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Seventh Edition
Susan Krauss Whitbourne, Ph.D.
University of Massachusetts Boston
Stacey B. Whitbourne, Ph.D.
VA Boston Healthcare System
Veronica Visentin
Glenn Wilson
Jannil Perez
Judy Howarth
Lisa Wojcik
Nichole Urban
Nicole Repasky
Vinolia Benedict Fernando
Courtesy of Susan K. Whitbourne & Stacey B. Whitbourne
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ISBN: 978-1-119-60787-8 (PBK)
ISBN: 978-1-119-60939-1 (EVALC)
Library of Congress Cataloging-in-Publication Data
Names: Whitbourne, Susan Krauss, author. | Whitbourne, Stacey B., author.
Title: Adult development and aging : biopsychosocial perspectives / Susan
Krauss Whitbourne, e, Ph.D., University of Massachusetts Boston, Stacey
B. Whitbourne, Ph.D., VA Boston Healthcare System.
Other titles: Adult development & aging
Description: Seventh Edition. | Hoboken : Wiley, 2020. | Revised edition of
the authors’ Adult development & aging, [2017] | Includes
bibliographical references and index.
Identifiers: LCCN 2020004059 (print) | LCCN 2020004060 (ebook) | ISBN
9781119607878 (paperback) | ISBN 9781119609438 (adobe pdf) | ISBN
9781119609377 (epub)
Subjects: LCSH: Gerontology. | Older people—Psychology. | Older
people—Health and hygiene. | Older people—Social conditions.
Classification: LCC HQ1061 .W48 2020 (print) | LCC HQ1061 (ebook) | DDC
LC record available at https://lccn.loc.gov/2020004059
LC ebook record available at https://lccn.loc.gov/2020004060
The inside back cover will contain printing identification and country of origin if omitted from this page. In addition, if the ISBN
on the back cover differs from the ISBN on this page, the one on the back cover is correct.
the scholarly field of aging as an undergraduate when she
decided to write a paper on personality and adaptation
in a developmental psychology course. At the same time,
her father’s professional activities had a profound influence
and made the choice of gerontology (the scientific study of
aging) a natural one.
It is our hope and belief that you will find yourself
as engrossed in the psychology of adult development and
aging as we are. Not only is everyone around you aging
but also the issues that researchers in field examine range
all the way from the philosophical to the practical. Why do
living things age? Is there a way to slow down the aging
process? How will society deal with the aging of the Baby
Boomers? How will job markets be affected by an aging
society? Will the young adults of today age differently
than did their parents and grandparents? Bringing it to a
personal level, as you take the course, you’ll start to ask
questions about your own life. What challenges await you
as you begin your career? What will it be like to start a
family? How will you manage the transition into your early
adulthood as you leave college behind to pursue your own
life? All of these, and more, are questions that you will find
yourself asking as you explore the many complexities of the
process that causes people to change and grow throughout
life. You will learn not only how people grow older but
also how to grow older in a way that is healthy and
veryone ages. This very fact should be
enough to draw you into the subject matter
of this course, whether you are the student
or the instructor. Yet, for many people, it
is difficult to imagine the future in 50, 40,
or even 10 years from now. The goal of our
book is to help you imagine your future and the future
of your family, your friends, and your society. We have
brought together the latest scientific findings about aging
with a more personal approach to encourage you to take
this imaginative journey into your future.
The seventh edition of Adult Development and Aging:
Biopsychosocial Perspectives incorporates material that we
believe is vital to your understanding of this rapidly developing and fascinating field of study. Much of what you
will read comes directly from Susan’s classroom teaching of the psychology of aging course at the University
of Massachusetts Boston. She continues to incorporate her
day-to-day teaching of the course into the text, which keeps
the material current, fresh, and engaging. At the same time,
her active involvement in research on the psychology of
adult development and aging gives her the ability to sift
through the available findings and pull out those that are
central to an understanding of individuals as they change
from the years of early adulthood through late life.
Stacey was inspired to pursue the field of aging after taking her mother’s course at the University of Massachusetts
Amherst. She continued her graduate work in social and
developmental psychology, focusing on cognitive functioning in later adulthood. Stacey is the program director for
a major national initiative that is building a health and
genomic database for future studies of military veterans.
Having also taught adult development and aging at Brandeis
University and the University of Massachusetts Boston, she
is also attuned to student needs and interests.
We are proud to say that Stacey is the third generation
of her family to be involved in the field of gerontology.
Theodore C. Krauss, M.D., Susan’s father, was an innovator in geriatric medicine. Susan became interested in
The biopsychosocial model emphasized in our text is
intended to encourage you to think about the multiple
interactions among the domains of biology, psychology,
and sociology. According to this model, changes in one
area of life have effects on changes in other areas. The
centerpiece of this model is identity, your self-definition.
You interpret the experiences you have through the framework provided by your identity. In turn, your experiences
stimulate you to change your self-definition.
This is an exciting time to be studying adult development and aging. The topic is gaining increasing media
attention and tremendous momentum as an academic
discipline within life span development. The biopsychosocial model fits within the framework of contemporary
approaches taking hold in the sciences in general that
emphasize the impact of social context on individuals
throughout all periods of life. Entirely new concepts, sets
of data, and practical applications of these models are
resulting in a realization of the dreams of many of the
classic developmental psychologists whose work shaped
the field in the early 20th century.
Adult development and aging are areas that have no
national boundaries. Aging is now being recognized as
a priority for researchers and policy makers around the
world, not only in the United States and Canada. We can
all benefit from this international perspective both for our
own countries and for those of citizens around the world.
If you read the chapters of this book in order from start to
finish, you will progress from the basics in the first three
chapters to more complex issues, starting in Chapter 4, that
place relatively more emphasis on the ‘‘bio,’’ the ‘‘psycho,’’
and the ‘‘social.’’ However, not all instructors choose to
proceed in this fashion, and we have designed the book
with this flexibility as an option. We emphasize the biopsychosocial model throughout, in that many of the topics,
regardless of where they appear in the book, span areas as
diverse, for example, as driving and diabetes.
We do recommend, though, that the last chapter you
read is not the one on death and dying, as is often the case in
other books in the field. Our last chapter covers successful
aging. Many students and instructors have shared with us
their appreciation of our ending on a ‘‘high note.’’ Even
though death is obviously the final period of life, we each
have the potential to live on after our own ending through
the works we create, the legacies we leave behind, and the
people whose lives we have touched. These are the themes
that we would like you to take with you from this book in
the years and decades ahead.
Up-to-Date Research The topics and features in this text
are intended to involve you in the field of aging from a
scholarly and personal perspective. You will find that the
most current research is presented throughout the text,
with careful and detailed explanations of the studies that
highlight the most important scholarly advances. We have
given particular attention to new topics and approaches,
including neuroscience and genetics, as well as continuing
to bring to students the latest advances in cognition, personality, relationships, and vocational development as well
as highlighting sociocultural influences on development,
including race, ethnicity, and social class.
AgeFeed The chapters begin with our very own ‘‘AgeFeed’’ openers to give you an introduction to the topic.
These are in the form of fact versus myth challenges,
self-tests, or lists relevant to each chapter that take one
of several formats. For AgeFeed openers that involve a
challenge or self-test, the answers are provided for you so
that you can score yourself. Your instructor may decide to
assign these to tests, so be sure to read them over carefully.
We hope you like them!
Engaging Figures and Tables All of the figures and photographs in this seventh edition were redesigned from
the previous editions with updated information and formats. These will help you learn and remember the key
information presented in the text. Our selection of these
materials connects to the PowerPoint slides that instructors
can download from the Wiley website.
Contemporary Approach With coauthors literally one
generation apart, it’s been our goal to find the balance
between the ‘‘professor’’ and the ‘‘student’’ perspectives.
As a result, you will find many current examples relevant
to people in your age group, whether you’re a returning
student or a student of traditional college age. Instructors,
too, will find material that they can relate to their own
experiences, whether they are relative newcomers or more
seasoned academics.
Glossary Terms We have made a concerted effort in
this edition to provide a large number of glossary terms,
indicated in bold in each chapter, and listed at the end
of the book. Although it may seem like you will have a
great many terms to memorize, the fact of the matter is
that you will need to learn them anyway, and by having
them provided in your glossary, you’ll find it easier to
spot them when it comes time to review for your exams.
Susan finds that her students like to study from flashcards
that they make up, and if you find this a useful study
tool, the glossary terms will make that process much
more straightforward. The majority of these terms relate
specifically to adult development and aging, but where we
felt it was helpful for you to review a term that you may
not have encountered for a while, we also included several
terms of a more general nature.
Numbered Summaries You will find a numbered summary for each chapter that will supplement your studying
and help you narrow down your reviewing to the chapter’s
main points. Together with the glossary terms, these will
give you a comprehensive overview, though they will help
you the most if you actually read the chapters themselves.
The first edition of Adult Development and Aging: Biopsychosocial Perspectives was intended to provide a fresh and
engaging approach to the field of the psychology of adult
development and aging by focusing on three themes: a
multidisciplinary approach, positive images of aging, and
the newest and most relevant research. We continue this
tradition in the seventh edition because we want you, our
readers, to feel as connected to the material as possible.
Our thinking is that students will be more motivated to
complete their reading if they like the text and feel that
they can relate to it. At the same time, instructors will
find their job that much easier because students sitting in
their classrooms will come to class ready to discuss what
they’ve read.
