Adulthood: Cognitive and Social Changes
Adulthood: Cognitive and Social Changes
As you’re reading, pay particular attention to the following key points and make notes on them in your
study journal.
F
From adolescence through to the end of middle adulthood, people are also at the pinnacle in terms of
their reproductive capacity. However, there is a notable drop in women’s fertility from the mid-thirties
onwards, and associated with this an increased risk of complications with pregnancy and birth defects
among children born to women who conceive beyond this age (Lewis, Legato, & Frisch, 2006). Men’s
reproductive capacity dips from around 40 years onwards, where there is a drop in the number of viable
sperm produced.
Relatively minor deterioration in physical capacity begins towards the end of early adulthood and
continues into middle adulthood. Sometimes this may become noticeable but, more often than not,
changes are so minor that they are not detected or noticeable. However, the senses become
progressively less acute, with presbyopia (far-sightedness) in many adults during this phase. Hearing loss
(presbycusis), which for men begun in the late twenties becomes progressively more acute, and from
55 years, this loss is more pronounced for men than women. One reason that deterioration often
goes unnoticed is that in middle adulthood people can still do almost all of the everyday activities
that people in early adulthood can. Only additional, strenuous activities or activities that push the
body to its physical limits are no longer possible or cannot be carried out to the same level. Thus, the
body begins to lose its reserve capacity, but core functions remain comparatively unaffected.
A key physiological change for women in middle adulthood is the menopause. There is wide variation
in the onset of this period of life, when a woman stops ovulating and menstruating and ceases to be
able to reproduce. Generally, women’s menopause occurs at around 50 years of age, but this can vary
widely. As with the age of onset, there is variation in the length of the menopause but for most women
it lasts somewhere between two and five years. From a physiological perspective, menopause occurs
because of a marked decline in the body’s production of the hormone oestrogen. The most distinctive
physical symptoms are hot flushes – unwanted and unexpected sensations of heat. Probably due to its
link with hormones, the experience of menopause is often assumed to have negative psychological
consequences such as greater variations in mood. There is some evidence that women with existing
psychological disorders such as obsessive-compulsive disorder (Labad et al., 2008) and bipolar
disorder (Freeman et al., 2002) experience greater difficulties associated with their disorder during
the menopause. However, for the majority of women there appear to be no negative psychological
consequences (Matthews et al., 1990).
Throughout middle adulthood both sexes begin to reduce their interest in sexual activity, and there is
a reduction in men’s production of the hormone testosterone (the ‘male’ hormone) from around the late
twenties onwards. A cluster of physical symptoms that are often reported by men during middle
adulthood include tiredness, irritability and also, occasionally, hot flushes. However, the decline in
testosterone for men is far more gradual than the decline in oestrogen for women during the
menopause. This has led to some controversy over whether the male menopause – the andropause –
exists at all.
Although there is a link between reductions in testosterone and depression in men, this link is
noteworthy only for elderly males (i.e., 60 years and older) (Margolese, 2000). Moreover, the
psychological characteristics of andropause may well be explained by social or psychological
processes rather than by hormones. For instance, traditionally male self-esteem has been closely
linked to career and sexual success. If a middle-aged man begins to lose interest in sex, or if his career
does not turn out as he had hoped, he might become depressed or begin a major reappraisal of
himself, his values, and ambitions (Lazarus & DeLongis, 1983). It is not surprising, then, that andropause
is also sometimes described as a ‘mid-life crisis’. Whatever its causes, there is widespread
acknowledgement that many men go through a major appraisal of their life and role at some stage
during middle adulthood.
The physical decline that begins in middle adulthood accelerates in late adulthood.
Although the declines in vision that lead to far-sightedness stabilize around 60 years, there is increasing
hearing loss. Hearing loss affects around a third of individuals aged 65–74 years and half of those 75–79
years.
Senses of smell and taste decline significantly from 60 years.
The loss of taste, in particular, is a source of concern because older adults often complain that food is
tasteless and, as a consequence, may not eat properly, lose weight, and suffer from malnutrition
(Fisher, 1990).
Into old age, muscle strength progressively diminishes, reactions slow, and the body takes longer to
recover from injury and illness.
However, there is wide variation in both the extent and the nature of physical decline: many
octogenarians remain in good physical health.
The ageing brain
In adulthood, changes with age in the physical characteristics of the brain also occur. These changes
include brain shrinkage and a loss of neuron connections and plasticity. However, few studies have
managed to link age-related changes in the brain with specific decline in cognitive functions in
adulthood. Throughout adulthood, there is a gradual and steady reduction of around 2% for each
decade of life in the weight and volume of the brain. This reduction is constant across adulthood and
does not accelerate in later years. The observation that cognitive and other processes can be
impoverished in old age is, therefore, a likely consequence of an accumulation of years of graduation
deterioration (although, clearly, sudden brain traumas such as stroke and injury can lead to sudden
problems with cognition). Brain shrinkage is partly due to the loss of neurons, but also due to the
neurons themselves shrinking in size. This shrinkage is not uniform: areas most frequently affected
are the frontal lobes and hippocampus (areas associated with memory processes). As neurons are lost
and shrink, the complex connections between neurons across the brain are also lost. These lost
connections may not be replaced, or new connections are not so easily formed. Levels of key
biochemical neurotransmitters such as dopamine also decline with age, further compromising the
brain’s ability to maintain efficient connections between neurons
Research close-up
BOX 16-1 Age-related cognitive changes involve some parts of the brain more than others
introduction: Current neuropsychological models suggest that the age-related decline in some cognitive functions is related to
a deterioration of the frontal lobes of the brain. However, when the performance of healthy ageing individuals is compared with
that of patients with damage to the frontal lobes, there seems to be some inconsistency. MacPherson et al. suggested that this
might be because the frontal lobes can be subdivided into two discrete areas which perform different functions and which age
differently. From a structural perspective, the frontal lobes can be divided into the dorsolateral (DL) and ventromedial (VM)
regions and there is some physical evidence, for example from autopsy studies, that the DL area ages faster than the VM area.
