If we want more evidence-based practice, we need more practice-based evidence.*

Chapter 8

Aging and Health of Older Populations

Table of Contents

OBJECTIVES AND PHILOSOPHY
OVERVIEW
HEADLINES, TIMELINES, & MILESTONES
WEB LINKS AND INFORMATION SOURCES
REFERENCES - since publication of 8th edition
OTHER REFERENCES
DEBATE TOPICS

STUDY QUESTIONS, ACTIVITIES, AND EXERCISES


OBJECTIVES AND PHILOSOPHY

Older people represent a growing proportion of the population of most communities as a result of reduced death rates at younger ages and increased longevity. with growing numbers and proportions, planning and a more important segment of the life span for community and population health planning and a more important political force demanding facilities, services and other health resources. Increasing proportions of the elderly also live in communities without disabling illness, so the planning for their health needs can be addressed more to the health promotion than in the past when most of the attention to the elderly had to be on medical care and nursing care. This chapter attempts to shift the student's focus from viewing old age as a pitiable state and an unhappy phase of life to viewing it as a period when specific community interventions and supports can achieve the prolongation of good health, independent functioning, and enhance quality of life.


OVERVIEW

This chapter concludes Part II of the text, Health Through the Life Span. It reflects the cumulative harvest of successes and failures from previous decades' community health programs for younger ages. The heavy smoking increases of the 1940s, for example, are reflected in the increased lung cancer rates found today in the elderly. The improved smoking, dietary, and blood pressure control statistics of the  middle-age population in the 1970s are showing up as reduced cardiovascular disease and coronary death rates in the elderly. But a new epidemic of obesity is producing increased rates of diabetes and a leveling of the improvements in cardiovascular diseases.

These demographic and epidemiological trends combine with the social and economic forces of recent decades to set the stage for community health approaches for the elderly now. A particular emphasis of this chapter is on the involvement of the elderly in setting their own priorities and in designing their own programs for health promotion. Nowhere is the paternalistic tendency of government and voluntary agency programs more likely to undermine the very purpose of health promotion--to enable people to control the factors influencing their health--than with the elderly. They need to define their own quality-of-life concerns and the want to retain the dignity of caring for themselves as long as possible.


HEADLINES, TIMELINES, & MILESTONES (Since publication of 8th edition)

Even Occasional Exercise Can Extend Life for Older People. July 2, 2004

Reminders Boost Weekly Exercise in Older WomenJuly 14, 2003

Exercise Programs Can Help Sedentary Older Adults.  April 21, 2003

Elderly Pain Complaints Tied More Closely to Life Satisfaction Than HealthMarch 11, 2003

High-Dose Vitamin D Prevents Bone Breaks in Elderly.  (Reuters Health, February 28, 2003) - According to a research team in the United Kingdom, high dose vitamin D supplements could reduce bone fractures in the elderly by 20%.

Newspapers Examine Deteriorating Health Benefits for Retirees.  Feb 13, 2003

Poor Sleep Linked to Earlier Death in Older AdultsFeb. 3, 2003

Expressing Anger May Protect Against Stroke and Heart Disease.  Jan. 31, 2003

Baby Boomer Demand for Long-Term Care Will Occur in 20-30 Years, Study Indicates.
(Los Angeles Times) Jan. 15, 2003

Elderly Dietary Supplement Users May Not Need ThemJan. 14, 2003

Benefits of Exercise Lead to Further Activity in Elderly.  July 23, 2002

WHO Launches Project to Support Africa's Elderly  SENEGAL. (Panafrican News Agency - May 26, 1999) The team leader of WHO's program on "Aging and Health" (AHE), Dr. Alexandre Kalache, said the project  will, among other things, involve the collection and analysis of relevant data from Ghana, Tanzania, South Africa and Nigeria.

