Psychology: Lifespan Development - Middle Adulthood | Chapter 8

But do U.S. workers take their time off?

- 55% did not take all of their paid vacation and holiday leave - A large percentage of this leave is lost - Reasons given for not taking time off: • worry that there would be a mountain of work to return to (40%) • concern that no one else could do the job (35%) • not being able to afford a vacation (33%) • feeling it was harder to take time away when you have or are moving up in the company (33%) • not wanting to seem replaceable (22%). - More American workers are willing to work for free rather than take the time that is allowed to them - Most (80%) would be willing if they had support from their boss to do so

Sleep problems:

- 9% of Americans report being diagnosed with a sleep disorder - 71% have sleep apnea and 24% suffer from insomnia - Pain is a contributing factor - An average of 42 minutes of sleep debt occur for those with chronic pain, and 14 minutes for those who have suffered from acute pain in the past week - Stress and overall poor health are also key components - Those with lower life satisfaction experience a greater delay in the onset of sleep - Can be the result of worry and anxiety - Menopause can affect a woman's sleep duration and quality

Caregiving and Stress:

- A disabled child, spouse, parent, or other family member that is part of the lives of some midlife adults - The typical caregiver is a 49 year-old female caring for a 69 year-old female - The typical caregiver for those 18-49 years of age is a female (61%) caring mostly for her own child (32%) followed by a spouse or partner (17%) - When looking at older recipients (50+) who receive care, the typical caregiver is female (60%) caring for a parent (47%) or spouse (10%) - Places enormous stress on the caregiver - Associated with poorer global health and more physical symptoms - Marital relationships factor how the caring affects stress and chronic conditions - Fathers who were caregivers identified more chronic health conditions - Caregiving mothers reported higher levels of chronic conditions when they reported a high level of marital strain - Age is important for handling stress difference - Older parents are less likely to experience the negative effects of having a disabled child - An age-related weakening of the stress occurred over time - 25% of adult children provide personal or financial care to a parent - Daughters provide basic care and sons provide financial assistance - Adult children 50+ who work and provide care to a parent are more likely to have fair or poor health when compared to those who do not provide care - Some adult children choose to leave the work force - The cost of leaving the work force early to care for a parent is high

Midlife Crisis?

- Adults go through stages and have an image of the future that motivates them - This image is called "the dream" - A dream of how their career paths would progress and where they would be at midlife - Time of reevaluating previous commitments; Making dramatic changes if necessary; Giving expression to previously ignored talents or aspirations - Feeling more of a sense of urgency about life and its meaning - By middle adulthood (45-50), they believed they were committed to the new choices made and placed their energies into these commitments - Normal part of development - The person is aware of how much time has gone by and how much time is left - They feel impatient and are no longer willing to postpone the things they had always wanted to do. - Midlife crisis is a rare occurrence - Most people do not experience a midlife crisis - The crisis tended to occur among the highly educated and is triggered by a major life event rather than out of fear of aging

Sleep

- Adults require at least 7 hours of sleep per night to avoid health risk - Less than 6 hours and more than 10 hours is not recommended for those in middle adulthood - Many adults do not receive the 7-9 hours of sleep recommended

The impact of exercise:

- Adults should avoid being inactive. - Activity will result in health benefits - For substantial health benefits: • At least 150 minutes per week of moderate-intensity exercise • OR at least 75 minutes of vigorous-intensity aerobic activity - Aerobic activity should occur for at least 10 minutes throughout the week. - For more extensive health benefit • Increased aerobic activity to 300 minutes per week of moderate-intensity • OR, 150 minutes per week of vigorous-intensity aerobic activity - Adults should also participate in muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on two or more days per week.

Excess Fat:

- Adults should consume less than 10% of calories per day from saturated fats - Aim for a dietary pattern that achieves 5% to 6% of calories from saturated fat - In the average American diet about 34.3% of the diet comes from fat, with 15.0% from saturated fat - Diets high in fat contribute to... • Weight gain • Heart disease • Stroke • High cholesterol

Excess Sodium:

- Adults should consume less than 2,300mg (1 teaspoon) per day of sodium - The average sodium intake among Americans is 3440mg per day - Processed foods are the main culprits of excess sodium - High sodium levels in the diet are correlated with increased blood pressure - Adults with high blood pressure are strongly encouraged to reduce their sodium intake to 1500mg

Nutritional concerns:

- Aging brings about a reduction in the number of calories a person requires - Many Americans respond to weight gain by dieting. - This may not always work - All adults need to be cognizant of the amount of sodium, sugar, and fat they are ingesting.

