According to the age classification approved by the Congress of Gerontologists and Geriatricians, the population over 60 years of age is divided into three age categories: elderly people - from 61 to 74 years of age; elderly people - 75 years and older, long-livers - 90 years and older.

Aging is a slow process of accumulation of age-related changes that manifest themselves at all levels of the whole organism. The changes and causes that shape aging include changes in the cells of the central nervous system, atrophy of the gonads, intestinal autointoxication, colloid degeneration, etc.

One of the most important factors causing aging is a decrease in the intensity of self-renewal of cell protoplasm. During the aging process, protoplasm loses nucleoproteins, nucleic acids and other components characterized by high self-renewal.

Aging is characterized by a weakening of the functional capacity of all body systems. Significant changes occur in the digestive system.

When preparing a balanced diet for older people, it is necessary to take into account, first of all, the reduced capabilities of the digestive system. In this regard, the first requirement for the nutrition of older people is moderation, that is, some restriction of nutrition in quantitative terms. Taking into account the decrease in the intensity of metabolic processes during aging, the second requirement should be considered to ensure high biological nutritional value by including sufficient amounts of vitamins, biomicroelements, phospholipids, polyunsaturated fatty acids, etc. The third requirement for the nutrition of the elderly is the enrichment of diets with natural anti-sclerotic substances contained in a significant amount quantity in food products.

To ensure the process of cell regeneration, an elderly person requires a fairly high amount of proteins. Along with this, there are recommendations regarding protein restriction in old age due to the fact that its excess can contribute to the development of atherosclerosis. Limiting protein in the diet of elderly and senile people, as well as limiting sugar, leads to a persistent decrease in blood cholesterol levels. It is generally accepted that the optimal protein requirement for older people is 1 g of protein per 1 kg of body weight. The protein intake recommended by the Institute of Nutrition of the USSR Academy of Medical Sciences for the elderly is given in Table. 6.

Animal proteins should make up approximately 55% of the total protein in the diet.

When creating a menu for the elderly, it is necessary to reduce the amount of fat, mainly due to fats of animal origin (lamb and beef fats). Of animal fats, milk fats are preferable.

It is also recommended to include vegetable oils in the diet daily in an amount of 20-25 g. The carbohydrate content in the diet of older people should be limited (Table 6) due to the hypercholesterolemic effect of excess low molecular weight carbohydrates. Against the background of a general decrease in the amount of carbohydrates in food, a slightly greater limitation of easily digestible carbohydrates - sugar and sweet foods - is required. Whole grain products (rye and wheat bread made from wallpaper flour, etc.), as well as potatoes and other vegetables, are desirable as sources of carbohydrates in old age. You should also use products that contain a lot of fiber and pectin. Fiber helps remove cholesterol from the body.

Providing older people with vitamins improves oxidative processes, normalizes metabolism and thereby slows down the aging of the body. An important role in this case belongs to vitamin C. Under the influence of ascorbic acid, the physiological balance between the biosynthesis of cholesterol and its utilization in tissues is stabilized. Ascorbic acid increases the body's reactivity and strengthens defense mechanisms. Providing the body with vitamin C should be done through natural sources. Excessive intake of vitamin C has an adverse effect on the pancreas.

Due to the fact that vitamins C and P are synergists, in old age it is rational to introduce P-active substances into the diet that have the ability to lower blood pressure. Vitamins with lipotropic properties that inhibit the development of atherosclerosis may include choline, inositol, vitamin B12 and folic acid, as well as, according to some data, vitamin B15. Vitamin B6 (pyridoxine) and pantothenic acid, as well as vitamin F (polyunsaturated fatty acids) have pronounced lipotropic properties.

Daily requirement of vitamins for elderly people

age is given in table. 7.

There are preventative agents that to some extent inhibit the development of premature aging. These products also include various vitamin complexes, which include a number of vitamins taken in certain proportions.

In old age, there are phenomena of both oversaturation and insufficiency of certain minerals. In an aging body, the mineralization of some tissues is often increased against the background of a decrease in the content of mineral substances and the intensity of their metabolism in others.

Calcium is of particular importance in the mineral metabolism of older people. Currently, the generally accepted calcium norm for older people is the norm adopted for adults, i.e. 800 mg per day. Another important mineral element in old age is magnesium. It has an antispastic and vasodilating effect, stimulates intestinal motility and promotes the secretion of bile. The effect of magnesium on reducing cholesterol levels in the blood has been established. With a lack of magnesium, the amount of calcium in the walls of blood vessels increases. The main sources of magnesium in human nutrition are cereals and legumes. The daily requirement for magnesium is 400 mg.

Potassium plays a major role in old age and old age. The main importance of potassium is its ability to increase the excretion of water and sodium chloride from the body. In addition, potassium increases heart contractions. All dietary products are involved in the daily supply of potassium to the diet. However, in old age, the most beneficial source of potassium is potatoes, figs, and dried apricots.

For older people, it is desirable to strengthen the alkaline orientation of nutrition through increased consumption of milk and dairy products, potatoes, vegetables and fruits.

When establishing a diet, it is necessary to take into account the reduced functionality of the altered and weakened digestive system, for which a large load becomes unbearable.

The basic principles of the diet for older people are eating strictly at the same time, limiting the intake of large quantities of food and eliminating long intervals between meals. Four meals a day are recommended. A diet regimen of eating 5 times a day can be established. With four meals a day, the food ration is distributed as follows: for the first breakfast - 25%, for the second - 15%, for lunch - 35% and for dinner - 25% of the energy value of the daily diet.

The problem of aging and old age is the object of a special interdisciplinary branch of knowledge - gerontology. Gerontology focuses on the biological, psychological and sociological aspects of aging.

The biological approach to aging is focused primarily on identifying the physical causes and manifestations of aging. Biologists consider aging as a natural process that occurs during the postnatal life of an organism and is accompanied by equally natural changes at the biochemical, cellular, tissue, physiological and system levels (V.V. Frolkis, 1988; E.N. Khrisanfova, 1999).

In foreign gerontology, four fundamental criteria of aging have become widespread, which in the 60s of the 20th century. were proposed by the famous gerontologist B. Strechler:

• aging, unlike disease, is a universal process; all members of the population, without exception, are susceptible to it;
• aging is a progressive, continuous process;
• aging is a property of any living organism;
• aging is accompanied by degenerative changes (as opposed to changes in the body during its development and maturation).

Thus, human aging is a basic universal biological process, which, however, is realized in specific sociocultural conditions. Therefore, gerontology views aging as a complex phenomenon, including personal, social and even economic aspects of human life. This is also evidenced by the fact that such indicators as life expectancy and periodization schemes, marking the onset of aging and the duration of its course, are subject to noticeable changes.

Among the most significant global phenomena observed in the 20th century is a radical (almost doubling) increase in life expectancy. This is associated with a change in views on the periodization of aging.

At the beginning of the century, the German physiologist M. Rubner proposed an age classification in which the beginning of old age was established at 50 years, and venerable old age began at 70 years. In 1905, the famous American physician V. Asler argued that 60 years should be considered the maximum age, after which old people become a burden to themselves and society. In 1963, at the WHO International Seminar on Problems of Gerontology, a classification was adopted that distinguishes three chronological periods in late human ontogenesis: middle age (45-59 years), old age (60-74 years), senile age (75 years and older) . The so-called long-livers (90 years and older) were placed in a separate category. According to the latest data, the age of 60-69 years is defined as pre-senile, 70-79 years - as senile, 80-89 years - as late-senile, 90-99 years - as frailty (Craig, 2000).

It should, however, be borne in mind that any scheme for identifying and classifying involutionary, or regressive, age is rather arbitrary, since physiologists do not yet have data for a comprehensive description of each of the above stages of ontogenesis. It is generally accepted that regressive changes in biochemical, morphological and physiological parameters statistically correlate with an increase in chronological age. Along with this, as in childhood, when assessing aging, it is necessary to distinguish between the concepts of biological and calendar/chronological ages. However, the assessment of biological age during aging is one of the controversial problems of age-related physiology.

Determining biological age requires a reference point, starting from which one can quantitatively and qualitatively characterize the psychosomatic status of a person. In childhood, biological age is determined using the concept of a statistical norm, where the reference point is the average group or population data characterizing the level of development of a structure or function in a given sample at the current point in time. Such an approach to assessing biological age during aging is very difficult, since it is often complicated by various diseases and there is no clear idea of ​​how natural aging, not complicated by diseases, should proceed.

However, as the famous physiologist I.A. pointed out. Arshavsky, using biochemical and physiological parameters, one can determine the average value of the maximum degree of disequilibrium (potential lability of various body systems), characteristic of physiologically healthy people in a stationary (adult) state, and in this way acquire a reference point (I.A. Arshavsky, 1975). Based on it, you can try to estimate the true biological age after the end of the stationary period. It is possible that reliable methods for assessing biological age during aging will be established in the future. For example, when assessing electrophysiological parameters - the time and amplitude parameters of the responses of the cerebral cortex - aging curves are obtained, which make it possible to estimate age based on indicators of the functioning of the cerebral cortex.