From a functional perspective, the DL region is considered to be important for the cognitive abilities known as executive
function, and for working memory. The VM area is considered to be involved in the processing of emotions and for control of
social behaviour. The researchers therefore hypothesized that there should be a faster deterioration in performance on tasks
which mainly involve executive function or working memory than on tasks which mainly involve emotional processing or social
decision making. Sorting test, the Self-Ordered Pointing Test, and a Delayed-Response Task. A further three tasks were chosen
to test VM function; these were a Gambling task, a Faux Pas task and an Emotion Identification task. In addition, two tasks that
tested the function of the medial temporal lobes were performed. These were required because there is some evidence that the
medial temporal lobes deteriorate with healthy ageing, and it was important to account for the effect of this on participants’
Results: Results showed that participants in the older age group performed significantly less well than the younger or middle-
aged participants in all tasks thought to be dependent on DL function. However, there was no difference between the groups
on the tasks dependent on VM function.
Discussion: This study shows that the effect of ageing on cognitive abilities can be better understood
by thinking of the frontal lobes as two distinct areas rather than just one. There is not a uniform global
deterioration in the function of the frontal lobes. Instead, the dorsolateral prefrontal region, which
supports executive function and working memory, seems to physically deteriorate more quickly than
the ventromedial prefrontal area, responsible for emotional and social processing. This physical
deterioration is reflected in functional performance. MacPherson et al. point out that the different areas
of the brain are closely interconnected and, therefore, interpretation of results of this type of test should
always be undertaken with caution; however, this study does offer a useful way to advance our
understanding of age-related cognitive changes.
These neurophysiological consequences of ageing are the most likely factor in any deterioration in
cognitive processes that is evident in the elderly.
However, it is important to remember that not all elderly individuals show impoverished cognitive
performance. Indeed, many octogenarians can function at the highest intellectual levels. Individual
differences in physiology may play a part, but lifestyle differences are an important part too. For
instance, diet and general physical health and an active mental and social life into old age may help
to maintain connections in the brain and cognitive functioning. In Chapter 4 we discuss the nervous
system and its role in development from before birth in fuller detail.
Brain plasticity may also explain why many older adults are able to resist cognitive decline due to
physical changes in the brain that are associated with age. In this respect, the brain can compensate for
loss of neurons or connections in one area by finding an alternative process or pathway that achieves
the same cognitive function. Imaging studies indicate that compensation may operate, partly, by
decreasing brain specialization such that more areas are activated in response to particular stimuli
in the old, compared with younger adults (e.g., Jonides et al., 2000).
Moreover, Cabeza et al. (2002) found less asymmetry in prefrontal cortex activity of older adults who
performed as well as younger adults on word recall tasks. In contrast, older adults who were
significantly worse at the tasks showed the same asymmetry of activity as the younger adults. The
high-performing older adults used more visual processing than the younger adults and low-
performing older adults. Thus, older adults’ brains appeared to show the signs of adjusting to find
alternative ways of solving the tasks.
Applied Developmental Psychology
BOX 16-2 Werner’s syndrome: a window into the biological basis of ageing?
Werner’s syndrome, also known as ‘adult progeria’, is a very rare autosomal, recessive disorder, which leads sufferers
to prematurely age from puberty onwards. First identified by German scientist Otto Werner in 1904, research into
the psychological functioning of Werner’s syndrome patients suggests that cognitive function, generally, remains
unimpaired (see Sild et al., 2006), while physical ageing is accelerated with early greying of hair, wrinkling skin, and
age-related disorders such as diabetes, cardiovascular disease, cancer, cataracts, and osteoporosis. There is also
evidence that normal body repair processes such as the ability to repair DNA fails to function properly in Werner
syndrome patients (Yu et al., 1996). Although development is normal up until puberty, most individuals with Werner’s
syndrome do not survive beyond 50 years of age. Adult sufferers tend to have shorter than normal stature with a thick
body trunk but thin arms and legs (Epstein et al., 1996). Werner’s syndrome has a genetic basis and is associated with
mutations in the WRN gene, although the precise nature of the mutation is complex and not fully understood (Ozgenc
& Loeb, 2005).
