1. Middle adulthood
40 – 65 years

2. 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

3. 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

5. 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

6. 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

7. 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

8. 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 10 30 50 70 90
Age in years

9. Adulthood: Physical Development
The Aging Senses 90
Percent correct when
Identifying smells 70 50 10 30 50 70 90
Age in years

10. Adulthood: Physical Development
The Aging Senses 90
Percent correct when
identifying spoken
words 70 50 10 30 50 70 90
Age in years

11. Gastrointestinal system:
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

12. 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

13. Climacteric (Andropause)
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

14. 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

15. 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

16. 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

17. 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.

18. 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.

19. (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.

20. Changes in Crystallized & Fluid Intelligence

21. 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.

22. 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…

23. 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.
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

24. 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

25. 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

26. 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.

28. 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

29. 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

30. 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.

31. (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.

32. 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

33. 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

34. The 3 Main Consequences of Stress

35. 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

36. 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

37. Health problems Obesity: Mental health alterations:
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