Physical and Cognitive Development in Middle Adulthood
Middle adulthood is difficult to define in generalities, since there are wide variations in
attitudes and behaviors at this point. People have made consistent choices in certain
directions and they often don’t feel much freedom to significantly change their lives. Life
crises often make the decision for them about change. Middle age begins around age 40
and ends around 60. Children leave home and career paths are more set by this time.
Attitudes largely determine how young (or old) people feel during this stage. Upbeat,
involved, active people feel healthier and more secure. People who feel cynical,
disappointed, and angry about their lives tend to feel less optimistic, older. With better
medical and nutritional benefits of progressive societies, older people feel much more
connected and youthful than in the past. There are some predictable declines in this stage,
but many of those are moderated by social networks, career connections, and family.
Physical Development
Physical changes are evident in the slight wrinkling of the face, thinning hair, and fuller
body. It is also evident in the slower pace of movement and thinking. There may be some
health episodes that orient people this age from youth to aging concerns.
 Vision is affected as the lens gets thicker and the muscle that adjusts the focus of
the eye gets weaker. By age 50, the accommodative ability of the lens is 1/6 of
what it was at age 20.
o Presbyopia means “old eyes”- about age 60, the lens loses its capacity to
adjust to objects at various distances. Many people get bifocals to adjust to
reading and driving. There is also loss of the ability to see well in dim
light. This is due to the pupil shrinking and the lens yellowing. The
vitreous humor in the eye also develops opaque areas which reduce the
light to the retina. It causes night driving to become difficult, as the
oncoming light and poorer dim vision limits depth perception at night.
There is also loss of cones and rods in the retina.
o Glaucoma is a disease where pressure builds up within the eye due to
poor fluid drainage, and it damages the optic nerve. It is a leading cause of
blindness among older adults. It runs in families and African Americans
are especially high risk.
 Hearing
o Presbycusis (“Old hearing”) is adult-onset hearing loss. This is due to
inner-ear structures deteriorating due to cell death and loss of blood
supply. High frequencies are the first to go, after age 50. Later the tones of
human speech get harder to discriminate. Men’s hearing declines earlier
and faster than women’s. Some hearing loss is due to exposure to loud
noise in workplaces, etc. Hearing aids may be necessary later.
 Skin aging occurs in all 3 layers of skin, leading to wrinkling and sagging. Lines
occur first in the 30s in response to repeated facial expressions. In the 40s they
become more pronounced, and in the 50s there is sagging as the skin loses
elasticity. Age spots occur as pigment under the skin collects in patches. Sun
exposure hastens wrinkling, so those people who have been outdoors without
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protection will show greater aging of the skin. Also those who smoke will wrinkle
faster, especially women.
Muscle-fat makeup changes as “middle age spread” occurs. Fat increases,
especially on the torso, and lean body mass decreases. Men accumulate fat on the
back and upper abdomen, and women gain fat around the waist and upper arms.
Low-fat diet can help older people adjust for age-related declines in BMR
Anti-aging effects of dietary restriction. In other animals, dietary restraint
increases longevity, and increases health and vitality. Rats fed 30-40% fewer
calories in early life show reduced levels of age-related disease and live 50%
longer. Even mild calorie restriction slows aging.
 Primate research – monkeys placed on 30% reduced calories,
supplemented with vitamins accumulate fat differently, less on the
torso. They seem better able to withstand stress and they retain
youthful levels of DHEA hormones, which relates to various
disease processes: CVD, diabetes, cancer, immune disorders.
Improved carbohydrate metabolism relates to reduced blood sugar
and insulin levels. There is also lower blood pressure and
cholesterol and better good HDL cholesterol. The earlier the
monkeys were placed on calorie restriction, the better the longterm consequences.
