Stress and Quality of Life Normative and non-normative events help us understand how change and stress may impact our quality of life. Using the South University Library, locate 2 scholarly journal ar

Middle Adulthood

In middle adulthood, what we have been forms what we will be. For some of us, middle age is a foggy place, a time when we need to discover what we are running from and to and why. We compare our life with what we vowed to make it. In middle age, more time stretches behind us than before us, and some evaluations, however reluctant, have to be made. As the young-old polarity greets us with a special force, we need to join the daring of youth with the discipline of age in a way that does justice to both. As middle-aged adults, we come to sense that the generations of living things pass in a short while and, like runners, hand on the torch of life. This section consists of two chapters: “Physical and Cognitive Development in Middle Adulthood” and “Socioemotional Development in Middle Adulthood.”

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chapter 15

PHYSICAL AND COGNITIVE DEVELOPMENT IN MIDDLE ADULTHOOD

© Digital Vision/Getty Images RF

chapter outline

1. 1   The Nature of Middle Adulthood

   • Learning Goal 1 Explain how midlife is changing, and define middle adulthood.

   • Changing Midlife

   • Defining Middle Adulthood

2. 2   Physical Development

   • Learning Goal 2 Discuss physical changes in middle adulthood.

   • Physical Changes

   • Health, Disease, Stress, and Control

   • Mortality Rates

   • Sexuality

3. 3   Cognitive Development

   • Learning Goal 3 Identify cognitive changes in middle adulthood.

   • Intelligence

   • Information Processing

4. 4   Careers, Work, and Leisure

   • Learning Goal 4 Characterize career development, work, and leisure in middle adulthood.

   • Work in Midlife

   • Career Challenges and Changes

   • Leisure

5. 5   Religion, Spirituality, and Meaning in Life

   • Learning Goal 5 Explain the roles of religion, spirituality, and meaning in life during middle adulthood.

   • Religion, Spirituality, and Adult Lives

   • Religion, Spirituality, and Health

   • Meaning in Life

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Our perception of time depends on where we are in the life span. We are more concerned about time at some points in life than others. The rock group Pink Floyd, in their song “Time,” described how when we are young life seems longer and time passes slower, but when we get older, time seems to fly by so quickly.

In middle adulthood as well as late adulthood, individuals increasingly think about time-left-to-live instead of time-since-birth (Kotter-Gruhn & Smith, 2011; Setterson, 2009). Middle-aged adults begin to look back to where they have been, reflecting on what they have done with the time they have had. They look toward the future in terms of how much time remains to accomplish what they hope to do with their lives. Older adults look backwards even more than middle-aged adults, not surprising given the shorter future in the life that they have. Also not surprisingly, given the many years they still have to live, emerging adults and young adults are more likely to look forward in time than backwards in time.

Another aspect of time perception in middle age is the observation that time seems to speed by much faster as we get older. Talk to just about any middle-aged person and he or she will tell you that time does indeed fly by much faster than it did earlier in life. Why might this be?

One view is that for 10-year-olds, one year makes up 10 percent of their life so far and for 20-year-olds it makes up 5 percent of their life. However, for 50-year-olds, one year represents just one-fiftieth of the their life, and thus the one year seems to fly by more quickly since it makes up a much smaller portion of the time they have lived.

A second view is that as middle age sets in, we begin to think more about the diminishing time we have left to live. Because of the fewer years we have left, we wish time would slow down. Because that can’t happen, we perceive time to be flying by even faster. A common comment by someone who has reached 60 is, “Where did my fifties go? It seems like only yesterday I was 50 and now I’m 60.”

A third view is that new experiences slow down our perception of time, while repeated experiences make time seem to go faster. Younger people are more likely to have new experiences, and all of these new experiences slow down their perception of time. By contrast, when we reach middle age, more of our experiences are ones we already have had and thus we perceive time to be speeding by.

topical connections looking back

Emerging adulthood, which occurs at approximately 18 to 25 years of age, is characterized by experimentation and exploration. Peak physical performance often occurs from about 19 to 26 years of age, but toward the latter part of early adulthood, a slowdown in physical performance is often apparent. Emerging adults have sexual intercourse with more individuals than young adults, but have sex less frequently. Thinking becomes more pragmatic and reflective in early adulthood than adolescence. Career development is an important aspect of early adulthood, and work becomes a more central aspect of most young adults’ lives.

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When young adults look forward in time to what their lives might be like as middle-aged adults, too often they anticipate that things will go downhill. However, like all periods of the human life span, middle age usually holds both positive and negative features. In this first chapter on middle adulthood, we will discuss physical changes; cognitive changes; changes in careers, work, and leisure; as well as the importance of religion and meaning in life during middle adulthood. To begin, though, we will explore how middle age is changing.

1 The Nature of Middle AdulthoodLG1Explain how midlife is changing, and define middle adulthood.

Is midlife experienced the same way today as it was 100 years ago? Is it different from what it was like just 25 years ago? How can middle adulthood be defined, and what are some of its main characteristics?

CHANGING MIDLIFE

Many of today’s 50-year-olds are in better shape, more alert, and more productive than their 40-year-old counterparts from a generation or two earlier. As more people lead healthier lifestyles and medical discoveries help to slow down the aging process, the boundaries of middle age are being pushed upward. It looks like middle age is starting later and lasting longer for increasing numbers of active, healthy, and productive people. A current saying is “60 is the new 40,” implying that many 60-year-olds today are living a life that is as active, productive, and healthy as earlier generations did in their forties.

Questions such as, “To which age group do you belong?” and “How old do you feel?” reflect the concept of age identity. A consistent finding is that as adults become older their age identity is younger than their chronological age (Setterson & Trauten, 2009; Westerhof, 2009). One study found that almost half of the individuals 65 to 69 years of age considered themselves middle-aged (National Council on Aging, 2000). Another study discovered a similar pattern: Half of the 60- to 75-year-olds viewed themselves as being middle-aged (Lachman, Maier, & Budner, 2000). And a recent British survey of people over 50 years of age revealed that they perceived middle age to begin at 53 (Beneden Health, 2013). In this study, respondents said that being middle-aged is characterized by enjoying afternoon naps, groaning when you bend down, and preferring a quiet night in rather than a night out. Also, some individuals consider the upper boundary of midlife as the age at which they make the transition from work to retirement.

How is midlife changing?© Colorblind Images/Getty Images RF

When Carl Jung studied midlife transitions early in the twentieth century, he referred to midlife as the afternoon of life (Jung, 1933). Midlife serves as an important preparation for late adulthood, “the evening of life” (Lachman, 2004, p. 306). But “midlife” came much earlier in Jung’s time. In 1900 the average life expectancy was only 47 years of age; only 3 percent of the population lived past 65. Today, the average life expectancy is 79, and 15 percent of the U.S. population is older than 65 (U.S. Census Bureau, 2015). As a much greater percentage of the population lives to an older age, the midpoint of life and what constitutes middle age or middle adulthood are getting harder to pin down (Cohen, 2012).

In a recent book, In Our Prime: The Invention of Middle Age, Patricia Cohen (2012) describes how middle age wasn’t thought of as a separate developmental period until the mid-1800s and the term midlife wasn’t in a dictionary until 1895. In Cohen’s analysis, advances in health and more people living to older ages especially fueled the emergence of thinking about middle age. People today take longer to grow up and longer to die than in past centuries.

Compared with previous decades and centuries, an increasing percentage of the population is made up of middle-aged and older adults. In the past, the age structure of the population could be represented by a pyramid, with the largest percentage of the population in the Page 462childhood years. Today, the percentages of people at different ages in the life span are more similar, creating what is called the “rectangularization” of the age distribution (a vertical rectangle) (Himes, 2009). The rectangularization has been created by health advances that promote longevity, low fertility rates, and the aging of the baby-boom cohort (Moen, 2007).

Compared with late adulthood, far less research attention has given to middle adulthood (Lachman, Teshale, & Agrigoroaei, 2015). In a recent U.S. Census Bureau (2012) assessment, more than 102,713,000 people in the U.S. were 40 to 64 years of age, which accounts for 33.2 percent of the U.S. population. Given the large percentage of people in middle adulthood and the key roles that individuals in midlife play in families, the workplace, and the community, researchers need to give greater attention to this age period.

The portrait of midlife described so far here suggests that for too long the negative aspects of this developmental period have been overemphasized. However, as will be seen in the following sections, it is important not to go too far in describing midlife positively. Many physical aspects decline in middle adulthood, and increased rates of health problems such as obesity need to be considered in taking a balanced perspective on this age period.

DEFINING MIDDLE ADULTHOOD

Although the age boundaries are not set in stone, we will consider middle adulthood to be the developmental period that begins at approximately 40 to 45 years of age and extends to about 60 to 65 years of age. For many people, middle adulthood is a time of declining physical skills and expanding responsibility; a period in which people become more conscious of the young-old polarity and the shrinking amount of time left in life; a point when individuals seek to transmit something meaningful to the next generation; and a time when people reach and maintain satisfaction in their careers. In sum, middle adulthood involves “balancing work and relationship responsibilities in the midst of the physical and psychological changes associated with aging” (Lachman, 2004, p. 305).

Middle age is a mix of new opportunities and expanding resources accompanied by declines in physical abilities.

—Lois Verbrugge
Research professor, Institute of Gerontology, University of Michigan

In midlife, as in other age periods, individuals make choices—selecting what to do, deciding how to invest time and resources, and evaluating what aspects of their lives they need to change (Hahn & Lachman, 2015). In midlife, “a serious accident, loss, or illness” may be a “wake-up call” and produce “a major restructuring of time and a reassessment” of life’s priorities (Lachman, 2004, p. 310). And with an absence of seniority protections, many middle-aged adults experience unexpected job loss and/or are strongly encouraged to take early retirement packages.

The concept of gains (growth) and losses (decline) is an important one in life-span development (Dixon & others, 2013; Lachman, Teshale, & Agrigoroaei, 2015; Lindenberger, 2014; Page 463Robinson, Rickenbach, & Lachman, 2016). Middle adulthood is the age period in which gains and losses as well as biological and sociocultural factors balance each other (Baltes, Lindenberger, & Staudinger, 2006). Although biological functioning declines in middle adulthood, sociocultural supports such as education, career, and relationships may peak in middle adulthood (Willis & Schaie, 2005).

Margie Lachman and her colleagues (2015) recently described middle age as a pivotal period because it is a time of balancing growth and decline, linking earlier and later periods of development, and connecting younger and older generations.

developmental connection

Life-Span Perspective

There are four types of age: chronological, biological, psychological, and social. Connect to “Introduction.”

Remember from our discussion in the “Introduction” chapter that individuals have not only a chronological age but also biological, psychological, and social ages. Some experts conclude that compared with earlier and later periods, middle age is influenced more heavily by sociocultural factors (Willis & Martin, 2005).

For many healthy adults, middle age is lasting longer than it did for previous generations. Indeed, an increasing number of experts on middle adulthood describe the age period of 55 to 65 as late midlife (Deeg, 2005). Compared with earlier midlife, late midlife is more likely to be characterized by “the death of a parent, the last child leaving the parental home, becoming a grandparent, the preparation for retirement, and in most cases actual retirement. Many people in this age range experience their first confrontation with health problems” (Deeg, 2005). Overall, then, although gains and losses may balance each other in early midlife, losses may begin to outnumber gains for many individuals in late midlife (Baltes, Lindenberger, & Staudinger, 2006).

