1 Psychology and human development1.12 Stages of human development
1.12.14 Normal ageing
2 min read1 figure
Written by Resident Doctor Committee · Published
Primary, secondary and tertiary ageing
Individual differences widen with age, so age predicts function poorly.
Type | Meaning | Example |
|---|---|---|
Primary | Intrinsic change without disease | Slower processing |
Secondary | Effects of disease, injury, disuse or exposure | Vascular cognitive impairment |
Tertiary | Accelerated decline near death | Terminal cognitive decline |
Secondary changes may be treatable, so do not put them down to age.
The ageing brain
Neuronal loss is regional. Brainstem cranial nerve motor nuclei keep a near-constant cell count across adult life, while other neuronal populations lose cells steadily.
Widespread neuronal loss does not explain cognitive decline in normal ageing.
Physical changes
Normal ageing brings presbyopia, high-frequency hearing loss, sarcopenia, lighter sleep with an earlier sleep phase, and reduced physiological reserve.
Correct sensory difficulties before cognitive testing.
Cognitive changes
Declines | Relatively preserved |
|---|---|
Processing speed | Vocabulary |
Working memory and divided attention | Semantic memory and expertise |
New learning and free recall | Recognition and cued recall |
Fluid intelligence | Crystallised intelligence |
Cattell and Horn distinguished fluid from crystallised intelligence.
Cross-sectional studies overestimate decline by mixing age with cohort effects; Schaie's Seattle Longitudinal Study found later, smaller declines.
Sudden change, loss of everyday independence or concern from an informant needs investigation, not reassurance.
Emotion and personality
Wellbeing often stays stable or improves, and depression is not normal ageing.
The positivity effect is a tendency to favour positive information in attention and memory.
Selection, optimisation and compensation (Baltes) means choosing priorities, developing retained abilities and finding alternatives for lost ones.
Personality is largely continuous, so marked change needs assessment, for example for frontotemporal dementia.
Social theories of ageing
Theory | How it explains reduced social contact |
|---|---|
Disengagement (Cumming and Henry) | Mutual, inevitable withdrawal that suits society and the person; largely rejected |
Activity | Withdrawal imposed by an ageist society against the person's wishes, so lost roles should be replaced |
Socioemotional selectivity (Carstensen) | Perceived limited time leads to a chosen narrowing towards close relationships |
Continuity (Atchley) | People adapt while keeping their values and preferences |
Retirement, loss and autonomy
Retirement goes better when it is chosen, planned, financially secure and followed by valued activity.
Bereavement raises short-term mortality, particularly in widowed men.
Capacity is decision-specific, and under the Mental Capacity Act 2005 a person with capacity may choose to accept risk.