Health, Fitness, and Wellness Issues

During
Adulthood
 “Every human being is the author of his own health.”—Swami
Sivananda,
Bliss Divine
• the term adult suggests both physical maturation and psychosocial
transition, from being dependent on others to becoming more self-reliant
and responsible for personal behaviors.
• During adulthood, there are many common characteristics between men
and women; however, priorities vary as men and women move from early
to late adulthood. the main life tasks that engage men and women are
health or physical vigor, relationships with others (a spouse or partner,
parents, and/or children), and financial security (property or income).
• Work during adulthood is often a key aspect of an individual’s identity.
• For many people, work is central to their lives for more than economic
reasons. Workers who have been laid off or disabled often feel lost,
depressed, and empty.
• According to one study, the indirect cost of illness due to lost wages
exceeds the cost of medical services by a large margin.
• psychologists suggest that individuals progressing through adulthood seek
2 basic needs: (1) intimacy in human relationships (affiliation, social
acceptance, or love and belonging) and (2) competence (achievement,
generativity, or productivity). Freud felt that the healthy adult has the
ability to both love and work.
ADULT HEALTH AND WELLNESS RISKS

• Adults face health risks that affect all major body systems, including the
integumentary, cardiovascular, neuromuscular, and musculoskeletal
systems, commonly treated in physical therapy.
• In addition, risks for developing diabetes, cancer, chronic pain, substance
abuse, gastrointestinal problems, migraine headaches, accidents,
infections, and sleep disorders increase during the adult years.
 Skin Conditions
• Screening for skin conditions often occurs during a comprehensive
examination but can be performed by asking questions related to common
integumentary problems that arise in adulthood. Although warts, acne,
impetigo, and tinea pedis are more common in youths and adolescents, adults
often present with chronic skin problems such as dermatitis and psoriasis.
• Dermatitis (eczema) is commonly seen as skin inflammation, generalized
redness, edema or swelling, and possible oozing, crusting, and scaling when
long term.
• Psoriasis is a common chronic, recurrent skin disease that is characterized
by dry, well-circumscribed, silvery, scaling papules and plaques of various
sizes. this skin condition often presents in a characteristic pattern on
extensor surfaces of elbows and knees, scalp, back, anogenital region, and
nails but may also appear on flexor surfaces, the tip of the penis, or the
palms.
• To prevent skin problems, individuals need proper hydration. According to
the Merck Manual, water can be therapeutic as a cleanser and hydrating
agent.
 Skin Cancer
• Skin cancer should always be considered as a threat to all adults,
especially fair-skinned individuals. Skin cancers, which are usually
curable, are the most common type of cancer; most arise in sun-exposed
areas of skin. According to the National Cancer Institute, there are more
than 76,000 new cases of malignant melanoma (a fatal tumor affecting the
skin, mucous membranes, eyes, and the central nervous system) yearly in
the United States, causing more than 9000 deaths.
 Type 2 Diabetes
• Diabetes is a chronic disease that has no cure but may be preventable. Advanced diabetes is a
leading cause of blindness, kidney disease, nontraumatic lower limb amputations, and severe
nerve damage. Reported rates of gestational diabetes range from 3% to 10% of pregnancies.
Overall, the risk for death among people with diabetes is approximately twice that of people
of similar age but without diabetes. Type 2 diabetes is most commonly diagnosed in
individuals over the age of 30 years, but it also occurs in children and adolescents.
• Diabetes has diverse presentations, but both type 1 and type 2 diabetes generally present with
hyperglycemia (high blood glucose). Symptoms of hyperglycemia include polyuria (frequent
urination), followed by polydipsia (excessive thirst) and weight loss from dehydration. Other
clinical manifestations of hyperglycemia include blurred vision, fatigue, and nausea, as well
as susceptibility to fungal and bacterial infections
• Type 2 diabetes is commonly associated with obesity, especially of the upper body
(visceral/abdominal), and often presents after a period of weight gain. Most
patients are treated with diet, exercise, and oral drugs, with some patients requiring
insulin to control symptomatic hyperglycemia.
• Type 2 diabetes patients with visceral/abdominal obesity may have normal glucose
levels after losing weight.
• According to the American Diabetes Association, “people with prediabetes can
prevent the development of type 2 diabetes by making changes in their diet and
increasing their level of physical activity. they may even be able to return their
blood glucose levels to the normal range.
• While some medications may delay the development of diabetes, diet and exercise
worked better. Just 30 minutes a day of moderate physical activity, coupled with a
5% to 10% reduction in body weight, produced a 58% reduction in diabetes.
Cancer or Uncontrolled Cellular Proliferation

