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How We Age. Physiological Changes of Aging January 27, 2005. Aging America. In 1900 3 million over age 65 In 2003 36 million over age 65 12.4% of the US population In 2011, the first Baby Boomers turn 65 By 2030 71.5 million over age 65 19.6% of the US population. B00MERS !.

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how we age

How We Age

Physiological Changes of Aging

January 27, 2005

aging america
Aging America

In 1900

3 million over age 65

In 2003

36 million over age 65

12.4% of the US population

In 2011, the first Baby Boomers turn 65

By 2030

71.5 million over age 65

19.6% of the US population

b00mers
B00MERS !

Born between 1946 and 1964

Turning 65 between 2011 and 2031

frail elders age 85 and up
Frail Elders: Age 85 and up

In 1900 … only 100,000

In 2000

4.2 million

1.5% of the US population

By 2030

20.9 million

2.6% of the US population (5% by 2050)

Those over 85 tend to be in poorer health and to use more services.

the growing 100 age group
The growing 100+ age group

In 2000

65,000 centenarians

By 2030

381,000 centenarians

aging missouri
Aging Missouri

In 2000

745,684 Missourians are over 65

13.6% of the Missouri population

living in poverty
Living in Poverty
  • Based on money income for community-dwelling older adults
life expectancy
Life Expectancy
  • At birth
    • In 1900 = 49 years
    • In 1960 = 70 years
    • In 2001= 79.8 years for women & 74.4 years for men
  • At age 65, 19.4 more years for women and 16.4 more years for men
  • At age 85, 6.9 more years for women and 5.7 more years for men
causes of death 2001
Causes of Death (2001)
  • Heart Disease
  • Malignant Neoplasm
  • Cerebrovascular Diseases
  • Chronic Lower Respiratory Diseases
  • Influenza & Pneumonia
  • Diabetes Mellitus
chronic conditions disability
Chronic Conditions & Disability
  • Contribute to decreased functional ability … 20% (+65) are disabled
    • Men = 15% and Women = 23%
  • Negatively impact quality of life
  • Affect housing choices and the ability to remain in the community
  • However … 73% of those over 65 years rate their health as good or better !
memory impairment
Memory Impairment
  • A major indicator of the need for institutional placement
  • Incidence of moderate to severe memory impairment (2002):
    • Age 65 and over … 12.7%
    • Age 65 – 69 …. 5.1 %
    • Age 85 + …. 31.2 %
clinically relevant depression
Clinically Relevant Depression
  • Having 4 or more symptoms from the list of 8 symptoms in an abbreviated form of the CES-D instrument
assisted living
Assisted Living

11,472 facilities

558,400 residents

24 % of the residents need help with 3 or more ADLs

An estimated 33% have moderate to severe cognitive impairment

Hawes, Rose, & and Phillips (1999)

nursing home placement
Nursing Home Placement
  • Nursing home use increases with age
  • In 1999
    • Age 65-74: 11 persons out of 1000
    • Age 75-84: 43 persons out of 1000
    • Age 85 +: 182 persons out of 1000
nursing home dependence in activities of daily living
Nursing Home Dependence in Activities of Daily Living

Residents over age 65 (1999 data)

ADLs = bathing, dressing, eating, walking, toilet use, transferring in or out of bed or chairs

