Psychology of Adulthood and Aging Notes:

Chapter 1 Studying Adult Development And Aging

Ageism: The untrue assumption that chronological age is the main
determinant of human characteristics and that one age is better
than another. A form of discrimination against older adults
based on their age.

Gerontology: The study of aging from maturity through old age,

as well as the study of older adults as a special group.

Life-span perspective: A view of the human life span that

divides it into two phases; childhood/adolescence and
young/middle/late adulthood.

Baltes: Four features of life span perspective-

1. Multidirectionality-Development involves growth and
decline; as people grow in one area they may lose in
another and at different rates.
2. Plasticity-One’s capacity is not predetermined or set in
concrete: With limits-Many skills can be trained or
improved with practice.
3. Historical context-We develop within a particular set of
circumstances determined by the historical time in which we
are born and the culture in which we grow up.
4. Multiple causation-How we develop results from a wide
variety of forces, development is shaped by biological,
physiological, sociocultural, and life-cycle forces.

Primary implications of a rapid increase in the number of older

adults include strains on the Social security, health care, and
other human services with the costs having to be borne by the
younger smaller generations.

Forces of development:
1. Biological forces - All genetic and health related factors
that affect development. Menopause, wrinkling, organ
changes.
2. Psychological forces – All internal-perceptual, cognitive,
emotional, and personality factors that affect development.
What people notice about our individualisms.
3. Sociocultural forces – Interpersonal, societal, cultural,
and ethnic factors that affect development.
4. Life-cycle forces – Reflect differences in how the same
event or combination of biological, psychological, and
 sociocultural forces affects people at different points in
their lives

Baltes: Influences that interact to produce developmental change

over life span:

1. Normative age-graded influences – Experiences caused by

biological, psychological, and sociocultural forces that
are highly correlated with chronological age.
a. Biological include: Puberty, Menarche, and Menopause.
b. Psychological include focusing on certain concerns at
different points in adulthood, such as a middle-aged
persons concern with socializing the younger
generation.
c. Sociocultural examples are the time when first
marriage occurs, or when retirement age is decided.
2. Normative history-graded influences – Events that most
people in a specific culture experience at the same time.
These events may be Biological (Epidemics), Psychological
(Particular stereotypes i.e. generation X or Baby boom) or
Sociological (Changing attitudes towards sexuality).
3. Non-Normative influences are random or rare events that may
be important for a specific individual but are not
experienced by most people. Favorable like winning the
lottery or unfavorable like losing a job or layoffs or
having an accident, such that a life can be changed
dramatically.

Controversies in Development

Nature – Nurture Controversy: The extent to which inborn,

hereditary characteristics (Nature) and experiential, or
environmental influences (Nurture) determine who we are.

Stability – Change controversy: Concerns the degree to which

people remain the same over time.

Continuity – Discontinuity controversy: Concerns whether a

particular developmental phenomenon represents a smooth
progression over time (Continuity) or a series of abrupt shifts
(Discontinuity).

Universal vs. Context-Specific development controversy: Concerns

whether there is just one path of development or several.
Aging:
1. Primary aging – Normal, disease-free development during
adulthood.
2. Secondary aging – Developmental changes that are related to
disease, lifestyle, and other environmentally induced
changes that are not inevitable (e.g., pollution).
Examples: Alzheimer’s and related forms of dementia.
3. Tertiary aging – The rapid losses that occur shortly before
death, i.e. Terminal drop in which intellectual abilities
show a marked decline in the last few years before death.

Types of age:

1. Chronological age – How long we’ve been around since birth.

A shorthand way to index time and organize events and data
by using a commonly understood standard: calendar time.
2. Perceived age - Refers to the age you think of yourself
as. “Your as young as you feel”.
3. Biological age – Is assessed by measuring the functioning
of the various vital, or life-limiting, organ systems, such
as cardiovascular system.
4. Psychological age – Refers to the functional level of the
psychological abilities people use to adapt to changing
environmental demands. These abilities include memory,
intelligence, feelings, motivation, and other skills that
foster and maintain self-esteem and personal control.
5. Sociocultural age – Refers to the specific set of roles
individuals adopt in relation to other members of the
society and culture to which they belong.

Research Methods

Measurement in Adult Development and Aging research

1. Reliability of a measure is the extent to which it

provides a consistent index of the behavior or topic of
interest.
2. Validity of a measure is the extent to which it measures
what researchers think it measures.
4. Systematic Observation involves watching people and
carefully recording what they say or do. Typically two
kinds.
a. Naturalistic Observation – People are observed as they
behave spontaneously in some real-life situation.
b. Structured Observation – The researcher creates a
setting that is particularly likely to elicit the
behavior of interest.
 5. Sampling Behavior with Tasks – When investigators can’t
observe a behavior directly, another popular alternative is
to create tasks that are thought to sample the behavior of
interest. However useful, it cannot prove validity.
Self Reports – Peoples answers to questions about the topic of
interest. Also not reliable, due to memory accuracy or
answers geared toward what is thought of as the correct
answer.
6. Representative sampling – A subset of a population.

General Designs for Research

1. Experimental Design – Involves manipulating a key factor

that the researcher believes is responsible for a
particular behavior and randomly assigning participants to
the experimental and control groups.
2. Independent variables – variables that are manipulated by
the experimenter.
3. Dependent variables – the behaviors or outcomes that are
measured.
4. Correlational design – A researcher measures two variables,
then sees how strongly they are related.
a. r=0 variables unrelated
b. r>0 variables positively related
c. r<0 variables inversely related
5. Case studies – An intensive investigation/study of an
individual in great detail.

Designs for Studying Development

(Age, Cohort, and Time of Measurement)

1. Age effects – Reflect differences caused by underlying
processes, such as biological, psychological, or
sociocultural changes.
2. Cohort effects – Differences caused by experiences and
circumstances unique to the generation to which one
belongs.
3. Time-of-measurement effects – Reflect differences stemming
from sociocultural, environmental, historical, or other
events at the time the data are obtained from the
participants.
4. Confounding – Any situation in which one cannot be
determine which of two or more effects is responsible for
the behaviors being observed.
5. Cross-Sectional Design – Developmental differences are
identified by testing people of different ages at the same
time.
 6. Longitudinal Design – The same individuals are observed or
tested at different points in their lives.
7. Time Lag Design – Measures people of the same age at
different points in time.
8. Sequential Design – Represents different combinations of
cross-sectional or longitudinal studies, and consists of
two or more cross-sectional studies.
9. Longitudinal-Sequential Design – Consists of two or more
longitudinal designs that represent two or more cohorts.
10.Extreme Age Groups Design – Age groups that are extremely
different (group of twenty year olds compared to group of
50 year olds) are compared for quick convenient data
gathering.

Ethical research: Investigators must obtain informed consent

from their participants before conducting research.

Chapter 2 Physical Changes

Biological Theories of Aging

1. Rate-of-Living Theories: Based on the idea that people are

born with a limited amount of energy that can be expended
at some rate.
a. Metabolic processes such as eating fewer calories or
reducing stress may be related to living longer.
b. The body’s declining ability to adapt to stress with
age may also be a partial cause of aging.
2. Cellular Theories:
a. Hayflick limit – Suggests that there may be limits on
how often cells may divide before dying (shortening of
Telomeres [enzymes] may be the major factor).
b. Cross Linking – Results when certain proteins interact
randomly and produce molecules that make the body
stiffer.
c. Free Radicals – Highly reactive chemicals produced
randomly during normal cell metabolism, cause cellular
damage. Anti-oxidants may postpone the appearance of
some age-related diseases.
3. Programmed Cell Death Theories: The appearance of a genetic
program that is triggered by a physiological process, the
innate ability to self-destruct, and the ability of dying
cells to trigger key processes in other cells.
4. Implications of the Developmental Forces – Although
biological theories are the foundation of biological
forces, the full picture of how and why we age cannot be
 understood without the other three forces (psychological,
sociocultural, and life cycle).