 Human parallels have been seen in residents of Okinawa, who
consume 20% fewer calories in a healthy diet. They show a 2-to40-fold increase in people living to age 100. Also the people who
took part in the Biosphere experiment ate 1800 cal./day and
worked hard to grow their own food showed beneficial changes
like those in calorie-restricted rodents- reduced blood sugar,
insulin, cholesterol and blood pressure, and a better immune
response. Most Americans would not be willing to change their
diets to that point, but adding exercise can offset some of the
problem with our high-fat diet.
Skeleton- the bones lose mineral content and become more porous. This loss of
bone mass begins in the late 30s and accelerates in the 50s, especially for women.
When women lose estrogen in midlife, their bone mineral absorption is also lost.
They lose 20 -30% of bone at this point. This relates to disks in the spine
collapsing. Height may drop an inch by age 60. Bones fracture more easily.
Women especially need to do weight-bearing exercise, avoid smoking, alcohol
consumption and take calcium supplements to slow bone loss.
o Osteoporosis occurs when bone loss is severe.
Reproductive system
o Climacteric is the midlife transition in which fertility declines. It brings
an end to the reproductive capacity in women, but men can still retain
fertility.
o Reproductive changes in women occur gradually over a 10-year span as
estrogen drops. Women’s cycles shorten and become more irregular. More
ova are defective. The end is menopause, the end of menstruation and
reproductive capacity, at about 51. As estrogen declines further, the
reproductive organs shrink in size, there is less lubrication to enable
enjoyable sex, and sexual stimulation is more difficult. Estrogen no longer
slows the accumulation of plaque on the arteries, increasing risk of heart
disease. Some of the symptoms are hot flashes, sweating and discomfort,
insomnia, mood swings and irritability, as well as cognitive deficits.
Hormone therapy has been used to reduce these discomforts- low daily
doses of estrogen. It comes in 2 types:
 ERT- estrogen replacement therapy when just estrogen is
replaced for women who have had hysterectomies.
 HRT- hormone replacement therapy when estrogen and
progesterone are replaced.
 These therapies are effective at counteracting menopausal
symptoms, as well as protecting against some bone deterioration
and colon cancer, but it increases risks of cancer of the uterus.
HRT also related to increasing risk of cardiac disease and breast
cancer after 4 years. Women with a history of CVD or breast
cancer are not recommended to use HRT.
o Women’s reactions to menopause relate to how they feel about their
lives in general. If they were satisfied with their choices, childbearing,
etc., then menopause is not so bad. Women who haven’t met their goals in
this area may have a harder time. Women whose identity is closely tied to
their physical attractiveness and sex appeal may have a hard time
accepting their physical changes. Many women welcome the change of
life and set new goals, unhindered by periods and PMS. Women with
better education and more satisfying jobs have more positive attitudes
about menopause.
o Menopause as a biocultural event – menopause has been medicalizedassumed to be a syndrome requiring treatment. But it has also been
considered a life transition or a symbol of aging. Middle-aged women’s
social status also affects the experience of menopause. Societies that
respect older women offer older women freedom and privileges of
attaining wisdom. In Asia women seldom report physical discomforts. But
in midlife, these women gain respect and responsibility, so menopause is
seen as a positive period. So perceptions lead to physiological differences.
o Reproductive changes in men are less evident- decreased quality and
amount of semen and sperm after age 40. There is reduced blood flow to
the penis, so more stimulation may be required for an erection and erectile
dysfunctions can occur, especially for men who drink or take psychotropic
or cardiac meds. Viagra works by increasing blood flow to the penis.
There is no comparable drug for women with arousal difficulties.
Health and Fitness- in midlife, about 75% of Americans rate their health as excellent or
good (95% of young adults rate this high).In middle age there is more chronic disease
creeping in. Men are more likely to suffer fatal illnesses, women suffer more nonfatal,
limiting health problems.
