Friday, March 9, 2018

GERIATRICS: PHYSICAL THERAPY IN THE AGING

The United States population is rapidly aging. By 2030, the number of Americans aged 65 and older will more than double to 71 million older Americans, comprising roughly 20 percent of the U.S. population. In some states, fully a quarter of the population will be aged 65 and older. An enhanced focus on promoting and preserving the health of older adults is essential if we are to effectively address the health and economic challenges of an aging society. The cost of providing health care for an older American is three to five times greater than the cost for someone younger than 65. By 2030, the nation’s health care spending is projected to increase by 25% due to demographic shifts unless improving and preserving the health of older adults is more actively addressed.

Resources:  Administration on Aging and American Psychological Association

1.            According to the Administration on Aging:” In 1985, according to the National Nursing Home Survey, at ages 65 and over, the percent of the population in nursing homes was only 5 percent, but for ages 85 and over, the figure was 22 percent A wide gap of this magnitude is likely to continue for the indefinite future. The very high concentration of women in nursing homes, with increasing proportions of women in older age groups as age increases, is also likely to continue, if only because of the continuation of the difference in mortality between the sexes.”

2.      All senses dull with age.  Starting at age 30, especially taste and smell

3.       About 11% (3.7 million) of older Medicare enrollees received personal care from a paid or unpaid source in 1999.
4.       Vital capacity and forced vital capacity decline starting at age 30

5.       According to  the American Psychological Association, overall prevalence of mental disorders in older adults is less than in any other age group, and general life satisfaction among older Americans is as good as, if not better, than any other age group.

6.       Muscle strength declines, studies vary, from 15 to 46%

7.            Only 28.2% of females 75 and older live with their spouses.
8.            Old drivers have fewer accidents per person, probably because they drive fewer miles.

9.            In most jobs, elders are as fast as  younger, except when reaction time is important.  Even then, accuracy makes up for loss of speed.  Also, there is less absenteeism, fewer accidents, less job turnover. Strength, reaction time, etc are much better in active elders than in sedentary ones.

10.          Limitations on activities because of chronic conditions increase with age. In 1996, over one-third (36.3%) of older persons reported they were limited by chronic conditions. Among all elderly, (10.5%) were unable to carry on a major activity. In contrast, only 10.3% of the population under 65 years old were limited in their activities, and only 3.5% were unable to carry on a major activity.

11.          Attitudes and adjustments change along with the rest of society, but at a slower rate than younger persons.

12.          Older persons take longer to learn something new, e.g. longer to learn a new job.

13.          Although slower, elders can learn the same new things as younger persons.

14.          Reaction times slow with age, especially if inactive.

15.          There is no difference in variability in things like amount of happiness, intelligence, illness, etc.

16.          Only 17% of elders are bored, and 66% say they were never bored during the past week.

17.          Most are not socially isolated or lonely.  Two-thirds are never or hardly ever lonely.  Churches, organizations, friends occupy time.  Women long outlive men, creating a disparity (see below).

18.          Elders have fewer accidents than younger persons.  In factories, they have about one-half as many as those under 30.

19.          In 1975, 10 % were over 65.  This is increasing dramatically because of lower birth rates, longer lifetimes.

20.          Most health care practitioners believe negative stereotypes about aged, would prefer to work with younger persons.

21.               10.5 % of aged are under poverty level.  Most are comfortably well off.
The median net worth (assets minus liabilities) of older households ($86,300), including those 75+ years ($77,700), was well above the U.S. average ($37,600) in 1993. Net worth was below $10,000 for 16% of older households but was above $250,000 for 17%.
The 1998 poverty rate for persons 65+ was 10.5%, no change from 1997, and the same as the rate for persons 18-64. Another 2.1 million or 6.3% of the elderly were classified as "near-poor" (income between the poverty level and 125% of this level). In total, one of every six (17.0%) older persons was poor or near-poor in 1998.

22.               Many do volunteering, etc. About 3.7 million older Americans (12%) were in the labor force (working or actively seeking work) in 1998, including 2.2 million men (16%) and 1.6 million women (8%)

23.          Older persons don't become more religious.  They were more religious even when younger than the present-day younger generation.

24.               50% are seldom or never angry at 65.  This rises to two- thirds of those over 80.

25.               Gaps between health and socioeconomic status of older persons compared to younger persons are closing. 

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