Keep in mind, though, that midlife is characterized by individual variations (Hayslip, Pruett, & Caballero, 2015; Lachman, Agrigoroaei, & Hahn, 2016; List & others, 2015; Robinson, Rickenbach, & Lachman, 2016; Schaie, 2013). As life-span expert Gilbert Brim (1992) commented, middle adulthood is full of changes, twists, and turns; the path is not fixed. People move in and out of states of success and failure.

Review Connect Reflect

1. LG1 Explain how midlife is changing, and define middle adulthood.

Review

• How is middle age today different from the way it was for past generations?

• How is middle adulthood defined, and what are some of its characteristics?

Connect

• In this section you read about the “rectangularization” of age distribution in our current times being influenced by, among other things, increasing longevity. What did you learn earlier about the history of human longevity?

Reflect Your Own Personal Journey of Life

• How do you think you will experience (are experiencing or have experienced) middle age differently from your parents or grandparents?

2 Physical DevelopmentLG2Discuss physical changes in middle adulthood.

What physical changes characterize middle adulthood? How healthy are middle-aged adults? What are the main causes of death in middle age? How sexually active are individuals in middle adulthood?

PHYSICAL CHANGES

Unlike the rather dramatic physical changes that occur in early adolescence and the sometimes abrupt decline in old age, midlife physical changes are usually more gradual. Although everyone experiences some downward physical change due to aging in middle adulthood, the rates of this aging vary considerably from one individual to another. Genetic makeup and lifestyle factors play important roles in determining whether chronic disease will appear and when. Middle age is a window through which we can glimpse later life while there is still time to engage in prevention and to influence some of the course of aging (Bertrand, Graham, & Lachman, 2013; Lachman, 2004; Lachman, Teshale, & Agrigoroaei, 2015). Recent research has shown that a combination of multiple adaptive factors, such as positive health behaviors (physical exercise and sleep), a sense of control, social support and social connections, and emotion regulation helped to buffer declines in physical health and cognitive functioning in middle age (Lachman & Agrigoroaei, 2010; Lachman, Teshale, & Agrigoroaei, 2015; Puteman & others, 2013).

Let’s now explore some of the physical changes of middle age.

Visible Signs The most visible signs of physical changes in middle adulthood involve physical appearance. The first outwardly noticeable signs of aging usually are apparent by the forties or fifties. The skin begins to wrinkle and sag because of a loss of fat and collagen in underlying tissues (Pageon & others, 2014). Small, localized areas of pigmentation in the skin produce age spots, especially in areas that are exposed to sunlight, such as the hands and face. Hair becomes thinner and grayer due to a lower replacement rate and a decline in melanin production. Fingernails and toenails develop ridges and become thicker and more brittle. A recent twin study found that twins who had been smoking longer were more likely to have sagging facial skin and wrinkles, especially in the middle and lower portion of the face (Okada & others, 2013).

Since a youthful appearance is valued in many cultures, individuals whose hair is graying, whose skin is wrinkling, whose bodies are sagging, and whose teeth are yellowing may strive to make themselves look younger. Undergoing cosmetic surgery, dyeing hair, purchasing wigs, enrolling in weight reduction programs, participating in exercise regimens, and Page 464taking heavy doses of vitamins are common in middle age. Baby boomers have shown a strong interest in plastic surgery and Botox, which may reflect their desire to slow down the aging process (Carruthers & others, 2015; Solish & others, 2016).

Height and Weight Individuals lose height in middle age, and many gain weight (Haftenberger & others, 2016; Winett & others, 2014). On average, men from 30 to 50 years of age lose about one inch in height, then may lose another inch from 50 to 70 years of age (Hoyer & Roodin, 2009). The height loss for women can be as much as 2 inches from 25 to 75 years of age. Note that there are large variations in the extent to which individuals become shorter with aging. The decrease in height is due to bone loss in the vertebrae. On average, body fat accounts for about 10 percent of body weight in adolescence; it makes up 20 percent or more in middle age.

Famous actor Sean Connery as a young adult in his twenties (top) and as a middle-aged adult in his fifties (bottom). What are some of the most outwardly noticeable signs of aging in middle adulthood?(Top) © Bettmann/Corbis; (bottom) © Matthew
Mendelsohn/Corbis

Obesity increases from early to middle adulthood. In a recent national U.S. survey, in 2011–2012 39.5 percent of U.S. adults 40 to 59 years of age were classified as obese compared with 30.3 percent of younger adults (Centers for Disease Control and Prevention, 2013). Being overweight is a critical health problem in middle adulthood (Kawakami & others, 2015; Wang & others, 2016). For example, obesity increases the probability that an individual will suffer a number of other ailments, among them hypertension (abnormally high blood pressure), diabetes, and digestive disorders (Mercado & others, 2015; Xie & others, 2016). A large-scale study found that being overweight or obese in middle age increases an individual’s risk of dying earlier (Adams & others, 2006). More than 500,000 50- to 71-year-olds completed surveys about their height and weight, and the researchers examined the participants’ death records across a 10-year period. Those who were overweight (defined as a body mass index, which takes into account height and weight, of 25 or more) at age 50 had a 20 to 40 percent higher risk of earlier death, whereas those who were obese (a body mass index of 30 or more) at age 50 had a 100 to 200 percent higher risk of premature death.

Strength, Joints, and Bones Maximum physical strength often is attained during the twenties. The term sarcopenia is given to age-related loss of muscle mass and strength (Spira & others, 2015). Muscle loss with age occurs at a rate of approximately 1 to 2 percent per year after age 50 (Marcell, 2003). A loss of strength especially occurs in the back and legs. Researchers are seeking to identify genes that are linked to the development of sarcopenia (Urano & Inoue, 2015). Obesity is a risk factor for sarcopenia (Meng & others, 2015). Recently, researchers have increasingly used the term “sarcopenic obesity” to describe individuals who have sarcopenia and are obese (Cauley, 2015; Lee & others, 2016; Ma & others, 2016). A recent study found that sarcopenic obesity was linked to hypertension (Park & others, 2013). In a recent study sarcopenic obesity was associated with a 24 percent increase in risk for all-cause mortality, with a higher risk for men than women (Tian & Xu, 2016). And a research review concluded that weight management and resistance training were the best strategies to slow down the decline of muscle mass and muscle strength (Rolland & others, 2011).

Peak functioning of the body’s joints also usually occurs in the twenties. The cushions for the movement of bones (such as tendons and ligaments) become less efficient in middle adulthood, a time when 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. The rate of this bone loss begins slowly but accelerates with further aging (Baron, 2012). Women lose bone mass twice as fast as men do. By the end of midlife, bones break more easily and heal more slowly (Gulsahi, 2015).

Middle age is when your age starts to show around your middle.

—Bob Hope
American comedian, 20th century

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. In particular, middle-aged individuals begin to have difficulty viewing close objects.

The eye’s blood supply also diminishes, although usually not until the fifties or sixties. The reduced blood supply may decrease the visual field’s size and account for an increase in the eye’s blind spot. At 60 years of age, the retina receives only one-third as much light as it did at 20 years of age, mostly because of the reduced size of the pupil (Scialfa & Kline, 2007).

Hearing also can start to decline by age 40. Auditory assessments indicate that hearing loss occurs in up to 50 percent of individuals 50 years and older (Fowler & Leigh-Paffenroth, 2007). Sensitivity to high pitches usually declines first; the ability to hear low-pitched sounds does not seem to decline much in middle adulthood. Men usually lose their sensitivity to high-pitched Page 465sounds sooner than women do. However, this gender difference might be due to men’s greater exposure to noise in occupations such as mining, automobile work, and so on.

Researchers are identifying new possibilities for improving the vision and hearing of people as they age (Wingfeld & Lash, 2016). One strategy involves better control of glare or background noise (Natalizia & others, 2010). Laser surgery and implantation of intraocular lenses have become routine procedures for correcting vision in middle-aged adults (Fang, Wang, & He, 2013). In addition, recent advances in hearing aids have dramatically improved hearing for many individuals (Banerjee, 2011). However, even with the advent of technologically sophisticated hearing devices, many people don’t always wear them, or they wear them inappropriately.

Cardiovascular System Midlife is a time when high blood pressure and high cholesterol often take adults by surprise. Cardiovascular disease increases considerably in middle age (Wu & others, 2016), as indicated in Figure 1.

FIGURE 1THE RELATION OF AGE AND GENDER TO CARDIOVASCULAR DISEASE. Notice the sharp increase in cardiovascular disease in middle age.

The level of cholesterol in the blood increases during the adult years and in midlife begins to accumulate on the artery walls, increasing the risk of cardiovascular disease (Choi & Lee, 2016). The type of cholesterol in the blood, however, influences its effect (Hasvold & others, 2016; Wang & others, 2014). Cholesterol comes in two forms: LDL (low-density lipoprotein) and HDL (high-density lipoprotein). LDL is often referred to as “bad” cholesterol because when the level of LDL is too high, it sticks to the lining of blood vessels, which can lead to arteriosclerosis (hardening of the arteries) (Perez de Isla & others, 2016). HDL is often referred to as “good” cholesterol because when it is high and LDL is low, the risk of cardiovascular disease is lower (Arora, Patra, & Saini, 2016).

High blood pressure (hypertension), too, often begins to appear for many individuals in their forties and fifties (Kitaoka & others, 2016). At menopause, a woman’s blood pressure rises sharply and usually remains above that of a man through life’s later years (Taler, 2009). A recent study found that uncontrolled hypertension can damage the brain’s structure and function as early as the late thirties and early forties (Maillard & others, 2012). In this study, structural damage to the brain’s white matter (axons) and decreased volume of gray matter (cell bodies and dendrites) occurred for individuals who had hypertension (systolic number above 140 and diastolic number above 90). And a recent study revealed that hypertension in middle age was linked to risk of cognitive impairment in late adulthood (23 years later) (Virta & others, 2013).

Members of the Masai tribe in Kenya, Africa, can stay on a treadmill for a long time because of their active lives. The extremely low incidence of heart disease in the Masai tribe is likely linked to their energetic lifestyle.Courtesy of The Family of Dr. George V. Mann

Exercise, weight control, and a diet rich in fruits, vegetables, and whole grains can often help to stave off many cardiovascular problems in middle age (Niu & others, 2016; Sallam & Laher, 2016). In a recent study, a high level of physical activity was associated with a lower risk of cardiovascular disease in the three weight categories studied (normal, overweight, and obese) (Carlsson & others, 2016). Also, although cholesterol levels are influenced by heredity, LDL can be reduced and HDL increased by eating food that is low in saturated fat and cholesterol and by exercising regularly (Koba & others, 2016). One study of postmenopausal women revealed that 12 weeks of aerobic exercise training improved their cardiovascular functioning (O’Donnell, Kirwan, & Goodman, 2009). And in another study, middle-aged adults who had exercised regularly during adolescence were less likely to develop cardiovascular disease (Nechuta & others, 2015).

