Guidepost 1: What are the distinguishing features of middle age?

• The concept of middle age is socially constructed. It came into use as an increasing life span led to new roles at midlife.
• Middle adulthood is a time of both gains and losses.
• The span of middle adulthood can be defined chronologically, contextually, or biologically.
• Most middle-aged people are in good physical, cognitive, and emotional condition. They have heavy responsibilities and multiple roles and feel competent to handle them.
• Middle age is a time for taking stock and making decisions about the remaining years.

PHYSICAL DEVELOPMENT

Guidepost 2: What physical changes generally occur during the middle years, and what is their psychological impact?

• Although some physiological changes result from aging and genetic makeup, behavior and lifestyle can affect their timing and extent.
• Most middle-aged adults compensate well for gradual, minor declines in sensory and psychomotor abilities, including such age-related conditions as presbyopia and presbycusis, increases in myopia, and loss of endurance due to slowing of basal metabolism. Losses in bone density and vital capacity are common.
• Menopause occurs, on average, at about age 51, following the physiological changes of perimenopause. Attitudes toward menopause, and symptoms experienced, may depend on personal characteristics, past experiences, and cultural attitudes.
• Although men can continue to father children until late in life, many middle-aged men experience a decline in fertility and in frequency of orgasm.
• Sexual activity generally diminishes only slightly and gradually, and the quality of sexual relations may improve.
• Among women, sexual dysfunction decreases with age; in men, it is just the opposite. A large proportion of middle-aged men experience erectile dysfunction. Sexual dysfunction can have physical causes but also may be related to health, lifestyle, and emotional well-being.
• The "double standard of aging" causes women to seem less desirable as they lose their youthful appearance. For both men and women, anxiety about getting older is heightened in a society that places a premium on youth.

Guidepost 3: What factors affect health at midlife?

• Most middle-aged people are healthy and have no functional limitations.
• Diet, exercise, alcohol use, and smoking affect present and future health. Preventive care is important.
• Hypertension is a major health problem beginning in midlife. AIDS tends to be more severe in older people because of weakened immune functioning.
• Leading causes of death in middle age are cancer, heart disease, liver disease, and stroke. Diabetes also is a major cause of death.
• Low income is associated with poorer health, in part because of lack of insurance.
• African Americans' elevated health risks may be due to a combination of hereditary factors, lifestyle factors, poverty, and stress caused by discrimination.
• Postmenopausal women become more susceptible to heart disease and bone loss leading to osteoporosis. Chances of developing breast cancer also increase with age, and routine mammography is recommended for beginning at age 40.
• About one in three U.S. women has a hysterectomy by age 60, usually because of uterine fibroids, abnormal uterine bleeding, or endometriosis. Many experts believe this procedure is overused.
• Hormone replacement therapy (HRT) is often prescribed for symptoms related to menopause, but there is mounting evidence that its risks may outweigh its benefits in long-term use. Alternative treatments are being tested.
• Personality and negative emotionality can affect health.
• Stress is related to a variety of physical and psychological problems. An accumulation of minor, everyday stressors can be more harmful than major life changes. Everyday hassles tend to decrease with age, perhaps because people learn strategies for managing stress.
• Causes of occupational stress include work overload, interpersonal conflict, sexual harassment, a combination of high pressure and low control, and inability to "unwind." Continual stress may lead to burnout.
• Unemployment creates psychological as well as financial stress. Physical and psychological effects may depend on coping resources.

COGNITIVE DEVELOPMENT

Guidepost 4: What cognitive gains and losses occur during middle age?

• The Seattle Longitudinal Study found that most basic mental abilities peak during middle age. Fluid intelligence declines earlier than crystallized intelligence.

Guidepost 5: Do mature adults think differently than younger people do?

• Some theorists propose that cognition takes distinctive forms at midlife. Advances in expertise, or specialized knowledge have been attributed to encapsulation of fluid abilities within a person's chosen field. Expertise also depends on the social context.
• Postformal thought seems especially useful in situations calling for integrative thinking.
• The ability to solve practical problems is strong, and may peak, at midlife.

Guidepost 6: What accounts for creative achievement, and how does it change with age?

• Creative performance depends on personal attributes and environmental forces, as well as cognitive abilities.
• Creativity is not strongly related to intelligence. However, according to Sternberg, the insightful, analytic, and practical aspects of intelligence play a part in creative performance.
• An age-related decline appears in both psychometric tests of divergent thinking and actual creative output, but peak ages for output vary by occupation. Losses in productivity with age may be offset by gains in quality.

Guidepost 7: How have work patterns changed, and how does work contribute to cognitive development?

• A shift from age-differentiated to age-integrated roles appears to be occurring in response to longer life and social change.
• Ginzberg's theory, based on more recent changes in work life, describes two basic career paths: stability and change.
• Complex work may improve cognitive flexibility. Changes in the workplace may make work more meaningful and cognitively challenging for many people.

Guidepost 8: What is the value of education for mature learners?

• Many adults go to college at a nontraditional age or participate in continuing education. Adults go to school chiefly to improve work-related skills and knowledge or to prepare for a change of career.
• Mature adults have special educational needs and strengths.