• Cancer or uncontrolled cellular proliferation is malignant by definition but

not necessarily fatal. Most cancers are curable if detected in their early
stages, and patients can help recognize early signs of possible malignancies.
• All individuals should be encouraged to perform self-examinations,
including skin cancer and breast cancer (both men and women are
vulnerable) and have appropriate diagnostic testing to screen for cancers that
affect specific populations, such as cervical cancer in adult women and
prostate cancer in adult men.
 Obesity
• According to the American Medical Association, obesity is the fastest growing health problem
in the United States. Currently, the US obesity rate is projected to reach 50% by 2030.
• In general, women and men from lower-income families experience a greater prevalence of
obesity than those from higher-income families.
• Health risks associated with obesity include premature death, type 2 diabetes, hyperlipidemia,
hypertension, coronary artery disease, stroke, certain types of cancer gastroesophageal reflux
disease, gallstones and gall bladder disease, gout, nonalcoholic fatty liver disease, pregnancy
complications, menstrual irregularities, bladder control problems, osteoarthritis, obstructive
sleep apnea, infertility, and psychological disorders, such as depression, eating disorders,
problems with body image, and low self-esteem.
 Metabolic Syndrome
• As many as 22% of American adults may have a sinister-sounding disorder
called syndrome X or metabolic syndrome, a condition significantly
increasing a person’s risk of developing life-threatening chronic diseases.
• According to the American Heart Association, risk factors associated with
metabolic syndrome include the following:
• Abdominal or “central” obesity (waist size greater than 40 inches in men and
greater than 35 inches in women)
• High levels of fasting blood triglycerides (fats; greater than 150 mg/dL)
• Low levels of blood high-density lipoprotein (HDL) cholesterol (men less
than 40 mg/dL and women less than 50 mg/dL)
• High blood pressure (greater than 130/85 mm/Hg)
• High levels of glucose (greater than 110 mg/dL as measured by a fasting
glucose test)
• Insulin resistance
 Insomnia
• Insomnia is an individual’s perception that sleep quality is inadequate or
nonrestorative, despite having the opportunity to sleep. Insomnia includes
difficulty falling asleep, sleeping too lightly, being easily disrupted with
multiple spontaneous awakenings, or early morning awakenings with an
inability to fall back asleep. Insomnia is considered a disorder when it
disrupts or impairs daily functioning.
• Transient insomnia lasts less than 1 week; short-term insomnia lasts 1 to 6
months and is usually associated with persistent, stressful situations (such
as death or illness of a loved one or environmental factors, such as loud
environmental noises); and chronic insomnia lasts more than 6 months.
• Insomnia can lead to depression and anxiety, abnormalities in
metabolism, daytime sleepiness, and memory problems.
 Sexually Transmitted Diseases
• Sexually transmitted diseases (STDs) have serious and sometimes fatal
complications. Sexually active teens and young adults are at highest risk,
but STDs can affect all age groups.
• Approximately 40 million people are currently living with HIV infection,
and an estimated 25 million have died from this disease.
 Acute Retroviral Syndrome/HIV
Infection
• Presentation of acute retroviral syndrome/HIV infection occurs from 2 to 4 weeks up to 3 months after exposure to HIV.
• Symptoms can include the following:
• Fever
• Chills
• Rash
• Night sweats
• Muscle aches
• Sore throat
• Fatigue
• Swollen lymph nodes
• Ulcers in the mouth
 AIDS
• Many of the signs and symptoms of AIDS come from opportunistic infections that occur in
patients with a damaged immune system. they include the following:
• Chronic dry, scratchy cough; shortness of breath; tightness or
• pressure in the chest
• Rapid weight loss
• Profuse night sweats
• Continuous unexplained fatigue
• Diarrhea longer than 1 week (found in both early and late stages of HIV)
• Swollen lymph glands (lymphatic nodes in the neck, armpits, and groin)
 HEALTH RISKS FOR ADULT MALES
• In the United States, the top 5 health risks for men are heart disease (leading
cause of death), stroke, cancer, depression, and suicide.

