Trends and Issues in Aging

1. Trends and Issuesin Aging Megan Shaw CSULB October 14, 2010 REC 573

2. What is a TREND? • An inclination • A general movement • A line of development

3. What are some trends in aging? • Rapid growth of 65+ • Baby Boomers (turning 65 next year) • High concentration of older adults in Florida, California, Arizona, Texas, and North Carolina due to aging in place and migration

4. More Trends in Aging • Declining retirement age (may be reversing) • Even if reversing, increase in years spent in retirement • Increases in life expectancy

5. Trends Continued • Number of Alzheimer’s cases will increase, but incidence may decrease due to scientific advances • Larger proportion of mild Alzheimer’s due to drugs that slow the progression • Increase in chronic conditions • Increase in obesity

6. Trends Continued • Sex ratio skewed towards women in later years • Greater ethnic diversity • Increasing education level • Increasing economic disparities among ethnicities • Married older adults declining • Compression of morbidity

7. Activity • Write down what age you expect to retire at or what age you would like to retire at

8. Now.. • Write down your life expectancy

9. MATH! • Subtract your age of retirement from your life expectancy • EX: 80.2 – 62 = 18.2 (Life Expectancy)-(Retirement Age)

10. Increasing Time Between Retirement and Death Evolution of Life Expectancy at Age 65 in the U.S. by sex: 1950-2003 • Notice that there is a considerable amount of time between your retirement age and the end of life • What does this mean for older adults?

11. Trend: Compression of Morbidity • Life expectancy has risen, but how much of life will be lived free of severe disability? • James Fries: Compression of Morbidity • The onset of chronic, irreversible illness will be delayed toward the end of life so morbidity (severe disability) is compressed into a shorter period before death • 1980s & 1990s: Started the DECLINE in people 65+ that had impaired ADLs and IADLs

12. Rectangularization • The Compression of Morbidity theory shows rectangular disability curves, with a longer period without disability and then a steeper decline

13. Aiming for Compression • Many of the studies done on the COM theory use exercise as a tool for testing the theory • The way to achieve a COM is by preventing disease and disability: exercise is an obvious variable that would prevent or delay morbidity • For example, Fries did a study where he compared a physically active group against a control group in the community • GOAL: find out if running deferred the onset of disability, or caused injury to joints and other structures that resulted in accelerated disability

14. Progression of Disability

15. Disability Level by Age

16. Fries • The study confirmed that physical activity, in this case running, deferred the onset of disability • Therefore, this supported the COM theory

17. Limitations • Every theory has its limitations • The Compression of Morbidity theory is limited by social class and education level • Several studies done on the COM theory have shown that there is a “rectangularization” of the disability curve, however, this shift is not as evident in the lower socioeconomic population

18. What does COM mean for older adults? • If people are living longer and they are free from severe disability until the very end of life, they will be active and needing something to do between retirement and death • Retirement age has been decreasing, as previously mentioned • Even if this trend is reversing, time between age of retirement and death will remain at least constant because life expectancy is increasing

19. More Time for Leisure • As we saw during the activity, after retirement the Compression of Morbidity theory shows that there will be a substantial period of time before morbidity occurs • This leaves time for leisure!

20. Conclusion • The trend of morbidity being pushed further and further back into the later years of life has profound significance for older adults, and leisure is just one part of that • Leisure time can be meaningful for older adults because they are free to do things that they find pleasure in without the constraints of a daily job and family to raise • The Compression of Morbidity theory provides a framework for looking at later life with the expectation that much time will be spent with the ability to continue to do what we choose, which is one of the best parts of getting older

21. References Cai, L., & Lubitz, J. (2007). Was there compression of disability for older Americans from 1992 to 2003? Demography,44(3), 479-495. Fries, J. F. (1996). Physical activity, the compression of morbidity, and the health of the elderly. Journal of the Royal Society of Medicine 89, 64-68. Kinsella, Kevn, & He, W. (2009). U.S. Census Bureau, international population reports, P95/09-1. An Aging World: 2008. U.S. Government Printing Office: Washington, DC. Parker, M. G, & Thorslund, M. (2007). Health trends in the elderly population: Getting better and getting worse. The Gerontologist, 47(2), 150-158. Wilmoth, J., & Longino Jr., C. (2006). Demographic trends that will shape U.S. policy in the twenty-first century. Research on Aging, 28(3), 269-288.