The good news is that deaths due to cardiovascular disease have been decreasing in the United States since the 1970s. Why is this so? Advances in medications to lower blood pressure and cholesterol in high-risk individuals have been major factors in reducing deaths due to cardiovascular disease (Alagona & Ahmad, 2015; Jackson & others, 2016; Pursnani & others, 2015). Regular exercise and healthy eating habits also have considerable benefits in preventing cardiovascular disease (Atashak, Stannard, & Azizbeigi, 2016; Eijsvogels & others, 2016; Patino-Alonzo & others, 2015). A recent national study confirmed that moderate-to-vigorous physical activity (such Page 466as running, swimming, bicycling) on a regular basis was linked to reduced rates of all-cause mortality, especially for men (Loprinzi, 2015a). Another recent study found that having an unhealthy diet was a strong predictor of cardiovascular disease (Menotti & others, 2015).

What characterizes metabolic syndrome?© Ryan McVay/Getty Images RF

Approximately 15 percent of adults with hypertension have resistant hypertension, defined as having hypertension despite using at least three hypertension drugs. These individuals have a longer history of hypertension, and they are more likely to be obese and also to have diabetes and kidney problems (Denolle & others, 2016; Doroszko & others, 2016; Lazaridis, Sarafidis, & Ruilope, 2015; Rimoldi & others, 2015). A national study revealed that resistant hypertension has increased in the United States in the twenty-first century (Roberie & Elliott, 2012).

An increasing problem in middle and late adulthood is metabolic syndrome, a condition characterized by hypertension, obesity, and insulin resistance (Choi & others, 2015; Frazer, 2015). Researchers have found that chronic stress exposure is linked to metabolic syndrome (Fabre & others, 2013). Metabolic syndrome often leads to the development of diabetes and cardiovascular disease (Masmiquel & others, 2016; Scuteri & others, 2015). Weight loss and exercise are strongly recommended as part of the treatment of metabolic syndrome (Samson & Garber, 2014; Steckhan & others, 2016). Several recent studies have provided information about risk factors for metabolic syndrome:

• A meta-analysis revealed that metabolic syndrome was an important risk factor for any cause of death (Wu, Liu, & Ho, 2010).

• Of four indices of obesity (body mass index, waist circumference, waist-hip ratio, and waist-height ratio), waist circumference was the best predictor of metabolic syndrome (Bener & others, 2013).

• Individuals with metabolic syndrome who were physically active reduced their risk of developing cardiovascular disease (Broekhuizen & others, 2011).

• The most important health factor in predicting metabolic syndrome was a high triglyceride level (Worachartcheewan & others, 2015).

Does your fitness level during early adulthood have much impact on your risk of cardiovascular disease in middle age? To find out, see Connecting Through Research.

Lungs There is little change in lung capacity through most of middle adulthood for many individuals. However, at about age 55, the proteins in lung tissue become less elastic. This change, combined with a gradual stiffening of the chest wall, decreases the lungs’ capacity to shuttle oxygen from the air people breathe to the blood in their veins. The lung capacity of individuals who are smokers drops precipitously in middle age, but if the individuals quit smoking, their lung capacity improves, although not to the level of individuals who have never smoked.

Exercise is linked to better lung functioning and a lower risk of developing lung cancer (Strookappe & others, 2015). In a recent study, more than 17,000 men were given a cardiovascular fitness assessment at 50 years of age (Lakoski & others, 2013). Subsequent analysis of Medicare claims and deaths found that the risk of being diagnosed with lung cancer was reduced by 68 percent for men who were the most fit compared with those who were the least fit.

Research also has found that low cognitive ability in early adulthood is linked to reduced lung functioning in middle age (Carroll & others, 2011). And reduced lung functioning is related to lower cognitive ability later in development (Shipley & others, 2007). Such links between reduced lung functioning and cognitive ability are likely related to the influence of pulmonary functioning on brain structure and function, which in turn affects cognition (MacDonald, DeCarlo, & Dixon, 2011).

Sleep The average American adult gets just under seven hours of sleep a night. How much sleep do adults need to function optimally the next day? An increasing number of experts note that eight hours of sleep or more per night are necessary for optimal performance the next day. These experts argue that many adults have become sleep deprived (McKenna & others, 2013). Work pressures, school pressures, family obligations, and social obligations often lead to long hours of wakefulness and irregular sleep/wake schedules (Soderstrom & others, 2012). Habitual sleep deprivation is linked to morbidity, especially among people with cardiovascular disease (Grandner & others, 2013). A recent Korean study found that these factors were linked to sleep problems in middle age: unemployment, being unmarried, currently being a smoker, lack of exercise, having irregular meals, and frequently experiencing stressful events (Yoon & others, 2015).

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connecting through research

How Does Physical Fitness In Young Adults Predict Cardiovascular Health In Middle Age?

One longitudinal study was the first large-scale observational study to examine the role of physical fitness on healthy young adults’ development of risk factors for heart disease (Carnethon & others, 2003). Previous studies had focused on the relationship between fitness and death from heart disease and stroke.

The study involved 4,487 men and women in four cities (Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California). Initial assessments were made when the participants were 18 to 30 years of age and follow-up assessments were conducted 2, 5, 7, 10, and 15 years later. Cardiorespiratory fitness was measured with an exercise treadmill test, which consisted of up to nine two-minute stages of progressive difficulty.

Poor cardiorespiratory fitness in young men and women, determined by the duration of their treadmill exercise test, was associated with their risk of developing hypertension, diabetes, and metabolic syndrome in middle age. Improved fitness over seven years was related to a reduced risk of developing diabetes and metabolic syndrome.

How might physical fitness in early adulthood be linked to health in middle adulthood?© Michael DeYoung/Blend Images/Getty Images RF

This research reinforces the importance of establishing good health habits early in life. Staying fit when you are younger not only improves your health at that point in your life but also increases the likelihood that you will remain healthy as you get older. Poor health habits in the current cohort of adolescents and younger adults threaten future good health in middle age and beyond.

How might physical fitness in early adulthood be linked to health in middle adulthood?

Some aspects of sleep become more problematic in middle age (Luik & others, 2015). The total number of hours slept usually remains the same as in early adulthood, but beginning in the forties, wakeful periods are 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 in middle age, and this can produce a feeling of being less rested in the morning. Sleep-disordered breathing and restless legs syndrome become more prevalent in middle age (Polo-Kantola, 2011). Researchers have also found that middle-aged adults who sleep less than six hours a night on average have an increased risk of developing stroke symptoms (Ruiter & others, 2012). Another study revealed that sleep deprivation was associated with less effective immune system functioning (Wilder-Smith & others, 2013). A research review concluded that sleep deprivation is linked to problems in long-term memory consolidation (Abel & others, 2013). Further, a recent study revealed that poor sleep quality in middle adulthood was linked to cognitive decline (Waller & others, 2016). Also, sleep problems in midlife are more common among individuals who use a higher number of prescription and nonprescription drugs, are obese, have cardiovascular disease, or are depressed (Koyanagi & others, 2014; Prairie & others, 2015).

HEALTH, DISEASE, STRESS, AND CONTROL

In middle adulthood, the frequency of accidents declines and individuals are less susceptible to colds and allergies than in childhood, adolescence, or early adulthood. Indeed, many individuals live through middle adulthood without having a disease or persistent health problem. However, disease and persistent health problems become more common in middle adulthood for some individuals.

Chronic disorders are characterized by a slow onset and a long duration. Chronic disorders are rare in early adulthood, increase in middle adulthood, and become common in late adulthood. Chronic disorders account for 86 percent of total health care spending in the United States (Qin & others, 2015). Overall, arthritis is the leading chronic disorder in middle age, followed by hypertension, but the frequency of chronic disorders in middle age varies by gender. Men have a higher incidence of fatal chronic conditions (such as coronary heart disease, cancer, and stroke); women have a higher incidence of nonfatal ones (such as arthritis, varicose veins, and bursitis).

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About 50 percent of U.S. adults have one chronic health condition, and the prevalence of multiple (two or more) chronic health conditions increased from 21.8 percent in 2001 to 25.5 percent in 2012 (Qin & others, 2015). In a recent analysis, adults with arthritis as one of their multiple chronic conditions had more adverse outcomes (social participation restriction, serious psychological distress, and work limitations) than their counterparts who had multiple chronic conditions but did not have arthritis (Qin & others, 2015).

Stress and Disease Stress is increasingly identified as a factor in many diseases (Jansen & others, 2016; Lagraauw, Kuiper, & Bot, 2015; Sin & others, 2016). The cumulative effect of stress often takes a toll on the health of individuals by the time they reach middle age. David Almeida and his colleagues (2011) conclude that chronic stress or prolonged exposure to stressors can have damaging effects on physical functioning, including an unhealthy overproduction of corticosteroids such as cortisol. Chronic stress can interfere with immune functioning, and this stress is linked to disease not only through the immune system but also through cardiovascular factors (Ortega-Montiel & others, 2015; Sin & others, 2016). A recent study discovered that chronic stress accelerated pancreatic cancer growth (Kim-Fuchs & others, 2014). Also, a study of middle-aged adults found that when they had a high level of allostatic load (wearing down of the body’s systems in response to high stress levels), their episodic memory and executive function was harmed (Karlamangia & others, 2014). And a study of occupationally active 44- to 58-year-olds revealed that perceived stress symptoms in midlife were linked to self-care disability and mobility limitations 28 years later (Kulmala & others, 2013).

developmental connection

Stress

Recently, a variation of hormonal stress theory has emphasized a decline in immune system functioning as an important contributor to lower resistance to stress in older adults. Connect to “Physical Development in Late Adulthood.”

How individuals react to stressors is linked to health outcomes. In one study, how people reacted to daily stressors in their lives was linked to future chronic health problems (Piazza & others, 2013). Also, in a recent study, adults who did not maintain positive affect when confronted with minor stressors in everyday life had elevated levels of IL-6, an inflammation marker (Sin & others, 2015). And in another recent study, a greater decrease in positive affect in response to daily stressors was associated with earlier death (Mroczek & others, 2015).

The Immune System and Stress The immune system keeps us healthy by recognizing foreign materials such as bacteria, viruses, and tumors and then destroying them (Hughes, Connor, & Harkin, 2016; Ransohoff & others, 2015). Immune system functioning becomes less effective with normal aging (Chalan & others, 2015; Deledi, Jaggle, & Rubino, 2015).

The immune system’s machinery consists of billions of white blood cells located in the circulatory system. The number of white blood cells and their effectiveness in killing foreign viruses or bacteria are related to stress levels. When a person is under stress, viruses and bacteria are more likely to multiply and cause disease. One study in young and middle-aged adults revealed that persistently unemployed individuals had lower natural killer (NK) cell levels than their previously unemployed counterparts who became reemployed (Cohen & others, 2007). NK cells are a type of white blood cell that is more likely to be present in low-stress circumstances (see Figure 2). Lower levels of NK cells in stressful situations indicate a weakened immune system. One study indicated aerobic fitness was related to the presence of a lower level of senescent T cells (prematurely aging cells that result from persistent immune activation) (Spielmann & others, 2011).

