Ageing

The ageing constitutes a whole of functional modifications decreasing the aptitude of the person gradually to ensure her physiological balance. Ageing is an inescapable process determined by a complex unit of factors biological, psychological and social clean with each individual. Consequently, there exist several definitions of ageing, according to the approach in which one places oneself.

The whole of the phenomena of weakening of the physiological functions related to the Vieillissement constitutes the Sénescence (formed on the Latin word senex , old man). The pathological state resulting from the senescence is the Sénilité.

The study of old age and ageing is the Gérontologie (term formed on the Greek word geron, gerontos , old man). The Médecine of old age is the Gériatrie.

Introduction

Ageing is a phenomenon “polysystemic” of complex interactions by the “diversity” of the levels physique, psychic and cultural and by the “variety” of components on each level. The Complexité is in multiple loops of feedback, Neurologie with the Endocrinologie on the only physical level, the social one with psychological on the only psychic level, values and significances on the only cultural level of the Anthropologie. Ageing is at the same time physical, psychic, social and cultural. It is cultural in the significances and values conferred on old age in various cultures and various times.

For a complete and major intelligibility of this phenomenon of ageing, a ecosystemic Approche consists in moving away for better perceiving, to connect for better including/understanding and to locate for better acting. Ageing presents a prospect broader and more total than simple the Sénescence, the Gérontologie and its slope medical of the Gériatrie, in the narrowness from a elementarist point of view and simplistic of the isolated tree and disjoins forest, itself isolated and disjoined its ecological Niche from fauna and Flore of a Biosphère dependant on the Lithosphère which directs and delimits the possibilities of survival, development and reproduction of the components of the biosphere.

Towards a definition

Categories of ageing

With the registry office, the brain and the spirit, we have three orders of ageing:

ageing symbolic system given by the calendar from which the location differs from a culture with another where, only, in the Occident of the three great revealed religions, the Christian new year, Hebraic and Moslem does not occur at the same moment and where in only Christendom exist the Julien calendar and the Gregorian calendar;
the physical ageing of the brain with the loss of the neurons and impoverishment in synapses in “normal” unfolding, i.e. without diseases;
the imaginary or psychological ageing of perceptions, i.e. attributions of direction (like orientation, relevance and significance) to ageing.

ecosystemic Approach with ageing

Some is the order, ageing poses the problems of the time which connects the various levels and the various fields of the interrogations and the interventions on the human behavior. Within the framework of the dissipative structures of the entropic degradation of the physical systems at Ilya Prigogine, the time of ageing is fluctuations and creations of order and disorder, activation and desactivation of genes and the viruses, of changes and junctions where the Développement is a quantitative variation of more-or-less same thing, while the evolution is a qualitative variation of a " chose" in others " choses" Morphogenesis S, transformations and metamorphosis S. In ageing at the organic level, the loss of the neurons is a quantitative variation, while impoverishment in synapses or nervous connections is a qualitative variation. In the preceding discussions, we saw that this impoverishment in synapses is perhaps representative of psycho-emotional and social impoverishment where ageing is connected to less of interest for the physical-activities and intellectual and with less of social relations.

Doctor Brian L. Mishara, Community professor of psychology to UQAM (University from Quebec in Montreal) and his colleague Robert G. Riedel of Southwest State University in Minnesota studied ageing in terms chronological, physico-biological, psycho-emotional and social (Brian L. Mishara & Robert G. Riedel, 1984, pp. 12-26, ageing , PUF, Paris.). The chronological age, on the one hand, is connected to the biological clock and, on the other hand, is determined by the registry office, in legal attribution, social and policy of the characteristics and properties at each period of the life, such as childhood, adolescence, maturity and old age, in the original intention determine the degree of legal responsibility for the behavior.

The religions and the cultures have also the Rite of passage of a group of age with another, childhood with adolescence through various types of initiation and dedication, adolescence to maturity and this one with old age. Mishara and Riedel distinguish there, then, the physical and biological age, the psychological and emotive age and the social age. Physical ageing, at Mishara and Riedel, is connected to the dysfunction of the immunological system, the degradation of the cells, the deterioration of the system endocrinien and the genetic factors. To give an account of deteriorations, of degradations and the dysfunctions, they evoke the theories of wear, the theories of the eschaton or waste and the theories genetic. Theories of wear are often associated with work of Hans Selye on stress which is distinct from tiredness or from overload physical, insofar as the Stress is a way of perceiving the physical-activities or intellectual of which a person makes proof, i.e. the values and the significances which it confers on these activities. In the theories of wear, the Entropie of the dissipative structures of Ilya Prigogine is perhaps even more interesting, since the basal metabolism or minimal energy expenditure of the body is measured by the quantity of heat released by the body according to body surface, in a situation of physical-activities and sensory reduced to the maximum, conceiving, thus, the human body like a heat engine. We already put under discussion previously the influence of the stress on the immune system at subjects of higher row or lower row in the production of glucocorticoïdes which destroy the neurons and which weaken the immune system. The theories of waste can become operational with the systemic model of Jay Forrester that Joel de Rosnay put so well in the public with " the macroscope " (1975). This systemic model of Forrester uses the metaphors hydrodynamics of flow, tanks, valves where the accumulation of waste of the metabolism ends up encumbering and poisoning the organization. The genetic theories refer to the capacity genes in the " programmation" activations and selective desactivations of certain genes.

General information

Perhaps more than with the Chimpanzee S, the human ones share with the Macaque S a close biological and social relationship. Doctor Donald Price gathered with the Université Johns Hopkins of Baltimore, MANDELEVIUM, a colony of the oldest macaques known, in their about thirty, which, in human terms would make worthy nonagenarians. Each day, these animals are subjected to the medical supervision to discover the biological bases of the abnormal behaviors which can occur at old subjects. No animal follows a trajectory identical to that of another in the deterioration of the activities with the age.

