Dr. David R Buyer, MD, MBA, FACP

Tag: Aging

  • Psychological Effects of Aging

    The effect of aging on emotional well-being is generally positive. Age brings acceptance which can be defined as the process of deliberately and non-judgmentally engaging negative emotions. Over time we have greater awareness and understanding. Acceptance does not depend upon mental capabilities or brain processing speed. Uncertainty, unpredictability and impermanence is better accepted with age. There is some evidence that today’s younger adults may not show increasing acceptance with age. 

    Another effect of age is decreasing anger. Sadness however is not reduced. One theory suggests that social connectedness is hindered by anger and anxiety, but helped by sadness. The difficulty with social connectedness as we age is fewer structured activities that promote connectedness.

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    “Life satisfaction is a comparison of life circumstances to one’s internal expectations. Satisfaction is affected by age and gender. Younger people tend to be unrealistic about the future, while older people are more realistic about the past and the future.”

    Evidence for the effects of age on anger, sadness and anxiety comes from a study measuring these emotions. A survey was given to people ages 21–73 before and after exposure to a stressful situation. Daily reports were also collected for two weeks. People were shown an emotionally-neutral short film prior to getting baseline measures, then they were given two minutes to prepare a speech stating their qualifications for a new job while being videotaped. The study results confirmed decreased anxiety and anger, but not sadness.

    Life satisfaction is a comparison of life circumstances to one’s internal expectations. Satisfaction is affected by age and gender. Younger people tend to be unrealistic about the future, while older people are more realistic about the past and the future. Men most highly rate satisfaction on partnership and financial position while women rate on partnership, relationship with children, sexuality, work situation, contribution to others’ welfare and financial situation.

    One survey of people ages 30–74 rated life satisfaction on health, financials, work, contribution to others’ welfare, relationship with children, partnership relations, and sexuality now, ten years ago and ten years from now. In all cohorts life was rated better now than in the past on all measures except for health and sex. People report health was worse than in the past and did not expect improvement, while sex was worse than in the past but expected to improve. The oldest cohorts were more satisfied with their partners than the youngest group.

  • Physical and Cognitive Effects of Aging

    Senior Asian mother and her adult daughter facing each other in profile and smiling warmly

    Aging is typically associated with physical decline. This seems to be true for populations, but not for individuals. This is evidenced by a study that examined health changes in older adults over a 5 year span. The study measured:

    • Number of hospitalizations in the past year
    • Number of days in bed due to illness or injury (in past 14 days)
    • Cognition (mental status examinations)
    • Extremity strength (problems of lifting, reaching, and gripping)
    • Grip strength in dominant hand (measured)
    • Feeling about life as a whole
    • Satisfaction with purpose of life
    • Depression
    • Self-rated health
    • Digit symbol substitution test
    • Number of difficulties with activities of daily living
      (walking, transferring, eating, dressing, bathing, toileting)
    • Number of difficulties with independent activities of daily living (heavy or light housework, shopping, meal preparation, money
      management, or telephoning)

    The study showed that 10–22% of the individuals improved over time on these measures while 25–51% stayed the same and 28–53% worsened. Although these intervals are quite large, at worst a third of the individuals did not decline over time. Of the measures, gait speed, activities of daily living and independent activities of daily living declined the most. This was age but not gender related.

    Similarly, on cognitive measures there is decline that is age-related. Cognitive function is on a continuum from normal to full dementia with mild cognitive impairment as the middle ground and in varying degrees. Dementia is an overall term and can be divided into vascular and non-vascular causes. Vascular dementia is a decrease in blood flow in the fine arteries of the brain. Alzheimer’s is the largest category of non-vascular. Other examples of non-vascular dementia include dementia with Lewy bodies and Parkinson’s dementia. The largest category of vascular dementia comes from strokes.

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    “There are numerous studies evaluating ways to ward off dementia. Recommendations include physical activity, mental activity, social activity, vitamins and supplements. ”

    Only 5% of people over age 65 have full dementia. An additional 5% have less severe dementia. Subtle decreases in cognition can be found in two thirds of older adults. This does not necessarily impair independent living. Chronic illnesses such as high blood pressure, diabetes, emphysema, strokes and other illnesses can increase the risk of cognitive impairment. A quarter of patients with Parkinson’s disease get dementia. High blood pressure is a risk for vascular dementia and half of the people with vascular dementia have high blood pressure. Dementia incidence peaks in the ninth decade and half of people over 85 are affected by Alzheimer’s disease to
    some degree.

    Stated another way, of people younger than 85, 90% do not have dementia and over 85, 50% do not have dementia. Not all dementia is disabling and people can oftentimes still lead active lives with or without some adjustments in daily routines.

    There are numerous studies evaluating ways to ward off dementia. Recommendations include physical activity, mental activity, social activity, vitamins and supplements. Each has studies supporting and refuting the evidence. Regardless, physical, mental and social activities have other health benefits and should be incorporated into daily routines.