Factors Affecting the Health of Older Americans
"Growing up" is viewed with anticipation, while "growing old" is regarded as something to dread. This feeling develops from viewing aging as a decline of physical and mental acuity and the fear of illness, loneliness and loss of independence. Aging and illness don't necessarily go together. Older adults are living longer and healthier lives. Advances in medical care, healthier lifestyles and better access to prevention information may keep them healthier and longer life.
More than 95% of hip fractures among adults ages 65 and older are caused by falls (Grisso et al. 1991). These injuries can cause severe health problems and lead to reduced quality of life and premature death. People with osteoporosis are more likely to sustain a hip fracture than those without this condition
In a study examining the aging American workforce and the potential health and productivity predicaments; Mitchell, vice president of the return-to-work programs for UnumProvident Corp. in Chattanooga, TN stated:
- instead of working two to three years post-retirement, Americans are now staying on the clock 10 to 15 years post retirement. The need to continue working, he explains, comes from the changes many companies are now making to pension programs and financial support after retirement. "People are going to retire and then have to go back to work.
- Secondly, the study allowed Mitchell to finally put his finger on the types of major impairments that aging workers experience. While he had expected to find cardiovascular disease to be at the top of the list, he wasn't too surprised to find that it was actually musculoskeletal impairments (arthritis-related or other types) that came out on top.
Although stroke affects people of all ages, risk factors are usually higher among older adults. Nationwide, stroke affects someone every 45 seconds and claims a life every three minutes. Although some risk factors cannot be controlled, other risk factors, such as high blood pressure, smoking, obesity, high cholesterol and physical inactivity can be addressed by making lifestyle changes and through medical treatment.
According to findings from a multi-university study led by Duke University Medical Center the three most common factors that compromise health in the elderly can be modified to maintain their health and affecting self-reported health – poor vision, hearing loss and mood – can often be treated with clinical interventions, such as prescriptive lenses, hearing aids or antidepressive therapy. Many of the problems older individuals listed as impairing their overall health and quality of life could potentially be modified and gender did play a role in the level of self-reported good health as individuals got older.
Sexual health is also essential element of the quality of life of adults 45+; according to AARP survey from 1999 to 2004. It would be the greater willingness of midlife and older adults to discuss sex as a health issue with their health professionals. But, it is important to remember that this survey also found many saying that good spirits, good health, close ties with friends and family and spiritual well-being were more important to their quality of lives than sex. And marital infidelity often undermines all of these things
While your genes and overall physical health play a role, two researches shows how psychosocial factors can also play an important role. 1st study by University of Texas Medical Branch at Galveston found that positive emotions may directly affect health via chemical and neural responses (by increasing a person's intellectual, physical, psychological and social resources) involved in maintaining homeostatic balance. Or a more indirect process may be at work.
2nd study from North Carolina State University investigated how negative stereotypes about aging influences older adults' memory. Results show memory performance in older adults was lower when they were primed with negative stereotypes than when they were primed with positive stereotypes. The results of this study add to a growing list of findings that implicate the importance of the social environment in how it affects older peoples' memory performance.
"As if diabetes weren't enough to handle, a new study shows that 92 percent of older people with the disease have at least one other major chronic medical condition -- and that nearly half have three or more major diseases besides their diabetes"; according to The researchers, from the University of Michigan Health System and the VA Ann Arbor Healthcare System.
If a person with diabetes also has arthritis pain, or shortness of breath from heart failure, and these aren't fully addressed, the person may refrain from physical activity. And that in turn means they'll struggle to control their blood sugar or blood pressure -- which is important to prevent future issues such as stroke. For instance, many people with diabetes still don't realize that their disease puts them at much higher risk of heart disease and stroke. That lack of awareness may mean that they don't put as much emphasis on their blood pressure or cholesterol, when in fact controlling those risk factors can greatly influence the health of a person with diabetes. And indeed, in the current study, diabetes self-care was worse among people who had both diabetes and heart disease.
Smoking had already been identified as one of the few modifiable risk factors for age-related macular degeneration (AMD), a leading cause of vision loss in older Americans. Smoking may contribute to AMD through several pathways, including by reducing antioxidant levels, decreasing blood flow around the eye or affecting the pigments (coloration) in the retina; a study addressed by the University of Wisconsin School of Medicine and Public Health, Madison.
"For the elderly, religion may do more than ease the soul. In fact, attendance at religious services may actually improve physical health and psychological well-being;" according to a collaborated study by at Rutgers' Institute for Health, Health Care Policy and Aging Research & Yale University School of Medicine.
Even after taken out the other variables such as friendship, leisure activities and social support, there was still evidence that attendance at religious services had a positive impact on health, particularly for those who experienced some level of disability at the beginning of the survey; a large representative sample of community-living elderly.
