As we age, our sensations and perceptions, our "bridges" to the world, may change and begin to decline. Some of our abilities to interact with and interpret the world correctly then may be dependent on our ability to perceive the world accurately and efficiently. As a matter of fact, some researchers believe that most of the declines traditionally attributed to senior's cognitive abilities are actually the result of inaccuracies in obtaining and processing information through our five senses.2 The following discussion describes each of the five senses, our physical support structure, sleep requirements, and reaction times as they affect our mental abilities.
The single most important thing you can do for your eyesight is to get an eye exam every one to two years. If you are a visual learner, sight is your primary mechanism for gathering information. Inaccuracies in judgments may be the result of erroneously perceived information. It is imperative that you have regular eye exams. Not only do you need someone to prescribe the proper corrective lenses, but early detection of diseases such as glaucoma and macular degeneration is essential to reduce damage.
The lens of the eye begins to stiffen in middle childhood, and we begin to focus less precisely. The decline is gradual and may not be noticed until the mid-thirties or mid-forties. For some people, this condition is corrected by glasses, contact lenses, or laser surgery. For declines in near- and far-sighted vision, glasses or contacts are compensation mechanisms. If you have progressed to bifocal prescriptions, you might consider monovision. This is a technique where a person wears two different lenses, one for nearsightedness and one for farsightedness. It takes most people approximately seven to 10 days to adjust, although a few people never adjust. If an eye exam reveals that you need a simple pair of reading glasses, you can get them at a drugstore. Just be sure that you get a professional exam, instead of self-prescribing, so that you can be checked for conditions such as glaucoma.
Other changes in vision can be attributed to diseases such as glaucoma, cataracts, or macular degeneration. Regular eye examinations allow for early detection that can stop or slow disease progression. Glaucoma damages peripheral vision first and then moves on to destroy central vision. Glaucoma is the result of pressure on the optic nerve. Medicated eyedrops have been the most popular and prevalent treatment, but recently laser surgery has been successful as a treatment. Glaucoma sometimes is referred to as a silent blinder. By the time you realize that something is wrong, the disease has progressed to an advanced stage. If you have a family history of glaucoma, are African-American, or are diabetic, your chances of developing glaucoma are higher than normal, and you should be especially conscientious about scheduling yearly eye exams.
Macular degeneration affects the central part of the retina, which allows you to see details. Peripheral vision remains intact. Some of the symptoms are dark spots in the center of the vision area, blurring, and line distortion. Eye specialists often recommend special vitamins to combat this disease. Dark green leafy vegetables are high in carotenoids and reduce the risk of advanced macular degeneration by 43 percent.3
Remember that the best foods for us are the most brightly colored ones.
Cataracts, another physical condition common to the aging of our eyes, are a clouding of the lens. In fact, some say that cataracts are inevitable, but we know some 90-year-olds who don't appear to have cataracts. Of course, they may just be aging at a different rate and they don't show yet. The symptoms of a cataract are double vision in one eye, colors appear less bright, and decreased light sensitivity. The good news is that cataracts are corrected easily by surgery.
It is also thought that reducing the eye's exposure to ultraviolet light reduces damage to the lens. You should wear sunglasses that are labeled indicating that they block 99 percent of both Ultraviolet A and Ultraviolet B light. Wearing a broad-brimmed hat while outdoors also reduces the amount of ultraviolet light to which the eye is exposed.
One of the changes in our perceptions that research has identified is that our perceptual window narrows. We do not scan a large area as easily as when we were younger and need to break a large visual area into smaller sections to identify a target object. In other words, if we took our family for an outing and stood looking at a picturesque street scene, the younger members might take it all in at a glance. Older members of the family might subconsciously break the street into sections and look each one over for details. We need to focus on smaller sections of the environment.
Upon occasion, I have "lost" my car in the parking lot. So, while I try to look like I know where I am going, I begin to scan the parking lot looking for my blue car among all the other cars. I don't have to slow down the scanning process and check out the nonblue cars as I come across them. However, the blue cars are all potentially mine, and I have to slow down and look more carefully to determine whether it is my blue car. To increase my speed and accuracy, I need to break the parking lot into sections and quickly scan one section at a time instead of looking repeatedly over the entire parking lot. Of course, if you have a general idea of where your car is located, you can just scan that one area. The simplest thing, I suppose, would be to tie something bright to the radio antenna and look for that. I think I'll do that!
