1. - DR DEEPIKA SINGH
DEPT OF PSYCHIATRY,
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SETH GSMC & KEMH 1

2. For many individuals, the passage from youth to
old age is mirrored by a shift from the pursuit of
wealth to the maintenance of health.
In late adulthood, the aging body increasingly
becomes a central concern, replacing the midlife
preoccupations with career and relationships.
This is so because of normal
diminution in function,
altered physical appearance,
and the increased incidence
of physical illness
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3. Old age, usually refers to the stage of the life
cycle that begins at age 65. Gerontologists
divide older adults into 3 groups:
young-old: ages 65 to 74;
old-old : ages 75 to 84 &
oldest old: age more than 85.
Older adults can also be
described as well-old
(persons who are healthy) &
sick-old (persons who
have an infirmity that
interferes with functioning
and requires medical or
psychiatric attention).
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4. Developmental Tasks of Late Adulthood
-To maintain the body image and physical integrity
-To conduct the life review
-To maintain sexual interests and activities
-To deal with the death of significant loved ones
-To accept the implications of retirement
-To accept the genetically programmed failure of
organ systems
-To divest oneself of the
attachment to possessions
-To accept changes in the
relationship with
grandchildren
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5. DEMOGRAPHICS
-The number of individuals over age 65 is rapidly
expanding.
-In 1900, for example, 4 percent of the U.S.
population was older than 65 years
-By 2003 it was 12.4 percent, and by 2030, it is
projected to be 20 percent
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6. BIOLOGY OF AGING
The aging process, or senescence (from the Latin
senescere, to grow old), is characterized by a
gradual decline in the functioning of all the body's
systems cardiovascular, respiratory, genitourinary,
endocrine, and immune, among others.
But the belief that old age is invariably associated
with profound intellectual and physical infirmity is a
myth.
Many older persons
retain their cognitive
abilities and physical
capacities to a
remarkable degree
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7. BIOLOGICAL CHANGES
ASSOCIATED WITH AGING
--Cellular Level
Change in cellular DNA and RNA structures:
intracellular organelle degeneration
Neuronal degeneration in CNS
--Immune System
Increased susceptibility to infection
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8. MUSCULOSKELETAL
-Decrease in height because of shortening of
spinal column (2-inch loss in both men and
women from the 2nd to the 7th decade)
-Reduction in lean muscle mass and muscle
strength.
-Loss of bone matrix,leading to osteoporosis
-Degeneration of joint surfaces
may produce osteoarthritis
-Risk of hip fracture is
10%-25% by age 90
-Graying of hair results
from decreased melanin
production in hair follicles
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9. Genitourinary and Reproductive
Decreased glomerular filtration rate and renal
blood flow
Decreased hardness of erection, diminished
ejaculatory spurt
Decreased vaginal lubrication
Enlargement of prostate
Incontinence
Cardiovascular
Decreased elasticity of heart valves
Increased susceptibility to arrhythmias
Altered homeostasis of blood pressure
Gastrointestinal (GI) System
Altered absorption from GI tract (at risk for
malabsorption Templates and avitaminosis)
syndrome
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Constipation

10. Endocrine
-Estrogen levels decrease in women
-Testosterone production declines in men
- Increase in follicle-stimulating hormone
(FSH) and luteinizing hormone (LH) in
postmenopausal women
Respiratory
Decreased vital capacity
Diminished cough reflex
Brain
Widened sulci, smaller
convolutions, gyral atrophy
Ventricles enlarge
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11. Special Senses
-Thickening of optic lens, reduced
peripheral vision
-Inability to accommodate (presbyopia)
-High-frequency sound hearing loss
(presbyacusis)25% show loss by age 60,
65% by age 80
-Reduced acuity of taste, smell, and touch
-Decreased light-dark adaption
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12. Neuropsychiatric
Takes longer to learn new material, but
complete learning still occurs
Intelligence quotient (IQ) remains stable
until age 80
Verbal ability maintained with age
Psychomotor speed declines
Memory
Tasks requiring shifting
attentions performed
with difficulty
Encoding ability
diminishes (transfer of
short-term to long-term
memory and vice versa)
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13. PSYCHOSOCIAL ASPECTS OF AGING
SOCIAL ACTIVITY
-Healthy older persons usually maintain a level
of social activity that is only slightly changed
from that of earlier years.
-In some cases, however, physical illness or the
death of friends and relatives may preclude
continued social interaction.
-Moreover, as persons
experience an increased
sense of isolation,
they may become
vulnerable to depression.
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14. -Growing evidence indicates that
maintaining social activities is valuable for
physical and emotional well-being.
-Old persons can pass on cultural values
and provide care services to the younger
generation and thereby maintain a sense of
usefulness that contributes to self-esteem
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15. AGEISM
Ageism, a term coined by Robert Butler,
refers to discrimination toward old persons
and to the negative stereotypes about old age
that are held by younger adults.
Old persons may themselves resent and fear
other old persons and discriminate against
them.
In Butler's scheme,
persons often associate
old age with loneliness,
poor health, senility,
and general weakness
or infirmity
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16. SOCIOECONOMICS
The economics of old
age is of paramount
importance to older
persons themselves
and to society at large.
-The past 30 years has
Seen a dramatic decline
in the proportion of the
U.S. elderly population who are poor, primarily as a
result of Medicare, Social Security, and private
pensions
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17. RETIREMENT
For many, retirement is a time for the pursuit of
leisure and for freedom from responsibility.
For others, it is a time of stress, especially when
retirement results in economic problems or a loss
of self-esteem.
Most of those who retire
voluntarily reenter the
work force within 2 years,
for a variety of reasons,
Including negative
reactions to being retired,
feelings of being
unproductive,
economic hardship,
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18. SEXUAL ACTIVITY
-The frequency of orgasm, from coitus or
masturbation, decreases with age
-factors determining the level of sexual activity with
age are the health and survival of the spouse, one's
own health & the level of past sexual activity.
-Although some degree of declining sexual interest
and function is inevitable with age, social and
cultural factors appear to be more responsible for
the sexual changes observed than the psychological
changes of aging per se.
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19. LONG-TERM CARE
-Many older persons require institutional care
-Although only 5 percent are institutionalized
in nursing homes at any one time, about 35
percent of older persons require care in a
long-term facility at some time during their
lives
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20. MENTAL DISORDERS OF OLD AGE
The most common mental disorders of old age are
depressive disorders, cognitive disorders, phobias,
and alcohol use disorders.
Older adults also have a high risk for suicide and
drug-induced psychiatric symptoms.
Many mental disorders of old age can be
prevented, ameliorated, or even reversed.
Of special importance are the reversible causes of
delirium and dementia; if not diagnosed accurately
and treated these conditions can progress to an
irreversible state.
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