women who had no money income at all.
While these people, and those in like circumstances in other urbanized countries, are often counted as victims of industrialism, the adverse economic consequences of aging were suffered by individuals long before the age of industrialism, and the emergence of the aged poor as a pressing social problem is more accurately described as a function of modern urban life (Gordon 1960, pp. 208-209). Its prime ingredients are (1) an increased proportion of older people whose salable skills are being outstripped by changing technology and (2) conditions of urban life that undermine the family as a source of economic security. Its frequent result is poverty among the aged who, since the beginning of this century, constitute a growing portion of the population.
If current income figures identify poverty in old age as a persistent problem, a comparison with income figures of earlier decades reveals that, on the whole, the livelihood of the aged is improving and that it is increasingly dependent upon sources other than current earnings. In 1950, approximately twelve million older Americans shared a $15,000 million income, half of which came from their earnings. By 1961, the seventeen million aged received $35,000 million; but of this total, less than one-third came from earnings.
The fact that older Americans are better off despite declining earnings is accounted for by the growth of public and private payments on which the livelihood of the aged must increasingly depend. The decreasing importance of earnings reflects a decline in the percentage of older men in the labor force—an increasingly important aspect of the age—income cycle.
The age-income cycle
The impact on earnings of those influences associated with age was first observed in English data near the turn of the century. Income tended, on the average, to rise in the early years, reach a peak in middle life, and then decline. Other studies, both in Europe and in the United States, using similar cross-sectional data, have confirmed the existence of this life cycle relationship between age and income.
It must be emphasized that these figures tell us only the relationship of income to age at a particular moment of time. They reflect the fact that older workers tend to have less education than younger workers; that there is downward occupational mobility and declining labor force participation; and that there is an increase in illness, in the amount of part-time work, and in the incidence of unemployment.
In his pioneering analysis of the age-income cycle, Woytinski (1943) cautioned against use of age-income data alone in predicting future family needs, since his analysis showed that over the long run the economic cycle in the life of an individual is overshadowed by secular variations in his earnings. Indeed, within its stable, approximately bellshaped profile, the age-income curve shifts in response to changes in employment requirements, perquisites, and patterns. United States census data for the two decades after World War II show that the income peak for men, although still in the age 35-44 range, has moved to a slightly younger age. The long-run trend of income is up, but it is noteworthy that the margin of increase in the middle years is greater than at retirement. Increasing labor force participation by women is steadily transforming their age-income curve to a male variety.
Age-income data reveal, therefore, that, relative to income of persons in mid-working life, income of those at retirement age is low. With an income of $2,530, the average older couple in 1960 had less than one-half the average income of younger couples and about three-fourths the money that the Bureau of Labor Statistics estimates is required for an older couple’s “modest but adequate” budget. Even so, the average couple is better off than older people who live alone. Their average yearly income was $1,055. Single women constitute the largest single class of aged economic units—about 43 per cent. There are almost as many aged widows as there are married men age 65 and over, but very few of these women are in the labor force. In 1961 their average yearly income was $960.
The aged represent about 10 per cent of the entire United States population and include people of widely varying economic circumstances. When these are all considered, however, it is not surprising that the U.S. President’s Council on Aging, in its first annual report, concluded: “No matter what standards might be used to judge the adequacy of income of today’s older people, one point is clear: their incomes are usually inadequate for even a modest level of living” (1963, p. 7).
The cost of providing for old age. Some of the expenses of older people—such as the costs connected with working, educating children, and housing—are lower than those of younger people. But basic expenses continue, and some are increased, particularly medical expenses.
Older people in good health must spend more to retain it, and those in poor health face formidable, and steadily rising, expenses. Old age carries with it a high incidence of illness; in the United States the average medical expenses incurred by a person over 65 in 1961 were approximately 2.5 times greater than the medical expenses of a person under age 65. It is estimated that the ratio shortly will be 3 to 1.
Provision for old age is a difficult economic problem—and harder to solve than is generally realized. Consider a U.S. couple planning for retirement, who might prudently expect average monthly expenses to exceed retirement income by $125. Since to provide this $1,500 yearly sum from interest alone would require, at 3 per cent, a principal of $50,000 (at 4 per cent, it would require $37,500), most couples with investments will have to plan to spend both interest and principal.
In the United States, a man who retires at age 65 has a life expectancy of about 13 additional years. If his wife is the same age, mortality tables grant her 16 years. Assuming interest at 3 per cent, a joint-and-survivor annuity of $1,500 a year, payable as long as at least one spouse survives, would cost about $21,000. By reducing the annuity to $1,000 during the period only one spouse is alive, its cost is cut to approximately $18,000.
How realistic are these capital requirements? In 1961, the average aged U.S. couple had about $1,000 in liquid assets such as savings bonds or money in the bank; life insurance with a total face value of about $1,850; and those who owned a home had an equity of less than $10,000 (U.S. President’s Council on Aging 1963, pp. 10-11). Those who lived alone had less. A 1957 survey of aged people drawing social security benefits revealed that of those who entered a general hospital that year, 40 per cent of the two-person families and 60 per cent of nonmarried people did not meet all their medical expenses from income, health insurance, and assets. The balance was paid by relatives, charity, or public assistance—until the depression the only methods, along with poorhouses, to help aged needy Americans.
Origin and evolution of social security
Although Germany had a fairly complete national insurance system by the close of the nineteenth century (compulsory old-age and invalidity insurance in 1889) and England introduced social insurance for the aged in 1925, the rise of these programs had little impact in the United States, where the efforts of energetic social reformers had made scant headway against the philosophy of individualism.
Soon after America became a nation, English, Elizabethan-type, poor laws were adopted, based on local responsibility, liability of relatives for support of indigent family members, and residence laws restricting eligibility for relief to residents of the locality. In the United States, before the twentieth century, government assistance to the aged consisted almost entirely of poorhouses. The power of the states and their competition for business investments, the frontier and cheap land,vand an enduring belief in individualism maintained this situation for a long period. Only seven states had passed old-age assistance laws prior to the depression, and two of these had been declared unconstitutional. And these old-age pension laws were merely liberalizations of the poor laws, with similar standards of eligibility.
In June 1934, when President Roosevelt appointed the Committee on Economic Security to study and recommend legislation that would promote economic security for the individual, the poverty and suffering of the depression were overwhelming relief programs for the poor. These conditions acquainted millions with the indignities of these programs and created a deep determination to eliminate this approach entirely. This committee, together with three other bodies established by the president’s executive order, on January 15, 1935, completed an exhaustive study of foreign experience with, and the need for, social assurance and assistance. Two days later President Roosevelt transmitted the report of the Committee on Economic Security to the Congress, with a special plea for fast action.
Faced with the reality and implications of vast human suffering and enormous relief costs, the U.S. Congress, in seven months of heated hearings and debate, reconciled the philosophy of individualism with the facts of economic interdependence. President Roosevelt signed the Social Security Act on August 14, 1935, and the United States became the 21st nation to enact an old-age insurance program. Today the right to social security is a recognized aspiration throughout the world.
United States legislation. In its original form, the Social Security Act established a federally administered compulsory old-age insurance program and provided (1) federal financial participation in state old-age assistance programs and (2) a supplementary program designed primarily for those who would be ineligible for old-age insurance. In addition, the act provided for a state-operated system of unemployment insurance (actually, inducements to states to enact unemployment insurance legislation) and offered grants to states in six major fields to enable them to make more nearly adequate provision for needy dependent children, crippled children, maternal and child welfare, aid to the blind, public health activities, and vocational rehabilitation programs. The income security titles of the act authorized the federal government to participate financially in individually enacted state measures.
When President Roosevelt signed the act, he called it the “cornerstone in a structure which is being built but is by no means complete.” Since the original act was passed, major amendments affecting the aged have greatly broadened coverage and extended types of benefit protection, raised the dollar amount of benefits, and liberalized eligibility qualifications and the retirement test. By 1965 the program approached almost universal coverage. Virtually all types of employment were covered by social security (90 per cent of employed workers) or by some other public retirement program (including those for railroad workers, government employees, and veterans). About 83 per cent of aged Americans were drawing benefits or would be eligible for them on retirement. Since the act was passed, the types of protection have been expanded from the original limited old-age coverage (OAI) to include survivorship and disability protection (OASDI) and hospital and medical benefits (Medicare). Benefit increases since 1935 have kept pace with rising living costs, although not with the rising productivity of the economy and the consequent rising standard of living of the American worker. Also, the maximum wage and contribution base has not been raised sufficiently to keep abreast of the wage level, which has more than tripled since 1935.
World-wide programs. A study of the principal provisions of social security programs in all countries of the world (U.S. Social Security Administration 1964) reveals that 112 nations have at least one branch of social security and 78 nations have old-age, invalidity, and survivor programs. Included are all the European and North American countries. Of the 11 Middle Eastern countries, 8 have such programs, as do 15 of the 21 Central and South American countries; 10 of the 19 countries of Asia and Oceania; and 15 of the 36 African countries. In a number of countries, programs cover only small segments of the population and sometimes list benefits that are planned but not yet paid.
Canada, Denmark, Finland, Iceland, New Zealand, Norway, and Sweden now provide their aged with universal pensions, with payments available to every resident past a specified age without regard to qualifying conditions, past contributions, or employment. Australia, Saudi Arabia, South Africa, Trinidad, and Tobago potentially provide pensions to any aged resident but require a means test.
Principles of social insurance
Most of the programs providing protection to the aged are based on principles of social insurance as distinguished from the other two methods of providing “social security”—social assistance and direct public services (poorhouses, etc.). Thanks in some part to the eloquent strictures of Lord Beveridge on “the nasty, dirty means test,” more than three-fourths of the countries rely on social insurance concepts, whose unifying characteristics are (1) compulsory coverage, with qualifying conditions prescribed by statute; (2) benefits paid as a matter of right and linked to contributions or to coverage under the program; (3) benefit amounts often, but not always, related to prior earnings and rarely dependent upon means or needs of the recipient, as is the case with social assistance; and (4) financing entirely, or in large part, from social insurance contributions paid into a special fund by employers, employees, and sometimes by government.
Some of the countries with social insurance systems supplement them with assistance payments to the needy aged, invalids, or survivors. Such programs are found in Austria, Czechoslovakia, France, West Germany, Ireland, the Netherlands, the United Kingdom, and the United States.
