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Rachel Pryor
EPID 691
April 22, 2013
Aging
In the US, we define the aging population as those who are older than age 65. Though more and more people are living far beyond age 65, individuals ages 65 and up are still considered members of the aging population.
By the year 2030, it is estimated that the number of individuals in the US who are older than 65 will be 71 million (which is more than double than the current above 65 population).1
The main health concerns for the aging population are noncommunicable, chronic diseases (though infectious diseases are often more severe in the elderly).2
Who are the aging population?
1.http://www.cdc.gov/chronicdisease/resources/publications/aag/aging.htm
2.http://www.who.int/features/factfiles/ageing/ageing_facts/en/index3.html
Mortality in the aging population
Mortality and the aging population
Morbidity and the aging population
Life expectancy over the past century at ages 65 and 85
Cardiovascular Disease in the aging populationTotal expenses
for CVD in 2009 were $121.2 billion for individuals aged 65 years and older, which was 38.8% of total CVD costs.1
1.http://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/
downloadable/ucm_319574.pdf
Cancer and the aging population
Stroke and the aging population Individuals older
than 85 years make up 17% of all stroke patients.
For individuals aged 60–79, 6.2% of men and 6.9% of women have had a stroke.
For individuals greater than 80 years 13.9% of men 13.8% of women have had a stroke.1
1.http://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/
downloadable/ucm_319574.pdf
Respiratory diseases and the aging population124,477 Americans
died from COPD in 2007.1
1.http://www.lung.org/lung-disease/copd/resources/facts-figures/COPD-Fact-
Sheet.html
Sensory impairments and the aging population
Sensory impairment and agingSensory impairments
can decrease an aging person’s quality of life.
Sensory impairments can lead to health problems.
Public health interventions can lead to awareness of which sensory impairments are a normal part of aging and what can be done about the ones that aren’t.
Types of sensory impairments: difficulty swallowing, malnutrition, bladder control problems, insomnia, vision and hearing difficulties, dizziness, fainting, difficulty walking, falls, osteoporosis, pressure ulcers.1
1.http://www.healthinaging.org/resources/resource:guide-to-geriatric-syndromes-part-
i/
Estimated depression rates for elderly individuals who live independently in their own homes range only less than 1% to about 5%. However, for those who require in-home health care (and thus have a decreased level of independence) the rate increases to 13.5%.1
Despite the relatively low rates of depression…
… Older Americans are disproportionately likely to die by suicide.
16% of suicides in 2004 were committed by those aged 65 and older in 2004.
Depression and the aging population
1.http://www.cdc.gov/aging/mentalhealth/depression.htm
http://apps.nccd.cdc.gov/MAHA/MahaHome.aspx
The state of mental health and aging in America -- interactive map
According to the CDC, “Cognition is a combination of mental processes that includes the ability to learn new things, intuition, judgment, language, and remembering. When cognition is impaired (referred to as cognitive impairment), a person has trouble with these processes that begins to affect the things he or she can do in everyday life.”1
CDC’s Healthy Brain Initiative is an Alzheimer's specific program that seeks to assess how much is truly known about Alzheimer's Disease and how to better protect and promote cognition.2
Cognitive changes and aging
1.http://www.cdc.gov/aging/healthybrain/index.htm
2.http://www.cdc.gov/aging/pdf/hbisummary_508.pdf
Health promotion in the aging population includes:Encouraging older adults to continue to practice
healthy behaviors. And also encourage them it’s never too late to make healthy lifestyle changes!
Encouraging them to take advantage of preventative services (doctors appointments, immunizations, etc)
Stressing the importance of remaining connected to family, friends, and social groups1
Preventative medicine and social support are vitally important to preventing the elderly from developing additional chronic diseases and complications from such diseases.
Public health and aging
1.http://www.cdc.gov/chronicdisease/resources/publications/aag/aging.htm
80% of the aging population have one chronic disease and 50% have two, so preventing complications from chronic diseases is very important.
Only 25% of the “pre”-aging (ages 50-64) are up to date on their cancer screenings and immunizations, which may have effects on the health of these individuals once they become part of the aging population.
