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Physical Changes Adulthood

  1. Why do we age (again)
    • Rate of living theories
      • Do we only have so much energy to expend in a lifetime?
        • restricting activities in insects may increase their life spans
        • some mammals live longer if hibernation is induced
      • the number of calories consumed is related to longevity
      • age of maturity in mammals is related to longevity
      • But — examination of many species does not support a direct relationship between metabolism and length of life
    • Cellular theories
      • replication senescence & telomeres
      • cross-linking
      • free radical damage
    • Programmed-cell-death theories
  2. Physical changes is in Young Adulthood
    • Changes in physical appearance and declines in body functioning in the 20’s and 30’s tend to be gradual
      • organ reserve: the part of the total capacity of our body’s organs that we do not normally need to use
      • the most significant changes in organ reserve occur in the heart, lungs, and kidneys
      • “A 50-year-old man might fish all day with his 25-year-old son and take a long walk with him without becoming exhausted, but has little change of winning a footrace against him.” (Fiore, 2011, p. 210)
    • Sensory
      • gradual changes from approximate age 30 in vision and hearing
      • Cardiovascular: heart disease is leading cause of death in adult population
    • Respiratory
      • Maximum vital capacity declines by approximately 10 percent per decade after age 25
        • a common measure of overall aerobic fitness is Maximum oxygen uptake (VO2 max): the ability of the body to take in and transport oxygen to various body organs. At rest VO2 shows only minimal decrements with age; when measured during exercise (like a treadmill test), it shows a decline with age of about 1% a year, beginning between ages 35 and 40 (Goldberg, Dengel, & Hagberg, 1996)
      • Aging of the lungs can make it harder for older adults to meet the body’s need for oxygen while exercising
    • Immune System: declines after age 20, usually due to changes in thymus the compromise the immune response; is also weakened by psychological and physical stress
      • T cells are a type of white blood cell produced in the bone marrow and maturing in the thymus, attacks antigens (foreign substances in body) directly; shows most decline of immune system
      • B cells are a type of white blood cell produced in the bone marrow which secrete antibodies into the bloodstream to multiple, surround antigens, allowing the antigens to be destroyed by the body
    • Skin and hair: loss of elasticity; hair becomes thinner and may gray
    • Reproductive capacity
      • Women’s fertility decline with age, especially in late 30’s and in the 40’s
      • Men’s semen volume, sperm concentration and motility gradually decrease after age 35, contributing to reduced fertility rates in older men
    • Motor performance
      • Declines in heart and lung functioning during exertion, combined with graduate muscle loss, lead to changes in motor performance
      • In ordinary citizens, the impact of biological aging on motor skills is difficult to separate from decreases in motivation and practice
      • The upper biological limits of motor capacity is reached in first part of early adulthood, but biological aging accounts for only a small part of age-related decline until advanced old age
  3. Middle Adulthood : physical development
    • Middle Adulthood: When does “middle” begin?
      • ages 40 to 65
      • midpoint, not end of life
      • continuations of adulthood changes
    • Physical Changes with Age
      • Vision: by the 40’s, visual “accommodation” becomes more difficult for nearby objects
        • by the 60’s, the lenses loses their capacity to adjust to objects at varying distances entirely, presbyopia (“old eyes”)
        • color vision declines, “night vision” declines
        • glaucoma–poor fluid drainage leading to destructive buildup of pressure in eye–becomes the leading cause of blindness
      • Hearing
        • about 14% of Americans between 45 and 64 suffer from hearing loss, often due to age-related changes called presbycusis (“old hearing”)
        • after age 50 high frequency loses become more apparent
        • gender, and possibly population differences
          • males have earlier, more rapid loss
      • Skin
        • the skin become less elastic and supple, “age spots” appear, blood vessels in the skin become more visible
        • sun exposure tends to exacerbate wrinkling and spotting
        • smoking
      • Voice
        • young adult voices tend to be full and resonate; older adult voices tend to be thinner or weaker
        • age related changes show lowering of pitch, increased breathlessness, and mumbling, slower & less precise pronunciation, decrease volume
        • may reflect changes in larynx, respiratory system, and muscles; may reflect poor health that are not part of normal aging
