tag:theconversation.com,2011:/africa/topics/middle-age-7145/articlesMiddle age – The Conversation2024-03-19T16:12:24Ztag:theconversation.com,2011:article/2254122024-03-19T16:12:24Z2024-03-19T16:12:24ZThe middle-aged brain changes a lot – and it’s key to understanding dementia<p>Our brains change more rapidly at various times of our lives, as though life’s clock was ticking faster than usual. Childhood, adolescence and very old age are good examples of this. Yet for much of adulthood, the same clock seems to tick fairly regularly. One lap around the Sun; one year older. </p>
<p>However, there may be a stage of life when the brain’s clock starts speeding up. The brain starts changing without you necessarily noticing it. It may even be caused (partly) by what’s in your blood. This stage of brain ageing during your 40s to 50s, or “<a href="https://doi.org/10.1016/j.tins.2024.02.001">middle-ageing</a>”, may predict your future health.</p>
<p>Psychologists studying how our mental faculties change with age find that they decline gradually, starting in our <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367038/">20s and 30s</a>. However, when assessing people’s memory of everyday events, the change over time appears to be especially <a href="https://pubmed.ncbi.nlm.nih.gov/28798624/">rapid and unstable during middle age</a>. That is, even among healthy people, some experience rapidly deteriorating memory, while for others, it may even improve.</p>
<p>This suggests that the brain may be going through accelerating, as opposed to gradual, change during this period. Several structures of the brain have been found to change in midlife. The hippocampus, an area critical for forming <a href="https://www.sciencedirect.com/science/article/pii/S0197458013001590?via%3Dihub">new memories</a>, is one of them. </p>
<p>It shrinks throughout much of adulthood, and this shrinkage seems to accelerate around the time of middle age. Abrupt shifts in the size and function of the hippocampus during middle age could underlie memory changes like the ones <a href="https://www.nature.com/articles/s41598-020-64595-z">mentioned above</a>.</p>
<p>Ultimately, what allows the brain to carry out its functions are the connections between brain cells – the white matter. These connections mature slowly throughout adulthood, especially the ones connecting areas of the brain that deal with cognitive functions such as memory, reasoning and language. </p>
<p>Interestingly, during middle age, many of them go through a turning point, from <a href="https://www.nature.com/articles/ncomms5932">gaining volume to losing volume</a>. This means that signals and information cannot be <a href="https://doi.org/10.1038/s41593-023-01272-0">transmitted as fast</a>. Reaction time starts <a href="https://www.frontiersin.org/articles/10.3389/fnagi.2021.661514/full">deteriorating </a> around the same time.</p>
<p>Through the white matter connections, brain areas talk to each other and form interconnected networks that can perform cognitive and sensory functions, including memory or vision. While the sensory networks deteriorate gradually throughout adulthood, the cognitive networks start deteriorating <a href="https://www.pnas.org/doi/10.1073/pnas.1415122111">faster during middle age</a>, especially those involved in memory.</p>
<p>Much like how highly connected people in society tend to form cliques with each other, brain regions do the same through their connections. This organisation of the brain’s communication allows us to perform some of the complex tasks we might take for granted, such as planning our days and making decisions. </p>
<p>The brain seems to peak in this regard by the <a href="https://onlinelibrary.wiley.com/doi/10.1111/psyp.14159">time we hit middle age</a>. Some have even referred to middle age as a “<a href="https://www.psychologicalscience.org/observer/financial-decision-making-and-the-aging-brain">sweet spot</a>” for some types of decision-making, but then the network “cliques” start to break up.</p>
<p>It’s worth stating at this point why these subtle changes matter. The global population aged 60 and over is set to roughly <a href="https://www.nature.com/articles/nature06516">double by 2050</a>, and with this, unfortunately, will come a considerable increase in <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00249-8/fulltext">dementia case numbers</a>. </p>
<figure class="align-center ">
<img alt="A blurry photo of an elderly couple." src="https://images.theconversation.com/files/582395/original/file-20240317-22-pddnzn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/582395/original/file-20240317-22-pddnzn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=417&fit=crop&dpr=1 600w, https://images.theconversation.com/files/582395/original/file-20240317-22-pddnzn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=417&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/582395/original/file-20240317-22-pddnzn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=417&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/582395/original/file-20240317-22-pddnzn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=524&fit=crop&dpr=1 754w, https://images.theconversation.com/files/582395/original/file-20240317-22-pddnzn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=524&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/582395/original/file-20240317-22-pddnzn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=524&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">As the population ages, dementia cases will inevitably rise.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/old-couple-man-woman-still-together-225478723">oneinchpunch/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Focus has been too much on the brain in old age</h2>
<p>Science has long focused on very old age, when the detrimental effects of time are most obvious, but, by then, it can often be too late to intervene. Middle age could be a period when we can detect early risk factors of future cognitive decline, such as in <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">dementia</a>. Critically, the window of opportunity to intervene may also still be open.</p>
<p>So, how do we detect changes without having to give everyone an expensive brain scan? As it turns out, the contents of blood may cause the <a href="https://www.nature.com/articles/s41593-022-01238-8">brain to age</a>. With time, our cells and organs slowly deteriorate, and the immune system can react to this by starting the process of inflammation. Inflammatory molecules can then end up in the bloodstream, make their way to the brain, interfere with its <a href="https://www.nature.com/articles/nature10357">normal functioning</a> and possibly impair cognition.</p>
<p>In a fascinating study, scientists from Johns Hopkins and the University of Mississippi analysed the presence of inflammatory molecules in the blood of middle-aged adults and were able to predict future cognitive change <a href="https://www.neurology.org/doi/10.1212/WNL.0000000000007094?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">20 years down the line</a>. This highlights an important emerging idea: age in terms of biological measures is more informative about your future health than age in terms of years lived. </p>
<p>Importantly, biological age can often be <a href="https://www.nature.com/articles/s43587-021-00044-4">estimated</a> with readily available and cost-effective tests used in the clinic.</p>
<p>“Middle ageing” may be more consequential for our future brain health than we think. The hurried ticking of the clock could be slowed from outside the brain. For example, physical exercise confers some of its beneficial effects on the brain through <a href="https://www.nature.com/articles/s41593-022-01238-8">blood-borne messengers</a>. These can work to oppose the effects of time. If they could be harnessed, they might steady the pendulum.</p><img src="https://counter.theconversation.com/content/225412/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span><a href="mailto:y.nolan@ucc.ie">y.nolan@ucc.ie</a> receives funding from Science Foundation Ireland. She s affiliated with APC Microbiome Ireland. </span></em></p><p class="fine-print"><em><span>Sebastian Dohm-Hansen Allard does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Middle age could be a period when we can detect early risk factors of future cognitive decline.Sebastian Dohm-Hansen Allard, PhD Candidate, Anatomy and Neuroscience, University College CorkYvonne Nolan, Professor in Neuroscience, University College CorkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2156952023-11-06T00:58:03Z2023-11-06T00:58:03ZHow much protein do I need as I get older? And do I need supplements to get enough?<figure><img src="https://images.theconversation.com/files/556550/original/file-20231030-24-lx7dsx.jpg?ixlib=rb-1.1.0&rect=27%2C0%2C6185%2C4136&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/one-woman-working-on-laptop-eating-2171905557">Shutterstock</a></span></figcaption></figure><p>If you are a woman around 50, you might have seen advice on social media or <a href="https://www.instagram.com/p/CyVwOSzucnh">from influencers</a> telling you protein requirements increase dramatically in midlife. Such recommendations suggest a 70 kilogram woman needs around 150 grams of protein each day. That’s the equivalent of 25 boiled eggs at 6 grams of protein each. </p>
<p>Can that be right? Firstly let’s have a look at what protein is and where you get it. </p>
<p><a href="https://www.betterhealth.vic.gov.au/health/healthyliving/protein">Protein</a> is an essential macro-nutrient in our diet. It provides us with energy and is used to repair and make muscle, bones, soft tissues and hormones and enzymes. Mostly we associate animal foods (dairy, meat and eggs) as being rich in protein. Plant foods such as bread, grains and legumes provide valuable sources of protein too. </p>
<p>But what happens to our requirements as we get older? </p>
<h2>Ages and stages</h2>
<p>Protein requirements change <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/protein">through different life stages</a>. This reflects changes in growth, especially from babies through to young adulthood. The estimated average requirements by age are: </p>
<ul>
<li><p>1.43g protein per kg of body weight at birth</p></li>
<li><p>1.6g per kg of body weight at 6–12 months (when protein requirements are at their highest point) </p></li>
<li><p>protein needs decline from 0.92g down to 0.62g per kg of body weight from 6–18 years. </p></li>
</ul>
<p>When we reach adulthood, protein requirements differ for men and women, which reflects the higher muscle mass in men compared to women: </p>
<ul>
<li><p>0.68g per kg of body weight for men</p></li>
<li><p>0.6g per kg of body weight for women. </p></li>
</ul>
<p>Australian recommendations for people over 70 reflect the increased need for tissue repair and muscle maintenance:</p>
<ul>
<li><p>0.86g per kg of bodyweight for men</p></li>
<li><p>0.75g per kg of bodyweight for women.</p></li>
</ul>
<p>For a 70kg man this is a difference of 12.6g/protein per day. For a 70kg woman this is an increase of 10.5g per day. You can add 10g of protein by consuming an extra 300ml milk, 60g cheese, 35g chicken, 140g lentils, or 3–4 slices of bread. </p>
<p>There is emerging evidence <a href="https://www.scopus.com/record/display.uri?eid=2-s2.0-85124835199&origin=resultslist&sort=plf-f&cite=2-s2.0-84881254292&src=s&nlo=&nlr=&nls=&imp=t&sid=c07c9e014577c86ab8cf85c62d9764cd&sot=cite&sdt=a&sl=0&relpos=39&citeCnt=6&searchTerm=">higher intakes</a> for people over 70 (up to 0.94–1.3g per kg of bodyweight per day) might reduce age-related decline in muscle mass (known as sarcopenia). But this must be accompanied with increased resistance-based exercise, such as using weights or stretchy bands. As yet these have not been included in any national nutrient guidelines. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/556547/original/file-20231030-30-1jln3u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="foods on table including eggs, salmon, eggs, meat, nuts, avocado" src="https://images.theconversation.com/files/556547/original/file-20231030-30-1jln3u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/556547/original/file-20231030-30-1jln3u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/556547/original/file-20231030-30-1jln3u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/556547/original/file-20231030-30-1jln3u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/556547/original/file-20231030-30-1jln3u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/556547/original/file-20231030-30-1jln3u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/556547/original/file-20231030-30-1jln3u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Protein can come from animal and non-animal sources.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/healthy-eating-diet-concept-natural-rich-684710068">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/am-i-too-old-to-build-muscle-what-science-says-about-sarcopenia-and-building-strength-later-in-life-203562">Am I too old to build muscle? What science says about sarcopenia and building strength later in life</a>
</strong>
</em>
</p>
<hr>
<h2>But what about in midlife?</h2>
<p>So, part of a push for higher protein in midlife might be due to wanting to prevent age-related muscle loss. And it might also be part of a common desire to prevent weight gain that may come with <a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17290?af=R">hormonal changes</a>. </p>
<p>There have been relatively few studies specifically looking at protein intake in middle-aged women. One large 2017 observational study (where researchers look for patterns in a population sample) of over 85,000 middle-aged nurses found higher intake of vegetable protein – but not animal protein or total protein – was linked to a <a href="https://academic.oup.com/aje/article/187/2/270/3886033">lower incidence of early menopause</a>. </p>
<p>In the same group of women another study found higher intake of vegetable protein was linked to a <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/jcsm.12972">lower risk of frailty</a> (meaning a lower risk of falls, disability, hospitalisation and death). Higher intake of animal protein was linked to higher risk of frailty, but total intake of protein had no impact.</p>
<p>Another <a href="https://journals.lww.com/menopausejournal/abstract/2017/05000/skeletal_muscle_mass_is_associated_with_higher.9.aspx">smaller observational study</a> of 103 postmenopausal women found higher lean muscle mass in middle-aged women with higher protein intake. Yet an <a href="https://journals.lww.com/menopausejournal/abstract/2021/03000/effects_of_high_protein,_low_glycemic_index_diet.11.aspx">intervention study</a> (where researchers test out a specific change) showed no effect of higher protein intake on lean body mass in late post-menopasual women. </p>
<p><a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17290?af=R">Some researchers</a> are theorising that higher dietary protein intake, along with a reduction in kilojoules, could reduce weight gain in menopause. But this has not been tested in clinical trials. </p>
<p>Increasing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539343/">protein intake</a>, improves satiety (feeling full), which may be responsible for reducing body weight and maintaining muscle mass. The protein intake to improve satiety in studies has been about 1.0–1.6g per kg of bodyweight per day. However such studies have not been specific to middle-aged women, but across all ages and in both men and women. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/running-gels-and-protein-powders-can-be-convenient-boosts-for-athletes-but-be-sure-to-read-the-label-200730">Running gels and protein powders can be convenient boosts for athletes – but be sure to read the label</a>
</strong>
</em>
</p>
<hr>
<h2>What are we actually eating?</h2>
<p>If we look at what the <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/australian-health-survey-usual-nutrient-intakes/latest-release">average daily intake of protein is</a>, we can see 99% of Australians under the age of 70 meet their protein requirements from food. So most adults won’t need supplements. </p>
<p>Only 14% of men over 70 and 4% of women over 70 do not meet their estimated average protein requirements. This could be for many reasons, including a decline in overall health or an illness or injury which leads to reduced appetite, reduced ability to prepare foods for themselves and also the cost of animal sources of protein. </p>
<p>While they may benefit from increased protein from supplements, opting for a food-first approach is preferable. As well as being more familiar and delicious, it comes with other essential nutrients. For example, red meat also has iron and zinc in it, fish has omega-3 fats, and eggs have vitamin A and D, some iron and omega-3 fats and dairy has calcium.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/557025/original/file-20231101-19-vhqfht.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="sliced boiled eggs on a floral plate with green napkin" src="https://images.theconversation.com/files/557025/original/file-20231101-19-vhqfht.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557025/original/file-20231101-19-vhqfht.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557025/original/file-20231101-19-vhqfht.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557025/original/file-20231101-19-vhqfht.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557025/original/file-20231101-19-vhqfht.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557025/original/file-20231101-19-vhqfht.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557025/original/file-20231101-19-vhqfht.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A person can only eat so many eggs.</span>
<span class="attribution"><a class="source" href="https://images.unsplash.com/photo-1606915018436-6cac3b1dc8b3?auto=format&fit=crop&q=80&w=2940&ixlib=rb-4.0.3&ixid=M3wxMjA3fDB8MHxwaG90by1wYWdlfHx8fGVufDB8fHx8fA%3D%3D">Tamanna Rumee/Unsplash</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-athletes-really-need-protein-supplements-92773">Do athletes really need protein supplements?</a>
</strong>
</em>
</p>
<hr>
<h2>So what should I do?</h2>
<p>Symptoms of <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/protein#getting-too-little-protein-protein-deficiency">protein deficiency</a> include muscle wasting, poor wound healing,
oedema (fluid build-up) and anaemia (when blood doesn’t provide enough oxygen to cells). But the amount of protein in the average Australian diet means deficiency is rare. The <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">Australian dietary guidelines</a> provide information on the number of serves you need from each food group to achieve a balanced diet that will meet your nutrient requirements. </p>
<p>If you are concerned about your protein intake due to poor health, increased demand because of the sports you’re doing or because you are a vegan or vegetarian, talk to your GP or an accredited practising dietitian.</p><img src="https://counter.theconversation.com/content/215695/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Evangeline Mantzioris is affiliated with Alliance for Research in Nutrition, Exercise and Activity (ARENA) at the University of South Australia. Evangeline Mantzioris has received funding from the National Health and Medical Research Council, and has been appointed to the National Health and Medical Research Council Dietary Guideline Expert Committee.</span></em></p>When we reach adulthood, protein requirements differ for men and women. But should you be eating more as you get older?Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2111082023-08-15T06:03:17Z2023-08-15T06:03:17ZResearch reveals who’s been hit hardest by global warming in their lifetime - and the answer may surprise you<p>Earth is warming and the signs of climate change are everywhere. We’ve seen it in the past few weeks as temperatures hit record highs around the world – both in the Northern Hemisphere and the <a href="https://theconversation.com/why-is-australia-having-such-a-warm-winter-a-climate-expert-explains-210693">warm Australian winter</a>.</p>
<p>Global warming is caused by humanity’s greenhouse gas emissions, which continue at <a href="https://theconversation.com/global-carbon-emissions-at-record-levels-with-no-signs-of-shrinking-new-data-shows-humanity-has-a-monumental-task-ahead-193108">near-record pace</a>. These emissions are predominantly generated by people in the world’s wealthiest regions.</p>
<p>Our world-first analysis, <a href="https://iopscience.iop.org/article/10.1088/2752-5295/aceff2">published today</a>, examines the experience of global warming over the lifetimes of people around the world: young and old, rich and poor. We sought to identify who has perceived warmer temperatures most keenly.</p>
<p>We found middle-aged people in equatorial regions have lived through the most perceptible warming in their lifetimes. But many young people in lower-income countries could experience unrecognisable changes in their local climate later in life, unless the world rapidly tackles climate change.</p>
<h2>Measuring the climate change experience</h2>
<p>We examined temperature data and population demographics information from around the world.</p>
<p>Key to our analysis was the fact that not all warming is due to human activity. Some of it is caused by natural, year-to-year variations in Earth’s climate. </p>
<p>These natural ups and downs are due to a number of factors. They include variations in the energy Earth receives from the sun, the effects of volcanic eruptions, and transfers of heat between the atmosphere and the ocean.</p>
<p>This variability is stronger in mid-to-high-latitude parts of the world (those further from the equator) than in low-latitude areas (in equatorial regions). That’s because the weather systems further away from the equator draw in hot or cold air from neighbouring areas, but equatorial areas don’t receive cold air at all.</p>
<p>That’s why, for example, the annual average temperature in New York is naturally more variable than in the city of Kinshasa (in the Democratic Republic of Congo). </p>
<p>To account for this, we applied what’s known as the “<a href="https://archive.ipcc.ch/ipccreports/tar/wg1/346.htm#:%7E:text=The%20%EF%BF%BDsignal%20to%20noise,to%20this%20natural%20variability%20noise.">signal-to-noise ratio</a>” at each location we studied. That allowed us to separate the strength of the climate change “signal” from the “noise” of natural variability. </p>
<p>Making this distinction is important. The less naturally variable the temperature, the clearer the effects of warming. So warming in Kinshasa over the past 50 years has been much more perceptible than in New York.</p>
<p>Our study examined two central questions. First, we wanted to know, for every location in the world, how clearly global warming could be perceived, relative to natural temperature variability.</p>
<p>Second, we wanted to know where this perceived change was most clear over human lifetimes. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Annual-average temperatures at four major cities with signal-to-noise ratios shown for 20, 50 and 80 years up to 2021." src="https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Annual-average temperatures at four major cities with signal-to-noise ratios shown for 20, 50 and 80 years up to 2021.</span>
<span class="attribution"><span class="source">Author provided</span></span>
</figcaption>
</figure>
<h2>Our results</h2>
<p>So what did we find? As expected, the most perceptible warming is found in tropical regions – those near the equator. This includes developing parts of the world that constitute the Global South – such as Africa, Latin America and the Caribbean, and Asia.</p>
<p>Household incomes in the Global South are typically lower than in industrialised nations (known as the Global North). We might, then, conclude people in the poorest parts of the world have experienced the most perceptible global warming over their lifetimes. But that’s not always the case.</p>
<p>Why? Because most parts of the Global South have younger populations than wealthier regions. And some people under the age of 20, including in northern India and parts of Sub-Saharan Africa, haven’t experienced warming over their lifetimes.</p>
<p>In these places, the lack of recent warming is likely down to a few factors: natural climate variability, and the local cooling effect of particles released into the atmosphere from <a href="https://iopscience.iop.org/article/10.1088/1748-9326/ac3b7a">pollution</a> and changes in land use.</p>
<p>There’s another complication. Some populated regions of the world also experienced slight cooling in the mid-20th century, primarily driven by human-caused <a href="https://www.nature.com/articles/nature10946">aerosol emissions</a>.</p>
<p>So, many people born earlier than the 1950s have experienced less perceptible warming in their local area than those born in the 1960s and 1970s. This may seem counter-intuitive. But a cooling trend in the first few decades of one’s life means the warming experienced over an entire lifespan (from birth until today) is smaller and less detectable.</p>
<p>So what does all this mean? People in equatorial areas born in the 1960s and 1970s – now aged between about 45 and 65 – have experienced more perceptible warming than anyone else on Earth.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/tourists-flock-to-the-mediterranean-as-if-the-climate-crisis-isnt-happening-this-years-heat-and-fire-will-force-change-210282">Tourists flock to the Mediterranean as if the climate crisis isn't happening. This year's heat and fire will force change</a>
</strong>
</em>
</p>
<hr>
<h2>Rich countries must act</h2>
<p>Our findings are important, for several reasons.</p>
<p>Identifying who has experienced significant global warming in their lives may help explain <a href="https://www.nature.com/articles/nclimate2660">attitudes to tackling climate change</a>.</p>
<p>Our findings also raise significant issues of fairness and equity.</p>
<p>Humanity will continue to warm the planet until we reach global net-zero emissions. This means many young people in lower-income countries may, later in life, experience a local climate that is unrecognisable to that of their youth. </p>
<p>Of course, warming temperatures are not the only way people experience climate change. Others include sea-level rise, more intense drought and rainfall extremes. We know many of these impacts are felt most acutely by <a href="https://www.aljazeera.com/opinions/2022/5/11/climate-change-is-devastating-the-global-south">the most vulnerable populations</a>.</p>
<p>Cumulative greenhouse gas emissions are much higher in the Global North, due to economic development. To address this inequality, rich industrialised nations must take a leading role in reducing emissions to net-zero, and helping vulnerable countries adapt to climate change.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-is-australia-having-such-a-warm-winter-a-climate-expert-explains-210693">Why is Australia having such a warm winter? A climate expert explains</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/211108/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrew King receives funding from the National Environmental Science Program. </span></em></p><p class="fine-print"><em><span>Ed Hawkins receives funding from the UK Natural Environment Research Council.</span></em></p><p class="fine-print"><em><span>Hunter Douglas receives funding from New Zealand's Ministry of Business, Innovation & Employment (MBIE). </span></em></p><p class="fine-print"><em><span>Luke Harrington receives funding from New Zealand's Ministry of Business, Innovation & Employment (MBIE) and Health Research Council. </span></em></p>Middle-aged people in equatorial regions have lived through the most perceptible warming in their lifetimes. But many others may experience unrecognisable changes in their local climate later in life.Andrew King, Senior Lecturer in Climate Science, The University of MelbourneEd Hawkins, Professor of Climate Science, University of ReadingHunter Douglas, PhD Candidate, Te Herenga Waka — Victoria University of WellingtonLuke Harrington, Senior Lecturer in Climate Change, University of WaikatoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2059602023-05-22T12:27:43Z2023-05-22T12:27:43ZGOP’s proposed expansion of SNAP work requirements targets many low-income people in their early 50s – but many of them already work<figure><img src="https://images.theconversation.com/files/527300/original/file-20230519-21-rnxqd4.jpg?ixlib=rb-1.1.0&rect=0%2C33%2C5488%2C3190&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many Americans in their early 50s take care of older loved ones.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/caregiver-woman-helping-senior-man-with-shopping-royalty-free-image/587506108">FredFroese/E+ via Getty Imagres</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em></p>
<h2>The big idea</h2>
