The Nature of Middle Adulthood

Changing Midlife

• Middle age is starting later and lasting larger

• As adults become older their age identity is younger than chronological age

• Some individuals consider the upper boundary of midlife as the age at which they make the transition from work to retirement

• Advances in health and more people living to older ages has fueled the emergence of thinking about middle age

• rectangularization of age distribution

  • percentages of people at different ages in the life span are more similar

  • created by health advances that promote longevity, low fertility rates, and the aging of the baby-boom cohort

Defining Midlife Adulthood

• middle adulthood: developmental period that begins at 40-45 and extends to 60-65

  • time of declining physical skills and expanding responsibility

  • people become more conscious of the young-old polarity and the shrinking amount of time left in life

  • individuals seek to transmit something meaningful to the next generation

  • people reach and maintain satisfaction in their careers

• although biological functioning declines in middle adulthood, sociocultural supports (education, career, and relationships) may peak

• neurobiological decline is slow and gradual and doesn’t interfere with effective functioning at work or in everyday life

Physical Development

Physical Changes

• midlife physical changes are usually more gradual

• rates of aging vary considerably from one individual to another

  • genetic makeup

  • lifestyle factors

• combination of multiple adaptive behaviors (positive health behaviors, sense of control, social support, and emotional regulation) help to buffer declines in physical health and cognitive functioning in middle age

• Visible Signs

  • first signs are apparent by forties or fifties

  • skin begins to wrinkle and sag because of a loss of fat and collagen in underlying tissues

  • age spots: small, localized areas of pigmentation in the skin, especially in areas that are exposed to sunlight

  • hair becomes thinner and greyer due to a lower replacement rate and a decline in melanin production

  • fingernails and toenails develop ridges and become thicker and more brittle

  • individuals may strive to make themselves look younger

    • cosmetic surgery

    • dying hair

    • heavy dose of vitamins

    • baby boomers have shown a strong interest in plastic surgery and botox

• Height and Weight

  • individuals lose height in middle age, and many gain weight

    • men from 30-50 lose an inch in height and may lose another from 50-70

    • height loss for women can be as much as 2 inches from 25-75 yrs

    • large variations

  • decrease in height is due to bone loss in the vertebrae

  • obesity increases from early to middle adulthood

    • women had a higher rate of obesity than men in middle age

    • linked to increased risk of earlier death, hypertension, diabetes, and cardiovascular disease

• Strength, Joints, and Bones

  • maximum physical strength is often attained during the twenties

  • sarcopenia: age related loss of muscle mass and strength

    • occurs at a rate of 1 or 2 percent a year after 50

    • loss of strength occurs especially ijn the back and legs

    • smoking and diabetes were risk factors for accelerated loss of muscle mass in middle-aged women

    • obesity is also a risk factor

  • peak functioning of the body’s joints usually occurs in the twenties

    • cushions for the movement of bones (tendons and ligaments) become less efficient in middle adulthood

      • many individuals experience joint stiffness and more difficulty in movement

    • maximum bone density occurs by the mid-to-late thirties, after which there is a progressive loss of bone

      • women lose bone mass twice as fast as men do

      • by the end of midlife, bones break more easily and heal more slowly

      • greater intake of fruits and vegetables was linked to increased bone density in middle-ages and older adults

• Vision and Hearing

  • accommodation of the eye: the ability to focus and maintain an image on the retina

    • experiences its sharpest decline between 40 and 59 years of age

    • middle-aged individuals begin to have difficulty viewing close objects

  • eye’s blood supply diminishes in the fifties or sixties

    • may decrease the visual field’s size

    • accounts for an increase in the eye’s blind spot

  • vision problems were linked to decreased life satisfaction, decreased self-esteem, increased depressive symptoms, and increased social isolation

  • hearing starts to decline by age 40

    • hearing loss occurs in up to 50% of people 50+

    • sensitivity to high pitches declines first

    • men lose their sensitivity to high-pitched sounds sooner than women do

      • may be due to occupational differences

  • new possibilities for improving the vision and hearing of people as they age

    • better control of gare or background noise

    • laser surgery and implantation of intraocular lenses

    • recent advances in hearing ages

• Cardiovascular System

  • cardiovascular disease increases considerably in middle age

  • level of cholesterol in the blood increases during the adult years and in midlife beings to accumulate on the artery walls, increasing the risk of cardiovascular disease

