Knowledge about adult development and aging for psychologists

Older adults experience changes in health, social functioning, personality, and emotional development that occur as part of the typical aging process. These changes are important for psychologists to understand so that symptoms aren’t accidentally dismissed as “normal aging” and also so that older adults aren’t overdiagnosed in situations where their symptoms represent a typical aging process. As an example within the social domain, it is common for older adults to have smaller social networks consisting mostly of family and close friends. Psychologists should view this “trimming” of social networks as typical, while also listening for any specific concerns about loneliness. Several theories help guide our understanding of typical older adult development, including:

  • Socioemotional Selectivity Theory (Carstensen et al., 1999)
  • Selective Optimization with Compensation (Baltes & Carstensen, 1996)
  • Successful aging models (Rowe & Kahn, 2015)
  • Models that explain the effects of racism and social inequality on the health and well-being of ethnic and racial minority older adults (weathering hypothesis; Forde et al., 2019).

Psychologists must strive to understand diversity among older adults in terms of race, sexual orientation, gender identity, country of origin, ethnicity, language, religion, socioeconomic status, and urban–rural residence. In light of the increasing diversity of older adults, psychologists should consider the specific impact that racism and other forms of discrimination may have for older adults who are seeking physical and mental health care. Black and Latino/a older adults are most likely to report unmet healthcare needs, as compared to White older adults (Berridge & Mor, 2018). Gerodiversity competencies are discussed in the Multicultural Aging Resource Guide, available online through APA with up-to-date resources for psychologists (APA, 2018a). Some of the specific competencies that psychologists may need to develop when working with racial and ethnic minority older adults include understanding how acculturation impacts well-being, how to discuss experiences of discrimination with older adults, and how to incorporate traditional healing practices into psychotherapy.

There is much variability in late-life development. Some aspects of emotional experience improve with age (daily emotional experience, emotion regulation) while some decline (emotion perception; Isaacowitz et al., 2017). Retirement is increasingly defined as more than a one-time event (Sterns & Dawson, 2012). Some older adults may have to re-enter the workforce after their planned retirement, and there may be multiple points of re-entry and exit. For many older adults, there is not one clear pathway to retirement and this may impact the well-being of older adults. The structure of families is increasingly diverse; 20.3% of non-institutionalized adults over age 65 live in multigenerational households (Joint Center for Housing Studies, 2017).  Long-term relationships do not follow one specific pattern, and the dominant pattern is one of relatively high and stable marital satisfaction (Anderson et al., 2010). Finally, older adults may be in a caregiving role, which may include caring for partners, other older family members, or grandchildren. It is important to note that many older adults find meaning in their role as caregiver. Older adults who report positive aspects of caregiving may report lower caregiver burden (Fauziana et al., 2018).

The same variability described above applies to biological, neurological, and cognitive changes that occur in older adults.  Many older adults have chronic health conditions to which they have successfully adapted while remaining highly functional in their everyday lives. Older adults remain sexually active into late life. Clinicians should be aware of changes that occur to vision with typical aging, and it can be helpful to provide services in a well-lit room and use materials that are high contrast (black font on white paper) with a slightly larger font. To accommodate changes to hearing that occur with age, psychologists can work to reduce the amount of environmental noise (e.g., televisions and radios) in health care settings.  Psychologists should avoid mistaking hearing loss for cognitive deficits, and avoid engaging in elderspeak. In the brain, some areas remain stable while others become smaller with time.  The hippocampus, the cerebellum, the caudate, and inferior association areas of the parietal lobe shrink the most with age, whereas the primary visual cortex shows little change with time (Raz et al., 2005). The rate of shrinkage tends to accelerate with age, particularly in people who have hypertension.

While the majority of adults will remain cognitively intact into very advanced age, the prevalence of neurocognitive disorders does increase with age, and psychologists should remain alert to signs of cognitive decline, such as forgetting appointments or forgetting conversations, and make appropriate referrals for cognitive assessment when needed.

