“Everyman desires to live long, but no man would be

old.”
Johnathan Swift, 1667-1745

Theories of Aging
 The Framework of Life Course
 Life - a three-pronged course.
 Components of life course: acquisition, struggle, legacy
 1. Acquisition – collecting all that we experience and pick up in life from the
time we come into existence
 2. Struggle – challenges, trials
 3. Legacy - reaching a level of self-actualization, able to model
goodness and kindness. One is called a “repository of values and of
wisdom”
 Theories of aging can be divided into two categories:
 those that answer the question “Why do we age?”
 and those that address the question “How do we age?”
 THE PROGRAMMED THEORY/
BIOLOGICAL CLOCK THEORY
 • The programmed theory proposes that every person has a “Biologic
clock” that starts ticking at the time of conception.
 • In this theory each individual has a genetic program specifying an
unknown but predetermined number of cell divisions.
 • As the program plays out, the person experiences predictable changes
such as atrophy of the thymus, menopause, skin changes and graying of
the hair
 • Aging has a biological timetable or internal biological clock.
 THE RUN OUT OF PROGRAM THEORY
 • Every person has a limited amount of genetic material that will run out
over time.
 • All events are specifically programmed into genome and are sequentially
activated.
 • After maturation genes have been activated there are no more
programs to be played and as cells age there may be chance of
inactivation of genes that cannot be turned on.
 GENE THEORY
 • The gene theory proposes the existence of one or more harmful genes
that activate overtime, resulting in the typical changes seen with aging
and limiting the life span of the individual.
 • Organism failure occurs in later life because of the presence of imperfect
genes activated over lengthy periods of time.
 • Two gene types, one supports growth and vigor, and the other supports
senescence and deterioration.
 MOLECULAR THEORIES
 The aging is controlled by genetic materials that are encoded to predetermine
both growth and decline. • The error theory • The somatic mutation theory
 1.THE ERROR THEORY • The error theory proposes that errors in ribonucleic acid
protein synthesis cause errors to occur in cells in the body, resulting in a
progressive decline in biologic function. • Error theory Aging is a result of internal
or external assaults that damage cells or organs so they can no longer function
properly.
 2. THE SOMATIC MUTATION THEORY • The somatic mutation theory proposes
that aging result from deoxyribonucleic acid (DNA) damage caused by
exposure to chemicals or radiation and this damage causes chromosomal
abnormalities that lead to disease or loss of function later in life. • Exposure to x-
ray radiation and or chemicals induces chromosomal abnormalities.
 CELLULAR THEORIES
 • The cellular theories propose that aging is a process that occurs because
of cell damage. • When enough cells are damaged, overall functioning of
the body is decreased. • The free radical theory • The crosslink or
connective tissue theory • Clinker theory • The wear and tear theory
 1.THE FREE RADICAL THEORY • Denham Harman 1956. • The term free
radical describes any molecule that has a free electron, and this property
makes it react with healthy molecules in a destructive way. • Free radical
molecule creates an extra negative charge. • This unbalanced energy
makes the free radical bind itself to another balanced molecule as it tries to
steal electrons. • Balanced molecule becomes unbalanced and thus a
free radical itself. • Diet, lifestyle, drugs (e.g. tobacco and alcohol) and
radiation
 2.THE CROSSLINK OR CONNECTIVE TISSUE THEORY/ GLYCOSYLATION THEORY
OF AGING
 • Cell molecules from DNA and connective tissue interact with free
radicals to cause bonds that decrease the ability of tissue to replace itself.
• The results in the skin changes typically attributed to aging such as
dryness, wrinkles, and loss of elasticity.
 • Fibrous tendons, loosening teeth, diminished elasticity of arterial walls and
decreased efficiency of lungs and GI tract.
 • It is the binding of glucose (simple sugars) to protein, (a process that
occurs under the presence of oxygen) that causes various problems.