Instructors who have developed their course based on
earlier editions will not need to change the basic structure
of their lectures and assignments. However, to reflect this
ever-changing field, we shifted material within the chapters,
in some cases deleting topics that by now are no longer
considered relevant in order to make room to cover the
newer approaches that have come into prominence within
the past 3 years.
Although many of the classics remain, we have included
over 500 references from the past 3 years, up through
mid-2019. In virtually all cases where we reference population data, we rely on sources from 2018 and 2019.
We also give expanded coverage to global population and
health data in keeping with our stated goal of providing an
international perspective.
In the sixth edition, we revamped much of the topical organization to be consistent with new developments
in theory and research. In the present edition, we have
trimmed some areas that had become outdated even further in order to be able to cover the emerging literature.
Additionally, to make the new material consistent with
the illustrations, we have provided narratives that will
allow readers to understand the main points of each of the
revamped figures. These changes came about, in part, as a
result of feedback from students in Susan’s undergraduate
course in gerontology.
Several trends in the literature that are reflected in
the seventh edition include greater appreciation of the
role of social context as an influence on development
such as income inequity, variations according to such
areas of diversity as race, ethnicity, and sexual orientation.
We also expand our treatment of international variations
and include considerable material from the World Health
Organization’s focus on ‘‘Active and Healthy Ageing.’’ All
references prior to 2015 have been checked to determine
whether newer information is available. Where sections of
the text covered topics that have diminished in importance
in the field, these have been condensed or eliminated. As
a result, although the text’s structure remains consistent,
there are new areas of emphasis reflecting the growth of
the field.
Our goal is to provide the latest findings while preserving information of relevance to the ‘‘classic’’ studies in the
field. Students will therefore have the best of all worlds,
with the opportunity to learn about cherished traditions in
adult development and aging but also to learn where this
exciting field is headed in the coming decades.
Supplements Wiley is pleased to offer an online resource
containing a wealth of teaching and learning materials at
Website Links References in this edition show the websites that students and instructors can consult to gather
updated information on changes in the field.
Instructor’s Manual The content in the Instructor’s Manual reflects the 45 years of experience that Susan has in
teaching this course. You will find chapter outlines, key
terms, learning objectives, and lecture suggestions. We
have updated our suggestions for videos, taking advantage
of the new resources available through YouTube, and also
provide instructors with resources for films, music, and
PowerPoint Slides Prepared for use in lectures, we provide you with a complete set of PowerPoint slides tested
in Susan’s class and designed specifically for this book.
Instructors can easily adapt them for their own specific
Test Bank Instructors have access to a complete downloadable test bank that includes 50 questions in each
chapter that follow the order in which concepts are presented in the text. Each multiple-choice question is labeled
according to the concept it tests, along with its difficulty
level (based on class testing). We include short answer and
essay questions that correspond with each section of the
chapter. Because they are in convenient Microsoft Word
format, instructors can adapt them to their own particular
Our first set of acknowledgments goes to our families. Husbands Richard O’Brien and Erik Gleason have graciously
provided important support that allowed us to spend the
many hours we needed over the period of a year to revise
the book. Jennifer O’Brien, daughter and sister, is a wonderful sounding board for our ideas; as she continues her
career in clinical psychology, we look forward to continued
‘‘collaboration’’ with her. We would also like to thank the
newest members of our family—namely Theodore James
Gleason, age 8 at the time of this writing, and Scarlett Beth
Gleason, who has just turned 6. Susan is thrilled to be a
grandmother, experiencing the joys of this special status
on a first-hand basis.
Throughout the writing of this book, students in the
Mental Health and Aging class at the University of Massachusetts Boston have provided valuable insights and
observations. As we were revising the book and preparing
the lectures, students continued to provide us with fresh
perspectives. Their good humor, patience, and willingness
to experiment with some new ideas have made it possible
to add the all-important student viewpoint to the finished
product. We also appreciate the contributions of Susan’s
graduate teaching assistants, who serve as sounding boards
in her preparation and review of lecture content.
Our final thanks go to the reviewers over the years
who provided helpful comments. Their insightful observations and thoughtful proposals for changes helped us
tighten and focus the manuscript and enhance the discussion of several key areas of interest in the field.
Thank you to Alex Bishop (Oklahoma State University),
Sue Burdett-Robinson (Hardin-Simmons University), Alvin
House (Illinois State University), Gary Montgomery (The
University of Texas-Pan American), and Nancy Partika
(Triton College). We have also benefited from informal
reviews provided by our colleagues who use the book
in their teaching. We greatly appreciate their helpful
In conclusion, we hope that we have given you something to look forward to as you venture into the fascinating
field of adult development and aging and that the subsequent pages of this book will fulfill these expectations. We
aim to present a comprehensive but clear picture of the
area and hope that you will be able to apply this knowledge
to improve your own life and the lives of the older adults
with whom you may be preparing to work. We hope you
will come away from the course with a positive feeling
about what you can do to ‘‘age better’’ and with a positive
feeling about the potentialities of later life. And maybe,
just maybe, as has happened on many past occasions with
people who read this book and take our courses, you will
decide to pursue this field and we can welcome you as
colleagues in the coming years.
Finally, we would like to comment on the process of
working together as a mother–daughter team. The first
author was pregnant with the second author when she
embarked on her first textbook in the field, the precursor
to the present volume. Little did she know that the child
she was about to have would become a psychologist, much
less a specialist in aging. Indeed, because Susan recently
relocated to Boston, where Stacey and her family live, we
have had more opportunities to talk about this revision
in depth, including some lively debates about several of
the topics. The AgeFeeds reflect Stacey’s desire to engage
readers with the type of material that students encounter
in their own informal Web searches and daily online news
updates. We greatly enjoy writing this book and are proud
and happy to be able to share our perspectives with you,
the reader.
Susan Krauss Whitbourne, Ph.D.
Stacey B. Whitbourne, Ph.D.
January 2020
Susan Krauss Whitbourne, Ph.D., is a Professor Emerita
of Psychological and Brain Sciences at the University of
Massachusetts Amherst and Adjunct Professor and Faculty
Fellow in Gerontology at the University of Massachusetts
Boston. She received her Ph.D. in developmental psychology from Columbia University in 1974 and completed
a postdoctoral training program in clinical psychology at
the University of Massachusetts at Amherst, having joined
the faculty there in 1984. Her previous positions were
as associate professor of education and psychology at the
University of Rochester (1975–1984) and assistant professor of psychology at SUNY College at Geneseo. Formerly
the Psychology Departmental honors coordinator at the
University of Massachusetts Amherst, she was also director
of the Office of National Scholarship Advisement where
she advised students who apply for the Rhodes, Marshall,
Fulbright, Truman, and Goldwater Scholarships, among
others. In addition, she was faculty advisor to the University of Massachusetts Chapter of Psi Chi, a position for
which she was recognized as the Eastern Regional Outstanding Advisor for the year 2001 and as the Florence
Denmark National Faculty Advisor in 2002. She served as
eastern region vice president of Psi Chi in 2006–07 and as
chair of the program committee for the National Leadership Conference in 2009. Her teaching has been recognized
with the College Outstanding Teacher Award in 1995 and
the University Distinguished Teaching Award in 2001. Her
work as an advisor was recognized with the Outstanding
Academic Advisor Award in 2006. In 2003, she received
the American Psychological Association (APA) Division 20
(Adult Development and Aging) Master Mentor Award and
the Gerontological Society of America (GSA) Behavioral
and Social Sciences Distinguished Mentorship Award.
Over the past 20 years, Dr. Whitbourne has held a
variety of elected and appointed positions in APA Division
20 including president (1995–96), treasurer (1986–89),
secretary (1981–84), program chair (1997–98), education
committee chair (1979–80), Student Awards Committee
chair (1993–94), Continuing Education Committee chair
(1981–82), and Elections Committee chair (1992–93). She
has chaired the Fellowship Committee and serves as the
Division 20 representative to the APA Council (2000–06
and 2009–14, and 2017–present). She is a fellow of Divisions 1 (General Psychology), 2 (Teaching of Psychology), 9
(Society for the Study of Social Issues), 12 (Clinical Psychology), 20, and 35 (Society for the Psychology of Women).
She served on the APA Committee on Structure and Function of Council, chaired the Policy and Planning Board in
2007, served on the APA Membership Board, served on
the Board of Educational Affairs, chaired Women’s Caucus
and Coalition of Scientists and Applied Researchers in Psychology, and is now on the Board of Educational Affairs.
In 2011, her contributions were recognized with an APA
Presidential Citation.
Dr. Whitbourne is also a fellow of the American
Psychological Society and was President of the Eastern Psychological Association (2017–18). She is the Chair of the
Behavioral and Social Sciences Section of the Gerontological Society of America. She is past president of the Council
of Professional Geropsychology Training Programs. Having
received her Diplomate in Geropsychology in 2015, she
currently serves as the Treasurer for the ABGERO board of
the American Board of Professional Psychology. A founding
member of the Society for the Study of Human Development, she was its president from 2005 to 2007. She is also a
founding member of the Society for the Study of Emerging
Adulthood. She also served on the Board of Directors of the
National Association of Fellowship Advisors. In her home
of Amherst, Massachusetts, she served on the Council on
Aging (2004–07) and was the president of the Friends of
the Amherst Senior Center (2007–09).
