Injuries Among Older Adults
In the United States, one of every three persons aged 65 years and older falls each year. Among older adults, falls are the leading cause of injuries, hospital admissions for trauma, and deaths due to injury. In 1999, about 10,097 seniors died of fall-related injuries. Fractures are the most serious health consequence of falls. Approximately 250,000 hip fractures, the most serious fracture, occur each year among people over age 65. Many of these falls and resulting injuries can be prevented. Strategies to prevent falls among older adults include exercises to improve strength, balance, and flexibility; reviews of medications that may affect balance; and home modifications that reduce fall hazards such as installing grab bars, improving lighting, and removing items that may cause tripping.
While rates of motor vehicle related death and nonfatal motor vehicle related injuries among older adults vary by state, there are some consistencies. In most states, the fatality rates for men are twice those for women. In all states, motor vehicle-related fatalities are higher among adults 75 years and older, as compared with adults between 65 and 74 years of age. Among older adult drivers, the number of motor vehicle-related fatalities increased 30% and the number of nonfatal injuries increased 21% between 1990 and 1997. However, the number of fatalities and nonfatal injuries among older adult pedestrians declined during these same years (23% and 24%, respectively).
Risk factors for suicide among the elderly differ from those among the young. Older persons have a higher prevalence of depression, a greater use of highly lethal methods and greater social isolation. From 1980–1998, the largest relative increases in suicide rates occurred among those 80–84 years of age. The rate of suicide is higher for elderly white men than for any other age group, including adolescents.
People aged 65 and older are twice as likely to die in a home fire as the population at large. The National Fire Protection Association, with assistance from CDC, has developed a fire and fall injury prevention program directed at older adults called Remembering When.
Mental Health
The majority of older Americans successfully cope with the physical and cognitive changes associated with aging as well as various losses, such as the loss of family and friends that frequently are associated with late life. However, a substantial proportion of the population aged 55 years and older—almost 20 percent of this age group—experience specific mental disorders that are not part of “normal” aging including depression, anxiety disorders, and dementia including Alzheimer’s disease which can be debilitating and severely affect an older adult’s quality of life.
Depression – between 8 to 20 percent of older adults in the community and up to 37 percent in primary care settings suffer from depressive symptoms. These symptoms can range from depressive illness (major depressive disorder, dysthymic disorder, or bipolar disorder) to depressive symptoms that fall short of meeting full diagnostic criteria for a disorder and is associated with an increased risk of developing major depression (subsyndromal depression). In any of these forms, however, depressive symptoms are not a normal part of aging. In contrast to the normal emotional experiences of sadness, grief, loss, or passing mood states, they tend to be persistent and to interfere significantly with an individual's ability to function. Depression often co-occurs with other serious illnesses such as heart disease, diabetes, or cancer. Because of these co-occurring conditions health care professionals may mistakenly conclude that depression is a normal consequence of these problems—an attitude often shared by patients themselves. These factors together contribute to the underdiagnosis and undertreatment of depressive disorders in older people. Depression can and should be treated when it occurs and many effective therapies are available. If left untreated, depression impairs one’s enjoyment of life and may increase disability. It can also delay recovery from or worsen the outcome of other co-occurring chronic illnesses.
Cognitive health – or brain health, is an important part of healthy aging. Cognitive health refers to maintaining and improving mental skills such as learning, memory, decision-making, and planning. Many older adults mistakenly believe becoming “senile” or forgetting is a normal part of aging. Although one in four older adults experiences these events (known collectively as cognitive decline), they are not a normal part of healthy aging. There are certain changes in cognitive health that occur as you age. Normal changes usually mean a slower pace of learning and the need for new information to be repeated. While the majority of older adults will experience these normal changes in cognition, some older adults will experience cognitive decline. Older adults with cognitive decline have a higher risk of developing dementia later in life. Among Americans 65 years and older, approximately 6–10% have dementia, and two-thirds of people with dementia have Alzheimer’s disease. Although research has not found a way to prevent dementia or Alzheimer’s disease, cognitive decline may be preventable. Recent research suggests that being physically active, controlling your hypertension, and engaging in social activities may help you maintain and improve your cognitive health.
Chronic Diseases
Chronic Diseases are generally not prevented by vaccines or cured by medication, nor do they just disappear. To a large degree, the major chronic disease killers — heart disease, cancer, stroke, and diabetes —are an extension of what people do, or not do, as they go about their daily lives. Eighty-eight percent of those over 65 years of age have at least one chronic health condition. Health damaging behaviors — particularly tobacco use, lack of physical activity, and poor eating habits — are major contributors to the nation's leading chronic diseases. Clearly, promoting healthy behavior choices, through education and through community policies and practices, is essential to reducing the burden of chronic diseases.