Of the 65 countries whose statutory old-age benefit or pension systems cover significant segments of the population, all but 18 include statutory protection against medical care costs, either through general sickness insurance or through health service programs. Almost thirty years to the day after its inception, the social security system in the United States in 1965 finally joined these more advanced systems by adding Medicare benefits.
Social insurance has become the important approach to the economic problems of old age. Within the broad, general principles summarized above, its application depends upon statutory provisions, myriad regulations, and administrative rulings whose complexity defies the grasp of all but those who make it the subject of specialized study.
In broad outline, however, the issues and economic problems are similar in most countries, and these may be best illustrated by examining in somewhat more detail the principles underlying a single system, in this case that of the United States.
Four of the important principles underlying the OASDI program may be summarized as follows:
(1) The right to benefits is based on presumptive need. A key element in the theory of social insurance is that benefits are paid not as a matter of grace, but as a matter of right for social risks defined by law. Under the U.S. system, the need is economic adversity in old age, not old age itself. Thus, benefits are not automatically paid upon attainment of a specified age, but only upon actual retirement. By the same benefit theory, surviving widows are eligible for payments only as long as they do not remarry or are not substantially employed, and the eligible disabled receive payments because they are unable to do substantial, gainful work. (In the case of Medicare benefits, the need is ill health, and benefits are paid upon the attainment of the required age, whether individuals are retired or not.) A majority of social insurance systems have a similar approach to presumed need, but in a number of countries (among them, France, West Germany, and Switzerland) retirement is not a precedent condition for benefit payments. Within the age range 50-70, 60 and 65 are the most typical ages at which retirement benefits are first payable. Because life expectancy generally is shorter in tropical latitudes, age requirements tend to be lower in these areas.
(2) Benefit amounts should establish a basic floor of protection. Along with the definition of presumed need, the concept of a minimum floor of protection is designed to encourage saving and, when combined with private pensions and other assets, to provide a reasonably comfortable level of retirement. Approximately 40 per cent of the labor force is covered by both social security and supplementary retirement pensions; but since most private plans are not portable, it is difficult to predict how many persons will actually secure private pensions upon retirement, and of what magnitude.
Given the continuing and rapid growth of private retirement plans and life insurance, this benefit theory, which requires savings and private supplements for adequate retirement income, may become reality in the future for almost all beneficiaries. Its failure to do so at present means that 12.5 per cent of aged persons must still rely on social assistance payments for their livelihood and brings continuing criticism that the benefit floor is too low.
This criticism applies with equal, or greater, force to most other countries. Provisions for automatic adjustments related to the trend of wages or the cost-of-living index have been adopted in a small number of nations, among them Belgium, Denmark, Israel, West Germany, and Sweden. These are satisfactory, however, only where the basic benefit is adequate.
(3) Benefits are financed entirely by contributions from workers and employers. Most nations finance social insurance protection for their aged under a tripartite system of contributions from insured persons, employers, and government. A few countries, including the United States, have no direct government contributions for social insurance benefits except for social assistance to the needy aged. When tripartite financing is proposed for the United States, it is resisted by critics on the ground that the system should be kept self-supporting and by others who fear that government participation might slow down the rate of benefit increases. Experience under the German system, however, contradicts this latter contention.
A much larger and changed role for government is proposed by those critics who contend that the present financing system is unsound and that the entire system should be financed on a current basis by annual government appropriation or made subject to the financial requirements of private insurance. Although the former proposal, which has several times been urged on the Congress, has made no headway, its major premise—that the present system of financing is unsound—continues to be a subject of popular writing and discussion. The issue arises because the goals of social adequacy and individual equity conflict. The former requires reasonable benefit levels; the latter requires benefits that are actuarially equivalent to contributions. Since the social security system requires contributions from potential beneficiaries who may not collect benefits and seeks to afford reasonable benefit levels on a current basis to many who have been covered only a few years, it must compromise between these two goals. It is estimated that in the early 1960s the proportion of current benefits “bought” by the contributions of the workers involved was about 5 per cent (Myers 1961, p. 3). Benefits and administrative expenses are paid from current contributions plus interest earned by the fund representing past contributions that exceed payments. This is as planned, for financing by private insurance principles would defeat the goal of social adequacy, and in any case is not necessary for public programs with nearly universal coverage and implicit federal backing— should such backing be required. The system is not intended to have a fully funded reserve, but it is nonetheless fully self-supporting and fiscally forthright.
(4) Benefits are related to prior earnings. A basic decision faced by any country establishing a social insurance system is whether the benefits paid should be related to prior earnings or whether all beneficiaries should receive an identical benefit.
The social security system in the United States adopted the earnings-related benefit from the beginning, despite the administrative difficulties and costs it involves, on the assumption that a relationship between contributions and benefits would be more acceptable to Americans. Although a flat-rate benefit would no doubt improve the relative position of low-income groups, the benefit formula adopted by the Social Security Act was not a simple earnings—benefit ratio but was weighted to result in a relatively larger benefit for those with low earnings than for those with high earnings. Thus, although the benefit increases as the average monthly wage increases, the ratio of benefits to average monthly wage decreases as the wage increases, so that the lower paid workers get more out of the system in relation to what they paid in than do the higher paid workers.
Until 1959, the British system relied entirely upon a flat-rate benefit, paid to all adult claimants (except widowed mothers). This system was criticized as being outdated and resulting in “fair shares in poverty.” In 1959, a limited wage-related benefit system was inaugurated, but there is still serious concern over its adequacy (Burns 1963, pp. 20-23).
Adequacy, the immediate issue
In its first annual report, the U.S. Social Security Board acknowledged that: “An attempt to find security for a people is among the oldest of political obligations and the greatest task of the state.” The legitimacy of this search is no longer seriously challenged; the immediate problem is how to attain adequate security, how to ensure that the steadily increasing number of old people are not left behind but will share the social and economic progress of the community. At the end of World War II, an expansion in employment opportunities was often proposed as a partial solution to the economic problems of the aged. Ideally, an older worker would have the choice between employment and adequate retirement benefits. But by the 1960s, the aged found it increasingly difficult to compete for jobs; and as their range of choice became more and more limited, their demand for more adequate income maintenance programs was intensified.
If adequacy depended solely upon the economic capacity of society to provide greater economic support for the aged, social insurance systems of most nations could protect them from want. But how much a nation is willing to spend is a political as well as an economic matter; and the compromise is often struck below what is economically possible.
Private pension plans. In some countries the tendency to enlarge social security benefits and contributions seems to be reducing the influence of private pension plans. In the United States, however, dissatisfaction with the benefit floor has spurred a strong labor movement to bargain for private pension plans, which are growing rapidly and promise to provide for a large segment of the population a comfortable “second story” to the “floor” of protection offered by social security. But those not employed by large corporations or protected by collective bargaining are in danger of being relegated to a second-class category, justified neither by logic nor equity.
Moreover, the pension funds behind these private programs, like the funds some nations have amassed under social insurance, are becoming a major source of new capital, whose economic implications and potential power are, as yet, only dimly perceived.
The future course
In the near future, social security programs throughout the world may be expected to follow a predictable course providing income and services to ease the encumbering costs of old age. Evidence of a significant shift away from this cash indemnity approach can be found in some social security programs that are slowly adopting the view that cash benefits are part of a broad national program of investment in human resources (Gordon 1963a, p. 35). With training, retraining, and rehabilitation at its core, this approach does more than pay benefits to help prop up the failing economic status of the aged; it seeks to restore individuals to a fuller economic and social life. This development, together with the growing interest in preventive approaches to the economic problems of aging—health education, medical care, training, and planned retirement— hold for the aged the promise, not of a new life, but of continued enjoyment of the old.
Earl F. Cheit
Burns, Eveline M. 1956 Social Security and Public Policy. New York: McGraw-Hill.
Burns, Eveline M. 1963 Social Security in Britain: Twenty Years After Beveridge. Industrial Relations 2, no. 2:15-32.
Gordon, Margaret S. 1960 Aging and Income Security. Pages 208-260 in Clark Tibbitts (editor), Handbook of Social Gerontology: Societal Aspects of Aging. Univ. of Chicago Press. > A lucid economic analysis, well documented. An excellent reference source for basic data in the field.
Gordon, Margaret S. 1963a The Economics of Welfare Policies. New York: Columbia Univ. Press.
Gordon, Margaret S. 1963b U.S. Welfare Policies in Perspective. Industrial Relations 2, no. 2:33-61.
Great Britain, Inter-departmental Committee on Social Insurance and Allied services 1942 Social Insurance and Allied Services. Papers by Command, Cmd. 6404. London: H.M. Stationery Office; New York: Macmillan. → Known as the Beveridge Report.
Haber, William; and Cohen, Wilbur J. (editors) 1960 Social Security: Programs, Problems and Policies; Selected Readings. Homewood, III.: Irwin.
Michigan, University of, Conference on Aging, 1962 1963 Aging and the Economy. Ann Arbor: Univ. of Michigan Press.
Myers, Robert J. 1961 Social Security: The Years Ahead. Pages 1-9 in California, University of, Chancellor’s Committee on the 25th Anniversary of the Social Security Act, Social Security in the United States: Four Lectures. Berkeley: Univ. of California, Institute of Industrial Relations. → An easy-to-read analysis, by the actuary of the U.S. system, of the basic financing principles of the social security program.
Schottland, Charles I. 1963 The Social Security Program in the United States. New York: Appleton. → A readable account of the U.S. social security program.
Social Security Bulletin. → This monthly publication of the U.S. Social Security Administration presents current research, operating statistics, and a current listing of recent publications in the field. Published since 1938.
Steiner, Peter O.; and DORFMAN, ROBE’RT 1957 The Economic Status of the Aged. A publication of the Institute of Industrial Relations. Berkeley: Univ. of California Press.
Turnbull, John G.; williams, C. Arthur, JR.; and
Cheit, Earl F. (1957) 1962 Economic and Social Security. 2d ed. New York: Ronald.
U.S. President’S Council on Aging 1963 Report [First].
Washington: Government Printing Office. → A good popular summary of the current programs and research findings about the status of older Americans.
U.S. Socialsecurity Administration 1960 Basic Readings in Social Security: 25th Anniversary of the Social Security Act; 1935-1960. Washington: Government Printing Office.
U.S. Social Security Administration 1964 Social Security Programs Throughout the World. Washington: Government Printing Office.