FIGURE 2NK CELLS AND CANCER. Two natural killer (NK) cells (yellow) are shown attacking a leukemia cell (red). Notice the blisters that the leukemia cell has developed to defend itself. Nonetheless, the NK cells are surrounding the leukemia cell and are about to destroy it.© Eye of Science/Science Source

Janet Kiecolt-Glaser and her colleagues have conducted many studies that further clarify the roles of stress and immune system functioning in a number of contexts:

• Failures in close relationships (divorce, separation, and marital distress) reduce immune system functioning, especially when spouses have hostile interactions, with the effects stronger in women than men (Jaremka & others, 2013a, 2016; Kiecolt-Glaser & others, 2015).

• Having positive social ties can boost immune system functioning, and lack of social ties, especially prolonged loneliness, can increase stress and lower immune system functioning (Fagundes & others, 2016; Jaremka & others, 2013b, 2016).

• Burdensome caregiving for a family member with a progressive illness reduces immune system functioning (Bennett, Fagundes, & Kiecolt-Glaser, 2016).Page 469

• Chronic and acute stress increase the inflammation associated with age-related diseases such as cardiovascular disease, type 2 diabetes, arthritis, and some cancers.

• Stress-reducing activities such as yoga, relaxation, and hypnosis have positive influences on immune system functioning (Derry & others, 2015; Kiecolt-Glaser & others, 2014).

Sheldon Cohen and his colleagues have extensively studied immunity and susceptibility to infectious disease (Cohen & Janicki-Deverts, 2012; Cohen, Janicki-Deverts, & Doyle, 2015; Cohen & others, 2012, 2013, 2015; Cohen & Shachar, 2012). They have found that factors such as stress, emotion, and lack of social support compromise people’s immune system functioning in ways that alter their bodies’ ability to fight off disease.

Stress and the Cardiovascular System Stress and negative emotions can affect the development and course of cardiovascular disease by altering underlying physiological processes (Ginsberg & others, 2015; Jansen & others, 2016; Ortega-Montiel & others, 2015). Sometimes, though, the link between stress and cardiovascular disease is indirect. For example, people who live in a chronically stressed condition, such as persistent poverty, are more likely to take up smoking, start overeating, and avoid exercising (Sowah, Busse, & Amoroso, 2013). All of these stress-related behaviors are linked with the development of cardiovascular disease (Lagraauw, Kuiper, & Bot, 2015).

Control Although many diseases increase in middle age, having a sense of control is linked to many aspects of health and well-being (Bertrand, Graham, & Lachman, 2013; Lachman, Agrigoroaei, & Hahn, 2016; Lachman, Teshale, & Agrigoroaei, 2015; Robinson, Rickenbach, & Lachman, 2015). Researchers have found that having a sense of control peaks in midlife and then declines in late adulthood (Lachman, 2006; Lachman, Rosnick, & Rocke, 2009). However, in any adult age period, there is a wide range of individual differences in beliefs about control. Margie Lachman and her colleagues (2015, 2016) argue that having a sense of control in middle age is one of the most important modifiable factors in delaying the onset of diseases in middle adulthood and reducing the frequency of diseases in late adulthood. Recent research indicates that control can have long-term consequences for health and even mortality risk (Turiano & others, 2014).

MORTALITY RATES

Infectious disease was the main cause of death until the middle of the twentieth century. As infectious disease rates declined and more individuals lived through middle age, rates of chronic disorders increased. Chronic diseases are now the main causes of death for individuals in middle adulthood.

In middle age, many deaths are caused by a single, readily identifiable condition, whereas in old age, death is more likely to result from the combined effects of several chronic conditions (Pizza & others, 2011). For many years heart disease was the leading cause of death in middle adulthood, followed by cancer; however, since 2005 more individuals 45 to 64 years of age in the United States died of cancer, followed by cardiovascular disease (Centers for Disease Control and Prevention, 2015; Kochanek & others, 2011). The gap between cancer and the second leading cause of death widens as individuals age. In 2013, about 46,000 45- to 54-year-olds died of cancer and about 35,000 died of cardiovascular disease; about 113,000 55- to 64-year-olds died of cancer and 73,000 died of cardiovascular disease (Centers for Disease Control and Prevention, 2015). Men have higher mortality rates than women for all of the leading causes of death (Kochanek & others, 2011).

SEXUALITY

What kinds of changes characterize the sexuality of women and men as they go through middle age? Climacteric is a term that is used to describe the midlife transition in which fertility declines. Let’s explore the substantial differences in the climacteric experienced by women and men.

Menopause Menopause is the time in middle age, usually during the late forties or early fifties, when a woman’s menstrual periods cease. The average age at which U.S. women have their last period is 51 (Wise, 2006). However, there is a large variation in the age at which menopause occurs—from 39 to 59 years of age. Later menopause is linked with increased risk of breast cancer (Mishra & others, 2009).

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The timing of menarche, a girl’s first menstruation, has significantly decreased since the mid-nineteenth century, occurring as much as four years earlier in some countries (Susman & Dorn, 2013). Has there been a similar earlier onset in the occurrence of menopause? No, there hasn’t been a corresponding change in menopause, and there is little or no correlation between ages at menarche and the onset of menopause (Gosden, 2007).

Perimenopause is the transitional period from normal menstrual periods to no menstrual periods at all, which often takes up to 10 years. Perimenopause usually occurs during the forties but can occur in the thirties (Martins & others, 2014; McNamara, Batur, & DeSapri, 2015). One study of 30- to 50-year-old women found that depressed feelings, headaches, moodiness, and palpitations were the perimenopausal symptoms that these women most frequently discussed with health-care providers (Lyndaker & Hulton, 2004). A recent research review found increased evidence that effective use of menopausal hormone replacement therapy is not linked to cardiovascular disease problems during perimenopause (Valdiviezo, Lawson, & Ouyang, 2013). Lifestyle factors such as whether women are overweight, smoke, drink heavily, or exercise regularly during perimenopause influence aspects of their future health such as whether they develop cardiovascular disease or chronic illnesses (ESHRE Capri Workshop Group, 2011; Gallicchio & others, 2015; Kagitani & others, 2014).

In menopause, production of estrogen by the ovaries declines dramatically, and this decline produces uncomfortable symptoms in some women—“hot flashes,” nausea, fatigue, and rapid heartbeat, for example (Brockie & others, 2014; Mitchell & Woods, 2015). However, cross-cultural studies reveal variations in the menopause experience (Hinrichsen & others, 2014; Sievert, 2014). For example, hot flashes are uncommon in Mayan women (Beyene, 1986). Asian women report fewer hot flashes than women in Western societies (Payer, 1991). It is difficult to determine the extent to which these cross-cultural variations are due to genetic, dietary, reproductive, or cultural factors.

Menopause overall is not the negative experience for most women that it was once thought to be (Henderson, 2011). Most women do not have severe physical or psychological problems related to menopause. For example, a recent research review concluded that there is no clear evidence that depressive disorders occur more often during menopause than at other times in a woman’s reproductive life (Judd, Hickey, & Bryant, 2012).

However, the loss of fertility is an important marker for women—it means that they have to make final decisions about having children. Women in their thirties who have never had children sometimes speak about being “up against the biological clock” because they cannot postpone choices about having children much longer.

Researchers have found that almost 50 percent of Canadian and American women have occasional hot flashes, but only one in seven Japanese women do (Lock, 1998). What factors might account for these variations?© Blue Moon Stock/PunchStock RF

Until recently, hormone replacement therapy was often prescribed as treatment for unpleasant side effects of menopause. Hormone replacement therapy (HRT) augments the declining levels of reproductive hormone production by the ovaries (Baber & others, 2016; Gambacciani & Levancini, 2015). HRT can consist of various forms of estrogen, usually in combination with a progestin. A study of HRT’s effects was halted as evidence emerged that participants who were receiving HRT faced an increased risk of stroke (National Institutes of Health, 2004). Since the link between HRT and increased risk of stroke was reported, there has been a 50 percent or more reduction in the use of HRT (Pines, Sturdee, & Maclennan, 2012). However, researchers have found a reduction of cardiovascular disease and minimal risks with HRT when it is initiated before 60 years of age and/or within 10 years of menopause and continued for six years or more (Hodis & others, 2012). Further evidence indicates that when women start HRT in their fifties and continue its use for 5 to 30 years, there is an increase in 1.5 quality life years for the women (Hodis & Mack, 2014). Also, a meta-analysis concluded that HRT was linked to decreased lung cancer in females, especially nonsmoking females and females with BMI less than 25 kg/m (Yao & others, 2013).

The National Institutes of Health recommends that women who have not had a hysterectomy and who are currently taking hormones consult with their doctor to determine whether they should continue the treatment. If they are taking HRT for short-term relief of menopausal symptoms, the benefits may outweigh the risks (Santen & others, 2014). Many middle-aged women are seeking alternatives to HRT such as regular exercise, dietary supplements, herbal remedies, relaxation therapy, acupuncture, and nonsteroidal medications (Al-Safi & Santoro, 2014; Buhling & others, 2014; Nasiri, 2015; Yazdkhasti, Simbar, & Abdi, 2015). One study revealed that in sedentary women, aerobic training for 6 months decreased menopausal symptoms, especially night sweats, mood swings, and irritability (Moilanen & others, 2012). Another recent study found that yoga improved the quality of life of menopausal women (Reed & others, 2014).

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Hormonal Changes in Middle-Aged Men Do men go through anything like the menopause that women experience? In other words, is there a male menopause? During middle adulthood, most men do not lose their capacity to father children, although there usually is a modest decline in their sexual hormone level and activity (Blumel & others, 2014). They experience hormonal changes in their fifties and sixties, but nothing like the dramatic drop in estrogen that women experience. Testosterone production begins to decline about 1 percent a year during middle adulthood, and sperm count usually declines slowly, but men do not lose their fertility in middle age. The term male hypogonadism is used to describe a condition in which the body does not produce enough testosterone (Mayo Clinic, 2016).

Recently, there has been a dramatic surge of interest in testosterone replacement therapy (TRT) (Carruthers, Cathcart, & Feneley, 2015). For many decades, it was thought that TRT increased the risk of prostate cancer, but recent research reviews indicate that is not the case, at least when taken for one year or less (Cui & others, 2014). Recent research indicates that TRT can improve sexual functioning, muscle strength, and bone health (Almehmadi & others, 2016; Hassan & Barkin, 2016; Mayo Clinic, 2016; Seftel, Kathrins, & Niederberger, 2015; Snyder & others, 2016). A recent study found that TRT was associated with increased longevity in men with a low level of testosterone (Comhaire, 2016). Also, a recent large-scale study involving more than 80,000 men revealed that testosterone replacement therapy was associated with a lower incidence of having a heart attack or a stroke, as well as a reduction in all-cause mortality (Sharma & others, 2015). Two recent studies found that TRT improved older men’s sexual function as well as their mood (Miner & others, 2013; Okada & others, 2014). Further, a recent study found that a higher testosterone level was linked to better episodic memory in middle-aged males (Panizzon & others, 2014). However, men who have prostate cancer or breast cancer should not take TRT, and men who are at risk for blood clotting (those who have atrial fibrillation, for example) also should not use TRT (Osterberg, Bernie, & Ramasamy, 2014).