The observation that physical ageing is accelerated while cognitive functions appear relatively unimpaired is intriguing
because it suggests that there is, on some level, dissociation between these two elements in the normal ageing
process (Goto, 1997). This has led some researchers to search the WRN gene for evidence of genes that may relate
to cognitive functioning and ageing. For instance, Bendixen et al. (2004) examined data from 426 dizygotic twins aged
70–90 years from the ‘Longitudinal study of Danish Twins’. The researchers were interested to see if they could
understand a genetic basis for why cognition deteriorated more in some twins compared with others. Dizygotic twins
were chosen because the researchers first conducted an unpaired analysis to see if they could find a general
relationship between certain cognitive and physical characteristics and specific gene markers. They then hoped to
follow up these findings to see if they could identify twins who differed in these characteristics, and then narrow down
particular variations in order to establish precise genetic markers of specific features of ageing. The first, unpaired
part of the analysis was successful and the researchers (confirming previous research; Kyng et al., 2003) found a 91%
concordance in expression profile – that is, the measurement of how many cells operating together affect
performance – between Werner and aged cells. Failure to maintain DNA (or DNA repair processes) was implicated in
the ageing process. To their surprise, however, the strongest association was for cognitive profile even though
cognitive decline is one area of normal ageing that is assumed to be unaffected in Werner’s syndrome.
However, the second part of the analysis, which planned to compare twins, was not successful, probably because
there were too few suitable pairs to make powerful statistical comparisons. This underscores the difficulty in
conducting this type of research. Bendixen et al. suggest that their findings, although tentative, have significance for
two reasons. First, they support a notion that normal ageing is partly due to failings in DNA maintenance (see ‘Theories
of ageing’, below). Second, from a more practical perspective, the authors argue that the effects of ageing could be
delayed in many people by targeting those most likely to show early decline and give these individuals training and
interventions, such as physical training and tailored exercise regimes, to slow this decline.
However, the second part of the analysis, which planned to compare twins, was not successful, probably because
there were too few suitable pairs to make powerful statistical comparisons. This underscores the difficulty in
conducting this type of research. Bendixen et al. suggest that their findings, although tentative, have significance for
two reasons. First, they support a notion that normal ageing is partly due to failings in DNA maintenance (see ‘Theories
of ageing’, below). Second, from a more practical perspective, the authors argue that the effects of ageing could be
delayed in many people by targeting those most likely to show early decline and give these individuals training and
interventions, such as physical training and tailored exercise regimes, to slow this decline.
studies with individuals with Werner’s syndrome may also help to identify
the onset and causes of age-related psychological disorders such as
psychosis (Barak et al., 2001). However, Werner’s syndrome really is
extremely rare. Estimates are that there are around 300 cases per
100,000,000 cases! So, although data may be valuable, it is no easy matter
identifying a suitable sample. Consequently, it may take a good deal of
time for insights from Werner’s syndrome to inform our understanding of
the processes involved in normal ageing
Theories of ageing
Why do we age ?
The pre-programmed theory of ageing proposes that we are genetically pre-programmed to reach a
certain age and no more. Wear-and-tear theories, or damage-based theories, of ageing (e.g., Holliday,
2004; Kirkwood, 2005) suggest that ageing is a consequence of the body getting worn down through
use, accidents, the buildup of toxins, various types of abuse and poor diet and/or inefficient cellular
repair processes to reverse this damage.
There is no question that our bodies deteriorate, get less efficient, and have less capacity and power
as we age. However, simple wear and tear is not really enough to explain the phenomenon of ageing.
The body’s own repair processes, for example fighting an infection, mending a broken bone, or
forming a scab and growing new skin over a wound, become less effective into old age. So it is unclear
whether it is failure of the repair systems of wear and tear (and affecting the ability to repair the body)
that is the main cause of ageing. The failure of body systems for maintaining and repairing DNA is
often cited as a likely causal factor in ageing (e.g., de Boer et al., 2002).
However, although doubtless wear and tear causes some of the features of ageing, evidence from
contrasting ageing processes in different animal species strongly suggests that there are genetic factors
at play too. A starfish will often re-grow a limb that is lost. However, other animal species (such as
mammals) do not replace lost body parts, at least not through the body’s own physiological processes.
For instance, although human teeth may be lost through accident (e.g., a well-aimed punch) or disease
(e.g., tooth decay), human teeth are not replaced when they fall out in adulthood (Williams, 1957). In
contrast, sharks’ teeth also suffer from wear and tear, but sharks continue to replace teeth throughout
their lifespan. These differences between species suggest that wear and tear alone does not explain
ageing processes. Rather, the genetic make-up of the species must determine some aspects of
ageing.
Genetic or pre-programmed theories view ageing as inevitable (e.g., Medvedev, 1990). The view, also
referred to as ‘developmental theories of ageing’ or ‘Dev-Age’ (Bowen & Atwood, 2004), stems from
observations and studies with various animal species. The central idea is that each species has a certain
lifespan through which development progresses, and this is determined by genes. Ageing is a feature
of the organism, not just a consequence of time or wear and tear. For instance, many insect species
have distinct phases in their development (e.g., egg, caterpillar (larva), pupa, butterfly). Often,
progression from one phase to the next (e.g., from pupa into butterfly) is not determined just by the
length of pupation but also by certain external, environmental triggers such as temperature, humidity,
and so on. In one case the organism may remain in its pupa form for a week, but in another case of the
same species it may remain in this state for a month or two months. In the latter case we can say that
development has been ‘arrested’ or delayed in some way. Importantly, however, this does not affect the
length of time the organism survives as a butterfly. So, the period as a pupa does not necessarily subtract
from the period of lifespan spent as a butterfly. The conclusion drawn in terms of the process of human
ageing is that lifespan is pre-programmed in terms of development rather than a specific period of
time
→Another factor, which has also been implicated as a key factor in ageing, is the endocrine system,
which regulates the body’s hormones, (Gosden, 1996). As we have seen, hormone levels decline with
age. Certainly, many anti-ageing cosmetics and medications such as hormone replacement therapy
(HRT) target the body’s hormonal levels to try and stave off some of the effects of ageing. However,
while hormones can undoubtedly affect some consequences of ageing, such as reproductive capacity, it
is less clear whether these are symptoms of or contributors to an underlying ageing process. However,
an interesting recent phenomenon is that modern medical techniques mean that women can now bear
children into old age (for instance, in 2009 a 70-year-old woman gave birth to a baby in Pakistan (Ramesh,
2009)), suggesting that human control over aspects of their own evolutionary destiny may complicate
such accounts still further. Moreover, the age of onset of the menopause, in Western societies at
least, appears to be getting later (perhaps due to changes in diet and health; Varea et al., 2000;
Rödström et al., 2003). Increases in the age at which women can bear children may provide more
information about how hormones relate to the ageing process.