The problem, however, is that in aging, as in childhood, the principle of heterochrony operates. It manifests itself in the fact that not all human organs and systems age at the same time and at the same rate. For most of them, the aging process begins long before old age. Many effects of aging do not manifest themselves until late adulthood, not only because the aging processes develop gradually, but also because, along with the aging processes, compensatory processes of vitaukta occur in parallel in the body.

In addition, we must not lose sight of the fact that although aging is a natural and normative process, it has a wide range of individual differences. At this stage of ontogenesis, differences between calendar and biological ages can be more pronounced than in childhood. Individual characteristics of human aging determine the existence of different variants of aging. Clinical and physiological indicators make it possible to distinguish several old age syndromes: hemodynamic (changes in the cardiovascular system), neurogenic (changes in the nervous system), respiratory (changes in the respiratory system).

According to the rate of aging, accelerated, premature (accelerated) aging and slow, retarded aging are distinguished. An extreme expression of accelerated aging has been described - progeria, when signs of aging appear even in children. Slow aging is characteristic of centenarians (V.V. Frolkis, 1988).

The aging of the body as a whole is associated primarily with violations of self-regulation mechanisms and information processing processes at different levels of life. Of particular importance in the mechanisms of aging at the cellular level is the disruption of information transmission in the system of the genetic apparatus of cells, at the level of the whole organism - in the system of neurohumoral regulation. As a result, aging is a total process that covers the entire human body, and its manifestations can be found in all organs, systems and functions.

External bodily changes during aging are well known (gray hair, wrinkles, etc.). In addition, changes in skeletal structure lead to a decrease in height, which can decrease by 3-5 cm due to compression of the intervertebral discs. Osteoporosis occurs (demineralization of bones, expressed in the loss of calcium), as a result of which the bones become fragile. Muscle mass decreases, resulting in reduced strength and endurance. Blood vessels lose their elasticity, some of them become clogged, and because of this, the blood supply to the body worsens with all the ensuing consequences. The efficiency of the cardiovascular system as a whole decreases, and the ability of the lungs to carry out gas exchange weakens. The production of antibodies in the immune system decreases, and the body's defenses weaken. At the same time, regular physical exercises that help strengthen muscles in old age improve the somatic status of the body.

A systematic study of age-related evolution and involution of human sensory-perceptual functions was carried out in the 60s at the school of B.G. Ananyev. These studies found that ontogenetic changes in sensory (vision, hearing) and propreoceptive sensitivity are of a general nature. Sensitivity increases in early adolescence, then stabilizes and, starting from 50-60 years of age, decreases. Against the background of this general trend, however, some age-related declines and rises are observed. In other words, both at the stage of positive development and during involution, changes in sensitivity are carried out in accordance with the principle of heterochrony.

Indicative in this regard is the age-related dynamics of color sensitivity. With the exception of the general optimum, which is observed at approximately 30 years of age, i.e., much later in comparison with general light sensitivity and visual acuity, all particular types of sensitivity to different wavelengths change differently. Beginning at the age of 30, there is a significant and steady decrease in sensitivity to extreme long- and short-wavelength colors - red and blue. At the same time, sensitivity to yellow color does not decrease even after 50 years. With regard to hearing sensitivity, it has been established that its increasing decline extends to the high-frequency part of the sound range and begins at the age of 30. If we use the hearing thresholds of twenty-year-olds as a standard, it turns out that sensitivity loss increases in the following order: at 30 years old - by 10 dB, at 40 years old - by 20 dB, at 50 years old - by 30 dB. Similar trends are observed in other types of sensory modalities.

However, as Ananyev emphasized, in cases where the profession places increased demands on the senses (for example, demands on the visual functions of pilots), their functioning remains at a high level even in adulthood. Any sensory function manifests its actual potential only if it is systematically in a state of optimal tension useful for it.

Age-related changes inevitably affect the human brain. It would be a mistake to consider the processes occurring in the brain of an aging person as simply fading. In fact, as the brain ages, a complex restructuring takes place, leading to a qualitative change in its reactions. Age-related changes have various morphofunctional manifestations. There are general and specific changes. General changes include changes indicating a decrease in the functions of energy-supplying structures and the apparatus responsible for protein synthesis. It is advisable to analyze specific changes at the levels of: an individual neuron, nervous tissue, individual structural formations that make up the brain, and the whole brain as a system.

First of all, age-related changes in the human brain are characterized by a decrease in its mass and volume. The brain weight of a person aged 60 to 75 years decreases by 6%, and unevenly in different parts. The cerebral cortex decreases by 4%, the greatest changes (12-15%) occur in the frontal lobe. Sex differences in the degree of brain atrophy with aging have been noted. The brain weight of women is approximately 110-115 g less than that of men. Between 40 and 90 years, brain weight decreases in men by 2.85 g per year, and in women by 2.92 g (V.V. Frolkis, 1988).

Most human brain researchers point to predominant neuronal loss in the cortex, hippocampus, and cerebellum. In most subcortical formations, the cellular composition remains unchanged until old age. In other words, phylogenetically “newer” brain structures associated with cognitive function are more susceptible to age-related neuronal loss than phylogenetically “older” brain structures (brain stem).

Synaptic contacts are known to play a decisive role in ensuring interneuronal interaction in neural networks; due to their plasticity, they are closely related to memory and learning. With aging, the density of the number of synapses decreases. However, synapse loss does not occur equally in all parts of the central nervous system. Thus, in the human frontal lobe, a decrease in the number of synapses with age has been reliably proven, while age-related changes are not observed in the temporal lobe.

Changes in the state of synapses are observed not only in the cortex, but also in subcortical structures. For example, age-related impairments in spatial memory have been attributed to decreased specificity, efficiency, and plasticity of synaptic transmission in the hippocampus. With aging, the ability to form new synapses decreases. Reduction of synaptic plasticity in old age can contribute to memory loss, deterioration of motor activity and the development of other functional brain disorders. At the same time, interneuron contacts in various areas of the central nervous system deteriorate, neurons seem to undergo “deafferentation”, and therefore their response to environmental signals, nervous and hormonal stimuli is disrupted, i.e. synaptic mechanisms of brain activity are damaged.

With aging, the state of the body's mediator systems changes significantly. One of the most characteristic phenomena of aging is the degeneration of the dopaminergic system of the brain, the latter is directly related to the development of diseases such as parkinsonism in old age. Disturbances in the activity of another neurotransmitter system of the brain, the cholinergic system, play a major role in disorders of memory, perception and other cognitive processes that occur in Alzheimer's disease.

Of particular interest is the problem of interhemispheric interaction during aging. The main feature of cerebral asymmetry in the aging brain is that the stable joint activity of the hemispheres is disrupted. There is some disagreement in estimates of the rate of aging of the left and right hemispheres. According to one point of view, the right hemisphere ages earlier than the left; according to another, the aging process of both hemispheres is characterized by high synchronicity.

N.K. Korsakova, discussing the neuropsychological aspects of brain aging, turned to Luria’s concept of functional blocks of the brain. According to her data, normal physiological aging is characterized at all stages of late age primarily by changes in the functioning of the block regulating tone and wakefulness: a shift occurs in it towards the predominance of inhibitory processes. In this regard, such characteristic phenomena arise as general slowness when performing various actions, narrowing the volume of mental activity while simultaneously implementing various programs. Along with this, the preservation of previously established forms of activity associated with the functioning of the information processing unit creates favorable preconditions for the successful implementation of existing stereotypes of activity.

Now let's move on to discussing the theory of aging. The main question, which, one way or another, is posed in all existing theories of aging, boils down to the following: is this process genetically programmed and naturally determined by the evolution of man as a species, or is it an analogue of mechanical wear and tear of a technical device, consisting in the gradual accumulation of minor disorders? which ultimately lead to the “breakdown” of the body. Accordingly, existing theories of aging are divided into two groups - theories of programmed aging and theories of body wear and tear (so-called stochastic theories).

Theories of programmed aging proceed from the fact that evolution has programmed the functioning of a living organism for the period of its active life, including the period of reproduction. In other words, a living organism is genetically embedded in biological activity, which extends only during the period of its so-called “biological usefulness.” The rapid degradation and death of an aging organism are predetermined by nature.

As applied to humans, this approach is related to those common at the beginning of the 20th century. ideas that in each period of an organism’s life a certain endocrine gland dominates: in youth - the thymus, during puberty - the pineal gland, in maturity - the gonads, in old age - the adrenal cortex. Aging is considered as the result of a change in the activity of various glands and their certain ratio. The theory does not explain the reasons for the change in dominance.

The theory of “built-in clocks” is close in meaning to this. This theory suggests that there is a single pacemaker (“pacemaker”), possibly located in the hypothalamus and pituitary gland of the brain. It turns on as a result of the fact that soon after the onset of puberty the pituitary gland begins to secrete a hormone that causes the onset of the aging process, which will subsequently proceed at a certain speed. The presence of a “built-in clock” is confirmed, in particular, by the existence for each organism of a strictly genetically determined program of cell division in ontogenesis. It is possible that the biological clock also controls the human immune system, which gains strength until the age of 20, and then gradually weakens.

Along with this, there is a theory according to which aging is determined by the programmed actions of specific genes. In other words, aging is a genetically programmed process, the result of a natural, consistent deployment of a program embedded in the genetic apparatus. It is assumed, in particular, that the average life expectancy is determined by specific genes that are contained in each cell of the body. The expression of these genes occurs at a predetermined point in time when the death of the organism should occur.