Her publications include 19 published books, many
in multiple editions, and more than 175 journal articles
and chapters, including articles in Psychology and Aging, Psychotherapy, Developmental Psychology, Journal of Gerontology,
Journal of Personality and Social Psychology, and Teaching of
Psychology, and chapters in the Handbook of the Psychology of Aging, Clinical Geropsychology, Comprehensive Clinical
Psychology (Geropsychology), the Encyclopedia of Psychology,
and the International Encyclopedia of the Social and Behavioral
Sciences. She has been a consulting editor for Psychology
and Aging, serves on the editorial board of the Journal of
Gerontology, and was a consulting editor for Developmental
Psychology. She is editor-in-chief of the Wiley-Blackwell
Encyclopedia of Aging. Her presentations at professional
conferences number over 250 and include several invited
addresses, among them the APA G. Stanley Hall Lecture
in 1995, the EPA Psi Chi Distinguished Lecture in 2001,
and the SEPA Invited Lecture in 2002. In addition to her
professional writing, she writes a blog for Psychology Today
called ‘‘Fulfillment at Any Age’’ and has consulted for publications of the National Geographic Society in psychology
and serves on the Prevention.com health review board.
Stacey B. Whitbourne, Ph.D., received her Ph.D.
in social and developmental psychology from Brandeis
University in 2005 where she was funded by a National
Institute on Aging training fellowship. She completed her
postdoctoral fellowship at the Boston University School of
Public Health, Department of Epidemiology, funded by a
National Institute on Aging Grant and a Department of
Veterans Affairs Rehabilitation Research and Development
Service Grant. Currently, she is a research health scientist
at the Massachusetts Veterans Epidemiology and Research
Information Center (MAVERIC), a research center housed
within the VA Boston Healthcare System. She serves as
the Program Director of Recruitment and Enrollment for
the Million Veteran Program, a longitudinal health and
genomic cohort funded by the Department of Veteran’s
Affairs Office of Research and Development. In addition,
she is an instructor of medicine at Harvard Medical School
and an associate epidemiologist at the Division of Aging
at Brigham and Women’s Hospital. The author of several
published articles, she is also a coauthor on a chapter for
the Sage Series on Aging in America. She is a member
of the American Psychological Association Division 20 and
the Gerontological Society of America. A member of the
Membership Committee of Division 20, she has also given
more than 30 presentations at national conferences. As an
undergraduate, she received the Psi Chi National Student
Research Award. In graduate school, she was awarded the
Verna Regan Teaching Award and an APA Student Travel
Award. She has received numerous commendations and
awards for her work with the Million Veteran Program from
the Department of Veterans Affairs. She has taught courses
on adult development and aging at Brandeis University and
the University of Massachusetts Boston.
The Baby Boomers Grow Up: Changes in the
Middle-Aged and Older Populations in the United
States and the World 16
Preface v
Themes and Issues in Adult
Development and Aging
United States 17
Aging Around the World 18
Summary 20
The Biopsychosocial Perspective 3
Four Principles of Adult Development and
Aging 4
Models of Development: Nature and
Nurture in Adulthood
Principle 1: Changes Are Continuous Over the Life
Span 4
Principle 2: Only the Survivors Grow Old 5
Principle 3: Individuality Matters 6
Principle 4: ‘‘Normal’’ Aging Is Different From
Disease 7
Models of Individual–Environment
Interactions 23
Reciprocity in Development 25
Sociocultural Models of Development 26
The Meaning of Age 8
Ecological Perspective 26
The Life Course Perspective 27
Ageism as a Social Factor in the Aging Process 29
Using Age to Define ‘‘Adult’’ 9
Divisions by Age of the Over-65 Population 10
Functional Age 10
Personal Versus Social Aging 12
Psychological Models of Development in
Adulthood 31
Key Social Factors in Adult Development and
Aging 14
Erikson’s Psychosocial Theory 31
Piaget’s Cognitive-Developmental Theory 34
Identity Process Theory 35
The Selective Compensation with Optimization
Model 38
Sex and Gender 14
Race 14
Ethnicity 14
Socioeconomic Status 15
Religion 16
Biological Approaches to Aging in Adulthood 39
Genes and DNA 39
Body Build 72
Programmed Aging Theories 41
Random Error Theories 43
Mobility 74
Summary 46
Muscles 74
Bones 75
Joints 76
The Study of Adult Development and
Aging: Research Methods
Vital Bodily Functions 77
Variables in Developmental Research 49
Descriptive (Single-Factor) Research Designs 49
Bodily Control Systems 81
Age, Cohort, and Time of Measurement 50
Longitudinal Designs 50
Cross-Sectional Designs 54
Endocrine System 81
Immune System 85
Nervous System 86
Sequential Research Designs 56
Central Nervous System 86
Sleep 88
Temperature Control 89
The Most Efficient Design 56
Correlational Designs 57
Simple Correlational Designs 59
Multivariate Correlational Designs 59
Sensation and Perception 89
Vision 89
Hearing 91
Balance 93
Smell and Taste 94
Somatosensory System 94
Types of Research Methods 61
Laboratory Studies 61
Qualitative Studies 61
Archival Research 61
Surveys 62
Epidemiological Studies 62
Case Reports 62
Focus Groups 63
Daily Diaries 63
Observational Methods 63
Meta-Analysis 63
Summary 95
Health and Prevention
Key Concepts in Health and Prevention 98
Measurement Issues in Adult Development and
Aging 64
Diseases of the Cardiovascular System 98
Cardiac and Cerebrovascular Conditions 99
Incidence 100
Behavioral Risk Factors 100
Prevention of Heart Disease and Stroke 102
Ethical Issues in Research 65
Summary 66
Cancer 102
Physical Changes
Appearance 69
Skin 69
Hair 71
Cardiovascular System 77
Respiratory System 79
Urinary System 79
Digestive System 81
Risk Factors and Prevention 103
Treatments 105
Disorders of the Musculoskeletal System 106
Osteoarthritis 106
Osteoporosis 107
Diabetes 108
Everyday Problem-Solving 145
Characteristics of Diabetes 108
Incidence and Risk Factors 108
Prevention and Treatment 109
Characteristics of Problem-Solving 146
Problem-Solving in Adulthood 146
Adult Learners 149
Respiratory Diseases 109
Intelligence 151
Theoretical Perspectives on Adult Intelligence 151
Research on Adult Intelligence 152
Training Studies 155
Neurocognitive Disorders 110
Alzheimer’s Disease 110
Other Forms of Neurocognitive Disorder 115
The Psychology of Wisdom 156
Summary 117
Summary 157
Basic Cognitive Functions: Information
Processing, Attention, and Memory
Processing Speed and Attention 119
Ego Psychology 161
Vaillant’s Theory of Defense Mechanisms 165
Adult Attachment Theory 167
Driving and Aging 124
Trait Approaches 168
Research on Aging and the Five-Factor Model 168
Health and Personality Traits 170
Memory 126
Working Memory 126
Effects of Aging on Long-Term Memory in
Adulthood 127
Psychosocial Influences on Memory 130
Memory and Health-Related Behaviors 131
Memory Training Studies 133
Social Cognitive Approaches 171
Cognitive Perspective 172
Possible Selves Theory 172
Coping and Control 173
Identity Process Theory 174
Summary 134
Midlife Crisis Theories and Findings 175
Theory of the Midlife Crisis 175
Critiques and Research on the Midlife Crisis 176
Executive Functioning and Its Measurement 138
Intelligence Tests 138
Neuropsychological Assessment 139
Aging and Executive Functioning 141
Language 142
Cognitive Aspects of Language 142
Social Aspects of Language 143
Bilingualism and Aging 145
Psychodynamic Perspective 161
Reaction Time 119
Attention 120
Video Games and Attention 122
Higher-Order Cognitive Functions
Summary 178
Marriage and Intimate Relationships 181
Marriage 181
Cohabitation 182
Same-Sex Couples 184
Divorce and Remarriage 184
Widowhood 186
Psychological Perspectives on Long-Term
Relationships 186
Mental Health Issues and Treatment
Psychological Disorders in Adulthood 226
Families 189
Major Depressive Disorder 227
Bipolar Disorder 228
Anxiety Disorders 228
Obsessive-Compulsive and Related Disorders 229
Trauma and Stress-Related Disorders 229
Schizophrenia and Other Psychotic Disorders 230
Substance-Related Disorders 231
Personality Disorders 232
Parenthood 189
The Empty Nest 191
Parent–Adult Child Relationships 193
Siblings 196
Grandparents 196
Friendships 198
Theoretical Perspectives 198
Patterns of Friendships 198
Elder Abuse 235
Summary 199
Suicide 236
Treatment Issues in Mental Health Care 237
Work, Retirement, and Leisure Patterns
Work Patterns in Adulthood 203
Vocational Development 205
Holland’s Vocational Development Theory 206
Super’s Life-Span Life-Stage Theory 207
Occupation as Calling 209
Variations in Vocational Development 209
Vocational Satisfaction 210
Intrinsic and Extrinsic Factors 210
Positive and Negative Moods 211
Person–Environment Correspondence 213
Work Stress 213
Relationships Between Work and Family Roles 214
Age and Vocational Satisfaction 215
Age and Vocational Performance 216
Retirement 217
Definitions of Retirement 217
Facts About Retirement 218
The Effects of Retirement on the Individual 220
Leisure Pursuits in Later Adulthood 222
Summary 223
Assessment 237
Treatment 238
Serious Mental Illness 241
Summary 241
Long-Term Care
Institutional Facilities for Long-Term Care 244
Nursing Homes 245
Residential Care Facilities 246
Community-Based Facilities and Services 247
Home Health Services 248
Day Treatment Services 249
Community Housing Alternatives 249
The Financing of Long-Term Care 249
Medicare 250
Medicaid 252
Legislative Landmarks in the Long-Term Care of
Older Adults 254
1987 Nursing Home Reform Act (NHRA) 254
1998 Nursing Home Initiative 255
2002 National Nursing Home Quality Initiative 255
2008 (to Present) CMS Five-Star Quality
Ratings 255
The Quality of Long-Term Care 256
Bereavement 275
Summary 278
Psychological Issues in Long-Term Care 258
Successful Aging
Suggestions for Improving Long-Term Care 259
Summary 261
What is Successful Aging? 281
An Overview of Successful Aging 281
Successful Cognitive Aging 282
Factors That Promote Successful Aging 283
Death and Dying
What Do We Know About Death? 264
Medical Aspects of Death 264
Death by the Numbers 265
Sociocultural Perspectives on Death and
Dying 270
Psychological Perspectives on Death and
Dying 271
Issues in End-of-Life Care 272
Advance Directives 272
Physician-Assisted Suicide and Euthanasia 274
Hospice Care 274
Improving Health Care and Mental Health Services
to Dying Patients 275
Creativity and Aging 287
What Is Creativity? 287
Creative Older Adults 288
Characteristics of Last Works 289
Biopsychosocial Perspectives on Creativity and
Aging 291
Successful Aging: Final Perspectives 293
Summary 293
Glossary G-1
References R-1
Author Index I-1
Subject Index I-16
Themes and Issues in Adult
Development and Aging
At the beginning of each chapter, we invite you to check out ‘‘Age Feed’’ to see top 10 lists, take
quizzes, or learn fun facts about the chapter ahead.
