Aging and society

Aging has a significant impact on society. People of different ages and gender tend to differ in many aspects, such as legal and social responsibilities, outlooks on life, and self-perceptions. Young people tend to have fewer legal privileges (if they are below the age of majority), they are more likely to push for political and social change, to develop and adopt new technologies, and to need education. Older people have different requirements from society and government, and frequently have differing values as well, such as for property and pension rights.[1] Older people are also more likely to vote, and in many countries the young are forbidden from voting. Thus, the aged have comparatively more, or at least different, political influence.[2]

In different societies, age may be viewed or treated differently. For example, age may be measured starting from conception or from birth, and starting at either age zero or age one. Transitions such as reaching puberty, age of majority, or retirement are often socially significant. The concepts of successful aging and healthy aging refer to both social and physical aspects of the aging process.[3][4]

Cultural variations

An elderly woman

Arbitrary divisions set to mark periods of life may include: juvenile (via infancy, childhood, preadolescence, adolescence), early adulthood, middle adulthood, and late adulthood. More casual terms may include "teenagers," "tweens," "twentysomething", "thirtysomething", etc. as well as "vicenarian", "tricenarian", "quadragenarian", etc.

The age of an adult human is commonly measured in whole years since the day of birth. Fractional years, months or even weeks may be used to describe the age of children and infants for finer resolution. The time of day the birth occurred is not commonly considered. In some cultures there are other ways to express age. For example, some cultures measure age by counting years including the current year, while others count years without including it. It could be said for the same person that he is twenty years old or that he is in the twenty-first year of his life. In Russian the former expression is generally used, the latter one has restricted usage: it is used for age of a deceased person in obituaries and for the age of an adult when it is desired to show him/her older than he/she is. (Psychologically, a woman in her 20th year seems older than one who is 19 years old.) Other cultures that express age differently may not use years elapsed since birth at all. Inuit culture is an example in which birthdays are not celebrated because maturity is not signified in terms of years. The Navajo culture is another in which age is not counted through years elapsed from birth. In this case, age is measured through certain milestones in a person's life, such as the first time they laugh.[5]

In cultures where age is not measured by years since birth, most individuals do not know how old they are in years. People in these cultures may find more importance in other aspects of their birth, such as the season, agricultural practices,[6] or spiritual connections[7] taking place when they were born. A culture may also choose to place a greater emphasis on family lineage than age, as is done in Mayan society. A Mayan adult would not determine a child's responsibility and status in terms of age by years, but instead by relative seniority to others in the family or community.

The main purpose of counting age in terms of years from birth is for the convenience of grouping individuals by age, as is needed in industrialized society. The medical practices and compulsory schooling that resulted from industrialization factored largely into the need for counting age in terms of years since birth.[8] Even in Westernized societies such as the United States, age in terms of years since birth did not begin until the mid-1800s.[5]

Depending on cultural and personal philosophy, ageing can be seen as an undesirable phenomenon, reducing beauty and bringing one closer to death; or as an accumulation of wisdom, mark of survival and a status worthy of respect. In some cases numerical age is important (whether good or bad), whereas others find the stage in life that one has reached (adulthood, independence, marriage, retirement, career success) to be more important.

East Asian age reckoning is different from that found in Western culture. Traditional Chinese culture uses a different ageing method, called Xusui (虛歲) with respect to common ageing which is called Zhousui (周歲). According to Luo Zhufeng (1991), the Xusui method, people are born at age 1, not age 0, possibly because conception is already considered to be the start of the life span and possibly because the number '0' was not historically present in Ancient China, and another difference is the ageing day: Xusui grows up at the Spring Festival (aka. Chinese New Year's Day), while Zhousui grows up at one's birthday.[9] In parts of Tibet, age is counted from conception i.e. one is usually 9 months old when one is born.[10]

Age in prenatal development is normally measured in gestational age, taking the last menstruation of the mother as a point of beginning. Alternatively, fertilisation age, beginning from fertilisation can be taken.

