About global life expectancy
Why is there a difference in male and female life expectancy? UK has a year difference, which is standard for western countries. Russia male life expectancy is 59, whilst female is 79 years old. There is such a huge disparity because in Russia smoking, drinking and violence (including war and conflict) are high. The demographics of Russia are strange. In Japan they have historically had the highest life expectancy, male life expectancy is 86 while female is 88. This is now going down, Japan losing it’s life expectancy because of Americanisation, with the largest shift being the shift from fish to meat. They also have some of the lowest rates of cancer in the world because of lifestyle factors such as diet (bowel cancer).
At the end of the second world war, 1 million UK men were killed, over 6 million Jews had died, whilst 19 million Russians had been killed, with 26 million injured. This has affected the population as all the Russian deaths were men, so there were no men left at the end of the war and that is partly why there is such a lower life expectancy fro men now as this happened.
Population pyramid - triangle with base at bottom. Many people when young and as you age people die so gets thinner.
What is the mortality blip?
in the 6 months following retirement you have a higher chance of dying. If you don’t retire you don’t get this, for example cultures like Japan, so its not to do with the age.
You can only delay your own death by about a week - you can delay your time of death.
Christmas/boxing day there is a very low death rate, however around a week later there is a huge increase compared to what we would expect.
We can also suffer more deaths as result of a psychological concept, such as retirement. This is because of the loss of social contact/support. The average male over 40 in the UK has 1 friend, whilst females have 7. This is because although males are good at social support through work, they are not so good in daily life so this is lost following retirement. Retirement also has a negative effect on your perceived usefulness.
To get rid of the mortality blip individuals can take up something else which is seen as contributing to others, eg starting up own business, buying a holiday house and renting it out, etc.
About life landmarks…
If we had to describe the average life we would start with birth, then childhood (biological terms of social terms, its about dependency ~14 years), school (male and female disparity in many countries of the world is important to remember), job/work (~40-42 years in the UK), marriage (29-30), children (~31), retirement, failing health and death.
National divorce rate is ~40%, in London its around 50%. Average age of divorce is around 50, when the children leave home. The ages for getting marriage and having children are going up dramatically, particularly in London. During working life likely to also be caring for elderly relatives. Average age for suicide in the UK is in the part of your life where you have kids, work, caring for relatives, paying mortgage etc. This shows us that this part of life is hard. This is only in males, women’s suicide rates are stable across lifetime. The three high points for make suicide are 15-21, 46 and over 80s.
We have put the life landmarks at average ages, but we know that these things can occur at completely different ages, for example can get married really old or really young. If things occur at the normative time, it requires no psychological adjustment (Neugarten). Particularly in females, if haven’t met the right person by the average age of marriage etc, socially people start to be intrusive and questioning, potentially setting people up. They are doing this to try and tie you into the socially normative timeline of ages. If you’re someone who doesn’t want to get married etc, society will start asking questions like ‘are you gay?’, ‘don’t you want a family?’. This timeline of events is also there to make us reproduce, keeping things occurring at the right ages. Neugarten’s theory also suggests that if one of these things happens at a non-normative time, it is much more psychologically damaging, requiring much more adjustment.
What is the importance of ageing?
- People over 50 years of age are the fastest growing age group in the UK
- By 2031 nearly half of the UK population will be over 50 years of age (Shaw, 2001, ONS 2003)
- In the European Union 30% of the population will be over 65 by 2050 (Eurostat, 2005)
- Health issues
Supporting this ageing population is the main problem. Government have increased tax for this reason.
What are some age related issues?
- Health
- Income
- Social status
- Contact
- Working
- International outlook
Social status - a composite of earnings, education and cultured background. Not a simple measure. Can have phenomenally wealthy people who may not have a very high social status if not well educated or cultured background etc. This is important as the mortality blip is mainly due to a drop in social status, so can have an effect on physical health. This is possible as it can affect your self-worth, as we link our own perception of out worth to a social construct of worth. Historically, would have heard things like ‘you have ideas above your station’ meaning that you think you’re better than you are, but these things still exist.
Contact - basically social contact with others which has a massive effect on life expectancy, is one of the most protective for health.
Working - in people who don’t work we see reduced LE, massively elevated rates of mental and physical health problems. There is an argument fro research over the direction of causality. Both affect each other.
International Outlook - Problems are similar internationally. Either we can elevate the birth rate, which would be a massive strain on resources. Don’t currently have the resources to cope with the population we currently have worldwide. This tells us that one way it can be solved is through immigration.
What is the socioemotional selectivity theory?