It acts, of course, of the experimental conditions and observation perfectly far away from the living conditions " naturelles" of these subjects. But, the studies of Jane Goodall on the social behavior of the chimpanzees, under their “natural” conditions of life, are almost impassable in the biological studies of the behavior. In addition, the requirements of the social studies are different from those of the biological studies. The studies of Hans Selye on the biological processes of the Stress do not overflow on the social etiology of this stress and remain, nevertheless, the organic bases of this attack. At the human ones, one as well observes old characters overflowing of brilliant activities like: Pablo Picasso, Konrad Adenauer, George Bernard Shaw, Golda Meir and well of others still, that old characters completion stray.

According to the cultures, the ones develop old age and the others scorn it. " alive national treasures of Japon" , made up by elderly honoured by exceptional excellence their arts of which they are the guardians, testify to this valorization who goes until the veneration, of their alive. With the lengthening of the life expectancy and the inversion of the demographic pyramid, ageing became a subject, socially, politically and biologically, more previous occupant. The Gérontologie biological and social is in full rise. In ageing, one distinguishes the chronological age, the biological age and the mental age, i.e. the registry office, the brain and the spirit.

The decline of the physical-activities and mental is noticed mainly by a greater slowness which, recadrée, could reveal another " réalité" of a considered and précautionneux behavior, following the experiences gained during the life and of the confusions, already announced by Ernest Hemingway, between " action" and " agitation" , often made by neophytes in the inexperience and the enthusiasm of the discoveries. The first aspect is perhaps degradation continues of one hundred billion Neuron S with the birth. The weight of the Cerveau decreases, gradually and surely, from approximately 10%, during all the life, by the death of the neurons which does not occur at the same rate/rhythm and the same areas at all the people. This loss takes place in the associative external layers especially, leaving the intact internal parts, persons in charge of the reflex actions which do not depend on the training.

It is located mainly in the cerebral Cortex, person in charge of motricity, the thought and the directions. But, the loss of the cerebral weight, with the age, is less meaning and significant that impoverishment in quality and quantity of neuronal connections or Synapse S which would allow a neuropathologist, in his dissection and its observation, to determine the age, starting from the wealth of synapses. The plasticity or lability of the synapses means that these neuronal connections are done, is demolished and remade with use and any age. The war-horse of Jean-Pierre Changeux is this “synaptic Plasticité” where the neuraux circuits are done by activities of training and demolish themselves by inactivity. It is a device which wears when one does not make use of it.

Doctor William T. Greenough, professor of psychology and president of the programme of biology of the brain and the behavior with Champaign-Urbana in Illinois, suggested that the cerebral structure and the function of a person reflect in all points of view the balance of the interactions between the growth and the degeneration. With the age, the degeneration carries on the growth. But, the experiments of Greenoygh on the Animal and the Man also show as by increasing the complexity of the environment and the interest of the subject for this environment, the cerebral complexity of this subject increases as well at the people as in the rats.

Causes

A process multidimentionnel

Ageing results from interactions of bio-psycho-social dimensions.

According to the psychosocial approach, the level of study, the socioprofessional category, the level of resources…. are as many factors of inequalities vis-a-vis ageing. Indeed, far from growing blurred, these inequalities increase with the age.

From the biological point of view, ageing results from the interaction of genetic factors and factors from the environment of which the effects are cumulative during time (Jeandel 2003).

These theories are not exclusive from/to each other and are complementary to explain the strong inequalities which exist in term of ageing.

Another theory

One of the theories on the causes of ageing would advance that ageing would be a genetic disease, a change similar for example to trisomy 21 or the hemophilia. The size of this phenomenon (all the human ones age) would come owing to the fact that contrary to the other genetic diseases, ageing causes an extremely late death, affects only very late the functions of reproduction and causes a mental degeneration spread out over very a long life. All these characteristics would have made it possible the disease to affect a very great number of people - all the world of makes since the patients had the capacity to reproduce without problem causing the disappearance of the healthy lines. There would exist also ageings much faster (on 10 or 20 years) but these extremely rare genetic diseases very early inhibit the capacity of reproduction preventing the reproduction of affected individuals. Not to forget that this is only a " theory intéressante" basing itself only on one of the many existing analyzes.

Private clinic

Normal ageing

Ageing is a phenomenon whose biological, psychological and social repercussions are closely dependant.

Physiological aspects

the respiratory function: thoracic compliance is strongly decreased with the age; one notes a loss of elastic retreat pulmonary and a reduction in force of the respiratory muscles. The respiratory function of rest is deteriorated by an increase in residual volume and a reduction in the vital capacity. Pulmonary arterial blood flow decreases and the pulmonary blood pressure increases with the age.
the circulatory function: the arterial Hypertension increases with the age and the arteriosclerosis appears.
the locomotor function: the osseous ageing characterized by a reduction in the osseous anabolism, being able to lead to a Osteoporosis and the Osteomalacia; the articular ageing characterized by the Osteoarthritis; the muscular ageing characterized by a Sarcopénie, involving a reduction in the muscular force. The repetition of effort is more difficult, and forces it and the endurance are preserved longer than the Résistance, speed, the flexibility and the coordination of the movements.
sensitivo-sensory capacities: At the perceptive level, a reduction in the sensitivo-sensory capacities appears involving a postural instability, as well as a deterioration on the level of hearing (presbyacusia) and sight (presbyopia, cataract).
the physical capacity: the maximum Puissance Aérobie declines; the aerobic capacity decreases.