Woytinski, Wladimir S. 1943 Earnings and Social Security in the United States. Washington: Social Science Research Council, Committee on Social Security. → See especially “Wages by Age of Workers,” pages 124-133.
Aging in humans is a combination of two processes: development or maturation, and senescence or decline. Development or maturation is the positive aspect of aging; humans typically acquire greater wisdom, experience, and expertise in specific fields as they grow older. Senescence, on the other hand, refers to the gradual loss over time of the ability of cells in body tissues to divide and multiply, the ability of the body to grow, and the ability to maintain good functioning.
Biology of aging
The biology of aging can be described at the level of cells and molecules or at the level of an entire organism. On the cellular level, cells in most human tissues eventually lose their ability to divide unless they become cancerous. In the mid-1960s, a biologist named Leonard Hayflick discovered that human cells stop dividing after about 50 or 52 divisions. It is now known that Hayflick's limit is the result of the shortening of telomeres—regions of repetitive DNA at the ends of chromosomes—with each successive cell division. The telomeres protect the ends of the chromosomes from damage during cell division; some biologists think that this mechanism evolved as a protection against the unregulated multiplication of cells characteristic of cancer. After Hayflick's limit is reached, the cell cannot divide again and is said to be
|Country or area||Total population all ages (in thousands)||Population age 65 and over (in thousands)||Percent age 65 and over|
|Table excludes countries and areas with less than 100,000 total population.|
|source: U.S. Census Bureau, International Data Base, 2007|
|(Illustration by GGS Information Services. Cengage Learning, Gale)|
|Bosnia and Herzegovina||4,499||647||14.4%|
|Hong Kong S.A.R.||6,940||890||12.8%|
senescent. It will continue to exist for some time and gradually enlarge but eventually die.
The relationship of Hayflick's limit to the aging of the entire human body is not completely understood as of the early 2000s. Some cells in the human body, such as stem cells, which exist in every tissue, are not affected by Hayflick's limit and will continue to reproduce throughout the lifespan. In humans, however, the body begins to enter what is called organismal senescence at some point between 20 and 35 years of age. Organismal senescence is marked by a reduced ability to respond to stress and by increased susceptibility to disease. Individual differences in the speed of the aging process at the organismal level are thought to result from a combination of genetic and environmental factors, with genetic factors being more important in determining longevity.
There is some disagreement among researchers as to which changes in humans over the lifespan represent so-called normal aging and which represent disease processes. The distinction may sometimes be a matter of statistical distribution; for example, some loss of memory is nearly universal in the elderly and is considered part of normal aging, while dementia, although more common in the elderly than in younger adults, is still considered a disease process. Another example is glucose intolerance; a certain degree of glucose intolerance is thought to be part of normal aging; however, diabetes is still defined as a disease even though type 2 (adult-onset) diabetes is more common in older adults in the early 2000s than it was in 1950.
As of the early 2000s, the following changes in humans are considered normal aging:
- Changes in height. Humans generally continue to grow taller until they are in their forties but then lose about 2 inches in height by age 80. The reasons for this loss of height include changes in posture, changes in the joints in the feet, and compression of the discs between the vertebrae in the spine.
- Changes in weight. Adults generally gain weight until their fifties (in men) and sixties (in women), but gradually lose weight in their seventies and eighties.
- Changes in body composition. People generally lose muscle as they age, replacing it with fatty tissue; however, this change can be minimized by regular exercise.
- Less effective regulation of various body processes. The ability to regulate blood pressure, body temperature, response to infection, and the level of fluid in body tissues declines as humans get older.
- Slowed reaction to visual or other stimuli. This change in response time is one reason why older drivers are at increased risk of accidents.
- Changes in vision. The ability of the lens in the eye to accommodate (change its focus in seeing objects at different distances) decreases with age.
It is important to note that normal aging covers a range of individual responses to the aging process. Not only do people vary among themselves in their overall rate of aging, but different organ systems may age at different rates within a given individual. For example, one person might have a well-functioning cardiovascular system and severe arthritis, while another might have strong joints and muscles but a weak heart or a visual disorder. As humans age they become less like one another biologically, so that health care regimens need to be individualized.
Some scientists are investigating several disorders characterized by premature aging to see whether they can provide information about controlling the rate of normal aging in humans. One is Hutchinson-Gilford progeria syndrome (HGPS), a very rare disorder in which children develop wrinkled skin, balding, replacement of muscle tissue by fat, and otherwise appear to age at a rate of six to eight times normal. Few children with progeria live past 13 years, and commonly die of heart attacks or stroke. Another disorder
of accelerated aging is Werner syndrome, a rare genetic disorder caused by a defective gene on chromosome 8. The gene affects the maintenance of telomeres, causing them to shorten rapidly and reducing the number of times the defective cell can divide.
Theories of aging
There are several different theories of aging that have been proposed as of the early 2000s. Some focus on the processes that govern aging while others are concerned with the evolutionary patterns underlying senescence.
- “Loose cannon” theory. This theory of aging holds that certain types of molecules—typically glucose or free radicals—damage cells and tissues over time through the accumulation of byproducts of oxidation, thus leading eventually to senescence and death.
- Rate of living theory. This theory holds that smaller mammals have shorter life spans than larger mammals because they have higher metabolic rates. It is no longer widely accepted, however, as studies of different mammalian species have shown wide variations in the relation between body size and metabolic rate.
- Weak link theory. This theory of aging maintains that the human body has a weak link—usually identified as either the endocrine system or the immune system—that is more susceptible to oxidative damage during senescence. Failure of the weak link leads eventually to loss of function in the body as a whole and then to death. Researchers have not found any evidence, however, that either neuroendocrine disorders or failures of the immune system contributes directly to age-related diseases or mortality.
- Error accumulation theory. The error accumulation theory maintains that errors in DNA transcription or RNA translation eventually lead to genetic errors that promote senescence. The major problem with this theory as of the early 2000s is that it does not explain most age-related changes in the human body.
- Master clock theory. This theory is related to Hayflick's limit in that it posits that aging is genetically controlled by the limits on cell division that have developed in each species over the course of its evolutionary history. According to the master clock theory (also known as the aging clock theory), aging is a preprogrammed sequence governed by the shortening of the telomeres during successive cell divisions.
- Autoimmune theory. This theory of aging holds that aging is caused by the development of autoantibodies that attack the body's own tissues.
The demographics of all but 18 countries of the world are characterized by significant population aging as of 2008. Population aging is a term that refers to a change in the distribution of a country's population in the direction of higher age. It can be caused by an increase in the size of the country's elderly population, a drop in the number of children, or a rise in the median age of the population.
Population aging results from a combination of increased life expectancy and lowered birth rates. If 65 years of age is used as a cutoff point, a population is considered relatively old when the proportion of those over 65 exceeds 8–10 percent. In 1900 people over 65 represented 4.1 percent of the population of the United States; by 2000, they represented 12 percent; and by 2030 they are projected to represent 20 percent. From 1900 to 2000, the total population of the United States tripled, while the number of those over age 65 increased tenfold. According to the United Nations, the median age of the population in the developed countries was 29 years in 1950; it rose to 37 by 2000, and is expected to rise to 45 by 2050.
The extension of the life span in the developed countries since 1900 is generally thought to result from lowered childhood mortality rather than by an increase in the maximum human life span. As of the early 2000s, the maximum life span is about 125 years for women and about 120 for men; these figures have not changed significantly across history. There are, however, some experts who think that the maximum human life span is slowly increasing.
Researchers studying population aging typically divide older adults into three groups: the young old, aged 65 to 74; the middle old, aged 75 to 84; and the oldest old, those aged 85 and older. It is not clear, however, how useful these divisions are in evaluating the health of a population, as two people may be the same chronological age yet function mentally and physically at very different levels.
What is known is that the oldest old are the group of seniors in the United States that is increasing the most rapidly. People over 85 accounted for 12 percent of the elderly population in 2000 but are expected to account for 19 percent by 2040. While the number of people over 65 in the general American population is expected to increase nine times in the period between 1940 and 2040, the number of those over 85 is expected to increase by a factor of 40 in the same time period. The number of centenarians (people who live to be over 100) is expected to increase from 50,000 in 2000 to 550,000 by 2040. It is the rapid growth in numbers of the oldest old that concerns policy makers studying rising health care costs.
Public policy aspects of aging
The aging of the population in developed countries is a major concern to policy makers because of the strain on health care systems and public financing of retirement. As seniors live longer and each retiree is supported by fewer younger workers paying into social security systems, governments in developed countries are facing hard choices between cutting benefits to the elderly, increasing the tax burden on younger adults, or reducing the role of the government in providing health care. One approach to this problem in some countries has been to increase the age at which a person is eligible for full benefits. In the United States, for example, persons born before 1938 could retire at age 65 with full Social Security benefits, while those born between 1943 and 1955 must wait until age 66, and those born after 1955 must wait until they are 67.
In the private sector, the same problem of financing pension plans for retired workers who are living longer than planners had anticipated has led to a shift away from defined benefit plans, in which the employer guarantees retired employees a monthly benefit for the duration of the retiree's life. The monthly amount is typically determined by a formula that takes into account the retiree's age, years of service with the company, and pay level at the time of retirement. Since the early 1980s many companies, as well as self-employed workers, have preferred defined contribution plans. In a defined contribution plan, each worker is responsible for selecting among a range of investment plans, usually mutual funds or similar securities. The money may come from the employee's salary, from the employer, or from both.
Theories of aging have led to speculation that humans might be able to slow or even stop the aging process by various interventions. Researchers who support the loose cannon theory of aging have suggested that aging could be slowed by consuming large quantities of antioxidants (vitamins A, C, and E), which prevent free radicals from oxidizing sensitive biological molecules; or by limiting glucose intake through calorie-restricted diets. Although experiments have shown that increasing the levels of free radicals in such experimental animals as fruit flies, worms, and mice shortens their life span, there is no evidence as of 2008 that adding antioxidants to the diet of these animals increases the life span. Similarly, although Roy Walford and a few other writers have urged calorie restriction as the key to a longer life span in humans on the basis of experiments with reducing food intake in mice, there is no conclusive evidence that these findings are applicable to humans. The American Aging Association is an organization dedicated to biomedical research on slowing the aging process.
