Ageing issues and challenges in adulthood pdf

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What’s my age again? Age categories as interactive kinds

This paper addresses a philosophical problem concerning the ontological status of age classification. These age categories prima facie seem to qualify as natural kinds under a homeostatic property cluster account of natural kindhood, insofar as they capture certain biological, psychological, and social properties of people that tend to cluster together due to causal processes. However, this is challenged by the observation that age categories are historically unstable.

The properties that age categories are supposed to capture are affected by healthcare and cultural developments, such that people are staying biologically, psychologically, and socially young for longer. Furthermore, the act of classifying people into age categories can bring about changes in their behaviors, which in turn alter the biological, psychological, and social properties that the categories are supposed to capture.

Accordingly, I propose that age categories are best understood as interactive kinds that are influenced in dynamic ways by looping effects. I consider some implications of these looping effects for our classificatory practices concerning age, including how different disciplines may need to review the ways they define and use age categories in their inductive inferences. This paper offers a philosophical analysis of the ontological status of age classification. I consider a homeostatic property cluster account of natural kindhood Boyd, a , which prima facie seems to accommodate many features of age categories.

This view, however, is confounded by the observation that age categories are affected by dynamics that make them historically unstable. This does not necessarily undermine the claim that age properties refer to homeostatic property clusters, but shows that these clusters are, to certain extents, historically and geographically contingent. Nonetheless, there remains a further challenge. Accordingly, I propose that age categories are best understood as interactive kinds that are influenced in dynamic ways by looping effects Hacking, a.

Classification serves a range of useful epistemic and practical purposes. Where categories capture stable similarities within a group and differences between groups, they can be used to support inductive inferences. In turn, these inductive inferences can inform interventions. For example, members of a given species have similar developmental histories and can be expected to require similar diets, samples of a given compound share the same molecular structure and can be expected to react in similar ways to a reagent, and cases of a given infectious disease have similar etiological agents and can be expected to respond to similar treatments.

Philosophers often refer to these theoretically significant and robustly generalizable categories as natural kinds.

Precisely what constitutes natural kindhood is a contested topic and different philosophers have suggested different criteria. The essentialist account suggests that members of a natural kind share the same intrinsic essence, such as samples of water all sharing the molecular structure H 2 O Ellis, The etiological account suggests that members of a natural kind share the same causal history, such as members of the species Canis lupus being descended from a common evolutionary ancestor Millikan, The homeostatic property cluster account suggests that members of a natural kind tend to share a cluster of properties that are contingently connected by causal mechanisms, such as members of the species Canis lupus tending to have long snouts, strong canines, and tails Boyd, a.

However, despite these diverging accounts, philosophers generally agree that members of a natural kind are alike in virtue of certain properties that are generalizable enough to support our epistemic activities. A classification we commonly apply to ourselves and one another in everyday discourse is age. The diverse uses have included, among other things, measuring suicide rates in different age cohorts Suicide Prevention Resource Center, , studying differences in voting patterns between young people and older people Prosser et al.

Elizabeth Lindemann and colleagues suggest the following classification, which uses the National Institute of Child Health and Human Development guideline for the pediatric categories and the United States Census guideline for the adult categories:. Infant and Toddler birth to 24 months of age , Early Childhood 2—5 years , Middle Childhood 6—11 years , and Early Adolescence 12—18 years … Young Adulthood 19—44 years , Middle Adulthood 45—64 years , and Older Adulthood 65 years and older.

Lindemann et al. As we shall later see, these contested boundaries reflect the unstable characteristics of some of the categories and the varying classificatory interests of different disciplines. Historically, the use of chronological age to define age categories was partly motivated by various political and economic interests. With the development of industrialization in the eighteenth century and the establishment of formal education, there was an incentive to structure society in a way that sets out the points of entry and exit from the labor market Neugarten, Governments began to record birth dates accurately and to use chronological age to organize cohorts for schooling, employment, and retirement.