Legal

Most legal systems define a specific age for when an individual is allowed or obliged to do particular activities. These age specifications include voting age, drinking age, age of consent, age of majority, age of criminal responsibility, marriageable age, age of candidacy, and mandatory retirement age. Admission to a movie for instance, may depend on age according to a motion picture rating system. A bus fare might be discounted for the young or old. Each nation, government and non-government organisation has different ways of classifying age.

Similarly, in many countries in jurisprudence, the defence of infancy is a form of defence by which a defendant argues that, at the time a law was broken, they were not liable for their actions and thus should not be held liable for a crime. Many courts recognise that defendants who are considered to be juveniles may avoid criminal prosecution on account of their age and in borderline cases the age of the offender is often held to be a mitigating circumstance.

Political

Older people have different requirements from society and government, and frequently have differing values as well, such as for property and pension rights.[1] Older people are also more likely to vote, and in many countries the young are forbidden from voting. Thus, the aged have comparatively more, or at least different, political influence.[2]

Education tends to lose political significance for people as they age.[11]

Coping and well-being

Elderly Gambian woman.

Psychologists have examined coping skills in the elderly. Various factors, such as social support, religion and spirituality, active engagement with life and having an internal locus of control have been proposed as being beneficial in helping people to cope with stressful life events in later life.[12][13][14] Social support and personal control are possibly the two most important factors that predict well-being, morbidity and mortality in adults.[15] Other factors that may link to well-being and quality of life in the elderly include social relationships (possibly relationships with pets as well as humans), and health.[16]

Retirement, a common transition faced by the elderly, may have both positive and negative consequences.[17] Individuals in different wings in the same retirement home have demonstrated a lower risk of mortality and higher alertness and self-rated health in the wing where residents had greater control over their environment,[18][19] though personal control may have less impact on specific measures of health.[14] Social control, perceptions of how much influence one has over one's social relationships, shows support as a moderator variable for the relationship between social support and perceived health in the elderly and may positively influence coping in the elderly.[20]

Religion

Religion is an important factor used by the elderly in coping with the demands of later life and appears more often than other forms of coping later in life.[21] Religiosity is a multidimensional variable; while participation in religious activities in the sense of participation in formal and organised rituals may decline, it may become a more informal, but still important aspect of life such as through personal or private prayer.[22]

Self-rated health

Positive self-perception of health has been correlated with higher well-being and reduced mortality in the elderly.[23][24] Various reasons have been proposed for this association; people who are objectively healthy may naturally rate their health better than that of their ill counterparts, though this link has been observed even in studies which have controlled for socioeconomic status, psychological functioning and health status.[25] This finding is generally stronger for men than women,[24] though the pattern between genders is not universal across all studies and some results suggest sex-based differences only appear in certain age groups, for certain causes of mortality and within a specific sub-set of self-ratings of health.[25]

Paradox of ageing

Seniors’ subjective health remains relatively stable while objective health worsens with age.[26] Furthermore, it seems that the perceived health improves with age when objective health is controlled in the equation.[27] This phenomenon is known as the paradox of ageing. People's expectations concerning health co-evolve with the health norms surrounding one's age. Elderly people often associate their functional and physical decline with the normal ageing process.[28][29] The elderly may actually enhance their perception of their own health through social comparison;[30] for instance, the older people get, the more they may consider themselves in better health than their same-aged peers.[31] Hence, the older a person becomes and the more their actual health declines, the greater the potential role is for social comparison processes to create a gap between a person's objective and subjective health.

Healthcare

Many societies in Western Europe and Japan have ageing populations. While the effects on society are complex, there is a concern about the impact on health care demand. The large number of suggestions in the literature for specific interventions to cope with the expected increase in demand for long-term care in ageing societies can be organised under four headings: improve system performance; redesign service delivery; support informal caregivers; and shift demographic parameters.[32]

However, the annual growth in national health spending is not mainly due to increasing demand from ageing populations, but rather has been driven by rising incomes, costly new medical technology, a shortage of health care workers and informational asymmetries between providers and patients.[33] A number of health problems become more prevalent as people get older. These include mental health problems as well as physical health problems, especially dementia.