Most theorists agree that ageing is a combination of overlapping influences of genes and wear and
tear to the body over time.
Consequently, a frequently used distinction is between primary and secondary ageing.
Primary ageing refers to the gradual process of deterioration in the body’s physical ability and
power; secondary ageing refers to deterioration in the body due to disease, accidents, and abuse
(including diet). Nothing can be done to slow the progress of primary ageing. But improved medical
care, lifestyles, and sensible behaviour such as taking regular exercise and eating a balanced diet can
go a long way to slowing the progress of secondary ageing over a lifespan.
Intelligence and problem-solving
A final area in which adults in middle and late adulthood appear to outperform younger adults is practical
problem-solving. When solving everyday problems younger adults may have greater manual skills and
physical abilities, but middle aged and older adults are better able to use experience and knowledge
and to take a more efficient or strategic view to solve a problem (Wagner, 2000). Middle-aged and
older adults also often take more responsibility or initiative or display great autonomy when solving
problems in everyday life (Denney, 1990).
Research close-up Source: Based on Grossmann et al. (2010).
BOX 16-3 Are older people wiser about social conflicts.
Introduction: Although it is generally accepted that there are significant age-related declines in many areas of
cognitive processing, there is also a belief that older people are wiser than younger people. Wisdom can be described
as the ability to deal with life problems, including the ability to appreciate different perspectives and values; therefore,
it is reasonable to believe that people gain more wisdom as they grow older, based on increased experience of life.
Previous research in this area has been problematic because there were often methodological problems such as
unrepresentative samples or poor stimulus materials. Therefore, the researchers carried out two studies that they
felt would overcome these problems. They expected to find that wisdom would increase throughout the lifespan.
Study 1: A sample of 247 participants was recruited from a county in Michigan, USA, covering the full range of social
classes. There were approximately equal numbers of both sexes and of each of three age groups: 25–40, 41–59 and
60+. Each participant read three articles, each of which described an intergroup conflict between two strong groups.
The topics of conflict were immigration, ethic tensions and natural resources. These are summarized in Table 16-1.
Table 16-1 The topics of intergroup conflict stories provided Grossman and colleagues’ participants
Each participant was then asked, ‘What do you think will happen after that?’ and ‘Why do you think it will happen this
way?’ Participants’ responses were coded on six dimensions of wisdom: change, compromise, flexibility, perspective,
resolution, and uncertainty. For instance, a participant who responded to the immigration story that both sides should
try to preserve a bit of each culture could be seen as reasoning using a high level of compromise reasoning, whereas
consideration of different points of view would encompass perspective-shifting. In addition, each participant
completed tests of crystallized intelligence (based on acquired knowledge) and fluid intelligence (ability to solve
problems).
Results showed a decline in fluid intelligence with increasing age but showed no age-related decline in crystallized
intelligence. As predicted, older participants scored significantly higher than younger or middle-aged participants on
each dimension of wisdom, as well as on a composite score of overall wisdom.
Study 2The aggregate wisdom score from the two studies was obtained and, again, the effect of age was substantial.
Older people were significantly over-represented in the top 20% on wisdom performance. The average age of
participants in this top 20% was 64.9 years, while the average age of people in the bottom 80% was 45.5 years. Further
analyses also showed that wisdom was positively correlated with crystallized intelligence and that the age effect of
wisdom held true regardless of social class or education.
Discussion Grossmann et al.’s study suggests that social reasoning, or wisdom, increases with advancing age despite
a decrease in fluid intelligence. Compared to younger and middle-aged people, older people showed more
understanding of multiple perspectives, the need for compromise and the limits of knowledge. Thus, older adults may
well be using their experience (crystallized intelligence) to resolve conflict. As a result, Grossmann et al. suggest that
older individuals could play a valuable role in key social roles such as making legal decisions, counselling, and
intergroup negotiations
Memory changes
In Chapter 10 we examined how memory changes through the earlier years of development. However,
deterioration of memory is often thought of as a problem linked to age.
However, there are at least two important reasons why this simple assumption is misleading
. First, as with many psychological and physical processes, there is tremendous variation in memory
processes across the population and in whether memory declines or remains stable with age for each
individual (Craik, Byrd, & Swanson, 1987).
Second, it is clear that there are many different types of memory and while some of these may decline
with age, others may remain stable over the lifespan. So, for instance, semantic (memory for
meanings) and procedural (remembering how to do something) memory may show no or minimal
decline with age (Fleischmann et al., 2004). Episodic memory (memory for events, linked in a specific
order) appears to undergo a marked decline with age (Nilsson, 2003).