© McGraw-Hill Companies, Suzie Ross, Photographer

Erectile dysfunction (ED) (difficulty attaining or maintaining penile erection) affects approximately 50 percent of men 40 to 70 years of age and 75 percent of men over 70 years of age (Berookhim & Bar-Charma, 2011; Mola, 2015). Low testosterone levels can contribute to erectile dysfunction. Smoking, diabetes, hypertension, elevated cholesterol levels, obesity, and lack of exercise also are associated with erectile problems in middle-aged men (Corona & others, 2015). The main treatment for men with erectile dysfunction has not focused on TRT but on Viagra and similar drugs such as Levitra and Cialis (Hosny, El-Say, & Ahmed, 2016; Sheu & others, 2016). Viagra works by allowing increased blood flow into the penis, which produces an erection. Its success rate is in the 60 to 85 percent range (Claes & others, 2010).

Sexual Attitudes and Behavior Although the ability of men and women to function sexually shows little biological decline in middle adulthood, sexual activity usually occurs less frequently in midlife than in early adulthood (Huhtaniemi, 2015; Waite, Das, & Laumann, 2009). Figure 3 shows the age trends in frequency of sex from the Sex in America survey. The frequency of having sex was greatest for individuals aged 25 to 29 years old (47 percent had sex twice a week or more) and dropped off for individuals in their fifties (23 percent of 50- to 59-year-old males said they had sex twice a week or more, and only 14 percent of the females in this age group reported this frequency) (Michael & others, 1994). Note, though, that the Sex in America survey may underestimate the frequency of sexual activity of middle-aged adults because the data were collected prior to the widespread use of erectile dysfunction drugs such as Viagra. Other research indicates that middle-aged men want sex more, think about it more, and masturbate more often than middle-aged women (Stones & Stones, 2007). For many other forms of sexual behavior, such as kissing and hugging, sexual touching, and oral sex, male and female middle-aged adults report similar frequency of engagement (Stones & Stones, 2007).

FIGURE 3THE SEX IN AMERICA SURVEY: FREQUENCY OF SEX AT DIFFERENT POINTS IN ADULT DEVELOPMENT. Why do you think the frequency of sex declines as men and women get older?Page 472

If middle-aged adults have sex less frequently than they did in early adulthood, does it mean they are less satisfied with their sex life? In a Canadian study of 40- to 64-year-olds, only 30 percent reported that their sexual life was less satisfying than it had been when they were in their twenties (Wright, 2006).

Living with a spouse or partner makes all the difference in whether people engage in sexual activity, especially for women over 40 years of age. In one study conducted as part of the Midlife in the United States Study (MIDUS), 95 percent of women in their forties with partners said that they had been sexually active in the last six months, compared with only 53 percent of those without partners (Brim, 1999). By their fifties, 88 percent of women living with a partner have been sexually active in the last six months, but only 37 percent of those who are neither married nor living with someone say they have had sex in the last six months.

A large-scale study of U.S. adults 40 to 80 years of age found that premature ejaculation (26 percent) and erectile difficulties (22 percent) were the most common sexual problems of older men, while lack of sexual interest (33 percent) and lubrication difficulties (21 percent) were the most common sexual problems of older women (Laumann & others, 2009).

A person’s health in middle age is a key factor in sexual activity. One study found that how often individuals have sexual intercourse, the quality of their sexual life, and their interest in sex were linked to how physically healthy they were (Lindau & Gavrilova, 2010). And a study of aging adults 55 years and older revealed that how sexually active they were was associated with their physical and mental health (Bach & others, 2013). In another recent study, higher abdominal fat mass and depression were risk factors for erectile dysfunction in 35- to 80-year-olds (Martin & others, 2014).

Review Connect Reflect

1. LG2 Discuss physical changes in middle adulthood.

Review

• What are some key physical changes in middle adulthood?

• How would you characterize health and disease in middle adulthood?

• What are the main causes of death in middle age?

• What are the sexual lives of middle-aged adults like?

Connect

• In this section, you read that the production of estrogen by the ovaries declines dramatically in menopause. What have you learned about estrogen’s role in puberty?

Reflect Your Own Personal Journey of Life

• If you are a young or middle-aged adult, what can you do at this point in your life to optimize your health in middle age? If you are an older adult, what could you have done differently to optimize your health in middle age?

3 Cognitive DevelopmentLG3Identify cognitive changes in middle adulthood.

We have seen that middle-aged adults may not see as well, run as fast, or be as healthy as they were in their twenties and thirties. But what about their cognitive skills? Do these skills decline as we enter and move through middle adulthood? To answer this question, we will explore the possibility of cognitive changes in intelligence and information processing.

INTELLIGENCE

Our exploration of possible changes in intelligence in middle adulthood focuses on the concepts of fluid and crystallized intelligence, the Seattle Longitudinal Study, and cohort effects.

Fluid and Crystallized Intelligence John Horn argues that some abilities begin to decline in middle age while others increase (Horn & Donaldson, 1980). Horn maintains that Page 473crystallized intelligence, an individual’s accumulated information and verbal skills, continues to increase in middle adulthood, whereas fluid intelligence, one’s ability to reason abstractly, begins to decline in middle adulthood (see Figure 4).

FIGURE 4FLUID AND CRYSTALLIZED INTELLECTUAL DEVELOPMENT ACROSS THE LIFE SPAN. According to Horn, crystallized intelligence (based on cumulative learning experiences) increases throughout the life span, but fluid intelligence (the ability to perceive and manipulate information) steadily declines from middle adulthood onward.

Horn’s data were collected in a cross-sectional manner. Remember that a cross-sectional study assesses individuals of different ages at the same point in time. For example, a cross-sectional study might assess the intelligence of different groups of 40-, 50-, and 60-year-olds in a single evaluation, such as in 1980. The 40-year-olds in the study would have been born in 1940 and the 60-year-olds in 1920—different eras that offered different economic and educational opportunities. The 60-year-olds likely had fewer educational opportunities as they grew up. Thus, if we find differences between 40- and 60-year-olds on intelligence tests when they are assessed cross-sectionally, these differences might be due to cohort effects related to educational differences rather than to age.

By contrast, in a longitudinal study, the same individuals are studied over a period of time. Thus, a longitudinal study of intelligence in middle adulthood might consist of giving the same intelligence test to the same individuals when they are 40, 50, and 60 years of age. As we see next, whether data on intelligence are collected cross-sectionally or longitudinally can make a difference in what is found about changes in crystallized and fluid intelligence and about intellectual decline (Abrams, 2009; Schaie, 2011a, b, 2013).

The Seattle Longitudinal Study The Seattle Longitudinal Study that involves extensive evaluation of intellectual abilities during adulthood was initiated by K. Warner Schaie (1994, 1996, 2005, 2010, 2011a, b, 2013). Participants have been assessed at seven-year intervals since 1956: 1963, 1970, 1977, 1984, 1991, 1998, 2005, and 2012. Five hundred individuals initially were tested in 1956. New waves of participants are added periodically. The main focus in the Seattle Longitudinal Study has been on individual change and stability in intelligence, and the study is regarded as one of the most thorough examinations of how people develop and change as they go through adulthood.

The main mental abilities tested in this study are:

• Verbal comprehension (ability to understand ideas expressed in words)

• Verbal memory (ability to encode and recall meaningful language units, such as a list of words)

• Number (ability to perform simple mathematical computations such as addition, subtraction, and multiplication)

• Spatial orientation (ability to visualize and mentally rotate stimuli in two- and three-dimensional space)

• Inductive reasoning (ability to recognize and understand patterns and relationships in a problem and to use this understanding to solve other instances of the problem)

• Perceptual speed (ability to quickly and accurately make simple discriminations in visual stimuli)

developmental connection

Cognitive Theory

A fifth, postformal stage of cognitive development has been proposed to describe cognitive advances in early adulthood. Connect to “Physical and Cognitive Development in Early Adulthood.”

As shown in Figure 5, the highest level of functioning for four of the six intellectual abilities occurred in middle adulthood (Schaie, 2013). For both women and men, peak performance on verbal ability, verbal memory, inductive reasoning, and spatial orientation was attained in middle age. For only two of the six abilities—number and perceptual speed—were there declines during middle age. Perceptual speed showed the earliest decline, actually beginning in early adulthood. Interestingly, in terms of John Horn’s ideas that were discussed earlier, for the participants in the Seattle Longitudinal Study, middle age was a time of peak performance for some aspects of both crystallized intelligence (verbal ability) and fluid intelligence (spatial orientation and inductive reasoning).

FIGURE 5LONGITUDINAL CHANGES IN SIX INTELLECTUAL ABILITIES FROM AGE 25 TO AGE 95.Source: K.W. Schaie: “Longitudinal Changes in Six Intellectual Abilities from Age 25 to Age 95,” Figure 5.7a, in Developmental Influences on Intelligence: The Seattle Longitudinal Study (2nd ed.), 2013, p. 162.

When Schaie (1994) assessed intellectual abilities both cross-sectionally and longitudinally, he found declines to be more likely in the cross-sectional than in the longitudinal assessments. For example, as shown in Figure 6, when assessed cross-sectionally, inductive reasoning showed a consistent decline during middle adulthood. In contrast, when assessed longitudinally, inductive reasoning increased until toward the end of middle adulthood when it began to show a slight decline. In Schaie’s (2008, 2009, 2010, 2011a, b, 2013, 2016) view, it is in middle adulthood, not early adulthood, that people reach a peak in many intellectual Page 474skills. Some researchers have found that cross-sectional studies indicate more than 90 percent of cognitive decline in aging is due to a slowing of processing speed, whereas longitudinal studies reveal that 20 percent or less of cognitive decline is due to processing speed (MacDonald & others, 2003; MacDonald & Stawski, 2015, 2016; Stawski, Sliwinski, & Hofer, 2013).

FIGURE 6CROSS-SECTIONAL AND LONGITUDINAL COMPARISONS OF INTELLECTUAL CHANGE IN MIDDLE ADULTHOOD. Why do you think reasoning ability peaks during middle adulthood?

In further analysis, Schaie (2007) examined generational differences in parents and their children over a seven-year time frame from 60 to 67 years of age. That is, parents were assessed when they were 60 to 67 years of age; and when their children reached 60 to 67 years of age, they also were assessed. Higher levels of cognitive functioning occurred for the second generation in inductive reasoning, verbal memory, and spatial orientation, whereas the first generation scored higher on numeric ability. Noteworthy was the finding that the parent generation showed cognitive decline from 60 to 67 years of age, but their offspring showed stability or modest increases in cognitive functioning across the same age range.

Such differences across generations involve cohort effects. In one analysis, Schaie (2011b) concluded that the advances in cognitive functioning in middle age that have occurred in recent decades are likely due to factors such as educational attainment, occupational structures (increasing numbers of workers in professional occupations and work complexity), health care and lifestyles, immigration, and social interventions in poverty. The impressive gains in cognitive functioning in recent cohorts have been documented more clearly for fluid intelligence than for crystallized intelligence (Schaie, 2011b).

