UNIT 1

INTRODUCTION
Gerontology is the study of old age and ageing. Although everyone has an intuitive sense of what
‘old age’ and ‘ageing’ are, providing a watertight objective definition is surprisingly difficult.
Ageing could be said simply to be the process of growing older. However, pedantically speaking,
we are all ageing from the moment of conception: do we really wish to say that children are
‘ageing’? Hence, ageing is more sensibly described as change within old age or change that
affects older people. It can thus include processes that started in earlier life but only manifest
themselves in old age (e.g. a cardiovascular problem that appears in a person's sixties resulting
from a poor lifestyle choice in that person's twenties).
Gerontology is the scientific study of the phenomena of aging, by which is meant the progressive
changes that take place in a cell, a tissue, an organ system, a total organism, or a group of
organisms with the passage of time. Aging is part of the development sequence of the entire life
span, from prenatal growth to senescence. Gerontology, however, is concerned primarily with
the changes that occur between the attainment of maturity and the death of the individual and
with the factors that influence these changes.
The problems of gerontology fall into four major categories:
(1) social and economic problems precipitated by the increasing number of elderly people in the
population,
(2) psychological aspects of aging, which include intellectual performance and personal
adjustment,
(3) physiological bases of aging, along with pathological deviations and disease processes, and
(4) general biological aspects of aging in all animal species.

DEFINITION OF GERONTOLOGY
Gerontology is the study of aging and older adults. It comes from the Greek words geron,
meaning “old man”, and -ology, a suffix meaning “the study of”. Gerontology is a
multidisciplinary field. It involves the scientific study of physical, mental, and social changes
that occur in older people, the investigation of societal changes from an economic, historical, and
philosophical standpoint, and the carrying out of policies and procedures to aid older people with
information from gerontology in mind. Gerontologists in the field of biology study the biological
changes that occur in older individuals. Gerontology is not to be confused with geriatrics, which
specifically refers to the medical care and treatment of older people.
The science of gerontology has evolved as longevity has improved. Researchers in this field are
diverse and are trained in areas such as physiology, social science, psychology, public health,
and policy. A more complete definition of gerontology includes all the following:
Scientific studies of processes associated with the bodily changes from middle age through later
life; Multidisciplinary investigation of societal changes resulting from an aging population and
ranging from the humanities (e.g., history, philosophy, literature) to economics; and Applications
of this knowledge to policies and programs.
DISTINCTIONS AMONG TERMS
Gerontology is multidisciplinary and is concerned with physical, mental, and social aspects and
implications of aging. Geriatrics is a medical specialty focused on care and treatment of older
persons. Although gerontology and geriatrics have differing emphases, they both have the goal
of understanding aging so that people can maximize their functioning and achieve a high quality
of life.

Ageing (“aging” U.S.) vs. senescence Senescence: “The decline of fitness components of an
individual with increasing age, owing to internal deterioration” Michael Rose
Gerontology: The scientific study of the biological, psychological, and sociological phenomena
associated with old age and aging.
Geriatrics: The branch of medicine that deals with the diagnosis and treatment of diseases and
problems specific to the aged.

Sub-fields
Biogerontology: The study of the biology of ageing and longevity Ageing: the basics.
Biogerontology is the special sub-field of gerontology concerned with the biological aging
process, its evolutionary origins, and potential means to intervene in the process. Aim of
biogerontology is to prevent age-related disease by intervening in aging processes or even
eliminate aging.
Social gerontology
Social gerontologists are responsible for educating, researching, and advancing the broader
causes of older people. Several social theories of aging are developed to observe the aging
process of older adults in society as well as how these processes are interpreted by men and
women as they age.
Environmental gerontology
Environmental gerontology is a specialization within gerontology that seeks an understanding
and interventions to optimize the relationship between aging persons and their physical and
social environments.
Jurisprudential gerontology
Jurisprudential gerontology (sometimes referred to as "geriatric jurisprudence") is a
specialization within gerontology that investigates the ways laws and legal structures interact
with the aging experience.