There appears to be some minor decline in general memory ability throughout middle adulthood, but
it is usually only into older (late) adulthood that there is notably slower recall (Babiloni et al., 2004). The
capacity for short-term memory (STM, also known as ‘working memory’) is also often significantly
reduced in older adults. Short-term memory is the ability to hold items in one’s memory at one time.
In a now classic study, West and Crook (1990) showed participants aged 18 to 85 years a series of
telephone numbers containing seven or ten digits. After they had seen the numbers, participants had
to dial the number on a keypad. However, some of the time they got a ‘number busy’ or engaged tone
and had to redial. Dialling immediately (i.e., no busy tone) led to the highest levels of recall for both
age groups, although there was steady decline in recall from middle adulthood (around 50 years)
onwards for the seven-digit version of the immediate recall task. Decline in recall for the ten-digit task
also declined steadily from middle adulthood onwards, but the decline from the start of late adulthood
was more marked. On the delayed recall task, when participants had to redial after the busy signal,
performance was generally poorer as the researchers had predicted. However, the decline in
performance with age was also more rapid than in the seven-digit immediate recall task, and particularly
marked on the ten-digit, delayed recall condition.
West and Crook’s findings suggest that information processing becomes less efficient or has a reduced
capacity with age. This loss of efficiency may be largely a consequence of a more general age-related
reduction in the speed with which neurons pass information around the central nervous system
(Salthouse, 2004). However, factors other than neurological degeneration also explain why memory
sometimes gets worse with age and why there is considerable variation in the memory abilities of older
adults.
One important factor that is associated with memory problems in older adults is diet (Nyberg & Pudas,
2019). The connection between diet and cognitive decline (including Alzheimer’s disease and also
other forms of memory loss such as ‘Mild Cognitive Impairment’ (MCI)) has been demonstrated in
several studies. Panza et al. (2004) examined diet and its effect on cognitive function in elderly
populations in several European countries. They found that high levels of consumption of mono-
unsaturated fatty acids (found in foods like nuts and olive oil) stemmed age-associated cognitive
decline in a southern Italian sample, and eating white fish and cereals was associated with reduced
levels of Alzheimer’s disease in European and North American populations. Lastly, the risk of
dementia was lower in a sample of French older adults who drank three or four glasses of wine a day,
compared with those who did not drink any alcohol! Ponza and colleagues suggest a complex
collection of factors including diet and, in particular, the presence of antioxidant molecules that
prevent or slow down the oxidation of other molecules, may help to stem some age-related
cognitive decline. Diet alone is unlikely to explain all of the variation in memory decline in older adults.
More plausible is the suggestion that cognitive processes are the consequence of a complex mix of
factors, social, cognitive, and biological.
Research close-up Based on White et al. (1996)
BOX 16-4 Explaining cultural and environmental influences on dementia: the Honolulu- Asia Ageing
Introduction: Occasionally, historical events or situations throw up opportunities to explore psychological phenomena
from an intriguing or novel perspective. One classic study of ageing and dementia was conducted by White et al.
(1996) on the Hawaiian island of Honolulu. The researchers used data that had been collected as part of the Honolulu-
Asia Ageing Study (HAAS). This study involved a large sample of Japanese-American men born between 1900 and
1919. All of these men were born in Japan but had emigrated to Honolulu by the time they were 19 years old. They
were living on the Hawaiian island of Oahu in 1965 when the survey began. The body of study data had been collected
to measure the effects of living in Honolulu (USA) by comparing these men with a similar cohort of men who remained
in Japan. However, the large dataset made it possible to explore other factors related to the ageing of these different
groups. Thus, the aim of the study was to compare the rates of dementia among the Japanese-American men (those
born in Japan, but living most of their adult life in the USA) with rates of dementia in this Japanese comparison group.
Method: Participants were 3734 Japanese-American men aged between 71 and 93 years. Data were collected from
these individuals using a variety of cognitive tests and diagnoses as part of large study comparing various physiological
and other effects of ageing across a wider population. The researchers used a stratified, random sampling technique.
Specifically, participants were given a version of the Cognitive Abilities Screening Instrument (CASI) which tests several
abilities such as memory and problem-solving. Tests were conducted in three phases – a first phase across the sample,
and a second phase where 948 participants who had low scores on the CASI were then asked to come for further,
neurological examination and an informant (usually the participant’s wife) was interviewed to explore the extent of
any cognitive decline over the past ten years. A third phase involved giving further tests to 426 individuals who had
shown the most marked decline in the previous years, according to participant informants. For phase 3, interviewers
were blind to findings from the first two stages and sought to make a clear diagnosis of dementia.
Results: The researchers compared participants’ responses in terms of two criteria for establishing dementia –
Cummings and Benson’s criteria and DSM-III-R. On both measures, rates of dementia in the Japanese-American
sample were similar to those of the general US population (Cummings and Benson, 10.3%; DSM-III-R, 7.6%) for men
in a similar age range. However, comparable Japanese data show prevalence rates for Japanese men who remain
living in Japan throughout their adult life significantly lower, between 4% and 6%. Thus, the Japanese-American men
in the present study showed dementia levels approaching those of European and American populations.
