Physical and Cognitive Development in Middle Adulthood Chapter 15: Physical and Cognitive Development in Middle Adulthood

Cognitive functioning In This Chapter Physical changes Health and wellness Cognitive functioning

Physical Changes Diverse physical development in middle adulthood Primary aging Secondary aging More research on midlife is needed! Development more an account of differences than universals Primary aging—more universal (gray hair) Secondary aging—earlier habits have strong effects (smoking, drinking, exercise)

Physical Changes The Brain and Nervous System Cognitive tasks activate larger area of brain tissue Cognitive processing less selective and react slower to cognitive tasks Less ability to control attention inhibits responses to irrelevant stimuli Sensory stimuli processed differently 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.

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

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 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.

Physical Changes Menopause in Women Timing Cessation of menses Secular trend 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

Physical Changes Menopause Phases Premenopausal phase Perimenopausal phase Postmenopausal phase 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

Physical Changes Hormone Therapy (HT) Hormone therapy: Progesterone and estrogen administration Women’s Health Initiative Study Protocol Findings 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

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 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

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 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

Physical Changes Menopause: Psychological Effects Does ethnicity influences attitudes about menopause and aging? Let’s look at the next slide and see! Ethnicity can influence women’s attitudes about menopause and aging African American women less concerned

Figure 15.1 Ethnicity and Women’s Attitudes about Aging 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.

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. 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

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 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

Physical Changes Vision: Loss of Visual Acuity Presbyopia: Farsightedness Eye lens thickens Total amount of light reaching the retina decreases Reduced focus adjustment 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

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 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

Stop and Think Why is there a different stereotype about the use of glasses versus hearing aids?

Figure 15.2 Trends in U.S. Life Expectancy UPDATE

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

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 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

Health and Wellness Cardiovascular Disease: Personality and Health Friedman and Rosenman Personality Patterns Type A Type B Type D 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.

Wait a minute! Did you say “type D”? Chronic pattern of emotional distress combined with tendency to suppress negative emotions

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 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

? ? Questions To Ponder 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?

Health and Wellness Gender and Health Men’s life expectancy less than women’s Women have greater ability to recover Men have fewer diseases and disabilities that limit daily activity Men die of CVD at higher rates than women. Women recover higher levels of physical functioning from heart attacks than men 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

Health and Wellness Socioeconomic Class, Race, and Health Social class discrepancies in secondary aging Occupational level and education differences Ethnicity related to overall health 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

Health and Wellness Ethnicity and Gender: Cardiovascular Disease Cardiovascular Disease: Heart attack and stroke Ethnicity influences Risk factors by gender 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

Health and Wellness Socioeconomic Class, Race, and Health Diabetes Growing for all racial groups Risk factor for CVD, blindness and kidney failure Race differences 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.

Health and Wellness Socioeconomic Class, Ethnicity, and Health Cancer Incidence and race Failure to receive screening and care Prevention strategies 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.

Health and Wellness Alcoholism Alcoholism: Physical and psychological dependence on alcohol Incidence by gender Risk (alcohol x aging) Long-term effects 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

Cognitive Functioning Overview Cognitive loss and cognitive improvement Role of knowledge and experience Compensation Adults have large bodies of skill and knowledge Can compensate for some cognitive losses

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! 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

Figure 15.3 Denney’s Model of Physical and Cognitive Aging Denny’s model suggests a basic decay curve and a fairly large gap between actual and level of performance on exercised and unexercised abilities

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 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

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 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

Figure 15.4 Exercise and Mortality What do these data tell you? 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 Figure 15.5

Cognitive Functioning Memory Subjective experience of forgetfulness Visual memory Overcoming perceived memory limitations 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

Cognitive Functioning Semantic and Episodic Memories Do you know the difference? Episodic memories Semantic memories Episodic memories slow with age, but not semantic memories 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

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 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.

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? 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

Cognitive Functioning Creativity Preparations Incubation Illumination (the aha! moment) Translation Goleman’s stages focus on divergent thinking 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