A DEMOGRAPHIC PROFILE OF THE AGED

The elderly population is defined as people aged 65 and over.
An increasing proportion of the population is living beyond 65 years of age. In 1900, only 5% of
the population was older than 65.1 In the year 2030 it is projected that nearly 20% of the
population will be older than 65 (Fig. 1).2 Life expectancy curves for women indicate a
remarkable improvement in life expectancy from 51 years in 1900 to 80 years in the year 2000
(Fig. 2). The curve gives a false impression that only in this century have women begun to
outlive their reproductive function; however, the figures depicting the distribution of the
population in the years 1900 and 1995 illustrate the fact that the low average life expectancy in
1900 was the result of the numerous early deaths in infancy, childhood, and young adulthood
(Figs. 3 and 4).2,3 Because many of these deaths have been eliminated by advances in health
care, a greater proportion of those born now live a long life. Reducing infancy and childhood
deaths has dramatically increased the calculated life expectancy of the U.S. population. This
phenomenon has been referred to as rectangularization of the survival curve.

Fig. 1. The percentage of the population older than 65 has been increasing substantially in the
latter part of the 20th century. The projection for 2030 is 20%.(Data from U.S. Bureau of the
Census: Statistical Abstract of the United States: 1996, p 33. 116th ed. Washington, DC: US
Government Printing Office, 1996, and from Statistical Abstract of the United States: 1997, p 17.
117th ed. Washington, DC: US Government printing Office, 1997.)

Fig. 2. Change in life expectancy for Caucasian women over the century.(Vital Statistics Rates in
the United States 1940-1960, 1968. In Vital Statistics of the United States, pp 2, 309, sect 6.
Washington, DC: US Government Printing Office, 1992.)

Gender Differences In Life Expectancy

Men and women do not have the same life expectancy. In 1994, male life expectancy in the
United States was 72.3 years, and female life expectancy was 79.0 years.4 The gender
discrepancy is even greater between African-American men and women (Table 1). Life
expectancy around the world is greater for women than for men in all but a few Third World
countries. In the United States, the number of men per 100 women older than 65 years of age has
gone from approximately 90 in 1950 to 69 males per 100 women older than 65 in 1995.5 There
are a few more male babies than female babies born each year, and below the age of 14, there are
approximately four more males for every 100 females. That number has been relatively constant
for the past 40 years.6 After age 14, the male death rate is higher than the female death rate,
leading to a marked imbalance between the sexes older than 75 years (Fig. 5). As the elderly
become an enlarging proportion of the population, concerns arise regarding issues such as quality
of life, health status, and the problem of chronic ailments and disabilities. The economic burden
of poor health will be another area of concern for individuals and for society as more people live
long enough to acquire limitations.

Independent Living
One measure of quality of life is the percent of the population able to live independently
compared with the percent requiring a nursing home facility. Over the age of 65, there are
1,065,800 women in nursing homes.7 That figure represents about 5% of the women older than
65. The number rises sharply per decade (Fig. 6). Within the nursing homes, 75% of the residents
require assistance with dressing, 70% cannot walk independently, and more than 50% have a
continence problem with bowel or bladder.8 Incontinence and propensity to fall are major
reasons for placement in a nursing home. These figures regarding impairment do not include the
women receiving assistance in their own home.
Fig. 6. The number of women (in thousands) in care facilities by age group.(National Center for
Health Statistics: Health United States, 1996-97, and Injury Chartbook, p. 223. Hyattsville, MD;
National Center for Health Statistics, 1997.)
Among the noninstitutionalized, limitations of activity are reported in a more generic fashion. In
order of increasing limitations, these are the categories: limited but not in a major activity;
limited in amount or kind of activity; and inability to carry on major activity (i.e. bathing,
dressing, shopping, or eating). The older the population, the greater the percent with limitations.
In 1994, approximately 12% of the noninstitutionalized women older than 75 were not able to
perform major activity, and an additional 34% of that age group were split between the other two
lesser categories of limitation.
The absence of a spouse may contribute to the likelihood of a nursing home admission. In 1985,
most elderly people admitted to a nursing home did not have a spouse. Only 16% of nursing
home residents had a spouse compared with 44% of the functionally impaired elderly still living
in the community.
Data regarding the presence of living children do not support the theory that lack of living
children contributes to nursing home admissions. Most elderly nursing home residents (63%) had
living children. Even among residents older than 85 years, 69% had living children. Functionally
impaired elderly African Americans are more likely to live with children than their Caucasian
counterparts are. Among elderly nursing home residents, only 42% of African Americans had
living children compared with 65% of Caucasians.11 Information regarding confounding factors
is not available. It is unknown whether geographic availability of children, level of skilled care
needed, or financial issues play a role in these data.
About one third of Americans older than 65 who are living in the community are living alone.12
This represents about 8 million people, one half of whom are older than 75. Eighty percent of
those living alone are women, and most are widowed. The longer life expectancy for women,
coupled with the fact that they tend to marry older men, contributes to this imbalance. Many live
in the same place they lived for years. Although 29% of those surveyed had no living children,
most of those with children stayed in touch through weekly or more frequent visits or telephone
calls. Mail was not a commonly used means of communication. Most thought they were doing
well on their own.13
Education And Health
In 1984, the National Health Interview Survey, an annual survey of 42,000 households
conducted by the National Center for Health Statistics, added a special “Supplement on Aging”
to collect additional information on the older segment of the population. Preliminary data from a
sample of 5982 people living in the community reveal that education levels are lower among the
elderly.14 About one half of the people 65 years of age and older had not completed high school.
One third had not gone beyond eighth grade.
Among those older than 85, 48% had not completed eighth grade. These data do not imply that
the less well educated live longer. The opposite is true: better educated people tend to survive
longer. The data reflect the customs of the era when these people were young. Among those
older than 65, 20% were college graduates.15