Stress Management:

- Americans aged 39-52 rated their stress at 5.3 - Those age 53-71 rated their stress at 3.9 - Common sources of stress: • The future of our nation • Money • Work • Current political climate • Violence and crime - The sources of our stress are often difficult to change - Interventions designed to reduce stress: • Relaxation activities • Forms of meditation • Breathing exercises • Muscle relaxation • Mental imagery. • Biofeedback • Exercise

Symptoms:

- Caused by the decreased production of estrogen and progesterone - Shifting hormones contribute to the inability to fall asleep - The declining levels of estrogen may make a woman more susceptible to environmental factors and stressors which disrupt sleep. - Hot flashes can be disruptive to sleep and comfort levels - Vaginal lubrication diminishes and becomes waterier, contributing to pain during intercourse. - The vaginal wall also becomes thinner, and less elastic. - Osteoporosis (decreased bone mass) - Depression, irritability, and weight gain are often associated with menopause, but they are not menopausal - Weight gain - Depression and mood swings are common among women who have prior histories of these conditions - Women vary greatly in how these symptoms are experienced - Most go through menopause with few problems

Concluding Thoughts:

- Changes that occur in midlife can be easily compensated for, such as buying glasses, exercising, and watching what one eats. - Exercise is Very Important in Middle Age - The prevalence of diabetes has increased by 55% and the prevalence of obesity has increased by 25% - Lifestyle has a strong impact on the health status of midlife adults - It is important for midlife adults to take preventative measures to enhance physical well-being - Midlife adults who have a strong sense of mastery and control over their lives are most likely to enjoy a plateau of good health through these years

Automatic:

- Complex thoughts and actions become more routine for experts. - Their reactions appear instinctive over time, and this is because expertise allows us to process information faster and more effectively

Cultural Differences:

- Cultural influences play a role in the way menopause is experienced - Prevalence of language specific to menopause is an important indicator of the occurrence of menopausal symptoms in a culture - Example: Hmong tribal women living in Australia and Mayan women report that there is no word for "hot flashes" and both groups did not experience these symptoms. When asked about physical changes during menopause, the Hmong women reported lighter or no periods. - Example: A study with First Nation women in Canada found there was no single word for "menopause" in the Oji-Cree or Ojibway languages, with women referring to menopause only as "that time when periods stop" - While some women focus on menopause as a loss of youth, womanhood, and physical attractiveness, career-oriented women tend to think of menopause as a liberating experience. - Japanese women perceive menopause as a transition from motherhood to a more whole person, and they no longer feel obligated to fulfill certain expected social roles, such as the duty to be a mother - In India, women welcome menopause. - Aging women gain status and prestige and no longer have to go through self-imposed menstrual restrictions, which may contribute to Indian women's experiences - Overall, menopause signifies many different things to women around the world and there is no typical experience.

Added Sugar:

- Eating healthy means adults should consume less than 10% of calories per day from added sugars - 15% of the calories in the American adult diet come from added sugars (22 teaspoons of sugar per day) - Excess sugar contributes to weight gain, diabetes, and other health problems.

Challenges in the Workplace for Middle-aged Adults:

- Economic downturns - 55% of adults reported some problems in the workplace: • Fewer hours • Pay-cuts • Having to switch to part-time, etc. - Overall financial resources suffer - Retirement nest eggs disappeared and house values shrank, while foreclosures increased - Those who find themselves unemployed are likely to remain unemployed longer - Those who are able to keep up with all the technological changes or are willing to uproot and move around the country or even the world have a better chance of finding work - The decision to move may be easier for people who are younger and have fewer obligations to others.

Male Sexual and Reproductive Health:

- Erectile dysfunction (ED) refers to the inability to achieve an erection or an inconsistent ability to achieve an erection - Affects 50% of men between the ages of 40 and 70 - 4% of men in their 40s - 17% of men in their 60s, - 47% of men older than 75 e - Causes for ED: • medical conditions • diabetes • kidney disease • alcoholism • atherosclerosis (build-up of plaque in the arteries) (accounts for 70%) • psychological factors (stress, depression, and anxiety) (account for 10% - 20%) - Many of these causes are treatable, and ED is not an inevitable result of aging. - Men during middle adulthood may also experience prostate enlargement - This can interfere with urination and deficient testosterone levels - If testosterone levels decline significantly, it is referred to as andropause or late-onset hypogonadism.

Hormone Replacement Therapy:

- Estrogen replacement and hormone replacement therapies have been prescribed for menopausal women - Associated with breast cancer, stroke, and the development of blood clots - Women who do this can be treated with lower doses of estrogen and monitored with more frequent breast and pelvic exams - Ways to reduce symptoms: • Avoid caffeine and alcohol • Eat soy • Remain sexually active • Practice relaxation techniques • Use water-based lubricants during intercourse

Exercise, Nutrition, and Weight

- Exercise is a powerful way to combat the changes associated with aging - It builds muscle, increases metabolism, helps control blood sugar, increases bone density, and relieves stress. - The best exercise programs are those that are engaged regularly - A well-rounded program that is easy to follow includes walking and weight training. - Exercise is particularly helpful in reducing stress in midlife. - Walking, jogging, cycling, or swimming can release the tension caused by stressors. - Learning relaxation techniques can also have healthful benefits.

Strategic:

- Experts have more effective strategies than non-experts. - Example: While both skilled and novice doctors generate several hypotheses within minutes of an encounter with a patient, the more skilled clinicians' conclusions are likely to be more accurate. - In other words, they generate better hypotheses than the novice. - They are able to discount misleading symptoms and other distractors and hone in on the most likely problem the patient is experiencing - Example: Consider how your note taking skills may have changed after being in school over a number of years. Chances are you do not write down everything the instructor says, but the more central ideas. You may have even come up with your own short forms for commonly mentioned words in a course, allowing you to take down notes faster and more efficiently than someone who may be a novice academic note taker.

