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Developmental Psychology Unit 9: Late Adulthood, Death and Dying

Late adulthood brings biological aging, changes in memory and thinking, and new social roles, and the lifespan ends with death and grief. This unit covers theories of aging, cognition and dementia, theories of successful aging, and research on dying and bereavement.

Covers: Aging populations and biological aging, Sensory and health changes, Memory, cognition and wisdom, Dementia and mental health, Theories of successful aging, Death, dying and end-of-life care, Grief and bereavement

Study guide

Older adults are often grouped as the young-old (65 to 74), the old-old (75 to 84) and the oldest-old (85 and up), the fastest-growing group in many countries. Women outlive men by about five years on average. Primary aging is the gradual, universal decline of the body, while secondary aging results from disease, disuse or poor health habits and can often be prevented. Theories of biological aging fall into two families. Programmed theories say aging follows a built-in schedule; Leonard Hayflick found that human cells divide only about 40 to 60 times, and shortening telomeres at the ends of chromosomes are one reason. Damage theories say aging comes from accumulated harm, such as free radicals from metabolism and cross-linking of proteins. Common sensory changes include cataracts, macular degeneration and presbycusis, or age-related hearing loss.

Cognitive aging is selective. Processing speed slows steadily, which affects many other abilities, and working memory and episodic memory, memory for specific events, decline. Semantic memory (general knowledge), procedural memory (skills such as riding a bike) and vocabulary hold up well. Older adults can still learn, and the brain stays plastic. Paul Baltes's selective optimization with compensation (SOC) describes how people age well by selecting fewer goals, optimizing performance in them and compensating for losses; the pianist Arthur Rubinstein played fewer pieces, practiced them more and slowed before fast passages to make them seem faster. Baltes also studied wisdom, expert knowledge about the practical problems of life, which is not guaranteed by age but can grow with experience. Cognitive reserve from education and mentally active lives can delay the effects of brain damage.

Dementia is a decline in memory and thinking severe enough to interfere with daily life; it is not a normal part of aging. Alzheimer's disease is the most common cause, marked by amyloid plaques and tau neurofibrillary tangles, and begins with problems in new learning and episodic memory before spreading to language, judgment and personality. Vascular dementia results from strokes and often worsens in steps. Risk rises steeply with age, especially after 85, and is lower with exercise, education, social engagement and control of blood pressure. Depression in older adults is often underdiagnosed, and older men have the highest suicide rates of any group in many countries. Elder abuse can be physical, psychological, financial or neglect, and it is most often committed by family members.

Several theories describe how people age well socially. Erikson's last crisis is integrity versus despair, in which older adults look back and either accept their life as meaningful or feel regret. Robert Butler described the life review, a reflection on one's past that can support integrity. Disengagement theory (Cumming and Henry) claimed that older adults and society naturally withdraw from each other, but research has not supported it. Activity theory argues that staying active and involved promotes satisfaction, and continuity theory says people do best when they maintain long-standing habits, roles and identities. Laura Carstensen's socioemotional selectivity theory holds that as time horizons shrink, people focus on fewer, emotionally close relationships, and older adults show a positivity effect, attending to and remembering positive information more than negative. Most retirees adjust well.

Death is now usually defined as brain death, the irreversible end of all brain activity. Elisabeth Kübler-Ross proposed five reactions to dying: denial, anger, bargaining, depression and acceptance; later research shows these are not fixed stages that everyone passes through in order. Hospice care focuses on comfort, dignity and family support at the end of life, while palliative care treats pain and symptoms at any stage of illness. Advance directives include a living will, which states treatment wishes, and a durable power of attorney for health care, which names someone to decide. Margaret Stroebe and Henk Schut's dual-process model says healthy grief alternates between loss-oriented coping and restoration-oriented coping. Disenfranchised grief is grief that society does not recognize, and prolonged grief disorder is intense grief that impairs functioning long after a loss.

Key ideas

• Primary aging is universal and gradual, while secondary aging comes from disease and habits and is often preventable.
• Programmed theories (Hayflick limit, telomeres) and damage theories (free radicals, cross-linking) explain biological aging.
• Processing speed, working memory and episodic memory decline, while semantic and procedural memory are well preserved.
• Dementia is a disease, not normal aging, and Alzheimer's disease is its most common cause.
• Selective optimization with compensation explains how older adults keep performing well despite losses.
• Socioemotional selectivity theory says shrinking time horizons lead people to prioritize close, emotionally meaningful relationships.
• Kübler-Ross's reactions to dying are not a fixed sequence, and the dual-process model sees grief as alternating between loss and restoration.

Formulas and rules

Common mistakes

• Treating dementia as a normal and expected part of aging.
• Assuming all memory declines equally; semantic and procedural memory hold up well.
• Presenting Kübler-Ross's five reactions as a fixed sequence that everyone follows.
• Confusing disengagement theory, which research does not support, with activity or continuity theory.
• Mixing up hospice care (end-of-life comfort) with palliative care (symptom relief at any stage).

Before the test, make sure you can

• Distinguish primary from secondary aging and programmed from damage theories.
• Identify which memory and cognitive abilities decline and which are preserved.
• Apply selective optimization with compensation to an example.
• Describe the features and causes of dementia, especially Alzheimer's disease.
• Compare disengagement, activity, continuity and socioemotional selectivity theories.
• Explain integrity vs. despair and the life review.
• Describe Kübler-Ross's reactions to dying and their limits.
• Distinguish hospice, palliative care and types of advance directives, and apply the dual-process model of grief.

Words to know

Primary aging

Gradual, universal physical decline that happens to everyone with age.

Secondary aging

Decline caused by disease, disuse or harmful habits, which is often preventable.

Hayflick limit

The limit of about 40-60 divisions that human cells can undergo before stopping.

Telomeres

Protective caps on the ends of chromosomes that shorten with each cell division.

Free radicals

Unstable molecules produced by metabolism that damage cells and may contribute to aging.

Presbycusis

Age-related hearing loss, especially for high-pitched sounds.

Episodic memory

Memory for specific personal events tied to a time and place.

Semantic memory

Memory for general facts and knowledge, which is well preserved in aging.

Selective optimization with compensation

Baltes's model of aging well by selecting goals, optimizing effort and compensating for losses.

Alzheimer's disease

The most common cause of dementia, marked by amyloid plaques and tau tangles in the brain.

Integrity vs. despair

Erikson's final crisis, in which older adults judge whether their life has been meaningful.

Life review

Butler's term for reflecting on one's past life, which can support integrity.

Activity theory

The view that staying active and socially involved promotes life satisfaction in old age.

Socioemotional selectivity theory

Carstensen's theory that limited time horizons lead people to focus on emotionally close relationships.

Positivity effect

Older adults' tendency to attend to and remember positive more than negative information.

Hospice

Care focused on comfort, dignity and family support for people at the end of life.

Living will

An advance directive stating what medical treatments a person does or does not want.

Dual-process model

Stroebe and Schut's model in which grieving people alternate between loss-oriented and restoration-oriented coping.

Disenfranchised grief

Grief that is not socially recognized, such as grief for an ex-partner or a pet.

Sample practice questions

30 more questions like these, from level 1 to 5, are in the practice set.