 Sexuality changes in various ways:
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o Frequency declines in middle adulthood, but not drastically. The best
predictor of frequency is marital happiness. People in happier marriages
have sex more often.
o Intensity of sexual response declines due to physical changes. Both men
and women take longer to feel aroused and reach orgasm. If partners
perceive themselves or their partner as less attractive, this contributes to
less desire. If they retain a sense of humor and acceptance of one another,
sex can become more fun and spontaneous.
o Gender differences really show up at this time: Numbers of men with no
sexual partners increases only slightly- 8% in the 30s to 11% in the 50s.
The rise for women in dramatic- from 9% to 30%- which grows even
more in older adulthood. Men die at higher rates in these ages, and women
are choosier about partners who offer affection and trust. So the pool of
available men of that sort is declining for older women. More older single
women are independent financially and so are pickier about a companion
and more older single men are blue collar, with some problems from their
past relationships which don’t make them very good prospects. Also older
men tend to search for partners among younger women. Women don’t
tend to do the same. Women more often look for older men.
Illness and disability- leading causes of death in middle age are cancer and
cardiovascular disease. Accidental injuries decline, as older adults are more
cautious as drivers. But falls resulting in broken bones increase. Men are more
vulnerable to most diseases and health problems.
o Cancer- the death rate due to cancer increases 10-fold from early to
middle adulthood. Lung cancer has dropped in men and 50% fewer men
smoke today than in the 50s. But lung cancer has increased in women as
they have taken up smoking. There does seem to be an inherited
vulnerability to certain cancers. Lifestyle factors do moderate risk,
however. Men tend to be more vulnerable, often due to occupation, or a
tendency to avoid going to the doctor. Breast cancer is the leading cancer
for women, prostate cancer for men. Lung cancer is second in both sexes,
followed by colon cancer. Regular screening tests can help.
 Reducing incidence of cancer and cancer deaths
 Know the symptoms
 Self-exams
 Regular checkups and screening
 Avoid tobacco, sun exposure, pollutants, X-ray
exposure
 Weigh the benefits of HRT
 Healthy diet
o Cardiovascular disease affects 28% of middle-aged Americans who die
from CVD. This disease includes high blood pressure, high blood
cholesterol, and atherosclerosis- buildup of plaque in coronary arteries
around the heart. The most extreme symptom is a heart attack- blockage
of blood flow to the heart, possibly due to a blood clot in a coronary
artery. The pain is due to muscle of the heart dying in response to lack of
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blood and oxygen. 50% of victims die before getting to the hospital; 15%
die during treatment and 10% die later. Arrhythmia is irregular heartbeat
that can prevent the heart from pumping enough blood. Angina pectoris is
the crushing chest pain that first shows an oxygen-deprived heart. Heart
disease is treated with bypass surgery, meds, pacemakers, and
angioplasty- the balloon surgery that flattens fatty deposits to open blood
flow in blocked arteries. Diet and exercise are essential in preventive tx.
o Reducing the risk of heart attack
 Quit smoking
 Reduce cholesterol
 Treat high blood pressure
 Maintain ideal weight
 Exercise
 Drink an occasional glass of wine
 Low-dose aspirin
 Reduce hostility and stress
o Osteoporosis is severe age-related bone loss. This affects 40% of
postmenopausal women. It progresses, so that over age 70, most men and
women are affected. It is seen in the dowager’s hump, slumped posture,
and frequent bone fractures, especially in the hip, spine and wrist. Women
lose 50% of bone mass after menopause. African Americans are less at
risk than Asian Americans, Caucasians, and Hispanics. Smoking, caffeine
and alcohol use relate to higher risk. Diet rich in calcium and Vitamin D.
exercise, hormone therapy and bone-strengthening meds can reduce the
damage from this progressive illness.