Flexible:

- Experts in all fields are more curious and creative - They enjoy a challenge and experiment with new ideas or procedures. - The only way for experts to grow in their knowledge is to take on more challenging, rather than routine tasks

Children in the home and sleep:

- Having children at home affects the amount of sleep one receives - It decreases the amount of sleep an individual receives - Having a partner can improve the amount of sleep for both males and females - The percentage of individuals not receiving seven hours of sleep per night based on the parental role

Hearing:

- Hearing problems increase during middle adulthood - Doubles between the ages of 40 and 55 - Triples by age 64 - More problems understanding speech in noisy environments - Lesser ability to hear higher frequencies - More common among men than women - Accumulates after years of intense noise levels - Men are more likely to work in noisy occupations - Exacerbated by cigarette smoking, high blood pressure, diabetes, and stroke - Prevented by guarding against being exposed to extremely noisy environments

The benefits of taking time away from work:

- It reduces job stress burnout - Improves both mental health and physical health - Can improve productivity and job satisfaction - Helps adults deal with balancing family and work obligations

Climate in the Workplace for Middle-aged Adults:

- Job satisfaction peaks - Higher wages, greater involvement in decisions that affect the workplace - Influenced by being able to do the job effectively and productively - In midlife, many adults lower their expectations and goals. They have reached the highest they are likely to in their career - This translates into lower absenteeism, greater productivity, and less job hopping in comparison to younger adults - However, not all middle-aged adults are happy in the workplace. - Women find themselves up against the glass ceiling - Females are twice as likely to quit their jobs - Another problem older workers may encounter is job burnout.

The Climacteric and Sexuality

- Many older adults are interested in staying sexually active - 74% of males and 70% of females aged 40-49 engage in vaginal intercourse - 58% of males and 51% of females aged 50-59 did so - Middle-age-related physical changes can affect sexual functioning - For women, decreased sexual desire and pain during vaginal intercourse because of menopausal changes - Less vaginal lubrication during arousal can affect the overall pleasure - Men may require more direct stimulation for an erection and the erection may be delayed or less firm - Men may experience erectile dysfunction or experience medical conditions (such as diabetes or heart disease) that impact sexual functioning - Couples continue to enjoy physical intimacy and may engage in more foreplay, oral sex, and other forms of sexual expression rather than focusing as much on sexual intercourse. - The risk of pregnancy continues until a woman has been without menstruation for at least 12 months - However, couples should continue to use contraception. - People continue to be at risk of contracting sexually transmitted infections

Metabolism and Weight Gain:

- Men tend to gain fat on their upper abdomen and back - Women tend to gain more fat on their waist and upper arms - Many adults are surprised at this weight gain because their diets have not changed, however, their metabolism has slowed during midlife.

Seattle Longitudinal Study:

- Middle-aged adults perform better on four out of six cognitive tasks - Verbal memory, spatial skills, inductive reasoning (generalizing from particular examples), and vocabulary increase with age until one's 70s - However, numerical computation and perceptual speed decline in middle and late adulthood

Dispositions and Stress:

- Negative dispositions and personality traits are tied to an array of health risks - Common behavioral and psychological patterns among heart patients included being competitive, impatient, hostile, and time urgent - They labeled it Type A Behavior and Type B Behavior

Intuitive:

- Novices follow particular steps and rules when problem-solving - Experts can call upon a vast amount of knowledge and past experience. As a result, their actions appear more intuitive than formulaic. - Example: Novice cooks may slavishly follow the recipe step by step, while chefs may glance at recipes for ideas and then follow their own procedure.

Heart Disease:

- Number one cause of death for Americans (23%) - Number one cause of death worldwide - Heart disease develops slowly over time and typically appears in midlife - Heart disease includes: • Heart defects and heart rhythm problems • Narrowed, blocked, or stiffened blood vessels (cardiovascular disease) - Complications of heart disease: • Heart failure (cannot pump enough blood to meet the body's needs) • Heart attack (blood clot blocks blood flow to the heart) - Treatment for heart disease: • Medication • Surgery • Lifestyle changes (exercise, healthy diet, and refraining from smoking). - Cardiac arrest is the unexpected loss of heart functioning, breathing, and consciousness, often caused by arrhythmia or abnormal heartbeat

Obesity:

- Obesity rates continue to increase - The current rate for those 40-59 is 42.8%, - Being overweight is associated with • diabetes • High blood pressure • Heart disease - Obesity is linked to Alzheimer's disease. - People with the highest body mass index (BMI) at age 50 are more likely to develop Alzheimer's disease. - Those with the highest BMIs have more brain changes - Fat cells may produce harmful chemicals that promote inflammation in blood vessels throughout the body, including in the brain

Negative consequences of insufficient sleep:

- Physical, cognitive, and emotional changes. - Sleep deprivation suppresses immune responses, and can lead to obesity, memory impairment, and hypertension - Increased risk for colon cancer, breast cancer, heart disease, and type 2 diabetes - Increases stress - Longevity - (Older adults who had better sleep patterns also lived longer) - Less growth hormone being released and subsequent physical decline seen in aging - Can impair glucose functioning - By disrupting circadian timing, bedtime variability may impair glucose metabolism and energy homeostasis. - Body mass index (BMI) and insulin resistance were measured at two-time points.

