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Adulthood & Late Adulthood - Coggle Diagram

- - - - Peripheral vision narrows, and some colors fade more than others.
      - Only 10% of people over age 65 see well without glasses.
      - Common issues include cataracts, glaucoma, and macular degeneration.
        
        Glaucoma: Fluid buildup damages the optic nerve. About 1% of those in their 70s and 10% of those in their 90s have glaucoma, but the damage can be prevented with early treatment.
        
        Macular Degeneration: The retina deteriorates. About 4% of those in their 60s and 12% of those over age 80 have macular degeneration, but early treatment can restore some vision.
        
        Cataracts: The lens thickens, causing vision to become cloudy, opaque, and distorted. By age 70, 30% of adults have cataracts, but this can be corrected with outpatient surgery.
    - - Hearing: Hearing fades, especially for high-frequency sounds (like a small child's voice), which are lost earlier than low-frequency sounds (like a man's voice). Hearing is most acute at about age 10, and again particular aspects follow age-related declines.
      - Hearing fades, especially for high-frequency sounds.
      - 36% of people over 65 report hearing trouble.
      - Men are twice as likely to experience hearing loss compared to women.
      - The exosystem plays a crucial role in mitigating the effects of hearing loss.
        
        For instance, a hearing loop can dramatically improve the concert or museum experience for those with hearing aids. Other helpful modifications include brighter lights, halogen streetlights, and newspapers with larger, darker print.
  - - - Adults are often concerned with visible signs of aging which can affect their attitudes and habits.
      - Noticeable changes start as early as age 30, especially in the skin. By age 60, facial aging is more significant.
    - - Collagen loss (about 1% per year after age 20) results in:
        
        Thinner, drier, less flexible skin.
        
        More variable cells beneath the surface.
        
        Visible wrinkles (especially around the eyes).
      - By age 40 (or 50), age spots, tiny blood vessels, and texture changes become apparent.
      - Skin becomes looser, withering, and wrinkling due to changes in all four layers of the skin.
    - - Gray hair typically starts in the 30s and becomes more widespread in the 40s.
      - Hair thins with age, with men experiencing regional hair loss (male pattern baldness).
      - Body hair becomes less dense, but unwanted hairs may appear in new places.
    - - Height decreases by about an inch by age 65 due to vertebral compression.
      - Torsos contract, and waists widen ("middle-age spread").
      - Fat accumulates on the limbs, stomach, and buttocks.
      - Muscles weaken, and joints lose flexibility.
  - - - Prescription Drugs: While many medications improve health (reducing heart disease deaths, managing psychological health), they can have side effects. The notes specifically mention the addictive nature of opioids and the importance of weighing costs and benefits.
      - Psychoactive Drugs: This category includes caffeine, marijuana, cigarettes, and alcohol.
        
        Alcohol: Moderate consumption may have benefits, but excessive alcohol can destroy brain cells, cause liver damage, and contribute to other diseases.
        