According to stochastic theories, aging is simply a decrease in the ability of cells to repair themselves. The human body is compared to a mechanism that wears out from constant use. Moreover, to this wear and tear is added the accumulation of cellular dysfunction and damage. The latter leads to the fact that aging cells are less able to get rid of metabolic products, and this interferes with the normal course of intracellular processes, disrupting and/or slowing them down.

It is also assumed that aging is caused by the existence in the body of remnants of oxygen metabolism, which is necessary for the life of every cell. These are the so-called “free radicals” - highly active chemical agents that are ready to enter into a chemical reaction with other intracellular chemical compounds and thus disrupt the normal functioning of the cell. Cells typically have repair mechanisms to reduce the damage caused by free radicals. However, after serious damage to the body, such as from exposure to radiation or severe illness, the damage caused by free radicals is quite serious.

It is also well known that with aging, the effectiveness of the immune system decreases, resulting in worse resistance to disease. Moreover, in some diseases, such as rheumatoid arthritis or some kidney diseases, immune cells attack healthy cells in the body's own.

Stochastic theories cannot, however, explain a number of situations. For example, they do not answer the question of why the body's internal "repair shop", which for some time did an excellent job of troubleshooting problems in it, suddenly stops working.

The mechanism that determines the stability and duration of existence of a living system is vitaukt. Developing the problem of aging, the famous domestic scientist V.V. Frolkis put forward a number of provisions:

1. studying the mechanisms of aging is possible only from the standpoint of a systematic approach;
2. aging is an obligatory element of age-related development, which largely determines its course; that is why understanding the essence of aging is possible within the framework of a theoretical hypothesis that explains the mechanisms of age-related development;
3. with aging, along with the fading of the activity of life support and metabolic functions, important adaptive mechanisms are mobilized - vitaukta mechanisms;
4. aging is the result of disruption of self-regulation mechanisms at different levels of the body’s vital activity.

The development of these provisions led to the advancement of the adaptation-regulatory theory of age-related development. The theory of V.V. Frolkis can be seen as intermediate between genetic and stochastic theories of aging. Based on the concept of self-regulation, this theory explains the mechanisms of age-related changes as a process of adaptive capabilities of the body. This process is aimed at stabilizing the vitality of the organism, increasing the reliability of its functioning, and increasing the longevity of its existence.

In accordance with the adaptation-regulatory theory, aging is not genetically programmed, but genetically determined, predetermined by the peculiarities of the biological organization of life and the properties of the organism. In other words, many properties of the body are genetically programmed, and the rate of aging and life expectancy depend on them.

Vitaukt, Frolkis emphasizes, is not just restoration of damage caused by the aging process, not just anti-aging. Rather, in many ways, aging is an anti-vitamin, destroying and weakening the mechanisms of the original viability of the organism. Not only in historical, but also in individual development, not only in phylogenesis, but also in ontogenesis, at the earliest stages of the formation of an organism, starting from the zygote, a destructive process occurs - aging. This is inevitable DNA damage, protein breakdown, membrane damage, the death of some cells, the action of free radicals, toxic substances, oxygen starvation, etc. And if at this stage, thanks to self-regulation mechanisms, the vitaukt process is reliable, the entire system develops, improves, and its adaptive capabilities increase.

Until some time, destructive processes in a number of cellular structures, thanks to the mechanisms of vitaukta, do not yet lead to aging of the organism as a whole. Ultimately, at a certain age (cessation of growth, completion of ontogenesis), the aging process of the organism as a whole begins to progress, with all the ensuing consequences. So, life expectancy is determined by the unity and opposition of two processes - aging and vitaukta. As Frolkis emphasizes, future gerontology will increasingly focus on studying the mechanisms of vitaukt.

The phenomenon of vitaukta creates favorable conditions for the full functioning of the psyche of older people. As some researchers note, the so-called age of involution is not at all characterized by a linear increase in abnormal processes in the psyche. According to N.K. Korsakova, in the age range from 50 to 85 years, the most pronounced neurodynamic disorders are characteristic of the initial and advanced stages of aging, after 80 years. At the age of 65 to 75 years, not only is there a stabilization of higher mental functions, but, in a number of parameters, in particular memory function, people of this age demonstrate achievements at the level of a person who is not yet old.

N.K. Korsakova generally emphasizes the importance of positive trends in the mental functioning of an elderly person. Considering the variety of ways to overcome disturbances in the functioning of higher mental functions during normal aging, we can say that it represents a stage of individual development that requires a change in strategies and the use of relatively new forms of mediation of mental activity. If we consider ontogenesis as a manifestation of new formations in the psyche and behavior that were absent at previous stages of development, then old age can be spoken of as one of the stages of ontogenesis. Empirical data show that in old age, intelligence is directed to a greater extent towards self-regulation of mental activity than towards knowledge of the world.

This corresponds to the modern view of aging not only in a negative aspect - as extinction, but also in a positive sense - as the possibility of a person developing ways to preserve himself as an individual and personality in the general continuum of his own living space.

Old age is one of the most paradoxical and contradictory periods of life, associated with the fact that the “last questions of existence” (M. M. Bakhtin) confront a person in full force, demanding the solution of the insoluble - to combine the capabilities of an old person in understanding the world and his life experience with physical weakness and the inability to actively implement everything understood.

But in contrast to the pessimism of everyday ideas about old age, psychologists talk about such peculiar new formations of old age as:

1. a sense of belonging to a group or groups;
2. the feeling that “you are at home here” - personal comfort in interacting with people;
3. a sense of community with other people, the experience of being similar to them;
4. faith in others - the feeling that there is something good in every person;
5. courage to be imperfect - the feeling that it is natural to make mistakes, that it is not at all necessary to always be “first” and “correct”, “best” and “infallible” in everything;
6. the feeling of being a human being - the feeling that you are part of humanity;
7. optimism is the feeling that the world can be made a better place to live.

At the same time, aging actually creates many psychological difficulties: after all, these are years of “forced idleness”, often spent in isolation from work with a feeling of contrast between “this” and “this” life, which is perceived by many as humiliating. Forced idleness often becomes a pathogenic factor in somatic and mental terms, so many try to remain able to work, work and be useful (although the opinion that all pensioners want to continue working is also incorrect: statistics show that this is only one third of all people of retirement age ).

The identification of the period of aging and old age (gerontogenesis) is associated with a whole complex of socio-economic, biological and psychological reasons, therefore the period of late ontogenesis is studied by various disciplines - biology, neurophysiology, demography, psychology, etc. The general aging of the population is a modern demographic phenomenon: the proportion of groups of people over 60-65 years old accounts for over 20% of the total population in many countries of the world (a sixth or eighth of the entire world population!).

The average life expectancy of a modern person is significantly higher than that of his ancestors, and this means that old age is turning into an independent and fairly long period of life with its own social and psychological characteristics. These demographic trends also lead to an increased role of elderly and old people in the social, political, and cultural life of society and require an analysis of the essential characteristics of human development in this period of life. Gerontologist I. Davydovsky said that experience and wisdom have always been a function of time. They remain the privilege of adults and the elderly. For gerontology as a science, “adding years to life” is not so important; it is more important to “add life to years.”

The aging process is not uniform. Traditionally, three gradations of the period of gerontogenesis are distinguished: old age (for men - 60-74 years, for women - 55-4 years), old age (75-90 years) and centenarians (90 years and older). But modern research shows that in recent decades the aging process has slowed down (a person 55-60 years old may not feel old at all and, in terms of social functions, may be in the cohort of adult – mature – people), and aging itself within these phases is not homogeneous ( someone gets tired of life by the age of 50, and someone can be full of strength and life plans even at 70). As B. Spinoza said, no one knows “what the body is capable of.”

From a physiological and psychological point of view, old age is less strictly related to chronological age than any earlier period of life (for example, early childhood, preschool or adolescence) up to 60-65 years. According to the observations of J. Botvinick and L. Thompson, if chronological age is the factor by which one judges who is old, then older people are still much more diverse in their biological and behavioral characteristics than younger people.

The complexity of the aging process is expressed in the intensification and specialization of the action of the law of heterochrony, as a result of which there is long-term preservation and even improvement in the functioning of some systems and accelerated involution of others, occurring at different rates. Those structures (and functions) that are closely related to the implementation of the main life process in its most general manifestations are preserved the longest in the body. Increased inconsistency is manifested mainly in the multidirectionality of changes occurring in individual functional systems of an individual organization. Although evolutionary-involutionary processes are inherent in all ontogenesis as a whole, it is during the period of aging that multidirectionality determines the specifics of both mental and non-mental development.

What happens when a person ages?

At the molecular level, changes occur in the biochemical structure of the body, a decrease in the intensity of carbon, fat and protein metabolism, a decrease in the ability of cells to carry out redox processes, which generally leads to the accumulation in the body of incomplete decomposition products (submetabolites - acetic, lactic acid, ammonia, amino acids ). Biochemists consider errors in the synthesis of nucleic acids as one of the causes of aging. Zh.A. Medvedev established that RNA and DNA are templates for the construction of living proteins and carry hereditary information about their chemical structure. With age, this mechanism ages, allowing errors in reproducing the specificity of living matter (every year the chains become shorter by 1 molecule).

