Chapter 24, Transitions, Middle and Older Adulthood Study Guide
Summer 2025
I. Theories of Aging
Genetic Theory: Focuses on the role of genetic inheritance in the aging process.
Neuroendocrine and Immunity Theories: Examine the influence of the endocrine and
immune systems on aging.
Stochastic Theories: Wear and Tear Theory: Proposes that the body wears out over
time due to repeated use and damage.
Cross-linkage Theory: Suggests that a chemical reaction damages DNA and leads to
cell death.
Free Radical Theory: Emphasizes the adverse effects of free radicals (formed during
cellular metabolism) on adjacent molecules.
II. Development of the Middle Adult
Physiologic Changes: Gradual internal and external physiologic changes occur.
Cognitive Development: Little change from young adulthood; increased motivation to
learn.
Psychosocial Development: Erikson: Generativity versus stagnation.
Havighurst: Emphasizes learned behaviors arising from maturation, personal motives,
values, and civic responsibility (e.g., accepting physical changes, maintaining occupation,
assisting children, adjusting to aging parents, relating to spouse).
Levinson: Individuals may continue an established lifestyle or reorganize it during a
period of transition.
Gould's Theory: Ages 35–43: Adults look inward.
Ages 43–50: Adults accept lifespan boundaries and focus on spouse/partner, friends, and
community.
Ages 50–60: Increased self-satisfaction, value spouse/partner as a companion, increased
health concerns.
Adjusting to Changes: Employment, spousal relationships, relationships with children
and aging family members.
Moral and Spiritual Development: Kohlberg: May remain at a conventional level or
move to a post-conventional level.
Fowler: May become less rigid in spiritual beliefs, recognize paradoxes, appreciate
symbolism, and engage in mutual perspective-taking (paradoxical-consolidative state).
Common Health Problems: Malignant neoplasms, cardiovascular disease, injury,
depression, suicide, diabetes mellitus, chronic lower respiratory disease, cerebrovascular
causes, liver/kidney disease, obesity, alcoholism, arthritis. Both acute and chronic
illnesses are more likely, and recovery takes longer.
Role of the Nurse: Health screenings, examinations, immunizations, teaching about
substance use dangers, healthy diet, and regular exercise.
III. Older Adulthood
Variation in Life Expectancy: Influenced by socioeconomic/race/ethnicity factors,
behavioral/metabolic risk factors, and health care factors.
Common Myths (Ageism):Old age begins at 65.
Most older adults are in long-term care facilities.
Older adults are sick, and mental deterioration occurs.
Older adults are not interested in sex.
1
, Chapter 24, Transitions, Middle and Older Adulthood Study Guide
Summer 2025
Older adults do not care how they look and are lonely.
Bladder problems are a problem of aging.
Older adults do not deserve aggressive treatment.
Older adults cannot learn new things.
**Fundamental to ageism is the view that older people are different than younger people;
therefore, they do not experience the same desires, needs, and concerns. **
Physiologic Changes: Occur across various body systems (integumentary,
musculoskeletal, neurologic, special senses, cardiopulmonary, gastrointestinal, dentition,
genitourinary).
Cognitive Development: Intelligence increases into the 60s; cognition does not change
appreciably with aging.
Response/reaction times may increase.
Mild short-term memory loss is common; long-term memory usually intact.
Dementia, Alzheimer’s disease, depression, and delirium can cause cognitive
impairment.
Delirium: Temporary state of confusion (hours to weeks) that resolves with treatment.
Sundowning Syndrome: Not a temporary state of confusion that resolves with
treatment.
Psychosocial Development: Self-concept: Relatively stable throughout adult life.
Disengagement Theory: An older adult may substitute activities but does disengage
from society.
Erikson: Ego integrity versus despair and disgust; involves life review.
Havighurst: Major tasks are maintenance of social contacts and relationships.
Adjusting to Changes: Physical strength and health, retirement and reduced income,
spouse/partner health, relating to one’s age group, social roles, living arrangements,
family and role reversal.
Moral and Spiritual Development: Kohlberg: Most older adults have completed moral
development and are at a conventional level.
Spiritually: May be at an earlier level (individuated–reflective); many demonstrate
conjunctive faith and trust in a greater power.
Self-transcendence: Characteristic of later life.
Gero transcendence: Transformation of reality view from rational/individualistic to a
more transcendent vision.
Health of the Older Adult: Most are not impaired but are more vulnerable to physical,
emotional, or socioeconomic problems.
Probability of illness increases; chronic health problems/disability may develop.
Polypharmacy: Use of multiple medications.
Diversity and chronic illness (structural racism).
Accidental injuries.
Dementia, delirium, and depression.
Elder abuse.
Causes of Accidental Injuries: Changes in vision/hearing, loss of muscle mass/strength,
slower reflexes/reaction time, decreased sensory ability, combined effects of chronic
illness/medications, economic factors.
