chapter fifteen physical and cognitive development in middle adulthood

CHAPTER FIFTEEN

PHYSICAL AND COGNITIVE DEVELOPMENT IN MIDDLE ADULTHOOD

Copyright © 2009 Pearson Education Canada 15-2

I. PHYSICAL CHANGES

Changes or declines in many physical functions occur very gradually through the 40s and 50s

Among adults who are otherwise healthy, the amount of loss is far less than folklore would have us believe

This period of life may be the intellectual and creative peak

For a few physical functions, however, change or decline is already substantial in the middle adult years


A. The Brain & Nervous System

New technology (primarily MRI) has recently increased our knowledge of normal brain function

White matter volume crests during middle adulthood, while grey matter volume continues its decline that began in childhood and does not level off until about age 60

New synapses are continuing to form in middle age, but unlike in the younger years, more synapses are lost than are formed

The general rule of brain maturation is that the areas of the brain that develop last are the ones that begin to decline first, namely areas located within the frontal and parietal lobes

(continued)


The Brain & Nervous System (continued)

Behavioural choices and mental health affect the adult brain

Cognitive tasks activate a larger area of brain tissue in middle-aged adults than they do in younger adults

The brains of middle-aged and younger adults respond differently to sensory stimuli

Despite these apparently negative findings, in everyday situations requiring intense concentration and rapid judgments (for example when driving a car), middle-aged adults perform better than their younger counterparts

Such findings illustrate the difficulty researchers face in finding direct relationships between age-related brain differences and cross-age variations in behaviour


B. The Reproductive System

Male Climacteric:

– Climacteric is the term used to describe the adult period during which reproductive capacity declines or is lost

– In men, the climacteric is extremely gradual, with a slow loss of reproductive capacity

Menopause:

– the cessation of monthly menstrual cycles in middle-aged women

– The average age of menopause is roughly age 50

(continued)


The Reproductive System (continued)

Menopausal Phases:– Premenopausal phase: the stage of menopause

during which estrogen levels fall somewhat, menstrual periods are less regular, and anovulatory cycles begin to occur

– Perimenopausal phase: the stage of menopause during which estrogen and progesterone levels are erratic, menstrual cycles may be very irregular, and women begin to experience symptoms such as hot flashes

– Postmenopausal phase: the last stage of menopause; a woman is postmenopausal when she has had no menstrual periods for a year or more

(continued)



Psychological Effects of Menopause:– None of several large studies reported any connection

between menopausal status and a rise in depression or other psychological symptoms

– Negativity during menopause may stem from a woman’s overall negativity and life stressors before entering menopause

– Individual differences: Women with significant symptoms, and whose symptoms last the longest, experience the most depression and negative moods

– Sleep deprivation from symptoms may be misdiagnosed as depression

(continued)



Sexual Activity: The great majority of middle-aged adults remain

sexually active, although the frequency of sex declines in these years

This decline is more likely to be from the demands from other roles, rather than the result of declining hormones


No Easy Answers: The Pros and Cons of Hormone Replacement Therapy

Most of the physical symptoms and effects of menopause can be dramatically reduced by taking estrogen and progesterone

The risk of endometrial cancer increased three- to ten-fold in women taking replacement estrogen

A combination of estrogen and progesterone at quite low doses:– has the same benefits as estrogen alone, but

without the increased risk of endometrial cancer– Decreases some other important health risks while

increasing others


C. The Skeletal System Bone loss begins at about age 30 for both men and

women, but in women the process is accelerated by decreasing estrogen and progesterone levels in menopause

The major consequence of this loss of bone density is a significantly increased risk of fractures, beginning as early as age 50 for women, and much later for men

Osteoporosis can be prevented by:– getting enough calcium during early adulthood, so the peak

level of bone mass is as robust as possible

– getting regular exercise, particularly weight-bearing exercise such as walking or strength training throughout adult life


Risk Factors for Osteoporosis


D. Vision & Hearing

Presbyopia: – Normal loss of visual acuity with aging, especially

the ability to focus the eyes on near objects

– The ability to focus on near objects deteriorates rapidly in the 40s and early 50s

