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

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

3. 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)

4. 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.

5. 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

6. 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.

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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.

14. 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

15. 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

16. 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

17. 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

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

19. Figure 15.2 Trends in U.S. Life Expectancy
UPDATE

20. 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.

21. 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 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

22. 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 for risk factors.

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

24. 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

25. ? ?
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?

26. 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

27. 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

28. 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

29. 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.

30. 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.

31. 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

32. 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

33. 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 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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.

41. 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

42. 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