Although some age categories were constructed for political and economic purposes, they are not arbitrary groupings, but are supposed to capture genuine properties of people. These properties roughly correspond to what James Birren and Walter Cunningham call biological age, psychological age, and social age. These three characteristics can come apart and, as we shall see, the ways they relate to chronological age are not straightforward Nathan, Nonetheless, the characteristics do tend to be contingently correlated with one another by means of causal processes.

These, along with other biological characteristics, are suggested to influence capacities such as memory, reasoning, spatial visualization, and processing speed Salthouse, How social age is related to biological age and psychological age is more complicated, because the roles and habits expected at a given age are contingent on the norms and values of the society wherein the person is situated.

Accordingly, the characteristics that are used as indicators of social age are likely to vary across cultures. As such, older adults may be exempted from work and considered eligible for senior social programs, because they are considered to have different physiological capacities and healthcare requirements from young adults. Biological senescence has also been associated with decreasing fecundity and increasing mortality, and so different biological ages tend to be correlated with different social roles with respect to reproduction and childrearing Giaimo, forthcoming.

Biological age, psychological age, and social age are commonly assumed to correlate with chronological age, because the effects of the various factors that occasion the respective physiological, cognitive, and behavioral changes tend to accumulate over chronological time. And so, chronologically defined age categories are used as rough indicators of certain physiological, cognitive, and behavioral properties of people, insofar as biological age, psychological age, and social age are assumed to correlate roughly with chronological age.

In light of the above, age categories do seem to have some features associated with natural kinds. However, they are not natural kinds according to an essentialistic account, as the members of a given age category do not all share an intrinsic essence that is not instantiated by members of other age categories.

Rather, they are closer to what Richard Boyd a calls homeostatic property clusters. A homeostatic property cluster is a set of properties that tend to cluster together due to contingent causal processes called homeostatic causal mechanisms.

These homeostatic causal mechanisms are probabilistic rather than deterministic, such that the presence of one property does not necessitate the presence of another property, but makes it statistically more likely.

Under this account, a category is a natural kind if its members share a sufficient number of properties. Importantly, the members may instantiate different combinations of properties and there is no single property that is essential for membership of the kind.

For example, members of the species Canis lupus tend to have long snouts, strong canines, and tails due to their having similar genetic ancestries and similar developmental environments, but English Bulldogs have short snouts and Pembroke Welsh Corgis lack tails.

Likewise, age categories could be considered to correspond to clusters of biological, psychological, and social characteristics that tend to correlate with one another due to contingent causal processes. Of course, there are significant variations among members of the category and not all members of the category instantiate the same combinations of properties. For example, the markers of biological age have been shown to vary between different people of the same chronological age and also between different cells within the same organism Nathan, It is important to note that not all of the properties in the cluster are intrinsic properties of individuals.

Some properties may obtain due to the stabilizing influences of conditions that are externally located. Based solely on what has been discussed so far, there appears to be little issue with construing age categories as homeostatic property clusters.

These causal processes include the cumulative effects of biological and environmental stressors over chronological time, the constraints that physiological capacities can set on cognitive capacities, and the interactions between these capacities and external influences in the social environment.

However, this view is confounded by the observation that the physiological, cognitive, and behavioral properties that age categories are supposed to capture are affected by dynamics in ways that make them historically unstable.

In the following section, I consider how healthcare and cultural developments are changing the characteristics of people, such that they are staying biologically, psychologically, and socially young for longer. We have seen that chronologically defined age categories serve to classify people into groups based on certain shared characteristics of their respective members.

As with any partitioning of a continuous distribution into categories, the precise boundaries between the categories must be chosen conventionally or at least informed by our values and interests. However, since these chronological boundaries between the age categories were initially established, healthcare and cultural developments have been changing the characteristics of people in ways that are allowing them to stay biologically, psychologically, and socially younger for longer.