        Cigarettes: Described by the World Health Organization as "the single largest preventable cause of death and chronic disease."
    - - BMI: A BMI over 25 is considered overweight, and over 30 is considered obese. However, the notes highlight that BMI may not be accurate for all demographics.
      - Health Risks: Obesity increases the rates of suicide, homicide, and accidents, and contributes to family disruption. It also elevates the risk of heart disease, stroke, type 2 diabetes, and some cancers.
      - Dietary Choices: The notes advocate for a Mediterranean diet and intermittent fasting as potential strategies for managing weight and improving health.
    - - The importance of intersectionality, where social context (gender, age, nationality, income) can influence health risks and outcomes.
      - The role of genetics in determining where fat is distributed on the body, with fat in the midsection being more harmful than fat on the limbs.
      - The potential for bias and prejudice against obese individuals, which can lead to avoidance of healthcare and further harm to health.
  - - - While genes play a role in aging (senescence), lifestyle choices and environmental factors are more influential in determining an adult's health.
      - Adults under 40 often underestimate the impact of aging on their bodies, as declines are masked by organ reserve, homeostasis, and allostasis.
    - - Primary prevention: Lifestyle changes (fewer cigarettes, more exercise, healthier diet) are the main reason premature deaths are less common. Less stress and less obesity reduce heart attacks, strokes, and many types of cancer. An example includes the potential benefit of intermittent fasting.
      - Secondary prevention: Medication is the best defense in high-risk situations, like when blood work indicates heart risk (statins and other drugs).
      - Tertiary prevention: Surgery is tertiary prevention, a last resort.
    - - A body mass index (BMI) above 25 is considered overweight, above 30 is considered obese, and above 40 is considered severely obese.
      - However, BMI measurements are not accurate for all demographics, with criticisms related to ethnic bias and the inability to account for muscle mass.
    - - Medication has improved health for many, especially in midlife. The rate of heart disease (the leading cause of adult death) before late adulthood has been reduced by two-thirds, largely due to drugs that reduce hypertension and cholesterol.
    - - Intersectionality highlights how social context (gender, age, nationality, income) can influence health risks and outcomes.
      - Social support is beneficial, too: Deaths of despair are rare when people are part of well-functioning families and have jobs with good health care.
      - The social context reflects cultural attitudes about sensory aging.
      - The social role of older women gains recognition, research on their specific health issues has increased.
    - - Refers to the number of deaths each year per 1,000 members of a given population.
      - Due to advances in medicine and technology, the mortality rate has decreased.
    - - Refers to the rate of diseases of all kinds in a given population, including both physical and mental conditions.
      - As mortality decreases, morbidity increases because people are living longer with chronic diseases.
    - - Refers to difficulty in performing activities of daily life, such as eating, bathing, toileting, dressing, and transferring from a bed to a chair.
    - - Refers to how healthy and energetic, physically, intellectually, and socially, an individual actually feels.
      - Subjective measure is very important to the older population.
- - - - Fluid Intelligence: Enables people to learn anything, including unfamiliar things disconnected from what they already know. It involves curiosity and learning for the joy of it.
      - Crystallized intelligence: Is the accumulation of facts, information, and knowledge as a result of education and experience.
    - - Analytic Intelligence includes the mental processes that foster academic proficiency by making efficient learning, remembering, and thinking possible. It draws on abstract planning, strategy selection, focused attention, and information processing, as well as verbal and logical skills. Strengths in analytic intelligence are valuable in college, with multiple-choice tests and brief essays that call for remembered information being indicators of this type of intelligence.
      - Creative intelligence is flexible and innovative, divergent rather than convergent, valuing the unexpected, imaginative, and unusual rather than standard and conventional answers. Tests of creative intelligence include tasks like writing a short story titled "The Octopus's Sneakers" or planning an advertising campaign for a new doorknob, with those having many novel ideas earning high scores.
      - Practical intelligence is adaptive and includes an accurate grasp of the expectations and needs of other people, requiring understanding and deploying whatever skills are needed to meet whatever challenges appear.
    - - Fluid Intelligence: Processing speed is closely related to fluid intelligence. Fluid intelligence is associated with being quick and flexible. It also relies on a large working memory. Bonus points on fluid intelligence questions are given for speedy solutions.
      - Automaticity: Complex actions become routine for experts, often making it seem as though they perform most aspects of a task instinctively.
      - Expertise in Action:
        Despite age-related cognitive slowdowns, age has little effect on chess expertise. Older experts can quickly recognize when their king is threatened, almost as fast as younger adults, even with age-related declines in standard tests.
      - Expertise and Aging
        While younger individuals might have an advantage in speed-related tasks, older adults often exhibit greater adeptness in vocabulary and communication.
  - - - As Baltes and Baltes (1990) explained, selective optimization means that each adult selects certain aspects of intelligence to optimize and neglects the rest. If the ignored aspects happen to be the ones measured on intelligence tests, then IQ scores will fall, even if the adult’s selection improves (optimizes) other aspects of intellect.
      - Key Components
        
        Selection
        
        Adults choose certain aspects of intelligence or skills to focus on and improve.
        
        This selection is often driven by personal values, interests, or needs.
        
        Optimization
        
        Concentrating efforts and resources to enhance the selected abilities or skills.
        
