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Aging

http://www.youtube.com/watch?v=NXrON2QX0vc

http://www.ageme.com/

© 1990-Life Care Centers of America

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Normal Aging

• Species-specific life-spans– Human = 120 years

• Time-dependent process– Begins gradually – Decreased reserve capacity– Associated with functional loss

“Old age is not an illness. It is a continuation of life with decreasing capacities for adaptation" Frederic Verzar (1973)- Swiss gerontologist

Suggested Age Categories

• MIDDLE AGE– Beginning of noticeable physical aging – Physical exertion becomes more difficult– Minor chronic conditions – Vision/hearing loss may begin – 40 is seen as the beginning of the aging process

• LATER MATURITY – Chronic illness is common– Activity limitation– Begins in 60's

• OLD AGE– Physical frailty– Disabling chronic disease – Slowing of mental processes – Begins in 70's

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Older Adults – A Diverse Population

Although age is sometimes called the great equalizer, today’s elderly represent a wide range of characteristics.

Heterogeneity vs. diversity

• Heterogeneity is individual level differences– May reflect the interaction of genetics and lived experience – Variations do not have an effect on social experience

• For example the biological difference in blood type has physical but not social implications

• Diversity, however, has political and social implications, usually reflected in the power structure of a society– Systematic – May result in disparity and inequities 5

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Literacy, Health, and Aging

•Reduced literacy can be due to many causes

•“Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” Healthy People 2010, Health Communication Terminology

•Patients’ health literacy may be affected – if they have health care providers who use words that patients don’t understand – Low educational skills – Cultural barriers to health care – Limited English Proficiency (LEP)

•Limited health literacy is more prevalent among – Older adults – Minority populations – Those who are poor – Medically underserved people

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Education and Literacy

Health Literacy and Older Adults

AgingStats.gov site

Potential Sources of Diversity other than Race/Ethnicity

• Cohort• Finances

– Income (amount & sources)

• Assets– Accumulated resources,

particularly property, wealth

• Roles (Social) – parenthood, widowhood, etc.

• Gender • Sexual orientation • Religion/Value systems• Language• Community (size, location)

● Occupation

● Marital status

● Family composition

● Education

● Living arrangements

● Health & functional status

● Personality

● Personal interests

● Diet

● Historic time

● Life stage

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“How old would be if you didn’t know how old you was?”

Satchel Paige

Health of Older Adults

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• Ten scales– General health – Cognitive function– Mental health– Functional

Independence– Sexual function

– Pain– Urinary incontinence– Sleep– Fatigue– Appearance

Expectations Regarding AgingAssessment

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Defining Health

• Distinction of aging and disease

• What is “uncompromised” health?– Who is healthy?

• Is looking “young for one’s age” a reflection of health?

• WHO (World Health Organization) defines health in terms of physical, mental, and social well-being

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Health As a Continuum

Excellent PoorAbsence of disease or impairment

HasCondition

Activity Restriction

Mild Disability

Severe Disability

Frailty

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Diagnostic Measures vs Functional Status

• 60-80% of older adults have at least one chronic condition

• Chronic disease does not always affect function– Many people who have chronic conditions lead

active, productive lives

• 60% of older adults are free of disability

• Chronic conditions may be accompanied by pain and physical limitation

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• Rowe and Kahn’s Model – Freedom from disease and disability– High cognitive functioning– Social engagement

Successful Aging

• Minimize risk of disease and disability• Maintain physical and cognitive function• Continue engagement with life

• Positive spirituality

The 7 dimensions of wellness are key to an active, healthy life

SOURCE: National Wellness Institute

Physical Intellectual Social Vocational Spiritual Emotional Environmental

http://www.icaa.cc/activeagingweek/resourcesaaw.htm

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• http://www.olderamericansmonth.acl.gov/index.html

• Unleash the Power of Age– Older Americans Month is a proud tradition that shows our commitment to honoring

the value that elders contribute to our communities. This year’s Older Americans Month theme—“Unleash the Power of Age!”—highlights the significant contributions made by thousands of older Americans across our nation.

OLDER AMERCANS MONTH 2013

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Older Americans Month

2000 - In the New Century. . . . The Future is Aging

2001 - The Many Faces of Aging

2002 - America: "A Community for all Ages"

2003 - “What We Do Makes A Difference.”

2004 - “Aging Well, Living Well”

2005 - Celebrate Long-term Living

2006 - Choices For Independence

2007 - Making Choices for a Healthier Future

2008 - Working Together for Strong, Healthy and Supportive Communities

2009 - Living Today for a Better Tomorrow

2010 - Age Strong! Live Long!