Even so, it has been estimated that population ageing only explains 0.2 percentage points of the annual growth rate in medical spending of 4.3 percent since 1970. In addition, certain reforms to the Medicare system in the United States decreased elderly spending on home health care by 12.5 percent per year between 1996 and 2000.[34] This would suggest that the impact of ageing populations on health care costs is not inevitable.

In United States prisons, medical costs for an ageing inmate could be above $100 per day as of July 2007, while typical inmates cost $33 per day. Most State DOCs report spending more than 10 percent of the annual budget on elderly care. That is expected to rise over the next 10–20 years. Some states have talked about releasing ageing inmates early.[35]

Successful ageing

Two men practising Tahtib. One of them is balding, suggesting vigorous activity at an advanced age.

The concept of successful ageing can be traced back to the 1950s and was popularised in the 1980s. Previous research into ageing exaggerated the extent to which health disabilities, such as diabetes or osteoporosis, could be attributed exclusively to age and research in gerontology exaggerated the homogeneity of samples of elderly people.[4][36] Other research shows that even late in life, potential exists for physical, mental, and social growth and development.[37]

Successful ageing consists of three components:[3]

1. Low probability of disease or disability;
2. High cognitive and physical function capacity;
3. Active engagement with life.

A greater number of people self-report successful ageing than those that strictly meet these criteria.[4]

Successful ageing may be viewed an interdisciplinary concept, spanning both psychology and sociology, where it is seen as the transaction between society and individuals across the life span with specific focus on the later years of life.[38] The terms "healthy ageing"[4] and "optimal ageing" have been proposed as alternatives to successful ageing, partly because the term "successful ageing" has been criticised for making healthy ageing sound too competitive.

Six suggested dimensions of successful ageing include:[14]

1. No physical disability over the age of 75 as rated by a physician;
2. Good subjective health assessment (i.e. good self-ratings of one's health);
3. Length of undisabled life;
4. Good mental health;
5. Objective social support;
6. Self-rated life satisfaction in eight domains, namely marriage, income-related work, children, friendship and social contacts, hobbies, community service activities, religion and recreation/sports.

Numerous worldwide health, ageing and retirement surveys contain questions pertaining to pensions. The Meta Data Repository – created by the non-profit RAND Corporation and sponsored by the National Institute on Aging at the National Institutes of Health – provides access to meta data for these questions as well as links to obtain respondent data from the originating surveys.

Ageing and communication

Display of healthy communication between the elderly

Healthy ageing implies optimal well-being in spite of barriers resulting from age.[39] The global population is ageing and will continue to have communication inabilities unless barriers of communication with the elderly are more highly promoted.[40] Sensory impairments include hearing and vision deficits, which can cause communication barriers. Changes in cognition, hearing, and vision are easily associated with healthy ageing and can cause problems when diagnosing dementia and aphasia due to the similarities.[40]

Hearing loss

Hearing aid

Hearing loss is a common condition among ageing adults. Common conditions that can increase the risk of hearing loss in elderly people are high blood pressure, diabetes or the use of certain medications harmful to the ear.[41] Hearing aids are commonly referred to as personal amplifying systems, which can generally improve hearing by about 50%.[42]

Hearing loss among the aged community lessens elders' ability to compensate for other age related social and/or physical problems.[43] Communication problems of elderly adults can be greatly impacted by mechanical problems such as: the translation of ideas into linguistic representation or expression, the perception of linguistic stimuli or the derivation of an idea from a given unit of disclosure. Changes in these mechanical problems are more important than changes in linguistic knowledge.[43] The main goal of hearing aids is to improve communication and quality of life, not just to restore hearing. Presbycusis is an example of a hearing deficit that cannot be corrected by hearing aids.[42] Presbycusis, the alteration of hearing sensitivity associated with normal hearing loss, is caused by the decreased amount of hair cells of the inner ear.[44] This is normally caused by long periods of distressing noise that diminish the hair cells which with increasing age will not grow back. Presbycusis and other such hearing-related problems promote social withdrawal, as individuals begin to lose touch with the world around them. Hearing loss among the aged community lessens elders' ability to compensate for other age-related social and/or physical problems.[44] This impairment can cause elders to lose touch of social skills because they may have trouble keeping up with fast-paced or hearing different pitched voices in conversation.[42]