Skin:

- Skin dries and loses the underlying layer of fat, so it becomes wrinkly - Loss of muscle tone and thinning skin can make the face appear flabby or drooping - Wrinkles are a natural part of aging and genetics play a role - Frequent sun exposure and smoking will cause wrinkles to appear sooner - Dark spots and blotchy skin also occur as one ages and are due to exposure to sunlight - Blood vessels become more apparent as the skin continues to dry and get thinner

Social Relationships and Stress:

- Social isolation increases our risk for disease and death - Our body has a physiological system that encourages us to seek out our relationships, especially in times of stress - Social integration is the number of social roles that you have - Maintaining different roles can improve your health via encouragement from those around you to maintain a healthy lifestyle - Your social network provides you with social support (e.g., when you are under stress) - This support might include emotional help (e.g., a hug when you need it), tangible help (e.g., lending you money), or advice. - Social relationships can have a powerful, protective impact on health, and in some cases, might even help people with serious illnesses stay alive longer

Menopause and Ethnicity:

- Symptoms vary greatly across countries, geographic regions, and ethnic groups within the same region - White women are more likely to disclose symptoms of depression, irritability, forgetfulness, and headaches (mental health) - African-American women experienced more night sweats (physical symptoms) - Chinese-American and Japanese-American reported fewer menopausal symptom

Brain Functioning

- The brain has gained new abilities. - Improved cognitive functioning - The brain continues to demonstrate plasticity and rewires itself in middle age based on experiences - Older adults use more of their brains than younger adults - White matter in the brain increases into the 50s - Emotionally less neurotic, more capable of managing emotions, and better able to negotiate social situations - Focused on more positive information and less on negative information than those younger - The amygdala responds less to negative stimuli. - They make better financial decisions and show better economic understanding - Cognitive improvements tend to be more physically, cognitively, and socially active.

Who is the U.S. workforce?

- The civilian, non-institutionalized workforce; the population of those aged 16 and older - The U.S. population is expected to grow slowly for the next few years - Adults aged 16 to 24 will shrink in size by nearly half a percent - Those aged 55 and up will grow by 2.3% over current rates - Those aged 65 to 74 will grow by nearly 4% - Steady declines in work participation as the baby boomer population cohort ages out of the workforce. - 53% of the workforce is male - The rate of participation in the labor force has declined - The exception is among the older middle-age groups (the baby boomers), and especially for women 55 and older - Hispanic males have the highest rate of participation in the labor force - Black women were more likely to be participating in the workforce - The rates for all racial and ethnic groups are expected to decline

Middle Adults Returning to Education

- The rate of enrollment for older Americans is rising fast - Developing skills and expertise in order to launch a second career or to take their career in a new direction. - Whether they enroll in school to sharpen particular skills, to retool and reenter the workplace, or to pursue interests that have previously been neglected - Older students tend to approach the learning process differently - The mechanics of cognition gradually decline with age. - Can be compensated for higher-order cognitive skills (forming strategies to enhance memory or summarizing and comparing ideas) - May take longer to learn the material - Less likely to forget - Tend to look for relevance and meaning when learning information - "Why is this important?" - More task-oriented learners and want to organize their activity around problem-solving - More independent, inquisitive, and motivated intrinsically - They processed information at a deeper learning level and expressed more satisfaction with their education.

Lungs:

- Thinning of the bones can change the shape of the rib cage and result in a loss of lung expansion - Age-related changes in muscles can reduce lung capacity - Both of these changes lower oxygen levels in the blood and increase the levels of carbon dioxide - Experiencing shortness of breath and feeling tired can result - In middle adulthood, these changes and their effects are often minimal, especially in people who are non-smokers and physically active. - More pronounced in those with • Lung-related disorders (chronic bronchitis, frequent pneumonia, asthma) • Smokers

Hair:

- With aging, the hair follicles produce less melanin (pigment), causing the hair to become gray - Graying begins in the 30s - Largely determined by genes - Occurs earlier in white people and later in Asians - Genes also determine how much hair remains on your head - Everyone has some hair loss with aging - The rate of hair growth slows with aging - Many hair follicles stop producing new hairs and hair strands become smaller - Men show signs of balding by 30 - Men are nearly bald by 60 - Male-pattern baldness is related to testosterone - It is identified by a receding hairline followed by hair loss at the top of the head - Women can also develop female patterned baldness as their hair becomes less dense and the scalp becomes visible

Atherosclerosis

A buildup of fatty plaque in the arteries NOTE: - Most common cause of cardiovascular disease - The plaque buildup thickens the artery walls and restricts the blood flow to organs and tissues - Cardiovascular disease can lead to a heart attack, chest pain (angina), or stroke - Symptoms of cardiovascular disease differ for men and women - Males: • Chest pain - Females: • Shortness of breath • Nausea • Extreme fatigue - Other Symptoms: • Pain in the arms, legs, neck, jaw, throat, abdomen, or back - Risk Factors: Medical conditions (high blood pressure, high cholesterol, diabetes, and obesity)

Secondary Aging

Aging occurs due to controllable factors, such as an unhealthy lifestyle including lack of physical exercise, and poor diet.