Hostility and anger often seems tightly connected to a variety of health
problems.
o Type A behavior pattern is characterized by extreme competitiveness,
ambition, impatience, hostility, angry outbursts, and time pressure. Men
displaying this type of personality were twice as likely as Type Bs (those
with more relaxed disposition) to develop heart disease (it’s as if there is a
spiritual restriction of their hearts, not just a physical one.) More accurate
research pinpointed the aspect of Type A that relates to heart disease:
hostility is the toxic ingredient. Expressed hostility – frequent angry
outbursts, rude behavior, critical attitudes in social interactions, glares,
contempt and disgust and a harsh voice- leads to greater CV arousal and
health complaints. When people let themselves indulge their anger, their
heart rate, blood pressure, and stress hormones increase and stress the
body. These people also display more depression, dissatisfaction with life,
have fewer social connections, and use more unhealthy coping behaviorssubstance abuse, etc. Men score higher in hostility than women, so
emotional coping contributes to sex difference in heart disease. Repeatedly
suppressing anger also associates with increased heart disease. Find
healthier ways to cope or change your job, relationships or attitude in such
a way as to retain some equanimity.
Adapting to the physical challenges of midlife
o Stress management includes managing daily hassles better. Some stressors can’t
be eliminated, but you can change how you view that problem and let yourself be
affected by it. Part of changing your attitude has to do with accepting change,
whether you had any choice in it or not.
o Problem-centered coping means people appraise the situation as
changeable, find the problem and decide what to do about it. Basic
problem-solving. This includes learning to be assertive, not hostile,
negotiate rather than explode, detach from an explosive situation and cool
down. People tend to engage these techniques more effectively as they
age. They also get a clearer picture of what they can change and what they
can’t. (Serenity Prayer) When intense stress has been managed effectively,
older adults get a sense of productivity and may make positive changes in
their lifestyle and relationships.
o Emotion-centered coping means internal, private control of distress when
there is little we can do about a situation. Most adults use both techniques
in a context of respect for self and others. Ineffective coping is blaming,
impulsive, or escapist.
o Exercise has a variety of benefits- one of these being better stress management.
Over half of older adults in America are very sedentary. To stay with an exercise
program, people must believe they can be successful (high self-efficacy beliefs)
and visualize the benefits physically. If they can, their physical self-esteem will
increase. Each person has to figure out what format their exercise program should
take, since if they don’t stay with it, it’s of no benefit to them.
o Optimistic outlook
o Hardiness is a quality of expectation that is beneficial in many ways.
People respond to positive expectations by cooperating and helping. It is
made up of 3 qualities:
 Controllable – you believe most difficulties are manageable or
controllable.
 Committed- this is an involved approach to daily activities,
finding interest and meaning in them.
 Challenge – seeing changes or difficulties as a challenge- a part of
life that gives us a chance for growth.
 Hardiness affects how we interpret our life events. The more
positive we see events, the better we manage them and the fewer
physical symptoms we will develop. Higher levels of hardiness
associate with higher levels of cortisol which regulates blood
pressure and helps resist stress. Optimism relates to lower blood
pressure.
o Gender and Aging: a Double Standard- negative stereotypes about aging are
applied more to women than men. Women this age say they feel more confident
and capable, but they are assessed as less attractive, with more negative
characteristics than men. Aging men actually gain in positive judgments- in
appearance, maturity, power, but aging women show declines. Men judge aging
females more harshly than women, too. It seems directly related to our ideals of
physical beauty- smooth skin, good muscle tone, lustrous hair. Media ads
emphasize men in middle-aged groups, focusing on their competence and skills.
Cosmetics ads are directed more to women to hide signs of aging, not to men.
Some older women are being portrayed as vibrant, confident, graceful, with inner
strength and wisdom. Perhaps some day the double standard will ease.
Cognitive Development- the stereotype is that the aging mind is in an inevitable decline.
Some of this myth is due to cohort effects in cross-sectional research. Also these studies
often test abilities that older people rarely use and haven’t needed to keep up.
Longitudinal studies of the same group over time don’t find such dramatic declines over
time.