Generally, the process of ageing, after the phase of maturation, conduit to a progressive reduction in the capacities of functional reserve of the organization (Jeandel, 2003) involving difficulties of physiological adaptations. This decline is accentuated by the reduction in the physical-activity which accompanies the projection in age.

Psychological aspects of ageing

It is difficult to distinguish the directly induced psychological modifications by ageing, of those sometimes accompanying the consequences by this one (Ninot, 2004). However, certain changes emerge like affecting cognitive dimension and emotional within the framework from normal ageing.

The awakening of ageing

As regards “old man”, the awakening of ageing and more exactly its ageing, is not uniform. It is related on its history of life and the progressive constitution even, of its thought. In “old age in analysis” CH. Herfray specifies that each one done of its ageing what the text which lives it makes it possible him to do. In the same way for P. Guillet in “the adventure of the age”, it is about a relative and subjective concept according to each human being This awakening is different and specific to each one, but not specifically related on the age (it is not the same one to 50 and 80 years), on the loss (somatic or psychic) or to the dependence. It can include all that and/or be sudden and call upon driven back, with unconscious interior data, described by in particular H. Bianchi in “Ego and time”. The reading of the talks highlights these two approaches of ageing, some stressing this continuity, this permanence, on this “nothing does not change”, of other on the progressiveness of the change, this “progressive and inescapable”. The concepts of “continuity” and “change” are fully present here.

The concept of continuity is defined as the unconscious consideration of a temporal persistence of its capacities, without existing change. It is thus an objective concept with the direction where it exists independently of the thought and because objectivity is “what is in conformity with reality”. However evidence of change, marks such as defines by E. Goffman in “Mark - the social uses of handicap”, appear nevertheless at certain time of advanced in age. This mark, this mark of time, makes resurgence abruptly, in a all the more strong way as it is sudden and unexpected, and because the individual cannot camouflage this mark with itself continuously. The retirement for some, the death, the disease, presbyopia, harbingers of inertia invading for V. Jankélévitch, the dependence of the “pars of age” as S. of Beauvoir depicts them, the violence of confrontation to the collective are indicators, as well as certain birthdays, that the arrival of the following generations or that the image returned by the mirror, specular indicator which can abruptly reveal vis-a-vis oneself the image of the defeat, to reveal vis-a-vis oneself this other me which one became, this me that one had hidden. It is this old image of a grandparent whom one had with deepest of oneself which suddenly appears in this mirror. That which one found so old formerly, today it is oneself. The mirror returns then suddenly by resurgence of an infantile stage unconscious (“mirror stage” developed per H. Wallon and in particular described in “psychological Evolution of the child”), with the creation of Ego within the meaning of seat of the conscience and place of unconscious demonstrations developed by J. Lacan in 1936. Ego, he writes, builds himself with the image of similar and initially of this image which is returned to me by the mirror, it am I, this Me freudien defines by Bela Grunberger in “Ego, Ca and the Super-ego”, like the authority of the imaginary register par excellence, therefore identifications and narcissism. The form or ideal ego to which the child in the mirror stage is identified, appears to him in a relief of statue which solidifies it and under a symmetry which reverses it, in opposition to the turbulence of the movement (constitution of the opposition “continuity” - “Change”). J. Lacan insists as well on the inversion of this image, putting forward its dimension of space lure, as on its power alienating by comparing it with an armor which will mark its rigid structure all the mental development. The image is not then any more what it was. It is different (Different). It seems possible to make an analogy with the Diagram L developed by J. Lacan. Admittedly this diagram is related to the word, but this concept of word, without to be developed here, appears in the awakening of ageing, because it contributes to the constitution of the subject. The diagram L sets up the two axes, symbolic system and imaginary, which order subjectivity: I can think like me (A), only from the image of the other, my similar (has'), in a relation out of mirror. But I as prone of the word (S) am determined by the symbolic system which preexists to him and supposes a (A) place, like place of meaning. For J. Lacan, this quadripartite structure is since unconscious the always exigible one in the construction industry from a subjective ordinance. We will re-examine this concept of subjective in the concept of “Change”. In other words, I exist by the image of the other as in reflection, the word is set up and what I saw in my mirror influences my life.

This diagram L requires to define the subject, because it is not it Me. The subject is the subject of the desire. This subject is an effect of the immersion of small of man in the language. It thus should be distinguished as well from the biological individual as of the subject of comprehension. It is not either it Me freudien and it is not therefore it I of grammar. Effect of language, it is not an element: it “ex-sist” (is held out) at the price of a loss, castration (within the meaning of dissociation Girl-Boy and entered the Oedipus). For RAIN. Assoun in “How agreeing to age? ”, the traces of castration are found at the time of the awakening of ageing, represented by physical statuses (wrinkles, menopause). They modify Narcissism, its image of oneself. It is necessary to succeed in dissociating them from Ego existing in order to accept this metamorphosis. H. Danon-Boileau in “old age with death” defining that as a collapse of the regard of oneself, an upheaval of its image of oneself and a wound of narcissism, characterized by a rupture of the feeling of All-powerful. Ego is thus a function which is spread in the dimension of the imaginary one. It is the feeling of a unified body produced by the assumption (in the literal sense: " to take with oneself) by the subject of its image in the mirror at the time where it did not conquer its driving autonomy yet: from where its capacity of fascination. It results from it that it Me is placed on a secondary axis in opposition to its own image (narcissism) or to that of similar (small other in the diagram L). This relation of Ego with its imaginary object makes obstacle with the recognition by the subject of its desire.

