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Demographics of Aging

Demographics of Aging. Min H. Huang, PT, PhD, NCS. Reading Assignments. Guccione : Ch 2 (review Ch 1). Learning Objectives. Explain what successful aging constitutes Describe demographics of the aging population in the United States

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Demographics of Aging

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  1. Demographics of Aging Min H. Huang, PT, PhD, NCS

  2. Reading Assignments • Guccione: Ch 2 (review Ch 1)

  3. Learning Objectives • Explain what successful aging constitutes • Describe demographics of the aging population in the United States • Examine the implications of these demographics for physical therapy practice • Discuss the impact of ageism on the care for the geriatrics patients

  4. Introduction to Geriatrics Paper • Write down your answers to the following questions and turn it in by the end of the class • What constitutes successful aging? • How do physical therapist promote optimal aging while working with the geriatric clients? • What are the implications of changing demographic of aging in the U.S. for physical therapy? • What might be a strategy to combat ageism?

  5. Gerontology vs. Geriatrics • Gerontology • The comprehensive study of aging and the problems of the aged • Geriatrics • A branch of medicine that deals with the problems and diseases of old age and aging people http://www.nlm.nih.gov/medlineplus/

  6. Geriatrics team • Members • Geriatrician • Nurse • Physician assistant • Social worker • Pharmacist • Nutritionist • Physical therapist • Occupational therapist • Speech therapist • Geriatric psychiatrist  • Goals • Evaluates the patient’s social supports and living situation • Considers the person’s ability to perform daily activities • Provide patient-centered plan of care

  7.  Slippery slope of aging

  8. World oldest marathon runner at 101 year old!

  9. Successful aging • Multidimensional concept • Disease and disability were not inevitable consequences of aging • What is the role of PT in successful aging?

  10. Rowe & Kahn. The Gerontologist. 1997;37(4):433-440.

  11. Active ageing • The process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age – WHO • “Active” • Continuing participation in social, economic, cultural, spiritual and civic affairs • Not just the ability to be physically active or to participate in the labor force

  12. Optimal aging • For people with disease and disability, physical therapist should • Assist an individual to achieve life satisfaction in multiple domains—physical, psychological, and social • Reduce the disabling effects of disease • Stop a vicious cycle of “disease–disability–new incident disease” to maintain quality of life

  13. Defining older adults • Older adults are defined as persons 65 years of age and older • Oldest old: 85+ years and older • Middle old: 76-84 • Young old: 55-75 • “Old” - very subjective concepts! • Chronological age ǂ Biological age

  14. Demographics • Americans age 65+ years • 1990: 4% of population • 1940: 6.9% of population • 2010: 13% of population (40 million people) • 2030: 20% of population • “Baby boomers” (born between 1946 and 1964) are responsible for a sharp increase from 2010 to 2030 • Americans age 85+ years • 2010: 5.5 million • 2050: 19 million people

  15. By 2050, the age structure “pyramid” is relatively rectangular except among the older age groups

  16. Aging around the world • The number of people today aged 60+ has doubled since 1980. • The number of people aged 80+ years will almost quadruple to 395 million between now and 2050. • By 2050, these older adults will outnumber all children under the age of 14. • By 2050, 80% of older people will be from low- or middle-income countries.

  17. Race and ethnicity

  18. Marital status: by men and women

  19. Living arrangements: by sex and race

  20. Economic status: source of income

  21. Economic status: household expenditure

  22. Economic status: poverty rate

  23. Mortality: leading causes of death

  24. Mortality: by men and women

  25. Life expectancy • U.S. 2010 data • http://www.cdc.gov/nchs/fastats/lifexpec.htm

  26. Life expectancy: by sex,1900-2009

  27. Morbidity

  28. Morbidity • The prevalence of certain chronic health conditions differed by sex. • Women reported higher levels of asthma, arthritis and hypertension than men. • Men reported higher levels of heart disease, cancer, and diabetes. • The prevalence of certain chronic health conditions differed by race and ethnicity • Non-Hispanic Blacks reported higher levels of hypertension and diabetes than non-Hispanic Whites

  29. Functional limitations caused by chronic health conditions

  30. Functional limitations in Medicare enrollees age 65+ years

  31. Health risks and behaviors • Social and lifestyle factors • Cancer screenings • Vaccinations • Diet • Physical activity • Obesity • Smoking • Socializing • Quality of the air

  32. Health risks and behaviors: use of time

  33. Health risks and behaviors: use of time

  34. Health risks and behaviors: physical activity • 11% of people age 65+ years reported participating in leisure-time aerobic and muscle-strengthening activities in 2010 • Even among frail and very old adults, mobility and functioning can be improved through physical activity. • Strengthening is recommended as part of a physical activity program in older adults and may help to improve balance and decrease risk of falls.

  35. Health care expenditure • In 2010, national health care expenditure was estimated to reach $2.6 trillion • In 2010, Medicare spending was estimated to reach $525.0 billion • By 2020, national health spending is expected to reach $4.6 trillion and comprise 19.8 percent of GDP • Average annual Medicare spending growth is anticipated to be 6.3% from 2013 to 2020

  36. Health care expenditure: by age, 1992-2008 After adjustment for inflation, health care costs increased significantly among older Americans from $9,850 in 1992 to $15,709 in 2008.

  37. Health care expenditure in people age 65+ years • Costs varied by demographic characteristics • Non-Hispanic Blacks: $19,839 • Hispanics: $15,362 • Individuals with income <$10,000: $21,924 • Individuals with income >$30,000: $13,149 • Costs varied by health status • Individuals with no chronic conditions: $5,520 • Individuals with 5+ conditions: $24,658 • Residents of long-term care facilities: $61,318 • Community-living residents: $13,150

  38. The top 5% of the health care spenders accounted for 49% of overall U.S. medical spending

  39. Percent of Total Health Care Expenses Incurred by Top 5 Percent of Health Care Spenders Within Different Age Groups: United States, 2002

  40. Health care workforce • Although 11.9% of workforce in the U.S. was in health care industries in 2008, the concentration of workers in these industries varied from state to state. • Current health care workforce is not sufficiently trained to meet existing demands of older patients, let alone higher future demands. • The total number of certified geriatricians is 7,162, less than 1% of health care workforce

  41. Relative to the United States as a whole, states with older populations tend to have larger shares of employees in health care industries.

  42. APTA Workforce Data: Patient Type and Time Management http://www.apta.org/WorkforceData/

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