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Theories of Aging

NURS 4100 Care of the Older Adult Spring 2014Joy A. Shepard, PhD(c), MSN, RN, CNE, BC

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Objectives Discuss the change in focus regarding

learning about factors influencing aging List the major biological theories of aging Describe the major psychosocial theories

of aging Identify factors that promote a healthy

aging process Describe implications of theories of aging

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Definitions Aging – Process of growing older that begins at

birth Compression of morbidity – Healthy old age,

followed by rapid decline & death (“Health Span”)

Homeostasis - The regulation of bodily functions within precise limits in order to maintain ideal bodily function

Homeostenosis - The decline of the body's ability to maintain homeostasis as a result of decreased organ function in old age

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Definitions Life expectancy –

Expected years of life from birth

Maximum life span – Maximum possible length of life

Senescence (old age) – Point in time when age-associated functional deficits are manifested

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Mystery of Aging Goal of

everlasting youth

Aging as a complex process

Highly individualized process

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Lifestyle Lift infomercialGlaring example of a youth-driven and youth-obsessed culture

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Who Has More Value?

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Focus of Research on Aging

Better understanding of aging process: Healthier lifestyles Postponement of

negative consequences

Healthy & active Understanding

factors that influence health and well-being

“Successful aging” Avoiding disease &

disability Maintaining mental

& physical function Continuing

engagement with life

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The Aging Process The aging process is

multifactorial, includes: Benign changes, such as

graying hair Nonbenign changes,

such as senescence Individualized aging

progression Modifiable changes

related to lifestyle Normal or universal

aging processes

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The Aging Process Senescence:

progressive deterioration of body systems

Characterized by failure to maintain homeostasis under conditions of physiological stress (homeostenosis)

Decreased viability, increased vulnerability of individual

Normal aging includes Loss of organ reserves

resulting in decreased response to physiological stress

Variations among individuals

Chronologic & biological aging, which are not synonymous

Organ system changes

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Aging: Many Interrelating Factors, Causes

No single factor, theory

Heredity, nutrition, health status, life experiences, environment, activity, & stress

Aging is highly individualized

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Theories of aging include biological, psychological, sociological, and spiritual aging

**Important: No single known factor causes or prevents aging; no one theory can explain the complexities of aging**

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Biological Theories of Aging

“FATE” – Internal (Nonstochastic) Program theories of aging (Genetic)

Genetically programmed events cause cellular damage that accelerates aging of the organism

“CHANCE” – External (Stochastic) Error Theories (Environmental)

Random events cause cellular damage that accumulates as organism ages

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Programmed Theories Programmed Longevity

Genetic clock (Hayflick limit) Human genome

Neuroendocrine & Neurochemical Theories

Immunological/ Autoimmune Theory Changes in immune function with aging Diminishing of thymus, impaired

immunologic function

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Error Theories of Aging Cross-Linking Theory

Loss of flexibility, diminished functional motility

Wear & Tear Theory Effects of stress Stress causes

structural & chemical changes resulting in irreversible tissue damage

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Error Theories of Aging Free Radical Theory

Oxygen radicals, antioxidants Lipofuscin Nutrition theory

Somatic Mutation (DNA Damage) Theory Radiation Theories

Decreased function & efficiency of cells & organs

Solar elastosis – “old age” type of skin wrinkling

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Solar Elastosis: Chronic Exposure to Solar Radiation (UV)

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Lipofuscin

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Question Which of the following statements

best describes the autoimmune theory of aging? A. Genetic programs determine life expectancy B. Cells undergo change and the body identifies

them as foreign C. Organs decline as a result of cellular

mutations D. Failure of the production of a growth

substance causes aging cells to die

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Question Is the following statement true or

false?

