Chapter Twenty

1
Chapter Twenty

• Middle Adulthood
• Biosocial Development

2
Middle Adulthood

• Biosocial development halfway between beginning
  and end of adulthood
• Variations in aging, influenced by
• genes
• income
• ethnicity
• life style

3
Primary and Secondary Aging

• Primary aging inevitable age-related changes
• Secondary aging age-related changes that are
  the consequence of a persons behavior or
  societys failure to eliminate unhealthy
  conditions
• drinking
• smoking
• eating
• lack of exercise

4
Looking Old

• Hair turns gray and thins
• Wrinkles appear and skin becomes dry
• Body size (people get shorter) and shape change
  (fat pockets settle on various parts of body)
• As people age, they can either accept or try to
  change their appearance
• Vision
• more likely to need corrective lenses
• Hearing
• some hear much better than others
• none hear perfectly
• hearing acuity also differs by sex, with men
  suffering greater loss

5
Menopause

• Occurs between ages 42 and 58
• marked decrease in the production of estrogen,
  progesterone, and testosterone
• primary factors in exact age are genes and chance
  factors before birth
• can also occur earlier because of health habits,
  particularly cigarette smoking and malnutrition
• Perimenopause, or Climacteric
• extends from 3 years before to 3 years after
  cessation of menstrual cycle
• timing of periods is erratic
• unpredictable ovulation, with several ova
  released sometimes, and at other times none
• can result in change of life baby
• Symptoms of the Climacteric
• lower estrogen, osteoporosis, inability to
  reproduce
• hot flushes, hot flashes, cold sweats (vasomotor
  instability)
• mood changes for some women
• psychic consequences extremely variable

6
Hormonal Replacement Therapy

• HRT
• treatment to compensate for hormone reduction
• usually involves estrogen and progesterone
• Womens Health Initiative revealed long-term use
  (10 years of longer) of HRT increases risk of
• heart disease
• stroke
• breast cancer
• Osteoporosis

7
Do men undergo menopause?

• Males
• decline in sperm production and motility, as well
  as lower testosterone levels
• No dramatic andropause
• though men can suffer from sudden, stress-related
  shifts in hormone levels
• the opposite can also occur a rise in
  self-esteem

8
Not as young as I use to be

• Mortality the number of deaths each year per
  1,000 people in a given population
• Morbidity the rate of diseases of all kinds,
  chronic and acute, in a given population
• Disability
• inability to perform activities that most others
  can
• more costly to society than either mortality or
  morbidity
• Vitality
• how healthy and energetic one is physically,
  socially, and emotionally

9
The Burden of Poor Health

• Quality-Adjusted Life Years (QALYS)
• years of full vitality
• useful in evaluation of the costs and benefits of
  various medical interventions
• for example, clean water, immunizations, and
  adequate nutrition all improve quality and length
  of life
• Disability
• inability to perform activities that most others
  can
• more costly to society than either mortality or
  morbidity
• Vitality
• how healthy and energetic one isphysically,
  socially, and emotionally

10
Health Habits Over The Years

• Health habits are relevant through all of life,
  but most crucial during 35-65 for reassessment
  and improvement
• many middleagers improve their health habits
• individual and environmental variations can
  affect who gets healthierchoices are crucial

11
Tobacco

• More than 1/4 of middle age nonsmokers are former
  smokers
• 1/4 currently smoke
• Quitting by age 65 is too late for some smokers
• death rates are about the same as they have been
  in the past
• Disability
• inability to perform activities that most others
  can
• more costly to society than either mortality or
  morbidity
• Vitality
• how healthy and energetic one isphysically,
  socially, and emotionally
• Disability
• inability to perform activities that most others
  can
• more costly to society than either mortality or
  morbidity
• Vitality
• how healthy and energetic one isphysically,
  socially, and emotionally

12
The Impact of the Epidemic

• According to the World Health Organization, there
  is a worldwide epidemic of obesity and overweight
• Excess pounds cut down 3 years of life
• 65 percent of U.S. population between 35 and 65
  years of age are overweight
• increased significantly for
• both sexes,
• in every decade
• in every cohort
• in every ethnic group
• In almost every nation, people weigh more than
  they did a few decades ago
• Being overweight increases risk of every cause of
  disease, as well as of disability and death

13
Losing Weight

• 3 factors make weight loss difficult
• environmental factors
• more easily alterable than evolutionary or
  genetic causes
• evolution
• homeostastis makes people who lose weight crave
  food to protect against starvation
• genes, which regulate
• metabolism
• fat accumulation
• Exercise
• Needed to attain and maintain a healthy weight
• Burns calories, decreases appetite, and increases
  metabolism
• Reduces ratio of body fat to body weight
• Enhances cognitive functioning

14
Ethnic Variations and Health

• Women outlive men in every nation of the world
• Well educated, financially secure people live
  longer than people of same age, sex, and
  ethnicity with less education and money
• income and education lead to access to services
• People in cities live longer than do people in
  the countryside

15
Explaining Variations

• Income and education are tied to
• community support
• quality of health care
• Personal factors affect variations
• medical
• socioeconomic
• genetic
• dietary
• religious
• cognitive
• cultural patterns

16
The Influence of Ethnicity on Health

• African-Americans 2x as likely to die as
  European-Americans
• Asian-Americans 1/2 as likely to die as
  European-Americans
• Subgroups within each of 5 broad ethnic
  categories has its own pattern
• for example, Cubans live longer than Puerto
  Ricans
• Japanese-Americans tend to live longer than
  Filipino-Americans
• Some immigrants are healthier than long-time
  residents of same age and ethnicity because
• only hardiest individuals emigrate
• health habits of immigrants are better
• immigrants have optimistic outlook
• immigrants have family communication and support