by the numbers
By the Numbers
  • www.agingstats.gov/
  • Federal Interagency Forum on Aging. (2005). Older Americans 2004: Key Indicators of Well-Being.
causes of age related changes rule of thirds
Causes of Age-Related Changes: Rule of Thirds
  • 1/3rd are the result of functional decline due to disease
  • 1/3rd are due to inactivity or disuse
  • 1/3rd are due to aging itself
  • BUT each of us ages in a way that is unique … because of genetic factors and life history
a summary of aging s effects
A Summary of Aging’s Effects
  • Structure
  • Strength
  • Flexibility
  • Speed
  • Capacity
  • Response to challenge
  • Sensory links to the world
structure
Structure
  • Distribution of body mass shifts
    • Truncal obesity
    • Center of gravity shifts lower in body
    • Thinner layer of subcutaneous fat
  • Bone mass less
    • Osteoporosis
  • Loss of height
    • 2 inches lost between 20 & 70
  • Postural changes
    • Dorsal kyphosis
strength
Strength
  • Less muscle strength due to replacement of elastic fibers
  • Changes in peripheral nerves to the muscles
  • Changes in bone (less sturdy)
  • Changes in joints (less stable)
  • Changes in skin (drier, more fragile)
flexibility
Flexibility
  • Joint changes due to arthritis
  • Ligament and tendon stiffening
  • Residual effect of trauma
speed
Speed
  • Slower nerve conduction velocity
    • Slower response to stimuli
    • Slower reflexes
  • Slower adaptation to changes in light
  • Slower recall of information
  • Slower learning
capacity
Capacity
  • Smaller lung volume
  • Smaller cardiac reserve
  • Slower metabolism
  • Smaller urinary bladder volume
response to challenge
Response to Challenge
  • Hemodynamics
    • Pulse
    • Blood Pressure: Orthostatic hypotension
  • Fluid balance
  • Postural balance
  • Thermal regulation
  • Immunity
sensory links to the world
Sensory Links to the World
  • Vision
  • Hearing
  • Taste
  • Smell
  • Touch
  • Kinesthetics
sensory changes eye
Sensory Changes: Eye
  • Diminished acuity
    • 18% have decreased vision even WITH glasses
  • Slower accommodation to changes in light
  • Altered color discrimination
    • Especially blue, green, gray, purple
    • Yellowing of lens
  • More brightness needed
    • Ambient and task-focused
  • Sensitivity to glare
    • Lighting, flooring, and windows
sensory changes ear
Sensory Changes: Ear
  • 1/2 of men & 1/3 of women have difficulty hearing without amplification
  • Hearing
    • Presbycusis
    • High frequency loss
    • Difficulty distinguishing conversations from background noise
  • Balance
    • Vestibular system
sensory changes taste
Sensory Changes: Taste
  • Threshold necessary for taste perception rises
  • Number of taste buds decreases
  • Taste may be altered by disease or medication
  • Taste and smell work together
  • At age 65 and over, 26% of men and 29% of older women have no natural teeth
sensory changes smell
Sensory Changes: Smell
  • Decreased number of olfactory nerve endings
  • Impaired sensitivity related to history of smoking, chronic nasal allergies
  • May be altered by disease
sensory changes touch
Sensory Changes: Touch
  • Reduced number of peripheral nerve endings
  • Altered perception of temperature, pressure, vibration, pain
sensory changes kinesthetic sense
Sensory Changes: Kinesthetic Sense
  • Proprioception
  • Altered balance
  • Altered spatial orientation
  • Slowed responses
    • To avoid obstacles
    • To prevent a fall
    • To regain balance
the results of these changes
The Results of these changes
  • Alterations in function
  • Alterations in how we live our lives
  • Susceptibility to illness and injury
special issues
Special Issues
  • Cognitive impairment
  • ADL/IADL Independence
  • Mobility
  • Assistive devices
  • Falls
  • Safety
cognitive impairment 4 a s
Cognitive Impairment: 4 A’s
  • Amnesia
    • Impaired memory
  • Agnosia
    • Impaired recognition of people and objects
  • Apraxia
    • Impaired task performance
  • Aphasia
    • Impaired language skills
cognitive impairment
Cognitive Impairment
  • Reasoning and judgment
  • Communication
  • Independence in IADL/ADL
    • Instrumental activities of daily living
    • Activities of daily living
  • Safety
mobility the key to independence
Mobility: The Key to Independence
  • Being able to get out of a chair or a bed
  • Being able to get to the bathroom
  • Being able to get to the kitchen
  • Being able to get to the phone

Mastrian’s study on independence

falls
Falls
  • 1/3rd of +65 living at home fall at least once in a year
  • Half of those who fall, fall more than once
  • Fractured hips after falling lead to 40% of nursing home admissions
  • In hospitals: 20% of patients fall
  • In LTC facilities: 45% of residents fall
safety
Safety
  • Accidents in the bathroom
  • Accidents in the kitchen
  • Falls
  • Burns
  • Fires related to smoking
  • Driving accidents
  • Wandering
  • Crime
  • Domestic Abuse … Elder Abuse
more references
More References
  • Ebersole, P & Hess, P. (1998). Toward Health Aging (5th ed.). St. Louis: Mosby.
  • Hawes, C; Rose, M; & Phillips, CD. (1999). Executive summary: Results of a national survey of facilities. Available online: http://aspe.os.dhhs.gov/daltcp/reports/

facreses.htm.

  • Mastrian, KG. (2001). Differing perceptions in defining safe independent living for elders. Nursing Outlook, 49, 231-237.
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