      • Muscle-Fat
        • both males and females tend to loss muscle mass and gain weight
        • basal metabolic rate slows, leading to a decreased caloric need (but not appetite)
        • weight bearing/resistance training exercise can help offset both excess weight and muscle loss
      • Skeleton
        • mineral content of bones declines, bones become more porous, and bone density declines
        • disk collapse in the spinal column lead to a decrease in height
        • great loss of bone density lead to the disorder of osteoporosis
      • Reproductive System
        • the climacteric, the mid-life transition in which fertility declines, brings an end to reproductive capacity in women and decreased fertility in men
        • menopause: estrogen production decreases over a decade the concludes with menopause, late 30’s to late 50’s–the end of menstruation and reproductive capacity
        • decreased genital size and sensitivity, become less easily stimulated, and the vagina lubricates more slowly during arousal
        • hot flashes and sexual problems are linked with menopause
        • common reports of less satisfying sleep, irritability, and mood problems are not clearly linked to menopause
        • psychological and physical effects
          • expectation and “meaning” dramatically affects the experience of menopause
          • marked cultural and subcultural differences
        • males experiences a decrease in quantities of semen and sperm produced after age 40, testosterone production reduces
          • erectile dysfunction–inability to attain/sustain an erection when desired–becomes more common in mid-life
          • drugs that increase blood flow to the penis and commonly prescribed for treatment
          • sildenafil (Viagra) was approved by the FDA in 1998 for treatment of erectile dysfunction in males
    • speech comprehension in the elderly
    • Health and Fitness
      • Behavior patterns/habits markedly influence health during mid-life
        • Type A behavior pattern: extreme competitiveness, impatience, angry outbursts
        • cardiac health and survival
        • the research literature: method variance, individual differences, and some “real” effect
        • hostility as the most dangerous element
      • Hardiness: control, commitment, and challenge that are associated with more adaptive coping with stress
        • regard most experiences as controllable
        • display a committed, involved approach to daily activities
        • view change as a challenge
  4. Late Adulthood : physical development
    • Physical Development in late Adulthood
      • Life expectancy
        • “average life expectancy” is the number of years a person born in a particular year can expect to live
        • “average life expectancy” can also be defined as the age at which half of the people born in a particular year will have died
          • in 2008 the average life expectancy in the U.S. reach 78.1
          • declines in infant death rates have historically been a major contributor to increases in average life expectancy
          • advances in medical care also boosted average life expectancy over the 20th century
          • women tend to live 4 to 7 years longer than men, although this difference is decreased in industrialized nations
          • life expectancy varies with SES, ethnicity, and nationality BUT:
          • life expectancy in late adulthood shows decreased differences between males and females, and among ethnic and SES groups; possibly reflecting attrition of less healthy individuals
        • chronological age is an imperfect indicator of “functional age”: the actual competence and performance of the older adult
          • “Average healthy life expectancy” refers to the number of years a person born in a particular year can expect to live in full health, without disease or injury
            • Japan currently ranks first in average healthy life expectancy, in part due to low rates of obesity and heart disease, and favorable health care policies
            • in developing nations with widespread poverty, disease, and armed conflict; average life expectancy is about 50 years
      • Factors in a long life:
        • Heredity
        • Environment/Lifestyle
          • freedom from exposure to acquired diseases, toxins, pollutants
          • healthy diet, normal weight
          • exercise
          • low substance use
          • optimism
          • low stress
          • social support
          • community involvement
          • life long learning
      • Quality of life
        • “activities of daily living” (ADL’s) refer to basic self-care tasks needed to live independently (bathing, dressing, managing medications, keeping appointments, transportation). Some discussions consider ADL’s in two classes: basic self-care and “instrumental activities of daily living” (paying bills); but many discussions tend to consider ADL’s as a whole.