Other attempts to forestall aging are based on experimentation with stem cells, organ transplantation, and molecular biology. Researchers in this field hypothesize that the human life span could be extended through periodic replacement of damaged tissues or organs or through rejuvenation of damaged cells. Some think that stem cells or molecular repair of damaged cells could serve as the basis for treatments that would restore youth as well as eliminate diseases and the aging process.
A third anti-aging strategy, cryonics, is based on the notion that humans (or animals) could be preserved at low temperatures until such time in the future when medicine will have advanced to the point that they could be resuscitated and successfully treated for diseases presently considered incurable. In the United States, cryonic preservation, or cryopreservation, cannot be legally performed upon a person until they have been declared legally dead. It is uncertain whether cryopreservation of humans could ever be reversed at some future date in order to revive and treat the person, as the process requires cooling the body to near 196°C (321°F), which is the boiling point of liquid nitrogen. Cooling an entire human body to this temperature causes injuries that are not reversible with present technology. As of 2008, fees for cryopreservation range from $28,000 to $150,000. The Alcor Life Extension Foundation in Arizona, one of the largest organizations in this field, currently has 77 members in cryopreservation.
Healthy or successful aging Healthy or successful aging is defined as a process or lifestyle that minimizes the negative effects of normal aging while maintaining mental and physical functioning as long as possible. People cannot change their genetic makeup but they can contribute to successful aging by adopting a healthy lifestyle. Behaviors associated with a healthy lifestyle include:
- Not smoking.
- Drinking alcohol only in moderation.
- Getting regular exercise, at least 30 minutes per day five days a week.
- Getting enough sleep.
- Eating a well-balanced diet, with plenty of fruits and vegetables to provide fiber.
- Learning to cope effectively with stress.
- Maintaining a positive attitude toward life.
There has been an increase since the 1980s in the proportion of people in the United States and Canada who are aging successfully. The percentage of adults over 65 living in the community who need help with activities of daily living has decreased since 1985, as has the percentage of seniors with disabilities.
Ageism is a term that refers to stereotyping of or prejudice against older adults on the basis of age. The word was coined by Robert Butler in 1969 to describe discrimination analogous to sexism and racism. Although ageism is sometimes used to describe prejudice against teenagers or young adults, it is most commonly used to refer to employment and other forms of discrimination against seniors. The federal Age Discrimination in Employment Act (ADEA) of 1967 forbids arbitrary age limits in hiring or retaining workers or refusal of retirement benefits to older employees.
Ageism —Stereotyping of or prejudice against people because of their age.
Centenarian —A person who is 100 years old or older.
Cryonics —The low-temperature preservation of humans and animals after death in liquid nitrogen in the expectation of reviving them at some point in the future for treatment.
Free radical —In chemistry, any molecule that has an unpaired electron. Free radicals are thought to contribute to the aging process because they are implicated in certain age-related diseases.
Hayflick limit —The length of a telomere below which a cell will stop dividing. The Hayflick limit for human cells is about 50–52 divisions, after which the cell is senescent.
Hutchinson-Gilford progeria syndrome (HGPS) —A rare disease that affects about 1 in 8 million children, characterized by accelerated aging. Researchers think that HGPS may yield clues about normal aging.
Longevity —The length of an organism's lifespan.
Population aging —A condition in which the median age of a country's population rises. It may be caused by a drop in the birth rate, by increased longevity, or by migration.
Senescence —In biology, the state or process of aging.
Stem cells —Unspecialized cells found in both embryonic and adult tissues in humans that are capable of differentiating themselves into a wide variety of specialized cells.
Telomere —A region of repetitive DNA at the end of chromosomes that protects the end of the chromosome from damage during the process of cell division.
Werner syndrome —A genetic disorder in which a defective gene on chromosome 8 causes telomeres to shorten too rapidly, thus lowering the number of times the cell can divide.
In addition to employment issues, ageism is also used to describe negative stereotypes of older adults as mentally deficient, sexually unattractive, or physically frail. Social scientists and psychologists are increasingly critical of the mass media and popular culture for spreading and reinforcing stereotypes of seniors as “geezers” or “crones.” The cruel depictions of older women in particular have become a feminist as well as a generational issue. One of the distinctive aspects of ageism, as noted by the editor of a collection of essays on the topic, is that “age, unlike race and sex, represents a category in which most people from the in-group (the young) will eventually (if they are fortunate) become a member of the outgroup (older persons).” Thus understanding ageism is important to persons in all age groups, because it is a form of prejudice that eventually affects everyone and makes no exceptions for gender, race, or social class.
Beers, Mark H., M. D., and Thomas V. Jones, MD. Merck Manual of Geriatrics, 3rd ed., Chapter 1, “Biology of Aging,” and Chapter 2, “Demographics.” Whitehouse Station, NJ: Merck, 2005.
Ettinger, Robert C. W. The Prospect of Immortality. Garden City, NY: Doubleday, 1964. This is the book that started the cryonics and life extension movement in the mid-1960s. Available for download in an e-book PDF format at http://www.cryonics.org/book1.html.
Gavrilov, L. A., and P. Heuveline. “Aging of Population.” In Paul Demeny and Geoffrey McNicoll, eds., Encyclopedia of Population. New York: Macmillan Reference USA, 2003.
Greer, Germaine. The Change: Women, Aging and the Menopause. New York: Fawcett Columbine, 1991. Contains some challenging reflections on negative stereotypes of older women.
Masoro, Edward J., and Steven N. Austad, eds. Handbook of the Biology of Aging, 6th ed. Boston: Elsevier Academic Press, 2006.
Nelson, Todd D., ed. Ageism: Stereotyping and Prejudice against Older Persons. Cambridge, MA: MIT Press, 2004.
Balaram, P. “Gerontophobia, Ageing and Retirement.” Current Science 87 (November 2004): 1163–1164.
Hayflick, Leonard. “The Limited In Vitro Lifetime of Human Diploid Cell Strains.” Experimental Cell Research 37 (March 1965): 614–636,
Mouton, Charles P., and David P. Espino. “Health Screening in Older Women.” American Family Physician 59 (April 1, 1999): 1835–1842.
Santacruz, Karen S., and Daniel Swagerty. “Early Diagnosis of Dementia.” American Family Physician 63 (February 15, 2001): 703–718.
29 U.S. Code, Chapter 14. Age Discrimination in Employment Act (ADEA) of 1967. Full text available online at http://finduslaw.com/age_discrimination_in_employment_act_of_1967_adea_29_u_s_code_chapter_14.
American Geriatrics Society Foundation for Health in Aging. How We Age. Available online at http://www.healthinaging.org/agingintheknow/topics_trial.asp?id=1 [posted February 2005; cited March 26, 2008].
Shah, Kara N., and Hans-Wilhelm Kaiser. “Hutchinson-Gilford Progeria.” eMedicine, January 24, 2007. http://www.emedicine.com/derm/topic731.htm [cited March 28, 2008].
Alcor Life Extension Foundation, 7895 East Acoma Drive Suite 110, Scottsdale, AZ, 85260, (480) 905-1906, (877) 462-5267, (480) 922-9027, http://www.alcor.org/index.html.
American Geriatrics Society (AGS), Empire State Building, 350 Fifth Avenue, Suite 801, New York, NY, 10118, (212) 308-1414, (212) 832-8646, [email protected] org, http://www.americangeriatrics.org/index.shtml.
National Institute on Aging (NIA) Information Center, P.O. Box 8057, Gaithersburg, MD, 20898, (800) 222-2225, www.nia.nih.gov.
Rebecca J. Frey Ph.D.
We tend to think of aging in terms of human beings living in time, and, in particular, as the chronology of human experience in later life. But human aging is set in a much wider context, encompassing the biological, geological, and cosmological spheres. Aging is the elegant and continuous means by which the forces of nature, from the microscopic to the universal, create the conditions for regeneration. Many scholars consider aging to be a great equalizer, because it submits all forms of matter, including biological life, to a common set of principles. In human life, there are forms of aging not tied to the individual life course, but to human creations and even whole societies. Buildings become beautiful through weathering; furniture gains a fine patina and great value as it ages; and wines and cheeses are deliberately aged through intricate processes of fermenting, ripening, curing, and storing to enhance their flavor. As for societies across time, they take on the status of "civilizations" if they trace their ancestry and lasting achievements across an extensive span, such as "Old World" European or Asian societies as compared to "New World" countries such as Canada or the United States. The concept of aging, grounded in the realities of both the biological and nonliving material worlds, has thus inspired the human artistic and cultural imagination for millennia.
Rates of aging
Everything that exists in time ages, but rates of aging within living and nonliving realms vary greatly. Geologists and paleontologists who study the earth's history use terms of reference in the hundreds of millions of years. Evidence for the earth's aging is sought in the erosion of mountain ranges or the effects of plate tectonics on the making of continents, and sedimented fossils of extinct plant and animal species mark out a precise record of the earth's aging. These, and related phenomena, beyond the human experience to discern, are subject to the restless vicissitudes of what scientists call the earth's deep time. Physicists, meanwhile, indicate the decay of subatomic particles in units of time so brief as to be unintelligible to the ordinary human mind. Living organisms also vary greatly, but within time spans ranging from minutes to millennia, rather than microseconds to millions or billions of years. From the days or weeks of unicellular organisms to the months of rodents or decades of primates, animal aging appears tied in part to size and complexity. Many plants, however, do not appear to have a "natural" lifespan: There are trees living up to three thousand years, such as the giant California sequoias (the General Sherman Tree in California's Sequoia National Park is estimated to be between three and four thousand years old). Among vertebrates, certain families of species seem to live longer than others: parrots among birds, tortoises among reptiles, and elephants and primates among mammals. What is biologically important is the tempo at which such creatures live their lives rather than the actual length of time they live. In turn, a species' or a creature's tempo is determined by laws of size, environmental niches, reproductive cycles, and metabolic rates. As Stephen Jay Gould notes, a rat may live at a faster rate than an elephant, but this does not mean that it lives any less than an elephant (Gould, 1977).
Among primates, Homo sapiens fully evince the paradox of aging posed by the higher primates. On the one hand, humans live the longest and take the longest time to mature. On the other hand, humans are the most "youthful" primate, because their lengthy neotenic, postnatal development ensures an extended retention of youthful mammalian features (such as a large brain relative to body size and a playful curiosity). Neoteny also means that humans, born relatively helpless and unformed, develop traits and characteristics outside the womb that most primates develop soon after birth, and with which most other mammals are born. Thus nature's experimentation with increased primate intelligence, carried to a high point in humans, has produced a course of life where more areas of behavior are shaped by societal and family learning than by instinct. The special product of this unique evolutionary experiment is human intelligence and the creation of culture and history as key forces in the species' development.
