CHAPTER FIFTEEN PHYSICAL AND COGNITIVE DEVELOPMENT IN MIDDLE

CHAPTER FIFTEEN PHYSICAL AND COGNITIVE DEVELOPMENT IN MIDDLE ADULTHOOD Copyright © 2009 Pearson Education Canada

I. PHYSICAL CHANGES l Changes or declines in many physical functions occur very gradually through the 40 s and 50 s l Among adults who are otherwise healthy, the amount of loss is far less than folklore would have us believe l This period of life may be the intellectual and creative peak l For a few physical functions, however, change or decline is already substantial in the middle adult years Copyright © 2009 Pearson Education Canada 2

A. The Brain & Nervous System l New technology (primarily MRI) has recently increased our knowledge of normal brain function l 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 l New synapses are continuing to form in middle age, but unlike in the younger years, more synapses are lost than are formed l 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 Copyright © 2009 Pearson Education Canada (continued) 3

The Brain & Nervous System (continued) l Behavioural choices and mental health affect the adult brain l Cognitive tasks activate a larger area of brain tissue in middle-aged adults than they do in younger adults l The brains of middle-aged and younger adults respond differently to sensory stimuli l 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 l Such findings illustrate the difficulty researchers face in finding direct relationships between age-related brain differences and cross-age variations in behaviour Copyright © 2009 Pearson Education Canada 4

B. The Reproductive System l 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 l Menopause: – the cessation of monthly menstrual cycles in middle-aged women – The average of menopause is roughly age 50 Copyright © 2009 Pearson Education Canada (continued) 5

The Reproductive System (continued) l 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 Copyright © 2009 Pearson Education Canada (continued) 6

The Reproductive System (continued) l 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 Copyright © 2009 Pearson Education Canada (continued) 7

The Reproductive System (continued) Sexual Activity: l The great majority of middle-aged adults remain sexually active, although the frequency of sex declines in these years l This decline is more likely to be from the demands from other roles, rather than the result of declining hormones Copyright © 2009 Pearson Education Canada 8

No Easy Answers: The Pros and Cons of Hormone Replacement Therapy l Most of the physical symptoms and effects of menopause can be dramatically reduced by taking estrogen and progesterone l The risk of endometrial cancer increased three- to ten-fold in women taking replacement estrogen l 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 Copyright © 2009 Pearson Education Canada 9

C. The Skeletal System l 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 l 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 l 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 Copyright © 2009 Pearson Education Canada 10

Risk Factors for Osteoporosis Copyright © 2009 Pearson Education Canada 11

D. Vision & Hearing l 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 40 s and early 50 s l 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 Copyright © 2009 Pearson Education Canada 12

II. HEALTH PROMOTION AND WELLNESS l No single variable affects the quality of life in middle and late adulthood as much as health l A middle-aged person in good health often functions as well and has as much energy as much younger adults l Mid-life is the era during which the poor health habits and risky behaviours of earlier years begin to catch up with us Copyright © 2009 Pearson Education Canada 13

A. Health Trends at Mid-life l 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 l Perhaps half of adults between 40 and 65 have either some diagnosed disease or disability or a significant, but undiagnosed problem l Life-expectancy is remarkably high, and has been rising over the past few decades l Middle-aged adults have more chronic diseases and disabilities than do young adults l Disease-related death increases in middle-adulthood Copyright © 2009 Pearson Education Canada 14

Life Expectancy at Age 40 in Canada Copyright © 2009 Pearson Education Canada 15

Disease Related Deaths in Canada Copyright © 2009 Pearson Education Canada 16

B. Cardiovascular Disease l 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 Copyright © 2009 Pearson Education Canada (continued) 17

Cardiovascular Disease (continued) l 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 Copyright © 2009 Pearson Education Canada (continued) 18

Cardiovascular Disease (continued) l 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 Copyright © 2009 Pearson Education Canada 19

