Figure 1: Number of Persons Age 65 and Older: 1900-2060
Figure 2: Percentage of Persons Age 65 and Older with a Disability, 2013
Note. From “A Profile of Older Americans: 2014,” by the Administration on Aging, 2014. Retrieved from http://www.aoa.acl.gov/Aging_Statistics/ Profile/2014/docs/2014-Profile.pdf.
Note: Increments in years are uneven. Note. From “A Profile of Older Americans: 2014,” by the Administration on Aging, 2014. Retrieved from http://www.aoa.acl.gov/Aging_Statistics/Profile/2014/docs/2014-Profile.pdf. Demographics of health and aging The experience of aging is inherently individual and varies by health, sociodemographic characteristics, and a lifetime of personal experiences. Aging is defined in a variety of ways and continues to evolve as advances in health care promote increased longevity (Cole, 2008). According to Rowe and Khan’s (1998) theory of “successful aging,” avoidance of disease, high physical and cognitive function, and active life involvement are key criteria for a positive aging experience. Research suggests that factors including gender, ethnicity, education, marital status, coping capacity, and living arrangements influence how people age (George, 2005; Patterson et al., 2008). The older population is not a homogeneous group; consolidating older adults into a single category such as “age 65 and older” is not useful due to the enormous heterogeneity exhibited among older adults. Therefore, categorizations of age cohorts by decades are commonly used and referred to as “young-old” (age 65 to 74), “middle-old” (age 75 to 84), and “old-old” (age 85 and older). However, even this expanded categorization does not account for the wide range of aging experiences within each group. The “old-old” age group is the fastest growing segment of the older adult population (AoA, 2013). The 85 and older age cohort represents the frailest of older age groups with the greatest health needs (Poon & Cohen-Mansfield, 2011), and is associated with higher rates of poverty and cognitive impairment, greater functional limitations, more chronic conditions, higher rates of widowhood, less social support, greater likelihood of living alone or in a skilled nursing facility, and higher rates of healthcare use (Federal Interagency Forum on Aging-Related Statistics, 2016). People age 85 and older use more acute care services and are more likely to be in their last years of life; both factors have been shown to correspond to high healthcare costs (Berlau, Corrada, Pelz, & Kawas, 2012). Although older adults may utilize the largest amount of acute care services, both unexpected and routine health needs are most often affected by chronic health conditions. Nearly all older adults have one or more chronic health conditions (Table 1), defined by the Centers for Disease Control and Prevention (CDC) as a persistent or recurrent illness or impairment that cannot be remediated (Goodman, Posner, Huang, Parekh, & Koh, 2013).
Table 1: Percentage of U.S. Adults Age 65 Years and Older in 2008 with One or More, Two or More, or Three or More of a Possible Six Chronic Conditions* Total Male Female %SE**% SE % SE Age 65 years and over (n=37,186,373) (n=16,006,733) (n=21,179,640)
1+ chronic conditions 2+ chronic conditions 3+ chronic conditions
85.6 0.6 83.0
1.0
87.6 0.7
56.0 0.9 51.4
1.4
59.4
1.1
23.1 0.7 1.0 *The six chronic conditions included in the percentages are arthritis, asthma, cancer, cardiovascular disease, chronic obstructive pulmonary disease, and diabetes. **SE = Standard Error. Note. From “Percent of U.S. Adults 55 and Over With Chronic 21.2 1.2 24.6 Conditions,” by the Centers for Disease Control and Prevention, 2009. Retrieved from http://www.cdc.gov/nchs/health_policy/adult_chronic_ conditions.htm. Examples of chronic health conditions common in older adults include arthritis, uncontrolled hypertension, heart disease, cancer, and diabetes (AoA, 2017). Because of the frequency with which older adults experience chronic conditions, it is often of little value to make determinations of health solely based on presence of chronic disease. Rather, health and wellness are best measured based on a combination of factors that include the impact of chronic disease on independence, the ability to participate in daily activities, and overall quality of life (Huber et al., 2011).
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