Arthritis and related conditions are the leading cause of disability in the United States affecting nearly 43 million Americans. Although cost-effective interventions are available to reduce the burden of arthritis, they are currently underused. Regular, moderate exercise offers a whole host of benefits to people with arthritis by reducing joint pain and stiffness, building strong muscle around the joints, and increasing flexibility and endurance.
Cardiovascular Health is a growing concern for all Americans. Heart disease is the nation's leading cause of death. Three health-related behaviors—tobacco use, lack of physical activity, and poor nutrition—contribute markedly to heart disease. Modifying these behaviors is critical for both preventing and controlling heart disease. Modest changes in one or more of these risk factors among the population could have a profound public health impact.
Cancer is the second most common cause of death in the United States. Cancer is largely controllable through prevention, early detection, and treatment. Reducing the nation's cancer burden requires reducing the prevalence of the behavioral and environmental factors that increase cancer risk. It also requires ensuring that cancer screening services and high-quality treatment are available and accessible, particularly to medically underserved populations.
Colorectal cancer is the second leading cause of cancer-related deaths in the United States, accounting for 10% of all cancer deaths. The risk of developing colorectal cancer increases with advancing age. Lack of physical activity, low fruit and vegetable intake, a low-fiber diet, obesity, alcohol consumption, and tobacco use may contribute to the risk for colorectal cancer.
Three screening tools flexible sigmoidoscopy, colonoscopy, and the fecal occult blood test (FOBT) are widely accepted and used to detect colorectal cancer in its earliest stages, when treatment is most effective. In 1999, 66% of Americans aged 50 years or older reported not having had a sigmoidoscopy or colonoscopy within the last five years, and 79% reported not having had a fecal occult blood test within the last year.
Breast Cancer is best detected in its earliest, most treatable stage by mammography. Seventy-six percent of all diagnosed cases of breast cancer (are among women aged 50 years or older.
Diabetes is a serious, costly, and increasingly common chronic disease. Early detection, improved delivery of care, and better self-management are the key strategies for preventing much of the burden of diabetes. Seven million persons aged 65 years or older (20.1% of all people in this age group) have diabetes.
Epilepsy and seizures affect about 2.3 million Americans, and result in an estimated $12.5 billion in medical costs and lost or reduced earnings and production annually. People of all ages are affected, but particularly the very young and the elderly. About 10% of Americans will experience a seizure, and about 3% will have or will have had a diagnosis of epilepsy by age 80.
Obesity has reached epidemic proportions among Americans in all age groups. Obesity among adults has doubled since 1980. People who are obese or overweight are at increased risk for heart disease, high blood pressure, diabetes, arthritis-related disabilities, and some cancers.
Oral health is an important and often overlooked component of an older adult's general health and well-being. Oral health problems can cause pain and suffering as well as difficulty in speaking, chewing, swallowing, and maintaining a nutritious diet. During the past 50 years, the oral health and use of dental services among older adults have improved. Although this trend is expected to continue, additional improvement will depend on access to appropriate dental care.
Overview
The United States is on the brink of a longevity revolution. By 2030, the proportion of the U.S. population aged 65 and older will double to about 71 million older adults, or one in every five Americans. The far-reaching implications of the increasing number of older Americans and their growing diversity will include unprecedented demands on public health, aging services, and the nation’s health care system.
Chronic diseases exact a particularly heavy health and economic burden on older adults due to associated long-term illness, diminished quality of life, and greatly increased health care costs. Although the risk of disease and disability clearly increases with advancing age, poor health is not an inevitable consequence of aging.
Much of the illness, disability, and death associated with chronic disease is avoidable through known prevention measures. Key measures include practicing a healthy lifestyle (e.g., regular physical activity, healthy eating, and avoiding tobacco use) and the use of early detection practices (e.g., screening for breast, cervical, and colorectal cancers, diabetes and its complications, and depression).
Critical knowledge gaps exist for responding to the health needs of older adults. For chronic diseases and conditions such as Alzheimer's disease, arthritis, depression, psychiatric disorders, osteoporosis, Parkinson's disease, and urinary incontinence, much remains to be learned about their distribution in the population, associated risk factors, and effective measures to prevent or delay their onset.
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National professional organization dedicated to promoting the mental health and well being of the elderly through advocacy, education and research.
CDC’s National Center for Chronic Disease Prevention and Health Promotion, the Healthy Aging Program (HAP) serves as the focal point for older adult health at CDC, and establishes programs, develops innovative tools, and provides a comprehensive approach to helping older adults live longer, high-quality, productive, and independent lives.
Established by the American Association for Geriatric Psychiatry, the Geriatric Mental Health Foundation is committed to raising awareness about psychiatric and mental health disorders affecting the elderly.
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