Chapter 15: Middle Adulthood: Physical and Cognitive Development

1. Chapter 15: Middle Adulthood: Physical and Cognitive Development Development Across the Lifespan

2. Physical Development in Middle Adulthood • Middle adulthood is the time when most people first become aware of the gradual changes in their bodies that mark the aging process. • Western society applies a double standard to men and women in terms of appearance. • Older women tend to be viewed in unflattering terms. • Aging men are more frequently perceived as displaying a maturity that enhances their status.

3. Height, weight and strength: The benchmarks of Change in Middle Adulthood • Height reaches a maximum during the 20’s for most people, and remains stable til about age 55. • After age 55, bones become less dense and ultimately women lose 2 inches and men lose 1 inch in height. • Women are more prone to declining height due to OSTEOPOROSIS, a condition in which the bones become brittle, fragile, and thin. • Osteoporosis is brought about by a lack of calcium in the body, and lack of exercise.

4. (Height, weight and strength, continued) • Both men and women continue to gain weight in middle adulthood. • The amount of body fat increases. • Exercise and weight control can ameliorate the weight gain. • Throughout middle adulthood, strength gradually decreases. • This is particularly so in the back and leg muscles. • By age 60, people have lost about 10 percent of their maximum strength.

5. The Senses: The Sights & Sounds of Middle Age • Starting at age 40, visual acuity - the ability to discern fine spatial detail in both close and distant objects - begins to decline. • The eye's lenses change shape and elasticity. • The lenses become less transparent, which reduces the amount of light entering. • A nearly universal change in eyesight during middle adulthood is the loss of near vision, called PRESBYOPIA

6. The Decline ofVisual Acuity Around age 40, the ability to discern fine detail begins to drop.

7. Declines also occur in depth perception, distance perception, the ability to view the world in three dimensions, and night vision. • Sometimes changes in vision are brought on by a disease called GLAUCOMA, a condition where pressure in the fluid of the eye increases, either because the fluid cannot drain properly or because too much fluid is produced. • About 1 percent to 2 percent of those over 40 are affected. • African-Americans are particularly susceptible. • It can be treated if caught early enough. • If left untreated it can cause blindness.

8. Hearing in Middle Age • Hearing undergoes a gradual decline beginning in middle adulthood. • The primary sort of loss is for sounds of high frequency, a problem calledPRESBYCUSIS. • About 12 percent of people between 45 and 65 suffer from presbycusis. • Men are more prone to hearing loss than women.

9. Hearing in Middle Age, continued • Because the two ears are not always equally affected by hearing loss, sound localization, the ability to detect the origin of a sound, is diminished. • Some hearing loss results from environmental factors, such as loud noises. • The rest are caused by aging, which brings a loss of hair cells in the inner ear. • Also, the ear drum becomes less elastic with age

10. Reaction time in Middle Age • Reaction time increases slightly in middle adulthood. • This is due to a gradual loss of muscle in the body and nervous system processing due to aging. • People can compensate by being more careful and practicing the skill. • Exercise can slow this loss & has other advantages...

11. --Slower decline in energy molecules, muscle mass, blood supply, speed of movement, stamina --Slower increase in fat & muscle soreness --Slower decline in processing central nervous system impulses --Slower increase in variations in speed of motor neuron impulses --Maintenance of lower levels of harmful cholesterol --Decreased risk of high blood pressure, atherosclerosis, heart attack, stroke --Slower decline in bone minerals --Decreased risk of fractures & osteoporosis

12. The Ongoing Sexuality of Middle Age • Contrary to popular stereotypes, sexual activity does not fade away for most middle age adults • Although the frequency of sexual intercourse decreases with age, sexual activities remain a vital part of most middle-aged adult's lives (see next slide for frequency rates of sexual intercourse by age). • With children grown and away from home, middle-aged adults have more freedom for sexual enjoyment. • With menopause, women no longer need to practice birth control.

13. Rates of Sexual Intercourse by Age

14. There are differences in the sexual experiences of people in middle adulthood… • Men typically need more time to get an erection. • The volume of fluid in ejaculation declines. • The production of Testosterone (Male sex hormone) also declines. • In women, the walls of the vagina become less elastic and thinner and the vagina shrinks, potentially making intercourse painful for some women.