2011 – Older Americans: Connecting the Community

2012 – Never Too Old to Play

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The Geriatric I’s

• Immobility • Instability• Incontinence • Intellectual Impairment • Impairment of vision and

hearing • Irritable colon

• Inanition • Impecunity• Iatrogenesis • Insomnia • Immune deficiency • Impotence• Isolation

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Acute vs. Chronic Disease

• Rapid onset• Amenable to quick

diagnosis and restorative measures

• Can be completely removed from the body

• Insidious onset• Often easily diagnosed,

can be ameliorated but effects cannot necessarily be removed

• Usually a long term or life long condition

ACUTE CHRONIC

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Acute Conditions in Older Adults

• Resistance (immune response) is lower• More debilitating• Recuperative capacity is lower • Older adults have 3x more days of restricted

activities compared to younger (17-44 year olds)• Older adults have more days spent “sick in bed” –

one study showed an average of 14 days

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Chronic Disease and Aging

http://www.silverbook.org/ The Cost of Chronic Disease

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The Impact of Stress, Chronic Disease, and Pain

• Stress – 43% of adults suffer adverse health effects from stress– 75%-90% of all doctor’s visits are for stress-related ailments – Costs businesses $300 billion a year (OSHA estimate)

• Chronic disease– 50%+ of U.S. health expenditures are related to 5 chronic conditions (mood disorders,

diabetes, heart disease, asthma, high blood pressure) – $1 trillion a year: cost to the economy– 20% of Medicare recipients have 5 or more conditions, accounting for two-thirds of Medicare

expenditures

• Pain – 40 million visits to health care providers are for pain – $100 billion a year in health care expenditures and lost productivity -- Shari Dwyer (Inside AARP)

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Data Source: National Health Interview Survey

Perc

ent (

%)

http://www.bandwidthonline.org/find-data.asp#tgm Trends in Health and Aging

Percent of Persons Age 65 and Over (age-adjusted) Reporting Selected Chronic Conditions by Sex, 2004-2005

Chronic Conditions of Older Adults

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Prevalence of Chronic Disease

http://www.cdc.gov/aging/pdf/saha_2007.pdf

• At least 80% of Americans have at least one chronic disease

• 50% have at least two chronic diseases

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Multiple Chronic Conditions

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Multiple Chronic Conditions

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Chronic Disease and Mortality

http://www.cdc.gov/aging/pdf/saha_2007.pdf

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Alabama Has High Rates of Chronic Disease

http://www.bandwidthonline.org/find-data.asp#tgm Trends in Health and Aging

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Chronic Disease and Activity Limitation

• 25% of individuals (all ages) with chronic illness also have activity limitations

• Chronic conditions limit the activities of about 12 million seniors who live at home.

National Center for Chronic Disease Prevention and Health Promotion 2005, Healthy AgingPartnership for Solutions 2004, Chronic Conditions:

Making the case for ongoing care

http://www.silverbook.org/ The Cost of Chronic Disease

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Data Source: National Health Interview Survey

0

10

20

30

40

50

60

1982 1985 1990 1995 2000 2005

White non-Hispanic Hispanic Black non-Hispanic

Perc

ent (

%)

Percent of Non-institutionalized Persons Age 65 and Over (age-adjusted) Reporting Fair to Poor Health by Race/Ethnicity, 1982-2005

Fair/Poor Health of 65+

http://www.bandwidthonline.org/find-data.asp#tgm Trends in Health and Aging

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0

5

10

15

20

25

30

35

65-74 75-84 85 years and over

IADL Only 1 to 2 ADLs 3 to 6 ADLs

Perc

ent (

%)

Percent of Medicare Beneficiaries Reporting Difficulty with IADLs or ADLs by Age, 2004

Data Source: Medicare Current Beneficiary Survey

IADL and ADL Difficulty

http://www.bandwidthonline.org/find-data.asp#tgm Trends in Health and Aging

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• Cancer• Cardiovascular Disease and

Stroke• Diabetes• Neurological Disease

– Alzheimer’s – Parkinson’s

• Comorbidity

Chronic Conditions and Age

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Older Adults Report Good Health

Percent Reporting Good to Excellent Health

Age White Black Hispanic65-74 80 66 66

75-84 75 59 60

85+ 68 54 54

Older Americans: Key Indicators of Well-Being, 2010

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A Typical Older Adult

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