Panel Stumped On Medicare Overhaul. WASHINGTON (AP, Mar. 10, 1999)  Is restructuring Medicare  enough, or will more money be needed to provide adequate health care for growing numbers of elderly Americans? A commission that is supposed to recommend Medicare changes has so far been unable to resolve that question and other serious differences delaying its report to Congress and President Clinton. "We are not in agreement yet and it remains quite doubtful that we will be," said commission member Stuart Altman, a health policy professor at Brandeis University in Waltham, Mass. Both Republican congressional leaders and the president have said they'd prefer not to resort to tax increases to bolster Medicare. But Clinton has suggested using federal budget surpluses that are expected in coming years.

No Alzheimer's Fillings Link Found LEXINGTON (AP, Feb. 8, 1999)  There appears to be no link between Alzheimer's disease and mercury used in dental fillings, say University of Kentucky researchers. Such a link has been speculated on in the past, as scientists took closer looks at the effects of heavy metals on the brain. But the University of Kentucky study said there appears to be no harm from mercury fillings. "Although very small amounts of mercury are released from dental amalgam - generally when rubbed or abraded due to brushing or eating - it is not taken up by the brain," said Dr. Stanley Saxe, one of the authors of the study published in Monday's (Feb. 8, 1999) Journal of the American Dental Association.

Study Refutes Hypertension Research. CHICAGO (AP, Feb. 5, 1999) Contrary to previous research, a new study found no direct link between high blood pressure and a decline in thinking ability as people age. "I'd hoped to find a really compelling relationship here, but...we just have very little information about what people can do to protect (themselves) from loss of their cognitive function," said the lead researcher, Dr. Robert J. Glynn of Brigham and Women's Hospital in Boston. He emphasized that controlling blood pressure is still vital to prevent heart disease and strokes, and that hypertension is often under-treated in the elderly.

For archives of related news stories, please click here. 


WEB PAGES AND INFORMATION SOURCES

Aging Initiative of the Bureau of Primary Health Care, Health Resources and Services Administration

http://bphc.hrsa.gov/Aging/

 

American Association of Retired Persons (AARP)   http://www.aarp.org

 

Arthritis Foundation   http://www.arthritis.org

 

WHO/OMS Aging and Health web site   http://www.who.int/hpr/ageing/index.htm

 

Administration on Aging   http://www.aoa.gov

Seniors Participatory and Community Quality of Life Projects:
http://www.utoronto.ca/qol and http://www.utoronto.ca/seniors

Living options for seniors                                         

http://www2.seniorcareweb.com/senior/livingoptions/                           http://www.cals.cornell.edu/dept/cardi/publications/innov/in1292-4.html

Social Security Administration - updates, information, services, research, questions, etc.  http://www.ssa.gov

Information on building retirement income, managed health care, trends, etc. in Canada: http://www.benefitscanada.com

United Nations Program on Ageing, Division for Social Policy Development
http://www.un.org/esa/socdev/ageing/index.html

Health Canada Division of Aging and Seniors  

US Census Bureau Population Projections   http://www.census.gov/population/www/projections/popproj.html

NIH Senior Health http://nihseniorhealth.gov/talkingwithyourdoctor/planningyourdoctorvisit/01.html 

Health for Seniors https://www.usa.gov/health 

22 Senior Health Risk Calculators for Healthy Aging http://www.calculators.org/health/aging.php 

Cats and Seniors http://www.americanhumane.org/animals/adoption-pet-care/cat-behavior/cats-and-seniors.html 

Canine Caregivers for Alzheimer’s and Dementia Patients https://www.rover.com/canine-caregivers-dementia-alzheimers/ 

Pets for the Elderly Foundation http://www.petsfortheelderly.org/ 

Older Adults & Anxiety http://www.adaa.org/living-with-anxiety/older-adults 

Seniors & Drugs - NCADD https://ncadd.org/learn-about-drugs/seniors-vets-and-women/241-older-adults 

Ultimate Guide to Rehab & Medicare https://www.discoveryplace.info/rehab-medicare-ultimate-guide 

Assisted Living Regulation and Laws http://www.alfa.org/alfa/ALFA_in_Your_State.asp 

Aging in Place http://ageinplace.com/ 

Senior-Friendly Home Remodeling http://www.homeadvisor.com/article.show.Senior-Friendly-Remodeling.8317.html 

A Guide to Helping Senior Citizens Stay Safe at Home https://www.goodcall.com/home/guide-helping-senior-citizens-stay-safe-home-2/ 