Appearance and Mobility

1. Changes in the Skin, Hair, and Voice – Normative changes

with age in appearance include wrinkles, gray hair, and
thinner and weaker voice.
2. Changes in Body Build – Normative changes include decrease
in height and weight in mid-life followed by weight loss in
late life.
3. Changes in Mobility –
a. The amount of muscle decreases with age (< 20% at 70
then more than 40% after age 80) but strength and
endurance only change slightly.
b. Loss of bone mass is normative: in severe cases,
though, the disease osteoporosis may result, in which
bones become brittle and honeycombed.
c. Joints –
(1) Osteoarthritis: A disease marked by gradual
onset and progression of pain and disability,
with minor signs of inflammation, caused
primarily by overuse of a joint.
(2) Rheumatoid Arthritis: More common and more
destructive disease of the joints that
develops slowly and typically affects
different joints, causes swelling, and a
different pain than Osteoarthritis.

Psychological Implications

1. Cultural stereotypes have an enormous influence on the

personal acceptance of age-related changes in
appearance. For example where women are seen as
becoming inferior with age, men are seen as more
distinguished, and experienced.
2. Losses of strength and endurance and changes in the
joints have important psychological consequences,
especially regarding self-esteem.

Sensory Systems

1. Vision –
 a. Structural changes (age 40) The amount of light which
passes through the eye decreases requiring more light
to read, however the eyes become more sensitive to
glare, and adaptation to light and dark requires more
time. The lens of the eye becomes more yellow,
causing poorer discrimination in the green-blue-violet
end of the color spectrum. Presbyopia causes a
decrease in the eye’s ability to focus on close
objects “necessitating longer arms or corrective
lenses”. Cataracts are opaque spots on the eyes,
which usually can be treated with surgery, and
Glaucoma is caused by the eye’s inability to drain
excess fluid, treated with eye drops.
b. Retinal changes (age 50) Macular Degeneration results
in the loss of ability to see details, and affects
roughly 1 in 5 over the age of 75. Diabetic
Retinopathy can involve fluid retention in the macula,
detachment in the retina, hemorrhage, and aneurysms.

Psychological effects of Visual changes include difficulty in

getting around. Compensation strategies must take several
factors into account; the more need for illumination must be
weighed against the susceptibility to glare.

2. Hearing – The cumulative effects of noise and normative

age-related changes create the most common age-related
hearing problem: reduced sensitivity to high-pitched tones,
called Presbycusis, which occurs earlier and more severely
than the loss of low pitched tones.
a. Sensory Presbycusis – little effect on other hearing
abilities.
b. Neural Presbycusis – Seriously affects the ability to
understand speech.
c. Metabolic Presbycusis – Produces sever loss of
sensitivity to all pitches.
d. Mechanical Presbycusis – Also produces loss of all
pitches, but loss is greatest for high pitches.

Psychologically, hearing loss can reduce the ability to have

satisfactory communication with others, and later in life can
cause numerous adverse emotional reactions, such as loss of
independence, social isolation, irritation, paranoia, and
depression.

3. Somesthesia and Balance:

a. Somesthesia – Changes in sensitivity to touch,
temperature, and pain: are complex and not understood;
 age-related trends are unclear or inconsistent in most
cases.
b. Balance – Dizziness and vertigo are common in older
adults and increase with age, as do falls. Changes in
balance may result in greater caution in older adults
when walking.

4. Taste and Smell – Age related changes in taste are minimal,

and the ability to detect odors declines rapidly after age
60 in most.

Vital Functions

1. Cardiovascular system – Some fat deposits in and around the

heart and inside arteries are a normal part of aging, and
heart muscle is gradually replaced with stiffer connective
tissue. The most important change in the cardiovascular
system is hardening of the arteries, which can be a lead
cause of the following cardiovascular diseases or
Cerebrovascular Accidents (CVA).
a. Congestive Heart Failure – A condition occurring when
cardiac output and the ability of the heart to
contract severely decline, making the heart enlarge,
increasing pressure to veins, and making the body
swell.
b. Angina Pectoris – A painful condition caused by
temporary constriction of blood flow. Same symptoms
as a Myocardial Infarction (Heart Attack) but
temporary in duration.
c. Atherosclerosis – A process by which fat is deposited
on the walls of the arteries.
d. CVA – An interruption of blood flow to the brain, also
known as a stroke
e. Hypertension – A disease in which one’s blood pressure
is too high.

2. Respiratory system – The amount of air we take into our

lungs and our ability to exchange oxygen and carbon dioxide
decrease with age, as with the amount of air we take in.
As we age our rib cage and passageways become stiffer
making it harder to breath.
a. COPD – Chronic Obstructive Pulmonary Disease: A family
of diseases that includes Chronic Bronchitis, and
Emphysema is the most common and incapacitating
respiratory disorder in older adults.
 b. Emphysema is the most serious COPD and is
characterized by the destruction of the membranes
around the air sacs in the lungs.

Reproductive System

1. Female Reproductive System –

a. Climacteric - The transition from childbearing years
to the cessation of ovulation. The Perimenopausal
stage is the onset of the climacteric and leads to the
menopausal stage.
b. Menopause is the point at which the ovaries stop
releasing eggs, and is accompanied by a variety of
physical and psychological symptoms including thinning
of vaginal walls, hot flashes, vaginal dryness, night
sweats headaches mood shifts difficulty concentrating
and a variety of aches and pains.
2. Male Reproductive System – Sperm production declines
gradually with age, and changes in the prostate gland occur
and warrants monitoring, and annual check-ups. Other
sexual performance changes include increase in time
required to obtain an erection, and ejaculation with an
increased refractory period (time in between) required.

Psychological Implications: Healthy adults of any age are

capable of engaging in sexual activity, and the desire to do so
does not diminish with age. However societal stereotyping
creates barrier to free expression of such feelings.

The Nervous System

1. Central Nervous System –

a. (Brain and Spinal Cord) Neurons are the basic cells in
the brain, composed of Dendrites (which pick up
chemical signals), Cell body (converts signal to
electrochemical impulse), the Axon (carries signal to
terminal branches) and the Terminal buttons (located
at the end of the branches) release neurotransmitters
and carry info to next set of neurons. Some neurons
develop neurofibrillary tangles, new fibers produced
in the Axon that are twisted. Large numbers of these
are associated with Alzheimer’s disease. Damaged or
dying neurons sometimes become surrounded by protein
and form neuritic plaques, large numbers of these
plaques also are found associated with Alzheimer’s
disease.
 b. Several neurotransmitter levels decrease with age,
including those of Dopamine, Acetylcholine, and
Serotonin. Some diseases, such as Parkinson’s,
Alzheimer’s and Huntington’s are related to changes in
neurotransmitter levels.
c. Three types of brain imaging are used in research:
Computed Tomography (CT), Magnetic Resonance Imaging
(MRI), and Positron Emission Tomography (PET). CT and
MRI are used most often in routine diagnosis of brain
disease, PET also provide info on brain metabolism.

