Middle Adulthood

age range for young adulthood

20-34 years

example of young adult

Dak Prescott

age range for young middle adulthood

35-44 years

example of young middle adult

Rafael Nadal

traits of young adults

biological function and physical performance reach their peak

traits of young middle adults

physical activity wanes, accumulation of body fat

age range of later middle adulthood

45-64 years

example of later middle adults

Savannah Guthrie, Kamala Harris, Roger Federer, Tom Brady, Dr. Carine Feyton

traits of later middle adults

output of sex hormones declines, physical deconditioning continues and accelerates

life expectancy range expected for middle adult males

17-34 years

life expectancy range expected for middle adult females

20-37 years

which gender typically experiences longer life expectancy

females

why can’t we assume that a younger individual may function better than an older individual

wide inter-individual differences, an active older adult would more likely perform better than a sedentary younger adult

why is it challenging to determine biological age

our systems age at different rates and depend on external factors

how do we come about with a heterogenous population

psychological, social, and cultural events interact with individual’s biology

which hormones produced by hypothalamus

GnRH

which hormones produced by anterior pituitary

GH

which hormones produced by posteiror pituitary

ACTH

which hormones decrease production in middle adulthood

GH, GnRH

course of GH

produce by anterior pituitary, has liver produce IGF-1

define somatopause

decrease in IGF-1

course of GnRH

released by hypothalamus, goes to ovaries or testes, produces estradiol and testosterone respectively

define menopause

decrease in estradiol

define andropause

decrease in testosterone

which hormones experience no change in middle adulthood

ACTH

course of ACTH

posterior pituitary releases ACTH to adrenal cortex, adrenal cortex releases cortisol

what happens in adrenal cortex middle adulthood

DHEA decreases

purpose of cortisol

BP regulation, stress, immune system

purpose of DHEA

protection from cancer, heart diagnoses

symptoms of menopause

• hot flashes

• sweats

• dizziness

• headaches

• insomnia

• irritability

• depression

• vaginal dryness

• skin changes

• atherosclerosis

• decreased bone density

symptoms of andropause

• skin and muscle changes

• smaller testes

• decreased sperm production

• slow erection

• unable to maintain erection

• delayed/absent ejaculation

• lengthened refractory period

• fatigue

• depression

• negative effect on cognition

• decreased bone density

benefits of estrogen replacement therapy

• relieve menoapuse

• reduce hip, wrist, and vertebral fractures

• neuro-protective

risks of estrogen replacement therapy

• increase risk of CVD

• increase risk of breast cancer

describe neuroprotective effect

estrogen protects brain from inflammation and stress, supports energy metabolism, preserves nerve connections

risks of testosterone replacement therapy

CVD, prostate cancer, skin changes, testicular shrink, infertility

which method of testosterone replacement therapy can lead to increase in acne

patch

exception of testosterone replacement therapy

androgen-deficient older men reduce risk of heart attack, stroke, mortality

when does strength typically peak

25 years

when does strength typically plateau

35-40 years

when does strength typically accelerate in decline

after 40 years

percentage of strength lost by 65 years

25%

skin changes in middle adulthood

cells of dermis become less elastic, results in wrinkling and sagging

hair changes in middle adulthood

graying, thinning, slower growth

percentage of decrease for resting metabolism by 65 years

10%

why does resting metabolism decrease

decrease in muscle mass

what happens to VO2 max in middle adulthood

declines 5 mL/min/decade

wby does VO2 max decrease in middle adulthood

• decrease in HR max, SV, atrioventricular O2 difference

• decrease of physical activity

VO2 formula

VO2 = Q x (a-v)O2

is the decrease in HR max inevitable or modifiable

inevitable

is the decrease in (A-V)O2 difference inevitable or modifiable

modifiable

is the decreaes in SV decrease inevitable or modifiable

partially modifiable

cardiac output formula

Q = SV x HR

what happens to heart size and weight in middle adulthood

increase

why does heart increase in size and weight in middle adulthood

fat deposition

what happens to HR max in middle adulthood

decreases

how much does A-V O2 max decrease in middle adulthood

20 mL/L

typically how much arterial O2 content do we have

20 mL/100mL of blood

typically how much venous O2 content do we have

5 ml/100 mL of blood

factors that increase risk of CVD in middle adults

low HDL cholesterol, high total cholesterol, hypertension, smoking, diabetes

genomics with lipid and inflammatory biomarkers cane be used to predict what disease

CAD

risk factors for dementia

hypertension, diabetes, smoking

factors of bone mass

muscle mass, fat tissue

how does muscle mass influence bone mass

exterts osteogenic effect through mechanical stress

how does fat tissue influence bone mass

convert androgen to estrogen, estrogen has osteogenic effect

bone health factors

genetics, hormone production, physical activity, nutrition

recommended calcium intake

1000 - 1200 mg per day

calcium supplement recommendations

no more than 500 mg at a time

function of vitamin D

increase intestinal absorption of calcium, magnesium, phosphate

recommended vitamin D intake

600 - 800 per day

sufficient vitamin D level

greater than 20 ng/mL

when does osteoclastic activity exceed osteoblastic activity

30 years

common sites of osteoporosis fractres

wrist, spine, hip

is osteoporosis fracture inevitable or modifiable

modifiiable

T score formula

T score = (patient BMD - mean BMD for normal young population) SD of BMD in young normal population

what does negative T score indicate

thinner bone

T score indicating osteopenia

-1 to -2.5

T score indicating osteoporosis

less than -2.5

what imaging technique is used to see bone density

DEXA (dual energy x-ray absoprtiometry)

age and t score slide

effect of flexibility

decrease elasticity of tendons, ligaments, and joint capsules

how much flexibility is lost by 65 years

8-10 cm

how to measure flexibility

sit and reach test

define free radicals

unstable, chemically reactive molecule or fragment

function of free radical

increase oxidative stress and cellular damage

purpose of antioxidants

eradicate free radicals

sources of antioxidants

vitamin C, vitamin E, beta carotene, fruits, vegetables

age of peak flexibility

adolescents

age of peak aerobic activity

mid 20s

age of peak anaerobic activity

late 20s to early 30s

age of peak experience based sports

30s to 40s

what happens to nervous system in 30s

myelination of association areas of cerebral cortex continues

what happens to nervous system after 40 years

• brain weight decrease

• thinning of cortex

• hippocampus loses neurons

• peripheral nerve conduction velocity decreases

how does vision change in 20s and 30s

acuity increases

define acuity

ability to see

how does vision change in 40s and 50s

stabilizes

when do cataracts form

30s

why may cataracts form

UV exposure

define cataract

cloudy or opaque area seen in vision

define presbyopia

decreased ability to focus on near objects

define presbycusis

loss of hearing