Changes are also observed at the level of functional systems. Thus, in the cellular-tissue system, an increase and proliferation of connective tissue is observed in blood vessels, skeletal muscles, kidneys and other organs. The composition of connective tissue includes proteins, collagen, elastin, which, changing in old age, become chemically inert. This causes oxygen starvation, deterioration of nutrition and death of specific cells of various organs, which leads to the proliferation of connective tissue.

Negative changes also occur in the cardiovascular, endocrine, immune, nervous and other systems during the process of involution of the body. Of particular importance are the processes occurring during aging in the nervous system. A decrease in energy potential due to a weakening of the intensity of energy generation (tissue respiration and glycolysis) occurs in parts of the brain at different rates. Thus, changes in the brain stem are more significant and significant than in the cerebellum and both hemispheres. Deviations from the general morphological law of development at different times occur in favor of the higher parts of the brain. High relative stability of metabolic processes in these sections is necessary for greater preservation of neurons that process, transmit and store accumulated information. The more complex the nervous structure, the more opportunities it has for its preservation. The reflex structure as a whole, as a more complex formation, thanks to multicellular contacts, retains its functionality and size for a long time due to more stable elements. The extremely pronounced redundancy and complexity of the central nervous system contribute to its morphological and functional preservation.

During the period of gerontogenesis, the processes of excitation and inhibition are weakened, however, even in this case, a frontal deterioration in the functioning of the nervous system as a whole is not observed. In young and old people (from 20 to 104 years old), conditioned motor reflexes change differently, depending on reinforcement. The defensive conditioned reflex turns out to be the most intact; differentiation is easily developed on defensive reinforcement. The food reflex in elderly and old people is developed more slowly, and differentiation on food reinforcement is difficult to develop after 55 years, and at 80 years and older it does not arise at all. These data confirm the pronounced heterochrony of conditioned reflex activity of the brain until old age.

Heterochrony is also revealed in the fact that with age, primarily the process of inhibition and the mobility of nervous processes age, and the latent periods of nervous reactions lengthen (in the oldest group, some reactions had a latent period of up to 25 s). Individualization is expressed at the level of not only the first, but also the second signaling system. Nevertheless, there are people who, until a very old age, are distinguished not only by their safety, but also by high rates of speech and other reaction times. The speech factor generally contributes to the safety of a person during the period of gerontogenesis. B.G. Ananyev wrote that “speech-thinking, second-signal functions resist the general process of aging and themselves undergo involutional shifts much later than all other mental functions. These most important acquisitions of the historical nature of man become a decisive factor in the ontogenetic evolution of man.”

In general, in the analysis of gerontogenesis, it is necessary to note the increased inconsistency, multidirectionality and, at the same time, the individualization of age-related changes in various parts of the central nervous system: the upcoming changes do not fit into the picture of uniform, harmonious decline of the brain.

Adaptation of the body to aging is achieved through the mobilization of reserve forces. So, for example, glycolysis can become more active, the activity of many enzymes increases, the activity of factors associated with DNA “repair” increases, adaptive functional mechanisms develop in the central nervous system (protective inhibition increases during long-term work, the sensitivity of nervous structures to a number of chemicals increases – hormones, mediators), smaller doses of insulin, adrenaline, thyroxine, etc. are produced. Biological adaptive mechanisms also include an increase in the number of nuclei in many cells of the liver, kidneys, heart, skeletal muscles, and nervous system, which improves metabolic processes between the structures of the nucleus and cytoplasm. Electron microscopic studies also show the appearance of giant mitochondria in old age, accumulating energy reserves.

In general, the weakening and destruction of some elements and systems leads to the intensification and “tension” of others, which contributes to the preservation of the body. This phenomenon is called the polarization effect. Another effect of gerontogenesis (reservation effect) is the replacement of some mechanisms with others, reserve ones, more ancient and therefore more resistant to the aging factor. This leads to changes in the functional and morphological structures of the living system. During the aging period, a compensation effect is also observed when existing systems take on functions that were not previously characteristic of them, thus compensating for the work of weakened or destroyed systems. All this leads to the emergence of new mechanisms of vital activity of the aging organism, contributing to its preservation and survival. This way of increasing biological activity is called the design effect.

Human development continues in old age, but if until now he looked at the world through the prism of himself and his achievements in the world around him, then in old age he sees himself through the eyes of the world and again turns inward, to his life experience, realized goals and opportunities from the point of view of their analysis and evaluation. For many people approaching 60 years of age, the need to reflect on the path of life from the point of view of assessing its implementation and assessing prospects for the future becomes obvious. Typical reflections of this time are considered to be: “how time flies”, “how quickly life has passed”, “it’s unclear what so much time was spent on”, “if there was a lot of time ahead, then I would...”, “how little has passed roads, how many mistakes have been made,” etc.

Researchers of this period of life especially note the age of about 56 years, when people on the threshold of aging experience the feeling that they can and should once again overcome a difficult time, try, if necessary, to change something in their own lives. Most aging people experience this crisis as the last opportunity to realize in life what they considered the meaning or purpose of their life, although some, starting from this age, begin to simply “serve out” the time of life until death, “wait in the wings,” believing that age does not give you a chance to seriously change something in your destiny. The choice of one strategy or another depends on personal qualities and the assessments that a person gives to his own life.

E. Erikson considered old age to be a stage of personality development, at which it is possible either to acquire such a quality as integrativeness - personality integrity (ego-integrity), or to experience despair from the fact that life is almost over, but it was not lived as wanted and planned.

E. Erickson identifies several characteristics of the experience of a sense of integrativeness:

1. this is an ever-increasing personal confidence in one’s propensity for order and meaningfulness;
2. this is post-narcissistic love of a human person (and not an individual) as an experience that expresses some kind of world order and spiritual meaning, regardless of the price at which they are obtained;
3. this is the acceptance of one’s only path in life as the only one that is due and does not need to be replaced;
4. this is a new, different from the previous, love for your parents;
5. this is a comradely, involved, affiliative attitude towards the principles of distant times and various activities as they were expressed in the words and results of these activities.

The bearer of such personal integrity, although he understands the relativity of all possible life paths that give meaning to human efforts, is nevertheless ready to defend the dignity of his own path from all physical and economic threats. The type of integrity developed by his culture or civilization becomes the “spiritual heritage of the fathers,” the stamp of origin. In the face of such final consolidation, his death loses its force. At this stage of development, wisdom comes to a person, which E. Erikson defines as a detached interest in life in the face of death.

E. Erickson proposes to understand wisdom as a form of such an independent and at the same time active relationship between a person and his life limited by death, which is characterized by maturity of mind, careful deliberation of judgments, and deep comprehensive understanding. For most people, its essence is cultural tradition.

The loss or absence of ego integration leads to a disorder of the nervous system, a feeling of hopelessness, despair, and fear of death. Here, the life path a person has actually traversed is not accepted by him as the limit of life. Despair expresses the feeling that there is too little time left to try to start life over again, arrange it differently and try to achieve personal integrity in a different way. Despair is masked by disgust, misanthropy, or chronic contemptuous dissatisfaction with certain social institutions and individuals. Be that as it may, all this testifies to a person’s contempt for himself, but quite often “a million torments” do not add up to one great repentance.

The end of the life cycle also gives rise to “final questions”, which not a single great philosophical or religious system passes by. Therefore, any civilization, according to E. Erikson, can be assessed by the importance it attaches to the full life cycle of an individual, since this importance (or lack thereof) affects the beginning of the life cycles of the next generation and affects the formation of a child’s basic trust (mistrust) in to the world.

No matter what abyss these “final questions” lead individuals to, a person, as a psychosocial creation, by the end of his life inevitably finds himself faced with a new edition of the identity crisis, which can be captured by the formula “I am what will survive me.” Then all the criteria of vital individual strength (faith, willpower, determination, competence, loyalty, love, care, wisdom) pass from the stages of life into the life of social institutions. Without them, institutions of socialization fade away; but without the spirit of these institutions permeating the patterns of care and love, instruction and training, no power can emerge simply from the succession of generations.

In a certain respect, most of the processes of individual life by the age of 63-70 acquire a stable character, which gives rise to the experience of “completeness of life.” A person is ready for the fact that further decline in mental strength and physical capabilities begins, that a time of greater dependence on others is coming, that he will participate less in solving social and professional problems, that his social connections and personal desires will weaken, etc.

Most of the destructive processes occurring in old age are above the threshold of consciousness, reflected in it only in the form of a number of painful symptoms (physical inactivity, stress, somatic and psychosomatic problems). That is why enhanced conscious control and regulation of biological processes are included in the lifestyle of old people and mean an increased role of a person as an individual and a subject of activity in preserving and transforming his own individual qualities. The participation of the individual himself in creating his own healthy lifestyle contributes to the preservation of his individual organization and the regulation of further mental development. Conscious regulation of age-related dynamics of functional systems is carried out through the emotional and psychomotor spheres, as well as speech.

Increased inconsistency and unevenness is also noticeable in the functioning of mental processes. Thus, starting from the age of 40, loudness hearing sensitivity in the high-frequency range (4000-16000 Hz) gradually but unevenly decreases. In the middle range, where phonetic and speech sounds are located, there are no special changes. At the same time, low-frequency sounds (32-200 Hz) retain their signaling value even in very late ontogenesis. This means that the deterioration of the auditory analyzer is selective in nature, due to both the historical nature of man and the protective functions of the body.

