Old age is the range of ages for people nearing and surpassing life expectancy. People who are of old age are also referred to as: old people, elderly, elders, senior citizens, seniors or older adults. Publication Manual of the American Psychological Association, 6th edition (American Psychological Association, 2009) Old age is not a definite biological stage: the chronological age denoted as "old age" varies culturally and historically. Some disciplines and domains focus on the aging and the aged, such as the organic processes of aging (senescence), medical studies of the aging process (gerontology), diseases that afflict older adults (geriatrics), technology to support the aging society (gerontechnology), and leisure and sport activities adapted to older people (such as senior sport).
Older people often have limited regenerative abilities and are more susceptible to illness and injury than younger adults. They face social problems related to retirement, loneliness, and ageism.
In 2011, the United Nations proposed a human-rights convention to protect old people.
Old age cannot be universally defined because it is context-sensitive. The United Nations, for example, considers old age to be 60 years or older. In contrast, a 2001 joint report by the U.S. National Institute on Aging and the World Health Organization WHO Regional Office for Africa set the beginning of old age in Sub-Saharan Africa at 50. This lower threshold stems primarily from a different way of thinking about old age in developing nations. Unlike in the developed world, where chronological age determines retirement, societies in developing countries determine old age according to a person's ability to make active contributions to society.Gorman M. Development and the rights of older people. In: Randel J, et al., eds. The ageing and development report: poverty, independence and the world's older people. London, Earthscan Publications Ltd., 1999:3-21 This number is also significantly affected by lower life expectancy throughout the developing world. Dating back to the Middle Ages and prior, what certain scholars thought of as old age varied depending on the context, but the state of being elderly was often thought as being 60 years of age or older in many respects.
Therefore, rather than lumping together all people who have been defined as old, some gerontologists have recognized the diversity of old age by defining sub-groups. One study distinguishes the young-old (60 to 69), the middle-old (70 to 79), and the very old (80+). Another study's sub-grouping is young-old (65 to 74), middle-old (75 to 84), and oldest-old (85+). A third sub-grouping is young-old (65 to 74), old (74 to 84), and old-old (85+). Describing sub-groups in the 65+ population enables a more accurate portrayal of significant life changes.
Two British scholars, Paul Higgs and Chris Gilleard, have added a "fourth age" sub-group. In British English, the "third age" is "the period in life of active retirement, following middle age". Oxford English Dictionary, s.v. "third age". Higgs and Gilleard describe the fourth age as "an arena of inactive, unhealthy, unproductive, and ultimately unsuccessful ageing".Paul Higgs and Chris Gilleard, Rethinking Old Age: Theorizing the Fourth Age (Palgrave Macmillan, 2015), vii, 119–120.
When defined in a legal context, senior citizen is often used for legal or policy-related reasons in determining who is eligible for certain benefits available to the age group.
It is used in general usage instead of traditional terms such as "old person", "old-age pensioner", or "elderly" as a courtesy and to signify continuing relevance of and respect for this population group as "" of society, of senior "rank".
The term was apparently coined in 1938 during a political campaign. Famed caricaturist Al Hirschfeld claimed on several occasions that his father Isaac Hirschfeld invented the term "senior citizen". It has come into widespread use in recent decades in legislation, commerce, and common speech. Especially in less formal contexts, it is often abbreviated as "senior(s)", which is also used as an adjective.
The age which qualifies for senior citizen status varies widely. In governmental contexts, it is usually associated with an age at which or medical benefits for the elderly become available. In commercial contexts, where it may serve as a marketing device to attract customers, the age is often significantly lower.
In commerce, some businesses offer customers of a certain age a "senior discount". The age at which these discounts are available varies from 55, 60, 62 or 65 upwards, and other criteria may also apply. Sometimes a special "senior discount card" or other proof of age needs to be produced to show entitlement.
In the United States, the standard retirement age is currently 66 (gradually increasing to 67). The AARP allows couples in which one spouse has reached the age of 50 to join, regardless of the age of the other spouse.
In Canada, the Old Age Security (OAS) pension is available at 65 (the Conservative government of Stephen Harper had planned to gradually increase the age of eligibility to 67, starting in the years 2023–2029, although the Liberal government of Justin Trudeau is considering leaving it at 65), and the Canada Pension Plan (CPP) as early as age 60.
These marks do not occur at the same chronological age for everyone. Also, they occur at different rates and order for different people. Marks of old age can easily vary between people of the same chronological age.