To get started, as you will learn in Chapter 1, there are many myths about aging. See if you’re able
to separate fact from fiction in these statements and check your answers on the next page.
1. All older adults are alike.
2. Most older adults live in nursing homes.
AGEFEED 3. Loss of interest in sex and intimacy is a normal part of aging.
4. Most older adults stay socially active.
5. Alzheimer’s disease is an inevitable part of aging.
6. Older adults are unable to learn new skills.
7. Memory loss is a normal as people grow older.
8. People become more pessimistic in later life.
9. Creativity peaks early in adulthood and declines after that.
10. As people get older, they need more assistance in daily life.
1. All older adults are alike.
Myth! The range of ages among older adults spans 5 decades; they
differ more than any other age group.
AGEFEED 2. Most older adults live in nursing homes.
…the facts
Myth! Only about 5% of older adults in the United States are in
nursing homes although this rises to 13% for those 85+.
3. Loss of interest in sex and intimacy is a normal part of aging.
Myth! Although the frequency of sexual activity may decrease,
most older adults continue to enjoy a fulfilling sex life.
4. Most older adults stay socially active.
Fact! Many older adults continue working, volunteer, and are part
of a family social network.
5. Alzheimer’s disease is an inevitable part of aging.
Myth! Alzheimer’s disease and other forms of cognitive loss occur
in a minority of older adults.
6. Older adults are unable to learn new skills.
Myth! Learning new skills may take longer, but the ability to learn
continues throughout later life.
7. Memory loss is a normal as people grow older.
Fact and myth! Short-term memory may be less efficient, but
long-term memory is maintained in later life.
8. People become more pessimistic in later life.
Myth! Older adults are more likely to feel satisfied with their lives
and to be optimistic about getting older.
9. Creativity peaks early in adulthood and declines after that.
Myth! There are many examples of famous creative older adults
but even ordinary individuals can be creative throughout their lives.
10. As people get older, they need more assistance in daily life.
Fact! The need for assistance increases in later adulthood, but only
reaches as high as 53% for women aged 85 and older.
The Biopsychosocial Perspective
initiate behaviors that can maintain, if not enhance, your
everyday functioning. A key goal we have in writing this
book is to involve you in the progression of your aging
process and show you ways to be an active part of your
own development.
We organize the book around the biopsychosocial perspective, a view of development as a complex interaction of
biological, psychological, and social processes. Aging is not
a simple, straightforward progression through time. Your
body undergoes biological changes largely influenced by
your genetics or physiology. At the same time, you change
psychologically in ways that reflect what’s happening to
your body that, in turn, affect your body’s changes. All of
this takes place in a social context. Holding biology and
psychology constant, people age differently depending on
where and when they live, whom they interact with, and
what resources they have available to them.
Figure 1.1 captures this complex biopsychosocial interaction. Biological processes refer to how the body’s functions and structures change throughout the aging process.
We cover these changes in the chapters on normal aging
and health. Psychological processes include the individual’s thoughts, feelings, and behaviors related to growing
older. We examine these changes in the chapters on
Social context
The Biopsychosocial Model
Aging affects everyone. Your aging process began the
moment you were born. If you are of traditional college age, you’re undergoing a time of transition that lasts
from adolescence to adulthood. The concept of being an
adult may be new to you, and the idea of being an older
adult may seem far off. Our purpose in writing this book
is to help you think about your own aging as well as the
aging process more generally. You may have decided to
take this course to help you understand your aging family
members or trends in society and before long, we hope
that you also think about what will happen to you as you
yourself get older.
Let’s start by asking you what comes to mind when
you think of your current age. Is it an important part of
who you are or do you not think about your actual age?
Next, ask yourself whether you consider yourself to be
an adult. What does the word adult mean to you? Is it a
term you would use to describe others who are older than
you are now? Finally, what are your thoughts about the
aging process? When you think of older adults, do you
immediately regard them as unable to care for themselves?
What is the ‘‘typical’’ older adult like, in your eyes?
Just by thinking about these questions, you’ve already
started to focus on what age means in terms of your overall
sense of self. These are the types of questions that we’ll
explore throughout the book. Even as we discuss in-depth
the effects of the aging process throughout adulthood, we
will often come back and question how much we really
know about a person based on age alone. We’ll also show
you that some age distinctions are almost arbitrary. Someone decided that a certain age means you’re in a certain
stage of life; from that point forward, people attribute a
great deal of meaning to that particular number. In reality,
however, the aging process isn’t completely linked to the
passage of time alone.
Our goal is to encourage you to take personal explorations as you gain factual information about the aging
process. Not only will the material help you in your career
regardless of what field you go into, but it will also help
you understand yourself and how you change over time.
You’ll also learn, perhaps surprisingly, that you don’t have
to sit back and let the aging process passively affect you.
There are active steps you can be taking now to make sure
that you keep functioning as well as possible for as long
as possible throughout your entire life. With a few simple
precautions, you can avoid the illnesses that limit people’s
ability to enjoy themselves into their later decades.
If you’re a traditional college-age student heading into
your 20s, we hope to help you appreciate that it is never
too early to start incorporating these changes into your
lifestyle. And for our readers of nontraditional college
age, we hope to help you see that it’s never too late to
According to the biopsychosocial perspective, adult development and
aging are understood as involving biological, psychological, and
sociocultural influences.
Themes and Issues in Adult Development and Aging
cognition, personality, and emotions. The social processes
of aging reflect the cultural, historical, and interpersonal
influences on the individual. We cover these in chapters
about relationships, family, work, and institutionalization.
In Chapter 2, we will explore how life-span development
theories grapple with explaining how these complex processes all interrelate. You’ll find that there’s a great deal
more to aging than you probably imagined when you first
started reading this chapter.
As you can see from the biopsychosocial model, we
intend to go beyond ‘‘psychology’’ in teaching you about the
processes involved in adult development and aging. In fact,
gerontology, the scientific study of the aging process, is an
interdisciplinary field. People who devote their professional
lives to the study of gerontology come from many different
academic and applied areas—biology, medicine, nursing,
sociology, history, and even the arts and literature. It’s
almost impossible to be a gerontologist without applying
this integrative view to your work. Knowledge, theories,
and perspectives from all disciplines contribute importantly
to the study of the individual over time. Gerontology is
distinct from geriatrics, which is the medical specialty
in aging.
To help put it all together for you as you develop
throughout adulthood, we will pay special attention to the
concept of identity. Identity is defined as a composite of
how people view themselves in the biological, psychological, and social domains of life. The interaction of these
domains forms an overall view of the ‘‘self.’’
We begin our study of adult development and aging by
sharing a set of four principles that form the foundation
of our biopsychosocial approach (see Figure 1.2). As you
read the book, you’ll find that we return frequently to these
principles, which we highlight when they appear in the
chapter. If you begin to understand them now, you will
find the course material much easier to master.
Principle 1: Changes Are Continuous
Over the Life Span
First and foremost, changes over the life span happen in a
continuous fashion. According to the continuity principle,
the changes that people experience in later adulthood build
on the experiences they had in their earlier years. This
means we can never isolate the later years of life without
considering the years preceding them. Since time moves
The Four Principles of Adult Development and Aging
Changes are
continuous over
the life span
Only the
survivors grow
Normal aging is
different from
in a forward direction, the changes throughout life build
upon themselves in a cumulative fashion. If you were hard
on your body as a young adult, chances are the changes
you’ll undergo when you’re older will be more negative
than if you took good care of yourself.
The continuity principle also applies to the way that
people think about their own identities. You know that
you’re the same person you always were, despite getting
older. Birthdays don’t transform you into a different person.
You don’t look the same to others, but you feel essentially
the ‘‘same’’ on the inside.
When others look at you, however, they don’t necessarily share this perspective. People don’t meet you for the
first time and think about what you were like when you
were younger—they see you as you are now. Unless they
are close relatives or friends, they have no way of knowing
what you were like when you were in your childhood or
teenage years. Anyone meeting you now judges you on the
basis of your current appearance because he or she has no
other data from which to draw.