From 25 to 80 years, different types of color sensitivity decrease at different rates. For example, by the age of 50, sensitivity to yellow remains practically unchanged, but to green it decreases at a slower pace. For red and blue colors (i.e., at the extreme - short and long-wavelength parts of the spectrum) sensitivity drops much faster.

Complex age-related dynamics are revealed in the study of visuospatial functions. So, for example, the oculometric function and the sensory field of vision are characterized by fairly high preservation up to 69 years. At relatively earlier periods (after 50 years), a general deterioration in visual acuity and the volume of the perceptual field occurs. There is no direct relationship between the period of maturation and the period of involution: functions that reach maturity in early (eye) or late periods (for example, the visual field is formed during school years) may be equally preserved up to 70 years of age, which indicates their importance role throughout life.

With age, the asymmetry of various psychological functions may increase: for example, one side of the body may be more sensitive to vibration or temperature stimulation than the other, one eye or ear may be more functionally intact than the other.

Memory studies have shown that after the age of 70, mechanical memorization mainly suffers, while logical memory is best preserved. Figurative memory weakens more than semantic memory, but is preserved better than mechanical imprinting. The basis for the strength of memory in older age is internal semantic connections. For example, in an associative experiment, an 87-year-old subject responds to the stimulus word “train” with “car”, etc. Fixing one's behavior in people over 70 years of age is weakened compared to long-term memory. Deformations are especially strong in figurative memory, where perception and memorization are not accompanied by the organizing function of speech. The leading type of memory in old age becomes semantic, logical memory, although emotional memory continues to function.

During the process of gerontogenesis, verbal and nonverbal intelligence undergoes changes. According to the English gerontologist D.B. Bromley, the decline in nonverbal functions becomes pronounced by the age of 40, and verbal functions from this moment progress intensively, reaching their maximum in the period of 40-45 years. This indicates that speech-cognitive second-signal functions resist the general aging process.

The work of mental functions in old age is influenced by work activity carried out or continued by a person, since it leads to sensitization of the functions included in it and thereby contributes to their preservation.

Although aging is an inevitable biological fact, the socio-cultural environment in which it occurs has its influence. The mental health of a modern person at any phase of life is largely determined by his involvement in communication.

The older a person gets, the more his social connections narrow due to objective reasons and his social activity decreases. This is due, firstly, to the cessation of compulsory professional activities, which naturally entails the establishment and renewal of a system of social connections and obligations; very few older people continue to actively participate in business life (as a rule, these are those who avoid dependence and value self-reliance and independence).

Secondly, his age cohort is gradually “washed out”, and many people close to him and friends die or difficulties arise in maintaining relationships (due to friends moving to their children or other relatives) - “others are no longer there, and those are far away.” A number of works on the problems of aging note that, in principle, any person ages alone, since due to old age he gradually moves away from other people. Elderly people are very dependent on collateral lines of kinship and indirect relationships, trying to maintain them in the absence of other close relatives. It is curious that many older people do not want to be reminded of old age, and because of this they do not like to communicate with peers (especially those who complain about old age and illness), preferring the company of younger people, usually representatives of the next generation. generations (at the same time, they often reveal a social attitude that young people despise old people and that old people have no place either in other age cohorts or in society as a whole).

Lack of contact with society can cause emotional changes in older people: discouragement, pessimism, anxiety and fear of the future. Elderly people are almost always accompanied, either explicitly or implicitly, by the thought of death, especially in cases of loss of loved ones and acquaintances, which, unfortunately, are quite common in old age. When every tenth person drops out of the ranks of their peers at this age, it can be difficult to find someone else to take their place from the younger generation. In this sense, in a more advantageous position are not European, but Asian cultures, for example, China or Japan, which do not force generations to walk in dense, homogeneous age ranks, but allow them to merge with each other, exchanging experiences. In these cultures, older people are given the role of patriarchs, elders, which allows them to remain involved in social relationships longer.

Thirdly, an old person quickly gets tired of intense social contacts, many of which do not seem relevant to him, and he limits them. An older person often wants to be alone, to “take a break from people.” The social circle of an elderly person is most often limited to immediate relatives and their acquaintances and a few close-living friends.

Involvement in communication inevitably decreases with age, which exacerbates the problem of loneliness. But the problem of decreased social activity and loneliness is experienced more acutely by older people living in cities than in rural areas, due to the specificity of the urban and rural lifestyles themselves. Old people with a healthy psyche and somatic health are more willing and longer to try to preserve and maintain existing social connections, often giving them the character of a ritual (for example, nightly phone calls, weekly shopping trips, monthly meetings of friends, annual joint celebration of anniversaries, etc. ). Women, on average, maintain more social contacts due to the fact that they have more social roles; They often have more friends than men. However, it is older women who more often than men complain about loneliness and lack of social contacts.

After 60 years, the awareness of the social alienation of old people from subsequent generations gradually comes, which is experienced painfully, especially in societies where there is no necessary social support for old age. Many old people often live with a feeling of uselessness, abandonment, lack of demand, and devaluation. This means that in old age there is not only a narrowing of interpersonal contacts, but also a violation of the very quality of human relationships. Emotionally unstable older people, acutely aware of this, often prefer demoralizing voluntary seclusion to the humiliation that they see in the risk of becoming a burden and experiencing the mocking arrogance of the young. These experiences can also become the basis for senile suicides, along with material insecurity, loneliness, and the fear of dying alone.

Social connections are influenced by a wide range of factors. Thus, it is known that people over 60 years of age often complain about their health and age, although they do not look very sick or very old. L.M. Terman noted that such phenomena are often observed after the loss of a loved one (widowhood) or in the situation of aging alone, i.e. Lonely older people are more likely to feel sick. In this case, the following processes become factors that contribute to the fact that a person begins to “feel his age”, experience despair and depression: experiencing grief and mourning; the need to look for new people who will accept a person into their circle and fill the resulting “vacuum”; the need to learn to solve many problems yourself, etc. On the contrary, a person experiences loneliness less acutely if he feels comfort and stability of existence, is happy in his home environment, is satisfied with his material conditions and place of residence, if he has the potential to make contacts with other people at his own request, if he is involved in any then daily, albeit optional, types of activities, if he is focused on elementary, but certainly long-term projects (waiting for a great-grandson, buying a car or defending his son’s dissertation, the harvest from an apple tree once planted, etc.).

Until now, we have considered the “vertical” of old age, its position in the structure of a person’s holistic life. Now let's turn to its “horizontal”, i.e. actually to the meaningful extent of age, to the mental makeup of old people and psychological portraits of old age. Here, for example, is how an old person is characterized in the work of E. Averbukh: “Old people have decreased well-being, self-awareness, self-esteem, and an increased feeling of low value, self-doubt, and dissatisfaction with themselves. The mood, as a rule, is reduced, various anxious fears prevail: loneliness, helplessness, impoverishment, death. Old people become gloomy, irritable, misanthropes, and pessimists. The ability to rejoice decreases; they no longer expect anything good from life. Interest in the outside world and new things is decreasing. They don’t like everything, hence the grumbling and grumpiness. They become selfish and self-centered, more introverted... the range of interests narrows, and an increased interest appears in experiences of the past, in re-evaluating this past. Along with this, interest in one’s body increases, various unpleasant sensations often observed in old age, and hypochondrization occurs. Lack of confidence in themselves and in the future makes old people more petty, stingy, overly cautious, pedantic, conservative, lacking initiative, etc. Old people's control over their reactions weakens; they do not control themselves well enough. All these changes, in interaction with a decrease in the acuity of perception, memory, and intellectual activity, create a unique appearance of an old man and make all old people to some extent similar to each other.”

In older people, the motivational sphere gradually changes, and an important factor here is the lack of the need to work every day and fulfill the obligations assumed. According to A. Maslow, the leading needs in old age and old age are bodily needs, the need for safety and reliability.

Many old people begin to live “one day at a time,” filling each day with simple concerns about health and maintaining vital functions and minimal comfort. Even simple household chores and simple problems become important for maintaining a feeling of being busy, the need to do something, to be needed by yourself and others.

As a rule, old people do not make long-term plans - this is due to a general change in their temporary life perspective. Psychological time changes in old age, and life in the present and memories of the past are now more important than the future, although certain “threads” are still stretched into the near, foreseeable future.

Old people, as a rule, attribute most of the most important events and accomplishments of their lives to the past. Thanks to causal and target connections, past and future events of human life form a complex system of ideas about it, which in everyday language is called “fate”, and in psychology – “a subjective picture of the path of life.” This picture is like a network, the nodes of which are events, and the threads are the connections between them. Some connections connect events that have already happened to each other; they belong entirely to the past and have become the content of human development and life experience. Old people, to a greater extent than people of other ages, tend to be educated on their own generalized experience, on the example of their personal life. This desire to “leave a mark” in life is realized in raising children and grandchildren or in the desire to have students and followers (old people are often drawn to young people) who are able to take into account the mistakes and achievements of a life already lived. An old person extracts from his own life experience one of the realized connections between events (“I became a good specialist because I studied diligently at school and university”) and shows its effectiveness or ineffectiveness. Old people have many such realized connections, and it is clear that they have something to educate the younger generation on. As a rule, upbringing also involves extending connections into the future: adults try to connect in the child’s mind (and old people in the minds of adults) two events possible in the future as cause and effect (“If you study well, it will be easier to go to university”). Such a connection, where both events belong to the chronological future, is called potential. The third type of connections are actual connections connecting events of the chronological past and future: they stretch from past events to expected ones, crossing the moment of the chronological present.

