Health Promotion and Risks for the Middle Adult
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Chamberlain University College of Nursing *
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Jun 23, 2024
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Health Promotion and Risks for the Middle Adult
Health and Wellness-Scheitlin > Unit 9
Introduction to Health Promotion and Risks for the Middle Adult
Middle adulthood is the period between the mid-thirties and the mid-
sixties. During the middle adult years, personal and career achievements have been experienced. Middle adults find satisfaction in helping the younger generation achieve success. Many middle adults lead productive and enriching lives. However, those experiencing significant social determinants of health may not be well prepared for this life transition.
In this lesson, you will learn normal developmental milestones for the middle adult, as well as ways the healthcare professional can promote healthy middle adulthood.
Middle Adults (35–65 Years)
The healthcare professional must provide care that meets the needs of the middle adult. During middle adulthood (35-65 years), adults make lasting contributions through involvement with others. Personal and career achievements have been experienced. Many middle adults enjoy helping their children or other young adults become productive and responsible. Middle adults often care for aging parents in addition to their own children. Therefore, middle adulthood is known as the “sandwich generation.” Adults in this age group experience a decline in:
skin turgor and moisture
hair growth and melanin
visual and auditory acuity
skeletal muscle mass
calcium and bone density
blood vessel elasticity
gastric secretions
estrogen and testosterone
glucose tolerance Middle Adult: Physical Changes
The most significant physiological changes during middle adulthood are menopause in women and climacteric in men. Select each tab to learn more.
Menopause
Climacteric
Menopause
Menstruation and ovulation begin during puberty in adolescence and continue until some time in the middle adult years. Perimenopause is the period of time during which ovarian function is declining. There is a declining number of ova (eggs) and menstrual cycles may become irregular. Perimenopause usually lasts 1 to 3 years.
Menopause occurs once the ovaries no longer produce estrogen and progesterone. It typically occurs between 45 and 60 years of age. Physical and psychological adaptation to menopause varies, with most women aware of physical changes but adapting well.
Menopause
Climacteric
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Climacteric
Climacteric occurs in males in the late 40s or early 50s. It is caused by decreasing levels of androgens (testosterone). This decline does not affect
sperm production but may affect penile erection and ejaculation. Middle Adults: Health Promotion Cognitive decline is rare in middle adulthood, except related to illness or trauma. Psychosocial adaptation involves children moving away from home and unexpected life events, such as job loss or separation from a partner. Select each tab for more details.
Psychosocial, Cognitive, and Moral Development
Body Image and Self-Concept
Lifestyle
Psychosocial, Cognitive, and Moral Development
Erikson’s stage of psychosocial development is generativity versus stagnation. Middle adults often seize life opportunities and parenting is an
important task. They must adjust to changes in physical appearance and ability. Piaget’s stage of cognitive development is formal operations. Reaction time and performance speed slow slightly; however, memory remains intact. Middle adults are secure in their convictions and spiritual beliefs become more important. There is a desire to maintain and strengthen intimate relationships. Children grow into young adults and leave home, creating “empty nest syndrome.” The departure of the last child from the home is a
stressor, which may lead to loneliness, sadness, and depression. Eventually, caregivers must reevaluate their relationship without children, which may lead to conflicts and separation.
Psychosocial, Cognitive, and Moral Development
Body Image and Self-Concept
Lifestyle
Body Image and Self-Concept
Middle adults may struggle to adapt to biological signs of aging, including changes in appearance. Sex drive may decline due to the loss of estrogen and testosterone or due to physical appearance changes. Females must cope mentally and physically with menopause. Males must adapt to decreasing physical strength and climacteric (age-related decrease in testosterone). Self-concept is influenced by menopause, sexuality, depression, job performance, and marital changes. Clients with high self-esteem, a favorable body image, and a positive attitude toward physiological changes are those who engage in physical activity, eat healthy meals, obtain adequate sleep, and follow good hygiene practices.
Psychosocial, Cognitive, and Moral Development
Body Image and Self-Concept
Lifestyle
Lifestyle
Lifestyle decisions in young adulthood are now either positively or negatively affecting the middle adult. Poor lifestyle choices may combine with risk factors and result in the diagnosis of chronic diseases. However, there is still time to mitigate modifiable risk factors.
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Generalized health promotion instruction should include avoiding substance use, eating a healthy diet, participating in recommended routine screenings (e.g., colonoscopy and mammograms), and reducing stress.
Maintaining a Healthy Weight
Obesity is a serious problem and its prevalence continues to increase in the United States. The most recent statistics indicate that as many as 42% of Americans are obese (CDC, 2021). It affects overall health and impacts healthcare costs. Obesity can lead to diabetes mellitus type 2, heart disease, stroke, and increases the risk for some types of cancer.
The estimated medical costs associated with obesity in the U.S. are approximately $147 billion (CDC, 2021). Obesity rates are highest among middle adults at almost 45% of Americans and obesity is the leading cause
of preventable, premature death (CDC, 2021). A healthy diet and regular physical exercise are necessary beginning in young adulthood and continuing through middle adulthood to prevent weight-related issues. A healthy body mass index (BMI) is between 18.5 and 24.9. Middle Adult:
Immunizations
The recommended schedule for adult
immunizations begins at 19 years and
continues through the older adult
period.
Review the CDC recommended
vaccination schedule for adults.
Recommended Adult Immunization Schedule
for Ages 19 Years or Older
(CDC, 2022) [PDF]
Assuming all previous childhood vaccinations were received, recommended vaccinations include:
seasonal influenza (inactivated or recombinant); live attenuated is not recommended after age 50
tetanus, diphtheria, pertussis (Tdap) – one dose with every pregnancy
tetanus (Td) or tetanus, diphtheria, pertussis (Tdap) – used for prophylaxis every 10 years or wound management
COVID-19
zoster recombinant (RZV) for shingles – two doses needed beginning
at age 50
other vaccinations may be recommended based on risk factors
Important!
Live virus vaccines, such as MMR and varicella, should not be administered to pregnant clients. Middle Adults: Health Risks
Middle adults should have a physical exam every one to two years. Routine screenings include height, weight, body mass index, vital signs, stress, blood cholesterol, blood glucose, and annual skin assessment. Colonoscopy should occur every 10 years beginning at age 50.
Women should begin the annual mammogram screenings at age 45.
Men should have an annual serum prostate-specific antigen test beginning at age 50.
Education about exercise and healthy nutrition is important, including the value of adequate protein and fiber, fresh foods, limiting fat and cholesterol, and increasing vitamin D and calcium. Middle adults are at risk for:
diabetes mellitus type 2
obesity
cardiovascular disease
cancer
substance use disorder
psychosocial stressors (anxiety, depression)
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