It is a cosmic irony, therefore, that this intelligence allows us to be aware of our own aging. As the only animal conscious of its own mortality, we have invented many different ways to deal with this knowledge across cultures and over the course of history. In Europe, Medieval and Renaissance thinkers saw aging and dying as part of the universal order, represented by the elements of the earth, the cycle of the seasons, and the movement of the planets. The modern biological and social sciences have developed theories of aging based on cellular, neurological, genetic, physiological, psychological, social, and demographic factors. Whereas cytogerontologists, such as Leonard Hayflick, locate the secrets of aging in cellular biology, those in the humanities, such as philosopher Ronald H. Manheimer, seek it in human wisdom and social relationships. Social and psychological gerontologists connect research on individual health, longevity, and cognitive abilities to wider issues of social inequality, gender, race, housing, and lifestyle. Broader still are demographic and global studies that profile the aging characteristics of whole populations. Thus, human aging, from the cell to the population, is a multifarious process that requires study using a multidisciplinary approach.
Measuring human aging
Despite their different backgrounds, researchers who study aging are challenged by the problem of how to measure it. While geological deep time is measured in large-scale epochs and eras, biological aging is calculated in maturational stages within specific life spans. Life spans represent longevity limits that are rarely achieved. The scientific community has set the human life span at 120 years. Life expectancy is the statistical figure based on the average person's length of life. In developed countries, medical advances and improved diet have allowed people to live longer and in greater numbers. Gerontologist Bernice Neugarten has divided the aging population itself into young-old and old-old categories to indicate this development. As the age curve lengthens, however, so do the possible number of diseases and incapacities suffered in later life. At the same time, in developing countries, poverty and the consequences of global inequality continue to undermine healthy populational aging.
Social aging is often measured in terms of ages or stages of life. For example, many African societies use complex and ritualized age-grade systems to identify the passages of life. Medieval European scholars mapped out seven ages of life according to a planetary model, beginning at birth with the moon and ending in old age with Saturn. Shakespeare's character Jaques, in As You Like It, articulated a memorable version of this model, making each age into a theatrical role: the infant, schoolboy, lover, soldier, justice, middle age, and old age—the "last scene of all . . . second childishness and mere oblivion, sans teeth, sans eyes, sans taste, sans everything." (act 2, scene 7) Ages-of-life models became superseded in the nineteenth and twentieth centuries by the sciences of aging, particularly developmental psychology, geriatrics, and gerontology. These sciences increasingly associated aging with the second half of life, or later life, which follows early-life processes of maturation and socialization. In psychology, G. Stanley Hall pioneered aging studies of both early and later life with his two influential books, Adolescence (1904), and Senescence (1922). Erik H. Erikson, a more contemporary developmental psychologist, theorized eight stages of development across the life cycle. He marked each stage by psychosocial modes of growth, crises, and resolutions centered around identity. For instance, in young adulthood (stage 6), the antithesis between generativity and self-absorption creates care. In old age (stage 8), the antithesis between integrity and despair creates wisdom (Erikson 1982). However, the work of Erikson and others in developmental psychology has been criticized by cross-cultural and feminist psychologists for its individualistic, ethnocentric, and masculinist models of the life cycle.
Geriatrics and gerontology emerged as fields of study in the early twentieth century by borrowing the expertise generated in psychology, biology, and medicine. Geriatrics and gerontology introduced two lasting contributions to the measurement of aging. First, aging and old age have their own physical, emotional, and psychological dynamics distinct from other stages of life. Second, aging and old age are best understood if disease pathologies and normal senile conditions are separated. Early clinicians such as Jean-Martin Charcot, Ignatz L. Nascher, Elie Metchnikoff, and Edmund V. Cowdry attributed the problems of aging to specific degenerative processes in the cells, tissues, and organs of the body. Gerontology grew apart from geriatrics in the later twentieth century to include sociological, demographic, and policy studies. Gerontologists also attacked traditionally ageist notions of decline with new, positive measurements of creativity, wisdom, and the benefits of aging. Gerontological research on positive measurements of successful aging has continued with criticism of the negation of aging stemming from modern culture's adulation of youthfulness.
Structuring the life course
Researchers have come to understand more of the complexities of aging throughout the life course; an idea that connects aging to social, gender, family, generational, and environmental contexts. On an individual, or micro, scale, the life course is a lived embodiment of time from which people distill a rich and versatile archive of meaning, memory, narrative, and identity. On a structural, or macro, scale, the life course is an aggregation of knowledges, technologies, institutions, and lifestyles through which aging is socially and temporally organized. Whether people "act their age" or resist it; whether they reckon their time through linear calendars or cyclical anniversaries—they do so through the norms and roles made possible by particular life courses. In Western societies, since the nineteenth century, the modern life course has been structured according to various institutional, industrial, and commercial standards. For example, early life is age graded according to schooling criteria, while later life is age graded according to retirement criteria (usually 65 and over). The modern life course, in turn, evolved in the twentieth century to become an elaborate framework within which people coordinate family, cohort, and intergenerational relations.
Profound shifts in labor, retirement, demographic patterns, and social programs in the late twentieth and early twenty-first centuries have led cultural gerontologists to posit the rise of a postmodern life course (see Featherstone and Hep-worth, 1991). The postmodern life course blurs or loosens the chronological and generational boundaries that have set apart childhood, middle age, and old age throughout the modern era. On the one hand, this has motivated marketing, cosmetic, and leisure industries to target seniors, Third Agers, or boomers (usually those 55 and over), and to recast later life as an active, youthful, consumer experience, one often associated with Hollywood film stars who exemplify the postmodern dream of growing older without aging. On the other hand, the postmodern life course creates new avenues of choice, mobility, well-being, and self-definition in later life, thus empowering senior citizens to innovate resourceful roles and ways of life both for themselves and those who will follow.
Metaphors of aging
Aside from scientific measurements of human aging and the social structuring of the life course, people understand what it means to age and grow older by producing their own metaphoric and symbolic images. The world's religious and literary traditions are a rich source of images about the aging process, while secular examples portray life as a wheel, a journey, a race, a procession, a clock, a hill, over which one climbs, or a return to second childhood. Metaphorical innovations in language can also shake up traditional conventions about aging. Terms such as male menopause or midlife crisis raise the issue of how individual and social aging are intertwined. The term late midlife astonishment (Pearlman, 1993) is a timely metaphorical antidote to centuries of negative images about middle-aged menopausal women. The mommy track is a creative metaphor about women's career path in the workplace, indicating that women must cope with combining careers and parenthood. Whatever their source, metaphors of aging serve to remind us that the human spirit renews itself, in large part, by confronting the paradoxes of living and dying in time.
See also Age; Geriatrics; Gerontology; Life Course; Prolongevity.
Bauman, Z. Mortality, Immortality and Other Life Strategies. Oxford: Polity Press, 1992.
Binstock, R. H., and George, L. K., eds. Handbook of Aging and the Social Sciences. San Diego: Academic Press, 1996.
Burrow, J. A. The Ages of Man: A Study in Medieval Writing and Thought. Oxford: Clarendon Press, 1986.
Chudacoff, H. P. How Old Are You? Age Consciousness in American Culture. Princeton, N.J.: Princeton University Press, 1989.
Cole, T. R. The Journey of Life: A Cultural History of Aging in America. Cambridge, U.K.: Cambridge University Press, 1992.
Dannefer, D. "The Race is to the Swift: Images of Collective Aging." In Metaphors of Aging in Science and The Humanities. Edited by Gary M. Kenyon, James E. Birren, and Johannes J. F. Schroots. New York: Springer, 1991. Pages 155–172.
Dannefer, D. "Neoteny, Naturalization, and Other Constituents of Human Development." In The Self and Society in Aging Processes. Edited by Carol D. Ryff and Victor W. Marshall. New York: Springer, 1999. Pages 67–93.
Erikson, E. H. The Life Cycle Completed: A Review. New York: W. W. Norton, 1982.
Featherstone, M., and Hepworth, M. " The Mask of Ageing and the Postmodern Life Course." In The Body: Social Process and Cultural Theory. Edited by Mike Featherstone, Mike Hepworth, and Bryan S. Turner. London: Sage Publications, 1991. Pages 371–389.
Featherstone, M., and Wernick, A., eds. Images of Aging: Cultural Representations of Later Life. London: Routledge, 1995.
Finch, C. E., and Kirkwood, T. Chance, Development, and Aging. New York: Oxford University Press, 2000.
Gillis, J. R. A World of Their Own Making: Myth, Ritual, and The Quest for Family Values. Cambridge, Mass.: Harvard University Press, 1996.
Gould, S. J. "The Child a Man's Real Father." In Ever Since Darwin. Edited by S. J. Gould. New York: W. W. Norton and Co., 1977. Pages 63–69.
Hall, G. S. Senescence: The Last Half of Life. New York: D. Appleton, 1922.
Hayflick, L. "The Cellular Basis for Biological Aging." In Handbook of the Biology of Aging. Edited by Caleb E. Finch. New York: Van Nostrand Reinhold, 1977. Pages 159–186.
Hockey, J., and JAMES, A. Growing Up and Growing Old: Ageing and Dependency in the Life Course. London: Sage Publications, 1993.
Katz, S. Disciplining Old Age: The Formation of Gerontological Knowledge. Charlottesville, Va.: The University Press of Virginia, 1996.
Kenyon, G. M.; Birren, J. E.; and Schroots, J. J. F., eds. Metaphors of Aging in Science and The Humanities. New York: Springer, 1991.
Manheimer, R. J. A Map to the End of Time: Wayfarings with Friends and Philosophers. New York: W. W. Norton and Co., 1999.
Montagu, A. Growing Young, 2d. ed. Granby, Mass.: Bergin and Harvey, 1989.
Mostafavi, M., and Leatherbarrow, D. On Weathering: The Life of Buildings in Time. Cambridge, Mass.: The MIT Press, 1993.