If realized connections belong to the world of memory and memories, and potential connections belong to the imagination, dreams and daydreams, then actual connections are the current life in its tense incompleteness, where the past is fraught with the future, and the future grows from the past. In psychology, the so-called Zeigarnik effect is known: actions that were started but not completed are remembered better. There is a current connection between the beginning of an action and the expected result, and we clearly remember what was unfinished, not completed. It is always alive in us, always in the present. By the way, this is precisely what explains the facts of painful experiences of the unrealized past by old people.

The past not only gets closer psychologically in old age, but also seems clearer and more understandable. Nevertheless, in old age, the orientation towards a certain time direction, described by A. Bergson and C. Jung, remains: there are old people who live only in the past (emotional, depressive); There are those who live in the present (impulsive, sensing), but there are also those who place their perspectives in the future (initiative). Orientation toward the future is also associated with greater self-confidence and a feeling of being the “master of one’s own destiny.” It is no coincidence that one of the achievements of psychotherapy for old age is a change in orientation - from the past to the future.

Is it true that old people want to be young again? It turns out not. As a rule, it is unfulfilled and immature individuals who want to remain “forever young,” people with unstable self-esteem, deprived and frustrated by life. And for most old people, the feeling of “realization” of age, of one’s own life (if it exists, of course), is more valuable: many old people say that if life were given a second time, they would live it almost the same way. In the experiments of A. A. Chronicle, the subjects, having accepted the entire content of their life as 100%, had to evaluate its fulfillment. The average figure was 41%, but the range was from 10 to 90%. Knowing how a person evaluates what he has done and lived, one can determine his psychological age. To do this, it is enough to multiply the personal “indicator of fulfillment” by the number of years that the person himself expects to live. Psychological age is higher the longer a person expects to live and the more he has managed to do.

Changes in the course of development in gerontogenesis largely depend on the degree of maturity of a person as an individual and subject of activity. Education received at previous age stages plays a huge role here, as it contributes to the preservation of verbal, mental and mnemonic functions until old age, and occupation. Persons of retirement age are characterized by high preservation of those functions that acted as the leading factor in their professional activity. Thus, for people engaged in intellectual work, their vocabulary and general erudition do not change; Older engineers retain many nonverbal functions; Old accountants perform tests of arithmetic speed and accuracy just as well as younger ones. It is interesting that drivers, sailors, pilots until old age retain the sharpness and field of vision, the intensity of color perception, night vision, depth of eye, and those whose professional activity was based on the perception of not distant, but near space (mechanics, draftsmen, seamstresses) progressively lost their sight in old age. This is explained by the result of the accumulation of previous experience of visual-motor coordination. Those functions that are the main components of ability to work are sensitized in the process of work.

Of particular importance is the implementation of creative activities by older people. The results of studying the biographies of creative individuals show that their productivity and performance do not decrease in late ontogenesis in various fields of science and art.

One of the curious phenomena of old age is unexpected bursts of creativity. So, in the 50s. XX century A sensation spread across newspapers around the world: 80-year-old Grandma Moses began to paint original artistic canvases, and her exhibitions were a huge success with the public. Many old people followed her example, not always with the same success, but always with great personal gain. For any society, a special task is to organize the life of aging generations. All over the world, this is served not only by social assistance services (hospices and shelters for the elderly), but also by specially created social institutions for adult education, new forms of leisure and a new culture of family relationships, systems for organizing the free time of aging but healthy people (travel, social clubs). interests, etc.).

In old age, not only the changes that occur to a person are important, but also the person’s attitude towards these changes. In F. Giese’s typology, there are 3 types of old people and old age:

1. a negative old man who denies any signs of old age and decrepitude;
2. an extroverted old man (in the typology of C. G. Jung), recognizing the onset of old age, but coming to this recognition through external influences and by observing the surrounding reality, especially in connection with retirement (observations of grown-up youth, differences in views and interests, death of loved ones and friends, innovations in technology and social life, changes in family status);
3. introverted type, acutely experiencing the aging process; dullness appears in relation to new interests, revival of memories of the past - reminiscences, interest in questions of metaphysics, inactivity, weakening of emotions, weakening of sexual moments, desire for peace.

Of course, these estimates are approximate, no matter how much we would like to classify old people into one type or another.

No less interesting is the classification of socio-psychological types of old age by I. S. Kon, built on the basis of the dependence of the type on the nature of the activity with which old age is filled:

1. active, creative old age, when a person retires and, having parted with professional work, continues to participate in public life, educating young people, etc.;
2. old age with good social and psychological adaptability, when the energy of an aging person is aimed at organizing his own life - material well-being, rest, entertainment and self-education - for everything that previously there was not enough time for;
3. “female” type of aging - in this case, the old man’s efforts are exerted in the family: in housework, family chores, raising grandchildren, in the country; Since housework is inexhaustible, such old people have no time to mope or be bored, but their life satisfaction is usually lower than that of the two previous groups;
4. old age in caring for health (“male” type of aging) – in this case, moral satisfaction and fulfillment of life are provided by caring for health, stimulating various types of activity; but in this case, a person may attach excessive importance to his real and imaginary ailments and illnesses, and his consciousness is characterized by increased anxiety.

These 4 types of I.S. Cohn considers psychologically successful, but there are also negative types of development in old age. For example, these may include old grumblers, dissatisfied with the state of the world around them, criticizing everyone except themselves, lecturing everyone and terrorizing others with endless claims. Another variant of the negative manifestation of old age is lonely and sad losers, disappointed in themselves and their own lives. They blame themselves for their real and imaginary missed opportunities, and are unable to drive away dark memories of life’s mistakes, which makes them deeply unhappy.

The general health and physical well-being of older people varies with age.

The incidence rate increases with age. At 60 years of age and older, it is 2 times higher than the incidence rates for people under 40 years of age. There is a constant increase in the number of old people, seriously ill people who need long-term drug treatment, guardianship and care.

According to the WHO classification (1963), the age of 60-74 years is considered elderly, 75-89 - senile, and 90 years and older - a period of longevity.

In the process of aging, the body's adaptive capabilities decrease, vulnerabilities are created in its self-regulation system, and mechanisms are formed that provoke and reveal age-related pathology. As life expectancy increases, morbidity and disability increase. The diseases become chronic with an atypical course, frequent exacerbations of the pathological process and a long period of recovery.

It is noted that the need of the elderly for medical care is 50% higher than that of the middle-aged population, and the need for hospitalization for people over 60 years of age is almost 3 times higher than this figure for the general population. In Moscow, up to 80% of people over the age of 60 seek medical and social assistance, and among those receiving home care, approximately half are over the age of 60. For one nursing visit to a patient under 60 years of age, there are 5-6 nursing visits to patients over 60 years of age.

Quality of life (QOL) is a person’s individual sense of his position in the life of society, taking into account the system of values, goals of a given individual, his plans, capabilities and degree of disorder. The fundamental properties of QoL are multicomponentity and subjectivity in assessment. We can say that this is satisfaction from psychosocial and other forms of activity under conditions of restrictions associated with the disease.

KZ depends on material comfort, health and active recreation (entertainment). It is believed that the concept of QoL combines indicators of at least four different, but correlated with each other areas: physical (physical well-being is a combination of manifestations of health and/or illness); functional (functional capabilities are a person’s ability to carry out activities determined by his needs, ambitions and social role); emotional (an emotional state of a bipolar orientation with correspondingly opposite results in the form of well-being or distress); social status (level of social and family activity, including attitude to social support, maintaining daily activity, performance, family responsibilities and relationships with family members, sexuality, communication skills with other people).

At the same time, it should be noted that the main component of the concept of quality of life for people in the older age group is, first of all, the availability of medical and social care. QoL is also affected by the fact that elderly patients, compared to people of working age, have significantly less financial resources and social support.

The use of this understanding of QoL presupposes the orientation of medical and social structures not only towards carrying out various therapeutic and preventive measures (drug and surgical treatment, rehabilitation), but also towards maintaining a state that would provide every member of society, including older people, with optimal physical, psychological and social comfort, even regardless of treatment results.

It is well known that living normally means being able to satisfy basic, intellectual and social needs, and being independent in their fulfillment. It should be recognized that eventually a period comes when an old person is unable to satisfy his needs - physical and mental decrepitude makes him completely dependent on those around him.

In this regard, the main task of organizations providing medical and social assistance to older people is to maintain a satisfactory quality of life for patients who have partially or completely lost the ability to self-care, and to protect the rights guaranteed by the state to medical and social services.

The general physical condition of old people is an integral indicator of health and ability to work. For them, the most important thing is to maintain the ability for normal life activities, that is, for self-care, and therefore their main characteristics should be considered;

Degree of mobility;

Degree of self-service.