D. The Breton one goes further in “faces”, by specifying that the report/ratio with the image of the body is not only under the aegis of Ego, but also depends on unconscious, i.e. internal data which is not under the control of the will, but are binding with force on the actor. Individual sees by these indices, to manage proof that it is not “most irreplaceable of the beings”, it undergoes wound of narcissism (with direction where this one is regarded as an unconscious protection against the effects of the time, disavowal) which awakes all the jealousies, desires and feelings of infantile impotence with this difference that formerly wish them compensation, in revenge supported by the phantasm of Absolute power (influenced by the religious concept of Immortality, rejection of Dead), did not butt against the reality of a dubious future. These indices reach the individual on two levels according to S. Freud. It is reached on the level of Ego, i.e. its identification on the level of the social roles (the image of the depression of the pulpits symbolizes social depression, for CH. Detrez in “social construction of the body”) and on the level of the subject of unconscious, i.e. which returns to the structure even of the subject. Ego regressing sometimes until the infantile Narcissism (anchored in each being, for A. Houziaux in “How agreeing to age? ”) and being diverted of a real-world which brings nothing any more but frustrations. The individual is thus led for H. Bianchi, to operate a choice between two steps which are, one that of a specific work of mourning (mourning of that which one was, as CH develops it. Herfray), which implies a late D-development of the experiment œdipienne, of mourning of Ego, the other, failing to grant this work, consistent, in the refusal, to refuse reality, to disinvest it, to refuse the acceptance of a loss of the regard of oneself and will impose the installation of strategy of pretenses (E. Goffman), of tactics of avoidance (H. Danon-Boileau), like that to stop going, stopping time, step seen in a maintenance, “fighting step by step against unceasingly renewed denials of the failure and of disappointment”, like writes it V. Jankélévitch in “ died”. The awakening of its ageing is then a crisis, “one moment when our desire clashes with our insufficiencies”, as developed by V. Caradec. The subject sees certainly changing the world, its envelope (its body, with its physiology and its form, own), its psychic life (its attitudes, its desires, its aptitudes), but all that is into final in externality compared to him: all moves compared to him. When in the unquestionable talks say “my memory decreases” or “my legs cannot any more carry me”, it is anything else to only refer to a motionless and external reference mark. It is a vision in externality, a refusal of reality. This refusal of reality, in a rejection of the image, refusal a-a', to take again the Diagram L, goes seems it to confront then hard still the individual at the time of occurred of a new mark, of a new temporal index, plunging it in a circle.

Persistence in this cycle which can involve the individual towards pathologies of the type Thanotose and Effacement, defines by J. Maisondieu in “the twilight of the reason” or worms of be delirious of negation, as described by J. Cotard in 1880 (Syndrome of Cotard). In these senile insanities, one again observes also the place of the mirror, like developed it J. Bouisson in an article entitled “the statute of the mirror in the elderly”.

The installation of this pseudo circularity raises the question of wondering whether the awakening of its ageing is not all the more strong as an important work of refusal took place before. As this awakening touches it to Me, it also seems to touch it I since the mirror stage is founder of the constitution of I, like described it J. Lacan in 1936. But this I seem also an unconscious Play against the time which passes, a play where one knows unconsciously that one cannot gain, a play always started again by the persistence of the phantasm of the Absolute power, by a refusal of a late D-development of the experiment œdipienne, by a kind of overpower of Ego, of which any change would even shake the individual. “The play is a mechanism of defense against the anguish, able to transform this anguish into pleasure” Melanie Klein in “the love and hatred wrote: the need for repair”, pleasure also gotten by “reviviscence” according to V. Caradec. P-L. Assoun putting forward the idea that to agree to age, it is necessary to destabilize the report/ratio of reality and the imaginary one. In other words, referring to the Node borroméen with 3 rounds, it is the cut of the one which releases the others, the acceptance of the loss of the symbolic system which separates the body and reality. The Node borroméen with 3 rounds has as a property the fact that the cut of a round releases all the others. One sees by this figure how Réel, Symbolique and Imaginary can owe their consistency with this type of tying.

In the continuum of this psychic evolution (in parallel of the somatic evolution), the concept of change is defined as a progressive acceptance of the transformations related to advanced of the age, punctuated of indicating moments in advance faster. It is about a subjective concept, being defined by “what is individual and likely to change according to each one”. This concept of acceptance is also found in the concept of Death, as if acceptance of its ageing went from pair with acceptance of an either probable death, but some. The awakening of its ageing seems more serene then and less traumatisante, making it possible to estimate itself happy to age slowly. It appears in the talks like the acceptance of the passage of the summer at the winter, as one finds it at E. Ionesco in “the king dies” or at V. Jankélévitch in “death”, in a vision in interiority. Acceptance is however not resignation, Mr. Tubiana defining the latter as an attitude involving a rise the speed of ageing in “well-aging It”. Resignation implies the concept of tender to its fate, voluntary renouncement, renouncement of the life in waiting of death, of setting to the voluntary variation like the writing P. Guillet in “the adventure of the age” whereas acceptance implies the assent, the admission. This acceptance of the process of fall of faculties by ensuring its consequences with dignity, as described by J.D. Bredin in “How to agree to age” because the brain is possible keeps its faculty to learn, for Mr. Tubiana and because the “strategies of compensation of the mark” (developed under the term of “déprise” by V. Caradec and under that “of selective optimization with compensation” by P. and Mr. Baltes) act like an unconscious means of narcissistic contribution, of of libido investment, like values renarcissantes defending against the anguishes of castration for H. Danon-Boileau. The word of a doctor collected in a maintenance confirming that “you have an activity which leads you to say if you are not agreement and to react (…) and as from the moment when you react, you keep your youth”. This is true only if one accepts that the strategy of pretense is in a negative attitude with regard to its ageing, in its refusal and that the strategy of compensation of the mark is on the other hand, in a positive vision, in the installation of a damping of a disorder, of a feeling of lack, frustration.