Elder Abuse: Experienced by 1 in 10 community-dwelling older adults; includes
physical, sexual, psychological/emotional, financial, and neglect. Risk increased by
2
Summer 2025
I. Theories of Aging
Genetic Theory: Focuses on the role of genetic inheritance in the aging process.
Neuroendocrine and Immunity Theories: Examine the influence of the endocrine and
immune systems on aging.
Stochastic Theories: Wear and Tear Theory: Proposes that the body wears out over
time due to repeated use and damage.
Cross-linkage Theory: Suggests that a chemical reaction damages DNA and leads to
cell death.
Free Radical Theory: Emphasizes the adverse effects of free radicals (formed during
cellular metabolism) on adjacent molecules.
II. Development of the Middle Adult
Physiologic Changes: Gradual internal and external physiologic changes occur.
Cognitive Development: Little change from young adulthood; increased motivation to
learn.
Psychosocial Development: Erikson: Generativity versus stagnation.
Havighurst: Emphasizes learned behaviors arising from maturation, personal motives,
values, and civic responsibility (e.g., accepting physical changes, maintaining occupation,
assisting children, adjusting to aging parents, relating to spouse).
Levinson: Individuals may continue an established lifestyle or reorganize it during a
period of transition.
Gould's Theory: Ages 35–43: Adults look inward.
Ages 43–50: Adults accept lifespan boundaries and focus on spouse/partner, friends, and
community.
Ages 50–60: Increased self-satisfaction, value spouse/partner as a companion, increased
health concerns.
Adjusting to Changes: Employment, spousal relationships, relationships with children
and aging family members.
Moral and Spiritual Development: Kohlberg: May remain at a conventional level or
move to a post-conventional level.
Fowler: May become less rigid in spiritual beliefs, recognize paradoxes, appreciate
symbolism, and engage in mutual perspective-taking (paradoxical-consolidative state).
Common Health Problems: Malignant neoplasms, cardiovascular disease, injury,
depression, suicide, diabetes mellitus, chronic lower respiratory disease, cerebrovascular
causes, liver/kidney disease, obesity, alcoholism, arthritis. Both acute and chronic
illnesses are more likely, and recovery takes longer.
Role of the Nurse: Health screenings, examinations, immunizations, teaching about
substance use dangers, healthy diet, and regular exercise.
III. Older Adulthood
Variation in Life Expectancy: Influenced by socioeconomic/race/ethnicity factors,
behavioral/metabolic risk factors, and health care factors.
Common Myths (Ageism):Old age begins at 65.
Most older adults are in long-term care facilities.
Older adults are sick, and mental deterioration occurs.
Older adults are not interested in sex.
1
, Chapter 24, Transitions, Middle and Older Adulthood Study Guide
Summer 2025
Older adults do not care how they look and are lonely.
Bladder problems are a problem of aging.
Older adults do not deserve aggressive treatment.
Older adults cannot learn new things.
**Fundamental to ageism is the view that older people are different than younger people;
therefore, they do not experience the same desires, needs, and concerns. **
Physiologic Changes: Occur across various body systems (integumentary,
musculoskeletal, neurologic, special senses, cardiopulmonary, gastrointestinal, dentition,
genitourinary).
Cognitive Development: Intelligence increases into the 60s; cognition does not change
appreciably with aging.
Response/reaction times may increase.
Mild short-term memory loss is common; long-term memory usually intact.
Dementia, Alzheimer’s disease, depression, and delirium can cause cognitive
impairment.
Delirium: Temporary state of confusion (hours to weeks) that resolves with treatment.
Sundowning Syndrome: Not a temporary state of confusion that resolves with
treatment.
Psychosocial Development: Self-concept: Relatively stable throughout adult life.
Disengagement Theory: An older adult may substitute activities but does disengage
from society.
Erikson: Ego integrity versus despair and disgust; involves life review.
Havighurst: Major tasks are maintenance of social contacts and relationships.
Adjusting to Changes: Physical strength and health, retirement and reduced income,
spouse/partner health, relating to one’s age group, social roles, living arrangements,
family and role reversal.
Moral and Spiritual Development: Kohlberg: Most older adults have completed moral
development and are at a conventional level.
Spiritually: May be at an earlier level (individuated–reflective); many demonstrate
conjunctive faith and trust in a greater power.
Self-transcendence: Characteristic of later life.
Gero transcendence: Transformation of reality view from rational/individualistic to a
more transcendent vision.
Health of the Older Adult: Most are not impaired but are more vulnerable to physical,
emotional, or socioeconomic problems.
Probability of illness increases; chronic health problems/disability may develop.
Polypharmacy: Use of multiple medications.
Diversity and chronic illness (structural racism).
Accidental injuries.
Dementia, delirium, and depression.
Elder abuse.
Causes of Accidental Injuries: Changes in vision/hearing, loss of muscle mass/strength,
slower reflexes/reaction time, decreased sensory ability, combined effects of chronic
illness/medications, economic factors.
Elder Abuse: Experienced by 1 in 10 community-dwelling older adults; includes
physical, sexual, psychological/emotional, financial, and neglect. Risk increased by
2
