Ageing in Society Chapter 1

• The proportion of older people (+60) has increased in all countries
• Old age is generally seen as a 'social problem'
• The change first occurred in developed countries an is due to lowered birth rates and improved life expectancy
• Child mortality has reduced which has lead to people having fewer children
• It is estimated that over 1 in 5 old people over 85's have dementia, and that more than 3 in 5 have a limiting longstanding illness.
• Women have greater longevity than men with a gender ratio of 100 to 123 in 65 to 74 year olds, and 100 to 289 in over 85 year olds.
• Women are also more likely to live alone or in institutions because of this factor, and also because women tend to marry older men. Men are also more likely to remarry than women, following widowhood or divorce.
• There is little research into aging minority groups
• 65 is the standard age of retirement for men, and 60 for women.
• The classification is an issue, and there are questions over what should be used to identify it. Some say it should be retirement age, while others believe that physical fitness or events such as becoming a grandparent
• There is much variability in the association between disability or frailty and chronological age
• Planning and prediction of the impact of current trends and behaviours is important as it has many implications for areas such as health, social care, education and more.
• Age distribution is becoming more rectangular
• Family size has decreased. In Victorian times there were as many as 8 children born to each family.
• Family structure has also changed, as people no longer live in the same place as they grew up, and often live more than 6 miles away from their older relatives
• Women working has restricted their previous roles as caregivers for the elderly
• Divorce has increased the complexity of family relationships in families
• Community care and peer relationships have become more important
• Stone (1977) believes that the decrease in respect for the elderly is partially due to the increase in egalitarianism and individualism.
• Fisher claimed that the attitudes towards the elderly, has gone from veneration, to contempt, and now pity.
• It could also be argued that the elderly are often a group who are marginalised and undervalued, in times of hardship.
• It could be considered that old age is a very lonely stage of life and is often associated with depression. This problem is increased by the fact the change in family structure, whereby younger members of the family do not live as close to elderly relatives as they used to. Isolation is also maintained by the tradition by many english women of continuing to maintain their own household, despite widowism and loneliness.
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Week 1, Lecture 2: Demography

What is Ageing?

• Very complicated
• Austad - Why we Age
• Bond And Coleman - Ageing in society ch1
• the study of aging really matters to everything in society, the economy etc.

Essential ingredients in aging

• survival,
• change: biological, psychological, social
• Probability of death

Pub Glass Death

• There is a linear relationship between time and 'death' of pub glasses as there is equal chance them dying at any point
• In wild populations, early and late age stages are more likely to have high risk of death compared to those who are middle age
• Pressure of mortality
• Protected populations: we do most of our dying at the end of our lives. rectangularised pattern.

Important Terms

• Life expectancy: how much life can be expected of an individual from a certain age. Usually referred to from borth
• Life Span: the life potential, defined from birth

Survival and aging

• Biological ageing is characterised by an increasing liklihood of death with increasing age.
• The Gompertz Function: in any given population mortality rates increase with age in a 'geometric' progression. He was really smart and worked in the insurance industry. He said that mortality rates double every 'x' years. He looked at life tables which list when people die. He made a exponential function
• Mortality Doubling Rate: there is a period after a certain age when the likelihood of dying doubles. This happens approximately every 7-8 years, and starts at about 11 years of age.
• This is a very biological way of looking at aging but not a way that people will assiciate their own aging processes

How and why patterns of survival are changing.

• Can look at dying curves over time
• In ancient times, there was a much more linear curve. In later years however there is a large bulge that occurs.
• Life Expectance has increased generally except for in times of great disease

L/E L/S

Greece 110BC 35 100

Rome 753 BC 32 100

England 1276 48 100

England 1385 38 100

USA 1950 70 100

• 65 is a key age
• the proportion of people over age 65 has increased significantly
• the proportion of increase in the oldest people within the older population are increasing the most.

Population Aging

• A demographic transition
• The median age of the population is increasing
• Transition from a young society to an aging society. It is occuring in all developed countries in the world
• This increases the interest in the study of aging both scientifically and politically.

Why are societies aging?

• Better healthcare: less disease...wrongg
• We naturally think aging is something that happens to old people.
• Three things influence why the change is taking place

1. mortality is changing
2. fertility is changing: average age will increase if this decreases
3. migration: if there is an out migration of young people, the mean age will increase

• plumbing- substantially increased survival rates
• Healthcare and public health, for both older people and babies. When babies stopped dying, people started having fewer babies,
• Women always live longer
• It is not what happens to elderly people that influences aging of population. It is the production of babies.
• life expectation for babies has increased massively
• 'Replacement Level' - approx 2.1 babies/woman is the amount of babies required to maintain the population
• Current fertility level - 1.74
• Baby boom/postwar period - 1961 ish
• Low fertility levels have implications for the economy

Demographic Transition

• main problem is reduced fertility
• followed by substantially reduced mortality
• and laterally improved healthcare
• this will result in an even more rectangular curve.

what about everybody dying from heart disease, diabetes etc....

Lecture 1

What is the point?

• when does aging start?
• how do you know what is due to ageing, and what is due to disease?

Coursework

• Critical review of a research paper
• there is a practice attempt. Read the other paper before the tutorials in week 4 and discuss with others

Critical Appraisal

• this about which terms you use to search for. eg. aging in us, ageing in uk. Some papers might not
• look at review papers and look at their references. These are very good for getting an overview of the area
• be aware that some websites may be sponsored by drug companies and may be biased
• Look at methods section - how was it done?
• Is this a good study?
• there is no perfect study as things must be compromised because of feasibility
• need to consider strengths as well
• Is the backgound adequately described? -who is it targeted at?
• is there a good rationale?
• is it relevant to the study?
• is the aim clearly stated?
• is the aim testable?

Experimental designs

• Survey: obtains descriptive data about a population
• cross sectional study: can tell you about differences between groups. Cannot determine causation however.
• cohort/longitudinal study: looking at same group of people over time
• intervention study: identifies the effects of an intervention. Compared a placebo group with a

Methods

• Is recruitment appropriate to obtain a representative sample
• has the sample size been justified?
• are the methods appropriate for what is being tested?
• is what is being tested the key measure that should be taken?
• are there better measures or factors available?
• are the measurements valid and reliable?
• are statistics being used described?
• are they appropriate?
• has a control group been used? is it appropriate?

Results

• is the sample described?
• are the necessary results presented to address the aims?
• have the results been presented clearly?
• has statistical significance been assessed using appropriate tests?
• could there be any confounding effects? eg. weight gain in bone study
• do graphs show error bars
• look at whether people have been selective in their presentation of results
• dont assume what is described in aims about who they study wants to look at
• who is included, who is excluded?
• what was their average age?

Discussion

• are the findings clearly summarised?
• does not go through every little detail
• should make some conclusions
• are those conclusions justified?
• are they considered in context of previous knowledge?
• have they ignored any findings? is there any important factors that have been ignores
• have they acknowledged any limitations?

Conclusion

• which are the key issues that impact of a research paper