    • the type of cholesterol in the blood influences its effect

      • when the level of LDL (low density lipoprotein) is too high, it sticks to the lining of blood vessels, which can cause arteriosclerosis (hardening of the arteries)

      • when the level of HDL (high density lipoprotein) is high and LDL is low, the risk of cardiovascular disease is lower

  • at menopause, a woman’s blood pressure rises sharply and remains above that of a man through life’s later years

  • uncontrolled hypertension can damage the brain’s structure and function as early as the late thirties

    • structural damage to the brain’s white matter (axons)

    • decreased volume of gray matter

  • hypertension in middle age was linked to risk of cognitive impairment in late adulthood

  • exercise, weight control, and a diet rich in fruits, veggies, and whole grains can help to stave off many cardiovascular problems in middle age

  • deaths due to cardiovascular disease have been decreasing in the US since the 1970s

    • advances in medications to lower blood pressure and cholesterol in high-risk individuals

    • regular exercise and healthy eating habits

  • metabolic syndrome: characterized by hypertension, obesity, and insulin resistance

    • sedentary behavior (especially moderate and high tv viewing time)  and chronic stress exposure are linked to metabolic syndrome

    • often leads to the development of diabetes and cardiovascular disease

    • weight loss and exercise are strongly recommended as part of the treatment of metabolic syndrome

• Lungs

  • at age 55, the proteins in lung tissue become less elastic

  • combined with a gradual stiffening of the chest wall, decreases the lungs’ capacity to shuttle oxygen to the blood in their veins

  • smokers experience this at a greater level

  • exercise is linked to better lung functioning and a lower risk of developing lung cancer

  • increased cardiorespiratory fitness from early adulthood to middle adulthood was linked to less decline in lung health over time

  • lower bmi, less exercise, frequent drinking, and a meat-based diet were risk factors for lung cancer among never-smoking women

• Sleep

  • the average American adult gets around seven hours of sleep a night

  • eight or more hours of sleep is necessary for optimal performance the next day

  • many adults have become sleep deprived

  • habitual sleep deprivation is linked to morbidity, especially among people with cardiovascular disease

  • sleep patterns change mainly between early and middle adulthood and then remain stable in healthy older adults

  • some aspects of sleep become more problematic in middle age

    • beginning in the forties, wakeful periods become more frequent and there is less of the deepest type of sleep

    • the amount of time spent lying awake in bed at night begins to increase

      • can produce a feeling of being less rested in the morning

    • sleep-disordered breathing and restless leg syndrome are more prevalent

  • sleep problems are more common with people who use a higher number of prescription and nonprescription drugs, are obese, depressed, or have cardiovascular disease

Chronic Disorders

• chronic disorders are characterized by a slow onset and a long duration

• rate in early adulthood, increase in middle adulthood, and become common in late adulthood

• account for 86% of total health care spending in the United States

• most common: arthritis

• frequency of chronic disorders vary by gender

  • men: fatal chronic conditions like coronary heart disease, cancer, and stroke

  • women: nonfatal chronic conditions like arthritis, varicose veins, and bursitis

• 50% of US adults have one chronic health condition

• adults with arthritis as one of their multiple chronic conditions had more adverse outcomes (restricted social participation, serious psychological distress, work limitations)

Mortality Rates

• infectious disease was the main cause of death until the middle of the twentieth century

• chronic diseases are now the main causes of death for individuals in middle adulthood

• men have higher mortality rates than women for all leading causes of death

Sexuality

• climacteric: describes the midlife transition in which fertility declines

• menopause: time in middle age when a woman’s menstrual periods cease

  • usually in late forties or early fifties (average age is 51)

  • late menopause was associated with an increased risk of breast cancer

  • menarche: girl’s first menstruation

    • timing of menarche has significantly decreased

  • perimenopause: transitional period from normal menstrual periods to no menstrual periods at all

    • takes up to 10 years

    • usually occurs during the forties but can occur in the thirties

    • symptoms: depressed feelings, headaches, moodiness, and heart palpitations

    • the more minutes per week that women exercised, the lower their perceived stress was