        It involves deliberate practice and strategic planning.
        
        Compensation
        
        It helps maintain overall functioning and well-being.
        
        Developing strategies to counteract or compensate for any losses or declines in other areas.
      - Example
        
        Cell phone use is an example of selective cognition. Many adults use cell phones when walking down the street, sitting in class, or cooking dinner at home. Yet each of those tasks involves moments of forgetfulness as the brain switches from talking to the task. People trip, misunderstand, or forget.
    - - Input is the initial stage and involves sensation, perception, and comprehension. As people age, senses become less sharp, which limits input.
        
        Example
        
        Consider the image of three elderly men on a park bench. The ability to discern subtle emotional cues, like an angry narrowing of the eyes, diminishes with age due to sensory decline, affecting how older adults perceive and interpret emotions, especially in face-to-face interactions.
        
        Sensory Decline: All senses become less sharp, limiting input.
        "In adulthood, all of the senses become less sharp, which limits input."
        
        Sensory Threshold: Information must cross the sensory threshold to be perceived.
        "In order to be perceived, information must cross the sensory threshold—the divide between what is sensed and what is not."
        
        Visual and Auditory Processing: Older adults are less accurate in judging movements, emotions, and have lower cognitive scores with hearing loss.
      - Processing and Memory
        
        Stereotype Threat: Anxiety about cognitive decline impedes processing.
        "Simply knowing that their memory is being tested can make older adults anxious, impacting their performance."
        
        Memory Types
        
        Implicit Memory: More resilient to age-related decline (e.g., riding a bike).
        
        Automatic Processing: Generally unaffected by aging.
        
        Explicit Memory: Declines faster with age (e.g., recalling names, dates).
        
        Source Amnesia: Forgetting the origin of information.
        "Source amnesia is forgetting the origin of a fact, idea, or snippet of conversation."
        
        Prospective Memory: Remembering to do something in the future fades.
        "Prospective memory involves remembering to do something in the future"
        
        Vocabulary Retention: Often increases throughout adulthood.
        
        Proactive Cognitive Control: Sustained attention to possibilities becomes difficult.
        ""Proactive cognitive control," which requires sustained attention to possibilities, becomes increasingly difficult with age..."
        
        Task Switching: Older adults struggle with changing gears between thoughts.
      - Control Processes
        
        Impaired control processes are a primary reason for cognitive decline.
        
        Older adults may not use helpful control processes.
        
        Executive Function: Selective attention, strategic judgment, and appropriate action.
      - Output
        
        Measurement: Standardized tests of mental ability.
        
        Ecological Validity: Ensuring tests are realistic and reflect real-life conditions.
        "Ecological validity: The extent to which the conditions and tasks in a study mirror real-world environments and situations."
        
        Circadian Rhythm: Cognitive performance is affected, with older adults often performing best in the early morning.
        
        Stereotype Threat: Can affect test results.
  - - - Genetic Factors in Alzheimer's Disease (AD)
        
        APOE4 Gene: Many genes have some impact, especially APOE4 (allele 4 of the APOE gene).
        
        Those who inherit two copies almost always develop the disorder if they live long enough, although longevity is negatively correlated with APOE4, so many people who inherit APOE4 from both parents die before they become forgetful.
        
        Individuals who inherit one copy of APOE4 (approximately one-fifth of the U.S. population) have about a 50/50 chance of developing AD, with women at a higher risk than men.
        
        Early-Onset AD: Rarely, AD begins in middle age due to trisomy-21 (Down syndrome) or inheriting one of three genes: amyloid precursor protein (APP), presenilin 1, or presenilin 2.
        
