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The population of the United States, like that of other industrialized nations, is aging. This rapid growth is evident with the aging of the "baby boomers" born between 1946 and 1964 who will begin turning 65 in 2011. The aging population is also heterogeneous with individuals expressing the poorest health often identified as 'frail" or "at risk" elders.

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In the rapidly changing fields of health care financing and delivery, services that promote or improve functional abilities, prevent or delay disease progression, and improve the overall health status of this aging population are needed. Little information and evidence are available about what constitutes the best practices in health promotion, prevention, and counseling for older adults. This chapter defines successful and healthy aging, provides recommendations for prevention and health promotion, and describes how to assess for at-risk elders.

Federal Interagency Forum on Aging-Related Statistics: Older Americans 2008: Key Indicator of Well-being. Federal Inter-Agency Forum on Aging-Related Statistics. Government Printing Office, 2008. Available at: http://www.agingstats.gov/agingstatsdotnet/main_site/default.aspx.

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In a highly heterogeneous population, some individuals are ravaged early by a multitude of chronic conditions and disabilities, whereas others appear to have excellent health and a high level of functioning. Aging is a process, and the term healthy aging does not imply an absence of limitations, but rather an adaptation to the changes associated with the aging process that is acceptable to the individual. Successful or healthy aging appears to include three factors: (1) low probability of disease and disability, (2) higher cognitive and physical functioning, and (3) an active engagement with life. (Table 39-1). Health care providers can promote healthy aging by assisting the older adult in developing competence in directing and managing future roles, thereby maintaining autonomy and a sense of self-worth.

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Table 39-1. Factors Associated with Healthy Aging. 
Bryant LL et al: In their own words: a model of healthy aging. Soc Sci Med 2001;53:927.  [PubMed: 11522138]
Kyle L: A concept analysis of healthy aging. Nurs Forum 2005; 40:45.

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Most older adults are healthy and independent, and contribute to the society in which they live. The epidemiology of aging evaluates not only the demographic changes associated with aging but also those diseases and conditions causing excess morbidity, mortality, disability, and decline in independent function. Many epidemiologic studies on aging focus on prevention in an ...

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