<p>Roughly half of the people who would be affected by a proposed expansion of <a href="https://theconversation.com/extra-snap-benefits-are-ending-as-us-lawmakers-resume-battle-over-program-that-helps-low-income-americans-buy-food-199929">Supplemental Nutrition Assistance Program</a> work requirements already do what’s needed to meet those requirements. There’s also evidence suggesting that many of the rest have caregiving or health conditions that prevent them from working.</p>
<p>Formerly known as food stamps, SNAP helps low-income people buy groceries. </p>
<p>Republicans want the federal government to make SNAP benefits for <a href="https://www.cnn.com/2023/04/26/politics/work-requirements-food-stamps-medicaid-debt-ceiling/index.html">adults age 50 to 55</a> without dependents or disabilities contingent on spending <a href="https://www.fns.usda.gov/snap/work-requirements#:%7E:text=Work%20at%20least%2080%20hours,least%2080%20hours%20a%20month">80 hours per month on work activities</a>, which may include employment, short-term training and community service. This proposed change is in a package that the Republican-led <a href="https://www.cnn.com/2023/04/19/politics/mccarthy-debt-limit-bill/index.html">House of Representatives passed in April 2023</a> that seeks to cut spending on several social programs.</p>
<p>Currently, the requirements only apply to adults under 50 without dependents who aren’t disabled.</p>
<p>We’re basing these estimates on our analysis of nationally representative time-diary data from the Bureau of Labor Statistics’ <a href="https://www.bls.gov/tus/">American Time Use Survey</a>.</p>
<p>We analyzed the time that low-income Americans ages 50-55 who didn’t have a disability or child at home spent working, caring for others or dealing with their personal health and well-being from 2012 to 2021. </p>
<p>We found that in most years, more than half of them worked at least 20 hours per week. We estimated that, on average, those who met the work requirement actually worked about 41-51 hours per week – a full-time schedule. </p>
<p>We also determined that relative to their counterparts who met the work requirements, those who did not spent 10 times as much time managing their own health, five times as much time on child care, and more than five times as much time caring for an elderly or disabled adult.</p>
<p><iframe id="Lcj3Y" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/Lcj3Y/4/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<h2>Why it matters</h2>
<p>The GOP bill is <a href="https://www.washingtonexaminer.com/restoring-america/faith-freedom-self-reliance/how-to-stop-the-lefts-dangerous-despicable-war-on-work">grounded in a belief</a> that people who get SNAP benefits and aid through other assistance programs are not employed but capable of working, and that enforcing work requirements can increase employment and earnings.</p>
<p>But <a href="https://www.census.gov/library/stories/2020/07/most-families-that-received-snap-benefits-in-2018-had-at-least-one-person-working.html">that’s a misconception</a>.</p>
<p>This measure and <a href="https://networklobby.org/devastating-debt-ceiling-bill/">several others like it</a> are part of a package that would raise the debt limit to avert a potential U.S. default and a global economic crisis.</p>
<p>Our findings <a href="https://www.cbpp.org/research/food-assistance/house-republicans-agriculture-appropriations-bill-would-cut-wic-benefits">support widespread concerns</a> that expanding SNAP work requirements would sever food assistance benefits for an estimated <a href="https://www.cbo.gov/publication/59102">275,000 low-income people</a> between the ages of 50 and 55, including many with health conditions and who care for others.</p>
<p>That’s troubling because the cost of <a href="https://blog.dol.gov/2023/01/24/new-childcare-data-shows-prices-are-untenable-for-families">professional child care</a> and <a href="https://www.cnn.com/2023/04/20/health/senior-care-cost/index.html">elder care</a>, as well as the <a href="https://www.nationaldisabilityinstitute.org/wp-content/uploads/2020/10/extra-costs-living-with-disability-brief.pdf">care for the disabled</a>, is very high in the U.S.</p>
<p>It’s reasonable to expect that the new work requirements would force many people to make hard choices between the caregiving arrangements for their loved ones and keeping their benefits. Also, since people who have poor health may not be able to work, they may find themselves unable to put food on the table if they lose SNAP benefits.</p>
<p><iframe id="Gpems" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/Gpems/5/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<h2>What other research is being done</h2>
<p>SNAP is associated with many positive trends beyond getting enough to eat. These include <a href="https://doi.org/10.1001/jamainternmed.2017.4841">spending less on health care</a>, having <a href="https://doi.org/10.1017/s1368980021003815">better health</a> and <a href="https://www.federalreserve.gov/econres/feds/financial-repercussions-of-snap-work-requirements.htm">becoming more financially secure</a>.</p>
<p>Further, when Americans use SNAP to buy groceries, studies have shown that it <a href="https://www.ers.usda.gov/topics/food-nutrition-assistance/supplemental-nutrition-assistance-program-snap/economic-linkages/">stimulates the economy where they live</a>, supporting low-income communities. </p>
<p>Additional research has found that work requirements tied to aid programs <a href="https://theconversation.com/snap-work-requirements-dont-actually-get-more-people-working-but-they-do-drastically-limit-the-availability-of-food-aid-204257">don’t get more low-income people to enter the labor force</a>. Studies also have found that these policies cause many people who are eligible for assistance to <a href="https://theconversation.com/medicaid-work-requirements-would-leave-more-low-income-people-without-health-insurance-but-this-policy-is-unlikely-to-pass-this-time-around-204731">lose their benefits</a> due to paperwork hassles and unclear guidelines.</p><img src="https://counter.theconversation.com/content/205960/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katherine Engel receives funding from the U.S. Department of Agriculture.</span></em></p><p class="fine-print"><em><span>Taryn Morrissey has received funding from the U.S. Department of Agriculture, the U.S. Department of Health and Human Services, the Robert Wood Johnson Foundation, the Bainum Family Foundation, DC Action for Children, and the Peter G. Peterson and Ford Foundations. Morrissey is a non-resident Fellow at the Urban Institute and previously a Senior Fellow at the Center for American Progress.</span></em></p>Republicans are pressing for policy changes based on a misconception that hardly anyone who gets help buying groceries with Supplemental Nutrition Assistance Program benefits is employed.Katherine Engel, PhD Student in Public Administration and Policy, American University School of Public AffairsTaryn Morrissey, Professor of Public Administration and Policy, American University School of Public AffairsLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2001582023-04-14T12:16:52Z2023-04-14T12:16:52ZSocial Security may be failing well over a million people with disabilities – and COVID-19 is making the problem worse<figure><img src="https://images.theconversation.com/files/520945/original/file-20230413-367-pgvlmu.jpg?ixlib=rb-1.1.0&rect=46%2C124%2C3410%2C2192&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Social Security has two programs aimed at helping those with disabilities. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/social-security-royalty-free-image/1214329962?phrase=social%20security%20disability">Kameleon007/iStock via Getty Images</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em> </p>
<h2>The big idea</h2>
<p>More than half of U.S. adults over the age of 50 with work-limiting disabilities – likely over 1.3 million people – do not receive the Social Security disability benefits they may need, according to <a href="https://doi.org/10.1017/S0047279422000745">new peer-reviewed research I conducted</a>. In addition, those who do receive benefits are unlikely getting enough to make ends meet. </p>
<p>The <a href="https://www.ssa.gov/disability">Social Security Administration operates two programs</a> intended to provide benefits to people with disabilities: Disability Insurance and Supplemental Security Income, the latter of which hinges on financial need. Their shared goal is to ensure that people with work-limiting disabilities are able to maintain a decent standard of living.</p>
<p>I think it’s fair to say that if a disability benefit is truly available to those who need it, then a large portion of people with work-limiting disabilities should actually receive the aid. </p>
<p>To learn if that is true for the disability programs, I analyzed data over time from a long-running survey of adults older than age 50 called the <a href="https://hrs.isr.umich.edu/about">Health and Retirement Study</a>. The survey included information on disabilities and finances for tens of thousands of people from across the country and was linked to disability benefit records from the Social Security Administration. As the disability programs primarily serve those in their working years, I only looked at people who hadn’t yet hit <a href="https://www.nasi.org/learn/social-security/retirement-age/">the full retirement age</a>.</p>
<p>The data showed that the share of people with substantial work-limiting disabilities who received Disability Insurance, Supplemental Security Income benefits or both rose from 32% in 1998 to 47% in 2016, which was the last year the data was available. This is just a little above the average among <a href="https://share-eric.eu">27 high-income countries</a> I compared the data with. </p>
<p>Using the most recent <a href="https://www.census.gov/data/tables/time-series/demo/popest/2020s-national-detail.html">Census data</a>, I estimate that more than half of those with work-limiting disabilities between the ages of 50-64 — about 1.35 million people — likely need these benefits but aren’t getting them.</p>
<p>I also examined the generosity of disability benefits in the U.S. by using <a href="https://corporatefinanceinstitute.com/resources/data-science/regression-analysis/">regression analysis</a>, a statistical tool that allowed me to compare the relationship between multiple variables. This helped me identify whether disability benefit recipients experience greater difficulty achieving financial security compared with adults who are not on benefits but have similar social and demographic backgrounds. </p>
<p>I found that those receiving benefits, and particularly Supplemental Security Income, struggled more and experienced less financial security than their peers. </p>
<h2>Why it matters</h2>
<p><a href="https://doi.org/10.1016/j.dhjo.2013.12.001">Nearly a quarter of U.S. adults</a> who head a household will report a severe disability that limits their ability to work at some point in their lives. </p>
<p>Many will look for financial support from Social Security’s disability programs, which <a href="https://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/">together provide benefits</a> to more than 12 million people in 2023. </p>
<p>The Disability Insurance program, established in 1956, provides benefits to those who meet a specific <a href="https://www.ssa.gov/OP_Home/cfr20/404/404-1505.htm">definition of disability</a> and have paid Social Security payroll taxes. The <a href="https://www.ssa.gov/oact/STATS/dib-g3.html">average payment as of February 2023</a> was $1,686 per month. </p>
<p>The Supplemental Security Income program, established in 1972, pays cash benefits to adults and children who also meet the definition of disability and who have financial need. The <a href="https://www.ssa.gov/oact/cola/SSI.html">maximum payment as of 2023</a> was $914, though <a href="https://eligibility.com/state-disability-insurance">some states supplement this</a> with their own programs. </p>
<p>My research suggests that well over 1 million people with disabilities who face substantial barriers to employment are not getting the assistance they need. But what’s more, even those who receive benefits are likely not getting enough. <a href="https://www.ssa.gov/policy/docs/rsnotes/rsn2022-01.html">Past research</a> shows that more than 20% of Disability Insurance recipients and 52% of Supplemental Security Income recipients live in poverty despite receiving these benefits.</p>
<h2>What still isn’t known</h2>
<p>This research looked at data from 2016 and earlier, but a lot has changed since then. </p>
<p><a href="https://www.washingtonpost.com/politics/2022/12/05/social-security-disability-benefit-offices-backlog-breaking-point/">Chronic understaffing</a> at benefit offices — long-running but worse since the COVID-19 pandemic began — are making benefits harder to get at a time of growing need. An <a href="https://www.nber.org/papers/w30435">estimated 500,000 people</a> are experiencing disabilities as a result of long COVID. And those experiencing it report having <a href="https://www.cnn.com/2023/02/25/business/long-covid-workforce-issues-disability-claims/index.html">even more trouble receiving benefits</a>. </p>
<p>So the problem is probably worse today.</p><img src="https://counter.theconversation.com/content/200158/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Zachary Morris received funding for this research from the Steven H. Sandell Grant Program for Retirement and Disability Research funded by the U.S. Social Security Administration (SSA) through the Retirement and Disability Research Consortium. </span></em></p>More than half of working-age adults over 50 with a work-limiting disability didn’t receive any benefits from Social Security in 2016.Zachary Morris, Assistant Professor of Social Welfare, Stony Brook University (The State University of New York)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1980752023-02-17T13:24:41Z2023-02-17T13:24:41ZTurning 50? Here are 4 things you can do to improve your health and well-being<figure><img src="https://images.theconversation.com/files/508743/original/file-20230207-27-jzu8l0.jpg?ixlib=rb-1.1.0&rect=0%2C31%2C5184%2C3406&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Turning 50 can be the time of your life – but it also means adapting to new challenges.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mature-retired-couple-stop-for-rest-and-hot-drink-royalty-free-image/1387313039?phrase=50%20year%20old&adppopup=true">monkeybusinessimages/iStock via Getty Images Plus</a></span></figcaption></figure><p>When the ball dropped on New Year’s Eve to mark the beginning of 2023, I came to grips with the fact that I would turn 50 years old this year. </p>
<p>Entering a new decade is often a time to pause and reflect on our lives, <a href="https://theconversation.com/midlife-isnt-a-crisis-but-sleep-stress-and-happiness-feel-a-little-different-after-35-or-whenever-middle-age-actually-begins-173131">particularly when reaching middle age</a>. For 50-year-old American men, the average remaining life expectancy <a href="https://www.cdc.gov/nchs/data/vsrr/vsrr023.pdf">is 28 more years; for women, it’s 32</a>. </p>
<p>As a <a href="https://scholar.google.com/citations?user=87v4Nk4AAAAJ&hl=en">public health professor</a> who is an expert in health promotion, I started to think about things one could do around this milestone birthday to improve the chances of living a healthy life for decades to come. </p>
<p>After reviewing the literature on healthy aging, I identified four things in particular that take on greater importance when you turn 50 – and that go beyond general health advice that’s beneficial at any age, like <a href="https://theconversation.com/kick-up-your-heels-ballroom-dancing-offers-benefits-to-the-aging-brain-and-could-help-stave-off-dementia-194969">staying active</a>, <a href="https://theconversation.com/ultra-processed-foods-like-cookies-chips-frozen-meals-and-fast-food-may-contribute-to-cognitive-decline-196560">eating well</a> and <a href="https://theconversation.com/better-sleep-for-kids-starts-with-better-sleep-for-parents-especially-after-holiday-disruptions-to-routines-196110">getting enough sleep</a>. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/F5rDA5k3R4c?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A TV reporter gets a colonoscopy.</span></figcaption>
</figure>
<h2>Get a colonoscopy</h2>
<p>Urging everyone to get a colonoscopy is certainly not the most fun piece of advice, but it’s one of the most important. The American Cancer Society estimates that there will be more than 105,000 new cases of colon cancer, more than 45,000 new cases of rectal cancer and <a href="https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html">over 50,000 deaths from colorectal cancer in 2023 alone</a>.</p>
<p>This makes colorectal cancer the <a href="https://seer.cancer.gov/statfacts/html/common.html#">second leading cause of cancer-related deaths</a> for men and women. </p>
<p>The good news is that the <a href="https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html">survival rate is high</a> if the cancer is detected early, before it spreads to other parts of the body. The survival rate drops precipitously if cancer is found in the later stages. </p>
<p>A <a href="https://www.niddk.nih.gov/health-information/diagnostic-tests/colonoscopy">colonoscopy</a> is a routine inpatient procedure that uses a <a href="https://theconversation.com/colonoscopy-is-still-the-most-recommended-screening-for-colorectal-cancer-despite-conflicting-headlines-and-flawed-interpretations-of-a-new-study-192374">scope to examine the rectum and colon</a> and that requires sedation or anesthesia.</p>
<p>In addition to detecting cancerous or potentially malignant polyps, your doctor can also detect swollen tissue and ulcers. These may indicate potential problems and increase the need for more frequent monitoring. </p>
<p>For people at low risk of colorectal cancer, there are <a href="https://www.health.harvard.edu/blog/colon-cancer-screening-decisions-whats-the-best-option-and-when-202206152762">less invasive tests</a> that can be done at home, <a href="https://www.healthline.com/health/cologuard">such as Cologuard</a>. This involves collecting and mailing a sample of poop to a lab. These options should be discussed with your doctor to figure out which screening is best for you. </p>
<p>In 2021 the U.S. Preventive Services Task Force, a national panel of experts, changed its recommendation for beginning colorectal cancer screening <a href="https://doi.org/10.1001/jama.2021.6238">from age 50 to 45</a> for people at low risk. As a result, <a href="https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-coverage-laws.html">insurance companies are required</a> to cover the cost of screening for anyone age 45 or older. </p>
<p>People at high risk <a href="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening">should get screened even earlier</a>. <a href="https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html">High risk</a> is defined as a family history of colorectal cancer or a diagnosis of <a href="https://www.cdc.gov/ibd/what-is-IBD.htm">inflammatory bowel disease</a>. Colorectal cancer can occur in younger people too; for example, the “Black Panther” star, actor Chadwick Boseman, <a href="https://www.nytimes.com/2020/08/28/movies/chadwick-boseman-dead.html">died of colon cancer at the age of 43</a> in 2020. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/510691/original/file-20230216-28-8dde3u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A photograph of a Black man wearing a tuxedo and bow tie." src="https://images.theconversation.com/files/510691/original/file-20230216-28-8dde3u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/510691/original/file-20230216-28-8dde3u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/510691/original/file-20230216-28-8dde3u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/510691/original/file-20230216-28-8dde3u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/510691/original/file-20230216-28-8dde3u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/510691/original/file-20230216-28-8dde3u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/510691/original/file-20230216-28-8dde3u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Actor Chadwick Boseman at the 2016 NAACP Image Awards in Pasadena, Calif. Boseman died of colon cancer in 2020 at age 43.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/actor-chadwick-boseman-poses-in-the-press-room-at-the-47th-news-photo/508687706?phrase=chadwick%20boseman&adppopup=true">Jason LaVeris/Film Magic via Getty Images</a></span>
</figcaption>
</figure>
<h2>Get the shingles vaccine</h2>
<p>For many people who grew up in the 1970s and 1980s, getting chickenpox was a rite of passage. I had a particularly severe case around my 10th birthday. </p>
<p>Once you have chickenpox, <a href="https://theconversation.com/chickenpox-and-shingles-virus-lying-dormant-in-your-neurons-can-reactivate-and-increase-your-risk-of-stroke-new-research-identified-a-potential-culprit-194627">the virus lies dormant</a> in your body for the rest of your life. And it <a href="https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054">can reemerge as shingles</a>. </p>
<p>While shingles are not usually life-threatening, they cause a rash and can be extremely painful. Getting shingles also <a href="https://doi.org/10.1093/infdis/jiac405">greatly increases one’s risk of having a stroke</a> over the following year.</p>
<p>The good news is that the shingles vaccine is highly effective. The Centers for Disease Control and Prevention recommends that <a href="https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html">adults 50 and older get the two-shot regimen</a>, two to six months apart, which is 97% effective at preventing shingles. </p>
<h2>Bump up retirement savings, look for discounts</h2>
<p>Retirement might seem like a long way off, but the <a href="https://news.gallup.com/poll/394943/retiring-planning-retire-later.aspx">average retirement age</a> in the United States in 2022 was 61. The same study found that on average people thought they were going to retire at age 66. </p>
<p>For anyone born after 1960, full retirement benefits <a href="https://www.ssa.gov/benefits/retirement/planner/agereduction.html">don’t kick in until age 67</a>, leaving a six-year gap between that and the average retirement age. </p>
<p>Retiring earlier than you had planned can occur for many reasons, but involuntary ones, like job loss, injury or illness, can be a financial strain. The general rule is that you need about <a href="https://www.aarp.org/retirement/planning-for-retirement/info-2020/how-much-money-do-you-need-to-retire.html">80% of your pre-retirement income</a> to be financially comfortable in retirement. This consists of all sources of income, including Social Security benefits, pensions and investments. </p>
<p>If you are behind where you should be in savings, the Internal Revenue Service allows you <a href="https://www.irs.gov/retirement-plans/plan-participant-employee/retirement-topics-catch-up-contributions">to make catch-up contributions</a> starting the year you turn 50. Employees who are 50 or older with a 401(k), 403(b) or 457(b) can contribute an extra US$7,500 a year. This money grows tax-free and helps provide an extra cushion when you retire. At age 50, an extra $1,000 per year can also be contributed for <a href="https://www.irs.gov/retirement-plans/plan-participant-employee/retirement-topics-ira-contribution-limits">individual retirement accounts and Roth IRA accounts</a>.</p>
<p>Another way to save: Many hotels, restaurants and retail outlets offer senior discounts starting at age 50. </p>
<p>You can find reliable and up-to-date discounts by joining the <a href="https://www.aarp.org/membership/benefits/all-offers-a-z/?intcmp=GLOBAL-HDR-LNK-CLK-BENEFITS-UXDIA">AARP</a>. This nonprofit organization advocates for people ages 50 and older. Membership is under $20 per year and provides hundreds of discounts. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/8G51OpWo0QI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">The challenges of turning 50.</span></figcaption>
</figure>
<h2>Get your paperwork in order</h2>
<p>While people in their 50s and beyond often still have their best decades ahead of them, it is vital to prepare for the unexpected – at any age. The <a href="https://www.statista.com/statistics/241572/death-rate-by-age-and-sex-in-the-us/">mortality rate for people ages 55 to 64 is double that</a> of those age 45 to 54. </p>
<p>This is an excellent time to decide how you want your affairs to be handled. According to the National Institute on Aging, this includes your <a href="https://www.nia.nih.gov/health/getting-your-affairs-order">will, living will and a durable power of attorney</a>. </p>
<p>A will describes how you would like your financial assets distributed after your death. However, <a href="https://theconversation.com/68-of-americans-do-not-have-a-will-137686">most Americans don’t have a will</a>. There are several <a href="https://theconversation.com/online-tools-put-will-writing-in-reach-for-most-people-but-theyre-not-the-end-of-the-line-for-producing-a-legally-binding-document-173569">online tools for wills</a> and <a href="https://theconversation.com/want-to-do-more-for-your-favorite-charity-consider-a-planned-gift-138241">bequests</a> that can make this process easier. </p>
<p><a href="https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303">Living wills</a> indicate the type of care you want or don’t want if you are unable to communicate your preferences. The <a href="https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303">durable power of attorney</a> is a document that allows someone you appoint to make health care decisions for you if you cannot. This is different from a general power of attorney, which ends if you can no longer make decisions on your own.</p>
<p>These may seem like a time-consuming list of things to do, but breaking them down into separate tasks makes it more manageable. So far, I have bumped up my retirement savings and scheduled my colonoscopy – even though I’m five years late on that one, based on the new recommendations. </p>
<p>I will get the rest done by the end of the year – and if you’re turning 50 or just planning ahead, I hope you do too. Admittedly, not all of it is fun, but everything on this checklist will add security to your years, and perhaps years to your life.</p><img src="https://counter.theconversation.com/content/198075/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jay Maddock does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Middle age means staying a step ahead on both the medical and financial fronts.Jay Maddock, Professor of Public Health, Texas A&M UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1917242022-10-18T16:12:29Z2022-10-18T16:12:29ZMuscle is important for good health – here’s how to maintain it after middle age<figure><img src="https://images.theconversation.com/files/490022/original/file-20221017-15-qepbij.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6048%2C4010&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A lack of muscle mass is associated with a range of preventable diseases.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fat-middle-aged-men-fitness-trainer-2123451146">Zamrznuti tonovi/ Shutterstock</a></span></figcaption></figure><p>While it’s almost unnoticeable to begin with, nearly every cell, organ and biological process gets a little bit worse every year we’re alive starting from age 30 or so. The sum of these processes is what we know as ageing.</p>
<p>For most of us, loss of muscle strength and mass are some of the first and most obvious age-related changes we see. While this might only start out as a couple of extra little aches and pains, over time a lack of muscle mass can lead to a number of issues – including poor balance, frailty and loss of independence. It’s also associated with a <a href="https://theconversation.com/muscle-loss-can-cause-a-range-of-health-problems-as-we-age-but-it-can-be-prevented-147882">myriad of health problems</a>, including higher risk of diabetes and cardiovascular disease and even dementia. </p>
<p>While researchers aren’t entirely sure why muscle mass decreases so much as we get older, the good news is that we do know regular exercise can help lessen this impact – and can even delay some of this inevitable muscle loss. Regular physical activity is also shown to <a href="https://pubmed.ncbi.nlm.nih.gov/36001316/">lower risk of preventable diseases</a>, maintain physical function well into old age, and even <a href="https://pubmed.ncbi.nlm.nih.gov/29517845/">improve immune function</a>.</p>
<h2>Get moving</h2>
<p>Given how important muscle is for our health, the best way to maintain it after 30 is to keep moving. </p>
<p>But let’s say you’re someone who hasn’t regularly exercised in a few years, or has never done muscle-building exercises before. </p>
<p>First and foremost, remember that ageing doesn’t mean you need to avoid heavy exercise. Our research suggested that younger and older men <a href="https://pubmed.ncbi.nlm.nih.gov/34650440/">recovered in a similar manner</a> to heavy muscle-building resistance training, so long as the training was tailored to each participant’s fitness level.</p>