A basic mark of old age that affects both body and mind is "slowness of behavior". The term describes a correlation between advancing age and slowness of reaction and physical and mental task performance.Donald H. Kausler and Barry C. Kausler, The Graying of America: An Encyclopedia of Aging, Health, Mind, and Behavior (University of Illinois, 2001), 376–377. However, studies from Buffalo University and Northwestern University have shown that the elderly are a happier age group than their younger counterparts.
In her The Denial of Aging, Dr. Muriel R. Gillick, a Baby boomers, accuses her contemporaries of believing that by proper exercise and diet they can avoid the scourges of old age and proceed from middle age to death.Gillick, The Denial of Aging: Perpetual Youth, Eternal Life, and Other Dangerous Fantasies (Harvard, 2007), 5–6. Studies find that many people in the 65–84 range can postpone morbidity by practicing healthy lifestyles. However, at about age 85, most people experience similar morbidity.Waneen Wyrick Spirduso, Karen L. Francis, Priscilla G. MacRae, Physical Dimensions of Aging (Human Kinetics, 2004), 26. Even with healthy lifestyles, most 85+ people will undergo extended "frailty and disability".
writes that the first man known to talk about his old age was an Egyptian scribe who lived 4,500 years ago. The scribe addressed God with a prayer of lament:(1989). 9780226530314, University of Chicago Press. ISBN 9780226530314
Minois comments that the scribe's "cry shows that nothing has changed in the drama of decrepitude between the age of the Pharaoh and the atomic age" and "expresses all the anguish of old people in the past and the present".
Lillian Rubin, active in her 80s as an author, sociologist, and psychotherapist, opens her book 60 on Up: The Truth about Aging in America with "getting old sucks. It always has, it always will." Dr. Rubin contrasts the "real old age" with the "rosy pictures" painted by middle-age writers.Lillian B. Rubin, 60 on Up: The Truth About Aging in America (Beacon, 2007), 1, 7–8.
Writing at the age of 87, Mary C. Morrison describes the "heroism" required by old age: to live through the disintegration of one's own body or that of someone you love. Morrison concludes, "old age is not for the fainthearted".Mary C. Morrison, Let Evening Come (1998), 2–3. In the book Life Beyond 85 Years, the 150 interviewees had to cope with physical and mental debilitation and with losses of loved ones. One interviewee described living in old age as "pure hell".
Research has shown that in high-income countries, on average, one in four people over 60 and one in three over 75 feels lonely.
"The problem of the ambiguity of old age has ... been with us since the stage of Urgesellschaft; it was both the source of wisdom and of infirmity, experience and decrepitude, of prestige and suffering."
In the Classical period of Greek and Roman cultures, old age was denigrated as a time of "decline and decrepitude".
Historical periods reveal a mixed picture of the "position and status" of old people, but there has never been a "golden age of aging". Studies have challenged the popular belief that in the past old people were venerated by society and cared for by their families.
In ancient times, those who were frail were seen as a burden and ignored or, in extreme cases, killed. People were defined as "old" because of their inability to perform useful tasks rather than their years.
Although he was skeptical of the gods, Aristotle concurred in the dislike of old people. In his Ethics, he wrote that "old people are miserly; they do not acknowledge disinterested friendship; only seeking for what can satisfy their selfish needs".
The Medieval and Renaissance periods depicted old age as "cruel or weak".
The 16th-century Utopians Thomas More and Antonio de Guevara allowed no decrepit old people in their fictional lands.
For Thomas More, on the island of Utopia, when people are so old as to have "out-lived themselves" and are terminally ill, in pain, and a burden to everyone, the priests exhort them about choosing to die. The priests assure them that "they shall be happy after death". If they choose to die, they end their lives by starvation or by taking opium.
Antonio de Guevara's utopian nation "had a custom, not to live longer than sixty five years". At that age, they practiced self-immolation. Rather than condemn the practice, Bishop Guevara called it a "golden world" in which people "have overcome the natural appetite to desire to live".
Attitudes toward old age well-being vary somewhat between cultures. For example, in the United States, being healthy, physically, and socially active are signs of a good old age. On the other hand, Africans focus more on food and material security and a helpful family when describing old age well-being. Additionally, Koreans are more anxious about aging and more scared of old people than Americans are.
