Middle Adulthood Physical and Cognitive Development

Question 1

Defining Middle Age

Answer 1

Defining Middle Age
•Life expectancy: 77.6 years

•Middle age statistically: 39 years but typically middle age defined as later

By middle age, females begin to outlive males – trend continues into the late stages of life

•Human body like a machine: does not function as well as when it was new!
●Organs less efficient

Question 2

Vision Changes

Answer 2

Vision Changes
•Presbyopia: normal condition: eye lens begins to harden, lose ability to accommodate. Symptoms: tired eyes, headaches, trouble reading at close range

• Adaptation to dark, glare harder
• Also decreased: distance acuity, contrast sensitivity, visual search, and pattern recognition.

Glaucoma: increased pressure caused by fluid buildup in eye, can lead to blindness if untreated

• Cataracts: clouding of the lens. Need surgery, then glasses.
• Floaters: annoying floating spots. May indicate retinal detachment.
• Dry Eye: decreased tears, need drops.

Macular Degeneration: thinning of the layers of the retina and/or rupturing of tiny blood vessels. Symptoms: faded, distorted or blurred central vision.

•Visual problems may be caused by a diet high in saturated fat (reduces blood flow to eyes)
●Smoking
●To avoid: lots of fruits and veggies

Question 3

Presbyopia

Answer 3

Presbyopia: normal condition: eye lens begins to harden, lose ability to accommodate.
Symptoms: tired eyes, headaches, trouble reading at close range

Question 4

Glaucoma

Answer 4

Glaucoma: increased pressure caused by fluid buildup in eye, can lead to blindness if untreated

damage caused by pressure on optic nerve

Question 5

Cataracts

Answer 5

Cataracts: clouding of the lens. Need surgery, then glasses.

affects 30-50% of individuals age 65+
Can appear in individuals in late 50’s
surgical removal of lens then use glasses.

Question 6

Floaters

Answer 6

•Floaters: annoying floating spots. May indicate retinal detachment.

particals suspended in gel-like fluid of the eyeball;
laser surgery to remove.

Question 7

Dry Eye

Answer 7

•Dry Eye: decreased tears, need drops.

occurs in individuals who look at a computer screen, long readers

Question 8

Macular Degeneration

Answer 8

Macular Degeneration: thinning of the layers of the retina and/or rupturing of tiny blood vessels.
Symptoms: faded, distorted or blurred central vision.

leading cause of visual impairment and legal blindness in people 50+

Question 9

Visual problems may be caused by….

Answer 9

•Visual problems may be caused by a diet high in saturated fat (reduces blood flow to eyes)
●Smoking
●To avoid: lots of fruits and veggies

Prediction of doubling of visual problems in future due to diets high in saturated fat

Question 10

Hearing Problems

Answer 10

Hearing Problems
•Changes in hearing: around age of 30

• Presbycusis: decreased ability to hear high pitched sounds
• Hearing loss can be caused by cumulative exposure to loud noise

Even a mild hearing loss can affect cognitive function since areas of the brain are reallocated to hearing instead of intellectual processes.

Audiology testing by audiologists determines extent/type of hearing loss.

How can it impact occupation?

Question 11

Presbycusis

Answer 11

Presbycusis: decreased ability to hear high pitched sounds

Question 12

Taste and Smell Problems

Answer 12

Taste and Smell Problems
•Taste buds replaced at a slower rate

• Sense of smell also begins to decline
• May increase likelihood of gaining weight by adding more and more fat and salt to diet to compensate

Question 13

Appearance

Answer 13

Appearance
•Gums begin to recede periodontal disease loss of teeth

•Hair thins, grays

•Skin becomes dryer, thinner and less elastic; wrinkles (from sun exposure).
●Wrinkles, droopy eyelids, age spots.
●Skin loses collagen, fat, oil glands

•Men look “mature, sophisticated”

Women look “old, tired”

Flossing, tooth brushing and dental visits can preserve teeth, tooth loss and appearance of face

Smokers have more wrinkles

At this age, important to monitor skin for scaly patches (basal cell carcinoma) or melanoma (tumor – bleed, darken, itch).

Question 14

Coping with Changing Appearance

Answer 14

Coping with Changing Appearance
•Women who were hugged, kissed and cuddled when younger accept their bodies

•Women who were active when younger are more positive
●athletes

•Women who were very attractive have a harder time

Changes in balance, mass, strength

May turn to cosmetic surgery –
Top female surgeries: liposuction, breast augmentation, eyelid surgery, nose reshaping, tummy tucks.
Top male surgeries: liposuction, nose reshaping, eyelid surgery, face lifts

Question 15

Body Composition

Answer 15

Body Composition
•Around age 30, muscles begin to atrophy, which can diminish strength, agility, and endurance.

• Weight gain becomes more pronounced as muscles diminish
• Can be prevented with resistance training, weight lifting

Question 16

Osteoporosis

Answer 16

Osteoporosis
•A disorder of thinning bone mass and deterioration of bone tissue

• Women at greater risk, should take calcium supplements after age 35
• Also, weightbearing exercise, decrease caffeine and alcohol (diuretics)

Takes years to advance to a stage of detection. Decline of estrogen is contributing factor to bone loss.

Men have 30% more bone mass at age 35 than females and slower loss.

Osteoarthritis with joint inflammation that results in cartilage degeneration and friction between the bones. Causes chronic pain, functional limitations.