We also become fractions of a second slower at identifying specific targets in a cluttered environment. A few hun-dredths of a second may not be important, or even noticeable to others, when looking for your car in a parking lot. Nevertheless, this fraction-of-a-second delay could contribute to an accident if you are driving a car. If you are traveling in a car at 60 miles per hour (88 feet per second), a delay of just one-tenth second results in your car being almost nine feet farther along the road, possibly running into a stopped car in front of you. So get your eyes tested, take your vitamins, wear your glasses, and give yourself a little extra time to identify objects visually.
A gradual loss of hearing sensitivity begins in young adulthood. After age 50, approximately 70 percent of the population has some form of hearing loss. Hearing loss may affect all sound frequencies or just specific frequencies. I have a friend named Shelly, for example, who is legally deaf. Shelly can hear the pitch of my voice and yet cannot understand what someone with a deep, booming, very loud voice says. It's not the loudness of the sound, it's the pitch that affects her hearing. Not all adults suffer from loss of hearing.
It may help to have a working definition for the degrees of hearing impairment as we continue our discussion about hearing. This table gives you a simple measurement scale of the degree of hearing loss you or someone you know may experience.
Can hear a whisper at 20 feet
Cannot hear a whisper at 3 feet
Cannot hear a conversational voice 1 foot away
Cannot hear a shout with someone's mouth next to your ear
You may have
No hearing loss Moderate hearing loss Severe hearing loss
Men usually have more extensive and more rapid hearing loss than women. Women tend to retain their hearing ability. People who have had to work or live in areas that expose them to damaging noise levels experience a more significant loss of hearing as they age. City dwellers and industrial workers experience greater hearing loss than those living in rural settings because of the constant exposure to background noise.
This is the case with Kathleen's father, Glenn Austin, whose office was located on the shop floor of an aircraft production plant with a constant high-level noise environment.
However, his problem is just the opposite of Shelly's: it's with high-frequency sounds. His daughters deliberately try to lower the pitch of their voices when they speak to him.
Certain medications, such as those that reduce high blood pressure and inflammation, can decrease hearing effectiveness in the high-frequency range.4 You must have your hearing checked. Just because you hear some sound frequencies does not mean that you are hearing all sound frequencies at a safe level.
This loss of hearing may have a great impact on social interaction. Asking people to repeat their conversations may cause older adults to become embarrassed, frustrated, and avoid interactions with others. You can use many strategies to accommodate this decline, however. An undesirable strategy is to pretend that you know what the person said. The consequences of this are not very appealing. Some people with hearing loss try to "listen in context." This means that if they miss a word or two, they continue listening to deduce what the speaker may have said. At times this is a useful strategy, but the consequences might be dreadful if the deduction is incorrect!
For those who sustain gradual hearing loss, there is a natural tendency to make accommodations. This anecdote is an example of how one senior citizen made an accommodation for his hearing loss. When someone spoke to him and he heard something, but not clearly and completely, he tried to determine from the portion he did hear and the circumstances involved what must have been said. At first, he found this to be a dangerous practice. He may nod "yes" in the wrong places. Noting the reaction to your response becomes very important. Soon he became very adept at observing nonverbal reactions. It became automatic—like a minicomputer was doing it. After a while, he agreed that he needed a hearing aid. When he was being tested, an audiologist assumed he must be lip reading, because he was responding to questions so well without a hearing aid, despite a significant hearing loss. When the elder said he didn't know how to lip read, the audiologist blindfolded him to check this out. The elder still was able to respond appropriately. The audiologist concluded that the elder was "listening in context" and not lip reading. This would seem to be a natural accommodation and probably not unique.
More positive compensation strategies include the following actions. You can eliminate competing sounds such as the TV or radio by turning them off. If a speaker talks too quickly, you can ask him to slow down or speak more clearly. You also might be able to rearrange your sitting area so that you can sit across from your visitors and more clearly see their mouths and faces to help you interpret their speech. Try these adjustments to boost your ability to carry on a conversation better. Stay in the conversation longer for more enjoyment!
When conversing with someone who may be using your nonverbal cues, give him time to do the processing. If the information you are passing on is critical, however, use the old tried-and-true formula: have him repeat the information back to you.
Hearing degradation can be dangerous—we use our hearing to warn us of many dangers. Is the heater running constantly? Is someone breaking in?
One of the simplest ways to minimize the effect of this decline is the use of a hearing aid. Amazingly, many people refuse to wear a hearing aid, even though the new hearing aids are very effective and fit into the ear canal so as to be invisible. In one research study, of those individuals who found it difficult to follow a conversation in a crowded room, 75 percent did not use a hearing aid. We have an aunt who always prefaces advice with "If you get cold, you get a sweater, if you get hungry, you get something to eat." She would be the first to say "If you can't hear, you might investigate getting a hearing aid."