Here, I am using the term healthcare broadly to encompass developments in health education, resource distribution, illness prevention, and treatment of disease. Therapeutic interventions and preventative measures to manage blood pressure and cholesterol have also become more widely implemented over the past four decades.

Partly due to these and other developments, average life expectancies have been increasing. In the United Kingdom, the average life expectancies for men and women were respectively 85 and 87 in , whereas they were respectively 77 and 82 in Office for National Statistics, The rates of senescence have also been decreasing.

In a study by Morgan Levine and Eileen Crimmins , people in a sample from to were matched according to their chronological ages with people in a sample from to and their respective physiological characteristics were compared. These were entered into an algorithm to calculate the biological ages of the people, which in turn allowed comparisons of the biological ages of the people from the two different historical periods relative to their chronological ages.

The results indicated that the people in the sample from to had significantly lower biological ages relative to their chronological ages than the people in the sample from to That is to say, the rates of senescence had decreased over the two decades that were studied, such that people are staying biologically younger for longer relative to their chronological ages. Compared to several decades ago, people are continuing their educations for longer, finding partners later, and are having children later.

People are also remaining employed for longer and are retiring later. For example, in the United Kingdom, politicians have advocated a gradual increase in the state pension age from 65 to 70 Salter, And so, the social roles and behavioral capacities expected at various chronological ages are changing in such ways that people are generally staying socially younger for longer. Given the changing characteristics of people across history relative to their chronological ages, there have been calls to revise the chronological age boundaries that define our age categories, in order that these categories can continue to capture the same biological, psychological, and social properties that they had previously captured.

The historical contingency of age classification is further compounded by its geographical contingency. Given that different parts of the world vary with respect to their public health systems, social conditions, and levels of poverty, the rates of senescence also vary across populations. The changing characteristics of people that result from the aforementioned healthcare and cultural developments present a practical challenge to age classification, because they suggest that the properties of people that are being captured by chronological age categories are not stable, but are historically and geographically contingent.

However, I argue that this on its own does not necessarily undermine the view that age categories are homeostatic property clusters. Many other things that we generally consider to be natural kinds are also to varying extents historically and geographically contingent, such as biological species and some disease kinds.

For example, reticulated pythons of the species Malayopython reticulatus exhibit considerable differences with respect to their sizes and appearances across geographical regions, partly due to genetic variations and partly due to the effects of different environmental conditions. The species is generally recognized as the longest species of snake on the world, although only populations on mainland Southeast Asia tend to reach such large sizes, while some of the populations on the islands of Indonesia, Malaysia, and the Philippines tend to be much smaller Auliya et al.

These geographical differences reflect changes in the morphological characteristics of reticulated pythons across history as they diversified into new habitats. Nonetheless, despite these historical and geographical changes, the species Malayopython reticulatus can be considered a homeostatic property cluster, insofar as the members of the species tend to share various biological properties that cluster together due to robust causal processes, such as their similar genetic ancestries and similar developmental histories.

While some of the morphological characteristics associated with the species have changed and diversified, the category still tracks a fairly robust cluster of biological properties. Another example of something that is an inductively useful category yet is to some extent historically contingent is the disease type II diabetes mellitus.

This is plausibly a homeostatic property cluster, as the diagnostic category picks out a cluster of metabolic properties, including insulin resistance and glucose intolerance, which are causally related. However, due to various healthcare and cultural developments, the demographic and clinical characteristics associated with type II diabetes mellitus have been changing. While the disease used to affect predominantly older adults, it is now also diagnosed in young adults, adolescents, and children, due to the increasing rates of obesity in these populations.

Furthermore, the increasing number of cases of type II diabetes mellitus that are related to obesity has changed it from a disease that was largely controllable through lifestyle changes and oral antidiabetic drugs to a disease that often involves more intensive therapies to reduce the risks of comorbidities Brunton, Again, despite these changes in some of the characteristics associated with the disease, it is generally unproblematic to consider type II diabetes mellitus a homeostatic property cluster, insofar as cases of the disease tend to share a cluster of metabolic properties that are causally related.

