Stress is a major health issue that is not always seen as the cause of the many health problems with which it is associated. Stress is associated with certain particular life events, such as a financial crisis or overwork, though stress can be caused by a number of different factors. Stress has been associated with age in various ways, showing some of the stressors that face the elderly and some of the health problems that result. Some of the research shows the course of stress over a lifetime, meaning how stress may increase during one's working life and then continue for different reasons in old age. Old age has particular stressors deriving from financial need, health problems, the health problems of loved ones, and problems with children and grandchildren.

Stress is associated with old age because of some of the changes involved in that time of life. Lieberman and Tobin (1988) point th

research has also shown that optimism has a good effect on physical and mental health throughout the life span (Reker & Wong, 1985; Scheier & Carver, 1992), while a lack of optimism, such as often develops in old age, can have the opposite effect and can damage health and increase stress. The perceptions of the elderly can be as important as the reality of their social situation.

For the elderly, the need to care for a loved one who is ill ads to levels of stress but may also mitigate against accepting help to reduce that stress.

Wilensky (2004) makes recommendations on how to guide the older person in order to reduce the harmful effects of stress, stating, "For too many Americans, old age is a roleless phase of existence, a time of heightened risk of social isolation. The development of interventions to promote social integration is essential to the quality of life of older persons" (p. 6). The role of peer support is discussed, noting research showing who will accept such aid and who will not:

Other types of loss also contribute to the degree of stress experienced by the elderly. Psychosocial variables affect stress levels, and among these, some that have a documented effect upon health status have been addressed in the literature, these being the number of symptoms and other measures of poor health status experienced by the individual, the loss of an external locus of control, and the size of (and degree of support from) the informal network of family and friends. These variables have been found to be associated with health even after controlling for income, gender, and age. Two of these variables, social support and stressful life changes, are often studied together to test the buffering hypothesis, holding that the adverse effects of high stress upon health are reduced by the presence of supportive associations, such as friends and family. The effect of locus of control upon health has been studied most often independently of the other two effects, but more and more the direction of research has been to look upon an internal locus of control as an additional buffer moderating the effect of stress on health and on life satisfaction Acredolo, Montgomery, Parks, and Pilisuk (1993) note that the three variables together had not previously been included in a single study of physical health outcomes, though the authors saw good reasons for doing so. They also point out the importance of changes in life in developing stress:

Shmotkin and Eyal (2003) consider counseling for the elderly and note the impact of psychological time on the perceptions of the older person, noting the effect that such perceptions may have on how the older persons views his or her role in life, the passage of time, the naure of illness, and so on. Whether the older person is able to construct a scenario of future events and planning depends on his or her sense of control:

Investigators interested in aging have long recognized the importance of distinguishing between pathologic as opposed to normal aging. Thus, researchers interested in normative physiologic or cognitive age changes have been careful to exclude persons suffering from illnesses that might adversely affect performance and thus give a distorted picture of age-related declines. Although the distinction between aging as a disease and aging as a normative process is both important and useful, several researchers have recently argued that it does not go far enough (p. 702).

A popular measure of individual differences in stress is a simple count of the number of significant life changes one has experienced in the recent past. While it is clear that some individuals are overwhelmed and others challenged by the same circumstance . . . a preponderance of life changes is almost always stressful, and it is for this reason that measures of significant life changes have so frequently been associated with illness. Bereavement, divorce, residential mobility, retirement, and co

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