Without a doubt, such an objective indicator of health in old age is being confined to a limited space. On this basis, the following categories of old people are distinguished: a) freely moving; b) due to limited mobility, confined to a house, apartment, room; c) immobilized, helpless, bedridden.

In the 1980s, a summary assessment based on the following scheme was proposed for epidemiological studies of older and older people: 1) activities of daily living; 2) mental health; 3) physical health; 4) social functioning; 5) economic functioning.

Daily activities are determined by the degree of mobility and the amount of self-care.

Mental health is characterized by the preservation of cognitive abilities, the presence or absence of symptoms of any mental illness, and emotional well-being in social and cultural contexts.

Physical (somatic) health is associated with self-esteem, diagnosed diseases, frequency of seeking medical help, including stay in inpatient medical institutions.

Social functioning is determined by the presence of ideological and friendly connections, participation in the life of society, and communication with social organizations.

Economic functioning is determined by the sufficiency of financial income (from any sources) to meet the needs of the old person.

There are two completely different groups, qualitatively different from each other. On the one hand, there is a group of people aged 63-75 years, which is characterized by a greater or lesser loss of the ability to provide material support and almost complete preservation of the ability to self-care.

The second group is people who are over 75 years old, with complete loss of ability to work, who have become dependent with a greater or lesser, and often absolute, loss of ability to self-care. Formally, both groups are old people, but in reality they are completely different people.

“Dislike of the unfamiliar” is very common among older people. Increasingly, they are surrounded by new, incomprehensible things, the need arises to reconsider their positions, and they are oppressed by material difficulties. When providing medical and social assistance to elderly and elderly people, it is important to maintain their interest in various activities and convince them of the need for mutual support.

Old age can become a worthy period of life if a person enters it as healthy as possible, retains the hygienic skills acquired at a younger age, and, finally, if he shapes his old age long before its onset. Preventive measures taken after the age of 40 contribute to a more prosperous course of old age and prevent many sufferings and senile infirmities. It is more difficult for a person who is already elderly, with developed dystrophic changes in the body, to change the nature of his diet, to start doing gymnastics or other types of physical therapy. While maintaining useful skills acquired over many years is easier and allows you to keep your aging body in good shape. An active lifestyle reduces the risk of coronary disease and the development of obesity, which in turn contributes to the occurrence of diabetes mellitus, and coronary disease complicates the course of hypertension that develops in an elderly person.

Manifestations of coronary disease are most often found in populations with low physical activity, less often in people with moderate activity, and very rarely in people with high physical activity.

Prevention of senile dementia is the activity of intellectual life and avoidance of animal proteins and fats.

The concept of “lifestyle” is a broad category that includes individual forms of behavior, activity and the realization of all opportunities in work, everyday life and cultural customs characteristic of a particular socio-economic structure. Lifestyle also refers to the quantity and quality of people's needs, their relationships, emotions and their subjective expression.

Senile infirmity is a condition in which a person, as a result of a long-term chronic illness, becomes unable to perform the daily functions necessary for a normal independent life. This condition is also called “senile vital failure”. In this case, constant care and assistance is already required; a frail old person cannot live alone, he must either be surrounded by his loved ones who are ready to care for him, despite all the difficulties, or go to live in a nursing home. Senile infirmity can be caused by a mental or physical defect (senility), but more often by the combined influence of both.

Helpless old people who have retained their intellectual abilities and clear minds present significantly fewer difficulties in caring for them.

It has been proven that the vast majority of cases of premature aging and death are the result of an unhealthy lifestyle (bad habits, unbalanced diet, alcoholism, smoking, drug addiction, environmental problems, etc.).

In conditions when the activities of health care institutions and insurance medicine are based on a new economic mechanism, medical and social assistance to elderly and elderly people acquires the following feature. Currently, it is constantly emphasized that the provision of medical services, i.e. Treatment of elderly and old people is a loss-making business for medical institutions, supposedly these medical institutions suffer significant economic losses. Death is rarely a consequence of old age. In this case, the person dies calmly, without physical suffering. More often, death in old people occurs suddenly from some random disease, which very quickly leads to senile infirmity, and the person, who does not have time to realize everything that is happening, dies in a dramatic situation of mental discord. However, most often old people die from chronic incurable diseases. In first place are diseases of the heart and blood vessels, in second place are malignant tumors, in third place is COPD (a lung disease caused primarily by smoking.

The last period of life can be a great test for the oldest person and his environment. Almost all people feel lonely and afraid before they die. Therefore, a dying patient should never be left alone. At this time, he needs to feel an atmosphere of goodwill and attention around him. Patience, understanding and kindness are integral components of a relationship with a dying old person. The issue of informing the patient about impending death must be decided absolutely individually. In some countries they talk about this openly, in others the principles of medical deontology do not allow this, so as not to deprive the patient of hope until the last moment.

QUESTIONS FOR SELF-CONTROL

What is the aging process associated with?

What is the reason for the need of older people for medical and social support?

What does the concept of “health” include?

What does the concept of “quality of life” include?

What are the health characteristics of older people?

What groups are old people divided into?

What is mental health characterized by?

What is physical health related to?

What determines the social and economic functioning of people?

What are the medical problems of old people?

What is senility?

What are the general principles of helping frail old people?

Describe the objectives of health care.

Information sources:

http://kurs.ido.tpu.ru/courses/gerontology/tema_11.html

http://www.clinvest.ru/part.php?pid=213

The average life expectancy of a modern person is much higher than that previously observed among his ancestors. This means that advanced age becomes an independent and rather long period of life with its own psychological and social characteristics. And although each person’s aging occurs individually, as numerous studies show, there are still characteristic differences between the psychology of the elderly and the lifestyle and worldview of middle-aged people.

Aging processes and psychology of older people

Aging is an inevitable process. It is characteristic of any living organism, is progressive and continuous, accompanied by degenerative changes in the body. According to the WHO classification, a person between 60 and 74 years old is considered elderly; later, old age begins. However, it should be taken into account that any scheme for identifying and classifying regression age is rather conditional.

The psychology of older people has its own characteristics. The aging process is a physiological, psychological and social phenomenon. During this period, a person’s entire life undergoes serious changes. In particular, there is a decrease in a person’s physical and mental strength, deterioration in health and a decrease in vital energy.

Destructive tendencies cover almost all functions of the body: the ability to remember decreases, reaction speed slows down, and the functioning of all senses deteriorates. Thus, people over 60 years of age represent a separate social group with its own characteristics and needs. And the psychology of the elderly and senile age differs from the views on life of the younger generation. With general age characteristics, several types of old age can be distinguished:

• Physical – aging of the body, weakening of the body, development of diseases;
• Social – retirement, narrowing circle of friends, feeling of uselessness and worthlessness;
• Psychological – reluctance to acquire new knowledge, complete apathy, loss of interest in the world around us, inability to adapt to various changes.

Around the same time, with a person’s retirement, his status changes, which is why late age is also called retirement age. Changes are taking place in the social sphere of life, his position in society becomes somewhat different. Due to these changes, an elderly person has to face many difficulties every day.

Moreover, it is quite difficult to single out problems of a psychological nature only, since deterioration in health or financial situation is always experienced quite strongly, which cannot but affect the psychology of an elderly person. In addition, you have to adapt to the new conditions of your life, although at a later age the ability to adapt is significantly reduced.

For many older people, retirement and cessation of work are a serious psychological problem. First of all, this is due to the fact that a large amount of free time appears, during which you need to occupy yourself with something. According to the psychology of the elderly, losing a job is associated with one's own worthlessness and uselessness. In such a situation, the support of the family is very important, ready to show the old man that he can still be of great benefit by doing some kind of housework or raising grandchildren.

Features of the psychology of older people

According to the results of gerontological studies, after 60-65 years a person’s attitude to life changes, prudence, calmness, caution and wisdom appear. The sense of value in life and level of self-esteem also increase. A feature of the psychology of older people is also that they begin to pay less attention to their appearance, but more to their health and internal state.

At the same time, negative changes in the character of a person of respectable age are also observed. This happens as a result of weakening internal control over reactions. Therefore, most of the unattractive features that were previously hidden or disguised come to the surface. Also, in the psychology of older people, egocentrism and intolerance towards those who do not give them due attention are often observed.

Other features of the psychology of elderly and senile age:

The psychology of the elderly has its own characteristics, so it is not always easy for the younger generation to understand the fears and concerns of the elderly. However, society needs to be more patient and sensitive to the needs of older people.

This age covers periods of a woman’s life from 55 to 75 years, and men from 60 to 75 years. In general, it is characterized by an increase in signs of aging and an acceleration of the aging process itself. If, in terms of external signs, an elderly person of the first 5-6 years and a person of mature age (the last 5-6 years) in most cases still differ slightly, and the age boundary itself is practically indistinguishable, then by the end of the period of old age it is difficult to confuse people of these ages.

Aging is a natural manifestation of many diverse life processes of the body that occur with different signs.

Elderly people bear the visible imprint of the years they have lived. First of all, this concerns the appearance - characteristic changes in hair, skin, general outline of the figure, gait, etc. Age-related graying usually begins from the head, sometimes from the beard, and a little later appears in the hair of the armpits and eyebrows. Graying of chest hair does not occur until age 40. There are, however, known cases of premature graying, which may be hereditarily determined in the family.