2. Autonomic Nervous system - (Nerves in the rest of the Body)

a. Regulating body temperature becomes increasingly
problematic with age. Older adults have difficulty
telling when their core body temperature drops, and
their vasoconstrictor response (ability of the body to
raise it’s core temp) diminishes. Also when they
become very hot they are less likely to drink water.
b. Sleep patterns and circadian rhythms change with age.
Older adults are more likely to compensate by taking
daytime naps, which exacerbates the problem.
Effective treatments include exercising, reducing
caffeine, avoiding daytime naps, and making the sleep
environment as quiet and dark as possible.

Psychological Implications: The term Senility no longer has

medical meaning, nor do all (or even most) adults become
“senile”. However, many people remain concerned about this
issue. Brain changes underlie many behavioral changes,
including memory.

Chapter 3 Longevity, Health, And Functioning

How Long Will We Live

1. Average and Maximum Longevity

a. Longevity: The number of years on lives; as jointly
determined by genetic and environmental factors.
b. Average Longevity: Commonly called average life
expectancy, refers to the age at which half of the
individuals who are born in a particular year have
died.
c. Maximum Longevity: The oldest age to which any
individual of a species lives.
d. Active life expectancy - The age to which one can
expect to live independently.
 e. Dependent life expectancy - Living a long time, but
with assistance.

2. Genetic and Environmental Factors in Average Longevity

a. Genetic Factors – Are significant factors that help to
determine longevity. On average add four years to
your parents age to which they lived. However
environmental, ethnic, and gender factors must also be
taken into account.
b. Environmental Factors – Diseases (cardiovascular,
Alzheimer’s), toxins (air and water pollution),
lifestyle (smoking or exercise) and social class are
all environmental factors.

3. Ethnic Differences in Average Longevity

4. Gender Differences in Average Longevity –
a. Females average 7 years over men.

Health And Illness

1. Defining Health and Illness

a. Health – The absence of acute and chronic physical or
mental disease and impairments.
b. Illness – Presence of a physical or mental impairment.
2. Quality of Life – How someone views their quality of life
has a lasting impact on how long they actually live it by
way of choice.
3. Changes in the Immune System – Older adult’s immune systems
take longer to build up defenses against diseases. Due in
part to a changing balance in T-Lymphocytes.

Autoimmunity – Process by which the immune system begins

attacking the body.

Psychoneuroimmunology – Study of relations between

psychological, neurological, and immunological systems that
raise or lower our susceptibility to and ability to recover form
disease.

a. AIDS And Older Adults – Because of the immune system

changes, progression from HIV to AIDS is much more
rapid. Lifestyle changes in older adults are also
factored, as older adults are less likely to use
condoms, test for HIV, and if diagnosed, less likely
to seek support groups.
4. Chronic and Acute Diseases
 a. Acute diseases – Conditions that develop over a short
period of time (colds, influenza, food poisoning) and
cause a rapid change in health. Most are cured with
medication (antibiotics) or allowed to run their
course.
b. Chronic Diseases – Conditions that last a longer
period of time (at least 3 months) and may be
accompanied by residual functional impairment
(arthritis and diabetes mellitus) that necessitates
long-term management.
c. As we age, our acute diseases decrease and chronic
diseases increase. However, with age acute diseases
are much more difficult to overcome, and thereby
increasing the risk of serious illness or death.
d. Diabetes Mellitus – Disease that occurs when the
pancreas produces insufficient insulin.

5. The Role of Stress

a. Stress and Coping Paradigm - Lazarus & Folkman view
stress not only as an environmental stimulus or as a
response but the interaction of a thinking person and
an event. “ A particular relationship between the
person and the environment that is appraised by the
person as taxing or exceeding his/her resources and
endangering his/her well being.”
b. Appraisal –
(1) Primary appraisal – categorizes events into
three groups based on the significance they
have for our well-being: irrelevant, benign or
positive, and stressful.
(2) Secondary appraisal – evaluates our perceived
ability to cope with harm, threat, or
challenge. (What can I do?)
(3) Reappraisal – involves making a new primary or
secondary appraisal resulting from changes in
the situation.
c. Coping – Any attempt to deal with stress.
(1) Problem-focused coping – involves dong
something directly about the problem.
(2) Emotion-focused coping – involves dealing with
ones feelings about a stressful event.
d. Aging and the Stress And Coping Paradigm – As people
age, their coping styles differ, younger people tend
to try and solve problems in a more defensive posture,
whereas older adults commonly use experiences, and a
more philosophical approach when dealing with stress.
First they determine how much control they have over
 the situation, and then use more of a management type
of strategy to del with the conflict.
e. Effects on Human Health – When the stressors are short
lived the effects usually have little more effect than
momentary loss of temper. However chronic stress can
lead to a myriad of health problems including immune
system suppression, leading to increased
susceptibility to viral infections, atherosclerosis
and hypertension, and impaired memory and cognition.
Women may experience inhibited menstruation.

Common Chronic Conditions And Their Management

1. General Issues in Chronic Conditions – Having a chronic

condition does not mean that older people are
incapacitated. Only about 2% of older people are actually
bedridden. Some may experience limitations. The four
developmental forces (Biological, Psychological,
Sociocultural, and Life-cycle) must be taken into account
to understand how chronic conditions arise.
2. Common Chronic Conditions
a. Arthritis – Rheumatoid and Osteoarthritis afflict many
adults. Rheumatoid arthritis is not age related,
however Osteoarthritis is. A primary problem with
arthritis is the pain associated. Pain can have a
paradoxical effect on arthritis sufferers, due to the
way in which they adapt. Non-movement of joints due
to pain prevents the flow of necessary fluids through
the joints that in turn keep them healthy and
lubricated. This eventually leads to contracture or
“freezing” the joints in place, thus people with
arthritis are encouraged to keep active.
b. Cardiovascular And Cerebrovascular Disease – A range
of cardiovascular diseases occur with age. Most can
be managed effectively through lifestyle
interventions. Hypotension: or low blood pressure can
cause dizziness or lightheadedness, this can lead to
falls and cause serious head injuries. CVAs often
create chronic conditions by causing brain damage.
Although the number of incidents has decreased by 40%,
CVAs can cause serious lifestyle difficulties, if not
from rehab, then residual problems from not fully
healing.
c. Diabetes Mellitus – Occurs when the pancreas does not
produce sufficient insulin, and can cause a person to
lose consciousness if blood sugar slips too low, or
slip into a coma if blood sugar levels go too high.
 Often associated with obesity in older adults. Common
long-term effects include nerve damage, diabetic
retinopathy, kidney disorders, CVAs, cognitive
dysfunction, damage to the coronary artery, skin
problems, and poor circulation to the arms and legs,
which may lead to gangrene. Diabetes also increases
the chance of developing atherosclerosis and coronary
heart disease.
d. Cancer – The second leading cause of death in the U.S.
after Heart Disease. Half of all cancer happens in
people age 65 or older. Prostate cancer is most common
in men and breast cancer in women. It is estimated
that nearly one in every two American men will develop
cancer, and one in every three of women.
e. Incontinence – Loss of the ability to control the
elimination of urine or feces on an occasional or
consistent basis.
(1) Stress incontinence-happens when pressure in
the abdomen exceeds the ability to resist
urinary flow, for example when sneezing,
coughing, or lifting a heavy object, causes an
episode of garment wetting.
(2) Urge incontinence-is usually caused by a
central nervous system problem after a
Cerebrovascular accident (CVA) or urinary
tract infection. People feel the urge to
urinate but cannot make it to the toilet in
time.
(3) Overflow incontinence-results from improper
contraction of the kidneys, causing the
bladder to become over distended. Certain
drugs, tumors, or prostate enlargement may be
the cause.
(4) Functional incontinence-occurs the urinary
tract is intact but because of physical or
cognitive impairment the person is unaware of
the need to urinate.
(5) Iatrogenic incontinence-usually is caused by
medication side effects
3. Managing Pain – Pain in older adults is normal, however it
is not necessary. Failure to understand pain in older
adults can lead to failure in providing adequate steps in
relieving it.

