Aging Faculty Scholars Orientation July 25, 2013 Patricia Sawyer, PhD
Overview • Gerontology and Geriatrics • An Aging Society • Demographics and life expectancy • Aging in Alabama • Defining “old”
Aging is . . . • Individual • Intergenerational • Societal
Why Study Older Adults? • Older adults are an increasing proportion of the population • Older adults are likely to have unique health care needs • Personal – everyone is aging or knows someone who is aging
VOCABULARY FOR AN AGING POPULATION • Gerontology – “geras” – old age + “-logy” –the study of • Geriatarics (word from Greek “geras” – old age, and “iatrikos” – physician) • Medical practice that focuses on • Complex needs of older adults • Maintenance of functional independence even in the presence of chronic disease • What to call older adults?
What is Gerontology? Adapted from D. Denton
PREPARING FOR AN AGING POPULATION • Both geriatrics and gerontology have the goal of understanding aging so that people can be helped to maximize their functioning and receive the highest quality of life. • Both are inherently multidisciplinary – needing to include the perspectives of all disciplines concerned with physical, mental, and social aspects of aging, particularly health care and the delivery of health care.
Formalizing GerontologyGerontological Society of America • In 1939, 24 scientists and physicians formed a Club for Research on Ageing. • In 1945 a group in New York City to sign the certificate to incorporate the Gerontological Society, to "promote the scientific study of aging." • Additional goals were to encourage exchanges among researchers and practitioners from various disciplines related to gerontology, and to foster the use of gerontological research in forming public policy • 1946: First Journal of Gerontology 1 • 1954: First Newsletter • 1955: Three sections (Biological & Clinical, Psychological & Social, Oranization • 1961: Two section & new magazine, The Gerontologist • 1988: Four journals – one cover • 1995: Two covers, new publication, The Public Policy and Aging Report • Annual meetings: 1st meeting January, 1946 – 50 members • Now annual meetings have approx. 4000.
Formalizing Geriatric CareThe American Geriatrics Society • The AGS was started 1942, by a group of physicians interested in advancing medical care for older adults. • The founding membership of the AGS decided that any physician with an interest in geriatrics who had graduated from a recognized medical school and was a member in good standing of a state medical society would be eligible to join the Society. • Current membership is comprised primarily of geriatrics health care professionals, including physicians, nurses, researchers, medical educators, pharmacists, physician assistants, social workers, physical therapists, occupational therapists, health care administrators, and others although historically, the Society's membership has been predominantly physicians. • Goal: to improve the health, independence and quality of life of all older people. • Annual meetings: First meeting in NYC in June 1944, 2nd 1946 and annually thereafter; • approx. 6000 health care professionals are members • Journal of the American Geriatrics Society (JAGS)
An Aging Society For the first time in history, people aged 65 and over will soon outnumber children under the age of 5. Throughout the world today, there are more people aged 65 and older than the entire populations of Russia, Japan, France, Germany and Australia—combined. By 2050, the U.N. estimates that the proportion of the world's population age 65 and over will more than double, from 7.6% today to 16.2%. The United States contains more people age 65 and older than the total population of Canada. Americans aged 65 and older outnumber the combined populations of New York, London, and Moscow. http://transgenerational.org/aging/demographics.htm#ixzz2YBlYejb0
45.5% Percentage of the population of Sumter County, Fla., that was 65 or older in 2011, which led all of the nation's counties.Source: Population estimates http://www.census.gov/popest/data/national/asrh/2011/index.html http://www.cdc.gov/aging/pdf/saha_2007.pdf
U.S. Life Expectancy at Birth by Sex 1960–2010 Overall life expectancy in 2010 was 79.5 years, an increase of 2.7 years since 2000
Projected Population Growth www.silverbook.org
More Women In Alabama, among those 85+ there were 43 men for 100 women. (2010 data from US Census)
Age Distribution of U.S. Population by Race/Ethnicity, 2005 White non-Hispanic Black non-Hispanic Hispanic 85+ 75-84 65-74 55-64 45-54 35-44 25-34 20-24 15-19 10-14 5-9 0-4 0% 5 % 10% 15% 20% 0% 5 % 10% 15% 20% 0% 5 % 10% 15% 20% http://www.bandwidthonline.org/find-data.asp#tgmTrends in Health and Aging
