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October - International Day of Older Persons
Older
People – a new power for development
Why a
"new power"?
A
demographic revolution is underway throughout the world.
Today, world-wide, there are around 600 million persons aged
60 years and over; this total will double by 2025 and will
reach virtually two billion by 2050 - the vast majority of
them in the developing world.
 In our
fast ageing world, older people will increasingly play a
critical role - through volunteer work, transmitting
experience and knowledge, helping their families with caring
responsibilities and increasing their participation in the
paid labour force.
Already
now, older persons make major contributions to society. For
instance, throughout Africa –and elsewhere - millions of
adult AIDS patients are cared for at home by their parents.
On their death, orphaned children left behind (currently, 14
million under the age of 15 in African countries alone) are
mainly looked after by their grandparents.
It is not
only in developing countries that older persons' role in
development is critical. In Spain for example, caring for
dependent and sick individuals (of all ages) is mostly done
by older people (particularly older women); the average
number of minutes per day spent in providing such care
increases exponentially with the carers' age: 201 minutes if
the carer is in the age group 65-74 and 318 minutes if aged
75-84 - compared to only 50 minutes if the carer is in the
age group 30-49 (Durán H, Fundación BBVA, 2002).
Such
contributions to development can only be ensured if older
persons enjoy adequate levels of health, for which
appropriate policies need to be in place. In line with the
Madrid International Plan of Action, the World Health
Organization launched in 2002 a document "Active Ageing - A
Policy Framework", outlining its approaches and perspectives
for healthy ageing throughout the life course.
"Ageing
is a development issue. Healthy older persons are a resource
for
their
families, their communities and the economy"
WHO
Brasilia declaration on healthy ageing, 1996
Health-Related Behaviors
Nearly 40% of deaths in America can be attributed to smoking,
physical inactivity, poor diet, or alcohol misuse-behaviors
practiced by many people every day for much of their lives.
Adopting healthy behaviors such as eating nutritious foods,
being physically active, and avoiding tobacco use can prevent
or control the devastating effects of many of the nation's
leading causes of death regardless of one's age.
Regular physical activity greatly reduces a person's risk
from dying of heart disease, and decreases the risk for colon
cancer, diabetes, and high blood pressure. Physical activity
also helps to control weight; contributes to healthy bones,
muscles, and joints; helps to relieve the pain of arthritis;
reduces symptoms of anxiety and depression; and can decrease
the need for hospitalizations, physician visits, and
medications. Finally, physical activity does not need to be
strenuous to be beneficial; people of all ages benefit from
moderate physical activity. However, people tend to be less
active as they age. By age 75, about one in three men and one
in two women do not engage in any physical activity.1
Organizations and agencies who are looking for assistance in
planning strategies to help older adults increase their
physical activity can use The National Blueprint: Increasing
Physical Activity Among Adults Age 50 and Older.
Good nutrition, including a diet that is low in saturated
fats and contains five or more servings of fruits and
vegetables each day (see the 5 A Day for Better Health
Program), is vital in maintaining good health. Improving the
diet of older adults could extend the productive life span of
Americans and reduce the occurrence of chronic diseases such
as heart disease, stroke, some types of cancer, diabetes, and
osteoporosis. Less than one-third of adults 65 years and
older meet the 5 A Day recommendation.2
Tobacco Use is the single most preventable cause of death and
disease in the United States. The American Cancer Society
estimates that cigarette smoking is responsible for one of
every five deaths in the United States, or more than 440,000
deaths each year. Tobacco use increases the risk for diseases
of the heart and cancer. Smoking cessation has major and
immediate health benefits for men and women of all ages,
regardless of whether they have a smoking-related disease.
Chronic Diseases
Chronic Diseases are generally not prevented by vaccines or
cured by medication, nor do they just disappear. To a large
degree, the major chronic disease killers — heart disease,
cancer, stroke, and diabetes — are an extension of what
people do, or not do, as they go about their daily lives.
Eighty-eight percent of those over 65 years of age have at
least one chronic health condition.3 Health damaging
behaviors — particularly tobacco use, lack of physical
activity, and poor eating habits — are major contributors to
the nation's leading chronic diseases. Clearly, promoting
healthy behavior choices, through education and through
community policies and practices, is essential to reducing
the burden of chronic diseases.
