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GERONTOLOGY THEORIES OF AGING CHAPTER 3 THEORIES: explain phenomena, give sense of order, and provide a framework from which we can view a world AGING most often described in terms of chronology, or by the measurement of time since birth. Various definitions based on different cultures: e.g., functional no longer able to perform usual activities; social determined by a role, e.g., becoming a grandparent; physiological aging phenotype (gray hair, wrinkled skin, etc.) Biological Theories of Aging Biological aging SENESCENCE a complex, genetically regulated, interactive process of change. Aging phenotype reflects declining functional capacity of the most basic structures in the cells. Cellular Functioning The cells accumulate changes in damage resulting in errors seen in replication. These changes are made visible in the traits we associate with aging. At this point we dont question the association of cellular errors and the aging phenotype, but the cause and patterns, e.g., are the changes predictable or random and chaotic. Programmed Aging Theories Aging is the result of predictable cellular death. All cells and organisms have genetically determined life span (biological clock or the Hayflick limit). Researchers: Hayflick & Moorehead Neuroendocrine Control or Pacemaker Theory Aging programmed decline in the functioning of the nervous, endocrine, and immune systems. Cells dont die; their ability to reproduce is lost (replicative senescence). Secretion of hormones such as DHEA and melatonin is decreased with aging. Immunity Theory Aging programmed accumulation of damage and decline in function of immune system (immunosenescence). Error Theories Aging phenotype the result of an accumulation of random errors in the synthesis of cellular DNA and RNA. With each replication, more errors occur until the cells are no longer able to fully function. Wear-and-Tear Theory

Cell errors are the result of wearing out over time because of continued use. Internal and external stressors including pollutants and injurious metabolic by-products (free radicals) have harmful effects on cells. They may cause decline in cellular function or death. Cross-linkage Theory Aging the result of accumulated damage from error associated with cross-linked proteins. Cross-linking between the protein and glucose causing them to become stiff and thick. The newly cross-linked proteins are called AGEs (advanced glycation endproducts). Cross-linking of collagen (the most abundant protein) can be seen in stiffening of joints and skin. Cross-linking may also cause cholesterol to attach to cell walls, leading to atherosclerosis. Other cross-linking agents include unsaturated fats and metal ions such as aluminum, zinc and magnesium. Oxidative Stress Theory (Free Radical Theory) Errors are the result of random damage from free radicals (molecules containing unpaired ions extra electrical charge). The accumulation of free radicals is called oxidative stress or oxidative damage. Over time, production of free radicals increases and the bodys ability to remove them decreases. The most effected appears to be mitochondrial DNA. HEALTHY AGING PROMOTION: Help people identify pollutants in their environments (e.g., industrial emission, ultraviolet light, second hand smoking, etc.) Encourage the healthiest diet, careful use of herbs and supplements Promote immunizations and avoidance of exposure to others with infections

Psychosocial and Developmental Theories of Aging These theories attempt to explain and predict the changes in roles and relationships in middle and late life, with emphasis on adjustment. Role Theory The ability of an individual to adapt to changing roles over the life course is a predictor of adjustment to personal aging (developed in 1942 by Cottrell). Resistance to role changes indicates poor adjustment to ones own aging. Age Norms socially and culturally constructed expectations of what is deemed as acceptable behavior. The aging of baby boomers proposes challenges to the role theory and age norms. Behavior and roles that were in the past questionable and unimaginable are becoming more acceptable.

Activity Theory Continued activity indicator of successful aging (Havinghurst, Albrecht 1953) Activity is necessary to maintain life satisfaction and positive self-concept.

Disengagement Theory In the natural course of aging, individuals should withdraw from their former roles and activities to enable the transfer of power to younger generations necessary for maintenance of social equilibrium. Continuity Theory Individuals tend to develop and maintain a consistent pattern of behavior, substituting one role for a similar one as the person matures. Personality influences the chosen roles and activities and the level of satisfaction drawn from life. Age-stratification Theory Social aging can be best understood by considering the individual as a member of an age group, with similarities to others in the group (cohort effects). Modernization Theory Social changes resulted in a diminished value of the contribution of older people. The status and value of elders are lost when their labors are no longer considered useful, their information is not pertinent to the society, and culture they live in no longer reveres them. Developmental Theories of Aging Aging is an ongoing and incremental step-wise progression between birth and death. Jungs Theory of Personality A personality is either extroverted (oriented toward the external world) or introverted (oriented toward the subjective inner world of the individual). Aging results in a movement from extraversion to introversion. The development of the inner person is accompanied by a search for personal meaning and the spiritual self. Erikson Successful mastery of one task is necessary for successful movement to the next stage of maturity (famous Ericksons Eight stage (Task Model)). Ericksons task of middle age: generativity (establishment and contribution in meaningful ways for the future generation) vs. stagnation Final task: ego integrity (sense of completeness and cohesion of the self) vs. despair In later modifications of the either/or stance, Erickson recognized the balance of each of the tasks; the goal is to achieve balance rather than an absolute resolution of despair and replacement with integrity. Peck Robet Peck (1968) took Eriksons last stage to a deeper level. An achievement of the following three tasks would result in ego integrity or even Maslows self-actualization: Ego differentiation vs. work role preoccupation: The person no longer defines herself of himself by life work role but by individual personhood.

Body transcendence vs. body preoccupation: The body and changes are accepted as part of life rather than as a source of identity and focus. Ego transcendence vs. ego preoccupation: The person sees oneself as part of a greater whole rather than as an individual requiring special attention.

Maslow Maslow hierarchy of needs combines the bio/psycho/social needs of the individual from the most basic need for food and shelter to the most complex such as self-actualization, or gerotranscendence. Moving toward healthy aging is an evolving and developing process. Biological and Physiological Integrity Safety and Security Belonging Self-Esteem Self-Actualization (Introversion) For more detailed description, please refer to a pyramid on page 41 of the book. Tornstam Tornstam (Swedish psychologist) proposed the theory of gerotranscendence. Aging is viewed as the movement from birth to death and maturation toward wisdom. Gerotranscendence implies achieving wisdom through personal transformation. Drawing inward does not have to be disengagement with the world and can be instead, a time of introspection leading to wisdom. HEALTHY AGING PROMOTION: Maslows hierarchy of needs is an example of how the theories can benefit patients and nurses. Application of the theory will lead to better understanding of individuals and their concerns at any particular time and in any particular situation. This theory can serve as a guide to set priorities in nursing interventions to promote healthy aging. A person whose basic needs are met, who feel safe and secure, and who has a sense of belonging will also have self-esteem and self-efficacy. Self-actualization is seen as people reaching out beyond themselves and finding meaning in their lives and sense of fulfillment. Nurses especially in assisted living facilities or nursing homes can work with older people to form new alliances and associations and create environments in which meaningful relationships and activities can remain a part of the elders life.