Similarly, when you look at a middle-aged or older
adult, it’s unlikely that you judge that person on the basis
of how he or she may have been in the past. You see an
older woman, perhaps walking with a little difficulty, and
don’t stop to think that she might have been a marathon
runner in her youth. However, that very same older woman
knows that she is the ‘‘same’’ person she’s always been.
True, she can no longer compete for a marathon, but this
accomplishment is part of her identity. She knows her
physical abilities have changed, but to herself she’s still the
Jane, Barbara, or Mary she has been her entire life.
There’s an important implication of the continuity
principle for anyone working with older adults. You need
to remember that they would prefer to be treated as the
people they always were, rather than as ‘‘old people.’’ As
we’ll see later, older adults are often stereotyped as weak
and infirm, when in reality, they want to be viewed as
individuals who possess strengths they have built up over
Gerd Altmann/Pixabay
Four Principles of Adult Development and Aging
The principle of continuity is illustrated here, showing that an individual may feel the same inside even though their outer appearance
their entire lives. They don’t want to be stereotyped on
the basis of the way they look to the world right now.
Some nursing home administrators, eager to remind their
employees of this fact, display pictures of the residents from
their younger years on the nameplates outside their doors.
The residents and their visitors think of them in this way,
and it’s helpful if those who work with them are reminded
of this fact as well.
Principle 2: Only the Survivors Grow Old
The survivor principle states that the people who live to
old age are the ones who managed to outlive the many
threats that could have caused their deaths at earlier ages.
Perhaps this is obvious because clearly, to grow old, you
have to not die. However, the survivor principle is a bit
more complex than that. Contrary to the Billy Joel song
‘‘Only the Good Die Young,’’ it’s not the good who die
young, but the ones who fall victim to the forces that cause
people to lose their lives. Some of these are random, to be
sure, such as being killed by someone else in an accident,
by an act of war, or in a natural disaster. However, many
other factors that lead some to survive into old age are
nonrandom. Survivors not only manage to avoid random
causes of their own fatalities but also are more likely to take
care of their health, not engage in risky behaviors (such
as driving too fast or getting involved in crime), or using
drugs and alcohol excessively.
The survivor principle exemplifies the biopsychosocial
perspective. The very fact that survivors avoid death until
late in life suggests that they may have inherited good
genes or at least managed to maintain their physical abilities
(biological factors), are cognitively and emotionally healthy
(psychological factors), and have surrounded themselves
with a good support system (social factors). Furthermore,
these factors build on each other. People with stronger
cognitive skills are more likely to attend college which, in
turn, provides them with greater economic resources that
can sustain their health and well-being. A combination of
mental and physical health and adequate resources, plus a
dose of good luck, allow them to be with us today.
Figure 1.3 illustrates the survivor principle. Across the
years of adulthood, the population of people born around
the same time thins out so that, by the later years, only the
hardiest are still alive. Gerontologists must take the survivor
principle into account when interpreting the results of
their research because it is quite likely that survivors are
not like the people born at the same time as they were.
They may have been born with greater resilience, but they
also likely took care to maintain their health and preserve
their longevity. There are so many ways to lose one’s life
as you get older, from such causes as terminal illness or
accidents, that to become an older adult, you have to
possess some incredibly special characteristics.
The survivor principle also impacts the way we understand research on aging. Clearly, all older adults who
participate in research are survivors of the conditions that
others did not endure. As time goes by, more and more
of the older population will die. When they reach age
90 or 100, they most likely represent a different population than their now-deceased age mates. The older they
get, the more select they become in such key characteristics as physical functioning, health, intelligence, and even
personality (Baird et al., 2010).
Consequently, when we examine differences between
younger and older people, we must keep in mind that older
people alive today were a special group when they were
young. The younger adults have not yet been subjected to
the same conditions that could threaten their lives. Some
of them will die before they reach old age. Knowing who
will be the survivors is almost impossible to predict, of
course, meaning we may be comparing highly select older
adults with a wider range of younger adults. Therefore,
we cannot conclude that age ‘‘caused’’ the older adults
to have the characteristics they have now because they
might always have been a special subset of their own
age group.
To help illustrate this principle, consider data on the
psychological characteristic of cautiousness. One of the
tried and true findings in the psychology of adult development and aging contends that older people are less likely to
take risks than are younger people. Similarly, older adults
are less likely to engage in criminal behavior. It’s possible
that as people age they are better able to avoid behaving
in ways that could bring them harm or get them arrested.
Alternatively, it’s possible that they did not change at all
and are the only ones left standing from their generation.
The people more likely to make risky decisions early on
Themes and Issues in Adult Development and Aging
Expected Survival of Birth
Cohort Born in 2020
18 years
35 years
55 years
70 years
85 years
100 years
110 years
in life died at younger ages or were imprisoned. Certainly,
those who made poor health decisions would be less likely
to have survived into old age.
As a result of the survivor principle, you need to remind
yourself continually throughout this book that the older
adults we study may have become less risky, more honest,
or better able to take care of their health. On the other
hand, they may not have changed at all—only survived
long enough for us to study them.
Principle 3: Individuality Matters
A long-held myth regarding development is that as people
age, they all become alike. This view is refuted by the
principle of individuality, which asserts that as people
age, they become more different from each other. This
divergence occurs in people’s physical functioning, psychological performance, relationships, interest in work,
economic security, and personality.
In one often-cited study, still considered relevant,
researchers examined a large number of studies of aging
to compare the divergence among older versus younger
adults on measures of the same characteristics (Nelson &
Dannefer, 1992). Research continues to underscore the
notion that individuals continue to become less alike from
each other with age. Such findings suggest that diversity
becomes an increasingly prominent theme during the adult
This figure shows the expected number
of people to survive to each age based
on calculations for all those born in
2020. As you can see, those who
survive to the age of 85 and older
represent an increasingly select group
of the population.
years, a point we will continue to focus on throughout
this book.
The idea of increasing divergence among older adult
populations does not mean that everyone starts out at
exactly the same point when they’re young. There are
always going to be differences within any sample of people
in almost any characteristic you can name. The issue is that
as people get older, these differences become magnified.
The top-performing person in a sample of young adults
may be 10 points higher than the next highest performer.
By the time, this person reaches his or her 70s or 80s,
these differences may grow by a factor of two, three, or
more. In part, this is a statistical fluke. As you’ll learn in
Chapter 3, it’s difficult to find a sample of older adults
who are as close in age as are the young adults researchers
tend to study (who are often within 2 or 3 years of each
other). If age is related to performance, then the odds are
that the older group will differ simply because they differ
more in age.
However, the increasing variation among older adults
isn’t just a statistical artifact. Even if you had a sample
of older adults who were exactly the same age, it’s likely
that they would differ more among themselves than they
would have when they were younger because they’ve lived
through more experiences affecting everything from their
health to their psychological well-being. Those experiences
have cumulative effects, causing them to change at different
rates and to differing degrees.
Four Principles of Adult Development and Aging
Inter- and Intraindividual Differences in Development
Individual age 55
outperforms both
age 35-year-olds
differences in
Individual 1 (age 35)
Individual 2 (age 35)
tor ledge
H ow
Individual 3 (age 55)
These illustrative data from a theoretical study on cognition show how people of the same age show different levels of performance on different
tasks (intraindividual variability) but also that on particular tasks, such as vocabulary, older individuals can perform better than younger
individuals (interindividual variability).
Consider what’s happened to you and the people you
grew up with by this point in your life. You have made the
decision to go to college, while others in your age group
may have enlisted in military service. You may meet your
future spouse in college, while your best friend remains
on the dating scene for years. Upon graduation, some
may choose to pursue graduate studies as others enter
the workforce. You may or may not choose to start a
family, or perhaps have already begun the process. With
the passage of time, your differing experiences build upon
each other to help mold the person you become. The
many possibilities that can stem from the choices you
make help illustrate that the permutations of events in
people’s lives are virtually endless. Personal histories move
in increasingly idiosyncratic directions with each passing
day, year, and decade of life.
There are actually two types of differences that come
into play when we talk about individuality. Interindividual
differences are differences between people. Intraindividual differences refer to the variations in performance
within the same individual. In other words, not all systems develop at the same rate within the person. Some
functions may increase over time, others decrease, and
others stay the same. Even within a construct such as
intelligence, an individual may show gains in one area,
losses in another, and stability in yet another domain.
Intraindividual differences illustrate the fact that development can proceed in multiple directions within the
same person (Baltes & Graf, 1996), a concept known as
Figure 1.4 illustrates interindividual and intraindividual differences by showing scores of two 35-year-old
individuals and one 55-year-old individual on four psychological tests. These illustrative data from a theoretical
study on cognition show how people of the same age show
different levels of performance on different tasks (intraindividual variability) but also that on particular tasks, such
as vocabulary, older individuals can perform better than
younger individuals (interindividual variability).
Principle 4: “Normal” Aging Is Different
From Disease
The principle that normal aging is different from disease
means that growing older doesn’t necessarily mean growing
sicker. It is important for both practical and scientific
reasons to distinguish between normal aging and disease.
Health care specialists who work with middle-age and
older adults need to recognize and treat the onset of a
disease rather than dismiss it simply as ‘‘getting older.’’
