Frank Infurna first started thinking about the plight of middle-aged adults 10 years ago. He conducted a monthly survey, asking about their health , well-being , relationships , and life events. But it was the open-ended responses that made him realize how much the group was struggling.
"It was really eye-opening for myself and my team members to see what people were writing about," said Infurna, a psychology professor at Arizona State University. "Financial issues with car repairs or AC units, caregiving-related issues with their family members, and issues with their children moving out of state and anxiety about that. There was just a lot happening."
Inspired to examine this type of midlife crisis, he and his colleagues conducted research comparing survey responses from middle-aged people (ages 40-65) today to responses from middle-aged adults 30 years ago. They found that loneliness , depression , and memory problems are increasing in middle-aged Americans, compared to earlier generations (Gonzalez Avilés et al., 2025; Infurna et al., 2025; Wettstein et al., 2025). Moreover, these issues seem confined to Americans. Peer nations in Europe, China, South Korea, and Mexico did not show these same trends across loneliness, depression, and memory.
Infurna suspects middle-aged adults are suffering in these ways now in part because of changing intergenerational relationships. They are balancing careers with caring for their aging parents, who are living longer, and their grown children, who are having trouble becoming independent, thanks to a challenging labor market and high housing costs.
"It's a sandwich generation, but on steroids," said Infurna.
Financial vulnerabilities are another factor that may help explain why middle-aged Americans struggle more than those elsewhere. Infurna's research has shown that nations with more income inequality , including the United States, had higher levels of loneliness (Infurna et al., 2026).
"The cost of living is just much higher within the United States, and there are fewer safety nets here," he said. "If something catastrophic or terrible were to happen health-wise or you lose your job, there's not a safety net to fall back on compared to in other nations."
Safety nets can include broad support for middle-aged adults and programs that are in place to help during challenging times, such as parental leave, subsidized childcare, and unemployment protections.
In a 2026 article in Current Directions in Psychological Science , Infurna created a multi-level framework to explain how factors at both the national and individual level interact to produce these historical trends."It's really tough to represent all the variables that could be in play and the factors and the resources, and we tried to divide it up as a way of thinking about it," said Infurna.
Upstream factors are broad, nation-level factors (such as access to healthcare, family benefits, and income inequality) that contribute to midlife health and well-being. Intermediary factors include neighborhoods and workplaces and the stressors encountered there. Finally, downstream, individual factors include relationships with family members and friends, health behaviors, and finances.
The model shows how associations between upstream and downstream factors are multidirectional. For example, declines in health could place a burden on the healthcare system and lead to changes in investment. Caring for an aging parent could lead to a family moving to a state with a more favorable policy. Additionally, the model serves as a basis to test questions aimed at understanding why these midlife trends vary among different nations.
Encouraging this kind of research is one of the reasons Infurna wrote the new paper.
"The biggest thing is to urge more people to conduct this type of cross-national research so that you can get a sense of not only what's transpiring within the United States, but how it compares to other nations," he said.
Comparing other nations, or even states, can give a sense of what to do to alleviate these increases in loneliness and depression. For example, nations that invest in family benefits (such as paid parental leave and subsidized childcare) have lower levels of loneliness among middle-aged adults, compared to countries that do not (Infurna et al., 2026). Relatedly, in the United States, people who live in states with more progressive policies have longer life expectancy (Montez et al., 2020).
"Some of these states are already implementing these European-style policies," said Infurna. But, he continued, that's a tough change to make. "It would be great if we can change policy, but I'm a realist and it may not be as immediate."
In the meantime, individuals can take control over some of the downstream factors, such as health behaviors and relationships.
"Individuals can find their own community, support system, or people they can go to in times of need, whether it be family or friends," he said. "Having that sense of community and engagement can go a long way to promoting more positive health outcomes among middle-aged adults."
References
Gonzalez Avilés, T., Infurna, F. J., Dey, N. E. Y., Cruz-Carrillo, Y., Grimm, K. J., Lachman, M. E., & Gerstorf, D. (2025). Midlife blues: A lifespan perspective on midlife depressive symptoms . Psychology and Aging, 40(6), 685–700.
Infurna, F. J., Cruz-Carrillo, Y., Dey, N. E. Y., Wettstein, M., Lachman, M. E., & Gerstorf, D. (2026). Historical change in midlife development from a cross-national perspective . Current Directions in Psychological Science.
Infurna, F. J., Dey, N. E. Y., Cruz-Carrillo, Y., Wettstein, M., Grimm, K. J., Lachman, M. E., & Gerstorf, D. (2026). Associations of family policy and income inequality with loneliness in midlife: Cross-national evidence from the United States and Europe . Social Science & Medicine, 395, Article 119048.
Infurna, F. J., Dey, N. E. Y., Gonzalez Avilés, T., Grimm, K. J., Lachman, M. E., & Gerstorf, D. (2025). Loneliness in midlife: Historical increases and elevated levels in the United States compared with Europe . American Psychologist, 80(5), 744–756.
Montez, J. K., Beckfield, J., Cooney, J. K., Grumbach, J. M., Hayward, M. D., Koytak, H. Z., Woolf, S. H., & Zajacova, A. (2020). US state policies, politics, and life expectancy . The Milbank Quarterly, 98(3), 668–699.
Wettstein, M., Infurna, F. J., Dey, N. E. Y., Cruz-Carrillo, Y., Grimm, K. J., Lachman, M. E., & Gerstorf, D. (2025). Trajectories of episodic memory in midlife: Historical change from a cross-country perspective . Psychology and Aging,40, 197–217.