<p>However, it’s important to consider your abilities before you begin exercising. A common mistake people make after being off training for years (or even decades) is trying to do what they used to do, or doing too much too quickly in those first workouts. This may lead to injury, so it’s important to build your workouts up gradually.</p>
<p>Realistically, the best workout plan to follow is the <a href="https://www.nhs.uk/live-well/exercise/exercise-guidelines/physical-activity-guidelines-for-adults-aged-19-to-64/">NHS’s physical activity recommendations</a> for 18-65-year-olds. This says people should aim to be physically active most days, and do muscle-building exercises <a href="https://pubmed.ncbi.nlm.nih.gov/35228201/">at least two days per week</a>. </p>
<figure class="align-center ">
<img alt="A middle aged man and woman perform a plank at the gym." src="https://images.theconversation.com/files/490023/original/file-20221017-18-d1c8dh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/490023/original/file-20221017-18-d1c8dh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/490023/original/file-20221017-18-d1c8dh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/490023/original/file-20221017-18-d1c8dh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/490023/original/file-20221017-18-d1c8dh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/490023/original/file-20221017-18-d1c8dh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/490023/original/file-20221017-18-d1c8dh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The best exercises to do are those you enjoy doing.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/middle-age-beautiful-sporty-couple-smiling-1641934243">Krakenimages.com/ Shutterstock</a></span>
</figcaption>
</figure>
<p>But what kind of muscle-building exercises should you do? Well, there’s actually a myriad of different types of resistance exercise to choose from, and all are more or less <a href="https://pubmed.ncbi.nlm.nih.gov/32539753/">equally</a> as <a href="https://pubmed.ncbi.nlm.nih.gov/33114782/">beneficial</a> as the other. The cliche people immediately think of is large, muscular people lifting heavy weights in a gym, but there many more options out there. </p>
<p>So if you prefer doing bodyweight exercises such as pilates, using resistance bands, or hard work while gardening over lifting barbells, that’s what you should aim to do twice a week. Enjoyment counts for a lot, especially if it means you’ll keep doing your new exercise routines. </p>
<p>Endurance-based exercise (such as walking, running and cycling) are also very good for you in multiple ways, beyond just building muscle and improving heart health. There’s also a very clear relationship between longevity and doing <a href="https://pubmed.ncbi.nlm.nih.gov/25977572/">light physical activity</a> daily.</p>
<p>However, it’s important not to do too much of a good thing – especially high-intensity, resistance-based training. Research shows that doing more <a href="https://pubmed.ncbi.nlm.nih.gov/25977572/">vigorous high intensity physical activity</a> than recommended isn’t associated with substantial benefits to longevity. For clarity, this data doesn’t suggest the high intensity is negative in terms of health, just that more isn’t necessarily better. </p>
<p>From a dietary point of view, many older people don’t eat enough protein. Sufficient protein intake is necessary to <a href="https://pubmed.ncbi.nlm.nih.gov/29092886/">increase and maintain muscle mass</a> – even more so if you’re regularly exercising. Current guidelines recommend a minimum of 0.8 grams of protein per kg of body mass per day for all adults. </p>
<p>But you’ll need to double this to 1.6 grams per kg of body mass if you’re looking to <a href="https://pubmed.ncbi.nlm.nih.gov/29092886/">build muscle</a>. So for a person who weighs 70kg, they would need to eat around 112g of protein per day to build muscle. This would be the equivalent of eating approximately one large chicken breast, a protein shake, three eggs and a can of tuna (though it will vary depending on what products you use, so be sure to check the labels).</p>
<p>This seems to be especially important for <a href="https://www.bases.org.uk/imgs/9345_bas_bases_tses_summer_2022_online_pg_8_9609.pdf">physically active older people</a>(over 60 years of age). It’s also good to spread the protein you consume evenly throughout the day to help your body absorb so much protein as it can <a href="https://pubmed.ncbi.nlm.nih.gov/20844073/">per meal</a>. </p>
<p>While muscle will still inevitably decrease with age no matter how much you exercise, being physically active often is still one of the best ways we know of when it comes to maximising both good health and fitness and lifespan. And the earlier you make exercise a habit, the better off you may be in old age.</p><img src="https://counter.theconversation.com/content/191724/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bradley Elliott receives funding from The Endocrine Society, The Physiological Society, the Quintin Hogg Charitable Trust and private philanthropic donors. He is affiliated with The Physiological Society, and is a Trustee of the British Society for Research on Ageing.</span></em></p>Every year after age 30 we progressively lose muscle mass. But that doesn’t mean there’s nothing you can do about it.Bradley Elliott, Senior Lecturer in Physiology, University of WestminsterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1823362022-05-26T20:37:13Z2022-05-26T20:37:13ZFriday essay: grey-haired and radiant – reimagining ageing for women<figure><img src="https://images.theconversation.com/files/464893/original/file-20220523-90509-27imdv.jpg?ixlib=rb-1.1.0&rect=39%2C23%2C5277%2C3515&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Musician and poet Patti Smith: 'always evolving'.</span> <span class="attribution"><span class="source">Dan Himbrechts/AAP</span></span></figcaption></figure><p><a href="https://theconversation.com/men-and-young-people-more-likely-to-be-ageist-study-93057">Ageist</a> thought patterns and reactions are so embedded in Australian culture that even educated people, people who otherwise insist on political correctness, will open their mouths and deliver a hurtful, hateful judgement. </p>
<p>Like the time a few years ago, sitting on the grass at a writers’ festival with a group of other women writers of whom I was the oldest. We were fellow graduates from a postgraduate <a href="https://theconversation.com/the-rise-and-rise-of-creative-writing-730">creative writing</a> course, some of us just beginning to be published; I knew the generational difference made parts of my life inaccessible to them, as parts of their lives would remain mysterious to me. </p>
<p>That afternoon, with literary conversations buzzing all around, I remarked in passing that I was thinking of colouring my hair with henna. That rich and blazing plant-based red had once been my signature shade, but what with study, family and moving countries, the process of sourcing, mixing up and applying the henna had all come to seem too messy, too difficult. </p>
<p>So I had let my colour fade; I had allowed a succession of hairdressers to cover my grey hairs with chemical dyes, at ridiculous expense. </p>
<p>Perhaps it was a niggling sense of needing to seize control again that prompted me to say what I did.
“I think I am going to henna my hair.”
Immediately, one of the women blurted: “Oh, I wouldn’t. Not at your age!”</p>
<p>My thoughts seemed to skid to a halt. I was 59: too old to need anyone’s approval or permission. Lost for a response, I remained silent. Out of all of us, this woman was the one who was always bleaching or dyeing or doing something to her hair, in the process often leaving it visibly damaged. </p>
<p>My memory of that moment is that she realised what she had said was offensive, and tried to retrieve it by disparaging the older women with hennaed hair who regularly fill seats at the festival. However, a second ageist comment could not defuse the first. </p>
<hr>
<p>Going further back, during the demanding MA year that would eventually result in my first published novel, I was paying the household bills by freelancing – words and pictures – for a local glossy lifestyle magazine. </p>
<p>The editor had sent me to a country race meeting, with instructions to take plenty of pictures of racegoers for the social pages. At the end of a long hot afternoon, filling time while waiting for the bus to take me back to Adelaide, I gathered a few last shots as people clambered into hired stretch limos. </p>
<p>Two suited-up young men were lounging in the back seat of one of these vehicles. I leaned into the open door and asked if they’d like to have their photographs taken for the social pages, and I named the magazine. They beamed obligingly; I snapped the picture, recorded their names, and turned away. </p>
<p>And then I heard one of them say in a sniggering undertone: “Why the hell are (name of the magazine) getting old grannies to do this work?”
I was checking their image on my digital camera, making sure the exposure was good, the framing right.
“Shhh!” hissed the friend. </p>
<p>I was a 54-year-old woman at the end of a long working day: I was not going to put up with this shit. My vengeful thumb moved to delete their image. </p>
<p>Of course, I should have turned to that arrogant boyo and asked whether he had a grandmother and, if he did, how he would feel if someone insulted her the way he had just insulted me. But I couldn’t face him because my eyes had filled with tears. </p>
<p>Walking away, I blamed my loss of control on the <a href="https://theconversation.com/a-shift-in-social-attitudes-can-make-menopause-a-positive-experience-46742">menopause</a>. But it wasn’t that: it was the shame women are made to feel simply for having lived a certain number of years.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/grace-and-frankie-is-the-longest-running-series-on-netflix-and-a-show-for-women-who-dont-see-themselves-on-television-182298">Grace and Frankie is the longest running series on Netflix – and a show for women who don’t see themselves on television</a>
</strong>
</em>
</p>
<hr>
<h2>Youth-obsessed culture</h2>
<p>In our <a href="https://theconversation.com/the-truth-about-madonnas-hairy-armpits-and-sexy-older-women-24706">youth-obsessed</a> culture, old people have become invisible. If we dare to put ourselves in the line of sight, we may become targets of this kind of humiliating, knee-jerk ageism. Both men and women suffer from the social erasing of the old, but it is worse for women. </p>
<p>The premium placed on feminine beauty means that older women often find themselves at the terrible nexus of sexism and ageism. </p>
<p>In 1972, in <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9780429496059-2/double-standard-aging-susan-sontag">“The Double Standard of Ageing”</a>, Susan Sontag identified the oppressive belief that men are enhanced by age while women are progressively destroyed. “Competing for a job” writes Sontag, “her chances often partly depend on being the ‘right age’, and if hers isn’t right, she will lie if she thinks she can get away with it.” A woman’s age, Sontag insists, is “something of a dirty secret”.</p>
<p>It often seems as if not much has changed since 1972. <a href="https://theconversation.com/as-the-party-faithful-drift-away-can-bill-shorten-reinvent-labor-31098">Bill Shorten</a> once admitted that his mother Ann, having qualified as a barrister at 53, discovered, in Bill’s words, that “sometimes, you’re just too old, and you shouldn’t be too old, but she discovered the discrimination against older women”. </p>
<p>Sex-ageism is not merely demoralising, but has the potential to affect women’s ability to survive. If we are not to be allowed to continue to work even though we are fit for it, if we have always been paid less than our male colleagues, if we have given years of our lives to the unpaid labour of child rearing, if we have <a href="https://theconversation.com/spirals-and-circles-snakes-and-ladders-why-womens-super-is-complex-103763">insufficient super</a> (or no super at all), what is to become of us in our sixties, seventies, and eighties? Alarmingly, older women make up the new demographic joining the ranks of the <a href="https://theconversation.com/how-chinese-courtyard-housing-can-help-older-australian-women-avoid-homelessness-151378">homeless</a>.</p>
<p>In <a href="https://www.goodreads.com/book/show/755360.At_Seventy">At Seventy: A Journal</a> (1987), May Sarton writes, “This is the best time of my life. I love being old.” She goes on to explain that she does not feel old at all, “not as much a survivor as a person still on her way”, and she speculates that perhaps real old age will only begin when you find yourself looking back rather than forward. </p>
<p>Sarton’s journals are rightly celebrated, and are a cache of gold well worth digging to find. For together with <a href="https://theconversation.com/doris-lessing-was-a-radical-in-the-truest-sense-20425">Doris Lessing</a>, May Sarton is one of the few women writers who have not shied from writing about age and ageing. </p>
<p>The shocking scarcity of older women in fiction that has left me with a sense of marching forward in the dark is balanced by the steadying beam of their work – especially Sarton’s, for the light she sheds is age-affirming, ever hopeful, an antidote to the “state of decline” narrative. </p>
<p>For example, when asked why she thought it was good to be old, Sarton replied: </p>
<blockquote>
<p>Because I am more myself than I have ever been. There is less conflict. I am happier, more balanced, and more powerful.</p>
</blockquote>
<p>She amended this to “I am better able to use my powers”. And May Sarton continued to use those powers, writing <a href="https://www.goodreads.com/book/show/603966.At_Eighty_Two">At Eighty-Two: A Journal</a> (1997). Though it was published under that title, her preferred name for it was Kairos, after “a Greek word meaning a unique time in a person’s life and an opportunity for change”.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/400-000-women-over-45-are-at-risk-of-homelessness-in-australia-142906">400,000 women over 45 are at risk of homelessness in Australia</a>
</strong>
</em>
</p>
<hr>
<h2>Realising our authentic selves</h2>
<p>This question of how to be, as we move from <a href="https://theconversation.com/age-and-happiness-debunking-the-myth-of-middle-aged-blues-7451">middle-age</a> into old age, is a lot like the dilemma of the teenage self. Back then it was the childish body transforming to adulthood, and although that destination was where most of us wished to be, the unfamiliarity of the changed self, and the pressures of <a href="https://theconversation.com/friday-essay-how-new-york-fashion-week-came-to-be-54389">fashion</a>, popular culture, and one’s peers, often made the transition awkward and painful. </p>
<p>While the destination of Old is not where most of us wish to be, if we live long enough we will have no choice. If there is any advantage to this passage, it must be the power described by May Sarton, to be more ourselves than we have ever been. Yet how many of us know ourselves well enough to be “more”? </p>
<p>Lately I have been taking inspiration from the musician, artist and poet, Patti Smith. Now pushing deeper into her seventies, Patti is a creative force; she still performs with her band. Smith describes herself as “always evolving”, but not changing because of any outside pressure. </p>
<p>Never one to conform to expectations of <a href="https://theconversation.com/friday-essay-how-19th-century-ideas-influenced-todays-attitudes-to-womens-beauty-111529">feminine beauty</a>, or of how a woman should appear on a stage, Patti Smith appears to be a completely authentic version of her younger self, only older. </p>
<iframe width="100%" height="315" src="https://www.youtube.com/embed/LoWfnFJ52rc" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen=""></iframe>
<p>Realising this authentic self is the task old age sets us, but how is it to be done? How are we to tell what the authentic self is? </p>
<p>In the preface to <a href="https://www.harpercollins.com.au/9780007136445/the-diaries-of-jane-somers/">The Diaries of Jane Somers</a> (1983) Doris Lessing – who initially submitted the two novels in this volume using a pseudonym – explains that by writing under another name she wanted “to get free of that cage of associations and labels that every established writer has to learn to live inside”. </p>
<p>She also wanted to “cheer up young writers, who often have such a hard time of it”. Interestingly, both the novels in Lessing’s publishing experiment deal with women and age. </p>
<p>The first, <a href="http://www.dorislessing.org/thediary.html">The Diary of a Good Neighbour</a>, evokes the unforgettable Maudie Fowler, who in her nineties remains so fiercely independent that she will not consider moving from the dauntingly uncomfortable rooms she inhabits, or even having helpers. (“With your own place,” Maudie says, “you’ve got everything. Without it, you are a dog. You are nothing.”)</p>
<p>In England, Doris Lessing’s publishers Jonathan Cape and Granada <a href="https://www.newyorker.com/books/page-turner/doris-lessing-and-the-perils-of-the-pseudonymous-novel">rejected</a> The Diary of a Good Neighbour, with Granada saying it was “too depressing” to publish. It was then accepted by Michael Joseph, who said it reminded them of Doris Lessing. When it was acquired by Lessing’s French publisher he rang her to ask if she had helped Jane Somers, because Somers reminded him so much of Lessing. </p>
<p>The perceptiveness of these publishers made Doris Lessing question what it was they had recognised. She had deliberately made Jane Somers’ style different from her own, and felt that each of her novels had a characteristic tone of voice, a style peculiar to itself. Lessing reasoned that </p>
<blockquote>
<p>behind this must sound another note, independent of style. What is this underlying tone, or voice, and where does it originate in the author? It seems to me we are listening to, responding to, the essence of a writer here, a groundnote.</p>
</blockquote>
<p>I am fascinated by this concept of the groundnote as it relates to writing, and in whether or not one can recognise it one’s own work. I am reminded of those black-and-white films we once watched on television that were set on board a submarine; the only soundtrack was the persistent <em>bleep bleep</em> of the sonar. </p>
<p>Often the act of writing itself is like being one of the submarine’s crew – tensed within the finite oxygen supply of a tiny lit capsule, pushing on through darkness under crushing force. I can still picture those submariners: sweating, silent, while the vessel shook and water trickled dangerously, and the periscope was cranked up to scan the surface. </p>
<p>Aside from writing, Doris Lessing’s experiment easily relates to the dilemmas of ageing, for older women, too, suffer the “cage of associations and labels”. It is good to be reminded that, whatever style we adopt, or imagine we possess, there is underneath, the groundnote of the true self. </p>
<p>Patti Smith writes in <a href="https://theconversation.com/hop-aboard-patti-smiths-m-train-a-memoir-on-the-right-side-of-the-tracks-49288">M Train</a> (2015): </p>
<blockquote>
<p>As a child I thought I would never grow up, that I could will it so. And then I realized, quite recently, that I had crossed some line, unconsciously cloaked in the truth of my chronology. How did we get so damn old? I say to my joints, my iron-coloured hair.</p>
</blockquote>
<p>Yet, Smith continues: </p>
<blockquote>
<p>If we walk the victim, we’re perceived as the victim. And if we enter […] glowing and receptive […] if we maintain our radiance and enter a situation with radiance, often radiance will come our way.</p>
</blockquote>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/464924/original/file-20220524-25530-npuujy.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/464924/original/file-20220524-25530-npuujy.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/464924/original/file-20220524-25530-npuujy.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=906&fit=crop&dpr=1 600w, https://images.theconversation.com/files/464924/original/file-20220524-25530-npuujy.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=906&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/464924/original/file-20220524-25530-npuujy.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=906&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/464924/original/file-20220524-25530-npuujy.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1139&fit=crop&dpr=1 754w, https://images.theconversation.com/files/464924/original/file-20220524-25530-npuujy.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1139&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/464924/original/file-20220524-25530-npuujy.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1139&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p>Understanding our groundnote must surely release us into our power. Hearing it, will we not become comfortable, even radiant, in our own skins? </p>
<p>I am visualising a state of being that has nothing to do with the positive ageing or <a href="https://theconversation.com/health-check-how-much-physical-activity-is-enough-in-older-age-103686">active ageing</a> campaigns directed towards the elderly. Those campaigns could be termed passive-aggressive, for their subtext is that ageing is bad. And in denying age its due dignity, in promoting a fantasy in which old people do not appear to age at all, they set the scene for many levels of failure. </p>
<p>So how are we to hear this groundnote? </p>
<p>It could be a case of careful and consistent listening. It must be different for everyone. Perhaps the transition is less about growing old and more about growing up. </p>
<p>When I think about this what comes to mind is the Michelle Shocked song <a href="http://www.azlyricdb.com/lyrics/Michelle-Shocked-When-I-Grow-Up-204312#.YowffZNByrc">“When I Grow Up (I want to be an old woman)”</a>, with its implication of a genuine desire to experience being old. If there are stages we must pass through, the first stage might be the cessation of denial.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/friday-essay-how-shakespeare-helped-shape-germaine-greers-feminist-masterpiece-59880">Friday essay: How Shakespeare helped shape Germaine Greer's feminist masterpiece</a>
</strong>
</em>
</p>
<hr>
<h2>Ageing feminists</h2>
<p>In her book <a href="https://www.goodreads.com/book/show/99173.Fountain_of_Age">The Fountain of Age</a> (1993) ground-breaking feminist writer Betty Friedan admits that in her fifties she “didn’t even want to think about age”; she, too, was locked in denial. </p>
<p>But as she researched that book, she “began to recognize some new dimension of personhood, some strength or quality of being in people who had crossed the chasm of age – and kept on going and growing”. </p>
<p>In her earlier book <a href="https://www.penguin.com.au/books/the-feminine-mystique-9780141192055">The Feminine Mystique</a> (1963), Friedan, at 35, had refused to let women be defined as sex objects, and in her book on age she refuses to let women or men over 65 be defined as objects of “care”, or old age be defined as a “sickness” to be “cured”. </p>
<p><a href="https://theconversation.com/a-human-being-not-just-mum-the-womens-liberationists-who-fought-for-the-rights-of-mothers-and-children-182057">Feminism</a> has fought hard for women’s rights, but despite some of the movement’s leaders like Friedan researching exhaustively and writing about women and ageing, ageism persists, the last of the undesirable “isms” to ever be mentioned. </p>
<p>Old women remain the butt of jokes; in real life, old women are some of society’s most marginalised people, while in literature they are disgracefully underwritten, other than as stereotypes. </p>
<p>Feminists have typically tended to address matters affecting younger women. This is a reflection of the age of the women involved in the battles for <a href="https://theconversation.com/50-years-after-equal-pay-the-legacy-of-womens-work-remains-118761">equal pay</a>, <a href="https://theconversation.com/paid-parental-leave-plan-ignores-economics-of-well-functioning-families-67549">paid maternity leave</a> and the calling-out of <a href="https://theconversation.com/sexual-harassment-is-too-much-and-not-enough-about-sex-93486">sexual harassment</a>. Sadly, when it comes to old women, even younger women do not see them. </p>
<p>The result is mutual deprivation: old women have no opportunity to contribute their experience and wisdom, and young women have no role models to show them how to manage their own inevitable ageing. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/friday-essay-double-standards-and-derision-tracing-our-attitudes-to-older-women-and-beauty-79575">Friday essay: double standards and derision – tracing our attitudes to older women and beauty</a>
</strong>
</em>
</p>
<hr>
<h2>An ordeal of the imagination</h2>
<p>One thing that gives me hope this will change is the <a href="https://www.instagram.com/explore/tags/greyhair/?hl=en">#greyhair</a> movement on Instagram.</p>
<p>When in preparation for my own switch to natural colour, I ceased dying my hair – no more henna, no more expensive sessions at the hairdressers – I stumbled over pages that led me to communities of women dedicated to supporting each other through this process. </p>
<p>And I needed encouragement, for when I had announced I would no longer colour my hair even my 92-year-old mother advised against it, telling me I would be sorry. </p>
<hr>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/CdxILuTI3w9","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<hr>
<p>From the stories shared on Instagram, I learned that for many women, the grey kicks in early – sometimes even during their teens. The candid posts with photographs of every imaginable shade and patterning of grey, and the ease of sharing them, make social media the perfect tool for this new women’s movement. </p>
<p>It could become instrumental in chipping away at our damaging self-beliefs about ageing, and recalibrate perceptions of female beauty.</p>
<p>Another signal of positive change is the recent high-profile publication of at least one Australian novel in which the main characters are all women in their seventies. Charlotte Wood’s <a href="https://www.allenandunwin.com/browse/books/fiction/The-Weekend-Charlotte-Wood-9781760292010">The Weekend</a> (2019) goes against the grain of decades of published fiction, with just a few notable exceptions. </p>
<p>Wood’s literary currency means the book has been widely read, and at literary festivals has sparked conversations about ageing, and especially about what it means for women. In the novel, the elderly actress Adele has a moment where she feels “on the edge of discovering something very important – about living, about the age beyond youth and love, about this great secret time of a person’s life”. Perhaps Adele is about to discover her <em>kairos</em>.</p>
<p>Liz Byrski is another Australian writer who has identified the absence of old people, especially old women, in fiction, and has set herself the task of addressing it. In her novels she makes a point of showing old women using computers and mobile phones, busting the stereotype of elders baffled by technology. </p>
<p>In her slender book <a href="https://www.panmacmillan.com.au/9781743340479/">Getting On: some thoughts on women and ageing</a> (2012) Byrski insists we need to challenge the public perception of ageing and change it to </p>
<blockquote>
<p>a positive conversation in which the phrase “the fight against ageing” is banned and the use of “anti-ageing” as a descriptor for any product is greeted with derision. </p>
</blockquote>
<p>She goes on to suggest how as individuals we should “start seeing old people”; we should strive to put aside our blindness, denial, and fear, and to focus instead on the richness and value of the lives old people are still living. </p>
<p>The negativity around ageing, the elitism of youth, means there are few older role models to encourage our young people. This has the effect of leaving them marooned, unable to imagine a way forward beyond middle age – and further on into the kind of old age that, if they are lucky enough to reach it, they might be willing, even proud, to be able to live. </p>
<p>Susan Sontag, while describing old age as a “genuine ordeal” maintained it was mainly “an ordeal of the imagination”. </p>
<p>I don’t believe she was underestimating the physical tests and challenges age brings, but rather acknowledging that nothing about it is so testing as being looked through, looked past, being patronised, being treated by others as diminished, or worthless. </p>
