CHAPTER 15
PHYSICAL AND COGNITIVE
DEVELOPMENT IN MIDDLE
ADULTHOOD
PHYSICAL DEVELOPMENT
Age Changes
• What stays the same as we age?
• What changes with age?
Physical Transitions in Middle Adulthood
• Definition: Time when most people first become aware of
gradual changes in body that mark aging process.
• Gradual psychological and emotional changes in body's
capabilities
• Reactions depend in part on self-concept and lifestyle
• Aging Signs signal
• A reduction in physical attractiveness
• Aging
• Mortality
Additional
Material
There was an old lady….
Society applies a double standard to men and women
in terms of appearance
• Older women tend to be viewed in unflattering terms
• Not as true of high status women
• Not as true of healthy, slim women
• Highly dependent on grooming, dress, ‘presentation’
• Aging men more frequently perceived as displaying
maturity that enhances status
• True of high status individuals
• Not so true of low status individuals
• Highly dependent on grooming, dress, ‘presentation’
Additional
Material
Height, Weight, and Strength: Benchmarks of
Change
• After age 55, bones become less dense
– Ultimately women lose 2 inches and men lose 1 inch
in height
• Women at risk of osteoporosis due to lack of exercise
(not inadequate calcium)
• People continue to gain weight in middle adulthood
– body fat tends to grow in average person
– Physical decline due to lack of exercise accelerates
• Strength
• Strength gradually decreases
particularly in the back and leg muscles.
• By 60, people have lost, on average, about 10
percent of their maximum strength
Additional
Material
Sights and Sounds of Middle Age
• Starting at age 40,
visual acuity declines
– Changing eye's
lenses in shape &
elasticity results in
loss of near vision,
called presbyopia
• Glaucoma Risk
• Lens clouds
– Night vision
– Glare
– Depth perception
Additional
Material
Do you hear what I hear?
PRESBYCUSIS - lose hearing sounds of high frequency
– About 12 percent of people between 45 and 65
– Men more prone to hearing loss
– Changing as women enter former male jobs
– Eardrum becomes stiffer
– Hair cells die
• Sound localization is diminished
– Differential loss
– High frequencies are better localized
Additional
Material
Reaction time:
Not-so-slowing Down
• Decreases slightly in middle adulthood
• Improves or compensated for by being more careful and
practicing the skill
• Lifestyle choices like exercise can slow this loss
• Predictive responses increase in accuracy which
compensates
“Use It or Lose It”
Additional
Material
Sex in Middle Adulthood: The Ongoing
Sexuality of Middle Age
Sexuality remains an important part of life for most
middle-aged people
•Frequency of sexual intercourse decreases with age
– (in many but not all couples)
– Sexual activities remain a vital part of most middleaged adults’ lives
– Adults have more freedom & privacy
– Women no longer need to practice birth control
(after menopause)
–
Sexual Intercourse
Both men and women can face some challenges to
their sexuality during middle adulthood
• Men typically need more time to get an erection
– Volume of fluid in ejaculation declines
– Production of testosterone also declines
• In women, walls of the vagina become less elastic
and thinner
– Vagina shrinks, potentially making intercourse painful
Frequency of Sexual Intercourse
Female Climateric
• Starting about age 45, transition from being able to bear
children to being unable to do so
• Perimenopause is period beginning around 10 years
prior to menopause when hormone production begins to
change
• Production of estrogen and progesterone drop
• Process may begin as early as 40 or as late as 60.
• Lasting about 15 to 20 years
• Menopause
• Symptoms such as "hot flashes," headaches, feeling
dizzy, heart palpitations, and aching joints are common
during menopause.
• Half of women report no symptoms at all.
Additional
Material
Menopause & ERT
Estrogen replacement therapy (ERT)
• Women's expectations about menopause relate to their
experience of menopause
– Variations by race and culture
• Estrogen replacement therapy (ERT), symptoms are
alleviated and variety of problems are reduced, such as:
• Osteoporosis
• Heart disease
• Colon cancer
• Stroke
• Skin elasticity
• Risks associated with ERT.
