This chapter presents a broad and general overview of the structural and physiological changes that occur with aging as well as the underlying pathophysiology of age-related diseases. The body comprises eleven organ systems that include the integumentary, muscular, skeletal, nervous, circulatory, lymphatic, respiratory, endocrine, urinary/excretory, reproductive, and digestive systems. As such, the ensuing sections are arranged by organ system and structured to cover age-related physiological changes and common disorders. Older adults experience a myriad of physiological changes as they age. While some of these physiological changes are benign, other changes increase the risk of age-associated pathophysiological changes, which can result in significant functional impairment or morbidity. These pathophysiological changes are not to be considered part of the normative aging process. Thus, it is essential that providers distinguish between the two states.

This chapter discusses several topics relevant to older adults' mental health including access and use of mental health services, prevalence of common mental health diagnoses, assessment of mental health symptoms, and empirically supported treatments for older adults. Although some topics presented in this chapter need additional research focused specifically on an older adult population, several conclusions can be drawn from the material. First, several studies have documented that older adults use mental health services less frequently than other age groups, although it is unclear why this is the case and likely involves a combination of barriers/access to treatment and stigma. Second, several of the mental health problems discussed may present differently among older adults, such as the specific symptoms of depression that older adults endorse. Third, assessment instruments for older adults need to be selected cautiously to ensure that adequate validity and reliability has been established for this population.

This chapter explores changes that occur to the brain, beginning with an overview of modern technologies that are used to answer questions about brain functioning in older adults. Next it summarizes the changes that occur to the brain with normal aging. Finally, the chapter presents an overview of neuroplasticity. Although the human brain clearly loses volume with age, the brain also shows plasticity that can be used to maintain functioning in old age. Research in the coming decades can use the principles of neuroplasticity described previously to enhance the functioning of older adults, whether they are experiencing normal age-related change or damage to the brain following strokes or other neurological events. Neuroimaging methods will continue to be developed that allow us to determine what happens to the brain with age, and in response to neurological events, and how neuroplasticity enables the brain to adjust to such changes.

Cognitive decline that is significant enough to interfere with independent living is known as dementia, and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) introduced the term major neurocognitive disorder to refer to this condition. This chapter reviews the most common causes of neurocognitive disorders in older adults. It begins with a discussion of delirium, which should be ruled out whenever an older adult is showing signs of cognitive decline. Next, it presents an overview of the current diagnostic terminology, including mild cognitive impairment (MCI), dementia, and the DSM-5 diagnoses of mild neurocognitive disorder and major neurocognitive disorder. The chapter next reviews traumatic brain injuries (TBIs), Alzheimer's disease, Lewy body disease, Parkinson's disease, vascular disease, frontotemporal degeneration, which includes a behavioral variant and a language variant, and alcohol-related dementia.

This chapter aims to discuss the cohort effects, health disparities and cultural stressors, and factors contributing to the resiliency and growth of ethnic, sexual, and gender minority older adults. Being part historian, student, and investigator can help clarify how these multifaceted aspects of identity affect the experiences of older adults in your personal and professional lives. The intersectionality of these factors makes for complex, inspiring, and sometimes distressing stories about overcoming adversity, achieving new heights, and at times sitting with the pain and frustration of discrimination and prejudice. The diversity within older adult populations also affords invaluable research opportunities to improve our knowledge of aging and enhance our provision of care. Moreover, developing a greater appreciation for older adults, including their strengths and hard-fought battles, can help us appreciate the privileges and civil rights we often take for granted.

This chapter introduces some of the concepts that are important in the psychology of aging. It starts by discussing definitions of older adulthood and some characteristics, as a whole, of older adults. It then reviews the data on the projected increase in older adults in the United States and internationally. The chapter discusses the importance of birth cohort and continues to be an important theme throughout this book. Specifically, it reviews characteristics of the Baby Boom generation since most of the current generation of older adults were born in that era. Erik Erikson and Paul Baltes are two researchers who have made substantial contributions to the development of aging studies. The chapter then reviews development of the professional field and training resources that are available to students and professionals, and ends with a discussion of research methods that attempt to untangle the effects of age, cohort, and time of measurement.

This chapter reviews age-related changes in personality and emotional functioning. There are several theoretical approaches to studying personality, and most of them have examined the extent to which the theory applies to older adults. For example, Joan Erikson's proposal of a ninth stage of psychosocial development, as well as ways in which attachment processes may be important in late life, and ways in which coping strategies change with age, all represent the application of existing theories to later life. The chapter focuses on emotional functioning in late life. Overall happiness and life satisfaction tends to increase with age. Older adults also show more effective strategies for regulating emotions, including situation selection and attentional deployment toward more positive features of the situation. Some of these changes can be accounted for through two theoretical models: socioemotional selectivity theory and the strength and vulnerability integration (SAVI) model.

Health professionals are often called upon to intervene in complex ethical dilemmas that involve respecting an older adult's autonomy while also considering protective interventions to ensure safety. This chapter addresses the foundational ethical competencies for psychologists and geropsychologists including the unique challenges associated with surrogate decision making, legal, clinical, and psychosocial interventions specific to working with vulnerable older adults, ethical dilemmas that can emerge within various situations including assessment and integrated care settings, detection and intervention strategies in cases of elder abuse, neglect, and exploitation, and ethical approaches to research with older adults. Finally, the authors discuss the multicultural dimensions that influence how ethical and legal issues are conceptualized and addressed. The micro-and macrosystems in which older adults live and thrive require a level of cultural sensitivity, an understanding of aging processes, and knowledge about professional ethics and legal standards involved in decision making.