15. The Female Climacteric & Menopause • Starting about age 45, women enter a period known as the FEMALE CLIMACTERIC, the transition from being able to bear children to being unable to do so. • This period lasts about 15 to 20 years. • The most notable sign is MENOPAUSE, the cessation of menstruation. • Perimenopause may impact development with similar symptoms (changes in hormones beginning about 10 years prior to menopause).

16. For most women, menstrual periods become irregular for about 2 years, starting at about age 47 or 48. • After a year goes by without a menstrual period, menopause is said to have occurred. • The production of estrogen and progesterone drop. • Symptoms such as "hot flashes", headaches, feeling dizzy, heart palpitations, and aching joints are common during menopause. • Half of women report no symptoms at all.

17. Symptoms of menopause differ by race/ethnicity • Japanese & Chinese women: fewer symptoms • African American women: more hot flashes & night sweats • Hispanic women: higher level of heart pounding & vaginal dryness ~ Reasons unclear: systematic physical differences in hormone production levels suspected

18.  Using hormone replacement therapy (HRT), symptoms are alleviated and a variety of problems are reduced, such as • Osteoporosis & colon cancer • stroke & skin elasticity • heart disease  There may be risks associated with HRT. • breast cancer • abnormal blood clots • cancer of the uterine lining ~ Women must make their own choices about whether the benefits of treatment outweigh the dangers.

19. Historically…  It was thought that about 10 % of women had psychological problems associated with menopause. • depression • anxiety • crying spells • lack of concentration • irritability

20. Today researchers view menopause from a different perspective… • It is now believed that women's expectations about menopause relate to their experience of menopause. • Indian women have few symptoms and look forward to the social advantages of being past the childbearing age. • Mayan women also have few symptoms and look forward to the freedom of being past childbearing age.

21. Men in Middle Age… • Do men experience the equivalent of menopause? Not really. • Since they haven’t experienced anything like menstruation, no similar large scale change ~Men do experience some changes during middle age that are collectively referred to as the MALE CLIMACTERIC, the period of physical and psychological change relating to the male reproductive system that occurs during late middle age.

22. Men in Middle Age, continued • The most common is the enlargement of the prostate gland. • By age 40, 10 percent of men have enlarged prostates. • Symptoms are problems with urination, including difficulty starting to urinate and frequent need to urinate during the night. • Men still produce sperm and can father children through middle age.

23. Health in Middle Age • Health concerns become increasingly important to people during middle adulthood. • The vast majority of people in middle age face no chronic health difficulties and have fewer accidents and infections because they are more careful and have built up immunities over their life. • Despite this, surveys show that health issues are a major concern to middle aged adults… 

24. The Worries of Adulthood Health worries outnumber financial worries in middle adulthood.

25. Health in Middle Age, continued • Some adults, however, are particularly susceptible to chronic diseases in middle adulthood. • Arthritis typically begins after age 40. • Diabetes is most likely to occur in people between the ages of 50 and 60. • Hypertension (high blood pressure) is one of the most frequent chronic disorders found in middle age

26. Health in Middle Age, continued • The death rate for people between 40 and 60 has declined dramatically; it is less than half of what it was in 1940. • Some people are genetically susceptible to chronic diseases, such as hypertension.

27. Ethnic Variations in Health  Social and environmental factors are related to health: African-Americans in the U.S. have twice the death rate of Caucasians. • Related to SES (socioeconomic status): When death rates are compared for Whites and African-Americans of the same SES, African-Americans' death rate drops below Whites'. • Poorer people are more apt to experience a disabling illness. • Poorer people tend to work in more dangerous occupations & are more likely to become disabled.

28. Disability & Income Level Workers living in poverty are more likely to become disabled than those with higher income levels. Why?

29. Gender differences in Health  During middle age, women experience more non-life threatening illnesses than men but men experience more serious illnesses. • Women smoke less. • Women drink less alcohol. • Women have less dangerous jobs. • Medical research has typically studied diseases of men with all male samples; the medical community is only now beginning to study women's health issues.