This acceptance is not possible, as we saw, that by the D-development of the experiment œdipienne, within the meaning of D-development of castration symbolic system generated by the “Name-of-Father” developed by J. Lacan. It stresses that, if the “Name-of-Father” provides this function in our civilization, that rises from the influence of the monotheism and does not have anything universal, approaching in that the concept of representation developed by J. Trincaz in “the imaginary bases of old age in the Western thought” and of collective conscience defended by E. Durkheim. The experiment œdipienne is active in the unconscious one of the Western, male or female individual, but in other civilizations, the Oedipus can be only one detail in an immense myth, other structures symbolic systems being there in position to promote castration. The psychoanalytical concepts of “feeling of Absolute power”, of “Name-of-Father”, “Castration” integrated into childhood at the time of the Oedipus, re-appear at the time of the awakening of ageing, in the sense that their importance is manifest in the unconscious one of the adult, like described it S. Freud in “Resistance to the psychoanalysis” in 1925.

Even if we do not have time to do it here, it could be interesting to look further into the dimension of the cerebral constitution and its evolution, in the awakening of ageing. Indeed, As of the birth, the environment directs the development of the individual, would be this only while speaking to him. That allows creation of neuronal combinations and by-there same, the constitution of the brain. With the advanced one in age, Sebban, Wolmarth and Poitrenaud in “cerebral Ageing and intellectual weakening” write that the reduction in the inter-neuronal relations would agree with the observations made on the deterioration of the systems of neurotransmission and could explain good number of things.

In the synthesis of this speech, it seems logical to think that the individual lives first of all in objectivity, in this “nothing exchange”, until the strong appearance for him, of a mark. It follows the advance then to develop higher until making the mourning of ego. Destabilizing his report/ratio of reality to imaginary, it will have to rebuild this me by a late D-development of the experiment œdipienne. According to the diagram L, it then will live in subjectivity, if there is not refusal or more often, when there is no more refusal, of persistence of the subject, because as H. Bianchi explains it, the subject does not erode. It is or it is not, but as long as it is, it persists in an identity of localization which places it in externality with respect to any event and of the time and which in addition however spares to him a possibility of variation as for the positions that it can take with respect to the events and of time. The awakening of ageing is finally a particular moment of disappearance of the refusal, acceptance, passage of objectivity to subjectivity, reconstitution, rebuilding of all its interior being, one moment more or less far in time if tried that the body leaves time to arrive there. Some arrive there early, others later and others never because the body releases front, by what the accident occurs or which pathology settles.

Emotional aspect

In the emotional plan, ageing is accompanied by the emergence of multiple feelings such as for example uselessness, the feeling to be a load for the others, the Solitude and the abandonment, the feeling to have a body becoming unverifiable. Three aspects emerge: the elderly tend towards a passive control of the environment, a reduction of her activity and a growing concern of her interior world. One classically observes an investment withdrawal of reality external and hyperinvestissement of Oneself (the Rider, 1994; Leger and Tessire, 1989), accentuated by the approach of dead (Caradec, 2004).

Neurological aspect of ageing

Jean-Pierre Changeux summarized and condensed the results of these experiments in the form of the " lability synaptique" and of the " stabilization sélective" Synapse S, in the training, during the development which can continue until an extremely advanced age through the interests and the activities of the growing old subject.

Synaptic lability and selective stabilization are based on the creation of new circuits and the destruction of old circuits unutilised or little used, in “wiring” (Jean-Pierre Changeux & Antoine Danchin, pp. 58-88, " To learn by stabilization from synapses in the course of développement" , in the Human brain , volume 2 of the series " The UNIT Of HOMME" , under direction of Edgar Morin and of Massimo Piatelli/Palmarini, Threshold, Paris, 1974), according to whether one adopts the model of the Newtonian clock or that of the computer which car-is organized, in extreme cases, in " recâblant" circuits of its configuration, if need be, starting from the components available or taken circuits unutilised or little used. What means, in practical terms, which intellectual competence and physics are what wears when one does not make use of it.

The more we learn and the more we activate ourselves, the more the synapses are formed and stabilized starting from the Neuron S available which are in superabundance in the brain. The Neuroscience S indicate this superabundance under the name of " redondance" where half, approximately, of the neurons of an operational grouping are not used and their disappearance will not affect the operation of this grouping, by remaking new neuronal circuits by " recâblage" synapses. The Cybernetic and the Data-processing , at the beginning, tried to imitate the structure and the operation of the brain and, then, become the model or the representation of this brain. The cerebral weight is of the quantitative order of the contents, while the wealth of synapses is of the qualitative order of the form. The accent on the cerebral weight is representative of the design of the universe in terms of objects, while that on the wealth of synapses is of that of a universe in terms of relations.

This difference of the designs of the universe has serious theoretical and practical incidences in the interpretation of ageing and the intervention on ageing, i.e. on its etiology and its therapeutic. While stressing the synapses in ageing, one can leave the organic level of the Neuropsychologie to approach the social standings and cultural of social psychology and Community psychology. Greenough said that one can stop and even reverse the process of degradation of the brain at the human ones and the rats by many activities, various and varied where the brain wears when one does not make use of it. In formalization in Thermodynamic mathematics and , Ilya Prigogine (1947, p. 16) already showed this stop and this inversion of the entropic process of degradation where the entropic variation can be divided into two shares. The object part of the universe is subjected to the law of the conservation and degradation of matter-energy, while the relational part is not it. Prigogine then imported this dual process of degradation-growth (entropy-néguentropie) in biology with an article " The thermodynamics of the vie" , in the review " Recherche" (vol. 3, No 24, pp. 547-562, June 1972).