Primary Aging

Biological factors, such as molecular and cellular changes, and oxidative damage.

Spousal Care:

Four Health-related outcomes for disabled spouses: 1. Spouses with no caregiving needed (Group 1) 2. living with a disabled spouse but not providing care (Group 2) 3. living with a disabled spouse and providing care (Group 3) 4. Helping a disabled spouse while reporting caregiver strain, including elevated levels of emotional and physical stress (Group 4) NOTE: - Group 4 are the least healthy and identified poorer perceived health, an increase in health-risk behaviors, and an increase in anxiety and depression symptoms. - Group 3 identified decreased levels of anxiety and depression compared to Group 2 and were actually similar to those in Group 1. - Greater caregiving is related to better mental health - Gender differences have also been identified - Example: Female caregivers of a spouse with dementia experienced more burden, had poorer mental and physical health, exhibited increased depressive symptomatology, took part in fewer health-promoting activities, and received fewer hours of help than male caregivers - Women experience more caregiving burden than men - There is an expectation that women should assume caregiving roles - Contributing to women's poorer caregiving outcomes is that disabled males are more (physically and sexually) aggressive than females - Female caregivers are at risk for negative consequences of caregiving

Presbyopia ("old vision")

It refers to a loss of elasticity in the lens of the eye that makes it harder for the eye to focus on objects that are closer to the person. NOTE: - When we look at something far away, the lens flattens out; when looking at nearby objects tiny muscle fibers around the lens enable the eye to bend the lens. - With age these muscles weaken and can no longer accommodate the lens to focus the light. - Age of Risk: 35

Floaters

Little spots or "cobwebs" that float around the field of vision. NOTE: - Floaters occur when the vitreous, a gel-like substance in the interior of the eye, slowly shrinks. - As it shrinks, it becomes somewhat stringy, and these strands can cast tiny shadows on the retina. - Floaters are harmless - Floaters that appear suddenly, or that darken and obscure vision can be a sign of more serious eye problems (retinal tearing, infection, or inflammation) - Risk Factors: • Nearsighted (myopic) • Diabetes • Cataract surgery

Dry Eye Syndrome

Occurs when the eye does not produce tears properly, or when the tears evaporate too quickly because they are not the correct consistency. NOTE: - Common over the age of 50 - It affects women more than men - Women who experienced early menopause may be more likely to experience dry eye

Scotopic Sensitivity

The ability to see in dimmer light NOTE: - By age 60, the retina receives 1/3 as much light as it once did - Night vision is affected as the pupil loses its ability to open and close to accommodate changes in light - Eyes become more sensitive to glare from headlights and street lights

Sarcopenia:

The loss of muscle mass and strength that occurs with aging NOTE: - Factor in the frailty and functional impairment - Caused by the decline of growth and anabolic hormones and decreased physical activity - Occurs 40 years of age - Contributes to a decrease in life quality, increase in health care costs, and early death in older adults - Exercise is important to increase strength, aerobic capacity, and muscle protein synthesis, but it does not reverse all the age-related changes that occur

Diastolic Pressure

The pressure in the blood vessels when the heart is at rest

Type B Behavior

This pattern included being calmer, more patient, and less hurried than Type A individuals. NOTE: - Absence of Type A behaviors

Type A Behavior

This pattern included being competitive, impatient, hostile, and time urgent. NOTE: - Hostility and competitiveness are especially harmful to heart health - Hostile individuals are quick to get upset - This angry arousal can damage the arteries of the heart. - Given their negative personality style, hostile people often lack a heath-protective supportive social network

Andropause (or late-onset hypogonadism)

When testosterone levels decline significantly NOTE: - not a concern unless it is accompanied by negative symptoms such as low sex drive, ED, fatigue, loss of muscle, loss of body hair, or breast enlargement. - Associated with diabetes, obesity, high blood pressure, and testicular cancer - The effectiveness of supplemental testosterone is mixed, and long-term testosterone replacement therapy for men can increase the risk of prostate cancer, blood clots, heart attack, and stroke

Metabolic Syndrome

a cluster of several cardiometabolic risk factors, including large waist circumference, high blood pressure, and elevated triglycerides, LDL, and blood glucose levels, which can lead to diabetes and heart disease. NOTE: - The prevalence rate is approximately 34% - It is especially high among Hispanics and African Americans - Prevalence increases with age, peaking in one's 60s - It increases morbidity from cardiovascular disease and diabetes - Having one or two of the risk factors for metabolic syndrome increased the risk of mortality - Increasing aerobic activity and reducing weight led to a drop in many of the risk factors of metabolic syndrome