Two General Techniques

 a. Pharmacological approaches to pain management include
narcotic and non-narcotic medication, depending on the
severity of the pain. Non-narcotic meds include
nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen, and acetaminophen, but must be used with
caution because they can sometimes have toxic side
effects in older adults. Narcotic drugs that work
well in older adults include morphine and codeine;
other commonly used drugs, such as meperidine and
pentazocine should be avoided because of age-related
changes in metabolism.
b. Non-pharmacological approaches are many, including
message, vibration, acupuncture, meditation,
distraction, hypnosis, ect. The key is to try to find
what works best and stick with it unless it is
necessary to change.

Pharmacology And Medication Adherence

1. Patterns of Medication Use – In the U.S. people over 60

take nearly 50% of all prescription and over-the-counter
meds. The lack of prescription drug insurance means most
older Americans cannot afford them.
2. Developmental Changes in How Medications Work –
Understanding how medications work involves examining
developmental changes in the following:
a. Absorption – the time needed for medication to enter
the bloodstream, transfer takes longer to reach the
small intestine from the stomach in older people,
however once in the small intestine, absorption takes
no longer than in younger adults.
b. Distribution – throughout the bloodstream depends on
the adequacy of the cardiovascular system. Toxic
levels of drugs can build up more readily in older
adults as well as those who are overweight. Maximum
drug effectiveness depends on the balance between the
portions of the drug that bind with plasma protein and
the portions that remain free, older adults do not
absorb as much medication leaving higher portions of
free medication in the bloodstream.
c. Metabolism – or the process by which the liver gets
rid of excess medication from the bloodstream take
longer in older adults, thereby leaving meds in the
body longer. This must be taken into account or
toxicity potential arises.
d. Excretion – occurs mainly through the kidneys in
urine, although some elimination may occur through
 feces, sweat and saliva occurs. Again as we age,
changes in kidney function also change, and drugs are
not excreted as quickly, also a setting that may lead
to possible toxic effects.
Because of physiological changes in older adults, doctors
may prescribe smaller doses, and avoid certain drugs
altogether.
3. Medication Side Effects and Interactions – Drug
interactions can produce symptoms that appear to be caused
by other diseases (dizziness, confusion, memory loss, as
with Alzheimer’s), therefore taking multiple medications,
also known as polypharmacy, must be closely monitored.
4. Adherence to Medication Regimens – The likelihood of
adverse drug reactions increases as the number of
medications increases. Adherence becomes less likely with
increase of meds, and diminished sensory, physical and
cognitive skills in older adults. The oldest are the most
at risk; most forget to take their prescribed medication.
Periodic reevaluations should be conducted and medications
should be kept to a minimum if possible.

Functional Health And Disability

1. A Model of Disability in Late Life – (Verbrugge and Jette)

Emphasizes the relations between Pathology (the chronic
conditions a person has), Impairments of organ systems
(such as muscular degeneration), Functional limitations in
the ability to perform activities (such as restrictions in
one’s mobility) and Disability (the effects of chronic
conditions on people’s ability to engage in activities that
are necessary, expected, and personally desired in their
society). The model also includes risk factors and
intervention strategies (Extraindividual as in
environmental and health care and Intraindividual as in
behavioral and personality).
2. Determining Functional Health Status – Helps to identify
older adults who need help with everyday tasks.
a. Frail Older Adults: Those individuals who have
physical disabilities, are very ill, and may have
cognitive or psychological disorders who need
assistance with everyday tasks. Determined by ADLs.
b. ADL: Activities of Daily Living-include basic self-
care tasks such as eating, bathing, toileting,
walking, or dressing. A person may be considered
frail if he/she needs help with one or more of these
tasks.
 c. IADL: Instrumental Activities of Daily Living-are
actions that entail some intellectual competence and
planning.
The number of older adults who need assistance with ADLs
and IADLs increases with age, 5% age 65 – 74 and 20% for
those over 85. All adult over 85 need some assistance,
and about half with all ADLs.
3. What Causes Functional Limitations and Disability in Older
Adults? Boult and associates identified two chronic
conditions as being strong predictors of functional
limitations, cerebrovascular disease and Arthritis.
Additionally, in a longitudinal study other predictive
factors included coronary artery diseases, smoking, heavy
drinking, physical inactivity, depression, social
isolation, and fair or poor perceived health.
A. How Important Are Socioeconomic Factors? The only
difference between those in an affluent community is
that they are expected to have the disabilities for a
longer period of time, and that there are no
differences in socioeconomic status, as people age
they develop the need for managed care.
B. Do Gender And Ethnicity Matter? Women’s health is
poorer across cultures, especially in developing
countries. Ethnic group differences are also
important. The validity of measures of functioning
sometimes differs across ethnicity and gender.

Chapter 4 CLINICAL ASSESSMENT, MENTAL HEALTH, AND

MENTAL DISORDERS

Mental Health And The Adult Life Course

1. Defining Mental Health and Psychopathology

A. Definitions of mental health must reflect appropriate
age-related criteria, what may be abnormal for younger
people, may well in fact be normal for an older person
who is trying to adapt to their surroundings.
Psychopathology is often referred to as the absence
mental health.
B. Behaviors must be interpreted in context. Mentally
healthy people have positive attitudes, accurate
perceptions, environmental mastery, autonomy,
personality balance, and personal growth.
2. A Multidimensional Life-Span Approach to Psychopathology
A. Biological Forces – Various chronic diseases,
functional limitations, and other ailments can change
 behavior. In addition genetic factors often underlie
important problems. Physical problems such as changes
in appetite may be symptoms of depression, or
irritability can be a sign of thyroid problems, or
memory loss can be due to certain vitamin
deficiencies. Physical health and genetic factors
should be taken into account when diagnosing
psychopathology.
B. Psychological Forces – Normal changes in ability to
remember, pay attention, and other intellectual
performance that happens with age can mimic certain
mental disorders, these changes can also help hide
symptoms of actual psychopathology.
C. Sociocultural Forces – Because customs differ across
culture, behaviors that may be normative in one
culture, may be viewed as indicating problems in
another. Is the person cautious because of a high
crime rate or just plain paranoid? Sociocultural
factors must be considered, and whether the person is
acting appropriate in a normative setting.
D. Life-Cycle Factors – The meanings of symptoms may
change with age. Early morning awakenings may be an
indicator of depression in younger people, but a
normal action for older adults.
3. Ethnicity, Aging, and Mental Health – There are both
similarities and differences in the incidence of specific
types of pathology across different ethnic groups. Little
research has been done to examine ethnic differences in the
definition of mental health and psychopathology in older
adults.

Developmental Issues In Assessment And Therapy

1. Areas of Multidimensional Assessment – Usually done by a

team of professionals, consisting of a physician (examine
the person and medication regimen, psychologist (cognitive
skills), nurse (daily living skills/ADLs/IADLs), and social
worker (economic and environmental resources).
A. Mental status exams-are especially useful as quick
screening measures of mental competence that are used
to screen for cognitive impairment. Psychological
function is typically assessed through interviews,
observation, and tests or questionnaires.
B. Social factors constitute the final area of
assessment. Three dimensions (Rook) include: ties
with one’s social network, content of interactions
 with members of the social network, and the number of
quality interactions with the network members.