<p>By continuing to denigrate old age we are contributing to this ordeal, condemning young folk to “walk the victim”, denying them, and ourselves, the possibility of <em>kairos</em>; the possibility of radiance.</p><img src="https://counter.theconversation.com/content/182336/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Carol Lefevre does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Old women remain the butt of jokes; they are some of society’s most marginalised people. But age also invites us to become our most authentic selves, writes Carol Lefevre.Carol Lefevre, Visiting Research Fellow, Department of English and Creative Writing, University of AdelaideLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1798052022-03-25T14:59:53Z2022-03-25T14:59:53ZLong-term antibiotic use by middle-aged women may affect cognitive function – new study<figure><img src="https://images.theconversation.com/files/454400/original/file-20220325-15-oytuk.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6709%2C4476&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People may need to take long-term antibiotics for a range of conditions.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/crop-close-young-african-american-woman-1863927673">fizkes/ Shutterstock</a></span></figcaption></figure><p>Antibiotics are one of the most commonly prescribed drugs in the world. They’re used to treat many different bacterial infections. While most people may only be on a course of antibiotics for a week or two at a time, some may take antibiotics for a longer period to treat certain chronic conditions, such as pneumonia or acne.</p>
<p>While antibiotics can be life-saving, long-term use can come with several side effects – not least of which is the risk of bacteria developing antibiotic resistance. And now, a recent study has also linked long-term antibiotic use by middle-aged women to an <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264649">increased risk of cognitive decline</a>.</p>
<p>To conduct their study, the researchers collected data from 14,542 participants who had taken part in the Nurses’ Health Study II. This study monitored the health and wellbeing of nurses every two years between 2014-2018. The average age of participants at the start of the study was 54.</p>
<p>The researchers recorded the participants’ antibiotic use up to four years prior to the start of the study. Some women had taken long-term antibiotics (two months or more) for a variety of conditions – such as respiratory problems or acne. Others had not been prescribed any antibiotics. The researchers measured cognitive ability using online tests that participants completed, which measured factors such as learning and working memory.</p>
<p>The women were followed up seven years later to see whether long-term antibiotic use in middle-age had lasting effects on cognition. Women who had previously used long-term antibiotics scored lower on learning, working memory, motor speed and attention tests compared to non-users. It’s unknown whether short-term antibiotic use had a similar effect as this wasn’t reported. </p>
<h2>Gut health</h2>
<p>Though the findings only show a link between antibiotic use and cognitive decline, the researchers think that gut microbiome changes caused by long-term antibiotic use may be the reason some women experienced poorer cognitive function. </p>
<p>Our bodies contain millions of tiny microbes invisible to the human eye. These bacteria and viruses quietly keep our health in check. But many things can disturb our microbiome’s balance – including poor diet and <a href="https://www.mdpi.com/2227-9059/8/11/502/htm">antibiotic use</a>. </p>
<figure class="align-center ">
<img alt="Woman holds an antibiotic pill between her thumb and index finger." src="https://images.theconversation.com/files/454401/original/file-20220325-17-10zqpx6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/454401/original/file-20220325-17-10zqpx6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/454401/original/file-20220325-17-10zqpx6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/454401/original/file-20220325-17-10zqpx6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/454401/original/file-20220325-17-10zqpx6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/454401/original/file-20220325-17-10zqpx6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/454401/original/file-20220325-17-10zqpx6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Antibiotics can disrupt our gut microbiome.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/selective-focus-medicine-pills-capsules-hand-405634465">Joe Besure/ Shutterstock</a></span>
</figcaption>
</figure>
<p>While antibiotics kill bacteria that cause infections in our body, they can also may kill other bacteria, including helpful ones. Even a small disruption in our microbiome’s balance can have an impact on our health – linked to conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039952/">inflammatory bowel disease</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/30366260/">type 2 diabetes</a>, <a href="https://www.sciencedirect.com/science/article/pii/S1931312817304407">obesity</a> and <a href="https://theconversation.com/how-parasites-and-bacteria-could-be-changing-the-way-you-think-and-feel-71309">mental health problems</a>. </p>
<p>Our <a href="https://www.sciencedirect.com/science/article/pii/S0163725815002259?via%3Dihub">gut microbiome and brain</a> are also connected, which is why a healthy gut is important for brain health. For example, the proteins our brain cells use to communicate are <a href="https://www.mdpi.com/2072-6643/13/6/2099">manufactured by gut microbes</a>. When the gut microbiome becomes unbalanced these <a href="https://www.frontiersin.org/articles/10.3389/fnins.2019.00369/full">proteins become damaged</a>. Not only does this affect how our brain works, it may even contribute to conditions such as <a href="https://theconversation.com/your-gut-microbiome-may-be-linked-to-dementia-parkinsons-disease-and-ms-144367">dementia, Parkinson’s disease</a> and even <a href="https://www.mdpi.com/2227-9059/9/8/875">schizophrenia</a>.</p>
<p>Given the microbiome’s connection to brain health and <a href="https://www.frontiersin.org/articles/10.3389/fnagi.2019.00170/full">cognition</a> and extensive evidence which shows antibiotics can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831151/">disrupt the microbiome</a>, it seems plausible that long-term antibiotic use can affect the cognitive functions of the brain. For example, there’s evidence antibiotic use in early childhood – an important time for brain and cognitive development – can have <a href="https://pubmed.ncbi.nlm.nih.gov/31041458/">negative effects on cognition</a> up to 11 years later.</p>
<p>Though few studies have measured both antibiotic use and cognitive function in adults, some studies have shown broad-spectrum antimicrobials (including antibiotics) can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007723/">affect our cognitive function</a> – causing side effects such as confusion, delirium and poorer attention in both men and women, even after short-term use.</p>
<p>While this recent study showed a link between long-term antibiotic use and cognitive decline, the study has some of limitations to take into account. First, the online cognitive test only assessed four functions. This means we don’t have a full picture of cognitive health, and we do not know if there are other cognitive deficits in addition to those measured in the study. </p>
<p>Another shortfall is that researchers did not collect faecal samples. This means we don’t actually know whether the microbiome changed significantly after long-term antibiotic use – and whether this change persisted. Though the researchers were able to show that antibiotic use had a greater link to poorer cognitive function than other lifestyle factors (such as diet, or other health conditions), it will still be important for future research to look at whether the microbiome really plays a role in antibiotic use and cognitive function.</p>
<p>The age of the participants is also an important factor, as the average age was 54 at the start of the study – which is the time most women experience menopause. Menopause causes <a href="https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-hormone-levels">hormonal changes</a> that can affect everything from how the immune system works, sleep quality, weight, blood pressure and even concentration and thinking. </p>
<p>Some research also shows that the menopause <a href="https://www.frontiersin.org/articles/10.3389/fcimb.2021.702628/full">alters the microbiome</a>. As such, it will be important to future studies to include men in mid-life to see whether they show similar effects.</p>
<p>These research findings indicate that it’s important to pay attention to gut health at all stages of life. Fortunately, there are many things you can do to make your microbiome healthier – such as eating a high-fibre diet and using prebiotics and probiotics. Fresh air and exercise also have positive effects on the microbiome. Of course for persistent problems medical attention should be sought.</p><img src="https://counter.theconversation.com/content/179805/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lynne A Barker has recently accepted a role on the Medical Advisory Board of a probiotic company</span></em></p>Our gut microbiome is connected to almost every aspect of our health – including brain health.Lynne A Barker, Associate Professor in Cognitive Neuroscience, Sheffield Hallam UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1731312022-02-08T13:34:23Z2022-02-08T13:34:23ZMidlife isn’t a crisis, but sleep, stress and happiness feel a little different after 35 – or whenever middle age actually begins<figure><img src="https://images.theconversation.com/files/444431/original/file-20220203-15-u5dii3.jpeg?ixlib=rb-1.1.0&rect=22%2C29%2C4885%2C3884&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">When midlife begins can vary from person to person.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/portrait-of-five-women-laughing-and-having-fun-royalty-free-image/901670548?">Flashpop/Digitalvision via Getty Images</a></span></figcaption></figure><p>Fewer than <a href="https://doi.org/10.1146/annurev.psych.55.090902.141521">one-fifth of Americans</a> say they actually experienced a midlife crisis. And yet there are still some common misunderstandings people have about midlife. </p>
<p>I <a href="https://scholar.google.com/citations?hl=en&user=ag1U45UAAAAJ">study midlife</a>, and especially how people in this stage of life experience sleep and stress. In my research, I have also found that midlife brings both opportunities and challenges. </p>
<h2>Are we there yet?</h2>
<p>Exactly when midlife begins is hard to pin down. Compared with other developmental periods – like childhood, adolescence and older adulthood – midlife lasts longer and includes more diverse social roles. There are fewer published studies on midlife than studies on childhood and older adulthood. So researchers still know little about the timing and unique experiences of this stage of life.</p>
<p>Midlife may begin at different times for different people. </p>
<p>In the 1990s, people generally agreed that midlife <a href="https://doi.org/10.1016/B978-012757230-7/50020-1">begins at age 35</a>. This has shifted toward an older age. Now Americans might say midlife begins at age <a href="https://doi.org/10.1037/amp0000591">44 and ends by 60</a>. An increased life expectancy and medical advances may have contributed to this shift. </p>
<p>Today’s adults are living longer and healthier lives than previous generations. Also, the demands of establishing a career while building a family have increased. That’s why some researchers have started referring to the period occurring roughly from age 30 to 45 as <a href="https://doi.org/10.1037/amp0000600">“established adulthood,”</a> distinguishing it from midlife as it was previously understood. </p>
<p>Chronological age is only one way to define the beginning of midlife. Psychologist Margie Lachman emphasizes looking at certain life transitions and social roles that commonly <a href="https://doi.org/10.1146/annurev.psych.55.090902.141521">occur in midlife</a> as a way of coming up with a definition.</p>
<figure class="align-center ">
<img alt="Woman with light-colored hair and dark eyes looking up and to the side, as if seeing her own thoughts, with her chin resting in her hand." src="https://images.theconversation.com/files/444432/original/file-20220203-17-yrpgly.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/444432/original/file-20220203-17-yrpgly.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=303&fit=crop&dpr=1 600w, https://images.theconversation.com/files/444432/original/file-20220203-17-yrpgly.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=303&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/444432/original/file-20220203-17-yrpgly.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=303&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/444432/original/file-20220203-17-yrpgly.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=381&fit=crop&dpr=1 754w, https://images.theconversation.com/files/444432/original/file-20220203-17-yrpgly.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=381&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/444432/original/file-20220203-17-yrpgly.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=381&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Longer lives and changes in social roles have shifted people’s thinking about when midlife begins.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/looking-upward-royalty-free-image/172168828">bobbieo/iStock via Getty Images</a></span>
</figcaption>
</figure>
<h2>So many roles, so little time</h2>
<p>Midlife is a time when individuals occupy the greatest number of social roles. The average U.S. adult in midlife typically has four key roles – paid worker or homemaker; spouse or partner; parent; and adult child. Having multiple roles may provide more opportunities to <a href="https://doi.org/10.1037/0003-066X.56.10.781">build resources</a> such as income, self-esteem, relationships and success. But people must also divide their <a href="https://doi.org/10.2307/2092933">time and energy</a> across these multiple roles. </p>
<p>[<em>Like what you’ve read? Want more?</em> <a href="https://memberservices.theconversation.com/newsletters/?source=inline-likethis">Sign up for The Conversation’s daily newsletter</a>.]</p>
<p>Risk factors for later-life diseases also show up in midlife. Slower metabolism, weight gain and hormonal changes are common. Also, women experience menopause, which involves hot flashes and emotional ups and downs. Men in midlife are more likely than younger men and women to develop <a href="https://doi.org/10.1111/jsr.12770">sleep apnea</a>. </p>
<p>All these factors are closely related to sleep, so it’s no surprise to find <a href="https://doi.org/10.1093/sleep/27.7.1255">poor sleep among midlife adults</a>. Sleeping less than six hours a night, getting poor-quality sleep and other <a href="https://doi.org/10.1016/j.socscimed.2021.113800">sleep issues are prevalent</a>. </p>
<h2>Sleep, stress, happiness</h2>
<p>Age-related physical changes are not the only threat to sleep, however. The struggle of midlife adults to <a href="https://doi.org/10.2307/2092933">juggle multiple often incompatible roles</a> also causes stress. Stress has negative consequences on sleep, such as chronic insomnia. What’s worse: <a href="https://doi.org/10.1111/jsr.12488">Stress can result from poor sleep</a>. So sleeping poorly or being stressed out can create a vicious cycle and cascading <a href="https://doi.org/10.1002/smi.1304">health problems</a>. </p>
<p>Both sleep and stress affect emotions, so you might expect low levels of happiness in midlife. Research backs this up. Fewer people <a href="https://doi.org/10.1073/pnas.1003744107">are happy during midlife</a> than older and younger groups. Yet it is important to note that midlife also <a href="https://doi.org/10.1007/s10834-006-9026-7">involves growth</a>, including peaks in work productivity, better financial decision-making and greater wisdom.</p>
<p>Although researchers have been able to identify overall patterns of degraded sleep, increased stress and lower happiness in midlife, experiences vary from person to person. For some people, there may be more growth than decline, or a balance of both. Indeed, some research shows that personal growth is <a href="https://doi.org/10.1111/j.1467-6494.2010.00688.x">related to well-being</a> during midlife. </p>
<p>For now, it is already clear that midlife is <a href="https://doi.org/10.1037/amp0000591">a pivotal time that determines the trajectory of aging</a>. That’s why self-care during midlife is especially important, despite the busy schedules brought on by a greater number of roles. It’s hard to overemphasize the value of getting enough sleep and managing stress. Doing these things could help individuals turn a “midlife crisis” into “midlife potential.”</p><img src="https://counter.theconversation.com/content/173131/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Soomi Lee receives funding from NIH/National Institute on Aging (R56AG065251). </span></em></p>Age is no longer the only definition of midlife. An expert in aging explains why.Soomi Lee, Assistant Professor of Aging Studies, University of South FloridaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1714782022-01-25T13:27:46Z2022-01-25T13:27:46ZLife’s stages are changing – we need new terms and new ideas to describe how adults develop and grow<figure><img src="https://images.theconversation.com/files/438111/original/file-20211216-13-1czwi0d.jpg?ixlib=rb-1.1.0&rect=0%2C48%2C5319%2C3519&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">These days, people in their 20s are figuring out who they are as adults, rather than experiencing "extended adolescence." </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/elderly-man-saying-goodby-to-family-after-bbq-royalty-free-image/1014771010?adppopup=true"> Hinterhaus Productions/DigitalVision via Getty Images</a></span></figcaption></figure><p>What image comes to mind when you think of a person in their 20s? </p>
<p>Do you imagine an adult stressed out by the weight of many new responsibilities in family and work roles? </p>
<p>Or do you envision someone who is bursting with hope and undeveloped potential, still more of a kid than an adult, struggling to define a life and making little or no money but managing to find occasional joy nevertheless? Perhaps your soundtrack here is <a href="https://youtu.be/AgFeZr5ptV8">Taylor Swift’s radiant “22”</a>: “We’re happy, free, confused and lonely at the same time. It’s miserable and magical.”</p>
<p>How about when you think of someone in their 60s? </p>
<p>Do you envision someone – or maybe a happy couple – enjoying life, living well, still vigorous but now freer than before from daily work and family duties? </p>
<p>Or do you see someone who is stooped over from a lifetime of carrying burdens, their health diminished, now shuffling toward no particular destination? Here the soundtrack might be the doleful Beatles song “<a href="https://youtu.be/ckV2ogbt8W4">When I’m 64</a>”: “Will you still need me? Will you still feed me? When I’m 64?” </p>
<p>The whole arc of adult development has changed over the past several decades, in ways that our psychological theories are still catching up with. In the 21st century, does it still make sense to refer to “young adulthood,” “midlife” and “late adulthood,” as psychologists have been doing for so long? If not, what are more accurate concepts? </p>
<p>Most of my career <a href="https://scholar.google.com/citations?user=8bvGDaYAAAAJ&hl=en&oi=sra">as a developmental psychologist</a> has been devoted to answering these questions. My theory of <a href="https://pubmed.ncbi.nlm.nih.gov/10842426/">emerging adulthood</a> recognizes that the lives of younger adults have changed vastly since the 1960s. As the father of 22-year-old twins, I’m keenly aware of their journey through the new life stage I have been researching and writing about for so long. As a 64-year-old, I’m also turning my attention to how the 60s have changed from what they used to be. </p>
<h2>A longer-than-ever journey to adulthood</h2>
<p>In my research over the past two decades, I’ve found that people ages 19 to 29 are neither fully adult nor in an “extended adolescence” – as this time of life was viewed over the course of the 20th century. In the early 21st century, these years had become a time of gradually and often erratically making one’s way toward <a href="https://www.amazon.com/Emerging-Adulthood-Winding-Through-Twenties/dp/0199929386/ref=sr_1_2?crid=KJSM1BSQUMBJ&keywords=jeffrey+jensen+arnett&qid=1637252495&s=books&sprefix=Jeffrey+Jensen%2Caps%2C175&sr=1-2">a more established adulthood</a>.</p>
<p>I invited scholars from all over the world to contribute to a special issue of American Psychologist, one of the top journals in psychology, on the theme of <a href="https://doi.apa.org/fulltext/2020-29966-001.html">“Rethinking Adult Development: New Ideas for New Times.”</a> The recently published results are a wonderfully diverse set of papers that go a long way toward reconceptualizing what adult development looks like now and where it might be going. </p>
<p>Most of the authors were developmental psychologists. About half were Americans and half were Europeans, although <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474435/">Shinobu Kitayama and his colleagues</a> offered a refreshingly different Asian cultural perspective. </p>
<p>Here are some of the highlights:</p>
<p>– Ages 30 to 45 are now “the rush hour of life.” Today people around the world wait later than ever to marry and have kids, and most have only one or two. But then couples typically have the dual challenge of trying to move ahead in their careers while also handling the intense responsibilities of caring for young children. Women have vastly greater opportunities in education and work than they did in 1960, which is welcome but also presents new challenges and stresses. </p>
<p>In <a href="https://doi.org/10.1037/amp0000600">their contribution</a> to the special issue, <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Famp0000600">Clare Mehta and her colleagues</a> propose the term “established adulthood” to distinguish these years as the most intense and demanding years of adult life, characterized by the “career-and-care-crunch,” when obligations are high in both work and family roles.</p>
<p>– In midlife – ages 45-60 – the crunch years of caring for young children abate. Adults reach their peak career earnings and status in their late 40s and 50s. But life can become complicated, as new responsibilities may arise with grandchildren and with aging parents who need more assistance. </p>
<p>Overall, as <a href="https://doi.org/10.1037/amp0000591">Frank Infurna and colleagues detail</a> in their contribution, mental health declines in midlife. Reports of depression and anxiety increase. Seeking professional help for mental health issues reaches a lifetime peak.</p>
<p>Furthermore, midlife well-being, health and life expectancy have declined notably in the U.S. since 2000, especially among working-class adults who have been left behind by the information-and-technology economy. This has led to an epidemic of <a href="https://press.princeton.edu/books/hardcover/9780691190785/deaths-of-despair-and-the-future-of-capitalism">“deaths of despair”</a> from suicide, opioid overdoses or alchoholism.</p>
<p>– Adults in later life, ages 60-75, are thriving like never before. Although life after age 60 is traditionally regarded as a time of inevitable decline, the reality of it has become sharply different –and better – in recent decades. </p>
<p>Life expectancy at birth is higher now than it has ever been, worldwide, and adults are smarter and healthier for longer than ever. <a href="https://doi.org/10.1037/amp0000596">Denis Gerstorf and his colleagues</a> show how these positive trends have taken place across many countries over the past century because of improvements in education, nutrition and health care. </p>
<p>[<em>Like what you’ve read? Want more?</em> <a href="https://memberservices.theconversation.com/newsletters/?source=inline-likethis">Sign up for The Conversation’s daily newsletter</a>.]</p>
<p>Physical health issues do arise with age for most people, but more people than ever before stay healthy through their 60s and early 70s by maintaining healthy diet and physical exercise practices. One of the exciting recent findings highlighted <a href="https://doi.org/10.1037/amp0000612">in Ursula Staudinger’s article</a> is that regular exercise promotes mental health as well as physical well-being, helping to maintain mental sharpness and prevent Alzheimer’s disease.</p>
<p>Life satisfaction also seems to rise in later life, as we gain a new freedom to choose the kind of work we do – or stop working altogether and spend more time with the people we care about most. <a href="https://doi.org/10.1037/amp0000615">According to Phillip Ackerman and Ruth Kanfer</a>, more people are working into their late 60s and early 70s than ever before, but they have more freedom to choose how they do it, whether it’s working part time, starting a small business or trying something they have always wanted to do. </p>
<h2>Adulthood’s new arc requires new concepts and ideas</h2>
<p>Over my decades of writing about emerging adulthood, I’ve learned that it matters how people think about the stages of human development. Thinking shapes expectations and how experiences are interpreted. Lots of compelling and exciting new findings about adult development point to the importance of rethinking previous theories, assumptions and stereotypes about the course of adult life.</p><img src="https://counter.theconversation.com/content/171478/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jeffrey Arnett does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Views of the stages of adulthood are stuck in the early 20th century, even though they’ve changed a lot over the past 100 years.Jeffrey Arnett, Senior Research Scholar, Department of Psychology, Clark UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1575692021-06-11T12:41:16Z2021-06-11T12:41:16ZMiddle-aged Americans in US are stressed and struggle with physical and mental health – other nations do better<figure><img src="https://images.theconversation.com/files/404594/original/file-20210604-21-143kmrc.jpg?ixlib=rb-1.1.0&rect=744%2C7%2C2827%2C3203&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Middle age was often a time to enjoy life. Now, it brings stress and bad health to many Americans, especially those with lower education levels.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mature-male-raising-eyebrow-royalty-free-image/615573053?adppopup=true">Mike Harrington/Getty Images</a></span></figcaption></figure><p>Midlife was once considered a time to enjoy the fruits of one’s years of work and parenting. That is no longer true in the U.S. </p>
<p><a href="https://press.princeton.edu/books/hardcover/9780691190785/deaths-of-despair-and-the-future-of-capitalism">Deaths of despair and chronic pain among middle-aged adults</a> have been increasing for the past decade. Today’s middle-aged adults – ages 40 to 65 – report <a href="http://dx.doi.org/10.1037/amp0000597">more daily stress</a> and <a href="https://doi.org/10.1037/amp0000481">poorer physical health and psychological well-being</a>, compared to middle-aged adults during the 1990s. These trends are most pronounced for people who attained fewer years of education.</p>
<p>Although these trends preclude the COVID-19 pandemic, COVID-19’s imprint promises to further exacerbate the suffering. Historical declines in the health and well-being of U.S. middle-aged adults raises two important questions: To what extent is this confined to the U.S., and will COVID-19 impact future trends?</p>
<p>My colleagues and I <a href="https://psyarxiv.com/pfgxq/">published a cross-national study in mid 2021</a>, which is currently in press, that provides insights into how U.S. middle-aged adults are currently faring in relation to their counterparts in other nations, and what future generations can expect in the post-COVID-19 world. Our study examined cohort differences in the health, well-being and memory of U.S. middle-aged adults and whether they differed from middle-aged adults in Australia, Germany, South Korea and Mexico. </p>
<figure class="align-center ">
<img alt="A middle-aged woman looking sad sitting in front of artwork." src="https://images.theconversation.com/files/405473/original/file-20210609-14900-1345osz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/405473/original/file-20210609-14900-1345osz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/405473/original/file-20210609-14900-1345osz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/405473/original/file-20210609-14900-1345osz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/405473/original/file-20210609-14900-1345osz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/405473/original/file-20210609-14900-1345osz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/405473/original/file-20210609-14900-1345osz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Susan Stevens poses for a photograph in her daughter Toria’s room with artwork Toria left behind at their home in Lewisville, N.C. Toria died from an overdose.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/susan-stevens-poses-for-a-photograph-in-her-daughter-torias-news-photo/1134365793?adppopup=true">Eamon Queeney/For The Washington Post via Getty Images</a></span>