For example, an 80-year-old man exhibiting symptoms of
depression can be successfully treated, assuming that the
clinician does not write his symptoms off as a feature of
normal aging. Personality development in adulthood does
not inevitably lead to the depressive symptoms of lowered
self-esteem, excessive guilt, changes in appetite, or lack of
Themes and Issues in Adult Development and Aging
interest in activities. Older adults may experience some
moderation in personality qualities such as becoming a
bit less judgmental in relation to others. However, the
development of psychological disorders for the first time in
later life is not typical. Clinicians who mistakenly think that
these symptoms are part of the normal aging process won’t
take the proper course of treatment that could alleviate the
depressed person’s suffering.
Gerontologists translate the principle that normal aging
is different from disease into terms that distinguish these
processes. Primary aging (or normal aging) refers to the
normal changes over time that occur due to universal,
intrinsic, and progressive alterations in the body’s systems.
Changes over time leading to impairment due to disease
rather than normal aging are referred to as secondary or
impaired aging. These changes are not due to universal,
intrinsic processes but are a function of an abnormal set of
changes afflicting a segment rather than the entirety of the
older population (Aldwin & Gilmer, 1999). Skin wrinkling
and discoloration represent primary aging but skin cancer
represents secondary aging.
The third type of aging process sets in toward the
very end of life, when individuals experience a rapid loss
of functions across multiple areas of functioning. This
precipitous decline is called tertiary aging (Gerstorf et al.,
2013). Representing the impact of disease on perhaps
already compromised areas of functioning, tertiary aging
deserves mention in its own right as distinct from primary
or even secondary aging.
Primary, secondary, and tertiary aging refer to processes that, over time, accumulate, and in the absence of
accident or injury, cause the individual’s death. Gerontologists believe that despite changes in the body that lead to
loss, aging can also involve gains. The term optimal aging
refers to age-related changes that improve the individual’s
functioning. Changes due to optimal aging may reflect the
preventative or compensatory measures that adults take
to counter the toll that aging would normally take on their
physical and psychological functioning. However, some
individuals do not even make special efforts to alter their
own aging, but for reasons not always entirely clear, seem
to age at a slower rate than their peers. They may be the
ones who never seem to get sick right until the very end
of their lives, when a sudden illness leads to their death.
Throughout life, age-related losses due to primary, secondary, and tertiary aging occur contemporaneously, as
we show in Figure 1.5. Thus, even while optimal aging
can slow the deleterious changes of primary and secondary
aging, eventually tertiary aging takes over and the individual’s life comes to an end. Remember that, according to the
principles of intraindividual and interindividual variability, the rates of each type of aging vary within individuals
and from person to person.
The study of aging implies that age is the major variable
of interest. However, the scientific study of aging faces a
challenge in that age carries with it a number of problems
as that major variable of interest. To be sure, there is
value in categorizing individuals in later life based on
their age. At the same time, attaching a numerical value
to people on the basis of their date of birth carries with
it a certain arbitrariness. Chronological age is a number
based on measures of the Earth’s movement around the
An example of optimal aging is Charles Eugster, shown here on the far left. Beginning
his fitness program when he was 85 years
old, he broke world records for masters athletes, winning more than 100 fitness awards
prior to his death at age 97.
The Meaning of Age
Primary aging
Optimal aging
Normal age-related
Changes that improve
the individual’s
Age-Related Losses and Gains
Secondary aging
Tertiary aging
Rapid decline shortly
before death
sun; however, we don’t know how much the changes in
the physical universe relate to what goes on inside the body
in any kind of precise fashion.
Consider what happens when people’s ages change at a
major birthday such as reaching the age of 40. The crossing
from an age that ends in 9 to an age that ends in 0 may
lead people to engage in self-scrutiny just because we’ve
all been socialized to believe that 40 means something
important. This belief is reinforced by birthday cards that
invoke the ‘‘over the hill’’ metaphor. In truth, your body
does not change in discrete fits and starts when you pass a
particular birthday.
The body does keep time in a cycle that approximates
a 24-hour period, but there is no evidence at the moment
to suggest that this time pacemaker is related to aging.
To say that chronological age (or time) ‘‘means’’ anything
with regard to the status of the body’s functioning is,
based on current evidence, questionable. The popularity
of such phrases as ‘‘30 being the new 20’’ and ‘‘60 the
new 50’’ capture the difficulty of defining people’s aging
processes based solely on a number. Chronological age
does have some value in describing a person, but like other
descriptive features of a person, such as gender or eye
color, it is the social meaning attached to chronological
age that often outweighs any intrinsic usefulness. As we
have already discussed, people of the same age can vary
substantially from one another, and people of different ages
can be more similar to each other than their differing age
might lead you to expect.
Using Age to Define “Adult”
Now that we have you thinking about the meaning of age,
we will move on to the next challenge—the meaning of the
word ‘‘adult.’’ Earlier, we asked you to decide whether you
consider yourself an adult. When you think of that word,
Normal aging is also referred to as primary aging,
which is different from secondary aging related to
disease and tertiary aging, which includes the rapid loss
of function before death. There are also gains associated
with aging referred to as ‘‘optimal aging’’ in which
people become better with age in certain functions.
perhaps the synonym of ‘‘mature’’ comes to mind. This, in
turn, may conjure up images of a person reaching a certain
level of accomplishment or growth. Consider, for example,
the term ‘‘mature’’ in reference to an apple. A mature apple
is one that is ready to be eaten, and you can judge that by
examining the apple’s color, size, and texture. An apple’s
maturity level is relatively easy to measure compared to
judging the maturity of humans. The complexity of the
biopsychosocial processes that occur within us are far
more difficult to quantify.
You might think that the most logical definition of
maturity should be based on physical development. Yet,
you also know that girls and boys who have passed through
puberty in their teenage years would, in contemporary
Western society, be regarded as anything but an adult.
Although their physical attributes define them as adults,
the psychological and social standards would not.
Perhaps a standard based on ability is a better option.
Consider 16 years, the age when most people can legally
drive. Or, alternatively, consider age 18, when U.S. society
ordains the person with the right to vote. Using the age of
21 presents another possible point of entry into adulthood.
Because it is the age when American adults can legally drink
alcohol, for many, the turning of 21 represents a defining
mark of the beginning of adulthood. However, the United
States is in a small minority of nations that set the drinking
age at 21. Some Canadian provinces set the drinking age at
19 (though it is 18 in most); countries such as Germany,
Barbados, and Portugal set it at 16. These conflicting age
demarcations for even such a seemingly concrete behavior
as drinking alcohol show that deciding when a person is
an adult on this basis has very limited utility.
Parenthetically, the variations in the legal drinking
age shown from country to country (and even within a
country) illustrate the interaction of biological and sociocultural factors in setting age-based parameters around
Themes and Issues in Adult Development and Aging
human behavior. People in Canada who are 18 years old
are, on average, not all that physiologically distinct from
18-year-olds who live in the U.S. For that matter, they are
probably not even psychologically different. It’s the culture
that distinguishes whether they’re able to drink alcohol
without getting arrested.
If you’re like many students, the age of 25 may hold
special importance for you. This is the age where, in the
United States, you can rent a car without having to pay a
tremendous surcharge. This age has no inherent meaning,
but it is used by car rental companies because the chances
of having an auto accident are lower after the age of 25. It’s
possible that a switch is flicked on a person’s 25th birthday
so that the unsafe driver now has become a model of good
behavior on the road. However, the odds are statistically
higher that people under age 25 are more likely to engage
in the risky combination of drinking and driving, which is
what leads to the higher insurance premiums.
Another set of criteria related to the age of adulthood
pertains to when people can marry without the consent of
their parents. There again, we find huge variation. Within
the United States alone, the age of consent varies from state
to state from 16 to 18 years of age, though the age at which
individuals can legally consent to sex may be younger. In
South Carolina, for example, 14-year-old girls are considered old enough to consent to having sex with partners who
are 18 or older. Moreover, the age when people actually
marry reflects factors such as the health of the economy; in
bad economic times, the median age of marriage goes well
above the age of consent. During these times, people in
their 20s (or older) may find they’re forced to move back
in with their parents because they aren’t earning sufficient
income to rent or buy their own place. Does that mean that
people become less ‘‘adult’’ when the economy lags?
Given these contradictory definitions of ‘‘adult,’’ it
might be wise to recommend that we set the threshold
into adulthood based on the individual’s having reached
the chronological age associated with the expectations and
privileges of a given society or subculture. For example,
in the United States, individuals may be considered to
have reached adulthood at the age when they are eligible
to vote, drink, drive, and get married. For the majority
of U.S. states, the age of 21 is therefore considered the
threshold to adulthood. In other countries, these criteria
may be reached at the age of 18. Regardless of the varying
definitions, up to as many as the first 10 or 11 years of
adulthood represent the period of emerging adulthood,
or the transition prior to assuming the full responsibilities
associated with adulthood, normally the years 18 to 29
(Arnett, 2000). Here again, however, there is a debate
about whether age can provide a useful definition even of
this relatively narrow period of life (Côté, 2014).
Divisions by Age of the Over-65
Traditionally, 65 years of age has been viewed as the entry
point for ‘‘old age.’’ The origins of this age of retirement
can be traced to Germany when, in 1889, the German
Chancellor Otto von Bismarck proposed an old-age social
insurance program. Although the original age in Germany
was 70 years, it became changed in 1916 to age 65, and
now this is the age traditionally associated with ‘‘old age.’’