2. Factors Influencing Assessment – Two areas of concern are

bias, and environmental conditions.
A. Bias either positive or negative can lead to
misdiagnoses because of either ethnic bias or ageism
bias.
B. Environmental concerns are also prevalent due to an
examination being done in less than optimum
conditions, which can also lead to missed, or wrong
diagnoses.
C. In either case, when assessing patients, all four life
forces (Biological, Psychological, sociological, and
Life-Cycle) need to be considered in order for an
accurate assessment.
3. Assessment Methods
A. Interview – Clinical interviews are the most widely
used, and provide both direct information in response
to questions, and nonverbal information such as
emotions.
B. Self-report – Usually questionnaires surveys.
Reliability and validity are often in question.
C. Report by others – Family members or friends can
provide viable information.
D. Psychophysiological assessment – EEG, heart rate
monitoring, and skin temperature can provide
information with regards to the correlation between
the physical and psychological factors.
E. Direct observation – Done either systematically or
through naturalistic observation, and is especially
useful when the problem involves a specific behavior.
F. Performance-based assessment – Involves giving the
patient a specific task to perform. This approach
underlies much cognitive and neuropsychological
assessment. Examples would be a memory or drawing
test.
4. Developmental Issues in Therapy – The two main approaches
are medical therapy (usually involving drugs) and
psychotherapy.

With Psychotherapy, clinicians must be sensitive to changes

in the primary developmental issues faced by adults of
different ages.
Clear criteria have been established for determining “well
established” and “probably efficacious” psychotherapies.
THE BIG THREE: DEPRESSION, DELIRIUM, AND DEMENTIA

1. Depression – 2-5% of adults all ages have clinical

depressive disorder. Rate of clinical depression declines
across adulthood. Young adults (30-44) most at risk.
Depression commonly accompanies other chronic conditions
(diabetes, cancer, or heart disease).
A. General Symptoms and Characteristics of People With
Depression –
(1) Most prominent symptom is dysphoria (feeling
down or “blue”).
(2) Physical symptoms include insomnia, changes in
appetite, diffuse pain, troubled breathing,
headaches, fatigue, and sensory loss.
(3) Symptoms must last at least two weeks.
(4) Other causes must be ruled out. Either
physical or other psychopathological that may
cause same symptoms. For example, other
health or neurological disorders, metabolic
conditions or alcoholism. All can affect
appropriate treatment decisions.
(5) Clinical depression involves significant
impairment in daily living.
B. Gender And Depressive symptoms – Women tend to be
diagnosed as being depressed more often than men.
Classic depression declines with age, but depletion
syndrome (Masked Depression) increases.
C. Assessment Scales – Numerous scales are currently in
place, the most recent for older adults is the
geriatric scale, which omits the physical aspect of
assessment. Even with the use of scales, further
physical and psychological assessment must be done on
the patient before diagnosing clinical depression.
D. Causes of Depression – Two theories, Biological, and
psychological.
1) Biological theories focus on genetic
predisposition and changes in neurotransmitters
or ineffective use of them (serotonin, or
noeprinephrine), they also cite abnormal brain
function or physical illness.
2) The most common Psychological theory of
depression is loss (Bereavement). Loss can be
real, threatened, or imaginary.
 E. Treatment of Depression – Medications (SSRIs, HCAs,
MAOs) Electroconvulsive therapy, Psychotherapy.
1) Selective Serotonin Reuptake Inhibitors (Prozac,
Zoloft) Heterocyclic antidepressants and in the
last line of treatment, Monoamine Oxidase
Inhibitors are all usually used for more severe
cases of depression, as well as
Electroconvulsive therapy.
2) Psychotherapy consists of 100 different types of
therapies including; Behavior Therapy-which
focuses on attempts to alter behavior without
necessarily addressing the underlying causes,
and Cognitive Therapy-which attempts to alter
the ways people think. These therapies seem to
work best for depression. For older adults, two
versions of psychoanalytic therapy are used,
review therapy, and reminiscence.
4. Delirium – Characterized by a disturbance of consciousness
and a change in cognition that develops over a short period
of time. Changes in cognition can include difficulties
with attention, memory, orientation, and language. It can
also affect perception, the sleep-wake cycle, personality
and mood.
A. Can be caused by any of a number of medical conditions
(stroke, cardiovascular disease, metabolic condition),
medication side effects, substance intoxication or
withdrawal, exposure to toxins, or any combination of
factors.
B. 50% of postoperative patients experience delirium.
C. Can be fatal or result in permanent brain damage.
5. Dementia – A family of diseases that are characterized by
cognitive and behavioral deficits involving some form of
permanent damage to the brain.
A. The Family of Dementias – Alzheimer’s, Vascular
dementia, Parkinson’s disease, Huntington’s disease,
Alcoholic dementia, and AIDS dementia complex.
B. Alzheimer’s Disease – The most common form of
progressive, degenerative, and fatal dementia,
accounting for as many as 70% of all cases of
dementia.
1) Neurological Changes in Alzheimer’s disease –
Rapid cell death, neurofibrillary tangles,
neuritic plaques all happen at an increased rate
when compared to normal aging of the brain, and
can only be seen upon performing an autopsy.
2) Symptoms and Diagnosis – Gradual changes in
cognitive functioning: declines in memory,
 learning, attention, and judgment;
disorientation in time and space; difficulties
in word finding and communication; declines in
personal hygiene and self-care skills;
inappropriate social behavior; and changes in
personality. Symptoms are vague in the
beginning and may mimic other psychological
problems, such as depression or stress
reactions. Symptoms are worse in the evening,
called sundowning.
3) Searching for a cause – No certain reasons for
Alzheimer’s exists, some hypotheses link
chromosome 21 to the disease and some new
researchers are finding chromosome 19 may play a
central role. All agree that the disease has an
autosomal dominance pattern, in which only one
gene from the parent is necessary to produce the
disease, meaning there is a 50% chance that a
child of a parent with Alzheimer’s may also be
affected by the disorder. This {autosomal} is
also the case in Pick’s disease and Huntington’s
disease.
4) Intervention Strategies – Most research being
done is in the form of drug and hormone
research, nothing has had any definitive effects
but some medications can be used to treat the
symptoms, or help the patient cope with
impairments, at least in the early stages of the
illness.
5) Caring for patients with dementia at home:
Usually done by female family members, and is
liken to an unexpected career.
6) Effective Behavioral Strategies: Differential
reinforcement of incompatible behavior, spaced
retrieval, medication and behavior modification
are all actions to be considered when caring for
persons with dementia.
C. Other Forms of Dementia
1) Vascular Dementia – possibly caused by a series
of CVAs, which may produce the global pattern of
cognitive decline.
2) Parkinson’s Disease – A cluster of
characteristic motor problems: very slow walking
stiffness, slow tremors. These behavioral
symptoms are caused by a deterioration of the
neurons in the midbrain that produce the
 neurotransmitter dopamine. 14-40% of people
with Parkinson’s will develop dementia.
D. Huntington’s Disease – Autosomal dominant disorder
usually beginning between 35-50. Symptoms include
inability to sustain a motor act, involuntary flicking
movements of the arms and legs, later, psychiatric
disturbances, hallucinations, inability to care for
ones self or control functions such as swallowing,
cognitive loss becomes prominent, death is imminent.
E. Alcoholic Dementia – (Wernicke-Korsakoff syndrome)
caused by a chronic deficiency of thiamine, causes
major memory loss and other cognitive functioning.
Treatable with vitamins if caught early and the
alcoholic must cease drinking.
F. AIDS Dementia Complex – Due to the HIV producing a
protein called gp120 death of neurons occurs, which in
turn cause dementia.