For its part, Doctor Peter Davies of the department of pathology to the college of medicine Albert Einstein in New York does not believe that there is a relationship between the intellectual abilities and the state of the brain, in ageing. He says to be struck by the similarity between brains of the elderly from approximately four twenty ten or ninety years and those of the people in the score. He says not to have a proof, in macroanatomy, with the effect that only the age affects the spirit whose brain is the substrate hardware requirement and insufficient. They are normal and healthy brains, but the redundancy and plasticity can be compromised by diseases.

The demonstrations of confusion, sinistrality, absence, amnesia of various forms or irrationality recover the term of “senile insanity” described by Doctor Robert Terry and Robert Katzman like a “progressive mental degeneration of the cognitive functions and mnemic from which the inaptitude with exhiber results from the current activities of the daily life in the elderly”.

The Cognition, defined by Doctor Marian Perlmutter, gerontologist with the University of Michigan, includes/understands not only the memory, but also the intelligences conceptual, practical and social which are expressed in the form of reasoning, of decision making and social contacts in the current fields of the daily life. The “senile insanity” is not only the extreme form of ageing, but a complex symptomology of many varied and various diseases, like the depression and the Agressivité. Modern studies on the " insanity sénile" go back from turning to this century, when Aloïs Alzheimer, a psychiatrist of the University of Breslau, identified a disease which bears its name, now. A degenerative, progressive and irreversible disease which erodes surely and gradually all the mental functions.

It is characterized by an accelerated loss of neurons and other cerebral modifications which leave the brain narrowed like a dry fruit. The preceding discussion on the neurons and the synapses and the Entropy and the néguentropie also applies to the Maladie of Alzheimer which represents from 50% to 60% of the cases of " insanity sénile" , another approximately 20% are ascribable to accidents cérébrovasculaires and the remainder with large varieties and diversities of organic factors, social and cultural, like the depressions, thyroid vitamin deficiencies, affections and side effects of certain medications. Certain forms are reversible and guérissables and others are not it. Usually, the loss of memory is the primary symptom of the disease of Alzheimer, but it is also the first sign of a disinterest for what occurred and for what occurs “here and now”, in the entourage of a person and inside it - even.

As for the memory, in its various forms, on the one hand, it is necessary to take into account the phenomenon of the predictions which are carried out themselves and, on the other hand, with the phenomenon of a function which is degraded when one does not appeal of it often and where the neuronal circuits are demolished by inactivity or with the profit of other more active circuits. The phenomenon of the predictions which are carried out themselves is that where by accept its next loss of memory and to be afraid of it, the person manages to lose it indeed. This phenomenon of the predictions which are carried out themselves finds its example illustrative biomedical in the Effet placebo.

This disease of Alzheimer is progressive and develop many cognitive dysfonctions, absences, confusions space and temporal, depressions, variations of mood and personality, and degradations physical up to the point where the person reached becomes unable to deal with itself, like return to the state of infant. The majority of the senile case of insanity of the type of Alzheimer presents itself at the end of about sixty and sixty-ten or septantaine. Early forms of this senile insanity can occur before and develop very quickly. As there do not exist tests of laboratory to confirm the presence of the disease of Alzheimer, the diagnosis is based only on one combination of symptoms or demonstrations, while excluding from other possible sources of these demonstrations and the progressive and increasingly many incapacities which have the person. An unquestionable diagnosis can be done only by autopsy: the brain is atrophied, which one can observe by techniques of medical imagery of the tomoscintillographies, and the neurons are filled with “black fibers” called “fibrillary tangles”, as the Angiome S are tangles of blood-vessels which put in ball interlacings. The “beauty spots” are subcutaneous angiomas; perhaps the angiomas can be located everywhere and are congenital (i.e. of birth), but not hereditary.

One does not know yet the etiology of the Maladie of Alzheimer where one of the members of a twin phratry monozygote can have it and the other not. But, it seems to have a genetic factor difficult to find because of the late demonstrations, in such a way that a person can have this disease and die before she declares herself. Many questions remained unanswered on the heritablity, of some form, this disease and on the factors and the conditions which activate gene responsible for this disease, if there exists. The knowledge of the conditions and the factors which activate this predisposition to this disease is of great importance to prevent and delay its occurrence.

The following stage with discovered defective gene would be to find therapies genic to correct it and especially to prevent and delay its activation, according to Doctor Peter Davies who, for that, organized a bank of brains of the people reached of this disease, for the Association of the disease of Alzheimer, at ends of study. In addition to the genetic studies, the neurosciences turn to the possibility of a virus to delayed action of which the effect is felt only a few decades after, such viruses express their presence in some cases of senile insanity. The neurologist Carleton Gajdusek received the Nobel Prize for the discovery of such viruses. Connected at the viral origin, the idea of the release of the disease of Alzheimer by weakening of the immune system makes its way to interpret the delayed action of the viruses of which the effect appears only later. The viruses which established a head of bridge for a long time in the brain can be activated only at the time when defenses of the immune system are weak.

But…

There remains however difficult to delimit the respective shares of the ageing and (for example) the defect of stimulation in the decline of these capacities. Institutionalization accelerates the physical and cognitive decline elderly.