Characteristic changes in the skin. By the age of 50, the skin color of the face acquires an earthy-pale hue, which intensifies as age increases. The skin loses its elasticity, pigment spots of varying degrees of severity appear, and signs of keratinization appear. At the age of 50-60, wrinkles are found on the earlobes, bridge of the nose, chin and upper lip. Later, wrinkles begin to cover the skin of the cheeks, forehead, and neck, becoming deeper and more noticeable every year. It should be borne in mind that wrinkles may appear on the skin of the face and neck earlier, especially in people who spend a lot of time outdoors, under the scorching sun and wind.

In an elderly person, with rare exceptions, the figure, posture and gait noticeably change, which is associated with age-related changes in the joints, muscles and skeleton. The mass and strength of the muscles, elasticity and mobility of the ligamentous apparatus gradually decrease, the degree of mineralization of the bones increases, which increases their fragility and the likelihood of fracture in the event of a fall or severe bruise. The body becomes heavy, the back becomes round and stooped. Due to the flattening of the intervertebral discs, growth is reduced. The gait becomes heavy, slow, but not yet “shuffling”, which is often characteristic of old age. These signs intensify in cases where a person is obese.

Changes in the activity of most internal organs and systems continue to increase. A decrease in heart mass and the elasticity of blood vessels is accompanied by a decrease in heart rate and a decrease in the volume of blood passing through the cardiovascular system per unit time. By the way, these changes occur against the background of aging of other organs and tissues and are therefore “convenient” for the heart, which no longer has to sharply speed up its work and work to the limit of its capabilities.

Significant age-related changes occur in the respiratory system. By reducing the elastic properties of the lung tissue, the vital capacity of the lungs decreases and the amount of air constantly remaining in the lungs increases. In addition, due to the progressive ossification of the costal cartilages and atrophic changes in the tendons and respiratory muscles, a decrease in the mobility of the chest occurs. As a result of these changes, breathing becomes shallow and rapid. The lungs no longer cope with their task sufficiently, especially during physical exertion - a person suffocates, he begins to feel short of breath, and begins to cough. Excess body weight, smoking, and diseases of the respiratory system only aggravate these manifestations.

Old age takes its toll on the digestive and excretory systems.

The genitourinary system is characterized by a number of manifestations, in particular in men due to the peculiarities of their anatomical structure. After 50, and more often after 60 years, in 1/3 of all men, the process of prostate hypertrophy begins, which, pinching and squeezing the ureter, causes difficulty urinating. Sometimes hypertrophic changes develop into a cancerous process that affects the prostate gland. In all cases of difficulty urinating, older people are strongly recommended to consult a urologist.

Atrophic changes occur in the nervous structures, their blood supply deteriorates, and individual connections with a number of other body systems (primarily the endocrine) are disrupted. On the other hand, the majority of older people clearly show disturbances in the processes of excitation and inhibition and their relationships. Memory impairment may also occur. But the nervous system and the brain have colossal reserve capabilities for timely and fairly effective compensation of disorders caused by both age-related changes and those introduced from the outside (trauma, etc.). Therefore, it would be premature to talk about “senile” changes in the nervous system. You just need to take into account possible and actually operating factors that affect the functioning of the nervous system. These include brain injuries, disorders of its blood supply, infectious diseases that in one way or another affect the activity of the brain (not only neuroinfections), intoxication, now we can talk about radiation effects on the nervous system, brain tumors of various origins and locations, etc. . Factors destructive to brain activity include “laziness of mind,” since active mental activity promotes the development of numerous new connections between nerve cells and activates their biochemical activity. Together, these processes determine the mobilization of that reserve of brain power that ensures its functioning under unfavorable conditions (in this case, age-related changes).

Now let's look at an elderly person from the point of view of mental changes that occur with age, as well as the social conditions in which he lives and exists. Let's remember what age interval occupies old age. At this time, most people are either planning to retire or have been receiving it for a long time. A sharp separation from a beloved and familiar job, a work collective with which one has been closely and for a long time connected, a violation of a long-term life pattern is a powerful stress factor for the nervous system and psyche, the effect of which cannot pass without leaving a trace. A person who has taken a “well-deserved rest”, or retired, seems to hang in the air: he is no longer needed by production, he does not need to rush to work in the morning; his children have grown up and are busy with their own problems, most of them have their own families and children. Material income is sharply declining. And ahead is old age with its illnesses, infirmities and the need for help. All this gives rise to pessimism and depression. It is good if a person is able to continue creative activity and find in it peace and compensation for his previous lifestyle. He especially needs a garden plot, a dacha, where he could spend his energy.

Elderly or retirement age can be considered decisive from the point of view of mental experiences. If a person is able to find pleasure in his grandchildren, his own gardening, dacha, fishing, home improvement, if he finally uses previously constantly missed opportunities in his creative development, going to museums, exhibitions, theaters, etc., then enough will easily and painlessly switch to a new regime of his life. Otherwise, this transition becomes extremely painful both for the person himself and for those around him and loved ones.

Old age requires a reasonable reconsideration of one’s capabilities in terms of physical activity, organization of one’s rest, habits, and diet. What was possible at 50 or 60 becomes unacceptable at 70. The intensity and duration of physical activity must be reduced, rest should be long enough and comfortable, food should be easily digestible and small in volume.

Society should not forget people of older generations who are leaving or have already retired. Moreover, personal activity, participation in professional and social life have become necessary for the majority of people who have crossed the retirement line.

Senile age- a conditionally allocated period of human life from 75 to 90 years. In general, the age periodization of the second half of a person’s life (i.e., after approximately 35 years) is quite complex. Thus, at the end of the 19th century and the beginning of the 20th, people who were barely 45-50 years old were considered old people. Later, due to the increase in human life expectancy, ideas about the time of onset of old age and old age began to shift: we can say that old age “recedes”, and the duration of young ages increases.

Considering the morphological and functional changes characteristic of old age, it should be emphasized that there are no fundamentally different changes in relation to those that are characteristic of old age in old age. There is only their deepening and more distinct manifestation. In particular, the skin, especially the hands, face and neck, becomes thin, wrinkled, and age spots appear on it. Hair turns gray, thins, and becomes brittle. Muscle atrophy and a sharp decrease in the thickness of subcutaneous fatty tissue lead to the formation of many skin folds. The eyes lose their inherent shine, become dull, and in some cases, eversion of the eyelids and ptosis occur. Height decreases, and many old people experience excessive stooping. The gait becomes uncertain and slow.

The aging process does not bypass internal organs. These organs, in accordance with the laws of senile decline, also gradually reduce their activity.

The totality of senile changes and pathological changes caused by external factors determine the picture of senile pathology. A decrease in the body's ability to adapt to existing factors also causes the development of metabolic or functional disorders, the most common of which are atherosclerosis, accompanied by impaired blood supply to the heart, subsequent heart failure; angina pectoris (angina pectoris); myocardial infarction; disorders of the blood supply to the brain with disorders of the activity of various organs. Hypertension is very often observed, which is usually combined with manifestations of atherosclerosis. In old age, numerous diseases of the musculoskeletal system (rheumatism, osteochondrosis, radiculitis, etc.), diseases caused by functional disorders in the endocrine sphere (diabetes mellitus, etc.) are not uncommon. Disturbances at the cellular level, in the genetic apparatus of the cell, lead to the development of various tumors.

The greatest changes manifest themselves in the mental sphere of an old person: the mobility of nervous processes and memory for recent events deteriorate, and emotional instability develops. These processes are accompanied by a weakening of the intensity of perception of new impressions, as if by a “flight into the past”, into the power of memories, as well as an “obsession” with thoughts about one’s health, “sores” and ailments. Conservatism in judgments and actions, a penchant for teaching are very noticeable; Some affectations are observed, expressed in some cases by previously unusual callousness, distrust, capriciousness, and inadequate touchiness. There is a fairly widespread opinion that in old age, characterological personality traits become sharper and more clearly manifested. For many people of this age, the described changes in the psyche are not of a pronounced nature and, according to the outstanding Soviet pathologist I.V. Davydovsky, are in the nature of an “illness of old age.” However, in some cases they become painful and can serve as the first manifestations of senile dementia.

The psyche of an old person is extremely susceptible to the influence of external factors, which is based on a change in the social status of the individual, role and place in society (perhaps this explains the desire for suicide that is often found in old people).

Thus, elderly people, due to the specific characteristics of their psyche and a certain helplessness, require special treatment and care from loved ones, acquaintances and simply those around them.

Previously, this role was played by religion, church, and way of life. In our time, with the rapid pace of life, when people have lost the habit of looking around and the principle of “help your neighbor” has practically ceased to apply, the need has come to stop, look around and remember that each of us will be old and will also need help.

The effect of any factors on human life and health should be considered as a whole. For example, the social environment and living conditions determine the nature of nutrition, consumption of alcohol, tobacco, drugs, etc. This, in turn, affects the state of health, the body’s resistance, and its vitality. A decrease in these indicators inevitably leads to the emergence of diseases, an increase in the mortality rate, and ultimately to a decrease in the life expectancy of the population. A targeted impact on these connections will increase the biological capabilities of the human body, delay old age, and facilitate the aging process itself.