Since they began in 1955, the Duke Longitudinal Studies have aging have been regarded as landmark investigations, amassing invaluable data on the typical physical changes that accompany aging, typical patterns of mental health and mental illness, psychological aging, and the normal social roles, self-concepts, satisfactions, and adjustments to retirement of the aged. Comprising information on more than 750 aged and middle-aged persons, these studies have contributed enormously to our ability to distinguish normal and inevitable processes of aging from those that may accompany aging because of accident, stress, maladjustment, or disuse.
Normal Aging III
Reports from the Duke Longitudinal Studies, 1975–1984
By Erdman Palmore, Ewald W. Busse, George L. Maddox, John B. Nowlin, Ilene C. SieglerDuke University Press
Copyright © 1985 Duke University Press
All rights reserved.
ISBN: 978-0-8223-0624-5Contents
Foreword,
List of Figures,
List of Tables,
Preface,
Contributors,
Section A. Physical Aging,
Introduction,
Self-image, Medicine, and Drug Use,
Sexuality in Middle and Late Life,
Predictors of the Longevity Difference,
Predictors of Successful Aging,
Successful Aging,
Psychomotor Performance and Cardiovascular Disease,
Cardiovascular Disease, Intellectual Function, and Personality,
Vibratory Threshold and Health,
Serum B1A Levels in Older Humans,
Section B. Mental Health and Mental Illness,
Introduction,
Mental Health and Mental Illness,
Psychiatric Problems in Later Life,
Senescence and Senility,
Electroencephalographic Changes in Late Life,
Cerebral Blood Flow Changes with Age,
Sleep Patterns in the Aged,
Clinical Correlates of the Vibratory Sense,
Stress and Coping in Later Life,
Sex Differences in Coping and Perceptions of Life Events,
Psychological Distress and Perceived Health,
Drowsiness and Driving,
Section C: Psychological Aging,
Introduction,
Intellectual Changes,
Selective Attrition and Intellectual Ability,
Cross-Sectional and Longitudinal Patterns of Intellectual Ability,
Memory and Blood Pressure,
Cross-Sectional and Longitudinal Patterns of Memory Scores,
Memory, Attrition, and Distance from Death,
Mental Performance in the Young-Old versus the Old-Old,
Longitudinal Comparisons of WAIS Factor Analyses,
Personality, Dropout, and Death,
Cross-Sequential Analysis of Adult Personality,
The Impact of Personality and Social Status upon Activity and Psychological Well-being,
Age Patterns in Locus of Control,
Self-Concept Content,
Life Graphs and Life Events,
Stability and Change in Life Graph Types,
Section D. Social Aging,
Introduction,
Aging and Individual Differences,
Socialization to Old Age,
Distribution of Life Events and Resources,
Stress and Adaptation in Later Life,
Assessing the Impact of Life Change Events,
Change in Life Satisfaction,
Continuities in the Experience of Aging,
Predictors of Successful Aging in Retirement,
Effects of Retirement and Former Work Life on Women's Adaptation,
Aging and Voluntary Association Participation,
Religion and Aging,
Activity and Happiness among Aged Blacks,
Total Chance of Institutionalization,
Summary and the Future,
Index,
CHAPTER 1
Self-image, Medicine, and Drug Use
Kurt W. Back and Deborah A. Sullivan
The problems associated with drug use can range from a physician's attempt to obtain a patient's acceptance of a regime of prescribed medicines to the prevention of frivolous or even dangerous drug abuse. The variation among individuals in their use of drugs depends on both their willingness to be changed and their acceptance of a chemical means of inducing this change. Some types of drugs are more socially acceptable than others. In fact, one could propose a spectrum of drugs which includes, at one end, those prescribed to treat acute infectious diseases or physiological disorders and, at the other end, those prohibited drugs used for "recreational" purposes. Motivation for the use of a drug may depend on the specific situation or the specific effect of the drug to be used. However, a predisposition to use or not to use drugs in any situation also may explain some of the variation in drug use patterns among individuals.
Previous studies (Brehm and Back, 1968; Brehm and Davis, 1971), have shown that the use of drugs is related to general personality tendencies, such as a "great desire to be changed, devaluation of the self-image, belief in the beneficial influence of somatic means, and even a positive reaction and curiosity about the effects of physical agents" (Brehm and Back, 1968). A questionnaire, devised to investigate this area, led to the identification of five factors which represent several different personality traits related to a preference for drug use, particularly the use of drugs with strong psychological effects such as opiates, energizers, and hallucinogens.
These previous studies principally include young subjects who were conscious of stimulating or recreational drug use. Moreover, the drugs listed in the questionnaire were mainly psychotropic, mood-changing drugs, and the setting of the data collection may have encouraged the subjects to interpret "drugs" in this sense. In the current study we focus on middle-aged and elderly subjects and shift the attention more toward drugs used for medicinal purposes, thereby looking at the general conditions of drug use.
Method
The data are derived from a multidisciplinary study of middle-aged and elderly population (Duke Second Longitudinal Study). This research uses data collected in two separate parts of the program. One source is the medical history section of the physical examination, where the respondents were asked to check the amount of drugs and medicines which they had taken in the preceding year. This list includes both prescription and nonprescription drugs and those used for specific physical ailments, as well as those used for general onerous conditions. In addition, the use of alcohol and tobacco was checked. Table A—1 shows the extent of use of the different drugs. They are classified into those which deal with specific ailments (medicines), with nonspecific complaints (medicinal drugs), and with nonmedical social use (social drugs).
Table A—1. Extent of use of different kinds of drugs.
The rest of the data are taken from the social history questionnaire. Besides the thirty-five statements that yielded the drug-use personality factors in the previously mentioned studies, a number of standard personality scales are used. These include the sick-role index (Mechanic and Volkart, 1961), the internal-external scale (I-E scale) (Rotter, 1966), the positive-negative affect indices (Bradburn and Caplovitz, 1965), and a series of semantic differentials. In these semantic differentials the concepts "myself," "how I would like to be," and "how I appear to others" are rated on seven bipolar scales. The Euclidian distance between these concepts (the square root of the means of the squared difference between the scale scores) gives an impression of the discrepancies between the three concepts. The distance between "myself" and "how I would like to be" is termed selfevaluation, that between "myself" and "how I appear to others" is termed persona, and that between "how I wpuld like to be" and "how I appear to others" is termed ideal persona.
Results
Factors
Five factors emerge from the principal components analysis of the thirty-five statements related to sickness and drug use among the middle-aged and elderly sample (table A—2). Items related to a dissatisfaction with oneself (e.g., seeing oneself as too nervous, anxious, self-conscious, or tired) and a desire for some physical action to overcome personal limitations dominate the first factor. As in previous studies, this factor is labeled "insecurity." The second factor accounts for 10.5 percent...
