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Older Adults

Older Adults

Goal

Improve the health, function, and quality of life of older adults.

Overview

Older adults are among the fastest growing age groups, and the first “baby boomers” (adults born between 1946 and 1964) will turn 65 in 2011. More than 37 million people in this group (60 percent) will manage more than 1 chronic condition by 2030.1

Older adults are at high risk for developing chronic illnesses and related disabilities. These chronic conditions include:

  • Diabetes mellitus
  • Arthritis
  • Congestive heart failure
  • Dementia

Many experience hospitalizations, nursing home admissions, and low-quality care. They also may lose the ability to live independently at home. Chronic conditions are the leading cause of death among older adults.2

Why Is the Health of Older Adults Important?

Health Services

  • Preventive health services are valuable for maintaining the quality of life and wellness of older adults. In fact, the Patient Protection and Affordable Care Act of 2010 includes provisions related to relevant Medicare services. However, preventive services are underused, especially among certain racial and ethnic groups.2, 3
  • Ensuring quality health care for older adults is difficult, but the Centers for Medicare & Medicaid Services (CMS) has programs designed to improve physician, hospital, and nursing home care, among others.
  • Older adults use many health care services, have complex conditions, and require professional expertise that meets their needs. Most providers receive some type of training on aging, but the percentage of those who actually specialize in this area is small. More certified specialists are needed to meet the needs of this group.4

Quality of Life

  • Through programs that address chronic illnesses, Federal Government agencies are improving the quality of life for older adults. To combat existing health disparities, many of these programs target minorities and underserved populations.
  • The ability to complete basic daily activities may decrease if illness, chronic disease, or injury limit physical or mental abilities of older adults. These limitations make it hard for older adults to remain at home. Early prevention and physical activity can help prevent such declines. Unfortunately, less than 20 percent of older adults engage in enough physical activity, and fewer do strength training.5, 6 Minority populations often have lower rates of physical activity.
  • Most older adults want to remain in their communities as long as possible. Unfortunately, when they acquire disabilities, there is often not enough support available to help them. States that invest in such services show lower rates of growth in long-term care expenditures.

Injury Prevention

  • Each year, 1 out of 3 older adults falls.7, 8 Falls often cause severe disability among survivors.9 Injuries from falls lead to:
    • Fear of falling
    • Sedentary behavior
    • Impaired function
    • Lower quality of life

Falls are the leading cause of death due to unintentional injury among older adults; deaths and injuries can be prevented by addressing risk factors.

Caregivers

  • Caregivers for older adults living at home are typically unpaid family members. Caregiver stress often results in unnecessary nursing home placement.
  • One to 2 million older adults in the United States are injured or mistreated by a loved one or a caregiver.10 A measure of elder abuse has been added to encourage data collection on this issue.

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Understanding the Health of Older Adults

The Healthy People 2020 objectives on older adults are designed to promote healthy outcomes for this population. Many factors affect the health, function, and quality of life of older adults.

Individual Behavioral Determinants of Health in Older Adults

Behaviors such as participation in physical activity, self-management of chronic diseases, or use of preventive health services can improve health outcomes.

Social Environment Determinants of Health in Older Adults

Housing and transportation services affect the ability of older adults to access care. People from minority populations tend to be in poorer health and use health care less often than people from nonminority populations.11

Health Services-Related Determinants of Health in Older Adults

The quality of the health and social services available to older adults and their caregivers affects their ability to manage chronic conditions and long-term care needs effectively.

Emerging Issues in the Health of Older Adults

Emerging issues for improving the health of older adults include efforts to:

  • Coordinate care.
  • Help older adults manage their own care.
  • Establish quality measures.
  • Identify minimum levels of training for people who care for older adults.
  • Research and analyze appropriate training to equip providers with the tools they need to meet the needs of older adults.

There is growing recognition that data sources are limited for certain subpopulations of older adults, including the aging lesbian, gay, bisexual, and transgender populations. Research for these groups will inform future health and policy initiatives.

References

1American Hospital Association; First Consulting Group. When I’m 64: How boomers will change health care. Chicago: American Hospital Association; 2007. 23 p.

2Kramarow E, Lubitz J, Lentzner H, et al. Trends in the health of older Americans, 1970–2005. Health Aff (Millwood). 2007 Sep–Oct;26(5):1417-25.

3US Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS). Medicare claims data [Internet]. Baltimore: CMS; 2010 [cited 2010 February 22].

4Institute of Medicine. Committee on the Future Health Care Workforce for Older Americans. Retooling for an aging America. Washington: National Academies Press; 2008.

5Christmas C, Andersen RA. Exercise and older patients: Guidelines for the clinician. J Am Geriatr Soc. 2000 Mar;48(3):318-24.

6Centers for Disease Control and Prevention. Strength training among adults aged ≥65 years—United States, 2001. MMWR. 2004 Jan 23;53(2):25-8.

7Hornbrook MC, Stevens VJ, Wingfield DJ, et al. Preventing falls among community-dwelling older persons: Results from a randomized trial. Gerontologist. 1994 Feb;34(1):16-23.

8Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: A one-year prospective study. Arch Phys Med Rehabil. 2001 Aug;82(8):1050-6.

9Centers for Disease Control and Prevention (CDC), National Center for Injury Control and Prevention Web-based injury statistics query and reporting system (WISQRS) [Internet]. Atlanta: CDC; 2010 [cited 2010 April 8]. Available from: http://www.cdc.gov/injury/wisqars/index.html

10National Research Council (US), Panel to Review Risk and Prevalence of Elder Abuse and Neglect. Elder mistreatment: Abuse, neglect and exploitation in an aging America. Richard J. Bonnie and Robert B. Wallace, editors. Washington: National Academies Press; 2003.

11Institute of Medicine, Committee on the Future Health Care Workforce for Older Americans. Retooling for an aging America. Washington: National Academies Press; 2008.

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