Heart Disease
Heart disease is the greatest health threat to men in the United States today.
According to the American Heart Association, men have a greater risk of heart
disease and have heart attacks much earlier in life than women. Risk factors
contributing to heart disease include increasing age, male sex, family history and
race smoking, high blood cholesterol, high blood pressure, physical inactivity,
obesity and overweight, and diabetes.
 Stroke
• Stroke is a leading cause of death in the United States and the third leading
cause of death for men. Stroke is one of the leading causes of disability as
well.
• Risk factors for stroke include increasing age, sex (more common in men until
age 75), race (African American men are at greatest risk), a personal history of
stroke or a transient ischemic attack (ministroke), diabetes, high cholesterol,
heart disease, smoking (including secondhand smoke), physical inactivity, and
obesity. Modifiable risk factors need to be incorporated in preventive care
 Depression and Suicide
• Men are more likely to commit suicide compared with women, in part due to
underdiagnosed depression in men. Signs of depression may include anger,
aggression, work burnout, risk-taking behaviors, midlife crisis, and alcohol and
substance abuse.
• One helpful measure that can be used to identify suicide risk factors is called the
SAD PERSONS scale, which includes the following criteria:
• Sex (male)
• Age younger than 19 or older than 45 years
• Depression (severe enough to be considered clinically significant)
• Previous suicide attempt or received mental health services of any kind
• Excessive alcohol or other drug use
• Rational thinking lost
• Separated, divorced, or widowed (or ending of significant relationship)
• Organized suicide plan or serious attempt
• No or little social support
• Sickness or chronic medical illness
 Screening Tests
• Prostate Cancer Screening Test: e PSA test is a blood test that measures
the amount of a protein secreted by the prostate gland and is used to
screen for possible prostate cancer.
• Blood Cholesterol: the level of blood cholesterol is a significant risk
factor for heart disease, particularly coronary artery disease. A lipid panel
should be routinely performed that measures total cholesterol, low-density
lipoprotein (LDL) cholesterol (the “bad” cholesterol), HDL cholesterol
(the “good” cholesterol), and triglycerides.
• Electrocardiogram: An electrocardiogram can detect abnormalities such as
heart damage after a heart attack, an irregular heart rhythm, or an enlarged
heart.
• Chest Radiographs: A chest radiograph images the size and shape of the
heart and provides information regarding the lungs’ condition. A chest
radiograph is typically ordered when a patient has symptoms of lung
pathology, including a persistent cough, a chest injury, chest pain,
coughing up blood, or difficulty breathing.
• Blood Chemistry Test: An adult’s blood chemistry reveals the functional status of
the liver, kidney, and pancreas, measuring sodium, potassium, calcium, phosphorus,
and blood sugar, as well as liver enzymes, bilirubin, and creatinine.
• Complete Blood Count With Differential: e complete blood count (CBC) is used
to identify cardiovascular and
• hematological problems. the CBC measures hemoglobin (an indication of the
blood’s oxygen-carrying capacity), hematocrit (the percentage of red blood cells in
total blood volume), leukocytes (the number and types of white blood cells in the
blood), and the number of platelets (an indicator of blood coagulability).
• Thyroid-Stimulating Hormone Test: this blood test identifies levels of
thyroid stimulating hormone (TSH), a pituitary gland hormone used to
produce the hormone thyroxine. TSH level should be between 0.4 and 4.0
mIU/L (milli-international units per liter), depending on the laboratory
processing the test. this test is used to detect too little thyroxine (an
indication of low thyroid activity or hypothyroidism) or too much
thyroxine (an indication of increased thyroid activity or hyperthyroidism).
• Transferrin Saturation Test: this blood test measures the amount of iron
bound to transferrin, an iron-carrying protein in the bloodstream, and is
used to detect hemochromatosis, a condition of iron overload in the blood.
• Urinalysis: A urinalysis is helpful for detecting levels of glucose excreted
from the body and the presence of red blood cells (signaling internal
problems, including possible tumors in the gastrointestinal tract), white
blood cells (indicating infection), and elevated bilirubin (suggesting liver
disease).
 ORAL HEALTH
• Oral health is essential during adulthood.
• All clients should be counseled to stop the use of all forms of tobacco and
to limit consumption of alcohol to reduce the risk of oral cancer as well as
cardiovascular pathology. Although clients generally have regular oral
examinations by their dentists.
 FITNESS
• Just as children and youth must complete a preparticipation examination,
adults should be thoroughly screened prior to initiating a fitness program.
Screening should provide the individual’s personal medical information,
information about any current medical information, medication, a family
history of medical conditions, as well as lifestyle behaviors (nutritional
habits, exercise habits, stress, smoking, alcohol consumption).
 Suggested Adult Physical Activities
• A variety of adult-oriented activities are effective for burning calories and
promoting general cardiopulmonary fitness. e following list provides
the number of calories generally burned by an adult when performing each
activity: Activity Calories burned per hour
Bicycling 6 mph 240
Jogging 5.5 mph 740
Jumping rope 750
Running in place 650
Swimming 25 yds/min 275
Tennis (singles) 400
Walking 2 mph 240