Neugarten, B. L., and Neugarten, D. A. "Changing Meanings of Age in the Aging Society." In Our Aging Society: Paradox and Promise. Edited by Alan Pifer and D. Lydia Bronte. New York: W. W. Norton and Co., 1986. Pages 33–51.
Pearlman, S. F. "Late Mid-Life Astonishment: Disruptions to Identity and Self-Esteem." In Faces of Women and Aging. Edited by Nancy D. Davis, Ellen Cole, and Esther D. Rothblum. New York: Harrington Park, 1993. Pages 1–12.
Rasmussen, S. J. The Poetics and Politics of Tuareg Aging: Life Course and Personal Destiny in Niger. DeKalb, Ill.: Northern Illinois University Press, 1997.
Sokolovsky, J., ed. The Cultural Context of Aging: Worldwide Perspectives. Westport, Conn.: Bergin and Garvey, 1997.
American Association of Retired Persons (AARP) (www.aarp.org).
Administration on Aging (www.aoa.dhhs.gov).
The Gerontological Society of America (www.geron.org).
The National Aging Information Center (www.ageinfo.org).
Starting at what is commonly called middle age, operations of the human body begin to be more vulnerable to daily wear and tear; there is a general decline in physical, and possibly mental, functioning. In the Western countries, the length of life is often into the 70s. The upward limit of the life span, however, can be as high as 120 years. During the latter half of life, an individual is more prone to have problems with the various functions of the body and to develop any number of chronic or fatal diseases. The cardiovascular, digestive, excretory, nervous, reproductive and urinary systems are particularly affected. The most common diseases of aging include Alzheimer's, arthritis, cancer, diabetes, depression, and heart disease.
Human beings reach a peak of growth and development around the time of their mid 20s. Aging is the normal transition time after that flurry of activity. Although there are quite a few age-related changes that tax the body, disability is not necessarily a part of aging. Health and lifestyle factors together with the genetic makeup of the individual, and determines the response to these changes. Body functions that are most often affected by age include:
- Hearing, which declines especially in relation to the highest pitched tones.
- The proportion of fat to muscle, which may increase by as much as 30%. Typically, the total padding of body fat directly under the skin thins out and accumulates around the stomach. The ability to excrete fats is impaired, and therefore the storage of fats increases, including cholesterol and fat-soluble nutrients.
- The amount of water in the body decreases, which therefore decreases the absorption of water-soluble nutrients. Also, there is less saliva and other lubricating fluids.
- The liver and the kidneys cannot function as efficiently, thus affecting the elimination of wastes.
- A decrease in the ease of digestion, with a decrease in stomach acid production.
- A loss of muscle strength and coordination, with an accompanying loss of mobility, agility, and flexibility.
- A decline in sexual hormones and sexual functioning.
- A decrease in the sensations of taste and smell.
- Changes in the cardiovascular and respiratory systems, leading to decreased oxygen and nutrients throughout the body.
- Decreased functioning of the nervous system so that nerve impulses are not transmitted as efficiently, reflexes are not as sharp, and memory and learning are diminished.
- A decrease in bone strength and density.
- Hormone levels, which gradually decline. The thyroid and sexual hormones are particularly affected.
- Declining visual abilities. Age-related changes may lead to diseases such as macular degeneration.
- A compromised ability to produce vitamin D from sunlight.
- A reduction in protein formation leading to shrinkage in muscle mass and decreased bone formation, possibly leading to osteoporosis.
Causes and symptoms
There are several theories as to why the aging body loses functioning. It may be that several factors work together or that one particular factor is at work more than others in a given individual.
- Programmed senescence, or aging clock, theory. The aging of the cells of each individual is programmed into the genes, and there is a preset number of possible rejuvenations in the life of a given cell. When cells die at a rate faster than they are replaced, organs do not function properly, and they are soon unable to maintain the functions necessary for life.
- Genetic theory. Human cells maintain their own seed of destruction at the level of the chromosomes.
- Connective tissue, or cross-linking theory. Changes in the make-up of the connective tissue alter the stability of body structures, causing a loss of elasticity and functioning, and leading to symptoms of aging.
- Free-radical theory. The most commonly held theory of aging, it is based on the fact that ongoing chemical reactions of the cells produce free radicals. In the presence of oxygen, these free radicals cause the cells of the body to break down. As time goes on, more cells die or lose the ability to function, and the body soon ceases to function as a whole.
- Immunological theory. There are changes in the immune system as it begins to wear out, and the body is more prone to infections and tissue damage, which may finally cause death. Also, as the system breaks down, the body is more apt to have autoimmune reactions, in which the body's own cells are mistaken for foreign material and are destroyed or damaged by the immune system.
Many problems can arise due to age-related changes in the body. Although there is no one test to be given, a thorough physical exam and a basic blood screening and blood chemistry panel can point to areas in need of further attention. When older people become ill, the first signs of disease are often nonspecific. Further exams should be conducted if any of the following occur:
- diminished or lack of desire for food
- increasing confusion
- failure to thrive
- urinary incontinence
- weight loss
For the most part, doctors prescribe medications to control the symptoms and diseases of aging. In the United States, about two-thirds of people 65 and over take medications for various complaints. More women than men use these medications. The most common drugs used by the elderly are painkillers, diuretics or water pills, sedatives, cardiac drugs, antibiotics, and mental health drugs.
Estrogen replacement therapy (ERT) is commonly prescribed to postmenopausal women for symptoms of aging. It is often used in conjunction with progesterone. ERT functions to help keep bones strong, reduce risk of heart disease, restore vaginal lubrication, and to improve skin elasticity. Evidence suggests that it may also help maintain mental functions.
Aging is unavoidable, but major physical impairment is not. People can lead a healthy, disability-free life well through their later years. A well established support system of family, friends, and health care providers, together with focus on good nutrition and lifestyle habits and good stress management, can prevent disease and lessen the impact of chronic conditions.
Antioxidants— Substances that reduce the damage of the highly reactive free radicals that are the byproducts of the cells.
Alzheimer's disease— A condition causing a decline in brain function that interferes with the ability to reason and to perform daily activities.
Vata— One of the three main constitutional types found under Ayurvedic principles. Keeping one's particular constitution in balance is considered important in maintaining health.
Consumption of a high-quality multivitamin is recommended. Common nutritional deficiencies connected with aging include B vitamins, vitamins A and C, folic acid, calcium, magnesium, zinc, iron, chromium, and trace minerals. Since stomach acids may be decreased, it is suggested that the use of a powdered multivitamin formula in gelatin capsules be used, as this form is the easiest to digest. Such formulas may also contain enzymes for further help with digestion.
Antioxidants can help to neutralize damage by the free radical actions thought to contribute to problems of aging. They are also helpful in preventing and treating cancer and in treating cataracts and glaucoma. Supplements that serve as antioxidants include:
- Vitamin E, 400-1,000 IUs daily. Protects cell membranes against damage. It shows promise in prevention against heart disease, and Alzheimer's and Parkinson's diseases.
- Selenium, 50 mg taken twice daily. Research suggests that selenium may play a role in reducing the risk of cancer.
- Beta-carotene, 25,000-40,000 IUs daily. May help in treating cancer, colds and flu, arthritis, and immune support.
- Vitamin C, 1,000-2,000 mg per day. It may cause diarrhea in large doses. If this occurs, however, all that is needed is a decrease in the dosage.
Other supplements that are helpful in treating agerelated problems including:
- B12/B-complex vitamins, studies show that B12 may help reduce mental symptoms, such as confusion, memory loss, and depression.
- Coenzyme Q10 may be helpful in treating heart disease, as up to three-quarters cardiac patients have been found to be lacking in this heart enzyme.
The following hormone supplements may be taken to prevent or to treat various age-related problems. However, caution should be taken before beginning treatment, and the patient should consult his or her health care professional.
DHEA improves brain functioning and serves as a building block for many other important hormones in the body. It may be helpful in restoring declining hormone levels and in building up muscle mass, strengthening the bones, and maintaining a healthy heart.
Melatonin may be helpful for insomnia. It has also been used to help fight viruses and bacterial infections, reduce the risk of heart disease, improve sexual functioning, and to protect against cancer.
Garlic (Allium sativa ) is helpful in preventing heart disease, as well as improving the tone and texture of skin. Garlic stimulates liver and digestive system functions, and also helps in dealing with heart disease and high blood pressure.
Siberian ginseng (Eleutherococcus senticosus ) supports the adrenal glands and immune functions. It is believed to be helpful in treating problems related to stress. Siberian ginseng also increases mental and physical performance, and may be useful in treating memory loss, chronic fatigue, and immune dysfunction.
Proanthocyanidins, or PCO, are Pycnogenol, derived from grape seeds and skin, and from pine tree bark, and may help in the prevention of cancer and poor vision.
In Ayurvedic medicine, aging is described as a process of increased vata, in which there is a tendency to become thinner, drier, more nervous, more restless, and more fearful, while having a loss of appetite as well as sleep. Bananas, almonds, avocados, and coconuts are some of the foods used in correcting such conditions. One of the main herbs used for such conditions is gotu kola (Centella asiatica ), which is used to revitalize the nervous system and brain cells and to fortify the immune system. Gotu kola is also used to treat memory loss, anxiety, and insomnia.
In Chinese medicine, most symptoms of aging are regarded as symptoms of a yin deficiency. Moistening foods such as millet, barley soup, tofu, mung beans, wheat germ, spirulina, potatoes, black sesame seeds, walnuts, and flax seeds are recommended. Jing tonics may also be used. These include deer antler, dodder seeds, processed rehmannia, longevity soup, mussels, and chicken.
Preventive health practices such as healthy diet, daily exercise, stress management, and control of lifestyle habits such as smoking and drinking, can lengthen the life span and improve the quality of life as people age. Exercise can improve the appetite, the health of the bones, the emotional and mental outlook, and the digestion and circulation.
Drinking plenty of fluids aids in maintaining healthy skin, good digestion, and proper elimination of wastes. Up to eight glasses of water should be consumed daily, along with plenty of herbal teas, diluted fruit and vegetable juices, and fresh fruits and vegetables with high water content.
Because of a decrease in the sense of taste, older people often increase their intake of salt, which can contribute to high blood pressure and nutrient loss. Use of sugar is also increased. Seaweeds and small amounts of honey can be used as replacements.
Alcohol, nicotine, and caffeine all have potential damaging effects, and should be limited or completely eliminated from consumption.