• Breast cancer
• Abnormal blood clots
• Cancer of the uterine lining
The Dilemma of Hormone Therapy
Estrogen and progesterone used to alleviate
menopausal symptoms: Early findings
PRO
• Changes ratio of “good”
cholesterol to “bad”
cholesterol
• Decreases thinning of
bones
• Associated with reduced
risks of stroke and colon
cancer
• Cognitive advantages
• Enhances sex drive
CON
• Increases risk of breast
cancer and blood clots
• Higher risk for pulmonary
embolism and heart
disease
And So…
• Results of the Women's Health Initiative study led to a
profound rethinking of the benefits of HT
– Questions if HT could protect postmenopausal
– women against chronic disease
• Many women stopped taking hormone replacement drugs
– 40 percent of postmenopausal women in the U.S. were
using hormone therapy in 2002
– 20 percent a decade later
• Most recent thinking among medical experts is that it's
not a simple all-or-nothing proposition
– Some women are simply better candidates for HT than
others
Additional
Material
Menopause - ERT
•
•
•
•
Huge controversy
Study results contradictory
Large ethnicity differences
Current recommendation is use only for
– Highly adverse symptoms
– Short period
– Low doses
• Major flaws in virtually all studies
– Premarin (Equine hormone) 90% of studies
• Not a good match for human estrogen
• Not a very ‘pure’ extract
– No control (or testing) for hormone mimics
– High dosages (usually)
Menopause Psychological Effects
• About 10 percent of women have psychological issues
• Depression
• Anxiety
• Crying spells
• Lack of concentration
• Irritability
• It is now believed that women's expectations about
menopause relate to their experience of menopause.
• Exercise plays a role
• Stress plays a role
• Overall health apart form aging plays a role
• Indian women have few symptoms and look forward to
the social advantages of being past the childbearing age.
• Mayan women also have few symptoms and look
forward to the freedom of being past childbearing age.
The Psychological Consequences of
Menopause
• Early research
– Menopause was linked directly to depression, anxiety,
crying spells, lack of concentration, and irritability
• Current research
– Normal part of aging that does not, by itself, produce
psychological symptoms
• Effects influenced by personal and cultural expectations
of menopause
Do men experience the equivalent of
menopause?
Additional
Material
Male Climacteric
• Male changes during middle age
– Period of physical and psychological change relating
to male reproductive system that occurs during late
middle age.
– Enlargement of the prostate gland (age 40 ~ 10%)
– Problems with urination, including difficulty starting to
urinate and frequent need to urinate during night
(Freq. of occurrence increases but it is NOT common)
• Men still produce sperm and can father children through
middle age
Additional
Material
Male Climacteric Psychological
• Career concerns
• Some men experience body image issues
– Sports prowess declines
– Very active men
• Knee problems
• Muscle injuries increase
• Pain perception changes w/ lower testosterone
– Belly fat increases
• Increased risk of depression
– Body image
– Lower testosterone
HEALTH
Complete the following sentences:
• Middle-aged people like to ____.
• Middle-aged people get annoyed by ____.
• Middle-aged people's health is ____.
• Middle-aged people's cognitive abilities are ____.
• The societal stereotype about middle age indicates____.
Been there, Done that, Have the immunity!
• Fewer accidents and infections
• More careful
• More practiced
• Have built up immunities over their life
• People between the ages of 45 and 65 are less likely
than younger adults to experience
• Infections
• Allergies
• respiratory diseases
• digestive problems.
What do Middle Adults Worry About?
• As people enter middle adulthood, health and safety
concerns become increasingly important, followed by
financial worries. (Source: USA Weekend, 1997.)
• Humans poor at ‘risk assessment’
• Middle adulthood doesn’t improve ability
• High visibility events seen as more likely while actual
high probability events may be seen as less likely.
Worries of Adulthood
Additional
Material
Chronic Diseases in Middle Adulthood
• Arthritis typically begins after age 40
NOTE: author means RA (Rheumatoid Arthritis)
Other types of arthritis have different onset ages
• Diabetes is most likely to occur in people between the
ages of 50 and 60
NOTE: Author means Type 2 Diabetes. Adult Onset
Diabetes is likely a result of excess body fat. As is Insulin
resistant Diabetes.
• Hypertension (high blood pressure) is one of the most
frequent chronic disorders found in middle age
• Obesity
Adult Preventive Health-Care Screening
Recommendations
Adult Preventive Health-Care Screening
Recommendations
Adult Preventive Health-Care Screening
Recommendations
Additional
Material
Gender Differences
• During middle age, women experience more non-life
threatening illnesses than men but men experience more
serious illnesses
– Women smoke less; drink less alcohol; have less
dangerous jobs (Historically. But this is changing)
– Men were exposed to more environmental chemicals
– Men are more likely to have served in the military
• Medical research has typically studied diseases of men
the medical community is only now beginning to study
women's health issues
Individual Variation in Health: Ethnic and Gender
Differences
Variations
• In middle age, African Americans death rate is twice that
of Caucasians
• Lower family's income  higher likelihood of
• disabling illness
• more dangerous occupations
• inferior health coverage
• When whites and African Americans of the same SES
level are compared, the death rate for African Americans
falls below that of Caucasians.