Physiological aspects

Approaches functional

the respiratory function: thoracic compliance is strongly decreased with the age; one notes a loss of elastic retreat pulmonary and a reduction in force of the respiratory muscles. The respiratory function of rest is deteriorated by an increase in residual volume and a reduction in the vital capacity. Pulmonary arterial blood flow decreases and the pulmonary blood pressure increases with the age.
the circulatory function: the arterial Hypertension increases with the age and the arteriosclerosis appears.
the locomotor function: the osseous ageing characterized by a reduction in the osseous anabolism, being able to lead to a Osteoporosis and the Osteomalacia; the articular ageing characterized by the Osteoarthritis; the muscular ageing characterized by a Sarcopénie, involving a reduction in the muscular force. The repetition of effort is more difficult, and forces it and the endurance are preserved longer than the Résistance, speed, the flexibility and the coordination of the movements.
sensitivo-sensory capacities: at the perceptive level, a reduction in the sensitivo-sensory capacities appears involving a postural instability, as well as a deterioration on the level of hearing (presbyacusia) and sight (presbyopia, cataract).
the physical capacity: the maximum Puissance Aérobie declines; the aerobic capacity decreases.

Endocrinology of ageing

The synthesis of the neuro-transmitters is a promising direction of research, because it is known that people who suffer from the disease of Alzheimer present a deficit from 60% to 90% of the enzymes which synthesize acetylcholine, a important Neurotransmetteur in the devices in connection with the memory. To the Autopsy of the people reached of the disease of Alzheimer, the brains present losses of neurons of the basal core of Meynert going up to 90%, an any small portion of the frontal which sends its nervous terminations towards the broad ones and various surfaces of the cerebral cortex. These lost neurons produce the Acétylcholine and their loss explains the deficit of this neuro-transmitter. As the instruments of an orchestra which contribute to a symphony, many chemical substances contribute to the orchestration of the brain and the spirit human, in the only partition of the chemistry of the brain and on the only organic level of the human behavior for which it is necessary to add the social standings and cultural.

The deficit of certain neuro-transmitters suggests the loss of the neurons which produce them, is located in strategic areas. Professor Alan Davison, of the National Hospital Queen Public garden of London, believes that many behavioral changes associated with normal ageing and the diseases with old age come from the deterioration of the neurons of the specific zones of the brain. He focused himself on the hippocampus where the loss of the producing acetylcholine cells affects the memory and that Ci affects after the cognitive functions and the various forms the intelligence. In addition to the hippocampus, he studied other areas of the brain, like the cerebral Cortex which, with the age, loses more neurons than the internal parts of the brain which control more the vegetative functions.

The loss of the neurons is approximately 50% on the cortex and affects the production of Noradrénaline and thereafter mood and other behavioral demonstrations. A loss of neurons, due ageing, in main parts of the brain can produce great effects in the human behavior, without common measurement with the smallness of these parts reached. That one thinks of the memory in many aspects of the human behavior where there is no communication without memory, some are the significance and the level which one gives at the end of communication. These parts are main because they maintain the operation optimal of other parts of the brain. These losses of producing neurons of neuro-transmitters and the consecutive deficit of these neuro-transmitters can be compensated artificially by risky suitable medications in intracranial injections until the cerebral areas implicated and of the heavy surgeries of cerebral fabric Clerc's Office coming from the fetuses to prevent or stop deteriorations in chain of other parts of the brain.

This is perhaps spring of the scientific fiction (Science Fiction) and bioethics. Neuro-transmitters, the studies turn to the hormones where, for a long time, the neurosciences suspected the stress like an important agent of the process of ageing. Doctor Robert Sopolsky, of the department of biological sciences to the University Stanford, considered the hormones connected to the stresses: the glucocorticoïdes, secreted by the glands adrénales, are absolutely critical for the body in order to leave a state of emergency, but “too many these substances make it sick”, known as Sopolsky which discovered that their prolonged action and chronicle kill the neurons, those of the hippocampus, in particular, in elderly. After laboratory experiments on the cells and the animals, Robert Sopolsky turned to groups of primates to Africa Orientale where baboons of high ranking, in the social hierarchy of the group, are subjected to the stress than those of the lower rows. The first have more effective answers to the stress than the second. The biological tests showed that the animals of the lower rows are under a chronic Stress which leads to an overproduction of hormones glucocorticoïdes and which affects their blood pressure, their cholesterol level and their immune system.

But, Sopolsky did not show the effect on the brain. Then, Sopolsky found that the most important factor of psychological stress is: the loss of control and of prediction of the events which is a crucial factor in the prolonged and chronic stresses and, thereafter, affects ageing and all the processes physical and mental. As nobody is omniscient and omnipotent to predict and control all the events, Sopolsky suggests, then, in human terms, to change the perception of these events, i.e. to allot other values and other significances to them.

In illustrative example, the physical and mental slowness of the elderly could be interpreted like a prudence and a serenity larger, contrasts about it with the temerity and the enthusiastic agitation of young people.

To decide between innate asset, the studies on ageing go on twin pairs monozygotes where the two members, dividing the same genetic luggage, are separate with the birth and grew separately. A project united between the University of Colorado and the Karolinska Institute of Stockholm sticks to these studies of ageing on these twin pairs, particularly, to identify the genetic and environmental influences in the answers of the elderly to medications. The studied population includes/understands more than seven hundred twin pairs monozygotes. Thereafter and to enrich these studies, of the twin pairs monozygotes, whose members grew and lived together, was added. Jerald McClearn, then professor at the University of Colorado and maintaining with the University of Pennsylvania, and his/her collaborators found the influences genetic which are exerted with the same intensity since youth until old age, with regard to the " tempérament" , the " personnalité" and factors of health.