A diet high in fiber and low in fat is recommended. Processed foods should be replaced by complex carbohydrates, such as whole grains. If chewing becomes a problem, there should be an increased intake of protein drinks, freshly juiced fruits and vegetables, and creamed cereals.
"Anti-Aging-Nutritional Program." December 28, 2000. 〈http://www.healthy.net/hwlibrarybooks/haas/perform/antiagin.htm〉.
"Effects of Hormone in the Body." December 28, 2000. 〈http://www.anti-aging.org/Effects_hGH.html〉.
"The Elderly-Nutritional Programs." December 28, 2000. 〈http://www.healthy.net/hwlibrarybooks/haas/lifestage/elderly.htm〉.
"Evaluating the Elderly Patient: the Case for Assessment Technology." December 28, 2000. 〈http://text.nlm.nih.gov/nih/ta/www/01.html〉.
"Herbal Phytotherapy and the Elderly." December 28, 2000. 〈http://www.healthy.net/hwlibrarybooks/hoffman/elders/elders.htm〉.
"Pharmacokinetics." Merck & Co., Inc. (1995–2000). December 28, 2000. 〈http://www.merck.com/pubs/mmanual/section22/chapter304/304a.htm〉.
"To a Long and Healthy Life." December 28, 2000. 〈http://www.healthy.net/hwlibraryarticles/aesoph/longandhealthy.htm〉.
Starting at what is commonly called middle age, operations of the human body become more vulnerable to daily wear and tear. There is a general decline in physical, and possibly mental, functioning. In the Western countries, the length of life often extends into the 70s. However, the upward limit of the life span can be as high as 120 years. During the latter half of life, an individual is more prone to problems with the various functions of the body, and to a number of chronic or fatal diseases. The cardiovascular, digestive, excretory, nervous, reproductive, and urinary systems are particularly affected. The most common diseases of aging include Alzheimer's, arthritis, cancer , diabetes, depression , and heart disease .
Human beings reach a peak of growth and development during their mid 20s. Aging is the normal transition time after that flurry of activity. Although there are quite a few age-related changes that tax the body, disability is not necessarily a part of aging. Health and lifestyle factors, together with the genetic makeup of the individual, determine the response to these changes. Body functions that are most often affected by age include:
- Hearing, which declines especially in relation to the highest pitched tones.
- The proportion of fat to muscle, which may increase by as much as 30%. Typically, the total padding of body fat directly under the skin thins out and accumulates around the stomach. The ability to excrete fats is impaired, and therefore the storage of fats increases, including cholesterol and fat-soluble nutrients.
- The amount of water in the body, which decreases, reducing the body's ability to absorb water-soluble nutrients. Also, there is less saliva and other lubricating fluids.
- Liver and kidney activities, which become less efficient, thus affecting the elimination of wastes.
- The ease of digestion, which is decreased, resulting in a reduction in stomach acid production.
- Muscle strength and coordination, which lessens, with an accompanying loss of mobility, agility, and flexibility.
- Sexual hormones and sexual function, which both decline.
- Sensations of taste and smell, which decrease.
- Cardiovascular and respiratory systems, with changes leading to decreased oxygen and nutrients throughout the body.
- Nervous system, which experiences changes that result in less efficient nerve impulse transmission, reflexes that are not as sharp, and diminished memory and learning.
- Bone strength and density, which decrease.
- Hormone levels, which gradually decline. The thyroid and sexual hormones are particularly affected.
- Visual abilities, which decline. Age-related changes may lead to diseases such as macular degeneration .
- A compromised ability to produce vitamin D from sunlight.
- Protein formation, which is reduced, leading to shrinkage in muscle mass and decreased bone formation, possibly contributing to osteoporosis.
Causes & symptoms
There are several theories on why the aging body loses functioning. It may be that several factors work together or that one particular factor is the culprit in a given individual. These theories include:
- Programmed senescence, or aging clock, theory. The aging of the cells for each individual is programmed into the genes, and there is a preset number of possible rejuvenations in the life of a given cell. When cells die at a rate faster than they are replaced, organs do not function properly, and they become unable to maintain the functions necessary for life.
- Genetic theory. Human cells maintain their own seed of destruction at the chromosome level.
- Connective tissue, or cross-linking theory. Changes in the makeup of the connective tissue alter the stability of body structures, causing a loss of elasticity and functioning, and leading to symptoms of aging.
- Free-radical theory. The most commonly held theory of aging, is based on the fact that ongoing chemical reactions of the cells produce free radicals. In the presence of oxygen, these free radicals cause the cells of the body to break down. As time goes on, more cells die or lose the ability to function, and the body ceases to function as a whole.
- Immunological theory. There are changes in the immune system as it begins to wear out, and the body is more prone to infections and tissue damage, which may ultimately cause death. Also, as the system breaks down, the body is more apt to have autoimmune reactions, in which the body's own cells are mistaken for foreign material and are destroyed or damaged by the immune system.
Many problems can arise due to age-related changes in the body. Although there is no individual test to measure these changes, a thorough physical exam and a basic blood screening and blood chemistry panel can point to areas in need of further attention. When older people become ill, the first signs of disease are often nonspecific. Further exams should be conducted if any of the following occur:
- diminished, or lack of, desire for food
- increased confusion
- failure to thrive
- urinary incontinence
- weight loss
Consumption of a high-quality multivitamin is recommended. Common nutritional deficiencies connected with aging include B vitamins, vitamin A and vitamin C, folic acid, calcium, magnesium, zinc, iron, chromium , and trace minerals. Since stomach acids may be decreased, powdered multivitamin formula in gelatin capsules are suggested, as this form is the easiest to digest. Such formulas may also contain enzymes for further help with digestion.
Antioxidants can help neutralize damage caused by free radical actions, which are thought to contribute to problems of aging. They are also helpful in preventing and treating cancer, and in treating cataracts and glaucoma . Supplements that serve as antioxidants include:
- Vitamin E, 400–1,000 IUs daily. Protects cell membranes against damage. It shows promise in preventing heart disease, and Alzheimer's and Parkinson's diseases.
- Selenium , 50 mg taken twice daily. Research suggests that selenium may play a role in reducing cancer risk.
- Beta-carotene, 25,000–40,000 IUs daily. May help in treating cancer, colds and flu, arthritis, and immune support.
- Vitamin C, 1,000–2,000 mg per day. It may cause diarrhea in large doses. The dosage should be decreased if this occurs.
Other supplements that are helpful in treating agerelated problems include:
- B12/B-complex vitamins. Studies show that B12 may help reduce mental symptoms, such as confusion, memory loss , and depression.
- Coenzyme Q10 may be helpful in treating heart disease. Up to 75% of cardiac patients have been found to lack this heart enzyme.
The following hormone supplements may be taken to prevent or treat various age-related problems. However, caution should be taken before beginning treatment, and the patient should consult his or her health care professional prior to hormone use.
DHEA improves brain functioning and serves as a building block for many other important hormones. It may be helpful in restoring hormone levels that have declined, building muscle mass, strengthening bones, and maintaining a healthy heart.
Melatonin may be helpful for insomnia . It has also been used to help fight viruses and bacterial infections, reduce the risk of heart disease, improve sexual function, and to protect against cancer.
Garlic (Allium sativa ) is helpful in preventing heart disease, and improving the tone and texture of skin. Garlic stimulates liver and digestive system functions, and also helps manage heart disease and high blood pressure.
Siberian ginseng (Eleutherococcus senticosus ) supports the adrenal glands and immune functions. It is believed to be helpful in treating problems related to stress . Siberian ginseng also increases mental and physical performance, and may be useful in treating memory loss, chronic fatigue , and immune dysfunction.
Ginkgo biloba works particularly well on the brain and nervous system. It is effective in reducing the symptoms of such conditions as Alzheimer's disease , depression, visual disorders, and problems of blood circulation. It may also help treat heart disease, strokes, dementia , Raynaud's disease, head injuries, leg cramps, macular degeneration, tinnitus, impotence due to poor blood flow, and diabetes-related nerve damage.
Proanthocyanidins, or PCO, (brand name Pycnogenol), are derived from grape seeds and skin, as well as pine tree bark. They may help prevent cancer and poor vision.
Green tea has powerful antioxidant qualities, and has been used for centuries as a natural medicine in China, Japan, and other Asian cultures. In alternative medicine, it aids in treating cancer, rheumatoid arthritis , high cholesterol, heart disease, infection, and impaired immune function. Several scientific studies have shown that antioxidant benefits are obtained by drinking two cups of green tea each day.
In Ayurvedic medicine , aging is described as a process of increased vata, in which there is a tendency to become thinner, drier, more nervous, more restless, and more fearful, while experiencing declines in both sleep and appetite. Bananas, almonds, avocados, and coconuts are some of the foods used in correcting such conditions. One of the main herbs used to treat these problems is gotu kola (Centella asiatica ). It is taken to revitalize the nervous system and brain cells, and to fortify the immune system. Gotu kola is also used to treat memory loss, anxiety , and insomnia.
In Chinese medicine, most symptoms of aging are regarded as signs of a yin deficiency. Moistening foods are recommended, and include barley soup, tofu, mung beans, wheat germ, spirulina , potatoes, black sesame seeds, walnuts, and flax seeds. Jing tonics may also be used. These include deer antler, dodder seeds, processed rehmannia, longevity soup, mussels, and chicken.
For the most part, doctors prescribe medications to control the symptoms and diseases of aging. In the United States, about two-thirds of people age 65 and over take medications for various conditions. More women than men use these medications. The most common drugs used by the elderly are painkillers, diuretics or water pills, sedatives, cardiac medications, antibiotics, and mental health remedies.
Estrogen replacement therapy (ERT) is commonly prescribed to alleviate the symptoms of aging in postmenopausal women. It is often used in conjunction with progesterone. These drugs help keep bones strong, reduce the risk of heart disease, restore vaginal lubrication, and improve skin elasticity. Evidence suggests that they may also help maintain mental functions.
Aging is unavoidable, but major physical impairment is not. People can lead healthy, disability-free lives throughout their later years. A well-established support system of family, friends, and health care providers, along with a focus on good nutrition and lifestyle habits, and effective stress management, can prevent disease and lessen the impact of chronic conditions.
Preventive health practices such as healthy diet, daily exercise , stress management, and control of lifestyle habits, such as smoking and drinking, can lengthen the life span and improve the quality of life as people age. Exercise can improve appetite, bone health, emotional and mental outlook, digestion, and circulation.