August 2013, more than 14 million Americans were receiving disability benefits
Disability and Income Level
Data skewed by fraud. Link
In Stanville, Kentucky, a poor
area of US, 10 to 15 percent
of the population receives
disability payments
Stress continues to have a significant impact on health during middle adulthood, as
it did in young adulthood, but the nature of what is stressful may have changed.
Psychoneuroimmunologists
Consequences of stress in middle adulthood
Stress produces three major consequences: direct physiological effects,
harmful behaviors, and indirect health related behaviors.
(Source: Adapted from Baum, 1994.)
True or False?
Heart and circulatory disease in middle age are responsible
for more loss of work and disability days due to
hospitalization than any other cause.
True !
Each year heart and circulatory diseases kill
around 200,000 people under the age of 65.
The A's B's of Coronary Heart Disease:
Linking Health and Personality
More men die in middle age of diseases of the heart
and circulatory system than any other cause.
• Both genetic&experiential characteristics are involved
• Heart disease runs in families
• Men are more likely to suffer than women, and risks
increase with age
• Women are less vulnerable, but not immune
• Women less likely to recognize heart attack, less likely to
get emergency care, and less likely to be properly
treated
Additional
Material
Heart Disease and Behavior
• There are several environmental and behavioral factors.
• Cigarette smoking
• High fat and cholesterol in diet (Perhaps not so much)
• Lack of physical exercise (Likely the big factor)
• Evidence suggests that some psychological factors are
also related to heart disease.
– The old: Type A personality
– Newer: Psychosocial stress
– Latest Behavioral Cardiology
Risk Factors for Heart Disease
Figure 15-7 Death
from Heart Disease
Worldwide
The risk of dying from
cardiovascular
disease differs
significantly
depending on the
country in which one
lives.
What cultural or
environmental factors
might help to explain
this fact?
(Source: Lloyd-Jones
et al., 2009.)
The Threat of Cancer
Cancer associated w/ genetic & environmental risks
• Poor nutrition, smoking, alcohol use, exposure to
sunlight, exposure to radiation, and particular
occupational hazards
• Early treatment is related to higher survival rate
– 40 percent of people diagnosed with the disease are
still alive 5 years later
– second leading cause of death in US.
• Therapy: radiation, chemotherapy, surgery
• Detection: breast exam, mammogram, testicle exam
Cancer Treatment
Treatment
• Takes a variety of forms
– Radiation therapy involves the use of radiation to
destroy a tumor
– Chemotherapy involves the controlled ingestion of
toxic substances meant to poison the tumor
• Surgery may be used to remove the tumor
• Early diagnosis is crucial
• But ‘success’ may be only in treatment of Cancers that
would have never been life threatening
Breast Cancer
• Mammography, a weak X-ray, is used to detect breast
cancer
• Death rate lower for those who had a "fighting spirit" or
those who denied they had the disease
• A positive psychological outlook may boost the body's
immune system
Breast Cancer Incidence and Age
Figure 15-8 Age and the
Risk of Breast Cancer
Starting around the age of 30,
the risk of breast cancer
becomes increasingly likely
(Source: Based on data from
the American Cancer
Society, 2003.)
Mammograms have become
controversial
Additional
Material
Mammograms. A mixed blessing?
Despite substantial increases in the number of cases of
early-stage breast cancer detected,
• Screening mammography has only marginally reduced
the rate at which women present with advanced cancer.
• Although it is not certain which women have been
affected, the imbalance suggests that there is substantial
over diagnosis
– accounting for nearly a third of all newly diagnosed
breast cancers
• screening is having, at best, only a small effect on the
rate of death from breast cancer.
New England Journal of Medicine, 2012
http://www.nejm.org/doi/full/10.1056/NEJMoa1206809
COGNITIVE DEVELOPMENT
Additional
Material
Does intelligence decline in middle adulthood?
Difficulties in answering this question may be tied
to research methodologies.
Difficulties in Answering the Question
Older research
Newer research
• Cross sectional studies
• Cohort effect
• Longitudinal studies
• Practice effect and
participant attrition
Additional
Material
Cognitive Development
Cross-sectional studies
• 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
– suggest decline with age in IQ scores may underestimate
intelligence in older subjects due to cohort effects.
Better stated as the Flynn Effect
– For a detailed treaties see this link
Longitudinal studies
• Different developmental patterns in intelligence
– Stable and even increasing IQ scores until mid-30s and
some to mid-50s, then declined
Complicating the Issue Further: What about
the Kinds of Intelligence?