Research on age-related attitudes consistently finds that negative attitudes exceed positive attitudes toward old people because of their looks and behavior.James E. Birren and K Warner Schaie, eds., Handbook of the Psychology of Aging (Academic, 2011), 253. In his study Aging and Old Age, Posner discovers "resentment and disdain of older people" in American society. Harvard University's implicit-association test measures implicit "attitudes and beliefs" about "Young vis a vis Old". Blind Spot: Hidden Biases of Good People, a book about the test, reports that 80% of Americans have an "automatic preference for the young over old" and that attitude is true worldwide. The young are "consistent in their negative attitude" toward the old.Mahzarin R. Banaji and Anthony G. Greenwald, Blind Spot: Hidden Biases of Good People (Random House, 2013), 67. Ageism documents that Americans generally have "little tolerance for older persons and very few reservations about harboring negative attitudes" about them.Todd D. Nelson, ed, Ageism: Stereotyping and Prejudice Against Older Persons (Bradford, 2004), ix.
Despite its prevalence, ageism is seldom the subject of public discourse.
Texas A&M University offers a plan for an "Aging Simulation" workshop. The workshop is adapted from Sensitizing People to the Processes of Aging. Sensitizing People to the Processes of Aging: The In-Service Educator's Guide by Marvin Ernst and Herbert Shore, Dallas Geriatric Research Institute, 1977. Some of the simulations include:
The Macklin Intergenerational Institute conducts Xtreme Aging workshops, as depicted in The New York Times. A condensed version was presented on NBC's Today Show and is available online. One exercise was to lay out 3 sets of 5 slips of paper. On set #1, write your 5 most enjoyed activities; on set #2, write your 5 most valued possessions; on set #3, write your 5 most loved people. Then "lose" them one by one, trying to feel each loss, until you have lost them all, as happens in old age.
Gerontology note the lack of research regarding and the difficulty in defining frailty. However, they add that physicians recognize frailty when they see it.
A group of Geriatrics proposed a general definition of frailty as "a physical state of increased vulnerability to stressors that results from decreased reserves and disregulation in multiple physiological systems".
Frailty is a common condition in later old age but different definitions of frailty produce diverse assessments of prevalence. One study placed the incidence of frailty for ages 65+ at 10.7%. Another study placed the incidence of frailty in age 65+ population at 22% for women and 15% for men.
A worldwide study of "patterns of frailty" based on data from 20 nations found (a) a consistent correlation between frailty and age, (b) a higher frequency among women, and (c) more frailty in wealthier nations where greater support and medical care increases longevity.
In Norway, a 20-year longitudinal study of 400 people found that bodily failure and greater dependence became prevalent in the 80+ years. The study calls these years the "fourth age" or "old age in the real meaning of the term". Similarly, the "Berlin Aging Study" rated overall functionality on four levels: good, medium, poor, and very poor. People in their 70s were mostly rated good. In the 80–90 year range, the four levels of functionality were divided equally. By the 90–100 year range, 60% would be considered frail because of very poor functionality and only 5% still possessed good functionality.
Old age survivors on average deteriorate from agility in their early retirement years (65–79) to a period of frailty preceding death. This deterioration is gradual for some and precipitous for others. Frailty is marked by an array of chronic physical and mental problems which means that frailty is not treatable as a specific disease. These problems, coupled with increased dependency in the basic activities of daily living (ADLs) required for personal care, add emotional problems: depression and anxiety.Muriel R. Gillick, Lifelines: Living Longer, Growing Frail, Taking Heart (Norton, 2001), x, xv–xvi, 5–6. In sum, frailty has been depicted as a group of "complex issues", distinct but "causally interconnected", that often include "comorbid diseases","diseases in addition to the primary disease" progressive weakness, stress, exhaustion, and depression.
Healthy humans after age 50, accumulate endogenous DNA single- and double-strand breaks in a linear fashion in cellular DNA. Other forms of DNA damage also increase with age. After age 50 a decline in DNA repair capability also occurs. These findings are in accord with the theory that DNA damage is a fundamental aspect of aging in older people.
According to a study by the Agency for Healthcare Research and Quality (AHRQ), the rate of emergency department visits was consistently highest among patients ages 85 years and older in 2006–2011 in the United States. Additionally, patients aged 65+ had the highest percentage of hospital stays for adults with multiple chronic conditions but the second highest percentage of hospital costs in 2003–2014.
These final years are also costly in economic terms.
Medical treatments in the final days are not only economically costly, but they are often unnecessary or even harmful. Nortin Hadler, M.D. warns against the tendency to medicalize and overtreat the frail.Nortin M. Hadler, Rethinking Aging: Growing Old and Living Well in an Overtreated Society (University of North Carolina, 2011) 1, 3. In her Choosing Medical Care in Old Age, Michael R. Gillick M.D. argues that appropriate medical treatment for the frail is not the same as for the robust. The frail are vulnerable to "being tipped over" by any physical stress put on the system such as medical interventions.
In addition to everyday care, frail elderly people and others with disabilities are particularly vulnerable during natural disasters. They may be unable or unwilling to evacuate to avoid a hurricane or wildfire.