Socioemotional selectivity theory - Between birth and death - there are shifts in motivation at different points in your life span. When you are young it makes sense to chance things that pay off in the future, the reward comes later - working, dates. Older you get, doesn’t make sense to do things that pay off in the future as that future may not ever come. Because of this, they are doing things that make them happy currently, in the moment, which means that older people are much happier than younger people in general.
What are the main themes of ageing?
- Bio-psychology: focus = ageing of the CNS and associated decline of mental functions. Second law of thermodynamics – given enough time all physical systems break down.
- With advancing age all body systems decline
- Concept of biological maturity – after which decline is constant until death – loss of biological fidelity.
- Bio-psycho-social approach: focus upon multiple sources of decline/vulnerability (physical health to social networks) and how individuals ‘adjust’
- Psychosocial approach: focus is upon ‘lifespan development’ and human character and personality across the whole lifespan
About age and CNS decline
We know that as we age the brain and CNS declines. The CNS loses neurones, neural regeneration does occur but it’s not massive. Over the course of your lifespan you lose more neurones than you gain. Across the lifespan IQ decreases, but only puzzle solving and speed IQ, not stored memory. Doesn’t decline sufficiently to impact on ongoing function. Normal decline with age you notice that you’re more forgetful and lower to do things, but should still be able to work and go on with life.
The second law of thermodynamics - everything breaks - means that materialism doesn’t make sense. The brain is no different to this. Eyes are the first system to go - by 80 years old, 90% of people will have cataracts. The body is like a machine, some parts last longer than others. Other parts certain to fail if live long enough include joints, hearing, prostate cancer, sarcopaenia (loss of muscle - between 20 and 65 lose 38% of body’s muscle)
About gender specific ageing
Women reach biological maturity at around 23, men at around 21. This is the point at which you will never be fitter, better, stronger - you are at your peak. Therefore it makes sense for people to have children at this age, the children would be much healthier. Society has shifted it because of women’s liberation (having careers etc), and because women no longer require a male in order to do this and have children, as there is now maternity pay, ability to freeze eggs, IVF, sperm donation, surrogacy etc.
Average number of children people have, in the UK it is currently 1.3 without immigration, with immigration it is over 2. Historically, people have been outliers in terms of global reproduction - most years of extra life have not been solved by people living longer, but by solving death in childhood. Have enabled people to survive to 5 years of age. Previously, to make sure continued family people would have lots of children, they would need good fertility and to keep having children to do this. Genghis Khan verified to have had over 600 children that survived, but it is possible that he had up to 1000 children, and estimated that 1% of Asian people are related to him. He reproduced everywhere that he went, distributing his offspring across a massive area.
Women are much more successful at reproducing than men - women 99.9% of women able to reproduce do, males only 50%. Historically no choice but to marry someone who could and would support women so made most sense for women to look for higher social status men because the child was then guaranteed the best possible chance of survival. This meant that the men who didn’t reproduce in history were less desirable and so didn’t pass on their genetic material.
There is evidence that the social construct operates at the biological sperm level, 30% of sperm stay behind to prevent other sperm from getting close to the egg. Males have evolved to fight even after they have already fought, in order to make sure they reproduce. This makes sense so that they have the child. Currently found that between 20-30% of children can not possibly be from their ‘father’.
People who don’t have children can be a bit uncomfortable with death as haven’t left anything behind, so historically people find different ways of leaving a mark. Eg - leaving something like a book or building, inventing something, or having a belief in the afterlife is another way of feeling more accepting of dying.
If you don’t have a faith the problem with aging is that you may believe nothing happens and this can make you very afraid of dying.
We don’t only see declines in CNS, also see social decline and an increase in vulnerability to diseases.
Females live longer - oestrogen etc protective for life, wars women don’t have to fight
What is the biopsychosocial approach to ageing?
- Suggests that the ageing brain is the principle determinant of psychological changes associated with age
- Cross sectional evidence of loss of brain weight/cell numbers indicate loss-deterioration of brain power - ie decline in cognitive skill.
Cross sectional not a great approach because there are so many other factors involved that aren’t considered, longitudinal across long period of time is much better.
What research has been done on intellectual decline in later life?
- David Wechsler - score on IQ tests were highest in early 20s and declines constantly afterwards
- When the first longitudinal studies followed up people’s performance on tests at various times after initial testing, results indicated less decline (Owens, Schaie)
- Laboratory vs real world - the evidence from prospective memory.
In the real world we don’t always find decline. Some time older adults out perform younger ones, this is because they develop strategies to overcome the deficits. Eg lists.