        For these individuals, the disease progresses rapidly, reaching the last phase within three to five years.
      - Genetic Link: Alzheimer’s disease is partly genetic.
    - - Vascular disease correlates with the APOE4 allele and other genetic precursors.
    - - There are many forms and causes of frontotemporal NCDs, including a dozen or so alleles.
  - - - Some scholars argue against the idea of an innate "g," suggesting cognitive differences are primarily due to social context:
        
        Schooling
        
        Income
        
        Nutrition
    - - Harm can begin long before late adulthood. A study (CARDIA) following 50-year-olds for 25 years found that smokers had smaller gray matter volume in the temporal, occipital, and frontal lobes, and in the amygdala, affecting the processing of emotions, sounds, and motor skills, but not memory (hippocampus).
      - Chronic marijuana use and poor circulation from decades of cigarette smoking also affect cognition.
      - Anything that impairs blood circulation, such as chronic cigarette smoking, high blood pressure, and diabetes, affects the brain and harms cognition.
    - - Every psychoactive drug affects cognition. Adults may use drugs to alter their brain state, resulting in a temporary high or relief from physical or psychological pain, but this can lead to permanent brain damage.
    - - Traumatic brain injury (TBI)
      - Post-traumatic stress disorder (PTSD)
      - Adverse Childhood Experiences
    - - Preventive measures like hand washing, mask wearing, food safety, and vaccination can help protect the brain from viruses. COVID-19 can lead to brain fog, which impairs memory and logic.
    - - The study aims to provide insights into the cognitive skills and strategies that differentiate expert parents from novice parents. This knowledge can be used to develop interventions and training programs to improve parenting skills and outcomes.
    - - Build safer houses
      - Stockpile supplies
      - Care for physical and mental health
      - Understand warnings from various devices
    - - Multitasking requires repeated switching from one task to another, and the time taken by switching leads to an overall slowdown (Lin et al., 2016). Crash rates increase when drivers talk on cell phones.
  - - - Some genes can negatively impact the adult brain. For example, about 1 in 1,000 people carry a dominant gene for Alzheimer's disease, and around 1 in 10,000 inherit genes for other severe neurocognitive disorders. The timing and manner in which these genes activate depend on other genes and environmental factors.
      - COVID-19's Impact on the Brain
        COVID-19 can affect the brain. Initial symptoms involve the respiratory system, but the virus can reach the brain, leading to:
        
        Loss of taste and smell
        
        Blurry vision or tinnitus (loud sounds in the head)
        
        "Brain fog," which impairs memory and logic
        
        These effects may stem from an overactive immune system or direct viral impact on the brain. The effects can be temporary or last for months or years. It remains uncertain whether "long COVID" will eventually disappear due to the brain's plasticity potentially repairing the damage.
        
        The brain can recover from loss of blood circulation. For example, stroke victims can restructure their brains to learn new movements. Similar recovery is observed in adults with brain damage from other viruses and medical conditions.
      - Viruses That Infect the Brain
        
        Syphilis
        
        HIV (the virus that causes AIDS)
        
        Bovine spongiform encephalopathy (BSE, or mad cow disease)
      - Drugs and the Brain
        
        Wernicke-Korsakoff syndrome is caused by a severe and chronic lack of thiamine (vitamin B1), not directly by alcohol. This condition can also occur in individuals severely undernourished for other reasons, such as multi-week starvation. Chronic alcohol abuse can lead to Wernicke-Korsakoff syndrome ("wet brain"), impairing mental function and causing confusion, inability to concentrate, memory loss, and impaired reasoning.
      - The Impact of Trauma on Cognition
        
        A blow to the head, a nearby explosion, or rapid acceleration or deceleration of the head can cause a traumatic brain injury (TBI).
        
        Chronic traumatic encephalopathy (CTE) is especially common in athletes who experience multiple blows to the head.
      - Post-Traumatic Stress Disorder (PTSD)
        