OTHER MENTAL DISORDERS AND CONCERNS

1. Anxiety Disorders – Include anxiety states, in which

feelings of severe anxiety occur with no specific trigger;
phobic disorders, characterized by irrational fears of
objects or circumstances; and obsessive-compulsive
disorders, in which thoughts or actions are performed
repeatedly to lower anxiety.
a. Symptoms and Diagnosis of Anxiety Disorders – Include
physical changes that interfere with normal social
functioning, and personal relationships or work.
Changes include dry mouth, sweating, dizziness, upset
stomach, diarrhea, insomnia, hyperventilation, chest
pain, choking, frequent urination, headaches and a
sensation of a lump in the throat. All happen more
often in older adults due to a myriad of reasons.
b. Treating Anxiety Disorders – Both drugs (Valium,
Librium and other Benzodiazepines) and psychotherapy
are used to treat anxiety disorders. Drugs should be
closely monitored and may produce effects similar to
those with dementia.
2. Psychotic Disorders – Psychoses involves losing touch with
reality and disintegrates personality. The two behaviors
associated are Delusions (belief systems not based on
reality) and Hallucinations (distortions in perception).
a. Schizophrenia – characterized by severe impairment of
thought processes, including style of thinking,
distorted perceptions (hearing voices), loss of touch
with reality (believing they are Jesus), a distorted
 sense of ones self (believing they’re bodies are
changing), and abnormal behavior (laughing at tragic
events).
b. Treating Schizophrenia – Usually through medication
because a schizoid personality is not going to
cooperate due to lack of trust, or belief that
anything is wrong with them. Most psychotherapy is
aimed at adaptation rather than curative.
3. Substance Abuse – Problematic throughout the adulthood
spectrum, only change is with regards to type of substance.
Younger adults abuse more illicit (cocaine, marijuana)
drugs, whereas older adults end up dependant on
prescription or over-the-counter meds. Older adults often
respond to education and awareness, but sometimes still
need to be monitored to ensure inadvertent overmedication
does not happen.

Chapter 5 PERSON-ENVIRONMENT INTERACTIONS AND OPTIMAL

AGING

DESCRIBING PERSON-ENVIRONMENT INTERACTIONS

1. Competence and Environmental Press - B = f(P, E)

Behavior(B) is a function (f) of both the person(P) and the
environment(E).
a. Competence – The theoretical upper limit of a person’s
capacity to function.
(1) Five Competencies: Biological health, Sensory-
Perceptual functioning, Motor skills, Cognitive
skills, EGO
b. Environmental Press – The classification of varying
demands environments place on a person.
(1) Can include any combination of three types of
demands: Physical, Interpersonal, and Social.
c. Adaptation – Point at which competence and
environmental press are in a balance.
2. Congruence Model – People with particular needs search for
environments that meet the needs best.
a. Kahana’s Congruence model proposes that people search
for environments that best meet their needs.
Congruence between the person and the environment is
especially important when either personal or
environmental options are limited.
b. The congruence model helps focus on individual
differences and on understanding adaptation in nursing
homes.
 3. Stress and Coping Framework – Schooler applied Lazuarus’s
model of stress and coping to a person-environment
interactions. Schooler claims that older adults’
adaptation depends on their perception of environmental
stress and their attempts to cope. Social systems and
institutions may buffer the effects of stress.
4. Loss Continuum Concept – Based on view of aging as a
progressive series of losses (children leaving, loss of
social roles, loss of income, death of spouse or close
friends and relatives, loss of sensory acuity, and mobility
due to poor health) that reduces one’s social participation
and makes them especially sensitive to even small
environmental changes. Thus, home and neighborhood take on
more importance. This approach is a guide to helping older
adults maintain competence and independence.
5. Common Theoretical Themes - The common theoretical themes
focus on the interaction between the person and the
environment, not one or the other. Also no one environment
meets everyone’s needs. Rather a range of potential
environments may be optimal.
6. Everyday Competence – A person’s potential ability to
perform a wide range of activities considered essential for
independent living.
a. Involves physical, psychological and social functioning.

LIVING IN LONG-TERM CARE FACILITIES

1. Types of Long-Term Care Facilities – Nursing homes,

Assisted living, and Adult foster homes (adult family
home).
A. Nursing Homes – Two main types: Skilled nursing,
consists of 24 hr care including skilled medical and
other health services. Intermediate care – Also 24 hr
care including nursing supervision, but in a less
intense level.
B. Assisted living facilities – Provide a supportive
living arrangement for people who need assistance with
personal care (bathing/medication) but who are not so
impaired physically or cognitively that they need 24
hour assistance.
C. Adult Foster Care – Another alternative to nursing
homes for adults who do not need 24 hr care. Not
Govt’ regulated so quality may differ, usually only 5
to 6 clients per facility.

2. Who is Likely to Live in Nursing Homes – Usually single

female over 85 white European decent with no siblings or
 children, some cognitive impairment and has one or more
problems with instrumental activities of daily living.
Afro-American women are closing the gap due to health
problems. Baby boomers are getting older and may pose a
problem with rising cost of health care to the Govt’.

3. Characteristics of Nursing Homes – Are examined on two

dimensions, physical and psychosocial. Little is measured
in the physical side as they vary in detail. However they
provide a good platform for psychosocial study.
A. Kahana – Congruence approach-Emphasizes the importance
of fit between the person and the nursing home, seven
environmental and individual dimensions. Members of
residents’ social network are important.
B. Moos – MEAP Multi Environmental Assessment Procedure
C. Langer – Treatment of clients can be detrimental to
their well being and internal attitude toward their
abilities, they become dependent on the environment to
make decisions for them.
4. Can a Nursing Home Be a Home? – Given circumstances can
help the client to feel that they are in a home
environment, but this is not true all the time depending on
the stimuli. By having the patient involved in several of
the decisions made, including placement, factor in to the
process.
5. Communicating with Residents – Inappropriate speech to
older adults that is based on stereotypes of incompetence
and dependence is called Patronizing Speech.
A. Secondary baby talk is also called infantilization
which involves the unwarranted use of a persons first
name, terms of endearment, simplified expressions
short imperatives, an assumption that the recipient
has no memory, and cajoling as a way to demand
compliance. All have a demeaning effect on the
cognitive persons feeling of self-respect.
B. Recognition of clues with regard to the patient will
assist in learning how to develop positive interaction
while still treating the patient with deserved
respect.
6. Decision-Making Capacity and Individual Choices
A. Takes an interdisciplinary team of
professionals, residents, and family members
working together to create an optimal solution.
B. PDSA works well in theory but not usually in
practice because most people admitted into
nursing homes have some form of cognitive
impairment.
 C. PDSA (Patient Self-Determination Act) – Mandates
all facilities receiving Medicare and Medicaid
funds comply with five requirements regarding
advance care planning.
1. Provide written information to people at the
time of their admission about their right to
make medical treatment decisions and to
formulate advance directives (i.e., decisions
about life-sustaining treatments and who could
make medical decisions for them if they were
incapacitated).
2. Maintaining written policies and procedures
regarding advance directives.
3. Documenting the completion of advance
directives in the person’s medical chart.
4. Complying with state law regarding the
implementations of advance directives.
5. Providing staff and community education about
advance directives.