The results from Schaie’s study that have been described so far focus on average cognitive stability or change for all participants across the middle adulthood years. Schaie and Sherry Willis (Schaie, 2005; Willis & Schaie, 2005) examined individual differences for the participants in the Seattle study and found substantial individual variations. They classified participants as “decliners,” “stable,” or “gainers” for three categories—number ability, delayed recall (a verbal memory task), and word fluency—from 46 to 60 years of age. The largest percentage of decline (31 percent) or gain (16 percent) occurred for delayed recall; the largest percentage of stable scores (79 percent) occurred for numerical ability. Word fluency declined for 20 percent of the individuals from 46 to 60 years of age.

Might the individual variations in cognitive trajectories in midlife be linked to cognitive impairment in late adulthood? In Willis and Schaie’s analysis, cognitively normal and impaired older adults did not differ on measures of vocabulary, spatial orientation, and numerical ability in middle adulthood. However, declines in memory (immediate recall and delayed recall), word fluency, and perceptual speed in middle adulthood were linked to neuropsychologists’ ratings of the individuals’ cognitive impairment in late adulthood.

Some researchers disagree with Schaie that middle adulthood is the time when the level of functioning in a number of cognitive domains is maintained or even increases (Finch, 2009). For example, Timothy Salthouse (2009, 2012, 2014, 2016) recently has argued that cross-sectional research on aging and cognitive functioning should not be dismissed and that this research indicates reasoning, memory, spatial visualization, and processing speed begin declining in early adulthood and show further decline in the fifties. Salthouse (2009, 2012) agrees that cognitive functioning involving accumulated knowledge, such as vocabulary and general information, does not show early age-related decline but rather continues Page 475to increase at least until 60 years of age. Salthouse (2014, 2016) recently has argued that a main reason for different trends in longitudinal and cross-section comparisons of cognitive functioning is that prior experience with tests increases scores the next time a test is taken.

K. Warner Schaie (right) is one of the leading pioneers in the field of life-span development. He is shown here with two older adults who are actively using their cognitive skills. Schaie’s research represents one of the most thorough examinations of how individuals develop and change as they go through the adult years.Courtesy of Dr. K. Warner Schaie

Salthouse (2009, 2012) has emphasized that a lower level of cognitive functioning in early and middle adulthood is likely due to age-related neurobiological decline. Cross-sectional studies have shown that the following neurobiological factors decline during the twenties and thirties: regional brain volume, cortical thickness, synaptic density, some aspects of myelination, the functioning of some aspects of neurotransmitters such as dopamine and serotonin, blood flow in the cerebral cortex, and the accumulation of tangles in neurons (Del Tredici & Braak, 2008; Finch, 2009; Hsu & others, 2008; Pieperhoff & others, 2008).

Schaie (2009, 2010, 2011a, b, 2013) continues to emphasize that longitudinal studies hold the key to determining age-related changes in cognitive functioning and that middle age is the time when many cognitive skills actually peak. In the next decade, expanding research on age-related neurobiological changes and their possible links to cognitive skills should further refine our knowledge about age-related cognitive functioning in the adult years (Klaassen & others, 2014; Lustig & Lin, 2016; Reuter-Lorenz, Festini, & Jantz, 2016).

INFORMATION PROCESSING

As we saw in our discussion of theories of cognitive development from infancy through adolescence, the information-processing approach provides another way of examining cognitive abilities. Among the information-processing changes that take place in middle adulthood are those involved in speed of processing information, memory, expertise, and practical problem-solving skills.

Speed of Information Processing As we saw in Schaie’s (1994, 1996, 2011a, b, 2013) Seattle Longitudinal Study, perceptual speed begins declining in early adulthood and continues to decline in middle adulthood. A common way to assess speed of information processing is through a reaction-time task, in which individuals simply press a button as soon as they see a light appear. Middle-aged adults are slower to push the button when the light appears than young adults are. However, keep in mind that the decline is not dramatic—under 1 second in most investigations.

A current interest focuses on possible causes for the decline in speed of processing information in adults (Salthouse, 2009, 2012). The causes may occur at different levels of analysis, such as cognitive (“maintaining goals, switching between tasks, or preserving internal representations despite distraction”), neuroanatomical (“changes in specific brain regions, such as the prefrontal cortex”), and neurochemical (“changes in neurotransmitter systems” such as dopamine) (Hartley, 2006, p. 201).

Memory In Schaie’s (1994, 1996, 2013) Seattle Longitudinal Study, verbal memory peaked during the fifties. However, in some other studies verbal memory has shown a decline in middle age, especially when assessed in cross-sectional studies (Salthouse, 2009, 2012). For example, in several studies in which people were asked to remember lists of words, numbers, or meaningful prose, younger adults outperformed middle-aged adults (Salthouse & Skovronek, 1992). Although there still is some controversy about whether memory declines during middle adulthood, most experts conclude that it does decline at some point during this period of adult development (Ferreira & others, 2015; Lundervold, Wollschlager, & Wehling, 2014; McCabe & Loaiza, 2012; Salthouse, 2012, 2015). However, some experts argue that studies that have concluded there is a decline in memory during middle age often have compared young adults in their twenties with older middle-aged adults in their late fifties and even have included some individuals in their sixties (Schaie, 2000). In this view, 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.

developmental connection

Memory

Some types of memory decline more than others in older adults. Connect to “Cognitive Development in Late Adulthood.”

Cognitive aging expert Denise Park (2001) argues that starting in late middle age, more time is needed to learn new information. The slowdown in learning new information has been linked to changes in working memory, the mental “workbench” where individuals manipulate and assemble information when making decisions, solving problems, and comprehending written and spoken language (Baddeley, 2007, 2012, 2013). In this view, in late middle age working memory capacity becomes more limited. Think of this situation as an overcrowded Page 476desk with many items in disarray. As a result of the overcrowding and disarray, long-term memory becomes less reliable, more time is needed to enter new information into long-term storage, and more time is required to retrieve the information. Thus, Park concludes that much of the blame for declining memory in late middle age is a result of information overload that builds up as we go through the adult years.

developmental connection

Memory

Working memory plays an important role in many aspects of children’s cognitive and language development. Connect to “Physical and Cognitive Development in Middle and Late Childhood.”

Memory decline is more likely to occur when individuals don’t use effective memory strategies, such as organization and imagery (Small & others, 2012). By organizing lists of phone numbers into different categories, or imagining the phone numbers as representing different objects around the house, many individuals can improve their memory in middle adulthood.

Expertise Because it takes so long to attain, expertise often shows up more in middle adulthood than in early adulthood (Charness & Krampe, 2008). Recall that expertise involves having extensive, highly organized knowledge and understanding of a particular domain. Developing expertise and becoming an “expert” in a field usually is the result of many years of experience, learning, and effort.

developmental connection

Information Processing

One study found that 10- and 11-year-old children who were experienced chess players (“experts”) remembered more about chess pieces than college students who were not chess players (“novices”). Connect to “Physical and Cognitive Development in Middle and Late Childhood.”

Strategies that distinguish experts from novices include these:

• Experts are more likely to rely on their accumulated experience to solve problems.

• Experts often process information automatically and analyze it more efficiently when solving a problem in their domain than novices do.

• Experts have better strategies and shortcuts for solving problems in their domain than novices do.

• Experts are more creative and flexible in solving problems in their domain than novices are.

Practical Problem Solving Everyday problem solving is another important aspect of cognition (Cheek, Piercy, & Kohlenberg, 2015; Kimbler, 2013). Nancy Denney (1986, 1990) observed circumstances such as how young and middle-aged adults handled a landlord who would not fix their stove and what they did if a bank failed to deposit a check. She found that the ability to solve such practical problems improved through the forties and fifties as individuals accumulated practical experience.

However, since Denney’s research other studies on everyday problem-solving and decision-making effectiveness across the adult years have been conducted (Cheek, Piercy, & Kohlenberg, 2015; Margrett & Deshpande-Kamat, 2009). A research analysis found no evidence for significant changes in everyday cognition from 20 to 75 years of age (Salthouse, 2012). One possible explanation for the lack of any decline in everyday cognition is the increase in accumulated knowledge individuals possess as they grow older.

Review Connect Reflect

1. LG3 Identify cognitive changes in middle adulthood.

Review

• How does intelligence develop in middle adulthood?

• What changes take place in processing information during middle age?

Connect

• In this section you read about longitudinal and cross-sectional studies of intelligence. What are the pros and cons of these two research approaches?

Reflect Your Own Personal Journey of Life

• Think about your life and the lives of your parents and grandparents. Are there experiences that you are likely to have, are having, or have had that will enhance your intelligence in middle age more than the experiences they had or are having? Also, think about experiences that you are likely to have or have had in the past that might not be as intelligence-enhancing as those experiences of your parents or grandparents. For example, have we become too dependent on calculators, computers, and the Internet for our knowledge and information?

Page 477

4 Careers, Work, and LeisureLG4Characterize career development, work, and leisure in middle adulthood.

What are some issues that workers face in midlife? What role does leisure play in the lives of middle-aged adults?

WORK IN MIDLIFE

The role of work, whether one works in a full-time career, a part-time job, as a volunteer, or a homemaker, is central during middle adulthood (Cahill, Gianadrea, & Quinn, 2016; Wang & Shi, 2016). Many middle-aged adults reach their peak in position and earnings. However, they may also be saddled with multiple financial burdens including rent or mortgage, child care, medical bills, home repairs, college tuition, loans to family members, or bills from nursing homes.

developmental connection

Work

Work defines people in fundamental ways, influencing their financial standing, housing, the way they spend their time, where they live, their friendships, and their health. Connect to “Physical and Cognitive Development in Early Adulthood.”

In 2015 in the United States, 79.4 percent of 45- to 54-year-olds were in the workforce (a decrease of 3.4 percent since 2000) and 64.1 percent of 55- to 64-year-olds were in the workforce (an increase of 8 percent since 2000) (Short, 2015). Later, we will describe various aspects of workforce participation of individuals 65 and over in the United States, which has increased a remarkable 50 percent since 2000 (Short, 2015).

Do middle-aged workers perform their work as competently as younger adults? Age-related declines occur in some occupations, such as air traffic controllers and professional athletes, but for most jobs, no differences have been found in the work performance of young adults and middle-aged adults (Salthouse, 2012; Sturman, 2003).

However, leading Finnish researcher Clas-Hakan Nygard (2013) concludes from his longitudinal research that the ability to work effectively peaks during middle age because of increased motivation, work experience, employer loyalty, and better strategic thinking. Nygard also has found that the quality of work done by employees in middle age is linked to how much their work is appreciated and how well they get along with their immediate supervisors. And Nygard and his colleagues discovered that work ability in middle age was linked to mortality and disability 28 years later (von Bonsdorff & others, 2011, 2012).

For many people, midlife is a time of evaluation, assessment, and reflection in terms of the work they are doing now and what they want to do in the future (Cahill, Giandrea, & Quinn, 2015; Moen, 2009). Among the work issues that some people face in midlife are recognizing limitations in career progress, deciding whether to change jobs or careers, determining how and when to rebalance family and work, and planning for retirement (Sterns & Huyck, 2001).

Couples increasingly have both spouses in the workforce who are expecting to retire. Historically retirement has been a male transition, but today far more couples are planning two retirements—his and hers (Moen, 2009b; Moen, Kelly, & Magennis, 2008).