        • ADL’s may be much more situational they we commonly realize: why microwave ovens are the greatest invention of all time
        • the “Third Age” refers to a current view that old age is a time of potential growth rather than decline; sometimes characterized as the “good news” about aging
          • increased life expectancy
          • substantial potential for physical and cognitive fitness
          • evidence of cognitive and emotional reserves
          • high levels of emotional and personal well-being
          • effective strategies to master the gains and losses of later life
        • the “Fourth Age” refers to the “oldest old” who are at the limits of their functional capacity; sometimes referred to as the “bad news” about aging
          • sizeable losses in cognitive potential and ability to learn
          • increases in negative effects of chronic stress
          • high prevalence of dementia, frailty, multiple chronic conditions
          • problems with quality of life and dying with dignity
        • “Maximum lifespan”: the genetic/biological limit to the life of a person (excluding external risk factors)
          • for most of us it appears to be between 70 and 110, with 85 being a commonly cited average
          • approximately 120 years of life appears to be the upper limit on human life span, although this continues to be a point of debate among scientists
    • Physical Changes
      • Nervous system
        • the aging of the central nervous system affects a wide range of complex activities in the older individual
        • brain weight declines throughout adulthood, but the loss becomes greater beginning in the 60’s due to death of neurons and enlargement of ventricles within the brain
          • structural changes in the neuron that reduce the effectiveness of information transmission and processing by neurons
            • neurofibillary tangles — spiral-shaped masses formed when fibers that compose the axon become twisted together
            • neurotic plaques — structural changes produced when damaged and dying neurons collect around a core of protein
            • dendritic changes — reduction of dendritic branching
          • decline in neurotransmitters
            • Parkinson’s disease is caused by insufficient levels of dopamine, often treated with L-Dopa
        • growth of neural fibers in healthy older adults occur at similar rates as in middle-aged adults
        • elders who do well on complex cognitive activities (memory, problem solving) tend to show more widely distributed neural activity across the cerebral cortex–this is usually interpreted as their compensating for neuron loss by recruiting additional brain areas to support cognition
        • the autonomic (peripheral) nervous system, involved in many life support functions, also performs less well with age–putting the elderly at risk during heat waves and cold spells
      • Sensory systems
        • vision:
          • several changes lead to increasing problems with vision
            • lens become more yellow, causing poorer color discrimination in the green-blue-violet end of color spectrum
            • presbyopia: difficulty seeing close objects clearly
            • cataracts, opaque spots, develop on lenses of eyes
          • diseases and abnormal process may also damage vision
            • if fluid in the eye does not drain properly, glaucoma may result, glaucoma (untreated) can lead to blindness
            • diabetes can cause abnormal aging of arteries, with blindness being one of the serious side effects
        • hearing: presbycusis, reduced sensitivity to high frequency sounds
        • olfactory: sense of smell remains largely intact until after age 70, when declines are often seen
        • decreased vestibular sensitivity (and decreased muscle strength and response times) make older individuals increasing likely to fall
          • falls (and decreased bone density) lead to broken bones (often hips) lead to placement in rehabilitation facilities lead to (sometimes) loss of functional skills and ADL’s lead to (worse case) loss of home placement lead to (worse case) premature deterioration and (sometimes) death
          • balance enhancing activities (T’ai Chi) lead to fewer falls, & weight bearing exercise lead to preserved bone density; lead fewer falls, fewer breaks, fewer nursing home placements, etc.
      • Cardiovascular and respiratory systems
        • aging in the cardiovascular and respiratory systems (in the absence of disease) tends not to be markedly apparent until late adulthood
        • decreased blood flow limits the oxygen delivery to body tissues during high physical activity
      • Immune system
        • as the immune system ages, T cells, which attack antigens directly, become less effective
        • immune system malfunctions become more frequent, “autoimmune responses” or “autoimmune diseases” reflect the immune system attacking normal body tissue
        • decrease immune system efficiency increases the risk for a variety of diseases in the elderly
      • Sleep
        • older adults appear to require approximately the same amount of sleep as younger adults, around 7 hours a night
        • increased difficulty with falling asleep, staying asleep, and sleeping deeply is reported in the elderly and seen in sleep lab studies
        • these problems may reflect changes in the brain systems controlling sleep, and by higher levels of stress hormones in the bloodstream
        • restful sleep can be enhanced by “good sleep habits”: consistent bedtime and waking time, using the bedroom only for sleep and sex, regular exercise
        • prescription sedatives (sleep medications) can help relieve temporary insomnia but long-term use is often problematic
  5. Consequences, Compensations, and Responses
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