 • Senile cataract and the appearance of tough, leathery and yellow skin.
 3. THE CLINKER THEORY
 • The clinker theory combines the somatic mutation, free radical and cross
link theories to suggest that chemicals produced by metabolism
accumulate in normal cells and cause damage to body organs such as the
muscles, heart, nerves and brain.
 4. THE WEAR AND TEAR THEORY
 • Body is similar to a machine, which loses function when its parts wear out.
• As people age, their cells, tissues and organs are damaged by internal or
external stressors. • Good health maintenance practices will reduce the
rate of wear and tear, resulting in longer and better body function.
 THE NEUROENDOCRINE THEORY
 • Prof Vladimir Dilman and Ward Dean
 • this theory elaborates on wear and tear by focusing on the
neuroendocrine system.
 • This system is a complicated network of biochemicals that govern the
release of hormones which are altered by hypothalamus.
 • The hypothalamus controls various chain-reactions to instruct other
organs and glands to release their hormones etc. The hypothalamus also
responds to the body hormone levels as a guide to the overall hormonal
activity. Accordingly, as ages the secretion of many hormones declines
and their effectiveness is also reduced due to the receptors down- grading.
 IMMUNOLOGIC THEORY
 • The immunologic theory proposes that aging is a function of changes in
the immune system.
 • The immune system weakens over time, making an aging person more
susceptible to disease, increase in autoimmune disease and allergies
 • Over time, cells involved in immune function are less self- regulatory,
resulting in cells being misidentified as foreign material and being attacked
by the immune system’s own defenses. Eg: rheumatoid arthritis (RA) and
lupus.
 THE MITOCHONDRIAL DECLINE THEORY
 • The power producing organelles.
 • Their primary job is to create Adenosine Triphosphate (ATP) and they do
so in the various energy cycles that involve nutrients such as Acetyl-L-
Carnitine, CoQ10 (Idebenone), NADH and some B vitamins etc.
 • Enhancement and protection of the mitochondria is an essential part of
preventing and slowing aging.
 Disengagement Theory
 developed by Cummings and Henry in late 1950’s.
 “aging is an inevitable, mutual withdrawal or disengagement, resulting in
decreased interaction between the aging person and others in the social
system he/she belongs to
 aging people withdraw from customary roles and engage in more
introspective, self-focused activities.
 • The disengagement theory was developed to explain why aging process
separate from the mainstream of society.
 • This theory proposes that older people are systematically separated,
excluded, or disengaged from society because they are not perceived to be of
benefit to the society as a whole.
 • This theory further proposes that older adults desire to withdraw from society
as they age, so the disengagement is mutually beneficial.
 THE ACTIVITY THEORY
 • This theory proposes that activity is necessary for successful aging.
 • Active participation in physical and mental activities helps maintain
functioning well into old age.
 • Purposeful activities and interactions that promote self-esteem improve
overall satisfaction with life, even at the older age.
 • The continuation of activities performed during middle age is necessary
for successful aging
 Activity theory,, sees a positive correlation between keeping active and
aging well.
 THE CONTINUITY THEORY
 • The continuity theory (Neugarten, 1964) state that personality remains the
same and the behaviours become more predictable as people ages.
 • Personality and behaviour pattern developed during a life time
determine the degree of engagement and activity in older adulthood.
 • Personality is a critical factor in determining the relationship between role
activity and life satisfaction.
 “basic personality, attitudes, and behaviors remain constant throughout
the life span”
 DEVELOPMENTAL THEORIES
 ■ Developmental theories or life-course theories
 ■ These theories trace personality and personal adjustment throughout a
person’s life.