Discussion: The findings strongly suggest that environmental or cultural factors are influential in causing dementia,
rather than solely genetic causes. Both the Japanese men living in Japan and those who had moved to Honolulu for
most of their adult life share a similar genetic heritage. So, something about their lifestyle or the experience of living
in the USA had influenced dementia rates. At the same time, data show that factors involved with cardiovascular
disease remain relatively unaffected. So, what in the cultural experiences of these men in the USA differs from those
in Japan and may therefore have led to the increased chances of
dementia during old age? Many factors are implicated, including
education and cultural expectations, whether an active or inactive
lifestyle was encouraged or required or diet. The researchers suggest
these possible explanations for their findings. However, further
research was required to identify possible causes with more certainty.
The observation that happiness tends to increase with age has proved consistent over a number of years.
Yang (2008), for instance, noting a similar result, suggests that this trend persists despite some cohort
effects; that is, people born in certain periods of time or eras are slightly happier than in some other
periods of time. It seems fairly obvious that social and historical conditions in different eras in history
probably explain cohort effects such as these individuals born in times of war, or difficult economic
or social conditions will doubtless have a very different quality of life than those born into times of
relative affluence and peace.
However, the relation between social or societal factors and happiness is not always
straightforward. For instance, Layard (2005) notes that general rates of happiness declined in many
affluent Western societies during a period of economic growth in the latter half of the twentieth
century.
For sure, happiness does not depend only on material well-being but also on an individual’s perception
of themselves and their relative well-being compared with others in a society. As we age, we may
become more reflective, more content with our lives, and more accepting of our social position, which
helps to increase positive, rather than negative, evaluations of one’s own well-being.
Time and social changes influence affective processes in other ways too. Yang also noted that gender
differences in happiness (women are generally happier than men) and ethnic differences (African
Americans are less happy than European Americans) become less marked as individuals age
(reminiscent of the age de-differentiation hypothesis of intelligence). However, gender differences in
happiness diminished over the last 30 years of Yang’s study for all cohorts, suggesting that underlying
changes in societal conceptions of gender and gender roles may change in terms of their impact on
how people evaluate and feel about their lives. Ethnic differences, however, appear to be more
enduring.
Differences in social roles, social relationships, and expectations may explain some age differences
in happiness. On the face of things, it might seem odd that early adulthood is typically a period of
optimal physical well-being and fitness but also of relative unhappiness compared with later life.
However, young adulthood is also often a period of considerable transition in people’s lives in terms
of establishing a career, moving away from the parental home, developing autonomy and life skills,
and starting intimate relationships. These challenges and changes may cause stress and
unhappiness. Or it may be that younger adults have not developed the ability to reflect on challenges
and negative life events in a positive way.
Consider again our discussion of the development of emotion in Chapter 7. How do these early
developmental processes relate to the sorts of changes in emotion seen across adulthood?
One significant cause of unhappiness in early adulthood may be the failure of romantic relationships;
the course of true love does not always run smooth, and loneliness can be a significant source of
unhappiness in early adulthood, where individuals may desire a long-term, intimate relationship but are
unable to find one. Rokach (2001) found that the emotional distress caused by loneliness increases
steadily during the teenage years and peaks in early adulthood. Although many older adults will
experience loss of friends, a spouse or partner, it appears that with age, people develop strategies for
coping with loneliness or may expect less of their relationships (or expect fewer relationships) than
younger adults (Rokach & Neto, 2006). Men are more negatively affected by loneliness than women,
perhaps because men form fewer friendships and disclose less intimate information to friends
(Stroebe & Stroebe, 1996).
Figure 16-2 Plotted regression lines showing the relation
between positive affect and age (diamonds) and
negative affect and age (squares) Positive and negative
affect scores have a possible range of 6 to 30, with higher
scores indicating higher levels of affect. The lines are
based on the following equations: positive affect _ 22.38
_ age(_.14) _age2(.002); negative affect _ 10.94 _
age(_.03).
Marriage
In many societies, intimate and romantic relationships in early adulthood progress towards marriage
or cohabitation. For heterosexual couples the path to marriage and formalization of the relationship
has been enshrined in social and religious ceremonies for many centuries. More recently, in
contemporary societies, homosexual relationships too may result in marriage although in many other
societies a considerable degree of discrimination against homosexual relationships of any kind still
exists. Although the norm in many Western societies is for individuals to find a partner themselves, in
other societies or in certain ethnic groups within Western societies, marriage and adult romantic
relationships are seen as being more closely enmeshed with community and family life (Buss et al.,
2001). In many cases marriages may be arranged by members of an extended family.
There is a dearth of reliable research data concerning the psychological consequences of arranged
marriages. What evidence there is suggests that men and women involved in arranged marriages are
not necessarily less happy than those in other marriages (what are, perhaps misleadingly, termed ‘love
marriages’). For instance, Yelsma and Athappilly (1988) compared marriage satisfaction and
communication between Indian couples in arranged and love marriages. They found that men and
women in the arranged marriages displayed higher marriage satisfaction scores than those in love
matches and a comparative sample of American men and women. In contrast, however, Xiaohe and
Whyte (1990) report greater dissatisfaction among women in arranged marriages in a Chinese
sample. The cultural context, and how accepting of it both partners are, would appear to be an
important influence on the success of a marriage and each partner’s satisfaction with it. This context
may influence not just expectations of romantic love, but of acceptance of gender roles, personal goals
and family support.