Visual impairment

The interpretation of facial expressions and mouthing can be difficult to understand when an individual has a visual impairment. Such problems hinder the ability of people to understand stimuli and translate information pertaining to perception with their brain for analysis.[42] Non-verbal communication is important in effective communication and elders with vision loss are more likely to misinterpret or read the other person's actions in a wrong way. Visual impairments also cause a loss in positive perceptions of the environment around them. This can lead to isolation and possible depression in elderly people.[42] Macular degeneration is a common cause of vision loss in elderly people. It diminishes the macula of the eye, which is responsible for clear vision. It causes progressive loss of central vision and possible loss of colour vision.[42] This degeneration is caused by systemic changes in the circulation of waste products and growth of abnormal vessels around the retina causing the photoreceptors not to receive proper images. Though ageing almost always causes this, other possible effects and risk factors include smoking, obesity, family history and excessive sunlight exposure.[42]

Digital world

In a world increasingly relying on digital technologies, older adults face higher risks of social exclusion and prejudices (see digital ageism). Generational segregation naturalizes youth as digitally adept and the old as digitally inept. Older adults’ experiences are often excluded from research agendas on digital media.[45][46]

Political struggle against ageing

Though many sex for men state that radical life extension, delaying and stopping ageing are achievable,[47][48] there are still no international or national programmes focused on stopping ageing or on radical life extension. There are political forces staying for and against life extension. In 2012 the Longevity political parties started in Russia, then in the USA, Israel and the Netherlands. These parties aim to provide political support to anti-ageing and radical life extension research and technologies and want to ensure the fastest possible and at the same time the softest societal transition to the next step: radical life extension and life without ageing, that will make it possible to provide the access to such technologies to the most of the currently living people.[49]

Social science of ageing

An elderly Iraqi man.

Seniors at a San Francisco Day Care Center in Chinatown, late 1970s.

• Disengagement theory is the idea that separation of older people from active roles in society is normal and appropriate, and benefits both society and older individuals. Disengagement theory, first proposed by Cumming and Henry, has received considerable attention in gerontology, but has been much criticised.[50][51] The original data on which Cumming and Henry based the theory were from a rather small sample of older adults in Kansas City and from this select sample Cumming and Henry then took disengagement to be a universal theory.[52] There are research data suggesting that the elderly who do become detached from society are those who were initially reclusive individuals and such disengagement is not purely a response to ageing.[50]
• Activity theory, in contrast to disengagement theory, implies that the more active elderly people are, the more likely they are to be satisfied with life. The view that elderly adults should maintain well-being by keeping active has had a considerable history and since 1972, this has come to be known as activity theory.[52] However, this theory may be just as inappropriate as disengagement for some people as the current paradigm on the psychology of ageing is that both disengagement theory and activity theory may be optimal for certain people in old age, depending on both circumstances and personality traits of the individual concerned.[50] There are also data which query whether, as activity theory implies, greater social activity is linked with well-being in adulthood.[52]
• Selectivity theory mediates between the activity and disengagement theories, and suggests that it may benefit older people to become more active in some aspects of their lives, more disengaged in others.[52]
• Continuity theory is the view that in ageing people are inclined to maintain, as much as they can, the same habits, personalities and styles of life that they have developed in earlier years. Continuity theory is Atchley's theory that individuals, in later life, make adaptations to enable them to gain a sense of continuity between the past and the present and the theory implies that this sense of continuity helps to contribute to well-being in later life.[16] Disengagement theory, activity theory and continuity theory are social theories about ageing, though all may be products of their era rather than a valid, universal theory.

Other definitions

As cyborgs currently are on the rise some theorists argue there is a need to develop new definitions of aging and for instance a bio-techno-social definition of aging has been suggested.[53]

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