Changes in Mental abilities
o Crystallized vs. Fluid intelligence
o Crystallized intelligence refers to skills that depend on accumulated
knowledge, experience, good judgment, and mastery of social
conventions. These skills are acquired because they are valued in our
culture. These are tested by vocabulary tests, general information tests,
verbal analogies, logical reasoning tests. This type of intelligence
increases through middle adulthood, as adults are always adding to their
knowledge and skills at work and in leisure activities. They are practiced
daily.
o Fluid intelligence represents basic information-processing skills- the
ability to detect relationships among stimuli, speed with which we analyze
information, the capacity of working memory. This supports reasoning,
abstraction, and problem solving. It is more inherited than culturally
trained. These skills are tested by number series tests, spatial visualization,
picture sequencing. This type of intelligence declines in the 20s.
o Schaie’s Longitudinal study found modest gains in 5 mental abilities from early
to middle adulthood that sustained until the 50s and early 60s, at which point they
declined. These abilities reflected both crystallized and fluid skills: verbal ability,
inductive reasoning, verbal memory, spatial orientation, numeric ability. Midlife
is actually the peak age of performance for some of the most complex mental
abilities. Perceptual skill (identifying which of 5 shapes is identical to a model)
does show a steady decline from the 20s to the 80s- cognitive processing slows as
people age.
o Kaufman’s research on Verbal and Performance IQ used 2500 healthy 16- to
85-year olds from a broad diversity of ethnic and SES backgrounds. He used the
WAIS to generate verbal (crystallized intelligence) and performance skills
(nonverbal reasoning tasks- fluid intelligence.) He found that verbal IQ peaked in
midlife, between 45 and 54, then declined slightly into the 80s. Performance IQ
showed an earlier and steeper decline, beginning as early as 30. So fluid
intelligence is more vulnerable to biological aging (scores dropped as much as 20
points.)
o Changes in Mental abilities seem to be related to a general slowing of the CNS.
Simply put, neural processing speed slows down. So well-practiced skills won’t
noticeably slow down, and adults will find ways to compensate by shifting their
job responsibilities in some ways.
o Individual and group differences aren’t described by generalities, however.
Some people lose cognitive function due to illness or adverse environments.
Others remain creatively intellectual into very old age. Those who keep their
intellect usually are busy using their skills. This may include work, leisure
pursuits, travel, reading, cultural/ arts involvement, civic commitments. People
who have flexible personalities, lasting marriages to an intellectually challenging
partner, are healthy and live in a higher SES will maintain their intellect longer.
o Gender makes a difference- in early adulthood women outperform men
on verbal tasks and perceptual speed. Men excel at spatial skills. Losses
over time are similar for both men and women, however. Cohort effects
particularly show up in this older middle-aged group however. Aging baby
boomer women perform better than women that age from earlier groups.
This reflects greater education, technology, stimulation from work, and
health care. Numeric ability declined more, however, as we tend to rely
more on calculators today. Those who keep higher levels of perceptual
speed tend to be advantaged on other mental abilities as well.
Information Processing
o Speed of processing – reaction time increases from the 20s into the 90s. It’s a
small decline at first, but as it increases it can impair driving ability. Why the
change?
o Neural network view says that as neurons die, breaks in the networks
occur. The brain will form bypasses, but these synaptic connections are
less efficient.
o Information-loss view says that older adults experience greater loss of
information as it moves through the cognitive system. The system must
slow down to interpret the information. Information degrades every time
we access and use it. For complex tasks with many steps, there is more
deterioration of information. Often adults remember something, but they
don’t remember where they learned it, or even if they read it or
experienced it somehow. Theory may get confused with fact. Skills that
are well-rehearsed do not experience as much loss, as there is more active
compensation going on to maintain steady performance. Practice and
experience compensate fro impairments in processing speed.
o Attention has to do with how much information adults can take into their mental
systems at once, how much can be attended to selectively, and how much we can
ignore distractions and irrelevant information, as well as how flexible we can be
in adapting attention as the situation demands. Sustaining 2 complex tasks at once
becomes progressively harder as we age. It’s also harder to switch back and forth
between mental operations. There is also a loss in the ability to combine many
pieces of information into a meaningful pattern. If we can’t see the pattern, we
can’t resist interference from irrelevant information- cognitive inhibition. Older
adults seem more distractible, scattered. If their jobs depend on accurate scanning
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of incoming information, they can retain critical skills in searching for relevant
information or dividing attention as needed. Training can also improve this skill.