Presbycusis: – Normal loss of hearing with aging, especially of

high-frequency or very low-frequency tones

– This progresses more slowly than presbyopia

– Hearing loss accelerates after age 55


II. HEALTH PROMOTION AND WELLNESS

No single variable affects the quality of life in middle and late adulthood as much as health

A middle-aged person in good health often functions as well and has as much energy as much younger adults

Mid-life is the era during which the poor health habits and risky behaviours of earlier years begin to catch up with us


A. Health Trends at Mid-life

Middle-aged adults report that they experience annoying aches and pains with greater frequency than when they were younger, and many are unhappy with their bodies

Perhaps half of adults between 40 and 65 have either some diagnosed disease or disability or a significant, but undiagnosed problem

Life-expectancy is remarkably high, and has been rising over the past few decades

Middle-aged adults have more chronic diseases and disabilities than do young adults

Disease-related death increases in middle-adulthood


Life Expectancy at Age 40 in Canada


Disease Related Deaths in Canada


B. Cardiovascular Disease

Cardiovascular disease (CVD):– A variety of physical problems, especially in the

arteries– Atherosclerosis: narrowing of the arteries caused

by deposits of a fatty substance called plaque– Significant arterial blockage results in a heart

attack or stroke– CVD decreased by 45.8% between 1985 and

1999– CVD remains the leading cause of death among

adults in Canada, accounting for more than one third of all deaths in men and women

(continued)


Cardiovascular Disease (continued)

General Risk Factors:– The Framington study (a long term epidemiological

study) identified characteristics that predicted CVD

– A large percentage of Canadians have CVD risk factors

• 44% of men, 33% of women have 2 or more major risk factors

– These risks are cumulative, not just additive• High cholesterol is 3 times more serious in a

smoker than in a non smoker

(continued)


Cardiovascular Disease (continued)

Personality and Health:– Type A personality pattern is associated with

greater risk of CVD; it includes competitive achievement striving, a sense of time urgency, and, sometimes, hostility or aggressiveness

– Some facets of Type A personality (especially hostility) produce higher risk

– If a person is already at high risk, personality type does not increase the risk further

– Neuroticism and depression may also be predictive


C. CancerCancer is the second great killer disease of middle

adulthood and old age in industrialized countriesThe lifetime probability of Canadians developing cancer is

one chance in 2.3 for men and one chance in 2.6 for women

In Canada, men have a 28.2% and women have a 23.9% probability of dying from cancer

Lung cancer is the number one cause of cancer deaths in Canada– The incidence has dropped steadily for men since 1980– For women new cases of lung cancer have jumped nearly

four-fold over the past thirty years

(continued)


Cancer (continued)

Cancer may replace CVD as the # 1 killer of Canadians by 2010

Cancer shares many risk factors with CVDWe can control most risk factorsDietary fat has been implicated as a risk factor for

many types of cancerSeveral cancers are infectious

– HPV is a sexually transmitted infection linked with several different cancers

– Epstein-Barr virus and H. pylori bacteria are linked with several cancers


Risk Factors for Heart Disease & Cancer


D. Gender and Health

Women’s life expectancy is greater than men’sWomen live longer, but they have more diseases and

disabilitiesMen die younger but are healthier while they are

alive Nearly 3 times as many men as women die of heart

disease between the ages of 45 and 54Men are more likely to die of CVD – women’s hearts

seem to cope better with the same level of diseaseWomen are more likely to suffer from nonfatal

illnesses like arthritis


E. Mental Health

Canadian men and women report improved mental health with increasing age

Self-esteem reportedly peaks between the ages of 35 to 54

About two-thirds of adults diagnosed with serious mental disorders in early adulthood continue to have difficulties in middle age (Meeks, 1997)

Though most addictive disorders begin in adolescence or early adulthood, they frequently go undiagnosed until they become problematic in middle adulthood

(continued)


Mental Health (continued)

Alcohol use disorders:– Canadian men are more likely to be regular

heavy drinkers than women (5 or more drinks at least once/month)

– The rate of heavy regular drinking peaks during young adulthood, begins to decline between 33 and 44, and then continues to decline

– Neurological deficits among alcoholics include problems with memory and language

– Alcoholics have increased risk for diseases of many systems (cardiovascular, digestive, immune, muscular, reproductive) and for death


