AIDS and Aging: ALL the Theories!

AIDS and Aging:

ALL the Theories!
Colin Greenup
Whittier College

Abstract
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AIDS and Aging: ALL the Theories!

The AIDS disease, as it implies in the name acquired immune

deficiency syndrome, attacks a patients immune system. However, it also
does a lot of damage unrelated to the immune system. It can lead to
severe depression and stress through the disengagement theory. The
disengagement theory states that as people grow older, they let
themselves fall into their own private world, shutting out everyone else.
This is increased in AIDS patients, who feel as though their chance of
living long is minimal, causing them to disengage. In order to combat
disengagement, one must look to the activity theory, which states that in
order to prevent disengagement, one must keep the AIDS patient active
in the same ways that any normal middle-aged man would.
Key Words: AIDS, Disengagement, Activity, Elderly

AIDS and Aging: ALL the Theories!

AIDS and Aging: ALL the Theories!

HIV is a virus that attacks the immune system in a person,
causing the immune system to become very deficient and making it
easier for the afflicted to contract various illnesses that they would
otherwise would have been able to deter, known as AIDS. As well as
causing the afflicted to become sick easily, it can have adverse effects on
how they age, and how they react to that aging. One way that people
react to this aging can be explained by the disengagement theory, which
states that people can be well adjusted, satisfied, and happy in old
age only if they remain active and involved [but] normal aging involves
a natural and inevitable mutual withdrawal or disengagement
(Quadagno 50).
This slow but sure disengagement is bolstered in patients with
AIDS, especially those over the age of fifty. Since more than 50% of
people who suffer from AIDS will be over the age of 50 by the year 2015
(Kirk 1), we cannot ignore the effects this will have in the coming years.
There are also a plethora of other theories that apply to the AIDS virus in
other ways. But how exactly do all these theories apply to AIDS and how
people age?

AIDS and Aging: ALL the Theories!

Disengagement occurs because people begin to understand how

short life is as they grow older. They see the end coming and decide to
break their ties with people they love early so it isnt as hard when theyre
on their deathbed. AIDS furthers the feeling of despair because it
significantly increases the risk of contracting a deadly disease without
warning. The fact of being old and having AIDS combined puts elders at a
much higher risk of suffering from severe depression and stress. Due to
the highly unstable nature of the heath of AIDS patients, they tend to
become more disengaged in a faster manner than that of a normal elderly
person.
Thus, signs of disengagement begin to show earlier in the lives of
those who have AIDS versus those who dont. By spending too much time
in their own world rather than interacting with others, they find
themselves reluctant to even try to extend their lives by reaching out and
getting treatment. Instead, they allow themselves to sink into their
sickness and let it control their lives, too disinterested to even care about
how much longer they have to live.
In order to prevent disengagement, younger generations must keep
their elders active in the same ways that younger people are, because
the psychological and social needs of the elderly were no different from
those of the middle-aged (Quadragno 50). This is where the bulk of
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AIDS and Aging: ALL the Theories!

theories about AIDS and aging come from. A majority of the theories rely
heavily on the activity theory. The main purpose of the activity theory is
to not let people disengage by spending more time with them.
Disengagement happens because an elderly person decides they want
more space, and their loved ones allow it, and the process repeats until
they are completely disengaged.
Once disengagement fully takes hold in a patient, the patient falls
subject to things like general anxiety disorder (GAD), panic disorder (PD),
or major depression (MD) (Quadragno 49). This can lead to one of the
more prominent signs of aging: telomere degradation. Telomere
degradation has been thought to been cause by stress, depression, and
anxiety. In a study done by Needham, Mezuk, Bareis, Lin, Blackburn, and
Epel, they tested telomere length in people suffering from those disorders
in an attempt to find a link between them and telomere degradation.
They found that women with PD and GAD had shortened telomere
length, whereas men did not. However, patients suffering from MD
suffered from shortened telomere length only if they were being treated
pharmacologically. Thus, women who become disengaged and both men
and women who are being treated for depression due to disengagement
from society can suffer shortened telomere length, which shortens their
life. This process can come on quickly, so countering it can be very

AIDS and Aging: ALL the Theories!