What characterizes work in middle adulthood?© BrandXPictures/PunchStock RF

Economic downturns and recessions in the United States have forced some middle-aged individuals into premature retirement because of job loss and fear of not being able to reenter the work force (Cahill, Giandrea, & Quinn, 2016). Such premature retirement also may result in accumulating insufficient financial resources to cover an increasingly long retirement period (de Wind & others, 2014).

HAGAR © 1987 King FEATURES SYNDICATE.Page 478

CAREER CHALLENGES AND CHANGES

Middle-aged workers face several important challenges in the twenty-first century (Brand, 2014). These include the globalization of work, rapid developments in information technologies, downsizing of organizations, early retirement, and concerns about pensions and health care.

Sigmund Freud said that the two things adults need to do well to adapt to society’s demands are to work and to love. To his list we add “to play.” In our fast-paced society, it is all too easy to get caught up in the frenzied, hectic pace of our achievement-oriented work world and ignore leisure and play. Imagine your life as a middle-aged adult. What would be the ideal mix of work and leisure? What leisure activities do you want to enjoy as a middle-aged adult?© Digital Vision/Getty Images RF

Globalization has replaced what was once a primarily White male workforce with employees of different ethnic and national backgrounds (Cahill, Giandrea, & Quinn, 2016; Short, 2015). To improve profits, many companies are restructuring, downsizing, and outsourcing jobs. One of the outcomes of these changes is to offer incentives to middle-aged employees to retire early—in their fifties, or in some cases even forties, rather than their sixties.

The decline in defined-benefit pensions and increased uncertainty about the fate of health insurance are decreasing the sense of personal control among middle-aged workers. As a consequence, many are delaying retirement.

Some midlife career changes are self-motivated; others are the consequence of losing one’s job (Brand, 2014). Some individuals in middle age decide that they don’t want to spend the rest of their lives doing the same kind of work they have been doing (Hoyer & Roodin, 2009). One aspect of middle adulthood involves adjusting idealistic hopes to accommodate realistic possibilities in light of how much time individuals have before they retire and how fast they are reaching their occupational goals (Levinson, 1978). If individuals perceive that they are behind schedule, if their goals are unrealistic, they don’t like the work they are doing, or their job has become too stressful, they could become motivated to change jobs.

A final point to make about career development in middle adulthood is that cognitive factors earlier in development are linked to occupational attainment in middle age. In one study, task persistence at 13 years of age was related to occupational success in middle age (Andersson & Bergman, 2011).

LEISURE

As adults, not only must we learn how to work well, but we also need to learn how to relax and enjoy leisure (Eriksson Sorman & others, 2014). Leisure refers to the pleasant times after work when individuals are free to pursue activities and interests of their own choosing—hobbies, sports, or reading, for example. In one analysis of research on what U.S. adults regret the most, not engaging in more leisure was one of the top six regrets (Roese & Summerville, 2005).

Leisure can be an especially important aspect of middle adulthood (Nicolaisen, Thorsen, & Eriksen, 2012). By middle adulthood, more money is available to many individuals, and there may be more free time and paid vacations. In short, midlife changes may produce expanded opportunities for leisure.

In one study, 12,338 men 35 to 57 years of age were assessed each year for five years regarding whether or not they took vacations (Gump & Matthews, 2000). Then the researchers examined the medical and death records over nine years for men who lived for at least a year after the last vacation survey. Compared with those who never took vacations, men who went on annual vacations were 21 percent less likely to die over the nine years and 32 percent less likely to die of coronary heart disease. And a recent Finnish study found that engaging in little leisure-time activity in middle age was linked to risk of cognitive impairment in late adulthood (23 years later) (Virta & others, 2013).

Adults at midlife need to begin preparing psychologically for retirement. Constructive and fulfilling leisure activities in middle adulthood are an important part of this preparation. If an adult develops leisure activities that can be continued into retirement, the transition from work to retirement can be less stressful.

Also, the type of leisure activity may be linked to different outcomes. A recent study found that engaging in higher complexity of work before retirement was associated with less decline in cognitive performance in retirement (Andel, Finkel, & Pedersen, 2016). However, when those who had worked in occupations with fewer cognitive challenges prior to retirement engaged in physical (sports, walking) and cognitive (reading books, doing puzzles, and playing chess) leisure activities during retirement, they showed less cognitive decline. Further, a study revealed that when middle-aged adults engaged in active leisure pursuits they had a higher level of cognitive performance in late adulthood (Ihle & others, 2015). And in another recent study, individuals who engaged in a greater amount of sedentary screen-based leisure-time activity (TV, video games, computer use) had shorter telomere length (telomeres cover Page 479the end of chromosomes, and as people age their telomeres become shorter and this shorter telomere length is linked to mortality) (Loprinzi, 2015b).

Recent research also has highlighted links between stress and leisure time (Qian, Yamal, & Almeida, 2014a, b, c). In one study, 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 affect.

Review Connect Reflect

1. LG4 Characterize career development, work, and leisure in middle adulthood.

Review

• What are some issues that workers face in midlife?

• What career challenges and changes might people experience in middle adulthood?

• What characterizes leisure in middle age?

Connect

• In this section you learned about the leisure time of adults in middle age. What have you learned about cultural differences and leisure time in adolescence?

Reflect Your Own Personal Journey of Life

• What do you want your work life and leisure to be like in middle age? If you are middle-aged, what are your work life and leisure activities like? If you are an older adult, what were they like in middle age?

5 Religion, Spirituality, and Meaning in LifeLG5Explain the roles of religion, spirituality, and meaning in life during middle adulthood.

What roles do religion and spirituality play in our development as adults? Is the meaning of life an important theme for many middle-aged adults?

RELIGION, SPIRITUALITY, AND ADULT LIVES

Can religion be distinguished from spirituality? Pamela King and her colleagues (2011) provide the following distinctions:

• Religion is an organized set of beliefs, practices, rituals, and symbols that increases an individual’s connection to a sacred or transcendent other (God, higher power, or ultimate truth).

• Religiousness refers to the 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 involves experiencing something beyond oneself in a transcendent manner and living in a way that benefits others and society.

What roles do religion and spirituality play in the lives of middle-aged adults?© Erik S. Lesser/Corbis

In thinking about religion, spirituality, and adult development, it is important to consider the role of individual differences. Religion and spirituality are powerful influences for some adults but hold little or no significance for others (Krause & Hayward, 2016; McCullough & others, 2005). Further, the influence of religion and spirituality in people’s lives may change as they develop (Sapp, 2010). In John Clausen’s (1993) longitudinal investigation, some individuals who had been strongly religious in their early adult years became less so in middle age, while others became more religious in middle age.

developmental connection

Religion

Religion and spirituality play important roles in the lives of many older adults. Connect to “Cognitive Development in Late Adulthood.”

In the MacArthur Foundation Study of Midlife Development, more than 70 percent of U.S. middle-aged adults described themselves as religious and said that spirituality was a major part of their lives (Brim, 1999). In a longitudinal study of individuals from their early thirties through their early seventies, a significant increase in spirituality occurred between late middle adulthood (mid-fifties/early sixties) and late adulthood (Wink & Dillon, 2002) (see Figure 7). Another survey found that 77 percent of 30- to 49-year-olds and 84 percent Page 480of 50- to 64-year-olds reported having a religious affiliation, compared with 67 percent of 18- to 29-year-olds and 90 percent of adults age 90 and over (Pew Research Center, 2012).

FIGURE 7LEVEL OF SPIRITUALITY IN FOUR ADULT AGE PERIODS. In a longitudinal study, the spirituality of individuals in four different adult age periods—early (thirties), middle (forties), late middle (mid-fifties/early sixties), and late (late sixties/early seventies) adulthood—was assessed (Wink & Dillon, 2002). Based on responses to open-ended questions in interviews, the spirituality of the individuals was coded on a 5-point scale with 5 being the highest level of spirituality and 1 the lowest.

connecting with careers

Gabriel Dy-Liacco, University Professor And Pastoral Counselor

Gabriel Dy-Liacco currently is a professor in religious and pastoral counseling at Regent University in Virginia Beach, Virginia. He obtained his Ph.D. in pastoral counseling from Loyola College in Maryland and has worked as a psychotherapist in mental health settings such as a substance-abuse program, military family center, psychiatric clinic, and community mental health center. Earlier in his career he was a pastoral counselor at the Pastoral Counseling and Consultation Centers of Greater Washington, D.C., and taught at Loyola University in Maryland. As a pastoral counselor, he works with adolescents and adults in the aspects of their lives that they show the most concern about—psychological, spiritual, or the interface of both. Having lived in Peru, Japan, and the Philippines, he brings considerable multicultural experience to teaching and counseling settings.

Women have consistently shown a stronger interest in religion and spirituality than men have. In the longitudinal study just described, the spirituality of women increased more than men in the second half of life (Wink & Dillon, 2002).

RELIGION, SPIRITUALITY, AND HEALTH

How might religion influence physical health? Some cults and religious sects encourage behaviors that can be damaging to health, such as ignoring sound medical advice (Manca, 2013; Williams & Sternthal, 2007). For individuals in the religious mainstream, researchers increasingly are finding that spirituality/religion is positively linked to health (Krause & Hayward, 2016). Religious commitment helps to moderate blood pressure and reduce hypertension, and religious attendance is linked to a reduction in hypertension (Gillum & Ingram, 2007). In an analysis of a number of studies, adults with a higher level of spirituality/religion had an 18 percent reduction in mortality (Lucchetti, Lucchetti, & Koenig, 2011). In this analysis, a high level of spirituality/religion had a stronger link to longevity than 60 percent of 25 other health interventions (such as eating fruits and vegetables and taking statin drugs for cardiovascular disease). In Connecting Development to Life, we explore links between religion, spirituality, and coping.

In sum, various dimensions of religion and coping can help some individuals cope more effectively with challenges in their lives (Krause & Hayward, 2016; Olson & others, 2012; Park, 2010, 2012a, b, 2013; Park & Iacocca, 2014; Park & Slattery, 2013). Religious counselors often advise people about mental health and coping. To read about the work of one religious counselor, see Connecting with Careers.

MEANING IN LIFE

Austrian psychiatrist Viktor Frankl’s mother, father, brother, and wife died in the concentration camps and gas chambers in Auschwitz, Poland. Frankl survived the concentration camp and went on to write about meaning in life. In his book Man’s Search for Meaning, Frankl (1984) emphasized each person’s uniqueness and the finiteness of life. He argued that examining the finiteness of our existence and the certainty of death adds meaning to life. If life were not finite, said Frankl, we could spend our life doing just about anything we pleased because time would continue forever.

When more time stretches behind than stretches before one, some assessments, however reluctantly and incompletely, begin to be made.

—James Baldwin
American novelist, 20th century

Frankl said that the three most distinct human qualities are spirituality, freedom, and responsibility. Spirituality, in his view, does not have a religious underpinning. Rather, it refers to a human being’s uniqueness of spirit, philosophy, and mind. Frankl proposed that people need to ask themselves questions such as why they exist, what they want from life, and what the meaning of their life might be.