The basis of marital and other long-term intimate relationships into middle adulthood and beyond
may be formed, at least in part, in early attachment relationships with a caregiver (see again Bowlby,
1969, 1980) where internal working models are set up that guide conduct in and expectations of close
relationships. Adults who report secure attachment relationships as a child reported more
satisfactory, stable, and secure relationships as adults compared with those who report anxious or
avoidant caregiver relationships as a child (Kirkpatrick & Davis, 1994). Individuals with an avoidant
working model tended to close themselves off from potentially rewarding relationships as adults,
and distance themselves from partners. Adults with an anxious internal model formed early in life
tended to be clingy, too dependent, or to ruminate on aspects of the relationship in a negative way
which led to negative consequences for their relationships with a partner.
Evidence suggests that marriage (or at least long-term, stable, romantic partnerships) has a positive
influence on well-being (Robles et al., 2014). Of course, not all marriages are beneficial in this respect,
and other types of relationships can also offer the same positive outcomes for different individuals. In
this respect the benefits of marriage may be linked to separate but inter-connected processes of
partner responsiveness and adult attachment style (Slatcher & Selcuk, 2017), which can be evident
across relationships and perhaps across different cultures.
From 70 years of age the number of friends with whom people have regular social contact begins to fall
(Carstensen, Isaacowitz, & Charles, 1999). This may be due to increased physical difficulty in visiting
friends, or to death of friends. A significant loss, obviously, is that of a partner or spouse, yet as we
have seen older adults can often employ very successful coping strategies to overcome the negative
effects of this loss in the longer term (see again Stroebe & Stroebe, 1993). However, the later the age
at which a man or woman is widowed, the less successful the recovery both in terms of affect and the
cognitive and physical symptoms associated with bereavement (Lund & Caserta, 2004).
As adults age, their own children leave home and have children. Older adults’ roles as grandparents
are influenced by culture: in many societies grandparents are seen as part of an extended family and
are often and frequently actively involved in their grandchildren’s care and upbringing. Grandparents
can have a very positive influence on children’s development by offering an additional source of
practical and emotional support to the child and parent (Adkins, 1999). Moreover, grandchildren can
have a positive influence on grandparents too because they can be a significant source of satisfaction
and well-being (Smith & Drew, 2002). Having and caring for grandchildren appears to be especially
beneficial for women (Thiele & Whelan, 2008) perhaps because, given historical female roles as primary
caregivers in many societies, female grandparents can feel they are more useful or helpful to their
own children.
Cherlin and Furstenberg (1985) classified three different grandparenting styles.
-Most grandparents (around half) in their study of American grandparents across the social spectrum
displayed compassionate relationships with their grandchildren. That is, they engaged in very loving
relationships with their grandchildren, although not always taking full responsibility for discipline.
The relationship between grandparent and grandchild was warm and mutually rewarding.
- Around a third of grandparents were remote; that is, they had little involvement in their grandchild’s
life.
- One in six grandparents was in an involved relationship with their grandchild or grandchildren. These
grandparents took on something akin to the parenting role, with responsibility for everyday aspects of
life and care.
The quality of grandparents’ involvement with their grandchildren is clearly dependent on several
factors including geographical distance, socioeconomic status, and the grandparents’ marital status.
A further important factor is the relationship between a child’s parents and grandparents. The quality
of this relationship can influence whether and how much a parent asks a grandparent to help with
childcare and other domestic activities (Mueller & Elder, 2003). Generally, the better the relationship
between parent and grandparent the better the quality and extent of grandparent’s involvement with
the child (Barnett et al., 2010). This association is especially strong in terms of grandparents’ relationships
with a child’s mother
Grandparents do not provide just instrumental support. They may also act as a link across
generations to ensure family continuity and identity. Moreover, it is not just in the early years that
grandparents have influence but also into adolescence, where grandparents may be a useful sounding
board for young people when difficulties with parent–child relationships arise (see, for instance, Tan
et al., 2010). grandparent in terms of an older individual’s social roles and relationships is an area where
further research is required in order to understand better its impact on development in adulthood.
The role and significance of grandparents in development is only recently becoming recognized by
researchers. This may, at least in part, be a feature of changing societal and economic demands and
family dynamics. Similarly, the importance of becoming a grandparent in terms of an older individual’s
social roles and relationships is an area where further research is required in order to understand better
its impact on development in adulthood.
There are notable age differences in individuals’ knowledge about and attitudes towards death.
Young children frequently have little experience of death or dying, but by 6–7 years most children have
a rudimentary concept of the biological basis of life and death. However, it is not until around 9 years
that most children understand that death is irreversible (CuddyCasey & Orvaschel, 1997).
Experience appears to play an important part. For instance, Slaughter and Lyons (2003) found that
teaching children about the characteristics and processes involved in life enhanced knowledge about
death and its causes. Again, children who have experienced the death of a close relative are more
likely to understand about its permanence than those who have not (Stambrook & Parker, 1987; Hunter
& Smith, 2008).
There may also be some cultural influences on beliefs about death. In a study comparing American
and Swedish adolescents, Wenestam and Wass (1987) asked participants to draw pictures representing
what they thought of when they heard the words ‘death’ or ‘dying’. Although there were broad
similarities between cultures, more Swedish participants tended to draw images of religion or religious
symbols, whereas more US teenagers drew pictures of violent deaths.
It does not appear that older adults talk or think less about death, but that they find the idea less
frightening and, possibly, have greater acceptance of the inevitable end of their life (Cicirelli, 2006).