Gerontologists recognized long ago that not only was
65 an arbitrary number for defining old age, but that it also
resulted in people being placed into too broad of a category
when defined as older adults. All other things being equal,
a 65-year-old faces very different issues than someone who
is 85 or 90. There are certainly 65-year-olds in very poor
health and 95-year-olds who have no serious ailments.
But because, on average, 65-year-olds are so different than
those who are 20 or more years older, we use a convention
to break the 65-and-older category into subgroups.
The subgroups most frequently used in gerontology
are young-old (ages 65 to 74); old-old (ages 75 to 84);
and oldest-old (ages 85 and older). We shouldn’t place
too much credence on numbers, as we’ve already said, but
these are good approximations for roughly categorizing the
65-and-older population. Bernice Neugarten, one of the
early pioneers in psychological gerontology, proposed these
distinctions in the mid-1970s, and they have remained in
use to this day even though 85 may be the ‘‘new’’ 65
with the oldest-old being in better health than they were
50 years ago (Neugarten, 1974).
With more and more people living to the oldest-old
category as defined in this manner, gerontologists are reexamining the divisions of the 65+ age group. Specifically,
people over the age of 100, known as centenarians, are
becoming more and more commonly represented in the
population, as we will show later in the chapter. It will
not be long before the very highest age category becomes
more prominent—the supercentenarians, who are 110
and older. Typically, the oldest person in the world at any
given time is between the ages of 114 and 116. Jeanne
Louise Calment, the oldest documented living human, was
122 at the time of her death. Supercentenarian will probably retain its definition as 110 and over, though, at least
for the foreseeable future.
Functional Age
Discontented with the entire concept of chronological age,
a number of gerontologists are devising a new classification
system that is based not on what the calendar says but
on functional age, which is how people actually perform
The Meaning of Age
Measures of Functional Age
Cardiovascular functioning
Respiratory (lung) functioning
Muscle and bone strength
Cellular aging
Reaction time
Learning ability
Social age
Work roles
Family status
Position in the community
Functional age measures use scores on given indicators to represent age rather than chronological age.
(see Figure 1.6). With functional instead of chronological
age as the basis for a system of studying aging, we could gain
a better grasp of a person’s true characteristics and abilities.
When we talk about research methods in Chapter 3,
we’ll see further advantages to using measures other than
chronological age to study the aging process.
Biological age is the age of an individual’s bodily
systems. Using biological age instead of chronological age
would tell us exactly how well people are able to perform
such vital functions as the heart’s pumping blood through
the arteries and getting oxygen to the lungs. With biological
age, you could also help people learn how best to improve
their muscle and bone strength.
In order to be able to use biological age as an index,
we would need a large repository of data showing what’s
to be expected for each major biological function at each
age. For example, we’d need to know the population
values for blood pressure readings in people with different chronological ages. Then, we would assign people a
‘‘blood pressure age’’ according to which chronological
age of healthy people their numbers most closely match.
A 50-year-old whose blood pressure was in the range of
normal 25- to 30-year-olds would then have a biological age that was 20 or 25 years younger than his or her
chronological age.
Popular culture has certainly caught on to the notion
of biological rather than chronological age. There are a
multitude of online calculators in which you answer various
questions to estimate how long you will live. In addition,
there are slightly more sophisticated ‘‘biological age tests’’
that let you calculate your ‘‘lung age,’’ for example.
Another, far more sophisticated approach, involves
measuring cellular aging. When exposed to harmful environmental conditions, the body’s cells undergo important
changes affecting their ability to function normally. By
indexing these changes, researchers can develop a scale
that assesses biological functioning at this very basic level
(Hannum et al., 2013).
Psychological age refers to the performance an individual achieves on measures of such qualities as reaction
time, memory, learning ability, and intelligence (all of
which are known to change with age). Like biological age,
a person’s performance on these tasks would be compared
with those of other adults and then scaled accordingly.
Social age is calculated by evaluating where people
are compared to the ‘‘typical’’ ages expected for people
to be when they occupy certain positions in life. These
positions tend to center on family and work roles. For
example, a grandparent would have an older social age
than would a parent, although the grandparent might
easily be chronologically younger than the parent.
Social age can have some interesting twists. For
example, people can be grandparents in their late 20s
(with a social age of 60 or older). Conversely, women
can become mothers in their late 60s. Perhaps you
have a friend whose grandmother is 93 and another
whose grandmother is 57. We see the same issue with
regard to work roles. A 70-year-old who is still working
has a younger social age than a 66-year-old who has
retired. Athletes and politicians present a similar contrast.
A gymnast may be forced to give up her sport at 18 years of
age and thus have an older social age than a still-employed
legislator who continues to win elections into her 70s
or beyond.
As we stated earlier, an advantage of using functional
indices of aging is that they can be more accurate than
chronological age. However, it’s much easier to use chronological age than these sophisticated calculations. Adding
to the problem is the fact that, functional ages must be
constantly calibrated and recalibrated to ensure that they
continue to be accurate. For example, a biological index
based in part on blood pressure may require adjustments
Themes and Issues in Adult Development and Aging
as health practitioners change the definition of what is
considered ‘‘normal.’’ Changes in both medical knowledge
and population norms for particular age groups may mean
that the definition of normal blood pressure for an average
60-year-old shifts to be more typical of a person in the 70s.
Psychological age and social age indices are also likely to
change over time.
Despite its faults, chronological age may be the most
expedient index for many areas of functioning. Just keep
in mind that it does not tell the whole story.
Personal Versus Social Aging
The aging process occurs within the individual, but as
you have learned already, it is shaped by events occurring
in the individual’s social context. When developmental
psychologists study the aging process, it is difficult to
disentangle those internal changes from those that reflect
a changing world, though we try to do so by applying the
appropriate controls in our research.
Personal aging refers to changes that occur within the
individual and reflect the influence of time’s passage on
the body’s structures and functions. This is how people
ordinarily think of the aging process and, indeed, it is what
is implied in primary, secondary, and tertiary aging.
Social aging refers to the effects of a person’s exposure to a changing environment. Over time, the changes
we see within the individual represent the unique blend
of personal and social aging as these play out in that
individual’s life.
Within the category of social aging, the changes that
take place in an individual’s life are seen as reflecting
a multitude of interacting factors. At any one time, the
individual’s life reflects one or more of three basic categories
of three social influences. These influences, identified by
psychologist Paul Baltes (1979) and still seen as relevant
today, include normative age-graded influences, normative
history-graded influences, and nonnormative influences.
We’ll look at each of these in turn.
Normative age-graded influences lead people to
choose experiences that their culture and historical period
attach to certain ages or points in the life span. The
term ‘‘normative’’ stems from the term ‘‘norm,’’ which
is a social expectation for behavior. In Western society,
age norms traditionally dictate that individuals graduate
from college in their early 20s, get married and begin
a family in their 20s or 30s, retire in their 60s, and
become grandparents in their middle to later years, usually
in the decades of the 50s, 60s, and beyond. These are
influences on behavior to the extent that people believe
that they should structure their lives according to these
age demarcations.
Events that occur in response to normative age-graded
influences occur in part because a given society has
developed expectations about what is assumed appropriate
for people of certain ages. The decision to retire at the age
of 65 years can be seen as a response to the norm more
true perhaps in the past than today, that 65 is the correct
age to leave the labor market. Graduation from high school
generally occurs at the age of 18 years for most because
in most industrialized societies, children start school at the
age of 5 or 6 and the educational system is based on 12 or
13 grades.
Normative age-graded influences exert their impact
beyond what the norms themselves imply because people
are socialized into believing that they should structure their
lives so that they conform to these influences. When people
don’t adhere to these norms, for whatever reasons, they
feel that there is something wrong with them. For example,
a 40-year-old office worker may consider retiring but feel
reluctant to do so because it is not what is expected for a
person of that age in that field of employment. Similarly,
a 35-year-old may prefer not to marry or to have children,
but feel pressured into doing so by other family members,
friends, or the society at large by virtue of having reached
their mid-30s.
The normative age-graded influences are partly linked
to the biological aging process. Parenthood traditionally
occurs between the ages of 20 and 40, at the peak of
a woman’s reproductive cycle. This age range sets the
normative age period for biologically becoming a parent.
Once this age is set, then a lower limit is set on the age
at which the adult can become a grandparent. If the child
also follows a normative age-graded influence, the parent
will likely become a grandparent for the first time between
the ages of 55 and 65 years. Similarly, manual laborers or
athletes may be at peak physical capacity up to their 40s,
when they may experience loss of strength and speed.
Now let’s turn to the second set of influences on development, those that relate to the impact of events in the outside world on the individual. Normative history-graded
influences are events that occur to everyone within a certain culture or geopolitical unit (regardless of age) and
include large-scale occurrences, such as world wars, economic trends, or sociocultural changes in attitudes and
values. One such example is a natural disaster that impacts
thousands of people living in a particular location or area
of the world. The California wildfires (shown in the photo)
of 2019 affected large parts of the state, causing many to
lose their homes and places of work. The impact of these
events on people’s lives may be felt immediately. They can
continue to have a lasting impact for many years on the
subsequent patterns of work, family, and quality of life of
the people affected by those events.
The Meaning of Age
or going through a divorce. In everyday language, you talk
about someone benefiting from the ‘‘right place, right time’’
effect or—conversely—suffering a negative fate from the
opposite set of coincidences.