</figcaption>
</figure>
<h2>US is an outlier among rich nations</h2>
<p>We compared people who were born in the 1930s through the 1960s in terms of their health and well-being – such as depressive symptoms and life satisfaction – and memory in midlife.</p>
<p>Differences between nations were stark. For the U.S., we found a general pattern of decline. Americans born in the 1950s and 1960s experienced overall declines in well-being and memory in middle age compared to those born in the 1930s and 1940s. A similar pattern was found for Australian middle-aged adults. </p>
<p>In contrast, each successive cohort in Germany, South Korea and Mexico reported improvements in well-being and memory. Improvements were observed in health for each nation across cohorts, but were slowed for Americans born in the 1950s and 1960s, suggesting they improved less rapidly than their counterparts in the countries examined. </p>
<p>Our study finds that middle-aged Americans are experiencing overall declines in key outcomes, whereas other nations are showing general improvements. Our cross-national approach points to policies that could could help alleviate the long-term effects arising from the COVID-19 pandemic. </p>
<h2>Will COVID-19 exacerbate troubling trends?</h2>
<p>Initial research on the short-term effects of COVID-19 is telling. </p>
<p>The COVID-19 pandemic has laid bare the fragility of life. Seismic shifts have been experienced in every sphere of existence. In the U.S., job loss and instability rose, <a href="https://www.hks.harvard.edu/centers/mrcbg/programs/growthpolicy/household-financial-fragility-during-covid-19-rising-inequality">household financial fragility and lack of emergency savings have been spotlighted</a>, and <a href="https://www.nytimes.com/2021/04/08/us/school-testing-education-covid.html">children fell behind in school</a>. </p>
<p>At the start of the pandemic the focus was rightly on the safety of older adults. Older adults were most vulnerable to the risks posed by COVID-19, which included mortality, <a href="https://doi.org/10.1186/s41256-020-00154-3">social isolation and loneliness</a>. Indeed, older adults were at higher risk, but an overlooked component has been how the mental health risks and long-haul effects will likely differ across age groups.</p>
<p>Yet, young adults and middle-aged adults are showing the most vulnerabilities in their well-being. Studies are documenting that they are currently reporting <a href="https://doi.org/10.1001/jama.2020.21231">more psychological distress and stressors</a> and <a href="https://doi.org/10.1177/0956797620967261">poorer well-being</a>, compared to older adults. COVID-19 has been <a href="https://doi.org/%2010.1016/S0140-6736(20)30893-X">exacerbating inequalities across race, gender and socioeconomic status</a>. Women are <a href="https://www.nytimes.com/2020/06/03/business/economy/coronavirus-working-women.html">more likely to leave the workforce</a>, which could further strain their well-being. </p>
<figure class="align-center ">
<img alt="A older women hugs her daughter." src="https://images.theconversation.com/files/405474/original/file-20210609-28514-1swikbg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/405474/original/file-20210609-28514-1swikbg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=412&fit=crop&dpr=1 600w, https://images.theconversation.com/files/405474/original/file-20210609-28514-1swikbg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=412&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/405474/original/file-20210609-28514-1swikbg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=412&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/405474/original/file-20210609-28514-1swikbg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=517&fit=crop&dpr=1 754w, https://images.theconversation.com/files/405474/original/file-20210609-28514-1swikbg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=517&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/405474/original/file-20210609-28514-1swikbg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=517&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Middle-aged people often have parents to take care of as well as children.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/african-american-senior-hugging-her-daughter-royalty-free-image/123167791?adppopup=true">Ron Levine/Getty Images</a></span>
</figcaption>
</figure>
<h2>Changing views and experiences of midlife</h2>
<p>The very nature and expectations surrounding midlife are shifting. U.S. middle-aged adults are confronting <a href="https://doi.org/10.1037/amp0000556">more parenting pressures</a> than ever before, in the form of engagement in extracurricular activities and pressures for their children to succeed in school. <a href="https://www.pewresearch.org/fact-tank/2020/09/04/a-majority-of-young-adults-in-the-u-s-live-with-their-parents-for-the-first-time-since-the-great-depression/">Record numbers of young adults</a> are moving back home with their middle-aged parents due to student loan debt and a historically challenging labor and housing market. </p>
<p>A direct effect of gains in life expectancy is that middle-aged adults are needing to take on more caregiving-related duties for their aging parents and other relatives, <a href="https://www.aarp.org/ppi/info-2020/caregiving-in-the-united-states.html">while continuing with full-time work</a> and taking care of school-aged children. This is complicated by the fact that there is no federally mandated program for paid family leave that could cover instances of caregiving, or the birth or adoption of a child. A recent AARP report estimated that in 2020, there were 53 million caregivers whose unpaid labor was <a href="https://www.aarp.org/ppi/info-2020/caregiving-in-the-united-states.html">valued at US$470 billion</a>.</p>
<p>The restructuring of corporate America has led to <a href="https://press.princeton.edu/books/hardcover/9780691190785/deaths-of-despair-and-the-future-of-capitalism">less investment in employee development and destabilization of unions</a>. Employees now have less power and input than ever before. Although health care coverage has risen since <a href="https://pubmed.ncbi.nlm.nih.gov/27400401/">the Affordable Care Act was enacted</a>, notable gaps exist. High numbers of people are underinsured, which leads to <a href="https://www.annfammed.org/content/11/1/37">more out-of-pocket expenses that eat up monthly budgets and financially strain households</a>. President Biden’s <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/28/executive-order-on-strengthening-medicaid-and-the-affordable-care-act/">executive order</a> for providing a special enrollment period of the health care marketplace exchange until Aug. 15, 2021 promises to bring some relief to those in need. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1305592358306627584"}"></div></p>
<h2>Promoting a prosperous midlife</h2>
<p>Our cross-national approach provides ample opportunities to explore ways to reverse the U.S. disadvantage and promote resilience for middle-aged adults. </p>
<p>The nations we studied vastly differ in their family and work policies. Paid parental leave and subsidized child care help relieve the stress and financial strain of parenting in countries such as Germany, Denmark and Sweden. Research documents how well-being is higher in both parents and nonparents in <a href="https://doi.org/10.1086/688892">nations with more generous family leave policies</a>. </p>
<p>Countries with ample paid sick and vacation days ensure that employees can take time off to care for an ailing family member. <a href="https://doi.org/10.1007/s40471-016-0068-6">Stronger safety nets</a> protect laid-off employees by ensuring that they have the resources available to stay on their feet. </p>
<p>In the U.S., health insurance is typically tied to one’s employment. Early on in the COVID-19 pandemic <a href="https://familiesusa.org/resources/the-covid-19-pandemic-and-resulting-economic-crash-have-caused-the-greatest-health-insurance-losses-in-american-history/">over 5 million people in the U.S. lost their health insurance</a> when they lost their jobs. </p>
<p>During the pandemic, the U.S. government passed policy measures to aid people and businesses. The U.S. approved measures to stimulate the economy through stimulus checks, payroll protection for small businesses, expansion of unemployment benefits and health care enrollment, child tax credits, and individuals’ ability to claim forbearance for various forms of debt and housing payments. Some of these measures have been beneficial, with <a href="http://sites.fordschool.umich.edu/poverty2021/files/2021/05/PovertySolutions-Hardship-After-COVID-19-Relief-Bill-PolicyBrief-r1.pdf">recent findings</a> showing that material hardship declined and well-being improved during periods when the stimulus checks were distributed.</p>
<p>I believe these programs are a good start, but they need to be expanded if there is any hope of reversing these troubling trends and promoting resilience in middle-aged Americans. A recent report from the Robert Wood Johnson Foundation concluded that paid family leave has a <a href="https://www.rwjf.org/en/library/research/2021/05/improving-access-to-paid-family-leave-to-achieve-health-equity.html">wide range of benefits</a>, including, but not limited to, addressing health, racial and gender inequities; helping women stay in the workforce; and assisting businesses in recruiting skilled workers. Research from Germany and the United Kingdom shows how <a href="https://www.oecd.org/economy/using-a-quasi-natural-experiment-to-identify-the-effects-of-birth-related-leave-policies-on-subjective-well-being-in-Europe.pdf">expansions in family leave policies</a> have lasting effects on well-being, particularly for women. </p>
<p><a href="http://dx.doi.org/10.1037/amp0000591">Middle-aged adults form the backbone of society</a>. They constitute large segments of the workforce while having to simultaneously bridge younger and older generations through caregiving-related duties. Ensuring their success, productivity, health and well-being through these various programs promises to have cascading effects on their families and society as a whole.</p>
<p>[<em>Get the best of The Conversation, every weekend.</em> <a href="https://theconversation.com/us/newsletters/weekly-highlights-61?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=weeklybest">Sign up for our weekly newsletter</a>.]</p><img src="https://counter.theconversation.com/content/157569/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Frank J. Infurna receives funding from the National Institute on Aging and previously from the John Templeton Foundation. The content is solely his responsibility and does not necessarily represent the official views of the funding agencies.</span></em></p>Adults in Germany, South Korea and Mexico reported improvements in health, well-being and memory.Frank J. Infurna, Associate Professor of Psychology, Arizona State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1567962021-05-19T16:29:39Z2021-05-19T16:29:39ZThe link between mental health problems and later physical health<figure><img src="https://images.theconversation.com/files/400033/original/file-20210511-13-1ejjoj.jpg?ixlib=rb-1.1.0&rect=0%2C57%2C3872%2C2370&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/mSXMHkgRs8s">Yuris Alhumaydy/Unsplash</a></span></figcaption></figure><p>Across the world, <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">populations are aging</a>. Increases in life expectancy over the last century, combined with declining birth rates mean that the proportion of older people is on the rise in many countries. <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">Projections</a> suggest that by 2050, one in five people worldwide will be over 60 years old (up from one in eight in 2015).</p>
<p>An aging population brings multiple challenges. As people age, chronic diseases such as diabetes, heart disease, stroke and cancer become more common. These diseases shorten people’s “healthspan” (the period of life spent in good health), take a toll on families, and drain healthcare resources. Policymakers and healthcare professionals are faced with an urgent question: how can we reduce the burden of physical disease in older people?</p>
<h2>Early-life mental-health problems and subsequent physical health</h2>
<p>New research from our team of researchers based at Duke University and the University of Michigan suggests a possible answer: by treating mental-health problems in younger people. Together with collaborators at the Universities of Auckland and Otago, our team recently conducted two studies to investigate how people’s mental-health problems earlier in life may impact their physical health as they age.</p>
<p>Linking together mental- and physical-health problems may seem surprising. The separation between the two is perpetuated by our healthcare system, which tends to divide treatment between the brain and the body. However, <a href="https://www.sciencedirect.com/science/article/pii/S0140673607612380">previous research</a> has shown that our mental health can shape our physical well-being, and vice versa.</p>
<p>We built on this work to address two questions:</p>
<ul>
<li><p>The potential link between experiencing a mental-health problem and subsequent chronic age-related physical disease and earlier death.</p></li>
<li><p>Whether experiencing a mental-health problem could be linked with faster aging even before people develop chronic age-related diseases.</p></li>
</ul>
<p>To test the first question, we conducted a nationwide hospital-register <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774902">study</a> of 2.3 million New Zealanders aged 10 to 60 years at baseline. We followed them across three decades (from 1988 to 2018) to test whether individuals with mental-health problems were at increased risk for subsequent chronic physical diseases and earlier mortality.</p>
<p>We collected information about hospital admissions for different mental disorders – substance use disorders, psychotic disorders, mood disorders, and anxiety disorders – as well as self-harm. We also collected information about hospital admissions for different chronic physical diseases, ranging from coronary heart disease to cancer.</p>
<h2>Greater disease burden and earlier mortality</h2>
<p>We found that across the 30-year period, people with mental disorders were more likely to develop subsequent physical diseases and they also died earlier than people without mental disorders. They also experienced more medical hospitalisations, spent more time in hospitals for physical-disease treatment, and accumulated more associated health care costs. These associations were present across all age groups and in both men and women.</p>
<p>The longitudinal association between mental disorders and physical diseases was evident across different mental disorders and different physical diseases. And importantly, the association held even after controlling for physical diseases that predated individuals’ mental disorders. Thus, we were able to rule out the possibility of reverse causation, in which having a physical illness precipitates mental-health problems.</p>
<p>We <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2776612">next</a> tested whether mental-health problems would also be linked with faster aging in people who had not yet developed chronic disease.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/400034/original/file-20210511-21-1vmq9sb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/400034/original/file-20210511-21-1vmq9sb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/400034/original/file-20210511-21-1vmq9sb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/400034/original/file-20210511-21-1vmq9sb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/400034/original/file-20210511-21-1vmq9sb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/400034/original/file-20210511-21-1vmq9sb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/400034/original/file-20210511-21-1vmq9sb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Not all persons age at the same rate. Research shows that those who experienced mental-health issues while young can age faster and have more health issues in later life.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/dRu3zxFb6uE">Cristina Seri/Unsplash</a></span>
</figcaption>
</figure>
<p>What does faster aging mean? We tend to think of age in years: a 51-year-old person is older than a 50-year old. Viewed in this way, all of us age at the same pace: one year per chronological year. However, at the biological level, the pace at which people’s bodies age can vary considerably, <a href="https://www.pnas.org/content/112/30/E4104.short">even among people born in the same year</a>. Some people’s bodies age faster than others’. A faster pace of aging has been <a href="https://elifesciences.org/articles/54870">linked</a> to greater risk of disease and death.</p>
<h2>Mental-health problems and aging</h2>
<p>This led us to wonder: do people with mental-health problems age faster, thereby putting them at risk for developing chronic physical diseases? To test this idea, we studied 1,037 individuals born in 1972-73 in the city of Dunedin, New Zealand. Study members have been followed up regularly until age 45 years. While age 45 might seem young, previous work suggests that differences in people’s biological aging are already evident at this age.</p>
<p>To measure mental-health problems, study members were interviewed every few years. We assessed a variety of problems, such as anxiety, depression, substance abuse, and schizophrenia.</p>
<p>We found that at age 45, people who had experienced more mental-health problems were aging faster. We measured the pace of biological aging by combining 19 biomarkers, such as cholesterol, blood pressure, and inflammation. People who experienced the most mental-health problems were aging approximately 5.3 years faster between ages 26 and 45, compared to participants with the fewest problems.</p>
<p>We also found differences in other signs of aging. At age 45, study members who had experienced more mental-health problems performed worse on tests of hearing, vision, balance and cognition, and on tests that gerontologists typically give to older adults, such as walking speed. They also reported greater difficulty in their everyday lives in these domains (for example, finding it difficult to follow conversations, or finding the words they want to use).</p>
<p>Furthermore, when we asked an independent panel to rate photographs of each study member’s face, study members who had experienced more mental-health problems were rated as looking older compared to their same-aged peers.</p>
<p>This pattern of findings remained when we took into account a number of factors that can lead to mental-health problems or faster aging, such as study members’ physical health as children, childhood maltreatment and socioeconomic status, overweight, smoking, medications, and prior physical disease. The pattern of findings was also very similar across different types of mental-health problems.</p>
<p>Taken together, the findings of our two studies reveal that people with mental-health problems are at outsized risk of chronic diseases and early death, and that they show signs of faster aging even before diseases first emerge. There are two implications.</p>
<p>First, preventing mental-health problems in young people has the potential to reduce age-related disease later in life. Mental-health problems tend to develop relatively early in life, often by adolescence or early adulthood, years before the typical onset of physical diseases. More investment in prompt mental-health care for the young might reduce subsequent physical diseases and associated healthcare costs.</p>
<p>Second, individuals with mental-health problems are a high-priority group to monitor for signs of faster aging – such as hearing impairment, motor problems, and cognitive decline – as well as chronic diseases. Such monitoring will require greater integration of mental- and physical-health services, to reduce health inequalities and lengthen healthy lives.</p><img src="https://counter.theconversation.com/content/156796/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jasmin Wertz receives funding from the AXA Research Fund.</span></em></p><p class="fine-print"><em><span>Leah Richmond-Rakerd receives funding from the National Institute of Child Health and Development through the Duke Population Research Center (grant P2C HD065563).</span></em></p>New research shows that people who suffer from mental disorders earlier in life were more likely to subsequent develop physical diseases, age faster, and also die earlier than those who did not.Jasmin Wertz, Postdoctoral fellow, Duke UniversityLeah Richmond-Rakerd, Assistant Professor of Psychology, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1472572020-10-14T01:01:56Z2020-10-14T01:01:56ZCobra Kai, Bill & Ted: comebacks redefine middle-aged masculinity, but where are the women?<figure><img src="https://images.theconversation.com/files/362843/original/file-20201012-23-193no9a.jpg?ixlib=rb-1.1.0&rect=571%2C2%2C1113%2C871&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Dad bods abound in the Karate Kid reboot. </span> <span class="attribution"><span class="source">Netflix</span></span></figcaption></figure><p>There are certain film roles that can define an actor’s career. <a href="https://www.imdb.com/name/nm0001494/?ref_=nv_sr_srsg_0">Ralph Macchio</a> has starred in over 25 films, yet he is most identifiable as the teenage Danny Larouso in The Karate Kid (1984). Similarly, <a href="https://www.imdb.com/name/nm0935664/?ref_=fn_al_nm_1">Alex Winter</a> has had a long career as a director and actor, but is best known as high school student Bill S. Preston, Esquire in Bill & Ted’s Excellent Adventure (1989). </p>
<p>The recent popularity and role reprisals by these actors: Winter in <a href="https://www.imdb.com/title/tt1086064/?ref_=nm_knf_t1">Bill & Ted Face the Music</a> (2020) and Macchio in <a href="https://www.imdb.com/title/tt7221388/?ref_=fn_al_tt_1">Cobra Kai</a> (2018–), combined with <a href="https://www.cinemablend.com/news/2552760/brad-pitt-and-jennifer-aniston-will-reunite-for-an-unexpected-project">celebrities reading aloud the scripts of old teen film classics via Zoom</a> suggests nostalgia. It is also an opportunity to revisit and consider the nuances of characters and gender roles with greater maturity and a wiser perspective.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/bill-and-ted-face-the-music-review-party-on-dudes-this-film-is-as-sweet-and-daggy-as-its-predecessors-144074">Bill & Ted Face the Music review: party on, dudes - this film is as sweet and daggy as its predecessors</a>
</strong>
</em>
</p>
<hr>
<h2>Dads today</h2>
<p>Generation X, <a href="https://www.pewresearch.org/fact-tank/2019/01/17/where-millennials-end-and-generation-z-begins/">born 1965–1980</a>, were in their adolescence when these two films premiered. Both movies present a version of teenage masculinity that was in remarkable contrast to male adult roles in action films of that time. In the 1980s, tough muscular bodies were pictured on screen in films such as <a href="https://www.imdb.com/title/tt0083944/?ref_=fn_al_tt_1">Rambo</a> (1982, 1985, 1988), <a href="https://www.imdb.com/title/tt0082198/?ref_=nm_flmg_act_68">Conan the Barbarian</a> (1982), <a href="https://www.imdb.com/title/tt0092675/?ref_=nv_sr_srsg_0">Bloodsport</a> (1988), and <a href="https://www.imdb.com/title/tt0095016/?ref_=nv_sr_srsg_0">Die Hard</a> (1988). </p>
<p>While the young male protagonists in The Karate Kid and Bill & Ted possess purposeful strength, they display a vulnerability, a gentle resilience, a sense of humour with suburban heroism. (Indeed nerd teen archetypes meet tough jocks in detention in 1985’s <a href="https://www.imdb.com/title/tt0088847/">The Breakfast Club</a>.)</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/362844/original/file-20201012-23-q3n670.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Young actors in Bill and Ted movies scene." src="https://images.theconversation.com/files/362844/original/file-20201012-23-q3n670.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/362844/original/file-20201012-23-q3n670.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=259&fit=crop&dpr=1 600w, https://images.theconversation.com/files/362844/original/file-20201012-23-q3n670.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=259&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/362844/original/file-20201012-23-q3n670.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=259&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/362844/original/file-20201012-23-q3n670.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=325&fit=crop&dpr=1 754w, https://images.theconversation.com/files/362844/original/file-20201012-23-q3n670.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=325&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/362844/original/file-20201012-23-q3n670.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=325&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Though he hasn’t had the screen success of his old pal Keanu Reeves, Alex Winter has continued to work in movies.</span>
<span class="attribution"><a class="source" href="https://www.imdb.com/name/nm0935664/mediaviewer/rm152513024">IMDB</a></span>
</figcaption>
</figure>
<p>Their hero’s journey is relatable yet undeniably epic. The films depict the story of the underdog, of young males who don’t quite fit into the mould and, significantly, are fine with this.</p>
<p>There is a desire to learn, whether from history, as in Bill & Ted, or from older characters sharing their wisdom, as in The Karate Kid. Accordingly, the phrase “wax on, wax off” became popular shorthand for a stern lesson in patience and skill development. </p>
<p>Now, as the characters return to our screens older and in the 21st century, there are still lessons to be learnt.</p>
<p>Rather than entering a mid-life crisis — popularly depicted with older males seeking renewed vigour in the embrace of young mistresses or new sports cars — these middle-aged characters convey the opportunity to relive, redo and revisit past triumphs. </p>
<p>The role reprise is also an opportunity to transform the tribulations of the past. Indeed, Cobra Kai is more focussed on Macchio’s onscreen karate opponent, Johnny Lawrence, played by <a href="https://www.imdb.com/name/nm0951420/?ref_=tt_cl_t6">William Zabka</a>. Now a “deadbeat dad”, Johnny reboots the Cobra Kai dojo and his sense of purpose. </p>
<p>As adult characters, now husbands and fathers, the midlife narrative can navigate an updated definition of masculinity. They may be comeback dudes, but they are also dads. In both the new Bill & Ted movie and the Cobra Kai TV series, the characters’ children have the opportunity to actualise the dreams of their fathers. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/MLpyi-oVoIY?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Character revivals provide a chance for a ‘do-over’.</span></figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-do-we-find-it-so-hard-to-move-on-from-the-80s-59445">Why do we find it so hard to move on from the 80s?</a>
</strong>
</em>
</p>
<hr>
<h2>‘Be excellent’ but it’s also complicated</h2>
<p>The 1980s films challenge toxic masculinity. The teen protagonists are undeniably nice, likeable guys who try to do the right thing. Bill and Ted are guided by a moral imperative to “be excellent to each other”.</p>
<p>The famous quote summarises a positive life mantra and shows how good and bad are clearly defined in the original films. The middle aged comeback vehicles show a more mature understanding of the moral complexities of life.</p>
<p>In reprising their roles, the notion that Macchio, Zabka and Winters have aged does not act as a hindrance but a point of identification for Generation X audiences. There is a strong connection to viewers’ own past lives. Seeing the actors again on screen is akin to seeing long lost friends at a high school reunion. </p>
<p>Macchio and Zabka remind us of the high school tensions that are painfully never quite resolved. Seeing Winter with Keanu Reaves’ Ted provides a joyous reminder of the strong bonds of same-sex friendships of our youth. And like a high school reunion there is a lot of reminiscing about the way things were compared to what life is like now. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/DskTb6nYq98?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Turns out everyone got older.</span></figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-new-seachange-is-a-sad-case-of-zombie-tv-when-your-favourite-programs-come-back-from-the-dead-123162">The new Seachange is a sad case of Zombie TV: when your favourite programs come back from the dead</a>