        For about 40 years, psychologists have recognized post-traumatic stress disorder (PTSD), which begins with a life-threatening or profoundly frightening event, such as rape, severe beating, active combat, or a major earthquake. People who have PTSD may experience distorted thinking for months or years after the event, even if no physical injury occurred. The problem originates in the emotions activated in the brain.
- - - - Intimacy, in this context, refers to establishing a close, reciprocal connection with another individual, demanding mutual investment of time and energy. Conversely, isolation can arise when established intimate relationships are disrupted, such as through divorce or death.
    - - Erikson posited that a mature adult "needs to be needed," emphasizing the significance of caring for the next generation through raising children, mentoring, teaching, or helping others. Generativity extends beyond child-rearing to encompass meaningful employment, creative endeavors, and social influence. Without generativity, adults may experience a sense of stagnation and personal impoverishment.
    - - Erikson believed that each person's life should be directed toward connecting a personal journey with the historical and cultural purpose of human society, the ultimate achievement of integrity.
  - - - Marriage: Marriage remains a common path to intimacy, even though marriage rates may be declining in some areas.
      - Cohabitation: Cohabitation can be as satisfying as marriage under equal circumstances. However, cohabitation is sometimes linked to economic and emotional strain.
      - Living Apart Together (LAT): LAT relationships are an emerging pattern where couples maintain separate residences but function as a committed couple.
      - Breakups: Partnerships can be affected by the presence of children and satisfaction tends to be highest during the "honeymoon period." Satisfaction can improve over the decades, with a few exceptions.
      - Importance: Committed partnerships are generally linked to increased wealth, happiness, and health. The notes state, "People in committed partnerships tend to be wealthier, happier, and healthier than those without partners. Humans are not meant to be loners."
    - - Importance: Friends are chosen for their reliability as fellow travelers through life. The notes state, "Mutual loyalty and aid characterize friendship."
      - Balanced Friendship: An unbalanced friendship, where one person is always giving and the other taking, is unlikely to last.
      - Quality Over Quantity: As adults age, they tend to have fewer friends overall but maintain and nurture their close relationships.
      - Open Communication: Having someone to talk to about problems and joys increases happiness, especially when friends celebrate accomplishments together.
    - - Family Connections: Adults maintain connections with siblings, nieces, nephews, parents, and grandparents, with childhood history influencing individuals even after they've left home.
      - Intergenerational Support: Support between generations tends to decrease when adult children marry but increases when they have children or experience divorce. Physical separation doesn't weaken family ties; in fact, intergenerational relationships may strengthen when adult children live apart from their parents.
      - Boomerang Children: The trend of adults returning to live with their parents is increasing. As many as 38% of adults do not live with a romantic partner and live with their own parents (31% of men and 21% of women).
      - Fictive Kin: These are individuals who aren't related by blood or marriage but are considered family due to close emotional ties and mutual support. They can be particularly important for those estranged from their biological families.
      - Grandparenthood: Grandparents often play a significant role in helping raise their grandchildren, especially when the parents face difficulties.
  - - - Generativity: Meaningful employment is one way that adults express their need to be generative. It can be just as important as raising children.
      - Re-examination of Gender Norms: Parenthood often leads to a re-evaluation of gender norms, with many adults tilting toward believing that women provide primary care and men provide primary income.
      - Stalled Revolution: Despite more equitable employment opportunities, old patterns persist, especially in family life, prompting the concept of a "stalled revolution."
      - Work-Life Balance: Both parents tend to reduce outside work or choose more flexible hours when raising children, but specifics depend on the age of the children.
    - - Challenges: While caring for one's own children is generally considered rewarding, caring for a spouse or parent is often more stressful, particularly if the care receiver is unappreciative or demanding.
      - Sandwich Generation: Middle-aged adults who are caring for both their children and their aging parents are sometimes referred to as the "sandwich generation," and they may experience significant stress and burnout.
      - Positive Aspects: Despite the challenges, caregiving can also be a source of meaning and purpose, especially when caregivers feel they are making a positive difference in the lives of their loved ones.
  - - - Gender Norms Re-examination: Parenthood often leads to a re-evaluation of gender norms, with many adults tilting toward believing that women provide primary care and men provide primary income. The notes state, "Parenthood requires re-examination of gender norms."
      - Stalled Revolution: Despite more equitable employment opportunities, old patterns persist, especially in family life, prompting the concept of a "stalled revolution."
      - Flexibility: Both parents tend to reduce outside work or choose more flexible hours when raising children, but specifics depend on the age of the children. For example, the notes state, "Mothers are more likely to scale back (working part-time instead of full-time) during infancy; fathers reduce work hours or choose more flexible schedules when the children are in elementary school".
      - Adequacy: Throughout the years of raising children, privacy and income rarely seem adequate, and almost every child encounters some difficulties.