 ■ Many of these theories are specific in identifying life- oriented tasks for the
aging person. Erikson’s Havighurst’s Newman’s Peck’s Jung’s theory
 CONCEPTS OF DEVELOPMENTAL THEORY • The concepts based on the
identification of traits and characteristics that may be developed early in life or
may change emphasis at different stages of development. • Those who
succeed at the final task also develop wisdom, which includes accepting
without major regrets the life that one has lived, as well as the inescapability of
death. • However, even older adults who achieve a high degree of integrity
may feel some despair at this stage as they contemplate their past. •
 ERIKSON’S THEORY
 Erickson’s(1963) theory identifies eight stages of developmental tasks that
an individual must comfort throughout the life span: Trust versus mistrust
Autonomy versus shame and doubt Initiative versus guilt Industry versus
inferiority Identity versus identity confusion Intimacy versus isolation
Generativity versus stagnation Integrity versus despair
 • The last of these stages is the domain of late adulthood, but failure to
achieve success in tasks earlier in life can cause problems later in life.
 • The stage pertaining to older adults is : Ego integrity versus Despair.
 • The task of this stage is acceptance of one’s life as meaningful and that
death is part of life, versus despair, which is failure to accept the
meaningfulness of one’s life, along with fear of death.
 PECK’S THEORY
 • Peck expanded Erikson’s theory and focused more on later
developmental stages.
 • Body transcendence versus body preoccupation is a phase concerned
with enjoyment of life in the face of physical discomforts associated with
aging.
 • Ego transcendence versus ego preoccupation is a phase concerned with
the older adult’s ability to focus on the welfare of the future generation
rather than on one’s own inevitable death
 HAVIGHURST THEORY
 • Havighurst’s(1968) theory details the process of aging and defines
specific task for late life, including 1. adjusting to decreased physical
strength and health, 2. adjusting to retirement and decreased income, 3.
adjusting to the loss of a spouse, 4. establishing a relationship with one’s
age group, 5. adapting to social roles in a flexible way, and 6. establishing
satisfactory living arrangements.
 • Later maturity is Havighurst’s term for older adults.
 • The task for later maturity is disengagement. Disengagement from tasks of
middle age allows involvement in new roles such as grandparent, citizen,
friend.
 NEWMAN’S THEORY
 • Newman’s theory identifies the task of aging as
 1. Coping with the physical changes of aging
 2. Redirecting energy to new activities and roles including retirement,
grandparenting and widowhood
 3. Accepting one’s own life; and
 4. Developing a point of view about death.
 JUNG’S THEORY
 • Jung’s theory proposes that the development continues throughout life by a
process of searching, questioning and setting goals that are consistent with the
individual’s personality.
 • As individuals age, they go through a reevaluation stage at midlife, at which
point they realize there are many things they have not done.
 • At this age they begin to question whether the decision and choices they
have made were the right choices for them. This is so called “midlife crisis”,
which can lead to radical career or lifestyle changes or acceptance of the self
as is.
 • As aging continues, Jung proposes that the individual is likely to shift from an
outward focus (wit concerns about success and social position) to a more
inward focus.
 • Successful aging includes acceptance and valuing of the self without regard
to the view of others.
 APPLICATION IN NURSING FIELD
 • Physical theories of aging indicate that, although biology places some
limitations on life and life expectancy, other factors are subject to behaviour
and life choices. Nursing can help individuals achieve the longest, healthiest
lives possible by promoting good health maintenance practices and a healthy
environment.
 • Psychosocial theories help to explain the variety of behaviours seen in the
aging population. Understanding all of these theories can help nurses recognize
problems and provide nursing interventions that will helping aging individuals
successfully meeting the development tasks of aging. Cultural, spiritual,
regional, socioeconomic, educational and environmental factors as well as
health status impact older adult’s perceptions and choices about their health
care needs.
 • Theories can predict patient outcomes hold the greatest promise for guiding
nursing practice in ways that help each individual patient age successfully.
 Selective Optimization with
Compensation Theory
 Selective optimization with compensation theory -- successful aging is
linked with three main factors: selection, optimization, and compensation
 ◦ selection -- older adults have a reduced capacity and loss of functioning
 ◦ optimization -- it is possible to maintain performance in some areas
through practice and use of new technologies
 ◦ compensation -- becomes relevant when life tasks require a level of
capacity beyond the current circumstances Effective when people pursue
successful outcomes.
