1. Chapter 2: The Aging Population

2. Learning Objectives
Review statistics related to aging in the United States.
Describe social and economic issues related to aging in the United States.
Discuss aging across different cultures.
Recognize differences between aging in the 21st century and aging in the past.
Critically evaluate successful aging.

3. Statistics of Aging in the United States
“The older population (65+) numbered 40.4 million in They represented 12.9% of U.S. population”.
“The older population in 2030 will be 72.1 million, twice than Old people will outnumber young people for the first time in history”.- the graying of America
Approximately 20,000 nursing homes in the U.S.
with 1.5 – 2 million nursing home beds.
Approximately 5% of the population age 65 & ^.

4. Real and Projected Numbers of People 65+ in the US

5. Health: Reasons of increasing older adults
Increasing life expectancy of seniors
improved sanitation through the 20th century
preventive health services implemented
medical advances treat formerly fatal illnesses
Older adults dealing with more chronic disease
average 75 year old has 3 chronic diseases and takes 5 medications

6. Gender As of 2010, 23 million older women vs. 17.5 million older men
In 2010,
72% of older men were married
42% of older women were married
Women age 75-84: 37% married
Women age 85+: 15% married

7. Education
Education affects older adults’ socioeconomic status: more educated have better income, standard of living, and health.
High school graduation rates among older adults in the U.S. have increased. Rates vary among ethnic groups.

8. Sources of Income for Persons 65+

9. Living Arrangements
Living arrangements of older adults are linked to income, health status and the availability of caregivers.
55.1% of non-institutionalized older adults lived with their spouse in 2010
The likelihood of living alone increases with age: 47% for women age 75+
485,000 grandparents age 65+ have primary responsibility for their grandchildren.
Older white and black females were more likely live alone than others.
Fig. 2-3, page 34

10. Effects of Ethnicity
Ethnic minority elders will be 42% of the older population in the next 40 years.
Health problems associated with aging affect different ethnicities at different rates.
Access to health care varies for different ethnicities.
Other minorities include older foreign-born people living in the U.S., veterans, the aging disabled population, elderly inmates

11. African Americans The largest cultural minority. (p. 35, table)
Poverty rate for older African Americans was 24% in 2004, compared to 10% for the total elderly population.
Often do not use routine preventive services at recommended rates and are less likely to have a regular provider of health care.
Higher rates of DM, HTN, CKD
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12. Hispanics
The over 65 year old Hispanic population is the fastest growing segment of the total U.S. population.
Diverse population from Mexico, Cuba, Puerto Rico, the Dominican Republic, and other Central and South America.
72% of Hispanics age 60 or over live in California, Florida, New York, and Texas.
Generally receive assistance in the home rather than to stay LTCF.

13. Asians and Pacific Islanders
Composed of 40 different ethnic groups with various economic, educational, and health profiles.
life expectancy : 79.3 years for males and 84.9 years for females, as compared to 73.6 and 80.1 for white males and females, respectively.
Top 5 causes of death: heart disease, cancer, stroke, unintentional injuries, and diabetes.

14. American Indians/Alaskan Natives
500 tribes and native villages in which 150 languages are used.
Heart disease is the leading cause of death due to a rise in risk factors (Obesity, diabetes, smoking, hypertension, high cholesterol, and sedentary lifestyle)
Leading cause of death: heart disease, cancer, injuries, DM, Cerebrovascular disease.

15. Other Minorities
The older foreign-born population: Nurses should explore whether patients are first generation in their new country, second, third, etc….
U.S. Veterans
Developmentally disabled
Elderly prison inmates

16. Mortality and Morbidity (cont’d)
Most older adults in the U.S. are, by and large, active and healthy.
Leading causes of elderly death (2004)
Heart disease 30.4%
Cancer 22%
Stroke 7.4%
Chronic lower respiratory disease 6%
Alzheimer’s disease 3.7%
Diabeties, influenza/pneumonia, nepthritis, accidents, septicemia - Less than 3.2% each

17. Mortality and Morbidity

18. History of Aging in the U.S.
Pre-1900:
old age started at age 60
elders were generally respected for their wisdom and experience
old age was usually a privilege of the rich; poor people did not live to old age
1900s:
President Theo. Roosevelt established old age as a disability – 25% of the elderly was receiving military pensions, which accounted for 43% of federal expenditure
President Franklin Roosevelt signed the Social Security act in 1935
Medicare and Medicaid established in 1965

19. Aging Today
55% of persons 85+ in the US are impaired and require long-term care
The majority of older adults are healthy, active, and continue to be engaged in society after retirement
Aging in Place
Is defined as the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.
Elders need better education on available services, financial preparation for retirement, and proactive measures to successfully age in place

20. Centenarians
The fastest-growing segment of the population, age >100, #316,600 worldwide
Lower income
Lower educational level
Widowed (84%)
More disabled people
Supercentenarian: age >110

21. Secrets of Aging Protective factors:
No smoking, no drinking and driving
Regular exercise
Moderate weight
Education
Low blood pressure
Stable marriage
Mature defenses

22. Secrets – What elders Say (Cont.)
Everything in moderation
Strong relationships
Ability to deal with stress
Fewer chronic diseases
Little to no alcohol intake
Always having something to look forward to

23. Successful Aging
Successfully adapting to changes in the aging process.
Acceptance of death, life satisfaction, and feelings of well-being.
An avoidance of disease and disability.
Achievement of a sense of autonomy, dignity, and absence of suffering

24. Summary Aging of baby boomers will greatly impact U.S. society.
Health disparities will continue among minority elderly groups.
Successful aging is possible with wise lifestyle choices and avoidance of risk factors.