</strong>
</em>
</p>
<hr>
<h2>What about the comeback mothers?</h2>
<p>Significantly, there are fewer female role revivals to remind us of the character growth related to womanhood. </p>
<p>Iconic teenage female actors seem more likely to have comebacks in supporting roles as mothers, rather than as the protagonists.</p>
<p>Examples here are Molly Ringwald in <a href="https://www.imdb.com/title/tt1179817/?ref_=nv_sr_srsg_6">The Secret Life of an American Teenager</a> (2008-2013), Holly Marie Combs in <a href="https://www.imdb.com/title/tt1578873/?ref_=nv_sr_srsg_0">Pretty Little Liars</a> (2010-2017) and Winona Ryder in <a href="https://www.imdb.com/title/tt4574334/?ref_=fn_al_tt_1">Stranger Things</a> (2016-). </p>
<p>Perhaps the current success of Bill and Ted, and Cobra Kai, could see Molly Ringwald’s iconic role in <a href="https://www.imdb.com/title/tt0088128/?ref_=nv_sr_srsg_0">Sixteen Candles</a> (1984) remade as Fifty-two Candles? Similarly, is it time for an update of <a href="https://www.imdb.com/title/tt0250494/?ref_=nv_sr_srsg_0">Legally Blonde</a> (2001) to Legally Grey?</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/362882/original/file-20201012-19-diac2d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Woman looks shocked" src="https://images.theconversation.com/files/362882/original/file-20201012-19-diac2d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/362882/original/file-20201012-19-diac2d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=300&fit=crop&dpr=1 600w, https://images.theconversation.com/files/362882/original/file-20201012-19-diac2d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=300&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/362882/original/file-20201012-19-diac2d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=300&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/362882/original/file-20201012-19-diac2d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=377&fit=crop&dpr=1 754w, https://images.theconversation.com/files/362882/original/file-20201012-19-diac2d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=377&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/362882/original/file-20201012-19-diac2d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=377&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">While comeback dads get to fulfill their destinies, comeback mums — like Winona Ryder in Stranger Things — return in a supporting role.</span>
<span class="attribution"><span class="source">Netflix</span></span>
</figcaption>
</figure><img src="https://counter.theconversation.com/content/147257/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Panizza Allmark does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The return of actors like Karate Kid Ralph Macchio and Bill & Ted’s Alex Winter sees them older and wiser. Fewer role revivals remind us of character growth related to womanhood.Panizza Allmark, Associate Dean of Arts, Associate Professor Media & Cultural Studies, Edith Cowan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1396442020-06-12T12:11:48Z2020-06-12T12:11:48ZHow ‘Karen’ went from a popular baby name to a stand-in for white entitlement<figure><img src="https://images.theconversation.com/files/341366/original/file-20200611-80746-10a4v55.jpg?ixlib=rb-1.1.0&rect=0%2C5%2C3681%2C2445&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Watch out, Karen coming through.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/passerby-wears-a-white-fendi-bag-a-white-flowing-top-a-news-photo/1243898427?adppopup=true">Edward Berthelot/Getty Images</a></span></figcaption></figure><p>When I read about <a href="https://www.nytimes.com/2020/05/26/nyregion/amy-cooper-dog-central-park.html">Amy Cooper</a>, the woman in Central Park who called the police on a black birder because he’d asked her to leash her out-of-control dog, I was horrified. </p>
<p>But, as a sociolinguist who studies and writes about <a href="https://www.annualreviews.org/doi/full/10.1146/annurev-linguistics-011718-011659%3C/u">language and discrimination</a>, I was also struck by the name given to Cooper in several headlines: “<a href="https://nypost.com/2020/05/29/nypd-discussing-charges-for-central-park-karen-amy-cooper-with-da/">Central Park Karen</a>.” On Twitter, the birder’s sister <a href="https://twitter.com/melodymcooper/status/1264965252866641920">also referred to her</a> as a “Karen.”</p>
<p>There was no confusion about what this meant: It was a label for a white woman who had used her privilege to threaten and try to intimidate a black man by calling the police.</p>
<p>But this was just one way “Karen” has been deployed in recent months. There was <a href="https://www.reddit.com/r/EntitledKarens/comments/cdc997/a_karen_story_that_happened_at_my_work">the woman dubbed a Karen</a> who, after being told that a waiter would bring ketchup to her table, ended up helping herself at the server’s station. And then there was the <a href="https://www.reddit.com/r/entitledparents/comments/gzsr4j/lady_tells_me_to_cover_up_at_the_beach_because_i">mom who was called a Karen</a> for telling a woman wearing a bikini to cover up. Countless other variations have emerged.</p>
<p>At first glance, a generic name becoming infused with so much meaning seems patently absurd. Imagine if your friend groused that his boss was being “a real David,” or a sibling pointed out that mom was acting like “such a Christina.” </p>
<p>So how, exactly, does a name like Karen become such a powerful form of social commentary? And how does it come to mean so many different things at the same time?</p>
<h2>The many shapes of meaning</h2>
<p>First names <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.575.9611&rep=rep1&type=pdf">tend to contain a range of social cues</a>. An obvious one is gender. But they can convey other kinds of information too, including age, ethnicity, religion, social class and geography. The first name <a href="http://www.nameplayground.com/karen">Karen</a> peaked in popularity in 1965, which means that in 2020, most people named Karen are middle aged. Because roughly 80% of the U.S. population <a href="https://www.census.gov/library/publications/1960/dec/population-pc-a1.htm">was white</a> in the 1960s, it’s safe to assume that the proportion of people named Karen in 2020 is predominantly white.</p>
<p>So that’s kind of a rough foundation for what the first name Karen might signal to people. But what about the way it evolved to mean much more than simply a first name relatively common among middle-aged white women? </p>
<p>On the one hand, meaning can directly reference something in the world. A kitchen is, well, a kitchen. For this reason, we often assume that meanings are fixed and stable. </p>
<p>But meaning can also be more indirect, indicating characteristics like where a person is from, their age or their ethnicity. Whether you say “soda,” “pop” or “Coke” for a carbonated beverage <a href="https://books.google.com/books?id=lL6mEYcKHFcC&pg=PA36&lpg=PA36&dq=soda+pop+coke+%22do+you+speak+american%22&source=bl&ots=e2yBJMHZys&sig=ACfU3U0TRi8-bz530gF0WH6GavDNsQ3P3w&hl=en&sa=X&ved=2ahUKEwiugo_wk_rpAhW4STABHcy-DPAQ6AEwAHoECAwQAQ#v=onepage&q=soda%20pop%20coke%20%22do%20you%20speak%20american%22&f=false">can indicate where in the United States you likely grew up</a>. In many African American communities, kitchen, in addition to being the place you cook, means “<a href="https://www.linguisticsociety.org/content/what-ebonics-african-american-english">nape of the neck</a>.”</p>
<p>These different definitions are often referred to as “<a href="https://doi.org/10.1016/S0271-5309(03)00013-2">indexical</a>” because different contexts indicate, or index, different meanings. Meaning, it turns out <a href="https://www.doi.org/10.1111/j.1467-9841.2008.00374.x">isn’t nearly as stable or fixed as we like to think</a>. </p>
<p>This is how the use and understandings of words change and shift over time. It’s also how they can become vehicles for social commentary.</p>
<h2>Karen’s origin story</h2>
<p>It’s largely a coincidence that Karen – rather than, say, other popular baby names from the 1960s like Linda or Cynthia – is the name that became the label. Instead, it’s the repeated use of the name on social media and on the street that reinforced its status. </p>
<p>By tracing the origins of Karen up until the Central Park incident, you can see how two separate threads of meaning converged to make Karen the label for an officious, entitled, white woman.</p>
<p>The first comes from African American communities, where certain generic first names <a href="https://www.theatlantic.com/technology/archive/2020/05/coronavirus-karen-memes-reddit-twitter-carolyn-goodman/611104">have long been a shorthand</a> for “a white woman to be wary of because she won’t hesitate to wield privilege at the expense of others.” Around 2018, people started posting pictures of white women calling the police on the mundane activities of black people. These individuals got labeled with hashtags like #bbqbecky, #permitpatti, #golfcartgail and #cornerstonecaroline. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"995868839555616768"}"></div></p>
<p>The goal was to call out the inherent racism and white privilege of these women using a particular kind of <a href="https://www.washingtonpost.com/news/morning-mix/wp/2018/10/19/bbq-becky-permit-patty-and-cornerstore-caroline-too-cutesy-for-those-white-women-calling-cops-on-blacks">alliterative flair</a>. This was the same sort of behavior that Amy Cooper engaged in when she called the police claiming to be threatened.</p>
<p>The second thread emerges from stand-up comedy and Reddit. In 2005, Dane Cook performed a sketch comedy piece in which Karen is “<a href="https://youtu.be/J_kg0W3AeIU">that friend nobody likes</a>.” In the sketch, she’s described as “always a douche.” This portrayal of a “Karen” is less about her racism and contains more gender-based critiques, which might be why <a href="https://www.theguardian.com/fashion/2020/apr/13/the-karen-meme-is-everywhere-and-it-has-become-mired-in-sexism">some continue to call the Karen meme sexist</a>.</p>
<p>Then, in late 2017, <a href="https://www.reddit.com/r/FuckYouKaren">Karen appeared on Reddit</a> as a parody of a Reddit user who had ranted about his ex-wife named Karen who received custody of their children and possession of the family home. That’s likely the point at which Karen became linked to pushy behaviors like “wanting to speak to the manager.” A link that may have occurred first through parody went on to serve as an actual label for self-important, bossy people.</p>
<h2>A Karen by many other names</h2>
<p>The Central Park incident created the perfect moment for these two strands to come together. There’s the intersection of entitled behavior, racism and demographics. </p>
<p>Interestingly, despite a lot of media analysis about what Karen “really” means, its use has been quite fluid. For example, we’ve seen people who <a href="https://www.theverge.com/21283993/nextdoor-app-racism-community-moderation-guidance-protests">deny the existence of racism</a>, <a href="https://www.reddit.com/r/Syracuse/comments/fh8uvc/stop_buying_all_the_supplies_karen">panic buy toilet paper</a> or <a href="https://www.youtube.com/watch?v=2o65d5NAkmI">call for an end to social distancing</a> all called “Karens.” </p>
<p>In fact, the meaning and use of Karen continues to shift. We can find <a href="https://www.reddit.com/r/FuckYouKaren/comments/gvya5b/what_do_you_call_a_male_karen/?utm_source=share&utm_medium=web2x">male Karens</a> and <a href="https://www.reddit.com/r/ActualPublicFreakouts/comments/fegjqb/black_karen_at_dunkin_donuts/?utm_source=share&utm_medium=web2x">black Karens</a>. <a href="https://www.theatlantic.com/ideas/archive/2020/05/trump-social-media-scarborough/612193">Donald Trump has even been called a Karen</a>. </p>
<p>And then there’s the way it’s being used to push for justice, with protesters of police violence <a href="https://preview.redd.it/ywf00603kp251.jpg?width=640&crop=smart&auto=webp&s=02bc01491df04f0fb0fa45604ae360399ded735e">holding signs</a> like “Karens against police brutality” and “I’d like to speak to the manager of systemic racism.”</p>
<p>So is Karen fundamentally about white women using their racial privilege as a weapon? Is it about being an obnoxious rule follower? Or is it about being a no-fun, hysterical mom? </p>
<p>Karen can be and is all of those. That doesn’t weaken the critique; it simply gives it more facets and nuance.</p>
<p>[<em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>.]</p><img src="https://counter.theconversation.com/content/139644/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Robin Queen does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Generic names can take on a linguistic life of their own, becoming powerful forms of social commentary.Robin Queen, Professor of Linguistics, English Language and Literatures and Germanic Languages and Literatures, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1143472019-07-15T12:03:44Z2019-07-15T12:03:44ZThe real midlife crisis confronting many Americans<figure><img src="https://images.theconversation.com/files/282540/original/file-20190703-126400-mtn2a5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Midlife is one of the least understood, appreciated and studied life stages.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/monochrome-portrait-face-middle-aged-woman-196185824?src=DUJmmi71INS753UJ6Kn6PA-1-60&studio=1">Sarah2/Shutterstock.com</a></span></figcaption></figure><p>The way my mom imagined it, midlife was going to be great: counting down days until retirement, spending winters in Florida and checking off destinations on her bucket list. But it hasn’t turned out that way. </p>
<p>Instead of more time spent in Florida, she’s still stuck in snowy upstate New York. She traded romps in the sea and traveling the world for her daily visits to her mom, who’s in a nursing home. Instead of the joys of living the snowbird life, she’s saddled with stress, guilt and the challenges of caring for my grandmother, who is 89 and dealing with dementia.</p>
<p>“This is not how I imagined my life at midlife,” my mom, who is 61, tells me. </p>
<p>She isn’t alone. </p>
<p><a href="http://pathwaystocharacter.org/research-project/does-adversity-lead-to-character-growth-if-so-how-and-for-whom/">In a study my colleagues and I conducted on middle-aged adults</a>, we followed 360 people on a monthly basis for two years, tracking their life events, health, well-being and character.</p>
<p>We found that midlife, <a href="http://aging.wisc.edu/midus/findings/pdfs/367.pdf">generally considered to encompass the ages of 40 to 65</a>, has become a time of crisis. But it’s not the kind of crisis that exists in popular imagination – when parents, with their kids out of the house, feel compelled to make up for lost time and relive their glory days.</p>
<p>There’s little time for jetting around the world. And splurging on a red sports car? Forget that. </p>
<p>Instead, the midlife crisis experienced by most people is subtler, more nuanced and rarely discussed among family and friends. It can be best described as the “big squeeze” – a period during which middle-aged adults are increasingly confronted with the impossible choice of deciding how to split their time and money between themselves, their parents and their kids.</p>
<h2>Parenting your parents and your adult kids</h2>
<p>Many middle-aged adults increasingly <a href="http://www.pewsocialtrends.org/2015/05/21/5-helping-adult-children/">feel obligated</a> to take care of both their aging parents and their kids.</p>
<p>Insufficient family leave policies force middle-aged adults to decide between maximizing their earning potential or caring for an aging parent. Of those who were working full-time while caregiving more than 21 hours a week for an aging parent, <a href="https://www.aarp.org/content/dam/aarp/ppi/2018/08/breaking-new-ground-supporting-employed-family-caregivers-with-workplace-leave-policies.pdf">25% took reduced work hours or accepted a less demanding position</a>. Studies have shown that juggling a job while caring for a parents <a href="https://psycnet.apa.org/record/1996-97051-000">strains relationships and takes a toll on mental and physical health</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/282546/original/file-20190703-126382-1cxm2s0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/282546/original/file-20190703-126382-1cxm2s0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=370&fit=crop&dpr=1 600w, https://images.theconversation.com/files/282546/original/file-20190703-126382-1cxm2s0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=370&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/282546/original/file-20190703-126382-1cxm2s0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=370&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/282546/original/file-20190703-126382-1cxm2s0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=465&fit=crop&dpr=1 754w, https://images.theconversation.com/files/282546/original/file-20190703-126382-1cxm2s0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=465&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/282546/original/file-20190703-126382-1cxm2s0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=465&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">People are living longer – and someone has to take care of them.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/profile-portrait-elderly-old-women-grandmother-550027804?src=nJq_xYww5MtJgzP6O67rhg-1-30&studio=1">Sjstudio6/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Middle-aged adults also find themselves contending with continued or renewed dependency of their adult children. <a href="https://www.pewsocialtrends.org/2015/07/29/more-millennials-living-with-family-despiteimproved-">Compared with 10 years ago</a>, more adult children nowadays are living with their parents. One reason is that <a href="https://doi.org/10.1093/geroni/igx026">their kids are spending more time in school</a>. </p>
<p>But there are also fewer employment opportunities, and young adults are having a tougher time securing basic needs, like health insurance. Together, these trends have led to <a href="https://doi.org/10.1037/a0023697">more anxiety and depression among middle-aged parents</a>, who fear their kids might never have the same opportunities they did.</p>
<h2>Longer lives, fewer opportunities</h2>
<p>Why is this squeeze happening now?</p>
<p>For one thing, the parents of middle-aged adults are living longer than ever before. The past century has seen remarkable gains in <a href="https://www.nature.com/articles/nature08984">life expectancy</a>. Options to care for aging parents in need range from in-home by oneself or with the help of home health aides to assisted living and nursing home facilities. Costs vary across the type of care, <a href="https://www.genworth.com/aging-and-you/finances/cost-of-care/cost-of-care-trends-and-insights.html">but overall costs are continually on the rise</a>.</p>
<p>Meanwhile, the adult children of middle-aged Americans are still reeling from the Great Recession of 2008. A tepid labor market combined with student loan debt <a href="https://doi.org/10.1016/j.ssresearch.2012.05.008">has left grown adult children struggling</a> to find stable, long-term employment, and they’ve delayed buying a house and starting a family.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/282545/original/file-20190703-126376-woa87n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/282545/original/file-20190703-126376-woa87n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=436&fit=crop&dpr=1 600w, https://images.theconversation.com/files/282545/original/file-20190703-126376-woa87n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=436&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/282545/original/file-20190703-126376-woa87n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=436&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/282545/original/file-20190703-126376-woa87n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=548&fit=crop&dpr=1 754w, https://images.theconversation.com/files/282545/original/file-20190703-126376-woa87n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=548&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/282545/original/file-20190703-126376-woa87n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=548&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Unable to secure stable employment, many young adults find themselves relying on their parents well into their 20s.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sad-girl-bared-shoulders-looks-camera-493620970?studio=1">tugol/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Finally, few policies are in place for those who try to balance work while caring for an aging parent. The U.S. doesn’t have a federal policy for paid family leave, only unpaid. </p>
<p>Six states and the District of Columbia <a href="https://www.aarp.org/content/dam/aarp/ppi/2018/08/breaking-new-ground-supporting-employed-family-caregivers-with-workplace-leave-policies.pdf">have paid family leave policies</a>, which include up to 12 weeks of paid time off and wage replacement at 50% to 80% of one’s salary. But it’s often those who cannot afford to take time off or accept a pay decrease <a href="http://www.aarp.org/content/dam/aarp/research/public_policy_institute/security/2013/impact-of-rising-healthcare-costs-AARP-ppi-sec.pdf">who end up as caregivers</a>. </p>
<h2>More financial risk</h2>
<p>Although midlife often <a href="https://doi.org/10.1177/0165025414533223">marks a high point</a> for earnings and represents the peak of decision-making abilities, middle-aged adults are less equipped than you might think to assume midlife’s new challenges and burdens. </p>
<p>Living wages are stagnant and labor market volatility has fueled job insecurity, with <a href="https://global.oup.com/academic/product/encore-adulthood-9780199357277?cc=us&lang=en&">24% of people aged 45 to 74 worried that they could lose their job in the next year</a>. </p>
<p>Plus, middle-aged adults have their own health to worry about. As people get older, their health costs rise, which eat away at bank accounts, making it harder to make ends meet. While wider access to health insurance <a href="https://doi.org/10.1001/jama.2016.9797">has made a difference</a> due to the Affordable Care Act, rapid increases in costs for coverage and medications can severely strain household budgets.</p>
<p><a href="https://doi.org/10.2139/ssrn.3226574">A recent report</a> found that middle-aged adults have the fastest-growing rate of bankruptcy – and one of the leading reasons is rising costs of health insurance coverage and medications. But parents who <a href="https://academic.oup.com/psychsocgerontology/article/72/6/1084/2645641">co-sign the student loans</a> of their children have also created another bankruptcy risk factor. </p>
<h2>What can be done?</h2>
<p>Although it may seem like doom and gloom for middle-aged adults, there is hope. Workplace and policy changes can alleviate their struggles. </p>
<p>Extensive research has documented <a href="https://www.sciencedirect.com/science/article/pii/S1064748112617746">the effectiveness of training programs to help adults who are caring for their parents</a>. These programs – which range from workshops on understanding dementia to tutorials on self-care – don’t help with costs, but they can ease the emotional burden.</p>
<p>Meanwhile, studies have found that <a href="https://www.doi.org/10.1177/0003122414531435">workplaces that give employees</a> more control over their schedules can lead to better health, workplace performance and retention. </p>
<p>As for broader policy, the U.S. can look to Europe for ideas on how to address paid family leave. European nations have <a href="https://slate.com/human-interest/2018/02/the-u-s-is-decades-behind-the-world-on-paid-leave-this-gives-us-an-advantage.html">generous family leave policies</a> that include long periods of paid time off following childbirth or for caregiving. Recently, <a href="https://time.com/5590167/paid-family-leave-united-states/">several bills</a> about family leave have been introduced in the U.S. Congress.</p>
<p>Midlife is arguably one of the least understood, appreciated and studied life stages. But it’s <a href="https://doi.org/10.1177/0165025414533223">a pivotal one</a>, with middle-aged Americans playing outsized roles in their workplaces, families and communities.</p>
<p>Unfortunately, without changes to social support or public policy, the problems facing middle-aged Americans will only exacerbate due to the sheer number of <a href="https://www.pewresearch.org/fact-tank/2010/12/29/baby-boomers-retire/">baby boomers entering old age</a>.</p>
<p>[ <em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>. ]</p><img src="https://counter.theconversation.com/content/114347/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Frank J. Infurna currently receives research funding from the John Templeton Foundation and National Institute on Aging. The content is solely his responsibility and does not necessarily represent the official views of the funding agencies. </span></em></p>What was once imagined as a time of exploration and reinvention has become marked by financial and emotional strain.Frank J. Infurna, Associate Professor of Psychology, Arizona State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/971922018-06-14T09:12:12Z2018-06-14T09:12:12ZHuge rise in number of middle-aged cannabis smokers seeking treatment<figure><img src="https://images.theconversation.com/files/220272/original/file-20180524-51130-15kygpf.jpg?ixlib=rb-1.1.0&rect=0%2C80%2C1000%2C514&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/320898851?src=ZBLd2DNLaMLvQM-s3iRwqA-1-75&size=medium_jpg">Ljupco Smokovsk/Shutterstock.com</a></span></figcaption></figure><p>Fewer people are using cannabis, but record numbers are seeking help as a result of using the drug. In the <a href="https://www.gov.uk/government/statistics/drug-misuse-findings-from-the-2016-to-2017-csew">last decade</a> the number of people using cannabis in the UK fell from 3m to 2m. Over the same period, there has been a 60% rise in demand for specialist drug addiction treatment for problems with cannabis.</p>
<p>Drugs like cannabis are often viewed as a young person’s problem, but our <a href="https://tandfonline.com/doi/full/10.1080/09687637.2018.1478948">latest research</a>
shows that people over the age of 40 are the fastest growing group seeking treatment for problems related to cannabis (where cannabis is the only or main drug used). In 2005-06, 471 people sought help, but by 2015-16 this figure had risen to 1,008 – a 114% increase. This is just the tip of the iceberg, however, as only <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1465-3362.2011.00313.x">one in ten</a> cannabis smokers who need treatment seek help.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/220974/original/file-20180530-120496-lqf1nk.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/220974/original/file-20180530-120496-lqf1nk.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/220974/original/file-20180530-120496-lqf1nk.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=361&fit=crop&dpr=1 600w, https://images.theconversation.com/files/220974/original/file-20180530-120496-lqf1nk.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=361&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/220974/original/file-20180530-120496-lqf1nk.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=361&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/220974/original/file-20180530-120496-lqf1nk.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=453&fit=crop&dpr=1 754w, https://images.theconversation.com/files/220974/original/file-20180530-120496-lqf1nk.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=453&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/220974/original/file-20180530-120496-lqf1nk.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=453&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Cannabis treatment presentations.</span>
<span class="attribution"><span class="source">Public Health England</span></span>
</figcaption>
</figure>
<p>We also found that women, of any age, who said cannabis was their primary drug problem, are accessing treatment for cannabis at a faster rate than men. So while the increase in men of any age seeking treatment has risen by 72%, the rise for women has been 95%.</p>
<p>We don’t know why older users and females are increasingly seeking treatment for cannabis use, but we do know that so-called “baby boomers” (people born between 1946 and 1964) will have been exposed to lower potency varieties of cannabis earlier in their lives. As the market has become dominated by higher potency strains, they might be encountering <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.13670">problems</a> that they didn’t have with the lower potency strains.</p>
<p>Women and older users are more likely to have additional responsibilities, such as dependent children, and this might prompt them to seek support so that they can maintain these relationships with their children.