Question 17

Rheumatoid Arthritis

Answer 17

Rheumatoid Arthritis
•An inflammatory disease that causes pain, swelling, stiffness, and loss of function of the joints

• May also have fatigue and fever
• An autoimmune disease
• Treatment: pain relief, rest/exercise balance, patient education.

Autoimmune disease – person’s own immune system attacks it’s own body tissue

Question 18

Menopause and Female

Midlife Change

Answer 18

Menopause and Female
Midlife Change
•Menopause: A process culminating in the cessation of menstrual activity

•Perimenopause: The time period preceding menopause

• Climacteric: Changes in the ovaries and hormonal processes over 2-5 years before complete cessation of menstruation
• Postmenopause: No menstrual cycle for 1 year
• Biggest change: huge drop of estrogen
• Between 45 and 55, average age: 51

Question 19

Menopause

Answer 19

Menopause: A process culminating in the cessation of menstrual activity

Question 20

Perimenopause

Answer 20

Perimenopause: The time period preceding menopause

Question 21

Climacteric

Answer 21

Climacteric: Changes in the ovaries and hormonal processes over 2-5 years before complete cessation of menstruation

Question 22

Postmenopause

Answer 22

Postmenopause: No menstrual cycle for 1 year

Question 23

Menopause Symptoms

Answer 23

Menopause Symptoms
•Hot flashes - sudden reddening or heating of face, neck and upper back, may produce sweating; a few minutes.

• Night sweats, which may disrupt sleep and lead to insomnia.
• Pain during intercourse, thinning of vaginal tissues and loss of lubrication.
• Increased nervousness, anxiety, or irritability.
• Need to urinate more often, at night.

Question 24

Hormone Replacement Therapy (HRT)

Answer 24

Hormone Replacement Therapy (HRT)
•A regimen to:
● maintain cardiovascular fitness
● slow bone loss
● maintain sexual desire
● slow memory loss
•Studies in early 2000s found:

●May increase incidence of breast cancer, heart disease, stroke, blood clots?

•Are we “medicalizing” menopause?

Question 25

Male Midlife Change

Prostate gland:

Answer 25

Male Midlife Change

•Prostate gland:
●enlargement of this gland located at the base of the urethra.
●10% of men over 40

•Prostatitis: inflammation of prostate
●discomfort, pain, frequent/infrequent urination, fever

•Cancer of the prostate: Most common malignant cancer in North America
●Impotence: the inability to have or sustain an erection (half of men over 40)

PSA (prostate-specific antigen) test used to identify cancer

Question 26

Male Midlife Change

Answer 26

Male Midlife Change
•Testosterone declines
•Loses muscle, bone mass and height
•Erectile Dysfunction caused by many possible factors – physical, medication, stress, social habits.

Through midlife may experience fatigue, increase in fat mass, decrease in sex drive, erectile dysfunction, sleep disturbances, some cognitive dysfunctions

Question 27

Assessing Health Changes

Answer 27

Assessing Health Changes

•See book pages 488-489 for schedule of checkups for men and women

Question 28

Other health related issues

Answer 28

Other health related issues
•Sleep

•Cardiovascular fitness- hypertension
●140/90 high, 120/80 normal

•Cholesterol
●HDL- good cholesterol cleans blood vessels
●LDL- bad cholesterol, builds up and clogs arteries

Question 29

Sexual Functioning

Answer 29

Sexual Functioning
•Stereotype: erotic interest by older adults: unnatural and undignified
•Reality: Age does not eliminate sexual desire
•Changes:
●Longer to achieve erection for men
●Frequency of sexual activity declines
Consider the role of OT?

Question 30

The Brain

Answer 30

The Brain
•Staying sharp: continue to problem solve and learn new things, challenge oneself

•Alzheimer’s Disease: most likely after 65, begins slowly as forgetfulness
●Physical exercise can prevent
●Signs: confusion, disorientation with everyday tasks

7-8 hours of sleep recommended at this age.

Cross-sectional study (snapshot of population) shows peak IQ in 20’s remains stable for a couple of decades, then drops dramatically.
Longitudinal research method different for results – overall IQ tens to rise until mid-50’s then gradually declines.

Question 31

Fluid versus Crystallized Intelligence

Answer 31

Cognitive Functioning
•Fluid versus Crystallized Intelligence

●Fluid intelligence: the ability to make original adaptations in novel situations

●Crystallized intelligence: the abilities learned in from education and experience

Question 32

Dialectical Thinking (related to post-formal operations)

Answer 32

Dialectical Thinking (related to post-formal operations)
•More open-ended, multiple solutions are sought, examined and probed
•No one right answer
•Merits of different points of view
•Life experience to see both sides

Question 33

Chronological/legal age

Answer 33

Chronological/legal age – was where one was in life course

Question 34

Subjective/personal age

Answer 34

Subjective/personal age – how young or old a person perceives self to be

Question 35

Intelligence views/definition:

Answer 35

Intelligence views/definition:
Binet – inherited from parents, can be measured by testing

Piaget – progressive stages building on each other; culminating with formal operation thought

Gardner – information-processing view that individuals vary in multiple intelligences (verbal, math, art, music). Some show decline (performance), others don’t (verbal)

Question 36

Fluid

Answer 36

Fluid – abstract reasoning tested with non-word tests (mazes, block designs, picture arrangements) culture-free, based on genetics/neurological structures.

Question 37

Crystallized

Answer 37

Crystallized – acquired by formal education/social experiences measured by achievement tests, individual awareness of concepts/vocabulary terms of science, math, social studies, English literature.