Older Adults' Views on Death is based on interviews with 109 people in the 70–90 age range, with a mean age of 80.7. Almost 20% of the people wanted to use whatever treatment that might postpone death. About the same number said that, given a terminal illness, they would choose assisted suicide. Roughly half chose doing nothing except live day by day until death comes naturally without medical or other intervention designed to prolong life. This choice was coupled with a desire to receive palliative care if needed.
About half of older adults have multimorbidity, that is, they have three or more chronic conditions. Medical advances have made it possible to "postpone death", but in many cases this postponement adds "prolonged sickness, dependence, pain, and suffering", a time that is costly in social, psychological, and economic terms.
The longitudinal interviews of 150 age 85+ people summarized in Life Beyond 85 Years found "progressive terminal decline" in the year prior to death: constant fatigue, much sleep, detachment from people, things, and activities, simplified lives. Most of the interviewees did not fear death; some would welcome it. One person said, "Living this long is pure hell." However, nearly everyone feared a long process of dying. Some wanted to die in their sleep; others wanted to die "on their feet".
The study of Older Adults' Views on Death found that the more frail people were, the more "pain, suffering, and struggles" they were enduring, the more likely they were to "accept and welcome" death as a release from their misery. Their fear about the process of dying was that it would prolong their distress. Besides being a release from misery, some saw death as a way to reunite with deceased loved ones. Others saw death as a way to free their caretakers from the burden of their care.
In the United States, 90% of old age Hispanics view themselves as very, quite, or somewhat religious.
In a British 20-year longitudinal study, less than half of the old people surveyed said that religion was "very important" to them, and a quarter said they had become less religious in old age. The late-life rise in religiosity is stronger in Japan than in the United States, but in the Netherlands it is minimal.
In the practice of religion, a study of 60+ people found that 25% read the Bible every day and over 40% watch religious television. Pew Research found that in the age 65+ range, 75% of whites and 87% of blacks pray daily. When comparing religiosity, the individual practice may be a more accurate measure than participation in organized religion. With organized religion, participation may often be hindered due to transportation or health problems.
The number of old people is growing around the world chiefly because of the post–World War II baby boom and increases in the provision and standards of health care. By 2050, 33% of the developed world's population and almost 20% of the less developed world's population will be over 60 years old.John Bond and others, editors, Ageing in Society (Sage, 2007 3rd ed), 1.
The growing number of people living to their 80s and 90s in the developed world has strained public welfare systems and has also resulted in increased incidence of diseases like cancer and dementia that were rarely seen in premodern times. When the United States Social Security program was created, people older than 65 numbered only around 5% of the population and the average life expectancy of a 65-year-old in 1936 was approximately 5 years, while in 2011 it could often range from 10 to 20 years. Other issues that can arise from an increasing population are growing demands for health care and an increase in demand for different types of services.
Of the roughly 150,000 people who die each day across the globe, about two thirds—100,000 per day—die of age-related causes. In industrialized nations, the proportion is much higher, reaching 90%.
For people in their 80s and 90s, Joan Erikson added a ninth stage in The Life Cycle Completed: Extended Version. As she wrote, she added the ninth stage because the Integrity of the eighth stage imposes "a serious demand on the senses of elders" and the Wisdom of the eighth stage requires capacities that ninth stage elders "do not usually have".
Newman & Newman also proposed a ninth stage of life, Elderhood. Elderhood refers to those individuals who live past the life expectancy of their birth cohorts. They described two different types of people in this stage of life. The "young old" are the healthy individuals who can function on their own without assistance and can complete their daily tasks independently, while the "old old" are those who depend on specific services due to declining health or diseases.Barbara M. Newman, Philip R. Newman, Development Through Life: A Psychosocial Approach: A Psychosocial Approach (Cengage Learning, 2011), Ch 13 "Later Adulthood (60–75 Years)" and Ch 14, "Elderhood (75 until death)".
One theory, proposed in 1961, is the disengagement theory, which proposes that, in old age, a mutual disengagement between people and their society occurs in anticipation of death. By becoming disengaged from work and family responsibilities, according to this concept, people are enabled to enjoy their old age without stress. This theory has been subjected to the criticism that old age disengagement is neither natural, inevitable, nor beneficial. Furthermore, disengaging from social ties in old age is not across the board: unsatisfactory ties are dropped and satisfying ones kept.
In opposition to the disengagement theory, the activity theory of old age argues that disengagement in old age occurs not by desire, but by the barriers to social engagement imposed by society. This theory has been faulted for not factoring in psychological changes that occur in old age as shown by reduced activity, even when available. It has also been found that happiness in old age is not proportional to activity.