Reference Article

Woodhead, E. L., & Yochim, B. J. (2022). Adult development and aging: A foundational geropsychology knowledge competency. Clinical Psychology: Science and Practice.

Discussion Questions

  1. Why is it important for psychologists to be aware of the typical aging process?
  2. How does older adults’ emotional and social functioning change with age?
  3. What are some typical health and cognitive changes
  4. How does race impact the typical aging process?

About the Authors

Erin L. Woodhead, PhD is an Associate Professor in the Psychology Department at San José State University and a licensed psychologist. She teaches undergraduate and graduate classes on psychology of aging, addictions, clinical psychology, ethics, and lifespan development. She co-edited a graduate textbook with Dr. Yochim titled Psychology of Aging: A Biopsychosocial Perspective, and her research interests are focused on substance use among older adults. Dr. Woodhead can be reached at Erin.Woodhead@sjsu.edu

Brian Yochim, PhD, ABPP is a board-certified neuropsychologist with the VA Saint Louis Health Care System, and a Fellow of the American Psychological Association. His principal interests lie in the neuropsychological assessment of older adults. He created the Verbal Naming Test to be used in the assessment of neurocognitive disorders, and also co-edited the graduate textbook Psychology of Aging: A Biopsychosocial Perspective, with Dr. Woodhead.

 

References Cited

American Psychological Association. (2018a). Multicultural aging resource guide. https://www.apa.org/pi/aging/resources/guides/multicultural

Baltes, M. M., & Carstensen, L. L. (1996). The process of successful aging. Ageing & Society, 16(4), 397-422. https://doi.org/10.1017/S0144686X00003603

Berridge, C., & Mor, V. (2018). Disparities in the prevalence of unmet needs and their consequences among Black and White older adults. Journal of Aging and Health, 30(9), 1427-1449. https://doi.org/10.1177/0898264317721347

Carstensen, L. L., Isaacowitz, D. M., & Charles, S. T. (1999). Taking time seriously: A theory of socioemotional selectivity. American Psychologist, 54(3), 165-181. https://doi.org/10.1037/0003-066X.54.3.165

Fauziana, R., Sambasivam, R., Vaingankar, J. A., Abdin, E., Ong, H. L., Tan, M.-E., Chong, S. A., & Subramaniam, M. (2018). Positive caregiving characteristics as a mediator of caregiving burden and satisfaction with life in caregivers of older adults. Journal of Geriatric Psychiatry and Neurology, 31(6), 329-335. https://doi.org/10.1177/0891988718802111

Forde, A. T., Crookes, D. M., Suglia, S. F., & Demmer, R. T. (2019). The weathering hypothesis as an explanation for racial disparities in health: A systematic review. Annals of Epidemiology, 33, 1-18. https://doi.org/10.1016/j.annepidem.2019.02.011

Isaacowitz, D. M., Livingstone, K. M., & Castro, V. L. (2017). Aging and emotions: Experience, regulation, and perception. Current Opinion in Psychology, 17, 79-83. https://doi.org/10.1016/j.copsyc.2017.06.013

Joint Center for Housing Studies (2017). The continued growth of multigenerational living. https://www.jchs.harvard.edu/blog/the-continued-growth-of-multigenerational-living

Raz, N., Lindenberger, U., Rodrigue, K. M., Kennedy, K. M., Head, D., Williamson, A., Dahle, C., Gerstorf, D., & Acker, J. D. (2005). Regional brain changes in aging healthy adults: General trends, individual differences and modifiers. Cerebral Cortex, 15(11), 1676–1689. https://doi.org/10.1093/cercor/bhi044

Rowe, J. W., & Kahn R. L. (2015). Successful aging 2.0: Conceptual expansions for the 21st centuty. The Journals of Gerontology: Series B, 70(4), 593-596. https://doi.org/10.1093/geronb/gbv025

Sterns, H. L., & Dawson, N. T. (2012). Emerging perspectives on resilience in adulthood and later life: Work, retirement, and resilience. Annual Review of Gerontology and Geriatrics, 32(1), 211-230. https://doi.org/10.1891/0198-8794.32.211

 

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