  • production of estrogen by the ovaries declines dramatically

    • decline produces uncomfortable symptoms: hot flashes, nausea, fatigue, rapid heartbeat

  • cross-cultural studies reveal variations in the menopause experience

  • few women have severe physical or psychological problems related to menopause

  • loss of fertility

  • until recently, hormone replacement therapy was prescribed as treatment for the unpleasant side effects of menopause

    • for short-term relief, the benefits outweigh the risks

      • lowers the risk of bone loss and bone fractures in post-menopausal women

      • associated with reduced risk of coronary heart disease

    • hrt is associated with a higher risk of breast cancer

      • the longer hrt is taken, the greater the risk

  • hrt alternatives: regular exercise, mindfulness training, dietary supplements, herbal remedies, relaxation therapy, acupuncture, hypnosis, and nonsteroidal medications

• hormonal changes in middle-aged men

  • most men do not lose their capacity to father children, although there is usually a modest decline in their sexual hormone level and activity

  • testosterone production begins to decline about 1 percent a year during middle adulthood

  • sperm count usually declines slowly

  • male hypogonadism: condition where the body doesn’t produce enough testosterone

  • testosterone replacement therapy

    • can improve sexual functioning, muscle strength, and bone health

    • associated with longevity in men with a lower level of testosterone

    • improved older men’s sexual function as well as their mood

    • associated with a lower incidence of having a heart attack or a stroke

  • erectile dysfunction: difficulty attaining or maintaining penile erection

    • affects 50% of men 40-70 yrs old

    • affects 75% of men over 70 yrs

    • low testosterone levels can contribute to erectile dysfunction

    • main treatment: Viagra and similar drugs (Levitra, Cialis)

      • allows increased blood flow into the penis

    • other treatments: low-intensity shock-wave therapy

• sexual attitudes and behavior

  • usually occurs less frequently in midlife than in early adulthood

  • middle-aged and older adults who had sex more frequently also had better overall cognitive functioning, especially working memory and executive function

  • past-year decline in sexual desire or frequency of sexual activities was associated with an increase in depressive symptoms and lower quality of life

  • living with a spouse or partner increases the chance for people to engage in sexual activity, especially for women over 40

  • premature ejaculation and erectile difficulties were the most common sexual problems of older men

  • lack of sexual nterest and lubrication difficulties were the most common in older women

  • a person’s health in middle age is a key factor in sexual activity

    • level of sexual activity was associated with their phycial and mental health

    • social and relationship factors are also important

Cognitive Development

Intelligence

• Fluid and Crystallized Intelligence

  • John Horn: some abilities begin to decline in middle age while others increase

  • crystallized intelligence: an individual’s accumulated information and verbal skills

    • continues to increase in middle adulthood

  • fluid intelligence: one’s ability to reason abstractly

    • begins to decline in middle adulthood

    • declined in individuals 65+ but not in those 45-60

    • differences might be due to cohort effects related to educational differences rather than age

• The Seattle Longitudinal Study

  • highest level of functioning for four of the six intellectual abilities occurred in middle adulthood

  • numeric facility and perceptual speed declined in middle age

    • perceptual speed showed the earliest decline - begins in early adulthood

  • middle age was a time of peak intelligence for some aspects of both crystallized and fluid intelligence

  • lower level of cognitive functioning in early and middle adulthood is likely due to age-related neurobiological decline

  • longitudinal studies hold the key to determining age-related changes in cognitive functioning

  • middle age is the time when many cognitive skills peak

Information Processing

• Speed of Information Processing

  • perceptual speed begins declining in early adulthood and continues to decline in middle adulthood

  • common assessment: reaction-time task

  • decline is not dramatic

• Memory

  • verbal memory has shown a decline in middle age, especially when assessed in cross-sectional studies

  • memory declines at some point during this point of adult development

  • memory decline is either nonexistent or minimal in the early part of middle age but does occur in the latter part of middle age or in late adulthood

  • changes in working memory

    • more time is needed to learn new information

    • in late middle age, working memory capacity becomes more limited

  • memory decline is more likely to occur when individuals don’t use effective memory strategies