Diabetes (Diabetes Mellitus)

a disease in which the body does not control the amount of glucose in the blood. NOTE: - Occurs when the body does not make enough insulin or does not use it the way it should - Insulin is a type of hormone that helps glucose in the blood enter cells to give them energy - 90% to 95% of all diagnosed cases of diabetes are type 2 - As the need for insulin increases, cells in the pancreas gradually lose the ability to produce enough insulin. - In some type 2 diabetics, pancreatic beta cells will cease functioning, and the need for insulin injections will become necessary. - Diabetics will vary in the experience of insulin resistance (some with minor dysfunction of the beta-cell secretion of insulin; others with the lack of insulin secretion) - 1-in-3 adults have prediabetes - Diabetes is common in adults aged 18 and up - The median age of diagnosis is 54 - Men are more likely to experience diabetes than women - Diabetes affects ethnic and racial groups differently (Non-Hispanics → Asian Americans → Hispanics → non-Hispanic Blacks → American Indians/Alaskan Natives) - Educational attainment is correlated with diabetes - Percentages Include: Less than a high school degree (21.6%), high school degree (9.5%), and more than a high school degree (7.2%) - Health complications: • Cardiovascular disease • Heart attack • Stroke • Blindness • Other eye problems • Diabetic retinopathy • Kidney failure • Non-traumatic limb amputations • Hearing loss • Tinnitus • Gum disease • Neuropathy

Insulin Resistance

a disorder in which the cells in the muscles, liver, and fat tissue do not use insulin properly. NOTE: - Type 2 diabetes begins with this

Stress

a pattern of physical and psychological responses in an organism after it perceives a threatening event that disturbs its homeostasis and taxes its abilities to cope with the event NOTE: - Plays a major role in mental and physical health - Major life stressors (e.g., a family death, a natural disaster) increase the likelihood of getting sick - Stress can result from negative events, chronically difficult situations, a biological fight-or-flight response, and clinical illness, such as post-traumatic stress disorder (PTSD) - Even small daily hassles, like getting stuck in traffic or fighting with your friend, can raise your blood pressure, alter your stress hormones, and even suppress your immune system function - Stress causes potentially damaging wear and tear on the body - Can influence almost any disease process

Stressor

a stimulus that had this effect on the body (that is, causing stress).

Hot flash

a surge of adrenaline NOTE: -Can awaken the brain from sleep - Often produces sweat and a change of temperature that can be disruptive to sleep and comfort levels - It may take time for the adrenaline to recede and allow sleep to occur again

Biofeedback

a technique where the individual is shown bodily information that is not normally available to them (e.g., heart rate), and then taught strategies to alter this signal. NOTE: - Reduces heart and hypertension risk, as well as other serious conditions

General Adaptation Syndrome (GAS)

a three-phase model of stress, which includes a mobilization of physiological resources phase, a coping phase, and an exhaustion phase (i.e., when an organism fails to cope with the stress adequately and depletes its resources).

Cholesterol

a waxy fatty substance carried by lipoprotein molecules in the blood. NOTE: - Creates hormones and digests fatty foods -Found in many foods - Too much can cause heart disease and stroke - Two important kinds of cholesterol: 1. low-density lipoprotein (LDL) 2. high-density lipoprotein (HDL) - A third type of fat is called triglycerides. - Your total cholesterol score is based on all three types of lipids - Total cholesterol: HDL + LDL + 20% of the Triglycerides - LDL cholesterol ("bad" cholesterol): • Makes up the majority of the body's cholesterol • High levels can form plaque in the arteries leading to heart attack and stroke. - HDL cholesterol ("good" cholesterol): • Absorbs cholesterol and carries it back to the liver, where it is then flushed from the body. • Higher levels can reduce the risk of heart attack and stroke. - Triglycerides • A type of fat in the blood used for energy. • High levels can increase your risk for heart disease and stroke when coupled with high LDL and low HDL. - Risk factors for high cholesterol: A family history of high cholesterol, diabetes, a diet high in saturated fats, trans fat, and cholesterol, physical inactivity, and obesity. - Almost 32% of American adults have high LDL cholesterol levels

Rheumatoid arthritis (RA)

an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. NOTE: - Occurs when the immune system attacks the membrane lining the joints - Second most common form of arthritis - It is symmetric in its attack - Thus, if one shoulder is affected so is the other shoulder - Those with RA may experience fatigue and fever - Begins in middle adulthood and occurs with increased frequency in older people - Occurs much more frequently in women than in men - 2 to 3 times as many women as men have the disease - The lifetime risk for RA for women is 3.6% and 1.7% for men - Genes play a role in the development, but something must occur to trigger the disease process (such as deficiencies or changes in certain hormones) - Can affect virtually every area of a person's life, and it can interfere with the joys and responsibilities of work and family life. - Treatment strategies • Pain-relieving drugs and medications (slows joint damage) • Balance between rest and exercise (lessen the symptoms of RA)

Plus 50 Initiative

assists community college in creating or expanding programs that focus on workforce training and new careers for the plus-50 population. NOTE: - Participating colleges offer workforce training programs that prepare 50 plus (50+) adults for careers in such fields as early childhood educators, certified nursing assistants, substance abuse counselors, adult basic education instructors, and human resource specialists - These training programs are beneficial - 80% of people over the age of 50 say they will retire later in life than their parents or continue to work in retirement, including in a new field

Diabetic Retinopathy

damage to the small blood vessels in the retina that may lead to loss of vision

Menopause

defined as 12 months without menstruation. NOTE: - The average age of menopause is approximately 51 - Many women begin experiencing symptoms in their 40s - These symptoms can occur 2 to 8 years before menopause - Periods become more or less frequent than before - After a year without menstruation, a woman is considered menopausal and no longer capable of reproduction.

