Aging
Jennifer Scott
What is aging?
• The process of growing old
• General decline in physical and possibly
mental functioning
• Aging and public health
What can aging affect?
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Hearing
Fat/muscle proportion
Water in the body
Kidneys
Digestion
Muscle strength
Coordination
Taste
Smell
Vision
• Sexual hormones and sexual
functioning
• Liver
• Cardiovascular system
• Respiratory system
• Nervous system
• Bone strength, density
• Hormone levels
• Vitamin D levels
Causes of aging
• Theories
– Aging clock theory
– Genetic theory
– Connective tissue/cross-linking theory
– Free radical theory
– Immunological theory
What to do about aging?
• Diagnosis
• Treatment
• Results
Prevention of Aging
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Healthy diet
Exercise
Lifestyle habits
Drinking fluids
The aging population in the United States
• In 2008, there were 38.9 million residents age 65 and over
• Life expectancy
– Men at 65 years: 17.6 years
– Women at 65 years: 20.3 years
• Health status
– 24% of noninstitutionaled persons age 65 and over in fair or poor health
– 7% of noninstitutionalized persons age 65 and over need help with
personal care from other persons
Every day, 10,000 Americans turn 65 years old
Life expectancy, 2007
Country
Male
Female
Australia
79.0
83.7
Germany
77.4
82.7
Greece
77.0
82.0
Japan
79.2
86.0
Mexico
72.6
77.4
New Zealand
78.2
82.2
Switzerland
79.5
84.4
United Kingdom
76.8
81.0
United States
75.4
80.4
Life expectancy at 65 years: 18.6 years
Life expectancy at 75 years: 11.7 years
Life expectancy in the
United States
Year
Both sexes
Male
Female
1980
73.7
70.0
77.4
1990
75.4
71.8
78.8
2000
76.8
74.1
79.3
2005
77.4
74.9
79.9
2007
77.9
75.4
80.4
Leading causes of death, United states, 2007
1980
Rank
2007
Cause of death
Deaths
All causes
1,341,878
1
Heart disease
595,406
2
Cancer
3
Rank
2009
Cause
Deaths
All causes
1,755,567
1
Heart disease
496,095
Heart disease
258,389
2
Cancer
389.730
Cancer
Stroke
146,417
3
Stroke
115,961
Chronic lower
respiratory diseases
4
Pneumonia,
influenza
45,512
4
Chronic lower
respiratory diseases
109,562
Stroke
5
COPD
43,587
5
Alzheimer’s
73,797
Accidents
6
Atherosclerosis
28,081
6
Diabetes
51,528
Alzheimer’s
7
Diabetes
25,216
7
Influenza and
pneumonia
45,941
Diabetes
8
Accidents
24,844
8
Kidney disease
38,484
Influenza, pneumonia
9
Kidney disease
12,968
9
Unintentional injuries
38,292
Kidney disease
10
Chronic liver
disease and
cirrhosis
9,519
10
Septicemia
26,362
Suicide
Aging- Health care utilization
• 289.7 million ambulatory
care visits by persons age
65 and over
• 13.9 million discharges
from hospitals
• 5.7 days average stay in
hospitals
Virginia Report Card
Health topic
US
VA
Rank
Physically unhealthy days (mean number of days in past month)
5.3
4.8
17
Frequent Mental Distress (%)
6.7
5.9
23
Oral health: Complete tooth loss (%)
18
14.6
10
Disability (%)
35.3
33.8
13
No leisure-time physical activity (%)
32.7
32.2
22
Eating at least 5 fruits and vegetables daily (%)
27.5
30.4
7
Obesity (%)
23.8
23.5
22
Current smoking (%)
8.3
9.8
43
Flu vaccine in past year (%)
68.9
69.9
27
Ever had pneumonia vaccine (%)
66.8
70.8
12
Mammogram within past 2 years (%)
79.1
80
18
Colorectal cancer screening (%)
66.6
72.2
5
Up to date on select preventive services- men
41.6
48.1
5
Up to date on selected preventive services- women (%)
37.4
29.7
16
Cholesterol checked in past 5 years
94.7
96.7
1
Health Behaviors
Preventive Care and Screening
Upper third
Middle third
Lower third
Grade
Heart Disease Prevalence
in the Aging
Hypertension
and the aging
High cholesterol and statin use in the aging
Cancer prevalence
in the aging
Diabetes prevalence
in the aging
Issues associated with aging:
Joint Pain
Physical activity
and the aging
Deaths among persons 65
years of age and over (41)
Hospice care
The King’s Fund
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Model of acute care is unsuited
Lack of social and professional status
Poor working conditions
Failure to keep pace
Care for the aging
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1.3 million nursing home residents
1 million patients with home health care
868,100 hospice care discharges
60% had dental visit
Aging and Mental Health
Main message: Depression is not a normal part
of growing older
• Older adults are at an increased risk for
depression
• Older adults are often misdiagnosed and
undertreated
• Estimates of major depression range from less
than 1% to 13.5%
Caregiving
• What is caregiving?
• The cost of being a family caregiver
Advance Care Planning
• What is Advace Care planning?
• Why is it necessary?
Emergency Preparedness
for the Aging
• Vulnerable population
• Planning
• Back ups!
Premature Aging
• Laminopathy
• Progeria/ HutchinsonGilford Progeria Syndrome
– Incidence = 1 in 4
million births
– Currently, between 3545 known cases
Total spending
$486 billion for Medicare in 2011
Overview of Medicare spending
Medicare, continued
• The Medicare
population
• Cost of
Medicare
• Affordable Care
Act
Translational research
CDC
• Healthy Aging Program
• Prevention Research Centers Healthy Aging Research Network (HAN)
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Implement interventions that promote good health in older adults
Provide community decision-makers with useful information and resources
Develop practical and effective tools for assessing and evaluating programs and policies
Summarize and disseminate findings to colleagues across multiple sectors and communities
Mentor and train public health practitioners
Inform research priorities
Provide access to experts in
healthy aging
Translational research:
National Institute on Aging
• National Institute of Health:
National Institute on Aging
– Division of Aging Biology
– Division of Behavioral and
Social Research
– Division of Geriatrics and
Clinical Gerontology
– Division of Neuroscience
Additional research
• Buck Institute for Research on Aging
• UC San Diego Stein Institute for Research
on Aging
• Tufts University Human Nutrition Research
Center on Aging
• American Federation for Aging Research
(AFAR)
• The Ellison Medical Foundation
• Retirement Research Foundation
The CR Society
• Calorie restriction
– Men = 1,800, rather than 2,500
– Women = 1,500, rather than
2,000
• History- rats at Cornell at
1934
• Medical improvements
• Research
Methuselah Foundation
• Mprize
• NewOrgan prize
• SENS
TED talks- Aubrey de Grey on
avoiding aging
• http://www.ted.com/talks/aubrey_de_grey_
says_we_can_avoid_aging.html