Lecture 16: Physical Development in Middle Adulthood

size of pupil shrinks and lens yellows

* limits ability to see in dim light

* limits color discrimination

reduced blood supply may decrease size of visual field and increase eye's blind spot

accommodation of eye experiences sharp decline b/w 40 and 59

size of pupil shrinks and lens yellows

reduced blood supply may decrease size of visual field and increase eye's blind spot

estimated 14% american adults b/w 45 and 64 have a hearing loss

heredity and age-related declines

decline typically starts w/a loss at high frequencies

men's hearing declines earlier and at a faster rate then women's

middle-aged spread= slowed metabolism- increase in body fat & loss of lean body mass (muscle and bone)

gradual loss in bone and mass density-- makes bones weaker

disks in spinal column move closer- shrinkage

rhinoplasty (decrease), liposuction, breast augmentation

minimally invasive procedures (botox)

men also partake

mid-life transition in which fertility decreases

Gradual changes for women over a 10 year period = perimenopause

*production of estrogen stops

*cycles shorten and become more irregular

menopause= the cessation of menstruation and of reproductive capacity-- no period for 12 consecutive months

Typically b/w 50 and 55; avg 50-51

genetics are a key factor in timing; also smoking

not affected by age of first period, height, usage of birth control pills

decreased elasticity of skin

risk of heart disease increases

bones may lose more calcium--risk of osteoperosis

1 of every 2 post menopausal women over 50 experiences a bone fracture related to osteoperosis

hot flash

profuse sweating and "night sweat"

other changes: weight gain, changes in sexual response, headaches

extent and duration of symptoms varies extensively (year on avg)

estrogen only-- for those that have had hysterectomy

estrogen + progestin for those with intact uterus

Believed to reduce risks of heart disease and osteoperosis & releive some symptoms

Highly used: 45% U.S. women born b/w 1897 and 1950 used at least 1 month

Early evidence seemed to support these benefits. e.g. hormone regimens assoc. w/ reduced "bad" LDL cholesteral and increased "good" HDL cholesterol

concerns-- overgrowth of uterine lining and other abnormalities

Large randomized clinical trial sponsered by NIH

Study 1 = 16,608 PM women took either estrogen + progestin or placebo. Enrolled 1993-1998

Study 2= 10,739 women who have had hysterectomy took either estrogen alone or placebo

Study 1 was to have continued until 2005 but was stopped in July of 2002 b/c risks of combined HRT appeared to outweigh benefits

Study 2 was allowed to continue. Yet recent National Cancer Institute data link estrogen only therapy w/ an increased risk of ovarian cancer

3/2/04 study 2 women asked to stop taking pills- also linked to increased risk of stroke

currently no longer recommended for long term use

compared w/placebo after 5 yrs HRT resulted in

INCREASED RISKS:
*breast cancer
*stroke
*heart attack
*doubled rate of blood clot in legs and lungs

INCREASED BENEFITS
*less colorectal cancer
*fewer hip fractures

No difference in # of deaths

Others found HRT linked to elevated risk of mild cognitive declines and nearly double the risk of Alzheimers

May not mark a major discontinuity (i.e. already done starting family)

Physical symptoms often "minor"

Experience doesn't have to be negative
*E.x. study of 2,500 women in Massachusettes aged 45-55; 75% were either relieved or neutral feelings
*Perspective may depend on personal and cultural attitudes/ expectations

Stress may be due to role changes

Emergence to a new freedom (no worry of period or birth control)

Weight

Cancer

Cardiovascular disease

obesity increases risk of suffering other ailments

see up to 55% lower risk for heart attack for those who maintain ideal body weight

difficult to sustain weight loss

Cancer and heart disease are leading causes of death in middle age

death rate due to cancer multiplies tenfold from early to middle adulthood

women: breast, lung
men: prostate, lung

half of all men and 1/3 all women will get cancer

40% of ppl w/ cancer are "cured" (disease free for 5 or more years)

approx 25% of deaths in Americans 45-64 (more men)

silent killer= signs often undetected
*high blood pressure
*high blood cholesterol
*atherosclerosis (build up of plaque in coronary arteries)

symptoms: heart attack, angina pectoris, arrythmia (irregular heartbeat)

for those who do not smoke, dietary choices and physical activity aremost important modifiable determinants of cancer risk

1. maintain a healthy weight

2. adopt a physically active lifestyle- 30min 5+ days/week of moderate to vigorous activity

3. consume a healthy diet with emphasis on plant sources- increase in phytochemicals= biologically active chemicals our bodies may use as part of their disease fighting arsenal (i.e. berries)

5. limit alcohol consumption