As you have read about the various types of influences on life, it may have crossed your mind that the
way in which they interact with each other is also important. Consider the example of divorce. Although society’s
norms have changed considerably regarding this life event,
many would still consider this a nonnormative occurrence
because the norm (and certainly the hope) of married
couples is to remain married. And although a divorce
is a personal occurrence, it may be seen in part as a
response to larger social forces. For example, a couple
who is exposed to financial hardship because one or
both partners lost a job due to living in harsh economic
times (normative historical influence) is now faced with
severe emotional stress. If they are in their middle years,
when couples are expected to have reached a degree of
financial comfort (age-graded normative influence), their
problems may be exacerbated. Yet, some couples may feel
closer to each other when exposed to such adversity, and
this is where the idiosyncratic nonnormative factors come
into play.
This example illustrates the dilemmas faced by researchers in human development who attempt to separate
out not only personal from social aging but also the impact
of particular influences that fall into the category of social
aging. Though challenging, the very complexity of the
equation fascinates those of us who try to understand
what makes humans ‘‘tick’’ and what causes that ticking to
change over the decades of the human life span.
U.S. Marine Corps photo by Cpl. Dylan Chagnon
An individual does not have to experience a historical
event directly to be affected by a normative history-graded
influence. For example, a terrorist attack or a mass shooting not only creates victims but also has wider influences
on a society’s sense of security as well as potential governmental actions that are the result of the incident. In 2019,
a partial shutdown of the U.S. government not only caused
nearly 800,000 federal workers to lose their paychecks but
also affected the effectiveness of the agencies for whom
they worked as well as the larger economy.
If the life course was influenced only by normative
age- and history-graded influences, predicting the course
of development of people of the same age living in the
same culture would not be easy, but it would be a manageable problem. Plug in a person’s age and the year of
the person’s birth, and you’d be able to figure out which
combination of age-graded and history-graded influences
set the course of that person’s life. However, people’s lives
are also affected by nonnormative influences, which are
the random idiosyncratic events that occur throughout
life. They are ‘‘nonnormative’’ because they occur with no
regular predictability.
There are almost an infinite number of examples of
nonnormative influences. Some are due to good luck, such
as winning the lottery or making a smart investment.
Nonnormative influences can also be negative, such as a
car accident, fire, or the untimely death of a relative. One
moment your life is routine and predictable, and in the next,
a single event irrevocably alters it. Other nonnormative
influences may unfold over a gradual period, such as being
fired from a job (due to personal, not large-scale economic
reasons), developing a chronic illness not related to aging,
An example of a normative history-graded
influence is a natural disaster such as the
wildfires that affected the lives of many
thousands of Californians in the late 2010s.
Themes and Issues in Adult Development and Aging
As we’ve just seen, social factors play an important role
in shaping the course of our lives. Here we make explicit
exactly how we define and use the key social factors that
we will refer to in this book.
Sex and Gender
In discussing the aging process, there are important male–
female differences related to the socialization experiences of
men and women. We will use the term gender to refer to the
individual’s identification as male, female, or nonbinary.
Gender is distinct from biological sex, which refers to the
individual’s inherited predisposition to develop the physiological characteristics typically associated with maleness
or femaleness. Both sex and gender are important in the
study of adult development and aging. Physiological factors
relevant to sex influence the timing and nature of physical
aging processes, primarily through the operation of sex hormones. For example, the sex hormone estrogen is thought
to play at least some role in affecting a woman’s risks of
heart disease, bone loss, and possibly cognitive changes.
Social and cultural factors relevant to gender are important to the extent that the individual assumes a certain role
in society based on being viewed as a male or female.
Opportunities in education and employment are two main
areas in which gender influences the course of adult development and becomes a limiting factor for women. Although
progress has certainly occurred in both domains over the
past several decades, women continue to face a more
restricted range of choices and the prospects of lower
earnings than do men. Furthermore, these differences are
important to consider when studying the current generation of older adults, as they were raised in an era with more
traditional gender expectations.
The phenomenon of transgendered individuals (i.e.,
those who adopt the sex other than what they were born
with) is too recent to have produced enough information
relevant to aging. We might expect that this will become an
area studied by gerontologists, particularly because it also
highlights the role of social influences on development.
Prior to the decade of the 2010s, there was relatively
little social awareness of the experience of transgendered
individuals and aging but this is rapidly changing (Kimmel
et al., 2015).
usage is broader than these biological features. Race is
used in a more widespread fashion to refer to the cultural
background associated with being born within a particular biologically defined segment of the population. The
‘‘race’’ that people use to identify themselves is more likely
to be socially than biologically determined. In addition,
because few people are solely of one race in the biological
sense, social and cultural background factors assume even
greater prominence.
The U.S. census, a count of those living in the United
States conducted every 10 years, attempts to provide an
accurate depiction of the size and makeup of the country.
The 2020 U.S. census defined race on the basis of a
person’s self-identification. The most frequently used racial
categories in data reported from the census are White, Black
or African American, American Indian or Alaska Native,
Asian, and Native Hawaiian or Other Pacific Islander. In
addition to these racial categories, the census also included
categories based on national origin and allowed individuals
to select more than one racial category.
To the extent that race is biologically determined,
racial differences in functioning in adulthood and aging
may reflect differences in genetic inheritance. People who
have inherited a risk factor that has been found to be
higher within a certain race are more likely to be at risk for
developing that illness during their adult years.
Racial variations in risk factors may also interact with
different cultural backgrounds associated with a particular
race. For example, people at risk for a disease with a
metabolic basis (such as inability to metabolize fats) will be
more likely to develop that disease if cooking foods high
in fat content are a part of their culture.
Social and cultural aspects of race may also alter an
individual’s development in adulthood through the structure of a society and whether there are systematic biases
against people who identify with that race. As we will
demonstrate throughout this book, many illnesses have a
higher prevalence among the African American population
than among the White population in the United States, and
this has led to significant disparities in the health of the two
groups. Part of the differences in health may be attributed
to lack of opportunities for education and well-paying jobs,
but systematic discrimination is also believed to take a toll
on health by increasing the levels of stress experienced by
African Americans (Green & Darity, 2010).
A person’s race is defined in biological terms as the classification within the species based on physical and structural
characteristics. However, the concept of race in common
The concept of ethnicity captures the cultural background
of an individual, reflecting the predominant values, attitudes, and expectations in which the individual has been
raised. Along with race, ethnicity is often studied in adult
Key Social Factors in Adult Development and Aging
Socioeconomic Status
Socioeconomic status (SES), or ‘‘social class,’’ reflects people’s position in the educational and occupational ranks of
a society. Technically, SES is calculated through a weighted
formula that takes into account a person’s highest level of
education and the prestige level of his or her occupation.
There is no one set way to calculate SES, however. Various
researchers have developed scales of SES that give differing
weights to these values in coming up with a total score.
People with higher levels of education tend to have occupations that are higher in prestige, and so some researchers
use level of education alone as the index of SES.
Income levels are not necessarily associated with SES.
High-prestige jobs (such as teachers) are often associated
with mid- or even low-level salaries. However, as a proxy
for or in addition to SES, some researchers use income
as the basis for analyzing social class differences in health
and opportunities. Income inequity can be expressed in
statistical terms. Figure 1.7 illustrates the Gini coefficient,
an index of income inequality in a given economy. If
income is equally distributed, 100% of the population
earns 100% of the accumulated wealth. Income equality is
reflected when a smaller percent of the population earns a
higher proportion of the wealth, such as when 10% of the
population earns 90% of the wealth. In the United States,
the Gini coefficient has risen steadily since 1990, indicating
the consolidation of wealth in the upper income brackets.
SES is an exceptionally important, but often unrecognized, influence on the aging process. In our book,
Gini Coefficient
0% of
earns 0%
Most of
earns small
share of total
Cumulative share of people
Cumulative share of income
100% of
earns 100%
development and aging as an influence on a person’s familial attitudes and experiences. For example, people of certain
ethnic backgrounds are thought to show greater respect
for older adults and feel a stronger sense of obligation to
care for their aging parents. Ethnicity also may play a role
in influencing the aging of various physiological functions,
in part through genetic inheritance, and in part through
exposure to cultural habits and traditions. Finally, discrimination against people of certain ethnic backgrounds may
serve the same function as race in limiting the opportunities
for educational and occupational achievements.
The term ethnicity is gradually replacing the term race as
a categorical variable in social research. We will follow that
tradition in this book unless there is a clear-cut reason to
refer specifically to race (i.e., if we are describing research
that also uses this term). However, there are occasional
points of confusion in that the U.S. census occasionally
combines race (White or Black) and ethnicity (Hispanic
or non-Hispanic). Many census statistics break down the
distributions they report into White non-Hispanic, White
Hispanic, Black non-Hispanic, and Black Hispanic.
The Gini coefficient makes it possible to classify an economy
according to the distribution of its wealth. The green line of complete
income equality occurs when income is distributed equally across the
population. The red curve shows an economy characterized by
inequity in which a small percentage of the population earns the
largest share of income as when the wealthiest 10% of the population
earns 90% of the income generated in that economy.
we will highlight studies that connect aging with SES.
One in particular stands out because of its size, length
of time of follow-up, and complexity. This is the landmark investigation known as Whitehall II, a survey of a
large sample of British adults focusing on the relationships
among health, social class, and occupation. Whitehall I
(the original study) was established in 1967 and involved
18,000 men working in civil service occupations in the
United Kingdom. This study showed that the men in the
lowest employment brackets had poorer health than their
health habits would predict.
Whitehall II was initiated by Sir Michael Marmot in
1985 to investigate specifically social and occupational
influences on health and illness including psychological
work load, control over work pacing and content, opportunity for using one’s s…
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