gerontological concepts pat mezinskis april 2008

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Gerontological Concepts

Pat MezinskisApril 2008

Terms

Geriatrics

Gerontology

Chronologic Categories

young-old 65-74 years (53%) middle-old 75-84 years (35%) old-old 85 years and older

(12%)

Demographics of Aging

Major demographic shifts have occurred in the U.S. in the 20th century

Population over 65: 1900 4% (3.1million) 2004 12.4% (36.3 million)Projected: 2030 20% (71.5 million)

Demographics of Aging

Demographics of Aging

Population 85 and older: 2000 2% (4 million)Projected: 2050 5% (19 million)

Demographics of Aging

Population 100 and older: 1990                   37,306

centenarians 2003                   50,639

centenariansProjected: 2030 381,000

centenarians

Demographics of Aging

Life Expectancy: 1900 47 years 2004 77.9 years

For those reaching 65, they have a

life expectancy of an additional 18.5 years

Demographics of Aging

Gender 2004

Women 21.2 million Men 15.2 million

Ratio 139 women/100 men

Demographics of Aging

Race 2006-19% minorities

8.3% African Americans 6.4% Hispanics 3.1% Asian or Pacific Islanders < 1% American Indian or Native

Alaskan

Demographics of Aging

Marital Status 2006

72% of older men married 42% of older women married 43% of older women widows over 4 times as many widows as

widowers 11.8% of the older population divorced

Demographics of Aging

Living Arrangements 2006

over half of non-institutionalized older adults lived with a spouse

30% of non-institutionalized older adults lived alone

in women over 75, half lived alone

Demographics of Aging

Living Arrangements Nursing Home Population

65-74 years 1% 75-84 years 4.4% over 85 15.4%

Demographics of Aging

California Florida New York Texas Pennsylvania

Ohio Illinois Michigan New Jersey

Geographic Distribution in 200651 % of the population lived in 9 states:

Demographics of Aging

Employment 2006

15.4% (5.5 million) Americans 65 and over were in the labor force

3.1 million men, 2.4 million women

Demographics of Aging

Education 1970-2006

high school grads increased from 28% to 77.5%

2006 19% had a bachelor’s degree or more

Demographics of AgingComputer and internet access: 2000 & 2003

Health Care

80% of older adults have at least one chronic illness

Older adults spent $4,331 in out-of-pocket expenses in contrast to the total population- $2,766

Older adults spent 12.4% of total expenditures on health vs. 5.7% for all consumers

Most Common Chronic Illnesses in those over 65, as of 2005

Hypertension 48% Arthritis 47%

Heart disease 29%

Cancer 20% Diabetes 16%

Sensory Changes

Skin Decreased subcutaneous fat >fragile

skin Decreased sebaceous gland

activity>dry skin Decreased vascularity of

dermis>decreased body temperature regulation

Sensory Changes Vision

Decreased elasticity of lens>presbyopia (diminished ability to focus on near objects)

Decrease in pupil size>slower responses to changes in light

Atrophy of photoreceptor cells, ciliary muscle>diminished depth perception, sensitivity to glare

Thinning of retinal blood vessels>altered color perception

Sensory Changes

Vision (Pathologic Conditions) Cataracts: Leading cause of visual

impairment in older adults- due to opacity of the lens. Vision becomes blurred

Macular Degeneration: damage to the macula, causing gradual loss of central vision

Glaucoma: damage to optic nerve leading to loss of peripheral vision

Sensory Changes

Hearing Hardened ossicles, stiff muscles>

impaired sound conduction Loss of cochlear neurons, decreased

blood supply>presbycusis (diminished ability to hear high-pitched sounds, especially in the presence of background noise

Sensory Changes

Smell Atrophy of olfactory

bulbs>diminished sense of smell Taste

Reduction in taste buds>reduced taste sensation

Ageism

Term coined by Robert Butler in 1968

Wrote Why Survive? Being Old in America (1975)

Myths about Aging

“To be old is to be sick” Facts

Only 4-5% of older adults live in nursing homes

Only 23% of elderly claim to have disability

Myths about Aging

“You can’t teach an old dog new tricks”

Facts The less people are challenged, the

less they perform Conditions of successful learning are

different for older people than for the young

Myths about Aging

“The horse is out of the barn” Facts

Bad habits do not produce irreparable damage

It is never too late to start good lifestyle habits of diet, exercise

Myths about Aging

“The secret to successful aging is to choose your parents wisely”

Fact Heredity is a factor but environment

and behavior strongly influence how well an elderly person functions

Myths about Aging

“The elderly don’t pull their own weight”

Facts The belief that the elderly are

unproductive is changing

Myths about Aging

“Ageism is endemic to all societies”

Facts Many eastern cultures revere their

older adults

Myths about Aging

“In today’s society, families can no longer care for older adults”

Facts In the US, 70-80% of the in-home care

of older adults is provided by families

Myths about Aging

“Dementia is a normal part of aging”

Facts Dementia is a syndrome characterized by

pathologic changes in the brain Alzheimer’s Disease accounts for 50-70% of all

dementias

Statistical data compiled from

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