This document summarizes physical and cognitive changes that occur in middle adulthood, including:
- Physical changes like declining vision, hearing, bone density and reproductive ability. Hormone therapy for menopause has risks.
- Cognitive functioning tends to peak around age 30 and then declines, though lifestyle factors like exercise and mental stimulation can help offset declines. Memory and processing speed may weaken.
- Health risks like cancer and cardiovascular disease increase, affected by genetics, behaviors and socioeconomic factors. Maintaining healthy habits is important for risk reduction.
5. Physical Changes
The Brain and Nervous System
Behavioral choices and mental health affect
brain
Circulatory system health affects parts of
brain involved with memory, planning, and
processing speed
6. Physical Changes
The Reproductive System: Males
Climacteric: Loss of reproductive capacity
Slight decline in quantity of viable sperm
produced
Very slow drop in testosterone
Erectile dysfunction or impotence increases
9. Physical Changes
Hormone Therapy (HT)
Hormone therapy: Progesterone and estrogen
administration
Women’s Health Initiative Study
Protocol
Findings
10. Physical Changes
The Pros and Cons of Hormone Therapy (HT)
Results from Women’s Health Initiative (WHI, 2002)
PROS
Reduction of hot flashes
Protection against osteoporosis
CONS
Long-term use related to increased risk of
breast and ovarian cancers
No protection against cardiovascular disease
11. Physical Changes
Menopause: Psychological Effects
Research mixed on menopausal effects
Negativity and overall life stressors affect
moods
Severe symptoms of sleep deprivation may
related to additional anxiety
Ethnic influences
14. Physical Changes
Menopause: Sexual Activity
Most remain sexually active, but with some
decline in frequency.
Demands of other roles compete with time
for sex.
Increasing illnesses explain declines.
15. Physical Changes
Skeletal System
Osteoporosis begins around 30 for women—
and men
Loss of estrogens and progesterone in
women
Improved by regular weight-bearing exercise
16. Physical Changes
Vision: Loss of Visual Acuity
Presbyopia: Farsightedness
Eye lens thickens
Total amount of light reaching the retina
decreases
Reduced focus adjustment
17. Physical Changes
Hearing
Presbycusis: Auditory nerve and structures in
the inner ear gradually deteriorate
Accelerates after 55
Occurs in high and low frequencies
Both primary aging and secondary aging
effects occur
18. Stop and Think
Why is there a different stereotype about the
use of glasses versus hearing aids?
20. Fill in the blank
No single variable affects quality of life in middle
and late adulthood as much
as _____.
21. Health and Wellness
Cardiovascular Disease (CVD) Overview
CVD: Disease process in heart and circulatory
system that accounts for 25% yearly death
Myocardial infarction and atherosclerosis
Majority of Americans have at least one risk
factor; risks are cumulative
22. Health and Wellness
Cardiovascular Disease: Personality and
Health
Friedman and Rosenman Personality
Patterns
Type A
Type B
Type D
23.
24. Health and Wellness
Cancer
Second leading cause of death for adults
45+ years
Risk factors similar to heart disease
Good health habits early on reduces risks
Dietary fat role is controversial risk factor
Some cancer caused by infectious agents
25. Looking at your parents, what risk factors do they
have for cancer or heart disease? What are
controllable variables in your life that could lead
to reduced risk for these diseases?
What cognitive functions or physical would you
miss the most if they begin to deteriorate as you
age? Why?
Questions To PonderQuestions To PonderQuestions To PonderQuestions To Ponder
26. Health and Wellness
Gender and Health
Men’s life expectancy
less than women’s
Women have greater
ability to recover
Women recover higher
levels of physical
functioning from heart
attacks than men
Men have fewer
diseases and
disabilities that limit
daily activity
Men die of CVD at
higher rates than
women.
27. Health and Wellness
Socioeconomic Class, Race, and Health
• Social class discrepancies in secondary
aging
• Occupational level and education
differences
• Ethnicity related to overall health
28. Health and Wellness
Ethnicity and Gender: Cardiovascular
Disease
Cardiovascular Disease: Heart attack and
stroke
Ethnicity influences
Risk factors by gender
29. Health and Wellness
Socioeconomic Class, Race, and Health
Diabetes
Growing for all racial groups
Risk factor for CVD, blindness and kidney
failure
Race differences
30. Health and Wellness
Socioeconomic Class, Ethnicity, and Health
Cancer
Incidence and race
Failure to receive screening and care
Prevention strategies
33. Cognitive Functioning
Physical and Cognitive Aging
Denny’s model of physical and cognitive
aging
Typical curve of age-related changes
Effects of exercise of the skill or ability
Underlying age-related decay curves
Let’s take a closer look!