Arthritis and related conditions are the leading cause of
disability in the United States affecting nearly 43 million
Americans. Although cost-effective interventions are
available to reduce the burden of arthritis, they are
currently underused. Regular, moderate exercise offers a
whole host of benefits to people with arthritis by reducing
joint pain and stiffness, building strong muscle around the
joints, and increasing flexibility and endurance.
Cardiovascular Health is a growing concern for all Americans.
Heart disease is the nation's leading cause of death. Three
health-related behaviors—tobacco use, lack of physical
activity, and poor nutrition—contribute markedly to heart
disease. Modifying these behaviors is critical for both
preventing and controlling heart disease. Modest changes in
one or more of these risk factors among the population could
have a profound public health impact.
Cancer is the second most common cause of death in the United
States. Cancer is largely controllable through prevention,
early detection, and treatment. Reducing the nation's cancer
burden requires reducing the prevalence of the behavioral and
environmental factors that increase cancer risk. It also
requires ensuring that cancer screening services and
high-quality treatment are available and accessible,
particularly to medically underserved populations.
Colorectal cancer is the second leading cause of
cancer-related deaths in the United States, accounting for
10% of all cancer deaths. The risk of developing colorectal
cancer increases with advancing age. Lack of physical
activity, low fruit and vegetable intake, a low-fiber diet,
obesity, alcohol consumption, and tobacco use may contribute
to the risk for colorectal cancer.
Three screening tools flexible sigmoidoscopy, colonoscopy,
and the fecal occult blood test (FOBT) are widely accepted
and used to detect colorectal cancer in its earliest stages,
when treatment is most effective. In 1999, 66% of Americans
aged 50 years or older reported not having had a
sigmoidoscopy or colonoscopy within the last five years, and
79% reported not having had a fecal occult blood test within
the last year.4
Breast Cancer is best detected in its earliest, most
treatable stage by mammography. Seventy-six percent of all
diagnosed cases of breast cancer (are among women aged 50
years or older.4
Diabetes is a serious, costly, and increasingly common
chronic disease. Early detection, improved delivery of care,
and better self-management are the key strategies for
preventing much of the burden of diabetes. Seven million
persons aged 65 years or older (20.1% of all people in this
age group) have diabetes.5
Epilepsy and seizures affect about 2.3 million Americans, and
result in an estimated $12.5 billion in medical costs and
lost or reduced earnings and production annually. People of
all ages are affected, but particularly the very young and
the elderly. About 10% of Americans will experience a
seizure, and about 3% will have or will have had a diagnosis
of epilepsy by age 80.
Obesity has reached epidemic proportions among Americans in
all age groups. Obesity among adults has doubled since 1980.
People who are obese or overweight are at increased risk for
heart disease, high blood pressure, diabetes,
arthritis-related disabilities, and some cancers.
Oral health is an important and often overlooked component of
an older adult's general health and well-being. Oral health
problems can cause pain and suffering as well as difficulty
in speaking, chewing, swallowing, and maintaining a
nutritious diet. During the past 50 years, the oral health
and use of dental services among older adults have improved.
Although this trend is expected to continue, additional
improvement will depend on access to appropriate dental care.
Infectious Diseases
West Nile virus is a flavivirus commonly found in Africa,
West Asia, and the Middle East. It was first detected on the
east coast of the United States in 1999. Since then the virus
has rapidly spread westward and West Nile virus has been
detected in nearly every state in the country. The main route
of human infection with West Nile virus is through the bite
of an infected mosquito. The easiest and best way to avoid
West Nile virus is to prevent mosquito bites. People over the
age of 50 are more likely to develop serious symptoms from
West Nile virus infection and should take special care to
avoid mosquito bites. You can Fight the Bite! by 1) applying
insect repellent containing DEET (Look for:
N,N-diethyl-meta-toluamide); 2) when possible, wear
long-sleeves, long pants and socks when outdoors to reduce
the amount of bare skin exposed to mosquitoes and; 3) reduce
the amount of time you are outdoors during dusk and dawn when
mosquitoes are most active. There are other things you can do
to reduce your risk of exposure to West Nile virus in your
home and community. Visit the CDC Fight the Bite! Website for
more information.