Gallstones

hard particles, including fatty materials, bile pigments, and calcium deposits, that can develop in the gallbladder. NOTE: - Ranging in size from a grain of sand to a golf ball - Typically take years to develop - Some people have developed over the course of a few months - 75% of gallstones do not create any symptoms, but those that do may cause sporadic upper abdominal pain when stones block bile or pancreatic ducts. - If stones become lodged in the ducts, it may necessitate surgery or other medical intervention - Present in about 20% of women and 10% of men over the age of 55 - Risk factors that increase the cholesterol in the bile and thus increase the risk of developing gallstones: • Family history of gallstones • Diets high in calories and refined carbohydrates (such as white bread and rice) • Diabetes • Metabolic syndrome • Crohn's disease • Obesity

Hypertension (Silent killer)

high blood pressure, is a serious health problem that occurs when the blood flows with a greater force than normal. NOTE: - 1-in-3American adults have hypertension - It can strain the heart, increase the risk of heart attack and stroke, or damage the kidneys - Uncontrolled high blood pressure in early and middle adulthood can also damage the brain's white matter (axons) and may be linked to cognitive problems later in life - Normal blood pressure is under 120/80 - Most people with hypertension experience no symptoms - Treatment: Making positive lifestyle changes reduces blood pressure

Tacit knowledge

knowledge that is pragmatic or practical and learned through experience rather than explicitly taught, and it also increases with age NOTE: -"know-how" or "professional instinct" - Cannot be codified or written down - Does not involve academic knowledge, rather it involves being able to use skills and to problem-solve in practical ways - Can be understood in the workplace and used by blue-collar workers, such as carpenters, chefs, and hairdressers.

Perimenopause

refers to a period of transition in which a woman's ovaries stop releasing eggs and the level of estrogen and progesterone production decreases.

Fatty liver disease (hepatic steatosis)

refers to the accumulation of fat in the liver. NOTE: - The liver contains little fat - Anything below 5% of liver weight is considered normal - Present in 33% of American adults - Due to excessive alcohol consumption, often eventually leading to cirrhosis and liver failure - Increased caloric intake, especially resulting in obesity, and little physical activity are the main causes - Can be reversed through healthy lifestyle changes

Novice

someone who has limited experience with a particular task.

Expertise

specialized skills and knowledge that pertain to a particular topic or activity. NOTE: - Everyone develops some level of "selective" expertise in things that are personally meaningful to them, such as making bread, quilting, computer programming, or diagnosing illness. - Expert thought is often characterized as intuitive, automatic, strategic, and flexible. - Expertise is a long-process resulting from experience and practice - It cannot fully make up for all losses in general cognitive functioning as we age

Crystallized intelligence

the accumulated knowledge of the world we have acquired throughout our live. NOTE: - Increases with age - Older adults have more crystallized intelligence - Reflected in semantic knowledge, vocabulary, and language - Adults generally outperform younger people on measures of history, geography, and even on crossword puzzles - It is this superior knowledge, combined with a slower and more complete processing style, along with a more sophisticated understanding of the workings of the world around them, that gives older adults the advantage of "wisdom" over the advantages of fluid intelligence which favor the young

Fluid intelligence

the capacity to learn new ways of solving problems and performing activities quickly and abstractly NOTE: - Decreases with age - The differential changes in crystallized versus fluid intelligence help explain why older adults do not necessarily show poorer performance on tasks that also require experience (i.e., crystallized intelligence), although they show poorer memory overall. - A young chess player may think more quickly, for instance, but a more experienced chess player has more knowledge to draw on

Social integration

the concept used to describe the number of social roles that you have NOTE: - Example: You might be a daughter, a basketball team member, a Humane Society volunteer, a coworker, and a student. - Maintaining these different roles can improve your health via encouragement from those around you to maintain a healthy lifestyle.