OPTIMAL AGING

1. A Framework for Maintaining and Enhancing Competence – By

applying key adaptive mechanisms of Selection,
Optimization, and Compensation. By applying these
principles we an address the social facilitation of nonuse
of competence. Nonuse of competence stems from people
becoming the stereotypes of which they have been labeled.
They tend to become dependent, where under other
circumstances they would be more competent within their
environment.
A. A key issue in the powerful role of stereotypes is to
differentiate usual from successful aging.
B. Successful aging involves avoiding disease, being
engaged with life, and maintaining high cognitive and
physical functioning.
2. Health Promotion and Disease Prevention – Key strategies
are sound health habits; good habits of thought, including
an optimistic outlook and interest in things; a social
network; and sound economic habits.

A. Issues in prevention –
1) Primary prevention – Any intervention that
prevents a disease or condition from occurring
(immunizations, or controlling risk factors i.e.
cholesterol and smoking)
 2) Secondary prevention – Instituted early after a
condition has begun (but may not yet have been
diagnosed) and before significant impairments
have occurred. (Cardiovascular disease/Cancer
screening and routine medical testing for other
conditions.
3) Tertiary prevention – Involves efforts to avoid
the development of complications or secondary
chronic conditions, manage the pain associated
with the primary chronic condition, and sustain
life through medical intervention. (Does not
focus on functioning but rather on avoiding
additional medical problems and sustaining
life.)
4) Quaternary prevention – Is efforts specifically
aimed at improving the functional capacities of
people who have chronic conditions.

3. Lifestyle Factors – Staying fit, eating right.

CHAPTER 6 Attention And Perceptual Processing

The Information-Processing Model

1. Overview of the Model – The information processing model

assumes an active participant, both quantitative and
qualitative aspects of performance, and information
processing through a series of hypothetical stages.
A. Information enters the brain, is transformed based on
what the person already knows. The more the person,
the more easily the information is incorporated.
B. Researchers look for age differences in how much
information is processed and what types of information
are remembered best under various conditions.

2. Sensory Memory – Where new incoming information is first

registered. The earliest step in information processing.
A. Sensory memory has a large capacity, but information
resides only for a very short time.
3. Attentional Process – Processing information usually uses
more than one Attentional function. Attentional processes
are influenced by the capacity to direct and sustain
attention and the speed with which information is
processed.
Attention
1. Selective Attention – The way in which we choose the
information we will process further.
A. Visual Search involves responding to specific stimulus
or target data and is useful in measuring reaction
time, spatial cueing.
B. Attention Switching is the ability to switch attention
from one set of stimuli to another i.e., narrow
condition to broad conditions.
2. Divided attention – The degree to which information
competes for our attention at any time.
A. Divided attention does not change with age. Rather,
task complexity is a primary determinant of age-
related decrements; older adults are at a disadvantage
when they must perform two or more complex tasks
simultaneously

3. Sustained Attention (Vigilance) – The ability to maintain

attention or focus in performing a task over a long period
of time.
A. There is no age difference in the rate at which
performance declines over time but as task complexity
increases, age difference on vigilant tasks increase.
4. Automatic Processing – Places minimal demands on
attentional capacity.
5. Effortful Processing – uses all available attentional
capacity.
6. Attentional Resources – Suspected that as people age the
available attentional resources diminish, however this is
inconclusive as the attentional resources have not been
defined.
A. Automatic processes – are those that are fast,
reliable and insensitive to increased cognitive
demands (e.g., performing other tasks.
B. Automatic attention response – the processing of a
specific and well-trained stimulus can automatically
capture attention.

Speed of processing

1. A major explanation on age-related decline in cognitive

performance is cognitive slowing.
2. Basic Psychomotor Speed: Reaction Time Tasks –
A. Simple reaction time involves responding as quickly as
possible to a stimulus.
 B. Choice reaction time involves making separate responses to
separate stimuli as quickly as possible.
C. Complex reaction time involves making complicated decisions
about how to respond based on the stimulus observed.
3. Processing Speed – Mental processing speed, as measured by
reaction time, is sensitive to aging, and may be a
contributing factor to age-related decline in memory and
attention.
A. Evidence shows that age-related slowing is specific to
particular levels.

4. What Causes Age-Related Slowing? –

A. Crella - Efficient thinking means making the fewest
connections of neurons from the point of input and the
point of reaction/output. Age related slowing may be
due to remapping of neurons due to broken connections
in the neural network.
B. Myerson – Information loss model - Uses the same
network idea but assumes that at each step of the
process, information is lost. The more the same
information is processed, the more information is lost
along the way (photo copy of photo copy effect).
5. Slowing Down How Much We Slow Down – Although practice
improves performance, age differences are not eliminated.
However “Experience” allows an older adult to compensate
for loss of speed by anticipating what is likely to happen.
The span of anticipation appears to be the reason that
experience helps.

Driving and Accident Prevention

1. Driving And Highway Safety as Information Processing –

Human factors research is intended to optimize the design
of living and working environments, however most design
comes from younger adults. Older drivers have several
problems, including reading highway signs, seeing at night
(Dusk is worse time) noting warnings and performing various
operating skills due to changes in information-processing
abilities and can make older adults more susceptible to
accidents. Hard to document this fact because older adults
don’t drive as much as the norm.
2. Home Safety and Accident Prevention – Declines in sensory
functioning and physiological (motor skills) are causes in
accidents (trip/falls) in older adults. Chap. 2 PHYSICAL
CHANGES
Language Processing

1. Language Comprehension and Sensory Systems – Language

comprehension involves attaching meaning to incoming words.
The less meaning attached, the less the process of
remembering them later.
A. Language production involves coming up with an
appropriate word or phrase. Speech recognition is not
usually affected by Presbycusis (Reduced sensitivity
of high pitched tones) until age 80. The faster
speech is presented, the greater the age differences
in understanding it.
B. Language Comprehension and Information Processing –
Lexical decision task is deciding if a string of
letters is a word. By attaching different connections
of information you already know is Contextual
Encoding. Older adults do not take advantage of
contextual cues when they encode information.

Chapter 7 MEMORY

Information Processing Revisited

1. Three general steps in memory processing –

A. Encoding: The process of getting information into the
memory system.
B. Storage: The manner in which information is
represented and kept in memory.
C. Retrieval: The process of getting information back out
of memory.
2. Working Memory – The active process and structures involved
in holding information in mind and simultaneously using
that information, sometimes in conjunction with incoming
information, to solve a problem, make a decision, or learn
new information.
3. Long-Term Memory – The ability to remember extensive
amounts of information from a few seconds to a few hours to
decades.
A. Explicit Memory: The deliberate and conscious
remembering of information that is learned and
remembered at a specific time.
B. Episodic Memory: The general class of memory having to
do with the conscious recollection of information from
a specific time or event.
 C. Semantic Memory: Concerns learning and remembering the
meaning of words and concepts that are not tied to
specific occurrences of time. Semantic memory is
spared with age in the absence of a diseased
state(Alzheimer’s)
D. Recall: Remembering information without hints or cues.
E. Recognition: Involve selecting previously learned
information from among several items.
4. Remote Memory (Autobiographical Memory) – Information that
must be kept for a very long time (few hours to many years)
is housed in “Remote Memory”.
A. Autobiographical Memory: Involves remembering
information and events from ones own life.
5. Implicit Memory – Is a facilitation or change in task
performance that is attributable to having been exposed to
information at some earlier time but does not involve
active, explicit memory.

