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GERONTOLOGY – THEORIES OF AGING

CHAPTER 3

THEORIES: explain phenomena, give sense of order, and provide a framework from which wecan view a world

AGING – most often described in terms of chronology, or by the measurement of time since birth.

Various definitions based on different cultures: e.g., functional – no longer able to perform usual

activities; social – determined by a role, e.g., becoming a grandparent; physiological – aging

phenotype (gray hair, wrinkled skin, etc.)

Biological Theories of Aging

Biological aging – SENESCENCE → a complex, genetically regulated, interactive process of

change. Aging phenotype reflects declining functional capacity of the most basic structures in thecells.

Cellular FunctioningThe cells accumulate changes in damage resulting in errors seen in replication. These changes

are made visible in the traits we associate with aging. At this point we don’t question the

association of cellular errors and the aging phenotype, but the cause and patterns, e.g., are thechanges predictable or random and chaotic.

Programmed Aging TheoriesAging is the result of predictable cellular death. All cells and organisms have genetically

determined life span (biological clock or the Hayflick limit).

Researchers: Hayflick & Moorehead

Neuroendocrine Control or Pacemaker Theory

Aging – programmed decline in the functioning of the nervous, endocrine, and immunesystems. Cells don’t die; their ability to reproduce is lost (replicative senescence). Secretion of hormones such as DHEA and melatonin is decreased with aging.

Immunity TheoryAging – programmed accumulation of damage and decline in function of immune system

(immunosenescence).

Error Theories

Aging phenotype – the result of an accumulation of random errors in the synthesis of cellular

DNA and RNA. With each replication, more errors occur until the cells are no longer able tofully function.

Wear-and-Tear Theory

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Cell errors are the result of “wearing out” over time because of continued use. Internal

and external stressors including pollutants and injurious metabolic by-products (free

radicals) have harmful effects on cells. They may cause decline in cellular function or death.

Cross-linkage TheoryAging – the result of accumulated damage from error associated with cross-linked

proteins. Cross-linking between the protein and glucose causing them to become stiff and

thick. The newly cross-linked proteins are called AGEs (advanced glycation end-

products). Cross-linking of collagen (the most abundant protein) can be seen in stiffening

of joints and skin. Cross-linking may also cause cholesterol to attach to cell walls, leadingto atherosclerosis. Other cross-linking agents include unsaturated fats and metal ions such

as aluminum, zinc and magnesium.

Oxidative Stress Theory (Free Radical Theory)Errors are the result of random damage from free radicals (molecules containing unpaired

ions – extra electrical charge). The accumulation of free radicals is called “oxidativestress” or “oxidative damage”. Over time, production of free radicals increases and the

body’s ability to remove them decreases. The most effected appears to be mitochondrialDNA.

HEALTHY AGING PROMOTION:

Help people identify pollutants in their environments (e.g., industrial emission, ultra-violet light, second hand smoking, etc.)

Encourage the healthiest diet, careful use of herbs and supplements

Promote immunizations and avoidance of exposure to others with infections

Psychosocial and Developmental Theories of Aging

These theories attempt to explain and predict the changes in roles and relationships in middle and

late life, with emphasis on adjustment.

Role TheoryThe ability of an individual to adapt to changing roles over the life course is a predictor of

adjustment to personal aging (developed in 1942 by Cottrell). Resistance to role changes

indicates poor adjustment to one’s own aging.

Age Norms – socially and culturally constructed expectations of what is deemed asacceptable behavior. The aging of baby boomers proposes challenges to the role

theory and age norms. Behavior and roles that were in the past questionable and

unimaginable are becoming more acceptable.

Activity Theory

Continued activity – indicator of successful aging (Havinghurst, Albrecht – 1953)Activity is necessary to maintain life satisfaction and positive self-concept.

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Disengagement Theory

In the natural course of aging, individuals should withdraw from their former roles and activitiesto enable the transfer of power to younger generations – necessary for maintenance of social

equilibrium.

Continuity TheoryIndividuals tend to develop and maintain a consistent pattern of behavior, substituting one role

for a similar one as the person matures. Personality influences the chosen roles and activities and

the level of satisfaction drawn from life.

Age-stratification Theory

Social aging can be best understood by considering the individual as a member of an age group,

with similarities to others in the group (“cohort effects”).

Modernization Theory

Social changes resulted in a diminished value of the contribution of older people. The status andvalue of elders are lost when their labors are no longer considered useful, their information is not

pertinent to the society, and culture they live in no longer reveres them.

Developmental Theories of Aging

Aging is an ongoing and incremental step-wise progression between birth and death.

Jung’s Theory of Personality

A personality is either extroverted (oriented toward the external world) or introverted (orientedtoward the subjective inner world of the individual). Aging results in a movement from

extraversion to introversion. The development of the inner person is accompanied by a search for

personal meaning and the spiritual self.

Erikson

Successful mastery of one task is necessary for successful movement to the next stage of maturity (famous Erickson’s Eight stage (Task Model)).

Erickson’s task of middle age: generativity (establishment and contribution in meaningful waysfor the future generation) vs. stagnationFinal task: ego integrity (sense of completeness and cohesion of the self) vs. despair

In later modifications of the “either/or” stance, Erickson recognized the balance of each of the

tasks; the goal is to achieve balance rather than an absolute resolution of despair and replacement

with integrity.

Peck

Robet Peck (1968) took Erikson’s last stage to a deeper level. An achievement of the followingthree tasks would result in ego integrity or even Maslow’s self-actualization:

Ego differentiation vs. work role preoccupation: The person no longer defines herself of himself by life work role but by individual personhood.

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Body transcendence vs. body preoccupation: The body and changes are accepted as part of life rather than as a source of identity and focus.

Ego transcendence vs. ego preoccupation: The person sees oneself as part of a greater whole rather than as an individual requiring special attention.

Maslow

Maslow hierarchy of needs combines the bio/psycho/social needs of the individual from the most basic need for food and shelter to the most complex such as self-actualization, or

gerotranscendence. Moving toward healthy aging is an evolving and developing process.

Biological and Physiological Integrity → Safety and Security → Belonging → Self-Esteem →

Self-Actualization (Introversion)

For more detailed description, please refer to a pyramid on page 41 of the book.

TornstamTornstam (Swedish psychologist) proposed the theory of gerotranscendence. Aging is viewed as

the movement from birth to death and maturation toward wisdom. Gerotranscendence implies

achieving wisdom through personal transformation. Drawing inward does not have to be

disengagement with the world and can be instead, a time of introspection leading to wisdom.

HEALTHY AGING PROMOTION:

Maslow’s hierarchy of needs is an example of how the theories can benefit patients and nurses.

Application of the theory will lead to better understanding of individuals and their concerns at

any particular time and in any particular situation.

This theory can serve as a guide to set priorities in nursing interventions to promote healthy

aging.

A person whose basic needs are met, who feel safe and secure, and who has a sense of belonging

will also have self-esteem and self-efficacy. Self-actualization is seen as people reaching out

beyond themselves and finding meaning in their lives and sense of fulfillment.

Nurses especially in assisted living facilities or nursing homes can work with older people to

form new alliances and associations and create environments in which meaningful relationships

and activities can remain a part of the elder’s life.

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