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Middle adulthood
40 – 65 years
1
Physical changes
• Appearance:
– Hair begins to thin, and grey hair appears
– Skin turgor and moisture decreases
– Subcutaneous fat decreases and wrinkling
occurs
– Fatty tissue is redistributed, resulting in fat
deposits in the abdominal area “spare tire”
– Nail & hair growth slows
– Baldness
2
• Musculoskeletal system:
– Skeletal muscle bulk decreases at about age of 60
– As the cartilage between the vertebrae starts to
degenerate from normal wear, the vertebrae
become compressed and the spinal column
gradually begins to shorten causes a decrease in
height of about 2.5 cm
– Calcium loss from bone tissue is more common
among post-menopausal women
– Bones lose mass and density, break more easily and
heal more slowly
3
4
• Joint pain may be caused by deterioration
of the bones under the cartilage in a
condition known as osteoarthritis.
• A more common form of arthritis is
rheumatoid arthritis which is a destructive
disease of the joints causing pain.
• During middle age, adults may begin
taking anti-inflammatory medications and
either steroidal, or non-steroidal drugs.
• Muscle growth continue in proportion to
use
5
• Cardiovascular system:
– Blood vessels lose elasticity and become thicken
– The ability of the heart muscle to contract
decreases leading to a lower cardiac output
• Respiratory system:
– Lung and bronchi become increasingly less elastic,
causing a progressive decrease in maximum
breathing capacity
– It takes individuals longer to catch their breaths
after exercise
6
• Sensory perception:
– Visual acuity declines, often by late forties,
especially for near vision (presbyopia)
– Hearing loss limited first to high pitches
sounds (presbyacusis) particularly in men
cause persons to stand or sit closer to the
source of sound, they may strain to hear or
may talk in compensatory louder tones
– Taste sensation also diminish
7
Adulthood: Physical
Development
 The Aging Senses
1.00
0.75
Proportion of normal
(20/20) vision when
identifying letters on
an eye chart
0.50
0.25
0
10
30
50
Age in years
70
90
8
Adulthood: Physical
Development
 The Aging Senses
90
Percent correct when
Identifying smells
70
50
10
30
50
Age in years
70
90
9
Adulthood: Physical
Development
 The Aging Senses
90
Percent correct when
identifying spoken
words
70
50
10
30
50
Age in years
70
90
10
• Metabolism:
– Slows resulting in weight gain commonly in the wall
of the abdomen, the hips, thighs and chest wall
• Gastrointestinal system:
– Gradual decrease in the process of digesting,
absorbing and eliminating food may predispose the
individual to constipation
• Urinary system:
– Nephron units are lost during this time and
glomerular filtration rate decreases
11
• Reproductive changes:
– Hormonal changes take place in both men
and women
– The reproductive organs of both men and
women begin to atrophy
– The end of the female reproductive cycle is
relatively clearly marked the menopause
12
• Menopause:
– Usually occurs between age of 40 – 55 years (average 47
years)
– Ovarian activities declines until ovulation ceases
– Two processes are often seen associated with menopause.
• Estrogen-related symptoms: hot flashes, night sweats,
vaginal dryness, and urine leakage.
• Somatic symptoms: sleep problems, headaches, rapid
heart-beat, stiffness or soreness in the joints.
• Climacteric (Andropause)
– The change of life in men when sexual activity decreases
– Less gradual and less obvious than menopause in women
13
Psychosocial development
• Erikson: Generativity vs. stagnation
• Generativity:
– The concern for establishing and guiding the next
generation
– Increase concept of service to others and love and
compassion: social work, political work,
community fund-raising
– Marriage can be more satisfying
– Feel a sense of comfort in their lifestyle
14
• Stagnation:
– People who are unable to expand their interests at
this time suffer a sense of boredom and
stagnation
– Have difficulty in accepting their aging bodies and
become withdrawn and isolated
– Preoccupied with self and unable to give to others
– Some may regress to younger behaviour in dress
or actions or marrying younger partners
15
Cognitive development
• Learning continues and can be enhanced by
increased motivation at this time
• The experiences of the professional, social,
and personal life will be reflected in their
cognitive performance thus approaches to
problem solving and task completion will vary
considerably
16
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.
17
Crystallized & Fluid Intelligence
•
Many researchers believe there are two
kinds of intelligence.
– FLUID INTELLIGENCE: is defined as one’s
reasoning and problem solving abilities,
independent from the culture and the
environment.
– It is the ability to deal with new problems and
situations
– Fluid intelligence does decline with age.
18
(Crystallized & Fluid Intelligence, continued)
•
•
•
CRYSTALLIZED INTELLIGENCE is the store of
information, skills, and strategies that people
have acquired through education and prior
experiences, and through their previous use of
fluid intelligence.
Crystallized intelligence includes numerical
and verbal abilities, such as solving a
crossword puzzle or a mathematical problem.
Crystallized intelligence holds steady or
increases with age.
19
Changes in Crystallized & Fluid Intelligence
20
•
•
Professional success may not rely exclusively
on cognitive ability.
Older, successful people may have
developed expertise in their particular
occupational area or SELECTIVE
OPTIMIZATION, the process by which people
concentrate on particular skill areas to
compensate for losses in other areas.
21
Memory in Middle Adulthood
•
•
According to research on memory
changes in adulthood, most people show
only minimal losses, and many exhibit no
memory loss in middle adulthood.
Memory is viewed in terms of three
sequential components…
22
Memory in middle adulthood, continued
Sensory memory is an initial, momentary storage of
information that lasts only an instant.
– No decline in middle age.
• Short-term memory holds information for 15 to 25
seconds.
– No decline in middle age.
• Long-term memory holds information that is
rehearsed for a relatively permanent time.
– Some decline in middle age.
– storage is less efficient
– a reduction in efficiency of memory retrieval
•
23
Nutrition
• As metabolic rate decreases, food intake
should be adjusted accordingly.
• If wise eating habits were not followed earlier
in life, the body may start giving its owner
messages of disease. Heartburn, ulcers, colitis,
high blood pressure -- all these and more are
at least partially caused by poor diet and poor
digestion
24
Health problems
• Life style patterns, aging, family history,
developmental stressors, situational stressors are
related to health problems
• CVD
• Cancer
• Accidents: Due to decreases reaction time and visual
acuity
25
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.
26
27
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
28
Heart disease, continued
•
There are several environmental and
behavioral risk factors for heart disease.
– cigarette smoking
– high fat and cholesterol in diet
– lack of physical exercise
29
The Type A’s and Type B’s personality
•
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.
30
(type A behavior, continued)
•
•
•
•
They engage in 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.
Most experts now say it is the negative emotion
and hostility that are the major links to heart
disease.
31
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
32
Stress in Middle Adulthood
• Stress continues to significantly impact
health during middle adulthood
• Stressors themselves may be different
• 3 main consequences…
– Direct physiological effect
– Harmful behaviors
– Indirect health related behaviors
33
The 3 Main Consequences of Stress
34
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.
Men at higher risk for lung and bladder cancer
Women at higher risk for breast cancer followed
by colon, uterus and lung cancer
35
•
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
36
Health problems
• Obesity:
– Due to low metabolic activity associated with physical
inactivity
– Places adults at greater risk for many chronic illnesses such
as DM, HTN
• Mental health alterations:
– Development of stressors such as menopause,
retirements, divorce, unemployment, death of spouse can
precipitate increased anxiety leading to depression
37