Immunizations for Adults
Although infectious diseases are no longer the most common
causes of death, pneumonia and influenza remain among the top
ten causes of death for older adults. In 2000, pneumonia and
influenza were responsible for 3.3% or 58,557 deaths among
people 65 years of age and older.6 Influenza vaccination can
reduce both direct health-care costs (physician visits and
antibiotic use) as well as indirect costs from work
absenteeism associated with influenza illness. Among person
aged 65 years and older, influenza vaccination levels have
increased from 33% in 1989 to 66% in 1999, surpassing the
Healthy People 2000 goal of 60%.7
Pneumonia is one of the most serious infections in older
adults, especially among women and the oldest old. In a study
of nursing home acquired pneumonia patients, pneumonia
resulted in death among 40% of individuals who required
hospitalization.8
Injuries Among Older Adults
In the United States, one of every three persons aged 65
years and older falls each year. Among older adults, falls
are the leading cause of injuries, hospital admissions for
trauma, and deaths due to injury. In 1999, about 10,097
seniors died of fall-related injuries.9 Fractures are the
most serious health consequence of falls. Approximately
250,000 hip fractures, the most serious fracture, occur each
year among people over age 65. Many of these falls and
resulting injuries can be prevented. Strategies to prevent
falls among older adults include exercises to improve
strength, balance, and flexibility; reviews of medications
that may affect balance; and home modifications that reduce
fall hazards such as installing grab bars, improving
lighting, and removing items that may cause tripping.
While rates of motor vehicle related death and nonfatal motor
vehicle related injuries among older adults vary by state,
there are some consistencies. In most states, the fatality
rates for men are twice those for women. In all states, motor
vehicle-related fatalities are higher among adults 75 years
and older, as compared with adults between 65 and 74 years of
age. Among older adult drivers, the number of motor
vehicle-related fatalities increased 30% and the number of
nonfatal injuries increased 21% between 1990 and 1997.
However, the number of fatalities and nonfatal injuries among
older adult pedestrians declined during these same years (23%
and 24%, respectively).
Risk factors for suicide among the elderly differ from those
among the young. Older persons have a higher prevalence of
depression, a greater use of highly lethal methods and
greater social isolation. From 1980–1998, the largest
relative increases in suicide rates occurred among those
80–84 years of age. The rate of suicide is higher for elderly
white men than for any other age group, including
adolescents.6
People aged 65 and older are twice as likely to die in a home
fire as the population at large. The National Fire Protection
Association, with assistance from CDC, has developed a fire
and fall injury prevention program directed at older adults
called Remembering When*.
References:
Department of Health and Human Services. Physical Activity
and Health: A Report of the Surgeon General. Atlanta, GA:
Centers for Disease Control and Prevention, 1996.
Centers for Disease Control and Prevention, Behavioral Risk
Factor Surveillance System.
Physical Activity Interventions Targeting Older Adults, Am J.
Prev. Med 1998;15(4):316–333.
Centers for Disease Control and Prevention. The Burden of
Chronic Diseases and Their Risk Factors: National and State
Perspectives. Atlanta, GA: U.S. Department of Health and
Human Services, Centers for Disease Control and Prevention,
2002.
Centers for Disease Control and Prevention. National diabetes
fact sheet: general information and national estimates on
diabetes in the United States, 2000. Atlanta, GA: U.S.
Department of Health and Human Services, Centers for Disease
Control and Prevention, 2002.
Andersen, RN. Deaths: Leading Causes for 2000. National Vital
Statistics Reports; Volume 50 No. 6. Hyattsville, MD:
National Center for Health Statistics, 2002.
Centers for Disease Control and Prevention. Prevention and
Control of Influenza — Recommendations of the Advisory
Committee on Immunization Practices (ACIP). MMWR 2002;3:5–6.
Marrie TJ. Pneumonia. Clin Geriatr Med 1992;8:721–34.
Centers for Disease Control and Prevention.Web-based Injury
Statistics query and Reporting System (WISQARS) [Online].
(2001). National Center for Injury Prevention and Control,
Center for Disease Control and Prevention (producer).
Available from: URL: www.cdc.gov/ncipc/wisqars. [2002 Oct
16].
* Links to non-federal organizations are provided solely as a
service to our users. Links do not constitute an endorsement
of any organization by CDC or the federal government, and
none should be inferred. The CDC is not responsible for the
content of the individual organization Web pages found at
this link.
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