Just as our descriptions of the demographic groups who can develop type II diabetes mellitus must be revised in order for the diagnostic category to capture the increasing range of people who exhibit the relevant metabolic characteristics, the chronological age boundaries that are used to define age categories must be revised in order for these categories to capture the equivalent clusters of physiological, cognitive, and behavioral properties that the categories had previously captured.

And so, we have seen how healthcare and cultural developments have been altering the characteristics of the members of age categories. Such historical contingency and geographical contingency do not necessarily undermine the claim that age categories are homeostatic property clusters, although they do indicate that the chronological age boundaries that are used to define these categories must continue to be reviewed in light of changing healthcare and cultural contexts.

This is an issue that is recognized by researchers, practitioners, and policy makers, who have been developing proposals to revise these chronological age boundaries accordingly. However, I argue that age categories are affected by a further set of processes that present more trouble for age classification. Hence, the interactions are not unidirectional, but involve bidirectional feedback.

All About Common Skin Disorders

Youth who are transitioning to adulthood need to have well developed self-esteem and self-efficacy skills that equip them to manage relationships in multiple contexts, including education and employment settings, as well as with friends and family members. Their life experiences can create additional problems resulting in mental illness , substance abuse problems , and a lack of confidence. These challenges impact the emotional and social development of foster care youth as they transition into adulthood. Ideally, foster youth should have a place to call home upon emancipation from the child welfare system, with connections to caring adults who can provide support, including helping them access necessary resources and services. Research suggests that youth in foster care who have natural mentors during adolescence have improved young adult outcomes. Youth who had the support of a mentor also demonstrated a decreased participation in unhealthy behaviors, such as unprotected sexual activity, alcohol and substance abuse, and delinquent activities.

Our Promise: Aging Well for All

The Aging Hub supports a nationwide ecosystem for measuring, fostering, and bringing to scale innovations that address social determinants of health. The initiative includes several Hubs that are focused on unique populations, issues, and systems. The Aging Hub supports a nationwide ecosystem for measuring, fostering, and bringing to scale innovations that address the social and behavioral determinants of health for older adults in the community. As leader of the Aging Hub, NCOA is encouraging other national, state, and local partners to participate in this nationwide initiative, so we can achieve systemic change. The rising tide of chronic disease, an aging population, structural inequity in health outcomes despite advances in health care , and new technology all demand a fundamentally different approach to fostering health—one that brings sectors together to address the SBDOH.

Americans are continuing to live longer and healthier lives. As we age, we become more likely to develop different kinds of health problems. These are called geriatric syndromes, which are problems that usually have more than one cause and involve many parts of the body. Doctors called geriatricians—who have advanced training in the care of older adults—and other geriatrics healthcare professionals can play an important role in diagnosing and managing these syndromes. There are many treatments available for these conditions that can help you maintain your independence and quality of life.

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The prevalence of dementia diagnoses among people with schizophrenia at 66 years of age was similar to the prevalence at 88 years of age for the group without serious mental illness. Understanding the magnitude and timing of this increased risk has important implications for practice and policy. The cohort with schizophrenia included adults with at least 12 months of continuous enrollment in fee-for-service Medicare and Part D and at least 2 outpatient claims or at least 1 inpatient claim for schizophrenia during the qualifying years. The comparison group included adults with at least 12 months of continuous enrollment in fee-for-service Medicare and Part D and without a diagnosis of schizophrenia, bipolar disorder, or recurrent major depressive disorder during the qualifying year. Data were analyzed from January 1 to July 31, Incident diagnoses were defined by at least 12 consecutive eligible months without a qualifying code before meeting dementia criteria. At 66 years of age, the prevalence of diagnosed dementia was

A geroscience-informed approach to the increasing prevalence of bladder control problems in older adults requires understanding the impact of aging on dynamic mechanisms that ensure resilience in response to stressors challenging asymptomatic voluntary control over urine storage and voiding.

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