Gerontological Concepts Pat Mezinskis April 2008

Terms Geriatrics Gerontology

Chronologic Categories young-old65-74 years (53%) middle-old75-84 years (35%) old-old85 years and older (12%)

Demographics of Aging Major demographic shifts have occurred in the U.S. in the 20th century Population over 65: 19004% (3.1million) % (36.3 million) Projected: % (71.5 million)

Demographics of Aging

Population 85 and older: % (4 million) Projected: % (19 million)

Demographics of Aging Population 100 and older: ,306 centenarians ,639 centenarians Projected: ,000 centenarians

Demographics of Aging Life Expectancy: years years For those reaching 65, they have a life expectancy of an additional 18.5 years

Demographics of Aging Gender 2004 Women21.2 million Men15.2 million Ratio139 women/100 men

Demographics of Aging Race % minorities 8.3% African Americans 6.4% Hispanics 3.1% Asian or Pacific Islanders < 1% American Indian or Native Alaskan

Demographics of Aging Marital Status % of older men married 42% of older women married 43% of older women widows over 4 times as many widowsas widowers 11.8% of the older population divorced

Demographics of Aging Living Arrangements 2006 over half of non-institutionalized older adults lived with a spouse 30% of non-institutionalized older adults lived alone in women over 75, half lived alone

Demographics of Aging Living Arrangements Nursing Home Population years1% years4.4% over %

Demographics of Aging California Florida New York Texas Pennsylvania Ohio Illinois Michigan New Jersey Geographic Distribution in % of the population lived in 9 states:

Demographics of Aging Employment % (5.5 million) Americans 65 and over were in the labor force 3.1 million men, 2.4 million women

Demographics of Aging Education high school grads increased from 28% to 77.5% % had a bachelor’s degree or more

Demographics of Aging Computer and internet access: 2000 & 2003

Health Care 80% of older adults have at least one chronic illness Older adults spent $4,331 in out-of-pocket expenses in contrast to the total population- $2,766 Older adults spent 12.4% of total expenditures on health vs. 5.7% for all consumers

Most Common Chronic Illnesses in those over 65, as of 2005 Hypertension 48% Arthritis47% Heart disease29% Cancer20% Diabetes16%

Sensory Changes Skin Decreased subcutaneous fat >fragile skin Decreased sebaceous gland activity>dry skin Decreased vascularity of dermis>decreased body temperature regulation

Sensory Changes Vision Decreased elasticity of lens>presbyopia (diminished ability to focus on near objects) Decrease in pupil size>slower responses to changes in light Atrophy of photoreceptor cells, ciliary muscle>diminished depth perception, sensitivity to glare Thinning of retinal blood vessels>altered color perception

Sensory Changes Vision (Pathologic Conditions) Cataracts: Leading cause of visual impairment in older adults- due to opacity of the lens. Vision becomes blurred Macular Degeneration: damage to the macula, causing gradual loss of central vision Glaucoma: damage to optic nerve leading to loss of peripheral vision

Sensory Changes Hearing Hardened ossicles, stiff muscles> impaired sound conduction Loss of cochlear neurons, decreased blood supply>presbycusis (diminished ability to hear high-pitched sounds, especially in the presence of background noise

Sensory Changes Smell Atrophy of olfactory bulbs>diminished sense of smell Taste Reduction in taste buds>reduced taste sensation

Ageism Term coined by Robert Butler in 1968 Wrote Why Survive? Being Old in America (1975)

Myths about Aging “To be old is to be sick” Facts Only 4-5% of older adults live in nursing homes Only 23% of elderly claim to have disability

Myths about Aging “You can’t teach an old dog new tricks” Facts The less people are challenged, the less they perform Conditions of successful learning are different for older people than for the young

Myths about Aging “The horse is out of the barn” Facts Bad habits do not produce irreparable damage It is never too late to start good lifestyle habits of diet, exercise

Myths about Aging “The secret to successful aging is to choose your parents wisely” Fact Heredity is a factor but environment and behavior strongly influence how well an elderly person functions

Myths about Aging “The elderly don’t pull their own weight” Facts The belief that the elderly are unproductive is changing

Myths about Aging “Ageism is endemic to all societies” Facts Many eastern cultures revere their older adults

Myths about Aging “In today’s society, families can no longer care for older adults” Facts In the US, 70-80% of the in-home care of older adults is provided by families

Myths about Aging “Dementia is a normal part of aging” Facts Dementia is a syndrome characterized by pathologic changes in the brain Alzheimer’s Disease accounts for 50-70% of all dementias

Statistical data compiled from