But having children can <a href="https://www.magonlinelibrary.com/doi/abs/10.12968/bjom.2013.21.11.768">act as barrier</a> as well as a prompt to seeking treatment. So while some women and older people are accessing treatment, there are likely to be many more who are reluctant to seek support. </p>
<p>Services will need to consider how they can engage these two groups more effectively, given the concerns they may have about losing their children to social services.</p>
<h2>Poor outcomes</h2>
<p>Treatment staff tend to view cannabis as relatively <a href="https://www.tandfonline.com/doi/abs/10.3109/09687637.2015.1090398">benign</a>, compared with drugs like heroin, which may account for the poorer recovery rates among cannabis smokers. One <a href="https://dspace.library.uu.nl/handle/1874/309585">study</a> found that 9% of those who use cannabis consumed 73% of the cannabis available. This small group of users are at greatest risk, as using cannabis more often and in greater quantities increases the risk of dependency. These factors could account for the poor <a href="https://www.gov.uk/%20government/statistics/substance-misuse-and-treatment-in-adults-statistics-2016-to-2017">outcomes</a> for people when they are in treatment for cannabis problems. For example, after six months in treatment 26% of opiate users had improved compared to only 8% of cannabis users. </p>
<p>Services can’t rely on extra resources to meet the increasing demand for specialists cannabis services, as there is no prospect of the government reversing <a href="https://www.gov.uk/government/news/acmd-warns-ministers-of-falling-local-funding-for-drug-treatment-services">the cuts</a> made in recent years to drug treatment. These cuts have resulted in services competing with each other to secure their survival as treatment providers. Consequently, they don’t share information and so may not realise that nationally there is growing demand from women and older people for help with cannabis. This analysis should help provide that national view so that local services can target care more effectively.</p><img src="https://counter.theconversation.com/content/97192/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ian Hamilton is affiliated with Alcohol Research UK and is an editorial board member of Drugs Education, Prevention and Policy. </span></em></p><p class="fine-print"><em><span>Mark Monaghan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Cannabis users seeking treatment in the UK is rising, especially among women and older smokers. But treatment services are sorely lacking.Ian Hamilton, Lecturer in Mental Health and Addiction, University of YorkMark Monaghan, Lecturer in Crimimology and Social Policy, Loughborough UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/923672018-03-05T15:17:34Z2018-03-05T15:17:34ZCan having high cholesterol reduce your chances of dementia?<figure><img src="https://images.theconversation.com/files/208251/original/file-20180228-36689-kbbgil.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/344282432?src=Rknj5Cb6GY_GxWNVEkEKwg-1-83&size=medium_jpg">SpeedKingz/Shutterstock</a></span></figcaption></figure><p>People over the age of 85 with high levels of cholesterol have a reduced risk of marked cognitive decline, according to <a href="http://www.alzheimersanddementia.com/article/S1552-5260(18)30028-1/fulltext">a new study</a>. Does this mean that having high cholesterol in old age can prevent the onset of dementia? </p>
<p>Cholesterol is <a href="https://heartuk.org.uk/health-and-high-cholesterol">a waxy substance produced by the liver</a> which is also found in many foods. It circulates through your bloodstream in carriers made of fats and proteins, <a href="http://www.heart.org/HEARTORG/Conditions/Cholesterol/HDLLDLTriglycerides/HDL-Good-LDL-Bad-Cholesterol-and-Triglycerides_UCM_305561_Article.jsp#.Wpa8dYKWRpg">known as lipoproteins</a>. </p>
<p>These lipoproteins are classified according to their density. Low-density lipoprotein (LDL) cholesterol is often called “bad” cholesterol, as it contributes to fatty buildup in arteries. High-density lipoprotein (HDL) cholesterol is often referred to as “good” cholesterol as it carries cholesterol away from the arteries and back to the liver. Collectively, the different forms are referred to as total cholesterol. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/208890/original/file-20180305-65547-12o858c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/208890/original/file-20180305-65547-12o858c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/208890/original/file-20180305-65547-12o858c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/208890/original/file-20180305-65547-12o858c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/208890/original/file-20180305-65547-12o858c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/208890/original/file-20180305-65547-12o858c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/208890/original/file-20180305-65547-12o858c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There’s no one cholesterol type.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/general-practitioner-checks-cholesterol-levels-patient-657028978?src=fY9dzRmNXifj1rrgunAkgQ-1-10">Shidlovski/Shutterstock</a></span>
</figcaption>
</figure>
<p>Cholesterol is essential for normal function of cells throughout the human body, but has gained a bad reputation as it is also <a href="https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease-risk-factors">linked to coronary heart disease</a>. This link means that cholesterol-lowering drugs, like statins, are used to <a href="https://www.sciencedirect.com/science/article/pii/S0140673694905665">manage the risk</a> of having a cardiovascular event, such as a heart attack or stroke. Nevertheless, scientific opinion over cholesterol and the use of statins to reduce cholesterol levels is split, making it an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513492/">intriguing and controversial area</a>. </p>
<p>Interestingly, research has shown that cholesterol is involved in a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814023/">loss of cognitive function</a>. Cognitive function includes <a href="https://www.sciencedirect.com/topics/neuroscience/cognitive-functions">mental processes such as</a> attention, processing speed, learning and memory and verbal fluency. Dementia, including Alzheimer’s disease, occurs when these functions decrease significantly more than you would expect with normal ageing. </p>
<p>While the studies in this field lack consistency, there is evidence that high cholesterol in middle age increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pubmed/19648749">developing Alzheimer’s disease</a>. Also, alipoprotein E, a protein that acts as a cholesterol carrier in the brain, is <a href="https://www.frontiersin.org/articles/10.3389/fnmol.2017.00319/full">a major risk factor</a> for the development of late-onset Alzheimer’s.</p>
<h2>What the new study found</h2>
<p>The new study compared cognitive function in people of different ages. The research team looked at existing data from the <a href="https://www.framinghamheartstudy.org">Framingham Heart Study</a>, an ongoing cardiovascular study of residents of Framingham, Massachusetts. </p>
<p>The researchers evaluated a variety of total cholesterol values, including “midlife” total cholesterol, “late-life” total cholesterol, mean total cholesterol since midlife, and change in cholesterol since midlife. Midlife would be around 40 years of age, and late-life around 75 years of age. </p>
<p>The team assessed whether marked cognitive decline was associated with any of the cholesterol values measured. They also studied whether these associations changed depending on the age when cognitive assessment was done. </p>
<p>The study showed that several cholesterol values, including increased cholesterol levels since midlife, were associated with increased risk of a marked cognitive decline. However, as the age of the people studied increased, some of these associations were reduced or reversed. </p>
<p>Most interestingly, in subjects aged 85 to 94, a high midlife total cholesterol level was associated with a reduced risk for marked cognitive decline. This finding is in contrast with both younger age groups in this study, and other studies where midlife cholesterol was associated with <a href="https://www.ncbi.nlm.nih.gov/pubmed/22269162">increased risk of cognitive decline</a>.</p>
<h2>The take home</h2>
<p>What does this new finding actually mean in real terms then? It is unlikely that high total cholesterol per se is actually good for cognitive function at 85 years of age. This means that it’s probably not wise to attempt to increase your cholesterol or to stop taking any medication that reduces cholesterol. </p>
<p>Controlling cholesterol levels, especially at midlife, would probably still benefit most of us. Taking into account the findings of other studies, it is almost certain that the people in this study, aged 85 and older, had unknown additional protective factors that prevented them from undergoing marked cognitive decline. This means that the risks associated with high cholesterol do not apply to them. </p>
<p>Until these factors have been identified it is impossible to know if cholesterol is a marker of these additional factors, or if cholesterol itself is important. For now cholesterol remains an intriguing and controversial subject.</p><img src="https://counter.theconversation.com/content/92367/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>James Brown currently receives funding from Alzheimer's Research UK.</span></em></p><p class="fine-print"><em><span>Eric J Hill receives funding from Alzheimer's research UK and The MRC. </span></em></p>A new study has assessed the links between cholesterol and cognitive function.James Brown, Senior Lecturer in Biology and Biomedical Science, Aston UniversityEric J Hill, Programme Director MSc taught programmes, Aston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/811062017-07-31T08:26:02Z2017-07-31T08:26:02ZOpioid misuse is increasing in middle-aged Britons – here’s how it could cause an addiction crisis<figure><img src="https://images.theconversation.com/files/179428/original/file-20170724-21564-1t4nyv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Tramadol.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/648598822?src=8LcxAx728VBlsGx7MZkQHQ-1-0&size=medium_jpg">chatuphot/Shutterstock</a></span></figcaption></figure><p>The older we get, the more likely we are to suffer with long-term health problems. Life expectancy may be increasing, but so are the number of years we spend in ill health. In people aged 50 and over, the leading causes of chronic ill health are <a href="https://www.gov.uk/government/publications/health-profile-for-england/chapter-3-trends-in-morbidity-and-behavioural-risk-factors">lower-back and neck pain</a>. It’s hardly surprising, then, that so many middle-aged people are hooked on painkillers.</p>
<p>Painkillers are often the first port of call for anyone seeking to rid themselves of discomfort from damage done to joints and muscles as part of the ageing process. Paracetamol was once the <a href="http://journals.lww.com/americantherapeutics/Abstract/2000/07020/Paracetamol__Past,_Present,_and_Future.11.aspx">mainstay of treatment</a>, but stronger painkillers are now <a href="http://bmjopen.bmj.com/content/6/5/e010276">more commonly prescribed</a>, especially highly addictive opioid painkillers, such as buprenorphine, fentanyl and oxycodone.</p>
<p>A study of prescribing in Tayside, Scotland, between 1995 and 2010, found an <a href="https://www.ncbi.nlm.nih.gov/labs/articles/24807782/">18-fold increase</a> in the number of people prescribed strong opioids. And between 2002 and 2013, the number of people in the UK prescribed strong opioids for chronic pain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912234/">rose six-fold</a>.</p>
<p>Opioid drugs, being derivatives of morphine, have a huge potential for misuse, particularly if used at high doses or over long periods of time. In older adults, these drugs are eventually taken for their <a href="http://www.sciencedirect.com/science/article/pii/S0376871615000472">pleasurable effects</a> rather than their pain-relieving potential – the slippery path to addiction.</p>
<p>Addiction to opioid painkillers in middle-aged people has resulted in a sharp increase in deaths associated with drug toxicity. A case in point being the drug tramadol. </p>
<p>In the UK, the Advisory Council on the Misuse of Drugs called for tighter controls on tramadol prescribing, as a result of its <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/144116/advice-tramadol.pdf">increasing misuse</a>. In 2000, in England and Wales, there were three deaths associated with tramadol in the 50-69 age group. This rose to a staggering <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/deathsrelatedtodrugpoisoningenglandandwalesreferencetable">70 deaths</a> by 2015. </p>
<p>Ageing also means changes to the way opioid drugs affect the body. Not only is there a higher chance of these drugs taking longer to clear from the bloodstream, opioid drugs are highly likely to cause more problems with <a href="http://www.cmaj.ca/content/174/11/1589.short">breathing, blood pressure, drowsiness and falls</a>. They also interact with other drugs, either <a href="https://www.rcpsych.ac.uk/pdf/Substance%20misuse%20in%20Older%20People_an%20information%20guide.pdf">increasing their side effects or changing their levels in the blood</a>.</p>
<h2>The baby boomer problem</h2>
<p>Unlike previous generations of middle-aged people, today’s “baby boomers” grew up in a permissive society. As a result, they are at considerably higher risk of addiction to both <a href="https://theconversation.com/grandmothers-little-helper-a-new-drug-problem-emerges-66377">non-opioid painkillers</a> and <a href="https://theconversation.com/having-lived-hedonistic-lives-the-baby-boomers-are-drinking-themselves-into-an-early-grave-64016">alcohol</a> compared with previous generations. And baby boomers in the 50-64 age group who are addicted to illicit drugs are also at high risk of <a href="http://www.tandfonline.com/doi/abs/10.1080/01634372.2017.1327469">opioid painkiller addiction</a>. Opioid painkillers appear to be part of a wider picture of addiction.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/179467/original/file-20170724-23039-1yk9k38.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/179467/original/file-20170724-23039-1yk9k38.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/179467/original/file-20170724-23039-1yk9k38.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/179467/original/file-20170724-23039-1yk9k38.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/179467/original/file-20170724-23039-1yk9k38.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/179467/original/file-20170724-23039-1yk9k38.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/179467/original/file-20170724-23039-1yk9k38.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Baby boomers grew up in a permissive era.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/vwcampin/35256750001/in/photolist-4z9Nv5-nzxBHZ-VHw4s2-4cTa1X-ooXhnX-81kP2V-fJMhck-2hYsBf-iJYKMV-qshR27-5JzMzH-qwnbHF-6dxx1N-aJ3pda-8BpENW-8Pomnt-aewwRS-4z5B84-5uauhW-6jUuyX-oH3ygj-dvDsSw-sucfr-6g93pG-qshbJ3-4Tp2sb-5tnDLQ-c261NA-BBqGp-fMo8Yg-9Qwduw-4UjKR5-eiqx4D-6d36Hh-6yuXEg-EjMzn-7Ghbsb-9t8YbZ-6aJa6r-5oxLjk-6pxmQV-6aAuQG-aaV3M1-hEEjVD-piCuJT-4ienTz-cxzJ7C-534KTK-dbJRb3-4oCymi">Shelby Bell/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Tackling opioid painkiller addiction in middle-aged people should start at a national policy level, but the Home Office’s new <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/628148/Drug_strategy_2017.PDF">drugs strategy</a> makes little mention of the risks posed by opioid painkillers, choosing instead to focus exclusively on illicit opioid drugs such as heroin. </p>
<p>The increasing use of prescription opioid painkillers in baby boomers shows little sign of slowing down. The problem is that it’s an invisible addiction where an easy fix with opioid painkillers is all too common. Prescribing drugs for pain may leap straight from paracetamol to opioids, with few alternative drug treatments in between for numbing the pain and discomfort caused by the ravages of ageing. </p>
<p>Curbing the inevitable and relentless descent into greater harm from opioid painkillers in baby boomers means that medical specialists need to work closer together. GPs will need to work more closely with pain clinics, as well as mental health services. Joint clinics between GPs and old-age psychiatry or geriatrics services could also reduce opioid prescribing by treating the mental and physical consequences of pain more effectively.</p>
<p>We are probably many years away from developing the <a href="https://theconversation.com/a-possible-alternative-to-morphine-inspired-by-spit-71394">perfect, harmless, non-addictive painkiller</a>. In the meantime, we need GPs to be more vigilant over the potential for addiction with opioid painkillers and to think about non-drug treatments for pain such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797112/">lifestyle changes and psychological interventions</a>. Without this, Britain faces a major public health crisis.</p><img src="https://counter.theconversation.com/content/81106/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tony Rao does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>More and more baby boomers are getting hooked on oxycodone, vicodin and tramadol.Tony Rao, Visiting Lecturer in Old Age Psychiatry, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/757332017-05-17T09:37:43Z2017-05-17T09:37:43ZMaintaining the same weight as you age may prevent diabetes – even if you’re overweight to begin with<figure><img src="https://images.theconversation.com/files/168371/original/file-20170508-20740-1f7loga.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/387061921?src=H238Hq4LB_heKGv7_DI5AA-1-2&size=medium_jpg">Billion Photos/Shutterstock</a></span></figcaption></figure><p>It is well known that losing weight reduces your risk of developing type 2 diabetes. Our <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4081-6">latest research</a> shows that maintaining the same weight as you age may also prevent diabetes, even in people who are moderately overweight.</p>
<p>Type 2 diabetes is a global health problem that affects about <a href="http://www.diabetesatlas.org/">414m adults</a>. The disease usually develops over many years as the body’s ability to absorb and metabolise sugar and carbohydrates slowly declines. It is mainly caused by diet, inactivity and smoking, but genes also play a <a href="https://www.nature.com/nrendo/journal/v10/n4/full/nrendo.2014.11.html">role</a>. </p>
<p>Although the number of people newly diagnosed with diabetes appears to be <a href="http://link.springer.com/10.1007/s00125-016-4054-9">stabilising</a>, and perhaps even <a href="http://onlinelibrary.wiley.com/doi/10.1111/dme.12716/abstract">decreasing</a>, the total number of people living with the disease is increasing. Diabetes is a chronic disease with many health consequences that often need lifelong treatment. The disease decreases a person’s quality of life and places a strain on the health service.</p>
<p>We know that being overweight is strongly associated with type 2 diabetes and that obese people who lose weight, exercise and improve their diet can <a href="http://www.bmj.com/content/334/7588/299.long">lower their risk of developing diabetes</a>. In many parts of the world, public health campaigns are focused on identifying and treating those at high risk of diabetes as a result of being obese and having high levels of blood sugar. But from a public health perspective, it is also worth exploring if other strategies could be more effective at preventing the occurrence of new cases of diabetes.</p>
<h2>Large Swedish study</h2>
<p>We studied over 30,000 people aged 30 to 60 from Västerbotten county in northern Sweden. The participants had their weight and blood sugar measured on two occasions, ten years apart. We wanted to see if what people weighed at the beginning of the study could tell us something about their risk of developing diabetes. But we also wanted to know the impact of weight change over time on the risk of developing diabetes.</p>
<p>The distribution of weight in the people we studied was very similar to that in the general Swedish population. Based on their body mass index (BMI), just over a third of people were overweight and about a tenth were obese. (Putting on a bit of weight in middle age is normal.)</p>
<p>We found that, after ten years, just under a third of people had maintained the same weight, just over half had gained weight and about a sixth had lost weight. When comparing occurrence of newly diagnosed diabetes after 10 years in those who gained any weight to those who maintained their weight, we found that the risk of diabetes was considerably lower in those who maintained their weight. This was true not only for people who were a normal weight at the start, but also for those who were moderately overweight. </p>
<p>As expected, people who lost moderate amounts of weight had an even lower comparative risk of developing diabetes, especially among those who were overweight or obese at the start.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/168373/original/file-20170508-20738-1aicuop.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/168373/original/file-20170508-20738-1aicuop.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/168373/original/file-20170508-20738-1aicuop.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/168373/original/file-20170508-20738-1aicuop.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/168373/original/file-20170508-20738-1aicuop.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/168373/original/file-20170508-20738-1aicuop.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/168373/original/file-20170508-20738-1aicuop.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Putting on a bit of weight in middle age is normal.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/524573638?src=dXig7Ih4NYOJmMECWoCG4g-1-35&size=medium_jpg">pixelheadphoto digitalskillet/Shutterstock</a></span>
</figcaption>
</figure>
<h2>A new focus for public health</h2>
<p>As well as studying risk, we were also interested in how big a change in average weight, at a population level, would be needed to achieve a meaningful reduction in the occurrence of type 2 diabetes. We found that if everyone who gained weight had instead maintained their weight, an estimated one in five of all new diabetes cases could be prevented. This proportion should be compared to the fact that current prevention strategies that target those at high risk could only prevent an estimated one in ten of all new cases. </p>
<p>These results show that diabetes can be prevented even in people who are moderately overweight, and that it is worth investing in public health measures that support people in maintaining a healthy lifestyle and a healthy weight throughout their life.</p><img src="https://counter.theconversation.com/content/75733/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Adina L. Feldman is funded by the Medical Research Council. </span></em></p>Here’s a message public health officials should adopt. It could prevent many new cases of diabetes occurring.Adina L Feldman, Career Development Fellow, University of CambridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/491822015-11-05T06:02:25Z2015-11-05T06:02:25ZHard Evidence: are age and unhappiness related?<figure><img src="https://images.theconversation.com/files/98861/original/image-20151019-23249-1at19uf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Middle age via vicspacewalker/www.shutterstock.com</span></span></figcaption></figure><p>If it’s no fun getting old, then why do surveys of national well-being show that older people are happier than younger people? </p>
<p>Recent research into happiness, questioning people about their lives as a whole, their jobs, family, social activities and other aspects, has started to reveal some intriguing patterns. <a href="http://www.ons.gov.uk/ons/rel/wellbeing/measuring-national-well-being/older-people-s-well-being/art-older-people-s-well-being--2015.html#tab-Older-people--well-being-and-loneliness">New data</a> released by the Office for National Statistics (ONS) shows that older people tend to be happier rather than more miserable than younger people. But looking at <a href="http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=tcm%3A77-411542">ONS data</a> in more depth reveals an even more interesting pattern</p>
<p>Between the ages of around 20 and the decade between ages 40 to 50, people score progressively lower in measures of happiness on average. But after the middle years of their life, that trend is reversed so that average happiness becomes steadily greater, until it levels off when people are about 70.</p>
<iframe src="https://datawrapper.dwcdn.net/SUzsM/3/" frameborder="0" allowtransparency="true" allowfullscreen="allowfullscreen" webkitallowfullscreen="webkitallowfullscreen" mozallowfullscreen="mozallowfullscreen" oallowfullscreen="oallowfullscreen" msallowfullscreen="msallowfullscreen" width="100%" height="400"></iframe>
<p>This age pattern in the UK parallels <a href="http://www.pnas.org/content/107/22/9985.abstract">that found in other high-income countries</a>, although in other regions the curve is not present in the same way. In high-income countries it is visible in broad assessments of life satisfaction and (with increases in the middle years) through <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2961489-0/abstract">reports</a> about recent worry or stress. It also exists within particular domains of life: job satisfaction and job strain are <a href="http://www.ncbi.nlm.nih.gov/pubmed/1558703">respectively lowest and highest</a> in the middle years of our lives. And the U-shape is broadly similar for men and women, although the diagram below illustrates that women tend to worry more than men. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/100334/original/image-20151030-16554-lfnu0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/100334/original/image-20151030-16554-lfnu0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/100334/original/image-20151030-16554-lfnu0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=437&fit=crop&dpr=1 600w, https://images.theconversation.com/files/100334/original/image-20151030-16554-lfnu0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=437&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/100334/original/image-20151030-16554-lfnu0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=437&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/100334/original/image-20151030-16554-lfnu0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=550&fit=crop&dpr=1 754w, https://images.theconversation.com/files/100334/original/image-20151030-16554-lfnu0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=550&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/100334/original/image-20151030-16554-lfnu0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=550&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Proportion of respondents who reported that they experienced a lot of worry yesterday, based on data in Gallup-Healthways Wellbeing Index Poll.</span>
<span class="attribution"><a class="source" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2961489-0/abstract">Steptoe, Deaton and Stone, The Lancet</a></span>
</figcaption>
</figure>
<p>Surveys of this kind generate averages from different people, and we cannot assume that all people will travel along the average route. Longitudinal research into happiness over a life-span has not yet been possible, and research has not directly indicated that one variable – age – is causally determining the other – happiness. </p>