Development in the Information Age: Is the Internet addictive? Internet Addictive Disorder, or IAD (Griffiths, 1999). To be diagnosed with IAD, a person must demonstrate a

pattern of Internet use that interferes with normal educational, occupational, and social functioning

To use the term addiction in relation to a specific activity, the activity must have some addictive power; the experience of being online must have the capacity to induce some kind of reinforcing state in users

Excessive Internet use may be part of a behaviour pattern that is consistent across several media; those who are “addicted” to the Internet also spend inordinate amounts of time watching television and playing video games, and are more likely to be addicted to alcohol and other substances

Those opposed to the idea of Internet addiction suggest that excessive time online either is a symptom of another disorder or may simply reflect fascination with a new medium


III. COGNITIVE FUNCTIONING

In the middle adult years, some cognitive abilities improve, whereas others slow down a bit

Many adults have acquired large bodies of knowledge and skills that help them compensate for losses and solve problems within their areas of expertise more efficiently than younger adults do


A. A Model of Physical and Cognitive Aging Nancy Denney proposes that changes with age on

nearly any measure of physical or cognitive functioning follow a typical curve

Unexercised abilities will generally have a lower peak level of performance; exercised abilities will generally have a higher peak

Any skill (physical or mental) that is not fully exercised can be improved, even in old age, if the individual begins to exercise that ability

With increasing age a high level of functioning requires more and more effort, until eventually every adult reaches a point at which even maximum effort will no longer maintain peak function

Denney’s model does not reflect individual differences


Denny’s Model of Aging and Performance


B. Health & Cognitive Functioning

There are many links between the effects of secondary aging

Exercise may be one of the critical factors in determining an individual person's overall physical health and cognitive performance during middle adulthood

Among physically healthy middle-aged and older adults, those who are more physically active have higher scores on tests of reasoning, reaction time, and short-term memory

Exercise is linked to lower levels of disease and greater longevity


Physical Activity and Mortality Rate


C. Changes in Memory & Cognition

Major deficits in memory and cognition do not occur until after ages 60 to 65

Memory Function:– The subjective experience of forgetfulness

increases with age– Memory demands of middle-aged adults' everyday

lives are greater than for those of young adults– By increasing the use of reminders, or cues,

middle-aged adults are proficient at overcoming perceived memory limitations

– They are willing to use these cues (in contrast to older adults) because they believe their efforts will make a difference to their memory

(continued)


Changes in Memory & Cognition (continued)

Memory Function (continued): – Visual memory declines in middle age– Memory for auditory stimuli seems to remain

stable throughout adulthood– Performance on more complex tasks declines with

age, but usually not until after about age 55– Recognition of words and texts appears to remain

stable throughout adulthood– Short term (working) memory capacity stays stable

throughout adulthood, but the ability to use this capacity efficiently changes

(continued)



Semantic and Episodic Memory:– Research suggests that episodic memory (the

ability to re-experience personal events) slows with age, but not semantic memory (general knowledge of the world, facts, and the meaning of words)

– Flashbulb memories (those highly memorable moments of significant events) are not affected by age

(continued)



Practised and Unpractised Skills:– Most adults maintain or even gain in skills on any

task that they practice often or that is based on specific learning

– Expertise in a particular field helps to compensate for age-related deficits in cognitive functioning

– Performance on unfamiliar tasks decreases with age, but the losses are small until after age 60

(continued)



New Learning:– Middle-aged adults seem to be just as capable as

younger adults of learning and remembering new information

– Middle-aged students tend to be more academically successful than their younger peers, but this may be due to both motivational differences and the greater amount of background knowledge

– While research does not show significant differences in learning new job skills, employers believe young adults outperform older employees in this respect (continued)



Schematic Processing:– In adulthood there is a tendency to shift away from

the logical or formal-operational approach to a more pragmatic approach aimed at solving everyday problem (schematic processing)

– In memory, this might be reflected in a decline in memory for surface detail, but a compensatory memory for themes or meaning


D. Creativity Simonton identified the age at which notable

scientists published their first significant work, their best work, and their last work

In every scientific discipline represented, the thinkers produced their best work at about age 40

Most were publishing significant, even outstanding, research through their 40s and into their 50s

Among musicians or other artists, peak creativity may occur later or be maintained far longer

chapter fifteen physical and cognitive development in middle adulthood

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