Stop Fraud http://www.stopfraud.gov/protect-yourself.html 

National Center on Elder Abuse http://www.ncea.aoa.gov/ 

Considerations for Older Travelers http://travel.state.gov/content/passports/english/go/older-traveler.html

Tips for Senior Travelers in Southeast Asia http://www.frommers.com/destinations/southeast-asia/640209 

Tips for Senior Travelers to Morocco https://www.journeybeyondtravel.com/news/morocco-travel/tips-senior-travelers-morocco.html 


REFERENCES (Since Publication of the 8th Edition)

[Click on highlighted titles for abstract or full text of articles]

Boyle JP, Honeycutt AA, Narayan KMV, et al. (2001). Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the US. Diabetes Care 2001;24:1936--40.

Connell, C. M. (1999). Older adults In health education research: some recommendations. Health Education Research 14(3): 427-31.

Hoenig H, Taylor DH Jr, Sloan FA. (2003). Does assistive technology substitute for personal assistnace among the disabled elderly? American Journal of Public Health 93(2): 330-7.

Hubert H, Bloch D, Oehlert J, Fries J. (2002). Lifestyle habits and compression of morbidity. Journal of Gerontology: Medical Sciences 2002;57A:347--51.

Jacobzone S. (2000). Coping with aging: international challenges. Health Affairs 19:213-25.

Levit K, Smith C, Cowan C, Lazenby H, Sensenig A, Catlin A. (2003). Trends in U.S. health care spending, 2001. Health Affairs 22:154-64. For similar report on previous year, click on: 2000.

Liao, Y. L., McGee, D. L., Cao, G. C., Cooper, R. S. (1999). Black-White differences In disability And morbidity In the last years of life. American Journal of Epidemiology 149 (12): 1097-1103.

Moyer, A., Coristine, M., MacLean, L., & Meyer, M. (1999). A Model For Building Collective Capacity In Community-Based Programs: The Elderly In Need Project. Public Health Nursing 16 (3): 205-214.
    ABSTRACT: As the focus of health promotion moves from individuals to organizations, communities and broader social policy, the models that guide public health program planning and development need reexamination. Public health nurses are gaining experience in strengthening and supporting the ability of communities to grow and change. This study aimed to illuminate the process. Data, gathered as part of an action research project to develop individual and community-based strategies to decrease isolation in frail older adults, provided a rich source of qualitative data. Analysis was directed toward identifying the factors and processes of capacity-building. The emerging model was clarified and partially validated with academics and practitioners from health promotion programs across the age span. Four stages of building collective capacity were identified: identifying common ground, working cooperatively, working in partnership, and working across the community. At each stage, processes of relationship building, project management and capacity-building resulted in stage specific products. A model of building collective capacity, grounded in community health practice and supported by the Literature provides a base for developing practice indicators, and practice guidelines which will strengthen the ability to reach health goals.  See also: J Clin Nurs. 1999 Jan;8(1):103-11.

Ryan, A. A. (1999). Medication compliance and older people: a review of the literature.  International Journal of Nursing Studies  36 (2): 153-162.

Sloan, F. A., Taylor, D. H. Jr, & Picone, G. (1999). Costs And outcomes of hip fracture and stroke, 1984 to 1994. American Journal of Public Health  89 (6): 935-937.
 

Wilkins, K., Parsons, G. F., Gentleman, J. F., & Forbes, W. F. (1999). Deaths Due To Dementia: An Analysis Of Multiple-Cause-Of-Death Data. Chronic Disease in Canada 20 (1): 26-35.
 

OTHER REFERENCES

MMWR Series on Public Health and Aging.   Morbidity and Mortality Weekly Report 52 (6), February 14, 2003.

Trends in Aging --- United States and Worldwide.  Morbidity and Mortality Weekly Report 52 (6), February 14, 2003.

Symptoms of Arthritis and Chronic Joint Systems in Adults, US, 2001. MMWR 51 (43), October 25, 2002.


IHPR homeReturn to Community & Population Health Home Page
Back to topReturn to the top of this page