30. Stress in Middle Adulthood • Stress continues to significantly impact health during middle adulthood • Stressors themselves may be different • Psychoneuroimmunologists: study the relationships between the brain, immune system, and psychological factors connected to stress • 3 main consequences…

31. The 3 Main Consequences of Stress

32. The ABC’s of Heart Disease in Middle Adulthood • More men die in middle age of diseases of the heart and circulatory system than any other cause. • Both genetic and experiential characteristics are involved. • Heart disease runs in families. • Men are more likely to suffer than women, and risks increase with age.

33. Death From Heart Disease Worldwide

35. According to the American College of Sports Medicine and the Centers for Disease Control and Prevention, every adult should get at least 30 minutes of moderate-intensity physical activity daily. • walking • gardening • climbing stairs • reduces risk of heart disease, osteoporosis, weight gain, and hypertension • psychological benefits of sense of control and well-being

36. Heart disease, continued • There are several environmental and behavioral risk factors that for heart disease. • cigarette smoking • high fat and cholesterol in diet • lack of physical exercise

37. The Type A’s and Type B’s • Evidence suggests that some psychological factors are also related to heart disease. • People with TYPE A BEHAVIOR PATTERN,which is characterized by competitiveness, impatience, and a tendency toward frustration and hostility, are more susceptible to heart disease.

38. (type A behavior, continued) • They engage in polyphasic activities - multiple activities carried out simultaneously. • They are easily angered and become verbally and nonverbally hostile if prevented from reaching their goals. • Heart rate and blood pressure rise, epinephrine and norepinephrine increase. • Wear and tear on heart produces disease.

39. (type A behavior, continued) • Evidence is only correlational so we cannot say Type A behavior causes heart disease. • Most experts now say it is the negative emotion and hostility that are the major links to heart disease. • Most research has been done on men; we need to research women to see if Type A women are equally susceptible.

40. Type B’s and heart attack risk • By contrast, people with TYPE B BEHAVIOR PATTERN,which is characterized by noncompetitiveness, patience, and a lack of aggression, have less than half the risk of coronary disease that Type A people have. ~ Not all type A’s are destined to suffer heart disease! ~ Can learn to behave differently

41. The Threat of Cancer in Middle Adulthood… • Cancer is the second leading cause of death in middle age. • Many forms of cancer respond well to treatment. • 40 % are still alive 5 years after diagnosis. • Cancer is unchecked cell growth.

42. Cancer in Middle Adulthood, continued • Cancer is associated with several risk factors. • Genetics (family history of cancer) raises the risk. • Poor nutrition, smoking, alcohol use, exposure to sunlight, exposure to radiation, and exposure to occupational hazards such as certain chemicals raises the risk

43. Cancer, continued Treatment of cancer can take a variety of forms. • Radiation therapy involves the use of radiation to destroy a tumor. • Chemotherapy involves the controlled ingestion of toxic substances meant to poison the tumor. • Surgery may be used to remove the tumor.

44. Early diagnosis of cancer is crucial. • The earlier that breast cancer is diagnosed, the better a woman’s chance of survival • Mammography, a weak X-ray, is used to detect breast cancer. • Women over 50 should routinely have one. • Younger women have denser breasts and the problem of false positives increases, which is one reason younger women are not encouraged to have testing done.

45. Critical Thinking… • Mammograms are expensive ($100. on average), although prostate exams for men are not—What might this say about the medical community’s value of women’s lives?

47. Psychological Factors Related to Cancer • Increasing evidence suggests that cancer is related to psychological factors, also. • The death rate of women with breast cancer was much lower for those who had a "fighting spirit" or those who denied they had the disease. • People with close family ties are less likely to develop cancer. • Cancer patients who are habitually optimistic report less physical and psychological distress.

48. Psychological Factors Related to Cancer, continued • Participating in group therapy reduces anxiety and pain and increases survival rates. • A positive psychological outlook may be related to a tendency to adhere to a strict treatment regimen. • A positive psychological outlook may boost the body's immune system…

50. Cognitive Development Does intelligence decline with age? • Cross-sectional studies - which test people of different ages at the same point in time - clearly showed that older subjects scored less well than younger subjects on traditional IQ tests. • Intelligence peaks at 18, stays steady until mid-20s, and declines till end of life.