What is the cross sectional versus longitudinal approach to ageing?
- Cross sectional accentuates loss, due to cohort inequalities (eg progressively more education received from 1890s to 1980s, so each cohort of twenty year olds/seventy year olds, will be better educated than previous cohorts) - Flynn effect - https://www.youtube.com/watch?v=9vpqilhW9uI
- Longitudinal data collection minimises the evidence of decline, because those who are able and willing to be re-tested tend to be healthier, wealthier and wiser than those who ‘drop out or die’.
The flynn effect says that people are getting more intelligent. For every 30 years there is about a 9 point IQ gain. This is why we cant really do cross sectional studies.
IQ shifting hasn’t necessarily done much socially.
Is intellectual decline normal with age?
- There is evidence supported by both cross sectional and longitudinal studies of a drop in performance associated with greater age.
- This is more noticeable for tasks requiring speed of processing than for tasks dependent upon acquired knowledge and established problem solving strategies. BUT remember assessment issues.
- Not everyone follows such a path. The proportion of people exhibiting intellectual decline is small in a fifty to sixty year old population, but becomes common in people aged over eighty, often referred to as the “old-old”.
- Even then substantial numbers of people aged 80 and over do not show evidence of intellectual decline
About normal and abnormal ageing
- Statistically intellectual decline is more abnormal when it occurs earlier in old age.
- Loss of wisdom (crystallised intelligence) is less common than loss of wit (fluid intelligence). Lay perceptions suggest wisdom may even increase in older adults – however the research does not support this.
- The distinction between normal and abnormal is not fixed: however the transition from a maintained functioning to decline is usually one way.
- Recovery from progressive (vs. acute) mental decline remains an elusive goal and many prefer to bank on primary prevention. Importantly use of intellect and enriched environment across the lifespan appears protective (Leal-Galicia et al 2008).
Once you hit period of lifestyle where you start to decline it is one way, very rare to regain functioning.
Protective factors include having a higher intelligence to begin with, the more active you are throughout life the more protected you are (research has looked at occupations and rates of dementia - more use of brain, less dementia), caffeine, a more enriched environment is very protective.
What is Bernice Neugarten’s work on ageing?
- The life course is bio-socially structured through events such as birth, education, work, marriage, childbirth, children leaving home, retirement and widowhood
- The more predictable the event, i.e. the more socially expected it is, the less likely it is to demand individual adjustment (e.g. widowhood for women over sixty)
- The less predictable the event (e.g. death of an adult child) the more effortful the adjustment and the greater the risk of being destabilised
- Positive illusions work (Taylor & Brown)
To really mess up someone’s life, give them something unexpected at an unexpected time.
Positive illusions - an interesting phenomenon where Taylor and Brown sought out normal individuals with no medical knowledge, and asked them questions like what’s your likelihood of getting cancer? And they answer things like 1 in 10,000 which is obviously massively inaccurate. Taylor and Brown also looked at likelihood of other things such as accidents occurring. The estimates were again massively inaccurate. They then looked at every negative experience, and the estimation of likelihood in normal people was always massively underestimated the likelihood of it happening. Humans underestimate the likelihood of bad things happening which makes evolutionary sense because this allows us to be happier as not worrying about these things happening to us etc. This is bad though as people don’t screen for things or pick up on signs and symptoms and take precautions to things. They also found that people overestimate the likelihood of good things happening to them, including people normally overestimate how intelligent/attractive/personality they are. HOWEVER, when you ask them to estimate it happening to someone else they are much more accurate.
Depressed individuals are very accurate, this is called depressive realism. This happens even without them having any extra knowledge. Once the depression remits, you get a return of the inaccurate estimates.
This is a problem for the life course as when something bad happens, which it will, it is much harder to adjust. Therefore it is good to study this and learn that it may happen and to somewhat expect it, and to know that you’ll be ok when it does and that you are strong enough to cope with it.
About character and adjustment in ageing?
- The experience of permanent physical impairment is a stressor for many people.
- Some research suggests that those who express a sense of personal responsibility for what has happened are more likely to adjust to such trauma than those who see such events as their bad luck
- Positivity effects in old age (Carstensen).
Study found that in nursing hoes on average would fie within 6 months. She gave half of individuals a pot plant and half didn’t, and having a pot plant was so effective that they were living up to 4 months longer.
This is why we have moved from telling patients what to do, to giving them options, as this sense of responsibility has a massive effect.
About lifespan developmental psychology
- The work of Jung first introduced the idea that continuing psychosocial development is normal during adult life. Thus, development continues across the lifespan.