Cognitive impairment is a part of the aging experience for many individuals, so creating programs to aid in the burden of care caused by this impairment is very important.1
Public health and aging
1.http://www.cdc.gov/chronicdisease/resources/publications/aag/aging.htm
CDC has targeted eight preventative clinical services that the aging population should receive1
Public health and aging
1.http://www.cdc.gov/features/preventiveservices/
clinical_preventive_services_closing_the_gap_report.pdf
31% of the aging population reported not getting a flu shot in the past year
Flu vaccine in the aging population
33% of the aging population reported never getting the pneumonia vaccine
Pneumonia vaccine and the aging population
Almost 17% of women in the aging population reported not receiving a mammogram in the past year
Breast cancer screening and the aging population
Diabetes screening and the aging population 31% of the aging
population who had never been diagnosed with diabetes had not received a test for high blood sugar in the past three years
High cholesterol screening and the aging population95% of individuals in
the aging population reported having a cholesterol screen within the past five years!
Osteoporosis screening and the aging population
30% of women in the aging population reported not receiving smoking cessation advice in the past year, compared to 24% of men.
Smoking cessation counseling and the aging population
CDC and Merck partnered together to create reports titled State of Aging and Health in America
These reports look at 15 health indicators of the aging population:
Public Health and aging
• Physically Unhealthy Days• Frequent Mental Distress• Oral Health: Complete Tooth Loss• Disability• No Leisure-Time Physical Activity• Eating ≥ 5 Fruits and Vegetables Daily• Obesity• Current Smoking
• Flu Vaccine in Past Year• Ever Had Pneumonia Vaccine• Mammogram Within Past 2 Years• Colorectal Cancer Screening• Up-to-date on Select Preventive Services• Cholesterol Checked in Past 5 Years• Hip Fracture Hospitalizations
http://apps.nccd.cdc.gov/SAHA/Default/Default.aspx
Interactive map of indicators
Virginia and health indicators
Caregivers and the aging populationCaregivers provide help
and support to someone who is partially or fully incapacitated.
Typical caregivers for the aging population are adult children or grandchildren.
Caregiving can be extremely stressful and is associated with depression and anxiety
There are approximately 34 million unpaid caregivers in the US who care for someone over 18 years old.
A caregiver spends around $5,500 a year of his or her own money providing care when caring for someone older than 50 years.1
1.http://www.cdc.gov/aging/caregiving/facts.htm
The National Institute on Aging (part of NIH) has developed the following research goals:
“Improve our understanding of healthy aging and disease and disability among older adults.
Continue to develop and disseminate information about interventions to reduce disease and disability and improve the health and quality of life of older adults.
Improve our understanding of Alzheimer’s disease, other dementias of aging, and the aging brain. Develop drug and behavioral interventions for treating these diseases, preventing their onset and progression, and maintaining health.
Improve our understanding of the consequences of an aging society and provide that information to inform intervention development and policy decisions.
Improve our ability to reduce health disparities and eliminate health inequities among older adults.
Support the infrastructure and resources needed to promote high-quality research and communicate its results.”1
Research initiatives and aging
1.http://www.nia.nih.gov/about/living-long-well-21st-century-strategic-directions-
research-aging
Healthcare costs and the aging populationHealthcare costs
are on the rise for everyone.
One particular reason healthcare costs are on the rise is chronic diseases.
As people live longer, managing chronic diseases is becoming a huge expense.
Estimates state that as much as 75% of our healthcare costs are related to chronic diseases.
1.http://www.kaiseredu.org/issue-modules/us-health-care-costs/background-
brief.aspx
Healthcare costs and the aging population vs. children
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/02/15/feds-spend-7-on-
elderly-for-every-1-on-kids/
Though those who are greater than 65 years old make up only 13% of the current population, 36% of healthcare spending is for care of them
Below is a chart showing the breakdown of spending within the top five percent of healthcare costs.
Healthcare costs and the aging population
Because healthcare costs for the aging population are so great, health promotion and prevention is extremely important for this age group!
Though the body does change as one ages, aging does not equal frailty. Through health promotion the aging population can continue to live enjoyable and productive lives.
Healthcare costs and the aging population
Chronic illnesses disproportionately affect the aging population, but cognitive and mental health issues are also extremely important health care concerns.The severity and risk of communicable
illnesses also increases with ageAs the world’s population continues to age,
more and more will need to be done to promote the health of individuals age 65 and older.
End of life planning is an important discussion topic for physicians and their patients.
In conclusion…
POOR HEALTH DOES NOT HAVE TO BE AN
INEVITABLE PART OF AGING!
Most importantly…