Income Level And Health

Besides the expected effect of aging on physical limitations, family income also shows some
correlation with limitation of activity. Age-adjusted data reveal any degree of limitation of
activity was found to be 9.2% for families with an income over $50,000. In families in which the
income was less than $14,000 per year, the rate of limitation of activity was as high as 26.4%.16
Income levels also correlate with the number of days spent in short-term hospitalizations. In
1994, persons with an annual family income of $150,000 or more averaged 320 days in the
hospital per 1000 population, compared with persons with a family income less than $14,000,
who averaged 970 days of hospitalization, a threefold difference.17
With the custom of retiring at 65 years of age, most of the elderly are no longer gainfully
employed. It has been questioned whether the elderly will be able to support themselves
adequately for another 20 to 25 years. Statistics do not indicate an increasing level of poverty
among the elderly until age 75. The percent of the population that falls below the poverty level
appears to be relatively constant at about 11% between the ages of 55 and 74. After 75, the
overall percent of the population below poverty level is 13.9%, but the rate is twice as high for
Hispanics (23.2%) and African Americans (29.4%) as it is for Caucasians (12.5%)18

History of Gerontology
People have been fascinated with aging since ancient times. Of course, many ancient cultures,
much like today’s society, were highly interested in slowing the aging process or reversing it.
The earliest known recipe for an anti-aging ointment is from an Egyptian papyrus dating back to
2800-2700 B.C. called “The Book for Transforming an Old Man into a Youth of Twenty”. It
claimed to beautify the skin and remove any disfiguring signs of age. Another ancient papyrus
from 1550 B.C. describes some of the biological changes that can occur with aging, such
as heart pain, deafness, blindness, and what would later be known as cancer.
Gerontology research, and other forms of scientific research, really took off during the 19th
Century, when the use of the compound microscope became widespread. Many scientists at first
began to study bacteria under the microscope in order to study senescence, or aging, but this
proved difficult because bacteria reproduce by dividing themselves into two cells and do not
become senescent in the way that the cells of multicellular organisms do. Multicellular animal
models had to be used instead, and this is one reason why the use of mice became so ubiquitous
in research. With the use of the microscope, scientific knowledge advanced a great deal. For the
first time, researchers could examine the processes of aging at the cellular level, and really begin
to understand the specific changes that take place in the cells of older people. People began to
develop theories about why aging occurs; August Weissman, a German embryologist, proposed
that lifespan was related to an evolutionary selective advantage, and that species with different
body sizes, intelligence, and ecology had different lifespans. The term gerontology was coined in
1903 by Élie Metchnikoff, a Russian zoologist who did immunology research and won the Nobel
Prize in Physiology or Medicine for his work.
In the mid-20th century when the structure of DNA was uncovered, another paradigm shift
occurred in gerontology research. Scientists could now study genetics relating to aging; for
example, they looked at unique mutations in abnormally long-lived or short-lived fruit flies.
Other ways of extending an organism’s lifespan were also found, like putting mice on calorie-
restricted diets or putting fruit flies in very small cages so that they couldn’t fly as much. Further
progress was made when age-related decline in certain hormones, like growth hormone, thyroid
hormone, and estrogen, was discovered. More recently, genome sequencing has been used to
identify genes associated with aging.