According to the continuity theory, in spite of the inevitable differences imposed by their old age, most people try to maintain continuity in personhood, activities, and relationships with their younger days.
Socioemotional selectivity theory also depicts how people maintain continuity in old age. The focus of this theory is continuity sustained by social networks, albeit networks narrowed by choice and by circumstances. The choice is for more harmonious relationships. The circumstances are loss of relationships by death and distance.
In almost all countries, women, on average, live longer than men. The disparities vary between 12 years in Russia to no difference or higher life expectancy for men in countries such as Zimbabwe and Uganda.de Blij, Harm. The power of place. Geography, Destiny, and Globalization's Rough Landscape. Oxford University Press. London:2009. p161ff
The number of elderly people worldwide began to surge in the second half of the 20th century. In developed countries before then, five or less percent of the population was over 65. Few lived longer than their 70s and people who attained advanced age (i.e. their 80s) were rare enough to be a novelty and were revered as wise sages. The worldwide over-65 population in 1960 was one-third of the under-5 population. By 2013, the over-65 population had grown to equal the under-5 population and is projected to double the under-5 population by 2050.
Before the surge in the over-65 population, accidents and disease claimed many people before they could attain old age, and health problems in those over 65 meant a quick death in most cases. If a person lived to an advanced age, it was generally due to genetic factors and/or a relatively easy lifestyle, since diseases of old age could not be treated before the 20th century.
In October 2016, a group of scientists identified the maximum Ageing at an average age of 115, with an absolute upper limit of 125 years. However, the concept of a maximum lifespan of humans is still widely debated among the scientific community.
In the United States of America, and the United Kingdom, 65 (UK 60 for women) was traditionally the age of retirement with full old age benefits.
In 2003, the age at which a United States citizen became eligible for full Social Security benefits began to increase gradually, and will continue to do so until it reaches 67 in 2027. Full retirement age for Social Security benefits for people retiring in 2012 is age 66. In the United Kingdom, the state pension age for men and women will rise to 66 in 2020 with further increases scheduled after that.
Originally, the purpose of old age pensions was to open up jobs for younger unemployed people, and also prevent elderly people from being reduced to beggary, which is still common in some underdeveloped countries, but growing life expectancies and older populations have brought into question the model under which pension systems were designed.James H. Schulz and Robert H. Binstock, Aging Nation: The Economics and Politics of Growing Older in America (Johns Hopkins, 2008). 3–4. Some complained that "powerful" and "greedy", old people were getting more than their share of the nation's resources.Laura Katz Olson, The Not-so-golden Years: Caregiving, the Frail Elderly, and the Long-term Care Establishment (Rowman and Littlefield, 2003), 4. In 2011, using a Supplemental Poverty Measure (SPM), the old age American poverty rate was measured as 15.9%.
Many new assistive devices made especially for the home have enabled more old people to care for their own activities of daily living (ADL). Some examples of devices are a medical alert and safety system, shower seat (making it so the person does not get tired in the shower and fall), a bed cane (offering support to those with unsteadiness getting in and out of bed) and an ADL cuff (used with eating utensils for people with paralysis or hand weakness).
A Swedish study found that at age 76, 46% of the subjects used assistive devices. When they reached age 86, 69% used them. The subjects were ambivalent regarding the use of the assistive devices: as "enablers" or as "disablers". People who view assistive devices as enabling greater independence accept and use them, whereas those who see them as symbols of disability reject them. However, like Love for the Elderly aim to combat such age-related prejudice by educating the public about the importance of appreciating growing older, while also providing services of kindness to elders in senior homes.
Even with assistive devices as of 2006, 8.5 million Americans needed personal assistance because of impaired basic activities of daily living required for personal care or impaired instrumental activities of daily living (IADL) required for independent living. Projections place this number at 21 million by 2030 when 40% of Americans over 70 will need assistance. There are many options for such long-term care to those who require it. There is home care in which a family member, volunteer, or trained professional will aid the person in need and help with daily activities. Another option is community services which can provide the person with transportation, meal plans, or activities in senior centers. A third option is assisted living where 24-hour round-the-clock supervision is given with aid in eating, bathing, dressing, etc. A final option is a nursing home which provides professional nursing care.
Contemporary perspectives
Simulated
Frailty
Markers
Care and costs
Death
Religiosity
Demographic changes
Psychosocial aspects
Theories
Life expectancy
Benefits
Assistance
Culture
Artistic depiction
See also
Further reading
External links
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