McClearn drew the attention to the promises of the molecular genetics which showed the activation and the desactivation of genes during all the life, where the genes in action are not the same ones at various periods of the life. It is about a “partition with two votes”, that of the genetics and that of the environment. Colleague of Mc Clearn, Doctor Nancy Pedersen of the Karolinska Institute says that these studies on ageing near the twin couples monozygotes would make it possible to better locate the genetic and environmental influences and to better intervene on ageing by medications and the enrichment of the social environment of life and the activities of the elderly itself, where the spirit and the body wear more when one does not make use of it.

Social aspects

One observes a major reduction in the Social network in the elderly. Losses relating to the capacity of displacement and that of interaction with the environment (Seen and Hearing) are undergone by the elderly and lead it to limit its contacts with outside and to contain themselves on itself. The removal in institution accentuates this reduction in the social network and the Isolement.

E psycho-emotional ageing is perhaps in a greater social insulation, a greater loneliness than the elderly try to fight by the relation with drugs and other drugs, like substitute with the impoverished social relation, thus connecting psycho-emotional ageing to social ageing. On the organic level of physical ageing, knowing the contribution to the ageing of various terms or systems, one can plan to intervene by suitable products or processes to delay his occurrence or to mitigate his effects. Mishara and Riedel were turned, then, on the social standings and cultural under discussion to put the social aspect of ageing and death, through the psychological processes and attributions of values and cultural significances to old age and death.

In the social aspect of ageing, they treat broad topics like the mental health and sexuality. In the mental health, one finds the mental health disorders or psychopathologies of various orders, like one or the other form of the depressions connected or not to organic attacks, and the cerebral disorders which we already put under discussion previously. The field of sexuality in ageing is perhaps that of the amplification or the caricature of the attitudes or prejudices screw-with screw sexuality in its various forms and on its various levels where " minorities sexuelles" become even more minority by joining the minority of the elderly. The minority refers much more to the statute of minor, rather than with the quantity.

By the statute of minor, the elderly undergo an amplified sexual repression, as that which the women, the children and of the members of other groups known as minority undergo. As for the statute of minor allotted to the elderly, the company and the culture tend, on the one hand, to regard ageing as a progressive loss of responsibilities in the behavior, which is expressed by the withdrawal of the community activities and, to the extreme, by a setting under supervision. In addition, the social withdrawal and insulation often lead the elderly to be constituted in social groups with share, according to an unfolding close to that to the ethnicities, women and andicapés, with their subcultures, in such a way that the laws and payments on the equality in the access to employment put together to the women the visible handicapped people, ethnic minorities or not and the elderly in their compensatory measures.

Social problems of the elderly joined, then, that of the other minorities, characterized by the poverty, the segregation and the impotence which increase by as much the level of stress which accelerates, in return, ageing, from the cybernetic point of view for the effect-return or feedback. This feedback, in this case, is autoamplifacator and autojustificator where the ageing led to the stress which leads to ageing. These social problems of ageing, like a way towards the statute of minor, joined the psychological problems of the perception of oneself, of the autodevalorisation, which one finds in the minority groups.

In the cultures and the companies where the social security is ensured by the family, the relationship and the close community, the subsidiary responsibility is bound, like its corollary, with the parental responsibility, as the various Community responsibilities are bound, for example, in China and in the sinicized countries, by the values confucéennes of bénévolence, courtesy, honesty and obedience mutual insurance companies.

These problems can meet 1) on the organic level of physical ageing which present demonstrations directly observable and measurable that return account the Endocrinologie, the genetics, the Immunologie and the Neurosciences, 2) with the social status of the social interactions in various fields and on various occasions, 3) on the cultural level of the beliefs, the values and the significances conferred on the physical demonstrations of ageing and ageing itself.

conclusion on the psychosocial aspect

Psychological ageing is perhaps the interaction between these distinct levels organics, social and cultural where each level is the context and the environment which direct and delimit the possible activities and structures of the terms or systems of (or of) the level (X) lower (S) of a hierarchy of dependence whose orientation is verifiable by the " regulate extinction " theory of the contexts built on the logical typology of the Theory of the contexts of Anthony Wilden in ecosystemic Approach.

Psychomotor aspects

attenuation of the reflexes on the level of the muscles and the articulations,
turbid of balance in station upright involving a less assured step,
senile tremors (head and upper limbs), in particular when one passes from at-rest state to the action,
turbid of the knowledge of the clean body,
turbid motor (voluntary act),
turbid of the knowledge of its body, the Langage and the writing.

Pathological ageing

See:

of Albrecht To last (1507) .]]

The old age is the ultimate age of the human being, which succeeds the ripe age, also called by euphemism the “third age”. Old age is generally perceived in the 6th decade of the life, because it is at this period that the conscience of a Vieillissement is acutest. There is no really biological age of old age. On the other hand, there is a representation of the old age which starts towards the age of sixty-five years and corresponds to one period of the life where the majority of the people are withdrawn from the Working life (retirement or pension).

The study of old age and ageing is the Gérontologie (term formed on the Greek word geron, gerontos , old man). The Médecine of old age is the Gériatrie.

The International federation of Ageing

The mission of the International federation of Ageing is to inform, educate and promote policies, programs and practices in order to improve the Quality of life of the elderly throughout the world. It represents the elderly at the United Nations, of the World Health Organization, of the United Nations for Education, Science and Culture (UNESCO), the Economic commission and Social of Asia and the Pacific for the United Nations (UNESCAP) and the Council of Europe.

See too

three ages of the life: Youth | adulthood | Old age

External bonds

International federation of ageing
International federation of Ageing Promotes and helps with the comprehension of the policies and practices concerning ageing.

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