Drinking plenty of fluids aids in maintaining healthy skin, good digestion, and proper elimination of wastes. Up to eight glasses of water should be consumed daily, along with plenty of herbal teas, diluted fruit and vegetable juices, and fresh fruits and vegetables that have a high water content.
Because of a decrease in the sense of taste, older people often increase their salt intake, which can contribute to high blood pressure and nutrient loss. Use of sugar is also increased. Seaweeds and small amounts of honey can be used as replacements.
Alcohol, nicotine, and caffeine all have potential damaging effects, and consumption should be limited or completely eliminated.
A diet high in fiber and low in fat is recommended. Processed foods should be replaced by such complex carbohydrates as whole grains. If chewing becomes a problem, there should be an increased intake of protein drinks, freshly juiced fruits and vegetables, and creamed cereals.
Cox, Harold. Aging. New York, NY: McGraw Hill College Division, 2004.
Giampapa, Vincent, et al. The Anti-Aging Solution: 5 Simple Steps to Looking and Feeling Young. Hoboken, NJ: John Wiley & Sons, 2004.
Panno, Joseph. Aging: Theories and Potential Therapies New York, NY: Facts on File, Inc., 2004.
Landis, Robyn, with Karta Purkh Singh Khalsa. Herbal Defense: Positioning Yourself to Triumph Over Illness and Aging New York, NY: Warner Books, 1997.
Weil, Andrew M.D. Healthy Aging New York, NY: Knopf, 2004.
"Chemopreventive Effects of Green Tea Said to Delay Aging of Skin." Cancer Weekly (April 13, 2004): 10.
"Discovery Claims to Link DNA Test to Reversing Signs of Aging." Drug Week (February 27, 2004): 122.
"Fitness Can Improve Thinking Among Aging." Obesity, Fitness & Wellness Week (March 13, 2004): 16.
"Hormonal Activity Plays Role in Body Composition Changes with Aging." Obesity, Fitness & Wellness Week (March 20, 2004): 3.
Lofshult, Diane. "Aging Trends for 2004." IDEA Health & Fitness Source (March 2004): 14.
"Research Reports on Key Antioxidant to Slow Aging." Drug Week (April 2, 2004): 194.
The Anti-Aging Institute. 843 William Hilton Parkway, Hilton Head, SC 29928. (912) 238-3383. <http://www.anti-aging.org>.
The Rosenthal Center for Complementary and Alternative Medicine Research in Aging and Women's Health. Columbia University, College of Physicians and Surgeons, 630 W. 168th St., New York, NY 10032. <http://www.rosenthal.hs.columbia.edu>.
National Institute on Aging Senior Health Web site. <http://www.nihseniorhealth.gov>.
The process by which the human body changes and matures over time, especially the means by which dying cells are not replaced in sufficient numbers to maintain current levels of function; the process by which human behavior alters with time.
Psychological studies of aging populations began in earnest in the late nineteenth century when psychologists found that mental abilities deteriorated with age. These abilities included memory and the types of mental performance measured in IQ tests. In some individuals, verbal abilities were shown to deteriorate with advanced age, although at a slower rate than other skills; with others, verbal abilities, especially vocabulary, may increase with age. Such data have often been corroborated in tests with chimpanzees, where younger animals perform better in tests of memory and other such areas of mental functioning. For decades, then, it was assumed that the physical deterioration of the body, so evident in the elderly, was surely matched by a similar decline in the mind.
Recent studies, however, have begun to cast doubt on these assumptions. One area where current research has disproved a long-held belief about the aging of the mind is in the death of neurons, formally thought to necessarily lead to diminished mental functioning. It is now known that the brain has far more neurons than it could ever use, and that as they die their functions are taken over by nearby neurons. Scientists have recently proven that while abilities like short-term memory and performing certain specific tasks within a time constraint often deteriorate after mid-life, other areas of mental activity, such as wisdom and judgment, become more acute and powerful. Still other studies have shown that brains in older subjects are capable of performing many tasks as quickly and efficiently as brains in younger subjects, although the tasks are performed using different areas of the brain. For instance, research conducted at the Georgia Institute of Technology studied typing speeds in accomplished typists of college age and another group in their sixties. Common sense suggests that the older typists would perform less well because of decreased hand-eye coordination and slower reaction time . Surprisingly, both groups typed at the same speed. Researchers explained the results by pointing out that the assumptions about dexterity and response time were correct, but that the older typists had made clever, efficient adjustments, such as making fewer finger movements and to read ahead in the text, to compensate for their deficiency in those areas.
Fifty seems to be a crucial age in determining the brain's pattern of aging. Once a person has passed that age, brain functioning and mental ability are thought to be determined by essentially three factors: mental habits, chronic disease, and the mind's flexibility.
The elderly populations of many Western countries are the fastest growing segment of the population. In the United States, it is estimated that by the year 2030 there will be 50 million persons over age 65. Among the elderly, the fastest growing population is people over 85. Such demographic data will continue to focus attention on the process of aging and the psychological problems faced by the elderly. Perhaps the most common psychological disorder often associated with aging is depression . According to the National Institute of Mental Health, depression among the elderly range from 10 to 65 percent. Suicide rates among the elderly have been increasing at alarming rates. A study conducted by the federal government found that between 1980 and 1986, suicides by persons aged 65 and older increased 23 percent among white men, 42 percent among black men, and 17 percent among white women. The highest suicide rates are for white men over age 85. The elderly comprise about 13 percent of the nation's population (one in eight Americans) and account for about 20 percent of all suicides.
With the increase in the aging population, more focus is being placed on geriatric mental health issues, including disabilities since more than half the population has at least one, chronic health problems, living alone or in assisted housing, depression, loss, pain , Alzheimer's and dementia , among others. The nation's 78 million American baby boomers are expected to crave more vitality and longer life, which could contribute to a healthier version of aging.
Cadoff, Jennifer. "Feel Your Best at Every Age." McCall's (February 1994): 128.
Kahn, Ada, and Jan Fawcett, eds. The Encyclopedia of Mental Health. New York: Facts on File, 1993.
Schrof, Joannie M. "Brain Power." U.S. News and World Report (28 November 1994): 88+.
White, Kristin. "How the Mind Ages: Aging: Getting It Right." Psychology Today (November/December 1993): 38+.
Aging is the gradual loss of function in both cells and the overall organism. The natural process of aging, or senescence, results in bodily changes that make an organism less efficient and eventually contribute to its death. Aging is almost certainly affected by genes, and members of the same species have similar life expectancies.
After living for three weeks as a larva, a mayfly may spend only one day as an adult before it dies. A bird may live up to four years, a frog sometimes up to twenty, a human being can reach one hundred, and a Sierra redwood tree can live as many as four thousand years. Obviously, different species have radically different life spans. (Life span is the maximum time that an individual may live under ideal circumstances.) It is different from life expectancy, which is calculated from the average years lived by individuals of a certain generation. However, it appears that no matter how long or short the life span of an individual organism may be, it generally undergoes a process of getting older that is marked by gradual deterioration of its systems and abilities. In humans, this process becomes very obvious in what is called middle age. By forty or fifty, a person's body begins to act and appear different. The skin becomes less elastic or smooth and permanent wrinkles appear. These people lose muscle tissue and bone hardness, and their vision and hearing gets less sharp. Even their taste buds start to deteriorate.
Eventually all organisms die, and aging can be considered the process through which animals and plants go on their way through their individual life span. However, science has not yet been able to explain exactly why aging occurs. Gerontology, which is the study of all aspects of aging, has no single theory on how or why people age. One theory says that an individual's life span is programmed by his or her genetic inheritance. Some call this the "time-bomb" theory, claiming that each of us has our own genetic clock or clocks that slow down and eventually cause certain cells to die out. The other major theory of aging is that of wear-and-tear. This argument says that cells eventually break down under the constant assaults of heavy use and environmental insults like chemicals and radiation.
EFFECTS OF AGING
Although scientists are unsure of the exact cause or causes, they know very well the effects of aging on the human body. These include wrinkly skin, muscle loss, bone thinness, a less efficient heart, weakened lungs, poorer vision and hearing, decrease in mental quickness, reduced kidney function, and diminished resistance to infection, among many others. These effects appear to be the result of our cells becoming less efficient in their jobs. As we age, our cells do not do as good a job in functions like removing wastes, destroying poisons, repairing genes, and making proteins. As the cells get weaker and weaker, they do their jobs less well, which means that the entire body becomes less and less efficient or healthy. Although old age can have its share of diseases, such as hardening of the arteries, stroke, cancer, and the brain condition known as Alzheimer's disease, it is important to realize that these diseases are not a natural result of the aging process.
Aging occurs in plants as well as animals, and is usually connected to plant growth cycles. Plants that have what is called determinate growth have a built-in time when they stop growing, after which they slowly breakdown and die. Plants that we call annuals and biennials have a programmed time during which they grow, reach a certain size or age, and then wither and die. Plants that continue for a longer period have indeterminate growth. Some perennials can live for years, despite the fact that their above-ground systems die every winter. The below-ground plant stays alive and recovers in the spring. Others, like the common juniper tree, can live for two thousand years.
Although science has yet to pinpoint the exact reason that aging occurs in any organism, it is safe to say that genetics probably plays the largest role in determining the life span of an individual. The next largest role is probably that of our external environment. A toxic environment no doubt puts an enormous strain on all body systems, which inevitably deteriorate. While good living habits like a balanced diet and regular exercise can minimize some of the effects of the aging process, the reality of growing old and less efficient is, so far, an inevitable fact of life.
SeeAdulthood; Alzheimer's Disease; Death and Dying; Dementia; Depression: Adults; Elder Abuse; Elders; Grandparenthood; Grandparents' Rights; Grief, Loss, and Bereavement; Intergenerational Programming; Intergenerational Relations; Intergenerational Transmission; Later Life Families; Loneliness; Menopause; Respite Care: Adult; Retirement; Widowhood
ag·ing / ˈājing/ (also age·ing) • n. the process of growing old: the external signs of aging| [as adj.] the aging process. ∎ the process of change in the properties of a material occurring over a period, either spontaneously or through deliberate action. • adj. (of a person) growing old; elderly: looking after aging relatives. ∎ (of a thing) reaching the end of useful life; obsolescent.