aging 1 © 1990-life care centers of america
TRANSCRIPT
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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
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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.
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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
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Health Literacy and Older Adults
AgingStats.gov site
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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
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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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