35. Cognitive Functioning
Physical Decline and Compensation
Baltes and Baltes’s model of selective
optimization
Physical declines create selective
optimization with compensation to combat
aging effects
Selective optimization strategies
36. Health and Cognitive Functioning
Schie’s Analysis of Seattle Longitudinal
Study
Earlier cardiovascular disease related to
earlier and larger declines on intellectual
tests
Exercise lowers mortality risks
Physical activity related to maintenance of
cognitive functions
40. Cognitive Functioning
Practiced and Unpracticed Skills
Why does practice matter?
Helps maintain or gain cognitive skill
Helps compensate for age-related deficits in
cognitive functioning
Provide practice of different strategies to
remember expository text
41. Cognitive Functioning
Creativity
Creativity: Ability to produce original,
appropriate and valuable ideas or solutions
to problems
Simonton studied creativity and productivity
of thousands of notable scientists
Best work produced around 40; outstanding
work published in 50s
What will you be doing when you
are 40 years old?
Development more an account of differences than universals
Primary aging—more universal (gray hair)
Secondary aging—earlier habits have strong effects (smoking, drinking, exercise)
Cognitive tasks activate larger area of brain tissue in middle-aged adults
Cognitive processing may be less selective with age
Middle aged process sensory stimuli differently, experiencing problems with attentional control—but are still safer drivers than younger adults
When middle-aged and young adults are compared, the range of individual differences within each age group is far greater than the average difference between the two groups.
In participants in both age groups who perform poorly on tasks such as remembering words, larger areas of the brain are activated than in those who performed well.
Very slow drop in testosterone
Gradual loss of muscle tissue
Increased risk of heart disease
Lifestyle changes, such as weight loss and exercise, can restore some erectile function.
Performance anxiety increases, causing erectile dysfunction.
Viagra is a common treatment.
Occurs roughly at age 50, though anything between 40 and 60 is normal
Cessation of menses due to declines in sex hormones, estrogens and progesterone
May be occurring at later ages in more recent cohorts of women
Premenopausal phase
Estrogen levels begin to fluctuate and decline
Cycles without ovum are more common
Dramatic drop in progesterone
Perimenopausal phase
More extreme variations in menstrual cycle
Hot flashes – sudden sensations of being hot
85% will have hot flashes for more than a year, 1/3 for as long as 5 years.
Skin temperature can rise 1 – 7 degrees and can be elevated for about 3 minutes.
Hot flashes frequently disrupt sleep and may cause sleep deprivation in many women.
Sleep deprivation can generate psychological distress
Postmenopausal phase
Once a woman has stopped menstruation for one year
Estrogen and progesterone are very low
Breast tissue becomes softer
Uterus becomes smaller
Vagina becomes smaller, thinner, less elastic, and produces less lubricant
Once a woman has stopped menstruation for one year
Estrogen and progesterone are very low
Breast tissue becomes softer
Uterus becomes smaller
Vagina becomes smaller, thinner, less elastic, and produces less lubricant
Once a woman has stopped menstruation for one year
Estrogen and progesterone are very low
Breast tissue becomes softer
Uterus becomes smaller
Vagina becomes smaller, thinner, less elastic, and produces less lubricant
Ethnicity can influence women’s attitudes about menopause and aging
African American women less concerned
Research mixed on menopausal effects
Depressive symptoms may increase BUT
Longitudinal research shows no relationship between menopause and serious depression
Ethnicity can influence women’s attitudes about menopause and aging
African American women less concerned
The more positively women feel about aging, the less negatively they view menopause.
African-American women appear to have the most positive view of aging and the least negative view of menopause.
Most remain sexually active, although frequency of activity declines somewhat
Demands of other roles are pressing middle-aged adults, so less time for sex
Increasing illnesses such as diabetes and arthritis may explain declines
Osteoporosis
Reduced bone mass
More brittle and porous bones
Can cause bone fractures
Linked to loss of estrogens and progesterone in women
Hormone replacement therapy may help
Getting sufficient calcium early in life helps
Regular weight-bearing exercise helps
New bone-building medications
Menopause accelerates bone loss.
Significant increased risk of fractures occurs in women after 50.
Osteoporosis is a primary aging factor but individual differences occur.
See Table 15.1
Presbyopia: Farsightedness
Lens of the eye thickens and the total amount of light reaching the retina decreases
Harder for muscles around the eye to change the shape of the lens to adjust the focus
Part of primary aging requiring physical and psychological adjustment
Presbycusis: Loss of hearing
Auditory nerve and structures in the inner ear gradually deteriorate
Losses occur in high and low frequencies
After age 55, hearing loss accelerates
Both primary aging and secondary aging effects occur
Environmental noise hastens the loss of hearing
No single variable affects quality of life in middle and late adulthood as much as health.
See Table 15.2 for risk factors
Leading cause of death in U.S.