The genetic theories of aging best describe how and why a person ages

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Identical Twins (Age 52)

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Identical Twins (Age 61)

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Aging Disease: Progeria

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Psychosocial Theories of Aging

Disengagement theory

Activity theory Continuity

theory Developmental

tasks Erik Erikson

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Sociological Theories of Aging

Social & Psychological Models: Dynamic interplay betweens gains & losses Disengagement Theory

As individuals age, they inevitably withdraw from society Society withdraws from them Separation mutually agreed upon

Activity Theory Continue middle-age lifestyle; deny existence of old age Life satisfaction: involvement in new interests, hobbies,

roles, and relationships Volunteering: one way retirees stay connected to

community

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Sociological Theories of Aging

Continuity Theory – Values &

personality Goals & individual

characteristics Psychological

patterns Successful

adaptive strategies Values, morals, &

behaviors

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Question Is the following statement true or

false?

The continuity theory of aging states that personality and basic patterns of behavior are said to remain unchanged as the individual ages.

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Developmental: Erickson Final Stage - Integrity vs. Despair

Development – Process of natural growth, differentiation, or change

Old Age (after age 65) - Reflecting back on life Successful in accomplishments – Feel sense of

integrity Few regrets, satisfaction Attain wisdom, even when confronting death “Only when we are so old, only, we are aware of

the beauty of life.” Alice Herz Sommer, age 106 Unsuccessful - Feel life was wasted, many regrets

Bitterness, despair, depression, anger

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Developmental Challenges Associated with Aging

Certain developmental challenges bring opportunities for older people to experience feelings of success, loss

Social relationships, roles Retirement

Coping with loss Death of a loved one

Living arrangements Loss of independence

Financial challenges Fixed income

The strengths of each individual (including past coping skills) must be identified & utilized when planning care

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Opportunities for Older People to Experience Feelings of Success

Gaining insight or wisdom, self-understanding, self-acceptance

Deepening gratitude & appreciation Gaining new knowledge & experiences Developing better social skills, coping

ability Enhancing creativity & confidence Developing new skills, hobbies, &

interests

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Opportunities for Older People to Experience Feelings of Success

Civic & community positions of responsibility Seeing children transform into responsible,

successful adults Becoming a grandparent Renewing & deepening one’s relationship

with one’s spouse, significant others, or friends

Accepting & adjusting to physical changes associated with aging

Pursuing spiritual interests

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Opportunities for Older People to Experience Feelings of Success

Older adults often assume new roles, such as grandparents, as they mature

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More Challenging Developmental Tasks

Death of a spouse Major declines in health or physical ability

Physiologic changes may result in losses, causing impairments in communication, vision & learning, mobility, cognition, or psychosocial skills

Loss of social role, prestige, occupation, income

Loss of independent living Accepting a fixed income

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Erikson Question Which of the following best reflects Erikson’s

description of the old age task of reconciling ego integrity with despair?

A. 75-year-old woman who is insecure and has developed a general attitude of mistrust concerning the world.

B. 77-year-old man who fears death as he struggles to find purpose in his life, reflecting upon his experiences and failures.

C. 78-year-old woman who has unresolved feelings of inadequacy and inferiority, which shows in her relationships with friends and acquaintances.

D. 80-year-old man who has not been successful in finding deep intimacy and satisfying relationships and now feels isolated.

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Implications of Theories of Aging

No single theory can adequately explain aging process

Knowledge of all theories: guide nursing interventions to promote health and longevity

Sensitivity to the impact of attitudes toward aging on patients themselves

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Interesting Quotation… Do You Agree?

“Aging is a self-fulfilling prophecy. If we dread growing old, thinking of it as a time of forgetfulness and physical deterioration, then it so likely to be just that. On the other hand, if we expect it to be full of energy and anticipate that our lives will be rich with new adventures and insight, then that is the likely reality. We prescribe who we are. We prescribe what we are to become” (Bortz, 1990, p. 55).

Bortz, W. (1990). Use it or lose it. Runner’s World, 25, 55-58.

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“Blue Zones” of Longevity

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