The appearance of wrinkles, gray hair, fat, and the like can have major effects on a person’s self-concept (Aldwin & Gilmer, 2004) and reflect ageism in society (Clarke & Griffin, 2008). Middle-aged adults may still think of themselves as productive members of soci­ety and rebel against being made invisible (Clarke & Griffin, 2008). Because U. S. society places high value on looking young, middle-aged and older adults, especially women, may be regarded as inferior on a number of dimensions, including intellectual ability. Consequently, women report engaging in “beauty work" (dyeing their hair, cosmetic surgery, and the like) in order to remain visible in society. In contrast, middle-aged men with some gray hair often are con­sidered distinguished, more experienced, and more knowledgeable than their younger counterparts.

76 CHAPTER 3

Table 3.2

Similarities and Differences Among Osteoporosis, Osteoarthritis, and Rheumatoid Arthritis

Osteoporosis Osteoarthritis Rheumatoid Arthritis

Sources: National Institute of Arthritis and Musculoskeletal and Skin Diseases (2006), http://www. niams. nih. gov/Health_Info/Bone/Osteoporosis/ Conditions_Behaviors/osteoporosis_arthritis. asp.

Given the social stereotypes we examined in Chapter 1, many women (and increasingly, some men) use any available means to compensate for these changes. Some age-related changes in facial appearance can be disguised with cosmetics. Hair dyes can restore color. Surgical procedures such as face-lifts can tighten sagging and wrinkled skin. But even plastic surgery only delays the inevitable; at some point everyone takes on a distinctly old appearance.

Losses in strength and endurance in old age have much the same psychological effects as changes in appearance (Aldwin & Gilmer, 2004). In particular, these changes tell the person that he or she is not
as capable of adapting effectively to the environ­ment. Loss of muscle coordination (which may lead to walking more slowly, for example) may not be inevitable, but it can prove embarrassing and stress­ful. Exercise and resistance training can improve muscle strength, even up to age 90, and may also reduce the odds of getting dementia (Andel et al., 2008). Interestingly, the rate of improvement does not seem to differ with age; older adults get stronger at the same rate as younger adults.

The changes in the joints, especially in arthritis, have profound psychological effects (Aldwin & Gilmer, 2004). These changes can severely limit movement, thereby reducing independence and

Physical Changes 77

the ability to complete normal daily routines. Moreover, joint pain is very difficult to ignore or dis­guise, unlike changes in appearance. Consequently, the person who can use cosmetics to hide changes in appearance cannot use the same approach to deal with constant pain in the joints. Older adults use a wide range of adaptive behaviors to cope (Gignac et al., 2000). For example, participation in an exercise program appears to have some benefit. Older adults who suffer bone fractures face several other consequences in addition to discomfort. For example, a hip fracture may force hospitalization or even a stay in a nursing home. For all frac­tures, the recovery period is much longer than for a younger adult. In addition, older people who witness friends or relatives struggling during rehabilitation may reduce their own activities as a precaution.

Concept Checks

1. What changes occur with age in skin, hair, and voice?

2. What changes occur with age in muscles, bones, and joints?

3. What are the major psychological consequences of changes in appearance and mobility?