Increase in Minority Elders 2003 2030 *Hispanics can be any race
Life-Expectancy in the US http://www.washingtonpost.com/wp-srv/special/nation/life-expectancy-map/
Life-Expectancy Calculators • www.livingto100.com • http://www.nmfn.com/tn/learnctr--lifeevents--longevity • www.demko.com/neoyear.htm • Prognosis calculators • http://www.eprognosis.org/ (Shonberg calculation 9 year mortality)
Remaining Life-Expectancy • Life tables can be used to calculate persons remaining life expectancy if one has survived to a particular age. • As more progress is made in preventing death from heart disease, circulatory problems, more persons will live with better health, leaving more survivors that potentially could become frail • “Survivorship” - remaining life expectancy - for persons who have reached a particular age In the US • At age 80, a female has remaining life-expectancy of 9.7 years • At age 80, a male has remaining life-expectancy of 8.1 years (white males and 8.2 for all other males . http://www.infoplease.com/ipa/A0005140.html
Life-Expectancy at Birth and 65 National Center for Health Statistics. Health, United States, 2012
Active Life-Expectancy • Remaining years of functional well being. • Length of life/quality of life • Active vs. dependent life expectancy. (Adding life to years not years to life) • Importance of independent functioning • A 65 year old woman today has 20.0 (32% or 6.4 yrs. dependent) • A 65 year old man has 17.1 (17% dependent 2.9 yrs. dependent) • (Important difference in active life expectancy between poor and nonpoor)
What age would you like to live to? • One survey (2009) • 89 years of age • 20% into 90’s • 8% would like to pass 100 years • This is somewhat lover than a 2002 survey in which the desired life-span was 92 http://www.pewsocialtrends.org/2009/06/29/growing-old-in-america-expectations-vs-reality/
Conversation Just before the funeral services, the undertaker came up to the very elderly widow and asked, "How old was your husband?“ "Ninety-eight," she replied. "Two years older than I am.“ "So you're 96," the undertaker commented. She responded, "Hardly worth going home, isn't it?" The advantage of exercising every day is that you die healthier.
At a glance in Alabama. . . Vital Statistics, 2011 DEATHS Oldest Male Decedent: 107 Oldest Female Decedent: 115 BIRTHS Oldest Father: 74 Oldest Mother: 51 MARRIAGE Oldest Groom: 98 Oldest Bride: 94 Greatest Age Difference of Bride & Groom: 52 years DIVORCE Oldest Male Divorcee: 96 Oldest Female Divorcee: 95 Greatest Num. of Previous Marriages for Male Divorcees: 8 for Female Divorcees: 8 Marriage of Longest Duration Ending in Divorce: 57 years http://adph.org/healthstats/assets/AtAGlance2011.pdf
Alabama Vital Statistics (2011) • Live births 59,322 • Deaths 48,318 • During each day there was an average of • 132.4 deaths • 32.6 Heart disease deaths • 27.8 Cancer deaths
Projected PopulationGrowth in Alabama AARP State Profile 2009
Age 65+ in Alabama Age 65-74: 7.8% (US 6.5) Age 75-84: 4.4% (US 4.4) Age 85+: 1.6% (US 1.5) Poverty (2010 data) Below poverty 14.7% (US 11.3) 101-200% poverty 39.0% (US 32.0) Note: For a 1-person household the poverty threshold was less than $11,139 yr. For a 2-person household the threshold was $14,218. Persons 60+ raising grandchildren: 2.1% (US 1.6) www.census.gov
Age 65+ in Alabama Health With self-care limitation 11% (US 9) With Alzheimer’s Disease 15% (US 14) Nursing home resident 65+ 5.1% Residents with dementia 51% Note: For all ages, there were 49,922 nursing facility stays in contrast to 23,588 residents There were over ½ million family caregivers (12.3% of the Alabama population) Data are from http://www.alz.org; www.census.gov
Expectations Regarding Aging A 92 year-old man went to the doctor to get a physical. A few days later the doctor saw the man walking down the street with a gorgeous young lady on his arm. At his follow up visit the doctor talked to the man and said, “You’re really doing great, aren’t you?” The man replied, “Just doing what you said Doctor, ‘Get a hot mamma and be cheerful’.” The Doctor said, “I didn’t say that! I said you’ve got a heart murmur. Be careful!”
Defining “older” • Chronological Age • Functional Age • Subjective Age
When does old age begin? Age 68 was the average response. Women said 70; men 66. http://www.pewsocialtrends.org/2009/06/29/growing-old-in-america-expectations-vs-reality/
Markers of Old Age http://www.pewsocialtrends.org/2009/06/29/growing-old-in-america-expectations-vs-reality/