C. Cancer l Cancer is the second great killer disease of middle adulthood and old age in industrialized countries l The lifetime probability of Canadians developing cancer is one chance in 2. 3 for men and one chance in 2. 6 for women l In Canada, men have a 28. 2% and women have a 23. 9% probability of dying from cancer l 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 Copyright © 2009 Pearson Education Canada (continued) 20

Cancer (continued) l Cancer may replace CVD as the # 1 killer of Canadians by 2010 l Cancer shares many risk factors with CVD l We can control most risk factors l Dietary fat has been implicated as a risk factor for many types of cancer l Several 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 Copyright © 2009 Pearson Education Canada 21

Risk Factors for Heart Disease & Cancer Copyright © 2009 Pearson Education Canada 22

D. Gender and Health l Women’s life expectancy is greater than men’s l Women live longer, but they have more diseases and disabilities l Men die younger but are healthier while they are alive l Nearly 3 times as many men as women die of heart disease between the ages of 45 and 54 l Men are more likely to die of CVD – women’s hearts seem to cope better with the same level of disease l Women are more likely to suffer from nonfatal illnesses like arthritis Copyright © 2009 Pearson Education Canada 23

E. Mental Health l Canadian men and women report improved mental health with increasing age l Self-esteem reportedly peaks between the ages of 35 to 54 l About two-thirds of adults diagnosed with serious mental disorders in early adulthood continue to have difficulties in middle age (Meeks, 1997) l Though most addictive disorders begin in adolescence or early adulthood, they frequently go undiagnosed until they become problematic in middle adulthood (continued) Copyright © 2009 Pearson Education Canada 24

Mental Health (continued) l 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 Copyright © 2009 Pearson Education Canada 25

Development in the Information Age: Is the Internet addictive? l Internet Addictive Disorder, or IAD (Griffiths, 1999). l To be diagnosed with IAD, a person must demonstrate a pattern of Internet use that interferes with normal educational, occupational, and social functioning l 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 l 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 l 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 Copyright © 2009 Pearson Education Canada 26

III. COGNITIVE FUNCTIONING l In the middle adult years, some cognitive abilities improve, whereas others slow down a bit l 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 Copyright © 2009 Pearson Education Canada 27

A. A Model of Physical and Cognitive Aging l Nancy Denney proposes that changes with age on nearly any measure of physical or cognitive functioning follow a typical curve l Unexercised abilities will generally have a lower peak level of performance; exercised abilities will generally have a higher peak l 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 l 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 l Denney’s model does not reflect individual differences Copyright © 2009 Pearson Education Canada 28

Denny’s Model of Aging and Performance Copyright © 2009 Pearson Education Canada 29

B. Health & Cognitive Functioning l There are many links between the effects of secondary aging l Exercise may be one of the critical factors in determining an individual person's overall physical health and cognitive performance during middle adulthood l 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 l Exercise is linked to lower levels of disease and greater longevity Copyright © 2009 Pearson Education Canada 30

Physical Activity and Mortality Rate Copyright © 2009 Pearson Education Canada 31

C. Changes in Memory & Cognition l Major deficits in memory and cognition do not occur until after ages 60 to 65 l 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 Copyright © 2009 Pearson Education Canada (continued) 32

Changes in Memory & Cognition (continued) l 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 Copyright © 2009 Pearson Education Canada (continued) 33

Changes in Memory & Cognition (continued) l 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) Copyright © 2009 Pearson Education Canada 34

Changes in Memory & Cognition (continued) l 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) Copyright © 2009 Pearson Education Canada 35

Changes in Memory & Cognition (continued) l 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) Copyright © 2009 Pearson Education Canada 36

Changes in Memory & Cognition (continued) l 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 Copyright © 2009 Pearson Education Canada 37

D. Creativity l Simonton identified the age at which notable scientists published their first significant work, their best work, and their last work l In every scientific discipline represented, the thinkers produced their best work at about age 40 l Most were publishing significant, even outstanding, research through their 40 s and into their 50 s l Among musicians or other artists, peak creativity may occur later or be maintained far longer Copyright © 2009 Pearson Education Canada 38