<p>It does seem likely that age contributes in some way to positive or negative feelings, but the number of years since birth cannot directly cause anything. So we need to look for other, possibly causative, factors which may change with age. </p>
<h2>Happiness and the environment</h2>
<p>Happiness is of course hugely influenced by external factors, and <a href="https://books.google.co.uk/books/about/The_Joy_of_Work.html?id=0HirAgAAQBAJ&source=kp_cover&redir_esc=y">many investigations</a> have identified several which may contribute to the relationship between happiness and age.</p>
<p>As adults move towards middle age they often take on additional job and family responsibilities and can be increasingly troubled by job insecurity and future career uncertainty, as well as by childcare and commitments to elderly relatives. Conflicts between roles can become unusually great in these years, and income can increasingly fail to meet people’s needs. </p>
<p>Studies have <a href="http://www.uky.edu/%7Eeushe2/Bandura/Bandura2001ARPr.pdf">found that</a> people need to have some influence on what happens to them and what they do to avoid distress. They are <a href="https://books.google.co.uk/books?id=R8kCoofE8VsC&pg=PA271&lpg=PA271&dq=The+role+of+personal+control+in+adaptive+functioning&source=bl&ots=2wqQv1iepj&sig=sFwn12koOi98ty_jVc-iAuTa1Mg&hl=en&sa=X&ved=0CCwQ6AEwAWoVChMImN71wLblyAIVQTUUCh2U-ALr#v=onepage&q=The%20role%20of%20personal%20control%20in%20adaptive%20functioning&f=false">unhappy</a> being merely a pawn manipulated by other people and events, and they want to be able to take steps to reduce strain and enhance their enjoyment of life. </p>
<p>But the opportunity to influence your surroundings can be substantially impaired in your middle years because of conflicting demands made by other people and the roles you have taken on. You can feel particularly hemmed in by your situation.</p>
<p>This, alongside other aspects of a person’s environment, can depress happiness in middle age. But why does it improve, on average, after then? In part, it is because people move on to different stages of life, when demands on their time and money, experienced uncertainty and other negative features tend to decline. As children grow up, job and other activities become established and care-dependent relatives pass away, people’s happiness on average increases. </p>
<h2>Personal influences on happiness</h2>
<p>But feelings are not entirely determined by what happens to you – they also depend on how you interpret your world. People respond differently to many aspects of the environment, in part through mental filters such as those illustrated below. </p>
<iframe src="https://datawrapper.dwcdn.net/zu1U1/2/" frameborder="0" allowtransparency="true" allowfullscreen="allowfullscreen" webkitallowfullscreen="webkitallowfullscreen" mozallowfullscreen="mozallowfullscreen" oallowfullscreen="oallowfullscreen" msallowfullscreen="msallowfullscreen" width="100%" height="400"></iframe>
<p>Looking at number three in the table, “upward” comparisons (against alternatives which are seen as better than your own situation) encourage unhappiness. Yet sometimes thinking about ways in which life could have turned out worse (making “downward” comparisons) can lead to more positive feelings. </p>
<p>Often mental comparisons involve other people, such as number one in the table. In our 20s “upward” comparisons with other people are common – keeping up with the Jones’s, or checking body shape against celebrities. But in later years reduced levels of striving can be accompanied by more “downward” comparisons. As people move beyond middle age they increasingly review their life so far, often finding “downward” alternatives which can improve their happiness.</p>
<p>Particularly important for understanding why happiness may increase in the later years are processes of mental adaptation. Biological and psychological <a href="https://books.google.co.uk/books/about/Happiness_Pleasure_and_Judgment.html?id=UjI_6uZzX4MC&source=kp_cover&redir_esc=y">studies</a> have shown how responses to a stimulus become diminished after repeated presentation. This means that unpleasant conditions can become viewed less negatively after a period of time. </p>
<p>For stimuli that are new, cognition (what you think) and affect (how you feel) tend to be closely intertwined. But after a period of adaptation they may become uncoupled: you may be just as aware of what’s going on, but your feelings become more neutral. As features and events in your life become increasingly familiar they tend to generate less intense emotions, perhaps contributing to a gradual increase in happiness with increasing years.</p>
<p>Together, the combination of these two sets of factors – changes in what life doles out and shifts in the interpretation of those events – can provide some explanation of the U-shape pattern in happiness across ages.</p><img src="https://counter.theconversation.com/content/49182/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Warr previously received funding from the UK Medical Research Council and the Economic and Social Research Council.</span></em></p>After the middle years of their life, people report increasing levels of happiness. An expert unpicks the data.Peter Warr, Emeritus Professor, University of SheffieldLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/462812015-09-08T10:52:04Z2015-09-08T10:52:04ZBlaming the Baby Boomers does today’s young people no favours<p>A <a href="http://www.independentage.org/media/1098261/rfa-myth-of-baby-boomer.pdf">new report</a> by the Ready for Ageing Alliance argues that we should stop assuming that all members of the Baby Boomer generation are healthy, wealthy, and idle, and holding them responsible for everything that is currently wrong with the world. Too right.</p>
<p>One of the nastiest narratives to have developed over the past decade is that of “boomer blaming”, where the alleged good fortunes of the generation born in the 20 years or so after World War II (definitions of the boomer generation vary, often according to what it is being blamed for) are presented as the cause of myriad social problems. Everything from environmental destruction to the problems of the economy, the housing market, the welfare state, youth unemployment and children’s mental health, has been laid at the Boomers’ door.</p>
<p>Boomer blaming is not just a whinge – it has a real policy impact. Former government minister David Willetts has gone so far as to accuse the Boomers of breaking the “intergenerational contract”. His book, The Pinch, is <a href="http://www.theguardian.com/books/2010/feb/07/the-pinch-david-willetts">subtitled</a> “How the Baby Boomers took their children’s future – and why they should give it back”.</p>
<p>Lobby groups such as the Intergenerational Foundation (IF) publish an “<a href="http://www.if.org.uk/archives/6909/2015-intergenerational-fairness-index">Intergenerational Fairness Index</a>”, which directly counterposes the prospects of younger generations compared to older ones, and calls on the government to “embark on a programme of ‘intergenerational rebalancing’” – taking from Granny to give to Baby George. </p>
<p>The IF quotes Laurence Kotlikoff, professor of Economics at Boston MIT, claiming that: “The UK, like other developed economies, has engaged in fiscal, educational, health and environmental child abuse.”</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/92533/original/image-20150820-7231-1yjhho1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/92533/original/image-20150820-7231-1yjhho1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/92533/original/image-20150820-7231-1yjhho1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=478&fit=crop&dpr=1 600w, https://images.theconversation.com/files/92533/original/image-20150820-7231-1yjhho1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=478&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/92533/original/image-20150820-7231-1yjhho1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=478&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/92533/original/image-20150820-7231-1yjhho1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=601&fit=crop&dpr=1 754w, https://images.theconversation.com/files/92533/original/image-20150820-7231-1yjhho1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=601&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/92533/original/image-20150820-7231-1yjhho1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=601&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">David Willetts</span></span>
</figcaption>
</figure>
<p>The shrill hyperbole of boomer-blaming has left some quite bewildered. As the Ready for Ageing Alliance points out: “the term ‘Baby Boomer’ is increasingly used as a term of abuse”. In reality, the boomer cohort, like any other, contains a range of individuals living in a range of circumstances. Yes, some are well off, with stable pensions and appreciating housing assets – but others are poor, ill, unemployed, or unable to retire. </p>
<p>Why would we blame an entire cohort for having been born at a particular time in history? How could it benefit their children or grandchildren to be told that their future has already been “taken”?</p>
<h2>Not <em>Absolutely</em> Fabulous</h2>
<p>My study of <a href="http://www.palgrave.com/page/detail/baby-boomers-and-generational-conflict-jennie-bristow/?K=9781137454720">Baby Boomers and generational conflict</a> analyses the reasons behind all this blaming, by tracking how the media discussion has developed over the past quarter of a century. I found that, while the boomers have been of interest for some time, it is only in the past decade or so that they have been so clearly constructed as a problem. This has less to do with the actual characteristics or experiences of this generation, than with the way that society now understands social problems and their causes.</p>
<p>For example, one of the central charges levelled against the boomers is that, as a large generation, they have “monopolised” society’s resources: pensions, housing, and healthcare. But they have always been a relatively large generation (the clue is in the name) and, in different times, this would be seen as a good thing. More people can mean more wealth generation, more dynamism, a sense of greater possibility.</p>
<p>The current obsession with the size of the boomer generation is a result of limited economic and social policy outlook that is obsessed with sharing out the pie, rather than making a bigger pie. This approach is particularly tasteless when it comes to the boomers – who, having contributed to the pie through employment and taxation in their working years, are now seen as greedy in their attempts to access pensions or healthcare. That there has been a lively, and ongoing, discussion about <a href="http://www.bbc.co.uk/news/magazine-11550760">euthanasia</a> as one solution to the Baby Boomers’ enhanced longevity shows the grim logic of this kind of demographic determinism.</p>
<p>The other reason people have it in for the boomers is their cultural association with the 60s. Despite the fact that the majority of Boomers came of age in the crisis-ridden 1970s, our image of the generation as a whole seems to be taken directly from <a href="http://www.bbc.co.uk/programmes/b00jm3ms">Absolutely Fabulous</a>: selfish, narcissistic hedonists who have never had to do a day’s “real” work and rely on their long-suffering kids to cope with the reality of middle age.</p>
<h2>Spirit of the 60s</h2>
<p>In Britain 2015, the spirit of the 60s – experimentation, individualism, the freedom of youth – is seen as all very outré: the 60s has been recast as the era that brought us family breakdown, Jimmy Savile, and an interest in buying too much stuff. So the Boomers, just because some of them were there, are shunned like a smoker at a dinner party.</p>
<p>Yes, there was a lot of nonsense in the 60s – and periodic attempts to romanticise that era don’t get us very far. But rerunning the Culture Wars in a personalised fashion, against individuals who are still very much alive and playing a vital, responsible role in our society, is reprehensible. A critique of the 60s is one thing; the current Granny-bashing is an attack on old and young alike. It presents the recently retired as parasites – and the freedom of youth as something misguided and dangerous, to which today’s young people should not even aspire.</p>
<p>Solutions to the economic or cultural problems of today will not be found by rewriting the past and castigating those who happened to live there. We should be living in the present, and embracing the future.</p><img src="https://counter.theconversation.com/content/46281/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennie Bristow does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>It’s become fashionable to blame those born in the post-war baby boom for all today’s economic woes. But this is unfair – and wrong.Jennie Bristow, Lecturer in Sociology, Canterbury Christ Church UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/427272015-06-03T23:11:02Z2015-06-03T23:11:02ZWant to know your risk of dying in the next five years? Take the Ubble age test<figure><img src="https://images.theconversation.com/files/83715/original/image-20150602-19232-1ym5sw5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Err, ok.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-282782621/stock-photo-middle-aged-man-in-plade-shirt-with-mustashe.html?src=yQ2lxVmrN7Dv7HAfWwLkBQ-1-20">Middle age by Shutterstock</a></span></figcaption></figure><p>There is a great interest in understanding what might predict life expectancy in the general population. We already know several risk factors that have a substantial impact on mortality. For example, smoking, lack of exercise and increased body mass index have been shown to increase the risk of dying earlier. </p>
<p>Most previous studies have investigated one risk factor at a time – and usually in a limited number of individuals. However, in the first study of its kind, <a href="http://bit.ly/1Q6H9Qk">published in The Lancet</a>, we compared many potential risk factors in a large number of individuals and come up with a tool that can be used by anyone living in the UK and aged between 40 and 70 to calculate their risk of dying within the next five years. In addition users can work out their “Ubble age” – a single prediction score that uses information about you to match your risk profile to the age of the average person of your gender in the UK.</p>
<p>You can calculate your five-year risk of dying as well as your Ubble age using <a href="http://www.ubble.co.uk">our interactive website</a>, developed in collaboration with <a href="http://www.senseaboutscience.org/">Sense About Science</a>. After filling in a dozen or so simple questions, the tool is able to calculate your risk and your Ubble age. </p>
<h2>Coming up with the tool</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/83824/original/image-20150603-2935-12xk2nw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/83824/original/image-20150603-2935-12xk2nw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=280&fit=crop&dpr=1 600w, https://images.theconversation.com/files/83824/original/image-20150603-2935-12xk2nw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=280&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/83824/original/image-20150603-2935-12xk2nw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=280&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/83824/original/image-20150603-2935-12xk2nw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=352&fit=crop&dpr=1 754w, https://images.theconversation.com/files/83824/original/image-20150603-2935-12xk2nw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=352&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/83824/original/image-20150603-2935-12xk2nw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=352&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">How do you compare with 500,000 others?</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-279379331/stock-photo-crowd-of-people-at-the-street-city-center.html?src=pp-same_artist-279379328-v1CvKZoLHKUGSTUzAMo9eQ-1">Crowd by Shutterstock</a></span>
</figcaption>
</figure>
<p>We examined and compared more than 655 measurements of demographics, health, and lifestyle factors in around 500,000 people from the <a href="http://www.ukbiobank.ac.uk/">UK Biobank</a> who were aged between 40 and 70 years old. We then used a statistical survival model to work out the probability of these measurements predicting death from any cause, and also six specific causes, for men and women. </p>
<p>We analysed how well each measurement predicted mortality using something called the C-index. The higher the C-index, the more accurate the measurement is in discriminating between those who will die and those who won’t in the next five years. A C-index of 50-60% is considered a poor predictor, 60-70% moderate, 70-80% good, 80-90% very good and over 90% is considered excellent.</p>
<p>We further selected the most predictive measurements, 13 for men and 11 for women, and combined them into the prediction score. For example we selected questions such as: “Do you smoke now?” or “In general how would you rate your overall health?”. The prediction score is also used to calculate the Ubble age, which is simply the age of an average individual from the UK of same gender that matches the predicted risk. So for example, if you’re a 53-year-old woman and your estimated risk of dying in five years is 2.4%, the most similar risk in the UK life tables is of a 56-year-old woman. So your Ubble age would be 56.</p>
<h2>A simple questionnaire</h2>
<p>We found that the variables that most accurately predicted death from all causes within five years did not need to be measured by physical examination, but could be reported by individuals through a questionnaire. </p>
<p>For example, asking people to rate their overall health (self-reported health) and to describe their usual walking pace were two of the strongest predictors in both men and women for different causes of death. It turns out that walking pace is more predictive of five-year mortality (a C-index of 72%) than body mass index (C-index of 68%).</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/83822/original/image-20150603-2946-1bcsbly.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/83822/original/image-20150603-2946-1bcsbly.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/83822/original/image-20150603-2946-1bcsbly.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/83822/original/image-20150603-2946-1bcsbly.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/83822/original/image-20150603-2946-1bcsbly.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/83822/original/image-20150603-2946-1bcsbly.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/83822/original/image-20150603-2946-1bcsbly.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Walking pace.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&autocomplete_id=143334125956814320000&search_tracking_id=Qx3B_D93hrYmZZDDhVg8lw&searchterm=walking%20barefoot&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=283641227">Walking by Shutterstock</a></span>
</figcaption>
</figure>
<p>We also found that among individuals who did not have any known major disease, measurements of smoking habits were the strongest predictors of mortality within five years.</p>
<p>Overall, our study allows comparison of a large number of predictors of overall and cause-specific mortality in a way that has never been done before. As well as being open to use by people to improve their health awareness, health professionals and organisations can also use it to identify individuals at high-risk.</p>
<h2>Limitations</h2>
<p>Our website was evaluated by several audit groups, including scientists and representatives from patient organisations and other stakeholders as well as individuals from the general public. </p>
<p>However, there are some limitations in our study. The UK Biobank participants are not representative of the entire UK population, as they are more affluent and have lower mortality. We addressed this partly by recalibration of the prediction score using data from the UK census. We also only looked at the risk of dying within five years, and it is unknown how the prediction would look like beyond this period.</p>
<p>Finally, the tool is a predictor and cannot claim causality. Most of the strongest predictors of mortality are correlated, not proven as causally related. For example, a slow walking pace is a strong predictor of dying, but walking faster won’t necessarily lead to a reduced risk of dying. Smoking and dying, however, is one of the few things that we know are causally related.</p><img src="https://counter.theconversation.com/content/42727/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The study was funded by the Knut and Alice Wallenberg Foundation and the Swedish Research Council.</span></em></p><p class="fine-print"><em><span>Andrea Ganna does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A new tool that combines mortality risk factors across a big sample of the UK population can work out how middle-aged people compare.Erik Ingelsson, Professor of Molecular Epidemiology, Uppsala UniversityAndrea Ganna, Research Fellow, Harvard UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/180252013-11-05T14:22:29Z2013-11-05T14:22:29ZThe ups and downs of taking risks in middle-age<figure><img src="https://images.theconversation.com/files/34457/original/fspkdb6f-1383661029.jpg?ixlib=rb-1.1.0&rect=3%2C0%2C1020%2C677&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">I'll need a leather jacket to go with it.</span> <span class="attribution"><span class="source">Bigonroad</span></span></figcaption></figure><p>As a teenager I remember asking my parents if it was possible to have a mid-life crisis before you left high school. This was followed by hearty chuckles. Nonetheless, it forces one to ask the question: what exactly is a mid-life crisis and how would you know if you were having one? And is there evidence that such a thing even exists? And if so, what are the symptoms? Does mid-life put you at risk of divorce, dying in a motorcycle accident, or failing to open your parachute?</p>
<p>There are many ways to answer these questions. And there are a number of dominant factors (and preconceptions) that appear in our middle years. There is a wealth of studies out there, including data from the <a href="http://www.cdc.gov/injury/wisqars/index.html">Center for Disease Control</a> (CDC) in the US, recorded between 1999 and 2010. </p>
<h2>The upside</h2>
<p><strong>Divorce:</strong> Divorce does not increase in middle age. The <a href="http://ncfmr.bgsu.edu/">National Center for Family and Marriage Research</a> at Bowling Green State University found a steady decline in divorce rates across the adult lifespan. This is a typical pattern in other types of data as well. Peak divorce rates occur around the age of 20, with between 30 and 45 divorces per 1000 married couples per year. By the late forties and early fifties, this goes down to about 15 divorces per 1000 married couples, and it continues to decline from there. One of the biggest risk factors for divorce is having already had one - so avoid that, where possible.</p>
<p><strong>Behind the wheel:</strong> People might be more likely to buy expensive and fast cars, but then again people in mid-life make more money than they did when they were younger. So perhaps a better indicator would be whether or not we saw a rise in fatal car accidents. The answer appears to be no; crash rates and fatal car accidents are at their lowest among people in their 40s and 50s. Accident rates rise again when people are in their 70s, but the majority of these accidents happen between one and 20 miles per hour. It’s a different kind of joy ride.</p>
<p><strong>Homicide:</strong> Does middle age increase the chances that people will become homicidal killers? No. Starting from a peak homicide rate around the 20s, people grow increasingly meek as they get older. This is best known from the <a href="http://www.psy.cmu.edu/%7Erakison/dalywilson.pdf">research of Wilson and Daly</a> who studied homicide rates in Detroit, among other places. The principle results were that young, unmarried males were the primary offenders. The middle-aged, on the other hand, seemed to have their inner demons fairly well under control.</p>
<h2>The downside</h2>
<p><strong>Depression:</strong> Mid-life can indeed be truly depressing. A number of studies on happiness have consistently found that happiness across the lifespan is a U-shaped function. People are saddest when they’re about middle age, and they tend to be happier when they are younger or older. It appears this has nothing to do with being human. <a href="http://www.pnas.org/content/109/49/19949.short">New research led by Alexander Weiss</a> at the University of Edinburgh also found this U-shaped pattern in great apes. </p>
<p><strong>Suicide:</strong> You might be more likely to kill yourself in middle age. Studies on suicide across the lifespan indicate a small but possible rise in suicide rates as people age, though I’ve heard few claim a rise in mid-life. However, the CDC data tells a different story, with two clear peaks: one in people in their 80s and another nearly as high in the late 40s and early 50s, with about 17 suicides per 100,000 people. That’s about 10 more suicides per 100,000 people than occur in the late teens. </p>
<p>Also, though suicide rates are pretty much always higher for males, both males and females show this mid-life peak. </p>
<p><strong>Taking chances:</strong> There has been some recent suspicion that middle-aged men may take more risks, highlighted by <a href="http://www.thetimes.co.uk/tto/news/uk/article3838016.ece">a recent article in The Times</a>. With that in mind, I looked at data from the CDC on drowning and motorcycle accident rates. Not counting drowning and motorcycle accidents in individuals over 70 or under five, there are two telling peaks across the male adult lifespan: one in the late-teens and early twenties and a second smaller peak in the mid-forties. </p>
<p>This second peak represents an additional death toll of about 10 people per million in the age class. It’s certainly nothing near the size of the mid-life suicide peak. On the not unlikely chance that suicide victims and adventure-seekers are two sides of a complicated coin, one is forced to wonder when happiness is worth the risk.</p>
<p>In sum, there does appear to be a mid-life signal among the noise, though it doesn’t stand out as a hotbed of risk taking. It might leave some people a little more down than up. But these people should feel some solace in knowing that things do indeed get better. </p>
<p>For middle-age men feeling the call of youth, my recommendation is to wear a helmet and a life-vest at all times.</p>
<p><em>This article was originally published at <a href="http://www.psychologytoday.com/blog/statistical-life/201309/the-upside-and-downside-middle-aged-risk-taking?tr=HomeEssentials">Statistical Life</a>.</em></p><img src="https://counter.theconversation.com/content/18025/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thomas Hills does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As a teenager I remember asking my parents if it was possible to have a mid-life crisis before you left high school. This was followed by hearty chuckles. Nonetheless, it forces one to ask the question…Thomas Hills, Associate Professor of Psychology, University of WarwickLicensed as Creative Commons – attribution, no derivatives.