It is in middle adulthood that individuals begin to be faced with death more often, especially the deaths of parents and other older relatives. Also faced with less time in their life, many individuals in middle age begin to ask and evaluate the questions that Frankl proposed Page 481(Cohen, 2009). And, as indicated in Connecting Development to Life, meaning-making coping is especially helpful in times of chronic stress and loss.

connecting development to life

Religion, Spirituality, and Coping

What is the connection between religion, spirituality, and the ability to cope with stress? Researchers are increasingly finding that religion and spirituality are related to well-being (Krause & Hayward, 2016; Masters & Hooker, 2013). A recent study revealed that highly religious individuals were less likely than their moderately religious, somewhat religious, and non-religious counterparts to be psychologically distressed (Park, 2013). Also, in a study of 850 medically ill patients admitted to an acute-care hospital, religious coping was related to low rates of depression (Koenig & others, 1992).

Religious coping is often beneficial during times of high stress (Pargament & others, 2013). For example, in one study individuals were divided into those who were experiencing high stress and those with low stress (Manton, 1989). In the high-stress group, spiritual support was significantly related to low rates of depression and high levels of self-esteem. No such links were found in the low-stress group. One study revealed that when religion was an important aspect of people’s lives, they frequently prayed, had positive religious core beliefs, worried less, were less anxious, and had a lower level of depressive symptoms (Rosmarin, Krumrei, & Andersson, 2009).

A recent interest in linking religion and coping focuses on meaning-making coping, which involves drawing on beliefs, values, and goals to change the meaning of a stressful situation, especially in times of chronic stress such as when a loved one dies. In Crystal Park’s (2005, 2007, 2010, 2013) view, religious individuals experience more disruption of their beliefs, values, and goals immediately after the death of a loved one than individuals who are not religious. Eventually, though, individuals who are religious often show better adjustment to the loss. Initially, religion is linked with more depressed feelings about a loved one’s death. Over time, however, as religious individuals search for meaning in their loss, the depressed feelings lessen. Thus, religion can serve as a meaning system through which bereaved individuals are able to reframe their loss and even find avenues of personal growth.

How is religion linked to the ability to cope with stress?© Punchstock RF

If religion is linked to the ability to cope with stress better and if stress is linked to disease (as indicated earlier in the chapter), what can be concluded about a possible indirect link between religion and disease?

What characterizes the search for meaning in life?© Michael Prince/Corbis

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. A higher level of meaning in life also is linked to a higher level of psychological well-being and physical health (Park, 2012b). Roy Baumeister and Kathleen Vohs (2002, pp. 610–611) argue that this quest can be understood in terms of four main needs for meaning that guide how people try to make sense of their lives:

• Need for purpose. “Present events draw meaning from their connection with future events.” Purposes can be divided into (1) goals and (2) fulfillments. Life can be oriented toward a future anticipated state, such as living happily ever after or being in love.

• Need for values. This “can lend a sense of goodness or positive characterization of life and justify certain courses of action. Values enable people to decide whether certain acts are right or wrong.” Frankl’s (1984) view of meaning in life emphasized values as the main form of meaning that people need.

• Need for a sense of efficacy. This involves the “belief that one can make a difference. A life that had purposes and values but no efficacy would be tragic. The person might know what is desirable but could not do anything with that knowledge.” With a sense Page 482of efficacy, people believe that they can control their environment, which has positive physical and mental health benefits (Bandura, 2012).

• Need for self-worth. Most individuals want to be “good, worthy persons. Self-worth can be pursued individually.”

Researchers are increasingly studying the factors involved in a person’s exploration of meaning in life and whether developing a sense of meaning in life is linked to positive developmental outcomes. Many individuals state that religion played an important role in increasing their exploration of meaning in life (Krause, 2008, 2009; Krause & Hayward, 2016). Studies also suggest that individuals who have found a sense of meaning in life are physically healthier, happier, and less depressed than their counterparts who report that they have not discovered meaning in life (Debats, 1990; Krause, 2004, 2009; Krause & Hayward, 2016).

Review Connect Reflect

1. LG5 Explain the roles of religion, spirituality, and meaning in life during middle adulthood.

Review

• What are some characteristics of religion and spirituality in middle-aged individuals?

• How are religion and spirituality linked to physical and mental health?

• What role does meaning in life play in middle adulthood?

Connect

• In this section, you read about religion and spirituality in middle adulthood. What have you learned about the role of religion in adolescents’ lives?

Reflect Your Own Personal Journey of Life

• How important is finding a meaning in life to you at this point in your development? What do you think the most important aspects of meaning in life are?

topical connections looking forward

Later you will read about biological views on why people age and what people can do to possibly slow down the aging process. You also will learn about the factors that influence life expectancy and what the lives of centenarians—people who live to be 100 or older—are like. The many physical changes that occur in late adulthood, including those involving the brain, also will be described. You will also learn about numerous cognitive changes in older adults, as well as the influences of work and retirement, mental health, and religion in their lives.

Page 483

reach your learning goals

Physical and Cognitive Development
in Middle Adulthood

1 The Nature of Middle Adulthood

1. LG1 Explain how midlife is changing, and define middle adulthood.

Changing Midlife

• As more people live to older ages, what we think of as middle age seems to be occurring later. A major reason developmentalists are beginning to study middle age is the dramatic increase in the number of individuals entering this period of the life span.

Defining Middle Adulthood

• Middle age involves extensive individual variation. With this variation in mind, we will consider middle adulthood to be entered at about 40 to 45 years of age and exited at approximately 60 to 65 years of age. Middle adulthood is the age period in which gains and losses as well as biological and sociocultural factors balance each other. Some experts conclude that sociocultural factors influence development in midlife more than biological factors do.

2 Physical Development

1. LG2 Discuss physical changes in middle adulthood.

Physical Changes

• The physical changes of midlife are usually gradual. Genetic and lifestyle factors play important roles in whether chronic diseases will appear and when. Among the physical changes of middle adulthood are changes in physical appearance (wrinkles, age spots); height (decrease) and weight (increase); strength, joints, and bones; vision and hearing; cardiovascular system; lungs; and sleep.

Health, Disease, Stress, and Control

• In middle age, the frequency of accidents declines and individuals are less susceptible to colds and allergies. Chronic disorders appear rarely in early adulthood, increase in middle adulthood, and become more common in late adulthood. Arthritis is the leading chronic disorder in middle age, followed by hypertension. Men have more fatal chronic disorders, women more nonfatal ones in middle age. Immune system functioning declines with age. Emotional stress likely is an important factor contributing to cardiovascular disease. People who live in a chronically stressed condition are more likely to smoke, overeat, and not exercise. All of these stress-related behaviors are linked with cardiovascular disease. Having a sense of control peaks in middle adulthood and is linked to many aspects of health and disease.

Mortality Rates

• In middle adulthood, chronic diseases are the main causes of death. Until recently, cardiovascular disease was the leading cause of death in middle age, but now cancer is the leading cause of death in this age group.

Sexuality

• Climacteric is the midlife transition in which fertility declines. The vast majority of women do not have serious physical or psychological problems related to menopause, which usually takes place in the late forties or early fifties, but menopause is an important marker because it signals the end of childbearing capability. Hormone replacement therapy (HRT) augments the declining levels of reproductive hormone production by the ovaries. HRT consists of various forms of estrogen, usually combined with progestin. Recent evidence of risks associated with HRT suggests that its long-term use should be seriously evaluated. Men do not experience an inability to father children in middle age, although their testosterone levels decline. A male menopause, like the dramatic decline in estrogen in women, does not occur. Sexual behavior occurs less frequently in middle adulthood than in early adulthood. Nonetheless, a majority of middle-aged adults show a moderate or strong interest in sex.

3 Cognitive Development

1. LG3 Identify cognitive changes in middle adulthood.

Intelligence

• Horn argued that crystallized intelligence (accumulated information and verbal skills) continues to increase in middle adulthood, whereas fluid intelligence (ability to reason abstractly) begins to decline. Schaie and Willis found that longitudinal assessments of intellectual abilities are less likely than cross-sectional assessments to find declines in middle adulthood and are more likely to find improvements. The highest level of four intellectual abilities (vocabulary, verbal memory, inductive reasoning, and spatial orientation) occurred in middle age. Recent analysis shows considerable individual variation in intellectual abilities across middle adulthood and indicates that variations in some abilities are more predictive of cognitive impairment in late adulthood than others. Salthouse argues that decline in a number of cognitive functions begins in early adulthood and continues through the fifties. Declines have recently been identified in some aspects of neurobiological functioning that may be linked to age-related changes in cognitive functioning.

Information Processing

• Speed of information processing, often assessed through reaction time, continues to decline in middle adulthood. Although Schaie found that verbal memory increased in middle age, some researchers have found that memory declines in middle age. Working memory Page 484declines in late middle age. Memory is more likely to decline in middle age when individuals don’t use effective strategies. Expertise involves having an extensive, highly organized knowledge and an understanding of a particular domain. Expertise often increases in middle adulthood. Practical problem solving remains stable in early and middle adulthood but declines in late adulthood.

4 Careers, Work, and Leisure

1. LG4 Characterize career development, work, and leisure in middle adulthood.

Work in Midlife

• For many people, midlife is a time of reflection, assessment, and evaluation of their current work and what they plan to do in the future. One important issue is whether individuals will continue to do the type of work they currently do or change jobs or careers.

Career Challenges and Changes

• Today’s middle-aged workers face challenges such as the globalization of work, rapid developments in information technologies, downsizing of organizations, pressure to take early retirement, and concerns about pensions and health care. Midlife job or career changes can be self-motivated or forced on individuals.

Leisure

• We not only need to learn to work well, but we also need to learn to enjoy leisure. Midlife may be an especially important time for leisure because of the physical changes that occur and because of a desire to prepare for an active retirement.

5 Religion, Spirituality, and Meaning in Life

1. LG5 Explain the roles of religion, spirituality, and meaning in life during middle adulthood.

Religion, Spirituality,
and Adult Lives

• Religion and spirituality are important dimensions of many Americans’ lives. Women show a stronger interest in religion and spirituality than men do. It is important to consider individual differences in religious and spiritual interest.

Religion, Spirituality, and Health

• In some cases, religion and spirituality can be negatively linked to physical health, as when cults or religious sects discourage individuals from obtaining medical care. In mainstream religions, researchers are increasingly finding that religion is positively related to health. Religion and spirituality can enhance coping for some individuals.

Meaning in Life

• Frankl argued that examining the finiteness of our existence leads to exploration of meaning in life. Faced with the death of older relatives and less time ahead of them than behind them, many middle-aged individuals increasingly examine life’s meaning. Baumeister and Vohs argue that a quest for a meaningful life involves fulfilling four main needs: purpose, values, efficacy, and self-worth.

key terms

• chronic disorders

• climacteric

• crystallized intelligence

• erectile dysfunction (ED)

• fluid intelligence

• leisure

• meaning-making coping

• menopause

• metabolic syndrome

• middle adulthood

• religion

• religiousness

• spirituality

key people

• David Almeida

• Roy Baumeister

• Gilbert Brim

• John Clausen

• Sheldon Cohen

• Nancy Denney

• Viktor Frankl

• John Horn

• Janet Kiecolt-Glaser

• Pamela King

• Margie Lachman

• Clas-Hakan Nygard

• Crystal Park

• Denise Park

• Timothy Salthouse

• K. Warner Schaie

• Kathleen Vohs

• Sherry Willis

Internal