Aging

1
Aging

• Jennifer Scott

2
What is aging?

• The process of growing old
• General decline in physical and possibly mental
  functioning
• Aging and public health

3
What can aging affect?

• 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

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Causes of aging

• Theories
• Aging clock theory
• Genetic theory
• Connective tissue/cross-linking theory
• Free radical theory
• Immunological theory

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What to do about aging?

• Diagnosis
• Treatment
• Results

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Prevention of Aging

• Healthy diet
• Exercise
• Lifestyle habits
• Drinking fluids

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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
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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
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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
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Leading causes of death, United states, 2007
1980 1980 1980 2007 2007 2007 2009
Rank Cause of death Deaths Rank Cause Deaths
All causes 1,341,878 All causes 1,755,567
1 Heart disease 595,406 1 Heart disease 496,095 Heart disease
2 Cancer 258,389 2 Cancer 389.730 Cancer
3 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 Alzheimers 73,797 Accidents
6 Atherosclerosis 28,081 6 Diabetes 51,528 Alzheimers
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
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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

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Virginia Report Card
Health topic US VA Rank Grade
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
Health Behaviors
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
Preventive Care and Screening
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
Upper third
Middle third
Lower third
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Heart Disease Prevalence in the Aging
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Hypertension and the aging
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High cholesterol and statin use in the aging
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Cancer prevalence in the aging
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Diabetes prevalence in the aging
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Issues associated with aging Joint Pain
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Physical activity and the aging
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Deaths among persons 65 years of age and over (41)
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Hospice care
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The Kings Fund

• Model of acute care is unsuited
• Lack of social and professional status
• Poor working conditions
• Failure to keep pace

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Care for the aging

• 1.3 million nursing home residents
• 1 million patients with home health care
• 868,100 hospice care discharges
• 60 had dental visit

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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

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Caregiving

• What is caregiving?
• The cost of being a family caregiver

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Advance Care Planning

• What is Advace Care planning?
• Why is it necessary?

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Emergency Preparedness for the Aging

• Vulnerable population
• Planning
• Back ups!

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Premature Aging

• Laminopathy
• Progeria/ Hutchinson-Gilford Progeria Syndrome
• Incidence 1 in 4 million births
• Currently, between 35-45 known cases

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Total spending

• 486 billion for Medicare in 2011

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Overview of Medicare spending
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Medicare, continued

• The Medicare population
• Cost of Medicare
• Affordable Care Act

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Translational research CDC

• Healthy Aging Program
• Prevention Research Centers Healthy Aging
  Research Network (HAN)
• 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

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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

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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

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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

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Methuselah Foundation

• Mprize
• NewOrgan prize
• SENS

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TED talks- Aubrey de Grey on avoiding aging

• http//www.ted.com/talks/aubrey_de_grey_says_we_ca
  n_avoid_aging.html