  • having a higher level of education and engaging in frequent physical exercise were linked to less decline in middle-aged and older adults’ episodic memory

• Expertise

  • because it takes so long to attain, expertise often shows up more in middle adulthood than in early adulthood

  • expertise involves having extensive, highly organized knowledge and understanding of a particular domain

• Practical Problem Solving

  • everyday problem solving is an important aspect of cognition

  • ability to solve practical problems improved through the forties and fifties as individuals accumulated practical experience

  • everyday problem solving showed an increase in performance from early adulthood to middle adulthood, with performance showing a decrease at about 50

  • fluid intelligence predicted performance on everyday problem solving in young adults but with increasing age, crystallized intelligence became a better predictor

Careers, Work, and Leisure

Work in Midlife

• work is central during middle adulthood

• many middle-aged adults reach their peak in position and earnings

• multiple financial burdens

• age-related declines occur in some occupations, but for most jobs, no differences have been found in work performance

• quality of work done by employees in middle age is liked to how much their work is appreciated and how well they get along with their immediate supervisors

• work ability in middle age is linked to mortality and disability 28 yrs later

• couples increasingly have both spouses in the workforce who are expecting to retire

• economic downturns and recessions in the US have forced some middle-aged individuals into premature retirement because of job loss and fear of not being able to reenter the workforce

  • may also result in accumulating insufficient financial resources to cover an increasingly long retirement period

Career Challenges and Changes

• globalization has replaced what was primarily a white male workforce with employees of different ethnic and national backgrounds

• decline in defined-benefit pensions and increased uncertainty about the fate of heath insurance are decreasing the sense of personal control among middle-aged workers

  • many are delaying retirement

• some midlife career changes are self-motivated, others are the consequence of losing one’s job

  • for many US workers 50 yrs and older, the decision to leave a job won’t be theirs

  • more than 50% of these workers are pushed out of longtime jobs before they choose to retire, suffering considerable financial damage

  • only 10% of these workers ever again earn as much as they did

• cognitive factors earlier in development are linked to occupational attainment in middle age

  • task persistence at 13 yrs was related to occupational success in middle age

Leisure

• leisure: pleasant times after work when individuals are free to pursue activities and interests of their own choosing

• top six regrets: one is not engaging in more leisure

• midlife changes may produce expanded opportunities for leisure

• engaging in less leisure-time activity in middle age was linked to increased risk of cognitive impairment in late adulthood

• if an adult develops leisure activities that can be continued into retirement, the transition from work to retirement can be less stressful

• type of leisure activity can be linked to different outcomes

  • engaging in higher complexity of work before retirement was associated with a smaller decline in cognitive performance in retirement

• after individuals experienced daily stressful events, if they engaged in more leisure time than usual on those days, the leisure time served as a positive coping strategy in improving their moods

Religion, Spirituality, and Meaning in Life

Religion, Spirituality, and Adult Lives

• religion: organized set of beliefs that increases an individual’s connection to a sacred or transcendent other

• religiousness: degree of affiliation with an organized religion, participation in its prescribed rituals and practices, connection with its beliefs, and involvement in a community of believers

• spirituality: experiencing something beyond oneself in a transcendent manner and living in a way that benefits others and society

• 92% of US adults said they believe in God and 50% reported that religion is very important to them

• influence of religion and spirituality in people’s lives may change as they develop

• women have consistently shown a stronger interest in religion and spirituality than men have

• spirituality of women increased more than that of men in the second half of life

Religion, Spirituality, and Health

• some cults and religious sects encourage behaviors that can be damaging to health

• spirituality / religion is positively linked to health

• various dimensions of religion and coping can help some individuals cope more effectively with challenges in their lives

Meaning in Life

• three most distinct human qualities are spirituality, freedom, and responsibility

  • spirituality: human being’s uniqueness of spirit, philosophy, and mind

• in middle adulthood, individuals begin to be faced with death more often

• meaning-making coping is especially helpful in times of chronic stress and loss

• having a sense of meaning in life can lead to clearer guidelines for living one’s life and enhanced motivation to take care of oneself and reach goals

• higher level of meaning in life is linked to better physical health