• Fluid intelligence is the ability to deal with new
problems and situations
• Fluid intelligence is inductive reasoning, spatial
orientation, perceptual speed, and verbal memory.
Fluid intelligence does decline with age.
Complicating the Issue Further: What about
the Kinds of Intelligence? Cont.
• 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.
The Answer-Maybe
• When developmentalists looked at the two kinds of
intelligence separately, a new answer appears to the
question of whether intelligence declines with age
• There are two answers: yes and no
– Yes, because in general, fluid intelligence does
decline with age
– No, because crystallized intelligence holds steady
and in some cases actually improves
Even though scores on IQ tests decline with age,
middle-aged people show no decline in general cognitive
competence.
Traditional tests may not tap into practical intelligence.
Changes in Crystalized and Fluid Intelligence
One More Explanation: Schaie (1994)
• Many particular types of ability, such as spatial orientation,
numeric ability, and verbal ability, rather than the broad
divisions of crystallized and fluid intelligence
• When considered this way
– Certain abilities, such as inductive reasoning, spatial orientation,
perceptual speed, and verbal memory, begin to decline very
gradually at around age 25 and continue to decline through old age
– Numeric ability tends to increase until the mid-forties, is lower at
age 60, and then stays steady throughout the rest of life
– Verbal ability rises until about the start of middle adulthood, around
age 40, and stays fairly steady throughout the rest of the life span
Continued Competence during Gradual
Decline: Why?
Salthouse suggests four reasons why this discrepancy exists:
Additional
Material
Highly Successful Middle-Aged People
• Highly successful middle-aged people may not be
representative of all middle-aged people.
• Professional success may not rely exclusively on
cognitive ability. (DUH!)
• Older, successful people may have developed expertise
in their particular occupational area (DUH 2!)
• Or be successful due to SELECTIVE OPTIMIZATION,
the process by which people concentrate on particular
skill areas to compensate for losses in other areas.
Additional
Material
The Development of Expertise: Separating
Experts from Novices
Expertise is the acquisition of skill or knowledge in a
particular area, develops as people devote attention and
practice
• Expert = rely on experience and intuition, process
information automatically, use different neural pathways
to solve problems
• Operate on Principles
• Novice = strictly follow formal rules and procedures, use
better strategies and better problem-solving
• Operate on Rules
Because experts have so much experience,
their behavior is often automatic, performed without much thought.
What Is Multitasking Doing to Our Brains?
Multitaskers versus Non-multitaskers
• Multitaskers may be oversensitive to incoming information
(Ophir, Nass, & Wagner, 2009)
• Middle-aged adults with internet searching experience show
higher levels of brain activation when searching than those
reading pages of text
– Suggests development of new neural pathways involved in
decision-making and reasoning
• People with considerable experience playing video games
actually become better at reacting to stimuli, singling out
important information, and switching between tasks
Additional
Material
What IS Clear about Multitasking
• Certain kinds of tasks are inherently difficult to carry out
simultaneously, such as driving and texting:
• A considerable body of research shows that it can't
be done safely!
• Multitasking leads to poorer results on most tasks
(Except parallel tasks which has confused researchers)
Memory: You Must Remember This
According to research
on memory changes in
adulthood
• Most people show only
minimal losses
• Many exhibit no
memory loss in middle
adulthood
Memory is viewed in
terms of three
sequential
components
• Sensory memory
• Short-term memory
holds information for
15 to 25 seconds
• Long-term memory
Additional
Material
Memory
• Memory has three sequential components.
– Sensory memory is an initial, momentary storage of
information that lasts only an instant.
• No decline in middle age.
– Short-term memory holds info for 15 to 25 seconds.
(can be refreshed)
• No decline in middle age.
– Long-term memory holds info relatively permanently.
• Some decline in middle age.
Storage is less efficient (?)
• A reduction in efficiency of memory retrieval (?)
• Storage contains more
Schemas in Middle Adulthoodorganized bodies
of information stored in memory.
Schemas: organized bodies of info stored in memory.
People hold schemas for particular individuals as well as
for categories of people and behaviors or events
• Help people represent the way the world is organized
• Aid in categorization & interpretation of new information
• Convey cultural information
• organize their behavior into coherent wholes
• help to interpret social events
Additional
Material
Effective Strategies for Remembering
• Mnemonics: formal strategies for organizing material in
ways that make it more likely to be remembered.
• Get organized
• Develop intentional habits
• Pay attention
• Use encoding specificity phenomenon
Recall easier when more factors are the same
• Visualize
• Rehearse
• Say it out loud
• Share with someone else