Flow

the mental state of being completely present and fully absorbed in a task NOTE: - The individual is able to block outside distractions and the mind is fully open to producing. - Achieving great joy or intellectual satisfaction from the activity and accomplishing a goal. - Not concerned with extrinsic rewards - People describe flow as the height of enjoyment - The more they experience it, the more they judge their lives to be gratifying

Climacteric

the midlife transition when fertility declines NOTE: - Biologically based but impacted by the environment - Men experience a reduction in their ability to reproduce - Women lose their ability to reproduce once they reach menopause

Cancer:

the name given to a collection of related diseases in which the body's cells begin to divide without stopping and spread into surrounding tissues. NOTE: - Second leading cause of death for Americans (21.3%) - These extra cells can divide, and form growths called tumors (masses of tissue). - Cancerous tumors are malignant - Malignant Tumors • Cancerous • Maligent means they can invade nearby tissues • When removed malignant tumors may grow back. - Benign tumors: • Do not invade nearby tissues. • Can be quite large • When removed usually does not grow back • Not cancerous • Can be life-threatening - Cancer cells can prompt nearby normal cells to form blood vessels allowing them to grow - It can also hide from the immune system - It can metastasize (break from where they first formed and travel through the lymph system or blood to form new tumors in other parts of the body). - It does not have distinct functions and continues to divide without stopping. - It is able to ignore the signal to stop dividing or to begin cell death - Normal cells are crowded out and the body is unable to work the way it is supposed to - Example: The cancer cells in lung cancer form tumors that interfere with the functioning of the lungs and how oxygen is transported to the rest of the body. -More than 100 types of cancer. - Most common type of cancer is breast cancer - Next most common cancers are lung cancer and prostate cancer

Systolic Pressure

the pressure in the blood vessels when the heart beats.

Metabolism

the process by which the body converts food and drink into energy. NOTE: - The calories consumed are combined with oxygen to release the energy needed to function - Calories + Oxygen = Energy to function - More muscle = burn more calories (even at rest, and thus have a higher metabolism). - As you get older, the amount of muscle decreases. - Consequently, fat accounts for more of one's weight in midlife, and fat slows down the number of calories burned. - To compensate, increase levels of exercise, eat less, and watch nutrition to maintain their earlier physique.

Heartburn (Acid indigestion or pyrosis)

the result of stomach acid backing up into the esophagus. NOTE: - Can injure the lining of the esophagus and cause discomfort - Heartburn that occurs more frequently may be due to gastroesophageal reflux disease (GERD) - In GERD the lower sphincter muscle relaxes too frequently and the stomach acid flows into the esophagus - Prolonged problems with heartburn can lead to more serious complications (such as esophageal cancer) - Problems with heartburn can be linked to eating fatty or spicy foods, caffeine, smoking, and eating before bedtime

Leisure

time off from work and duties NOTE: - Most common leisure activity is watching television - 2-3 hours per day watching TV - Watching TV accounts for more than half of all the leisure time - Men spend 5 hours more per week in leisure activities than do women - The leisure gap between mothers and fathers is slightly smaller, about 3 hours a week, than among those without children under the age 18 - Those aged 35-44 spend less time on leisure activities - This age group is more likely to be parents and still working up the ladder of their career - Americans have less leisure time than people in many other developed nations

Burnout

unsuccessfully managed workplace stress Burnout consists of: • Feelings of energy depletion or exhaustion • Increased mental distance from one's job, or feelings of job negativism or cynicism • Reduced professional efficacy NOTE: - American workers experience the most burnout - No law a set number of paid vacation days - Not all employees are covered under overtime pay laws - 47 hours work week - 39% working 50 or more hours per week - Americans work more hours than most European nations

Risk Factors for Developing Heart Disease

• Advanced Age - increased risk for narrowed arteries and weakened or thickened heart muscle. • Sex - males are at greater risk, but a female's risk increases after menopause. • Family History - increased risk, especially if male parent or brother developed heart. disease before age 55 or female parent or sister developed heart disease before age 65. • Smoking - nicotine constricts blood vessels and carbon monoxide damages the inner lining. • Poor Diet - a diet high in fat, salt, sugar, and cholesterol. • Excessive Alcohol Consumption - alcohol can raise the level of bad fats in the blood and increase blood pressure • Stress - unrelieved stress can damage arteries and worsen other risk factors. • Poor Hygiene - establishing good hygiene habits can prevent viral or bacterial infections that can affect the heart. Poor dental care can also contribute to heart disease. NOTE (Other Factors): - Medical conditions (high blood pressure, high cholesterol, diabetes, and obesity)

Risk factors for high blood pressure include:

• Family history of hypertension • Diet that is too high in sodium, often found in processed foods, and too low in potassium • Sedentary lifestyle and Obesity • Too much alcohol consumption • Tobacco use, as nicotine raises blood pressure

Signs that someone has presbyopia:

• Hard time reading small print • Having to hold reading material farther than arm's distance • Problems seeing objects that are close • Headaches • Eyestrain

Features of Rheumatoid Arthritis:

• Tender, warm, swollen joints • Symmetrical pattern of affected joints • Joint inflammation often affects the wrist and finger joints closest to the hand • Joint inflammation affects other joints (neck, shoulders, elbows, hips, knees, ankles, and feet) • Fatigue, occasional fevers, a loss of energy • Pain and stiffness lasting for more than 30 minutes in the morning or after a long rest • Symptoms that last for many years • Variability of symptoms among people with the disease.

Risk Factors for Diabetes

• Those over age 45 • Obesity • Family history of diabetes • History of gestational diabetes (see Chapter 2) • Race and ethnicity • Physical inactivity • Diet.