Memory is important since we hold less information in working memory as we
age. Memory decline seems to be related to using fewer strategies in memory
consolidation. Techniques such as organization and elaboration are used less often
with age. So people don’t link new information as well with older information.
More irrelevant information takes up space in working memory, leaving less
available for new connections. General factual knowledge, procedural
knowledge, and knowledge related to work remain unchanged, or even increase
into midlife. They also keep a high level of metacognitive knowledge – knowing
how to maximize performance in important areas of life. This may be due to
organizing or following rituals that enable efficiency.
Practical Problem Solving and Expertise is an area that older people shine in.
This requires people to size up real-world situations and analyze how best to
achieve goals. Expertise is extensive, highly organized, and integrated knowledge
that supports a high level of performance. It begins in early adulthood but reaches
its height in middle adulthood. Because the expert has a high degree of basic
knowledge in his/her area of knowledge, s/he can approach new problems using
an accurate intuition in problem-solving. It’s very difficult to assess, since every
area of work has experts in their particular job. It encompasses physical dexterity,
technical knowledge, organizational skills, and social skills. Older adults
incorporate broader perspectives in solving problems, looking at the problems
systemically.
Creativity changes in 3 ways:
o Youthful creativity is more emotional and spontaneous. Later
creativity is more thoughtful, using more planning and specific skills.
o Creators shift from generating unusual products to combining
knowledge and experience into unique ways of thinking as they age.
Older creators are more about integrating ideas, not finding new
knowledge. Themes in literature are more reflective, about what has been
learned through aging.
o There is a transition from egocentric concerns with self-expression to
more altruistic goals. There is a desire to leave something behind for
others; generativity is a strong motive.
Information Processing in Context- while speed of processing may decline, in
the area of an older person’s expertise, s/he is likely to keep up or excel over
younger workers in efficiency and excellence of thinking. There is an increase in
specialization, but with opportunities for development, older adults can grow
cognitively for a long time.
Vocational Life and Cognitive Development- the nature of your job contributes to
cognitive development. More complex work leads to gains in cognitive flexibility.
Having a more stimulating, nonroutine job relates to SES and flexible, abstract thinking.
Those who do more challenging jobs also seek out stimulating leisure pursuits, & tend to
be more self-directed. This cognitive flexibility increases into middle adulthood.
Adult Learners: Becoming a Student in Midlife- more people are returning to school
today than in the past, especially those over 35. It may be motivated by a desire for a
different career, better income, personal achievement, or meaning in life. It often is
triggered by a life transition, such as a spouse’s death or a divorce, or a layoff.
o Characteristics of returning students- most are women, although they often feel
handicapped by anxiety about appearing inadequate. These women are also
handicapped by multiple roles and people they feel responsible to. These women
have to take fewer hours and often deal with interruptions to their academic career
as they deal with family demands, etc.
o Supporting returning students enables an older student to be successful in
school. This can mean a husband who feels comfortable with a wife’s focus on
school, or a job that will pay for the hours of school. Schools that offer classes at
night or on the weekend can enable older students to go to school and keep
working, as well as tutoring and advisement for minority students. Education will
transform the student, however, so sometimes getting a higher education puts
long-term relationships in some jeopardy. People are given multiple options as
they educate themselves and see themselves differently than in the past.
o Sources of support
 Partner and children who value the educational effort and assist
with household tasks.
 Extended family and friends who encourage education.
 Educational institution which offers orientation, counseling,
academic support, mentoring, evening or online classes, financial
aid, even on-campus day care.
 Workplace which values educational efforts and accommodates
work time to class time.