"The combined effects of aging and the obesity epidemic results in bigger body size and less lean mass among the elderly," said Ding; a researcher on aging at Wake Forest Baptist and supported by the National Institute on Aging. "This may lead to disability and other illnesses in the elderly and could be dramatic in the coming years. It points out the great public health importance of developing appropriate interventions that target fat loss while preserving skeletal muscle to prevent disability and other obesity-related illnesses."
Age-related macular degeneration (AMD) develops when the macula, the portion of the eye that allows people to see in detail, deteriorates. AMD is a leading cause of irreversible vision loss in elderly Americans. Older patients with advanced age-related macular degeneration and reduced vision may be more likely to also have cognitive impairment, or problems with thinking, learning and memory, according to a study published in Archives of Ophthalmology, one of the JAMA/Archives journals.
Howover, recent study shown that older Americans are living longer than ever and enjoying better health and financial security, a new report finds. Yet there continue to be lingering disparities between racial and ethnic groups.
In 2006, there were an estimated 37 million Americans 65 and older -- 2 percent of the population. By 2030, it's estimated at 71.5 million people will be 65 and older -- almost 20 percent of the population, according to the report, Older Americans 2008: Key Indicators of Well-Being.
"This report comes at a critical time," Edward Sondik, director of the National Center for Health Statistics, said Thursday in a prepared statement. "As the baby boomers age and America's older population grows larger and more diverse, community leaders, policymakers and researchers have an even greater need for reliable data to understand where older Americans stand today and what they may face tomorrow."
The report examined five broad areas of well-being: economics, health status, health risks and behaviors and health care.
Even though life expectancy for Americans continues to increase for those 65 years of age, it is lower than in countries such as Canada, France Japan and Sweden. For example, Japanese women 65 years of age live 3.2 years longer than women in the United States. Among men, the difference is 1.2 years, according to the report.
In terms of overall health, key indicators such as smoking rates, flu and pneumonia vaccinations and screening for breast cancer have improved but have leveled off in recent years.
As for chronic conditions, women reported higher levels of arthritis compared with men. Men reported higher levels of heart disease and cancer. Among African-Americans, there were higher levels of high blood pressure and diabetes compared with whites. Hispanics reported higher levels of diabetes than did non-Hispanic whites.
The number of people 65 and older who are obese increased from 22 percent in 1988-1994 to 31 percent in 2000-2006. At the same time, there was no significant change in the number of older people who engaged in physical activity. In fact, most days Americans 65 and older reported spending half their time watching television. Those 75 and older, however, spent more time reading and relaxing and thinking, compared with people 55 to 64 years old.
In addition, as people aged, they spent less time visiting friends or attending social functions. Socializing declined from 13 percent of those 55 to 64 to 10 percent of those 75 and older. And, time spent devoted to sports, exercising, recreation and travel also declined with age, according to the report.
Older people's ability to obtain, process and understand health information or services -- called health literacy -- declined with age. Thirty-nine percent of people 75 and older had below basic health literacy, compared with 23 percent of people ages 65 to 74, and 13 percent of people 50 to 64.
Escalating health-care costs, particularly for prescription drugs, also affected older Americans: From 1992 to 2004, costs rose from $8,644 to $13,052. In 2004, prescription drugs made up 61 percent of out-of-pocket health costs for older Americans, the report found.
These costs are expected to be mitigated by the Medicare Part D prescription drug benefit. From 2006 to 2007, the number of people enrolled in the program increased from 18.2 million to 19.7 million, according to the report.
Despite these rising costs, many older Americans are more economically secure. From 1974 to 2006, the number of older Americans living below the poverty line decreased from 15 percent to 9 percent. In addition, the number of older Americans with higher incomes increased from 18 percent to 29 percent.
However, racial disparities existed, with net worth among whites 65 and older six times that of older African-Americans. And older Americans, particularly women, continued to work after 55.
The report was prepared by the Federal Interagency Forum on Aging-Related Statistics, which represents 15 agencies responsible for collecting data on aging. The last report was released in 2006.
One expert thinks that lack of physical activity and lack of social activity are the two biggest factors affecting the health of older Americans.
"It's kind of sad when you think about all the money and all the effort that has gone into physical activity awareness and that the actual amount has not increased over the last 10 years," said Colin Milner, chief executive officer of the International Council on Active Aging. "What that is saying is, we're doing something wrong."
Milner thinks new ways of getting people to be more active are needed. People don't realize that only a little physical activity can have a major impact on their health, he said.
"People see athletic activity, and they say: 'Forget it. I can't do that, I'm old,' “Milner said.”We can save roughly $77 billion in health-care costs by increasing physical activity," he noted.
Milner said he's also concerned that older people spend too much time watching TV and becoming socially isolated.
"How long is it going to be before we engineer socialization out of our lifestyle," Milner said. "By 2020, depression will be the second-leading cause of premature death according to the World Health Organization. And now, you're taking socialization out of a lifestyle."