Sources of Age Differences in Memory

1. Age Differences in Encoding and Retrieval –

A. Elaborative Rehearsal: Involves making connections
between incoming information and already known info.
2. Emerging Role of Automatic Retrieval – Although conscious
recollection is impaired, automatic retrieval is spared.
3. Misinformation and Memory –
A. Source memory: is the ability to remember the source
of a familiar event and the ability to determine
whether an event was Imagined or experienced.
B. False memory: is the memory of items or events that
did not occur.

Discourse Memory

1. Text-Based Levels – Central or main ideas versus less

important details. Robbery of purse vs. color of purse
robbed.
a. When text is clearly organized with emphasis on
organization and structure and the main ideas recall
is easier. Conversely when text is disorganized and
random or rapid in presentation, older adults are at a
disadvantage.
2. Situation Models – people use their world knowledge to
construct a more global understanding of what the text is
about.
 a. Situation models of text include other features
besides text based information i.e. Characters
emotional states and goals and personality relations
between objects, people, and events described.
3. Text Variables – Differences in how text contains
information.
a. Basic information vs. expanding on main points.
4. Text Memory and Episodic Memory – Pacing, prior knowledge
or familiarity and organization of materials influences
performance on memory for word lists and memory for text,
age is not a factor.

Memory in Everyday Life

1. Spatial Memory – Memory of Location, Recall of Landmarks,

Route learning are all concepts of spatial memory. Where
we leave our keys, how we get to and from the store, and
navigating a new office building.
2. Memory of Activities – Cognitive effort or Automatic.
Depends on the extent of memory applied to perform
activities.
3. Prospective Memory – Involves remembering to perform a
planned action in the future, i.e. remembering to take
medication.
4. Memory of Pictures – Older adults sometimes rely on
schematic knowledge to help remember scenes in a picture.
This is especially true in disorganized pictures.

Self-Evaluations of Memory

1. Aspects of Memory Self-Evaluations –

a. Metamemory: Knowledge about how memory works and what
we believe to be true about it.
b. Memory monitoring: is the awareness of what we are
doing with our memory right now.
2. Age differences in Meta-memory – Usually measured by
questionnaires. Older adults believe that their memory
will decline with age and feel they have little control
over these changes. However, the belief in inevitable
decline does not apply equally to all aspects of memory.
How Metamemory is organized may differ across adulthood.
3. Role of Memory Self-Efficacy – The belief that one will be
able to perform in a specific situation and is an important
construct in understanding how people make judgments about
performance before they have experience with a task.
People who perform better will/may seek further challenges,
 where those who perform poorly will not challenge
themselves, possibly adding to decline due to non-use.
4. Age Differences in Memory Monitoring – When asked to
predict performance, prior to observing a task, older
adults tend to overestimate performance of memory recall,
where younger adults usually are more accurate. When shown
the task (recognition and recall of words from a list)
prior to performance, Older adults are usually more
accurate. However the prediction of recall is usually
overestimated, where prediction of recognition is
underestimated.

Clinical Issues and Memory Testing

1. Normal and Abnormal Memory Aging – Whether changes affect

daily functioning is one way to separate normal from
abnormal aging. Brain imaging techniques allow
localization of problems with more precision. Some diseases
also are marked by severe memory impairments.
Differentiating the difference between normal changes in
memory loss and those associated with disease is sometimes
difficult to discern.
2. Memory and Mental Health – Dementia (Alzheimer’s) and
severe depression both involve memory impairment. In
depression, negative belief systems may underlie these
memory problems. Researchers and clinicians must learn to
differentiate the various types of mental health problems.
3. Clinical Memory Tests –
a. Neuropsychological tests: Assess broad aspects of
cognitive functioning, including memory, attention,
and problem solving. Such tests are designed to
assess specific brain-behavior relations. These tests
are not all-inclusive and should be accompanied with a
physical assessment as well.
b. Behavioral and Self-Help Assessments of Memory
Problems: Scores on memory self-evaluation
questionnaires measuring memory complaints more often
correlate with depressed moods. Rating Scales are
completed by people other than the person with the
memory problems and often are used to diagnose
dementia. Two common types of rating scales are the
mental status exam and checklists of specific memory
problems.
4. Memory, Nutrition, and Drugs – Research evidence links
Niacin and vitamin B12 deficiencies with memory impairment.
Drugs such as Alcohol and some prescription and OTC meds
also have deleterious effects on memory.
Remediating Memory Problems

1. Training Memory Skills –

a. Memory aids or strategies such as E-I-E-I-O are
organized into groups.
b. External aids (Explicit) are memory aids that rely on
environmental resources such as note books, computers,
diaries or calendars. Some aids involve the use of
external cues (placing a book in plain sight so as not
to forget it. External Implicit combinations are used
more for children (Color coding cues) but are
sometimes used for older adults. The processing of
color-coded aspects are easier to identify when
learning or remembering new information.
c. Internal aids are memory aids that rely on mental
processes, such as Imagery, rote rehearsal, spaced
retrieval and conditioning. Internal implicit
strategies are more effective for people with
Alzheimer’s.
d. Exercising Memory – Practicing remembering things
helps to improve memory. Using memory enhancing drugs
does not prevail in the long run. Sometimes a
combination of different strategies is more suited.
2. Individual Difference Variables in Memory Training – Memory
training may be more effective when individual difference
factors, such as emotional issues, are taken into account.
Combining memory strategy training with relaxation
training, for example, has been shown to be effective.
However, older adults appear not to generalize the
strategies across a range of different tasks.

Chapter 8 INTELLIGENCE

DEFINING INTELLIGENCE
1. Intelligence in Everyday Life – Intelligence consists of
problem solving ability, verbal ability and social
competence. The life-span view emphasizes that there is
some intellectual decline with age, primarily in the
mechanics, but there is also stability and growth in,
primarily in the pragmatics.
2. The Big Picture – A Life-Span view – Multidimensional,
specifying many domains of intellectual ability, or the
many abilities that underlie intelligence.
 a. Multi-directionality is the distinct patterns of
change in abilities over life span.
b. Plasticity is the range of functioning within a
person and the conditions under which a person’s
abilities can be modified within a specific age range.
c. Interindividual variability, acknowledges that adults
differ in the direction of their intellectual
development.
3. A Life-Span View – Mechanics vs. Pragmatics
a. Mechanics: is the basic information processing and
concerns the neurophysiological architecture of the
mind with cognitive abilities including basic forms of
thinking and problem solving (reasoning, spatial
orientation, perceptual speed) and is greatest during
childhood.
b. Pragmatics: an acquired body of knowledge which is
content rich, culture dependent and experienced based.
Pragmatic intellectual growth is mainly during
adulthood and therefore crystallized into memory and
tends to decline less over the life course.
4. Research Approaches to Intelligence –
a. Psychometric approach: Measuring intelligence as
performance on standardized tests.
b. Cognitive Structural approach: Addresses the ways in
which people conceptualize and solve problems.
c. Information processing approach emphasizes basic
cognitive mechanisms.

DEVELOPMENTAL TRENDS IN PSYCHOMETRIC INTELLEGENCE

1. Measuring Intelligence
2. Age-Related Changes in Primary Mental Abilities
3. Secondary Mental Abilities
4. Moderators of Intellectual Change
5. Modifying Primary Abilities
QUALITATIVE DIFFERENCES IN ADULTS’ THINKING
1. Piaget’s Theory
2. Postformal Thought
EVERYDAY REASONING AND PROBLEM SOLVING
1. Decision Making
2. Problem Solving
3. Expertise
4. Wisdom