Majority of Americans have at least one risk factor
Risks are cumulative – the more risks you have the higher your risk for heart disease
However, rates recently have dropped
Atherosclerosis
Arteries become clogged with plaque
Clogged arteries cause heart attacks and stroke
Type A personality pattern
Competitive strivings for achievement
Sense of time urgency
Hostility or aggressiveness
Compare themselves to others
Frequent conflict with co-workers
Type B personality pattern
Less hurried and more laid back
Type D Personality is characterized by tendency toward negativity. Such people may experience much stress, anger, hostility, tension, and other negative and distressing emotions.This personality type is often characterized by low self-esteem, social inhibition, and a tendency toward depression.
See Table 15.2 for risk factors.
Type D
Chronic pattern of emotional distress combined with tendency to suppress negative emotions
See the right hand column of Table 15.2 on page 416 for cancer risk factors.
Second leading cause of death for adults 45 years+
Risk factors similar to heart disease
Establishing and maintaining good health habits early on reduces risks
The role of dietary fat is a controversial risk factor
Several types of cancer caused by infectious agents
HPV linked to cervical cancer
Epstein-Barr virus associated with ear, nose, and throat cancers
Helicobacter pylori implicated in many studies of stomach cancer
See Figure 15.1 for life expectancy figures.
Many women’s health issues can be attributed to childbearing.
Women’s life expectancy greater than men’s
Women have more diseases and disabilities that limit daily activity
Already present in early adulthood and difference grows larger with age
Men die of CVD at higher rates than women.
Women have greater ability to recover
Women recover higher levels of physical functioning from heart attacks than men
Social class more significant predictor of health variations in middle age than at other adult ages
Occupational level and education are best predictors of health
African Americans have shorter life spans than Whites
Rates are higher because minorities have more of the risk factors listed in Table 15.2.
Cardiovascular disease
Disables or kills higher proportion of African Americans, Mexican Americans, and Native Americans than either White or Asian Americans
Among women, obesity is a leading factor
Among men, hypertension is the key risk
Minorities have more complications with diabetes than whites.
Minorities tend to develop the disease earlier in life.
Minorities tend to have less access to regular medical care, partially because they have less health insurance.
Minorities have higher risks than Whites.
Minorities have higher risks for diabetes complications, too.
African Americans have higher rates of some cancers and poorer survival rates.
Prostate, colon, lung cancer
African American women have higher breast cancer rates.
Asian American have higher rates of liver cancer.
Minorities fail to receive routine screenings.
Between 14% and 24% of U.S. adults report alcohol problems at some point in life
Long-term drinking harms brain, heart, liver, digestive system
Increases risk of death
Some effects of alcoholism are reversible if the individual stops drinking
Adults have large bodies of skill and knowledge
Can compensate for some cognitive losses
See Figure 15.4 for Denny’s model of aging
On nearly any measure of physical and cognitive functioning, age-related changes follow typical curve
Height of the curve varies based on exercise of the skill or ability
The more fully one exercises that skill or ability, the higher the peak performance
There is an underlying decay curve related to age
Denny’s model suggests a basic decay curve and a fairly large gap between actual and level of performance on exercised and unexercised abilities
Physical declines of middle age create selective optimization with compensation to combat effects of aging
Be selective
Minimize distractions
Optimize strengths
Use compensatory strategies
EXAMPLE: Wear reading glasses
Looking at research from Warner Schaie’s analysis of the Seattle Longitudinal Study (1983)
Exercise data comes from the effects of exercise on Harvard alumni seen in Figure 15.5
Subjects who had cardiovascular disease showed earlier and larger declines on intellectual tests
Even adults on blood pressure medicine have declines in functioning
Exercise lowers mortality risks
Physical activity also may help maintain cognitive functions
Results from the Harvard Alumni Study show clearly that those who are more physically active in middle adulthood have lower risk of mortality over the next decades
Lack of mental exercise tends to be correlated with decline in memory and cognitive skills but major deficits not found until after age 60-65
Subjective experience of forgetfulness increases with age
Middle-aged experts are proficient at overcoming perceived memory limitations
Develop cognitive strategies to buffer effects of aging
Visual memory – the ability to remember an object you have seen for a few seconds – declines in middle age
Performance on remembering lists of words declines after age 55
Episodic memories
Recollections of personal events
Middle-aged use cues to help remember (Where did I put my car?)
Semantic memories
Represent general knowledge
Episodic memories slow with age, but not semantic memories
Practice helps maintain or gain a skill
“Use it or lose it” holds true for cognitive skills
Expertise in a particular field helps compensate for age-related deficits in cognitive functioning
Middle aged adults use different strategies than younger adults to remember expository text
Declines in math skill related to speed may be most susceptible to age declines.
Simonton looked at the creativity and productivity of thousands of notable scientists.
First significant work
Their best work
Their last work
Thinkers produced their best work at about 40, publishing outstanding work in their 50s
Divergent thinking a key to creativity
Generate multiple solutions to problems
Often arises from cognitive bits and pieces
Goleman’s stages:
Preparations
Incubation
Illumination (the aha! moment)
Translation