 Gerotranscendence
 the idea that as people age, they transcend the limited views of life they
held in earlier times.
 Tornstam believes that throughout the aging process, the elderly become
less self-centered and feel more peaceful and connected to the natural
world.
 Wisdom comes to the elderly,
 Tornstam’s theory states, and as the elderly tolerate ambiguities and
seeming contradictions, they let go of conflict, and develop softer views of
right and wrong
 THE SUBCULTURE THEORY
 • Rose (1965) theorized that older adults from a unique subculture within
society to defend against society’s negative attitude toward aging and the
accompanying loss of status.
 • Older adults are a subculture with their own norms and beliefs. The
subculture occurs as a response to loss of status.
 A subculture may develop when particular members of a society interact
with each other significantly more than they do with others in the
society.This pattern of interaction develops when group members have
common backgrounds and interests and / or are excluded from interaction
with other population groups in the society.
 • In the subculture, individual status is based on health and mobility,
instead of on education, occupation and economic achievement.
 trends contributing to development of
age subculture
 1) the growing number and proportion of persons who live beyond the age
of 65,
 (2)the self—segregation of older persons in inner cities and rural areas
(caused by migration patterns of the young);
 (3)the decline in employment of older people;
 (4)the development of social services designed to assist older people.
 MODERNIZATION THEORY
 it described the relationship between modernization and the charges in role
and status of older people.
 Modernization theory held that with increasing modernization, the status of
older people declines.
 This declining status is reflected in reduced leadership roles, power, and
influence, as well as increased disengagement of older people from community
life..
 Modernization is the transformation of a total society from a relatively rural way
of life based on animate power, limited technology, relatively undifferentiated
institutions, parochial and traditional outlook and values, toward a
predominantly urban way of life based on inanimate sources of power, highly
developed scientific technology, highly differentiated institutions matched by
segmented individual roles, and a cosmopolitan outlook which emphasizes
efficiency and progress
 Four subsidiary aspects of modernization

 Each of these aspects of modernization helps produce the lower status of older
people in society (Cowgill 1974)
 (1) scientific technology as applied in economicproduction and distribution.
 (2) urbanization- including the separation of work from home and the
geographical separation of youthful urban migrants from their parental
homes, Increases social distance between generations and leads to a reduced
status of the aged.
 (3) literacy and mass education,- Promoting literacy and education (almost
always targeted at the young in modernization efforts) generates a situation in
which children are more literate and have greater skill than their parents do
 (4) health technology.
 age stratification theory
 (Riley, Johnson, and Foner 1972). age stratification theorists were the first to
suggest that members of society might be stratified by age, just as they are
stratified by race, class, and gender.
 Because age serves as a basis of social control, different age groups will have
varying access to social resources such as political and economic power.
 Within societies, behavioral age norms, including norms about roles and
appropriate behavior, dictate what members of age cohorts may reasonably
do.
 For example, it might be considered deviant for an elderly woman to wear a
bikini because it violates norms denying the sexuality of older females.
 These norms are specific to each age strata, developing from culturally based
ideas about how people should “act their age.” 62
 Exchange Theory (Dowd 1975)
 suggests we experience an increased dependence as we age and must
increasingly submit to the will of others because we have fewer ways of
compelling others to submit to us.
 Indeed, inasmuch as relationships are based on mutual exchanges, as the
elderly become less able to exchange resources, they will see their social circles
diminish.
 In this model, the only means to avoid being discarded is to engage in
resource management, like maintaining a large inheritance or participating in
social exchange systems via child care.
 In fact, the theory may depend too much on the assumption that individuals
are calculating.
 It is often criticized for affording too much emphasis to material exchange and
devaluing nonmaterial assets such as love and friendship 63