This test is from the American Academy of Otolaryngology-Head and Neck Surgery Public Service Brochure. Answer each of the following questions by placing a checkmark in the column that is most like you. You'll find a scoring guide after the test.
Almost Half On Question Always the time Occasion Never
over the telephone.
the conversation when two or more people are talking at the same time.
turn theTV volume up too high.
common sounds like the phone or doorbell ringing.
conversations in a noisy background such as a party.
where sounds come from.
words in a sentence and need to ask people to repeat themselves.
understanding the speech of women and children.
environments (assembly line, jackhammers, jet engines, and so on).
seem to mumble (or don't speak clearly).
People get annoyed _ _
because I misunderstand what they say.
I mis-understand what _ _
others are saying and make inappropriate responses.
I avoid social activities _ _
because I cannot hear well and fear I'll reply improperly.
To be answered by a family member or friend:
Do you think this person _ _
has a hearing loss?
To calculate your score, give yourself three points for every time you checked the Almost Always column, two for every Half the Time, one for every On Occasion, and 0 for every Never. If you have a blood relative who has a hearing loss, add another three points. Then total your points and find your score in the following table.
The American Academy of Otolaryngology-Head and Neck
This quiz was field tested on 71 older patients in five cities; audiograms also were run on them. Results showed that those whose quiz scores indicated a need to see a physician were confirmed, on the audiogram, as having a hearing impairment.5
Your hearing is fine. No action is required. Suggest you see an ear nose and throat (ENT) specialist.
Strongly recommend you see an ENT specialist.
In general, the decrease in taste sensitivity with age is due to fewer taste buds, decreased salivary secretions, formation of fissures on the tongue, and age-related changes in the process of taste sensations by the central nervous system. This affects our quality and enjoyment of life. Nothing tastes right anymore. We do not enjoy eating and may decide it is not worth the trouble to cook or go out to eat. We may not get all the nutrition we need to feed our muscles, organs, and brains.
You might want to consider this as an opportunity to be adventurous and try new foods. How about the foods you tried before and did not like? Your tastes have changed, so perhaps you should give foods you did not like a second chance. Try hot sauce, anchovies, new fruits, and new vegetables. Use this opportunity to investigate new cooking styles. You might be careful when adding spices to your foods for company. They may find it a little strong!
Smell olfactory— relating to the sense of smell
In general, some mild decrease of olfactory sensitivity is common with increasing age. Olfactory sensory receptor cells decrease in number as you age. A decrease in smell may influence our sensitivity to taste (as in when you have a cold). The smell of foods actually starts the digestive process because it triggers the release of insulin. This, in turn, influences our tastes, diet, and nutrition. In addition, a decrease in olfactory abilities could affect our safety if we cannot detect a gas leak or notice the smell of spoiled foods.
Some dentures have an effect on your sense of smell. Those dentures with a full upper plate across the roof of the mouth interfere with the absorption of the aroma of foods. If you have a set of these dentures and you notice that food does not smell or taste as well as before, consult with your dentist about the possibility of a different style with a partial upper plate.
Research at the University of Pennsylvania Medical Center's Smell and Taste Center indicates that a profound loss of smell is not normal and should be reported to your physician. Although many physicians do not ask about your sense of smell during an examination, a drastic loss of smell is one of the initial signs of neurodegenerative diseases, such as Alzheimer's, Parkinson's, multiple sclerosis, and others.6 Keep in mind that if you have started a new medication, it might be the medication that suddenly has affected your sense of smell and taste. You might want to check with your physician and pharmacist about possible side effects of your medications.
neurodegenerative—relating to the decline of the powers of the brain
Touch is a combination of sensitivities to pressure, pain, and heat/cold. Not a lot of information is available on the changes to these sensitivities as we age. There is evidence that our sensitivity to pressure decreases. Although studies have been performed to determine the effects of aging on our perception of pain, it is difficult to pinpoint the exact effect, because so much of our evaluation of the pain is psychological. It just seems that some of us tolerate pain better than others. There is no clear-cut understanding of the changes with respect to pain. As far as our sensitivity to temperature differences, you are well aware that your body adjusts to gradual changes in temperature. In the middle of winter, for example, 45-degree temperatures seem warm after weeks of temperatures in the 20s to 30s. In the summer, however, a 45-degree temperature would seem very cold after weeks of temperatures in the 80s. It takes approximately three days for our bodies to adjust to new temperatures. That is why when you go to another part of the country on vacation, it takes about three days for your body to adjust to the new temperature and humidity.
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