difficult. However, you can nip it in the bud if you detect it early on and
take action. How do you take action?
The activity theory explains this- if you never allow them too much
space, they cannot become disengaged. Activity theory is central to
combatting disengagement in elderly. However, everyone suffers from
disengagement in different ways, so just having one set plan to use on
everyone to avoid disengagement is difficult to imagine. The many subtheories that build off of this all have differing ideas on how to handle
different types of disengagement for different types of patients.
The first of many theories that builds off of the activity theories is
called the continuity theory. This theory tries to prevent disengagement
by providing a continuity to the patients life. It revolves around
maintaining a remembered inner structure, such as the persistence of a
psychic structure of ideas, temperament, affect, experiences,
preferences, dispositions, and skills (Quadragno 53). Simply put, this
theory wants to continue any activity that the patient had beforehand,
such as being involved in the local rotary club or playing chess with
strangers at the park. This way they always have an activity to turn to in
order to remain involved and active rather than disengaging . However,
only having one activity to do can be boring if repeated over and over, so

AIDS and Aging: ALL the Theories!

unless the patient takes up more than one hobby, the effect of activity
theory can be lost.
Another theory that promotes activity is the subculture theory of
aging. It too also shares many aspects of the disengagement theory,
activity theory, and continuity theory, but instead relies on a sociological
theory of subcultural development (Quadragno 53). This theory
promotes finding people who are similar to the patient and grouping them
together. This grouping happens though both finding people who share
the same interests as the patient and having them socialize as well as
accidental grouping when patients who are both excluded from a wider
society recognize one another in the same situation and come together
(Quadragno 55).
These subcultures are most commonly found in retirement homes
due to the large amount of elderly living in a concentrated area. This
theory too has its downfalls though. According to Quadragno, when these
subcultures are formed, certain roles are filled, such as a leader or a
supportive role. When the roles are being filled, some people fill different
roles than they had before in their life, which can lead to even more
severe disengagement if they are uncomfortable with their role .
When subcultures are formed and someone is uncomfortable with
their role and become disengaged, it can affect everyone else in the
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AIDS and Aging: ALL the Theories!

group. This is called social exchange theory. Social exchange theory

suggests that personal relationships feel most satisfying when both
participants are perceived as contributing equally to the relationship
(Adams-Price and Morse, 2009). This can start to tear a subculture apart if
a patient starts to become disengaged again, which only furthers the
disengagement of the other patients. This poses a dangerous situation for
patients who have become disengaged due to AIDS because it shows that
even if a somewhat stable environment is formed, there is always the
potential to fall back into depression.
Along with the above psychological effects, AIDS also has a
massive physical effect on the human body. Its primary target is the
immune system. It inhibits the T-cells that help keep your body free of
diseases in order to weaken the immune system and allow diseases that
would normally be very minor, like a cold, and make them extremely
severe and possibly life threatening. In fact, a simple flu shot can possibly
spell the end for a patient suffering from AIDS (aids.com). AIDS will also
affect how cells divide, causing them to weaken greatly over time and
cause muscles to atrophy, organs to malfunction, and skin to become
baggy and wrinkled (aids.com). All these characteristics of aging are
greatly sped up in patients with AIDS, with such processes causing people
to seem physically and mentally older by a great margin .

AIDS and Aging: ALL the Theories!

Avoiding disengagement is crucial to understanding and eradicating

AIDS. 1.1 million Americans currently suffer from the AIDS virus, but only
25% of those have taken the available viral suppression (Insel 1). Too
many people feel disengaged and arent interested in trying to protect
themselves and lengthening their lives simply because of the AIDS virus
even though it is considered easily manageable. However, if
disengagement were combated with activity, the viral suppression could
be given to more and more people suffering from AIDS, hopefully
preventing the spread and eradicating it once and for all.

AIDS and Aging: ALL the Theories!

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References

Insel, T., (2014) AIDS: a cautionary tale Psychiatric Times (31) 1 retrieved from
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<http://www.nia.nih.gov/health/publication/hiv-aids-and-older-people>.
Kirk, Jason B., and Matthew Bidwell Goetz. "Human Immunodeficiency Virus in an Aging
Population, a Complication of Success." Journal of the American Geriatrics Society
57.11 (2009): 2129-2138. Print.
Roger, Kerstin Stieber, Javier Mignone, and Susan Kirkland. "Social Aspects of HIV/AIDS and
Aging: A Thematic Review." Canadian Journal on Aging / La Revue canadienne du
vieillissement 32.03 (2013): 298-306. Print.
Quadagno, Jill S. Aging and the Life Course: An Introduction to Social Gerontology. Boston:
McGraw-Hill Colleg, 1999. Print.
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<http://aids.com/hiv-basics/understanding-hivaids/>.

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