Changes in Personality and Behavior

Personality remains stable with age. However, whether behavior also remains stable with age is debated. Usually, behavioral and psychologic adaptiveness continues and does not normally regress or become rigid. Increasingly exaggerated, maladaptive, and unmodifiable behaviors or traits may represent psychologic or neurologic problems and not normal aging.

In general, frail or disabled elderly persons are more cautious than younger persons, especially when risk taking involves a predictable and constant payoff (eg, they may not fly standby for a routine visit to family members, even if it increases savings); however, the elderly are not more cautious if the payoff appears to exceed the degree of risk (eg, they may fly standby if it represents the only chance to visit family members for a special occasion). Excessive cautiousness in elderly persons may signal underlying anxiety or a related physical disorder; however, excessive cautiousness in frail or disabled persons may reflect good judgment.

The elderly usually adapt to the concept of impending death after becoming aware of it (sometimes suddenly) during middle age. Although the elderly often think about death, they fear death less than other age groups. Thoughts or conversations about death are more common among the elderly, who likely have peers and relatives who have died or are dying.

A terminal illness, an underlying depression, or other emotional conflict predisposes certain elderly persons to anxiety about death and, in some cases, can lead to despondency. The ability to cope with such stress is maintained or improved with age.