- For Jung he argued that there needed to be a shift in character and temperament from early to late adulthood
- One central feature was the expression of aspects of one’s character in later life that had been hidden or held back in early adulthood [e.g. exhibiting one’s feminine/masculine side]
Argued that at each age group there is a particular crisis that you have to go through. Seen in Eriksonian stages of psychosocial development slide.
What is the socioemotional selectivity theory?
- Carstensen et al 2003.
- Perception of time remaining in life prompts shifts in motivation away from gaining knowledge towards emotional satisfaction.
- May confer defensive advantages in later life.
Without this emotional shift, ageing would be terrible.
What is the theory of the third age?
• Peter Laslett (1989)
• Looks at late life as a period of self-fulfilment when
individuals can follow their own projects and plan their
lives.
• But this has been criticised as this is only possible if
physical and material well being in ok.
• Responsible for growing emphasis on older adults
taking an active role in their care and treatment.
This is bad theory and has been dropped as it is a narrow minded theory from a very Western perspective. Assumes that you have good enough income and health which we know isn’t true - the average old age pension is £7,200 per year, if married then it is £12,000 TOGETHER, which is not enough to live on at all.
What are erikson’s stages of development?
- Erikson’s model is probably the best known though least well researched example of lifespan development
- He argued that at each stage of life we face a particular type of psychosocial crisis, whose resolution helps establish an emergent trait or ‘virtue’ that then serves us well in addressing challenges later in life
Infancy: basic trust vs mistrust Early childhood: autonomy vs doubt Play age: initiative vs guilt School age: industry vs inferiority Adolescence: identity vs role diffusion Young adulthood: intimacy vs isolation Middle adulthood: generatively vs stagnation Late adulthood: integrity vs despair
What are the applications of Eriksonian theory to assessment?
- Key adult ‘qualities’ are
- Sense of identity [being a somebody]
- Capacity for intimacy [having a somebody]
- Experience of generativity [helping a somebody]
- Acquisition of integrity [taking responsibility]
- How can care maximise the chances that these qualities continue to be expressed?
- How can care support these qualities to develop?
- How can care protect those with limited or no experience of developing or exercising these qualities?
- Older adult assessment is difficult in view of their tendency to underreport psychological complaints.
- “Masked depression” – Older adults are high risk for suicide – especially older adult males (Szanto et al., 2001) Yet difficult to detect as older adults tend to minimise psychological symptoms and great overlap between physical symptoms and psychological.
- 50% of suicide victims older than 60 had seen GP in the month of death with 26% in the week of death yet more than half only reported physical complaints (Harwood et al 2000).
World wide, the most likely group to kill themselves is males over 80.
What are the psychological constructs of ageing?
- Research and practice reflect and reinforce implicit models of ageing
- Some reinforce a notion of decline, and a categorisation of normal/natural versus abnormal/unnatural types of decline
- Others focus upon what living longer adds to human personality development
- Finally some steer a middle position looking at how ageing challenges personal adjustment and the factors that help or hinder such adjustment.
- The different approaches vary in the distinction they make between individuals and the ageing process
Personality change with age
- Introversion – extroversion
- Neuroticism
- Agreeableness
- Conscientiousness
- Openness
- What happens to these personality dimensions across the life span?
- Roberts, Walton & Viechtbauer (2006)
- With age conscientiousness and emotional stability increase especially between 20 and 40
- Openness decreases across the lifespan
- Agreeableness rises
- Neuroticism declines
This happens to everyone, but because it happens to everyone, your relative position compared to everyone else stays the same.
Really strong effect in mental health - even in the absence of treatment they all decline with age.
What are longevity studies in ageing?
- longevity studies - positive emotionality (extraversion) and conscientiousness predict longer lives (Danner et al. 2001, Friedman et al. 1995).
- hostility (low agreeableness) predicts poorer physical health (e.g., cardiovascular illness)
-
The mind and the concept of free will22
-
Differences between psychology and psychiatry10
-
clinical interview49
-
research methods25
-
Human personality and aetiology38
-
Intelligence51
-
Memory60
-
Attention54
-
Working Memory30
-
Disorders of Perception, Neglect, Blindsight and Prosopagnosia83
-
Judgement and Decision making and Problem Solving52
-
Alcohol and other Drugs of abuse44
-
Aging27
-
Social Psychology55
-
PTSD27
-
Depression31
-
Personality Disorders29
-
BPAD30
-
ADHD13
-
Schizophrenia and Psychosis55
-
Anxiety26
-
OCD15
-
Learning Disabilities65
-
Mental disorder and offender behaviour51
-
Case studies34