Fear of death is also affected by personal beliefs, and in particular religious beliefs. Those with
religious beliefs are reported to fear death less than those without (Kalish, 1985). People who feel
their lives have been worthwhile, or who feel they have achieved personal goals, also seem to
experience less anxiety about death as they age (Ardelt & Koenig, 2006).
Beliefs and attitudes towards death may go some way to helping people to cope with their own and
others’ deaths. Alongside inevitable physiological deterioration and medical complications, people
suffering with terminal illnesses face particular emotional and psychological challenges. Elisabeth
Kübler-Ross (Kübler-Ross, 1969, 1974) developed an account of the stages of dying and approaches to
coping with death. The stages were built upon analysis of responses to interviews from cancer
patients who were terminally ill. The progression of states is;
Denial – "I feel fine.”
"This can't be happening, not to me." Denial is usually only a temporary defense for the individual. This
feeling is generally replaced with heightened awareness of situations and individuals that will be left
behind after death.
Anger – "Why me? It's not fair!"; "How can this happen to me?"; "Who is to blame?"
Once in the second stage, the individual recognizes that denial cannot continue. Because of anger, the
person is very difficult to care for due to misplaced feelings of rage and envy. Any individual that
symbolizes life or energy is subject to projected resentment and jealousy.
Bargaining – "Just let me live to see my children graduate."; "I'll do anything for a few more years.";
"I will give my life savings if..."
The third stage involves the hope that the individual can somehow postpone or delay death. Usually, the
negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle.
Psychologically, the individual is saying, "I understand I will die, but if I could just have more time..."
Depression – "I'm so sad, why bother with anything?"; "I'm going to die... What's the point?"; "I miss
my loved one, why go on?"
During the fourth stage, the dying person begins to understand the certainty of death. Because of this,
the individual may become silent, refuse visitors, and spend much of the time crying and grieving. This
process allows the dying person to disconnect oneself from things of love and affection. It is not
recommended to attempt to cheer up an individual who is in this stage. It is an important time for grieving
that must be processed.
Acceptance – "It's going to be okay."; "I can't fight it,
I may as well prepare for it." In this last stage, the individual begins to come to terms with their mortality
or that of their loved one.
Table 16-2 Kübler-Ross’s stages of dying
Kübler-Ross’s stage theory has been influential in the psychological treatment and counselling of
terminally ill patients. Although presented as a stage model, she suggested that these stages do not
form the same invariant sequence for all individuals, and not all people will experience all five.
However, according to Kübler-Ross, individuals who are dying will always experience at least two, and
the stages are universal (that is, they do not vary between cultures). Often there may be a
‘rollercoaster’ ride, with people moving rapidly between anger and depression, denial, and
bargaining.
However, although it has proved influential for therapeutic work with dying and other trauma victims,
the attempt to chart dying as a series of stages has come in for considerable criticism in light of
subsequent research.
→ Kastenbaum (2000), for instance, argues that no two individuals are similar and no two contexts for
dying are the same.
→Moreover, empirical support for the stage model is thin, and the methods used for selecting
interviewees did not always have regard for ages and other important details such as the extent of illness
and diagnosis.
→ Kastenbaum also argues that Kübler-Ross fails to consider how contextual factors – support from
friends, family, the institution in which they die – influence the dying process.
→Lastly, the claim that the stages of dying are universal does not fit easily with observations of
widespread differences in coping with death between cultures (see again, Lobar et al., 2006). It is also
unclear why some people go through some stages while others do not. Perhaps there is no ‘right’ or
‘correct’ way to die and all individuals will have their own means of coping. Certainly, it seems that not all
individuals reach a phase of acceptance before their death (Schneidman, 1980).
The style of coping with a diagnosis of a serious illness is not just important for considering the quality
of life of the terminally ill. Coping strategies of patients with diagnoses of serious, life-threatening
illnesses may also relate to the chances of surviving the illness.
→ Greer (1991) reported a study that involved interviewing over 60 women who had been diagnosed with
early-stage breast cancer in the 1970s. Interviews were used to establish how women coped with the
diagnosis. For instance, some women entered denial (ignoring the severity of the illness, akin to Kübler-
Ross’s first stage), others developed a ‘fighting spirit’, still others were fatalistic, anxious, or felt
helpless about the illness, stoically accepting the diagnosis and likelihood of death. Researchers then
followed up to establish how these styles related to survival after 5, 10 and 15 years, making sure that
they compared survival rates of women with similar diagnoses at the outset.
By far the greatest majority stoically accepted the diagnosis – in the 1970s death rates from breast
cancer were considerably higher than today – and of these 76% had died from cancer 15 years later.
However, those women who were in denial about the illness or adopted a fighting spirit fared much
better: 15 years later, only 35% had died from the cancer.
→The role of coping strategies in surviving diagnoses of serious illness is probably complex. For
instance, fighting spirit may work well for cancer but not so well in combating chronic heart disease.
Moreover, there are always difficulties in establishing causal links because not enough is yet known
about the genetic or physiological mechanisms that underpin personality, coping and risk of illnesses
such as cancer.
→Social support (from family, friends, or social welfare bodies and charities) has also been linked to
increased likelihood of surviving serious illness (Spiegel et al., 1989).
→Moreover, counsellors and others need to be wary of giving a message that adopting one coping
style or another may help a patient to avoid death because it may prevent them from fully coming to
terms with or accepting their death, which may have negative consequences for well-being and dying in
a dignified way.