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The population of the United States, similar to that of other industrialized nations, is aging. The US population of adults aged ≥65 years increased at a faster rate (15.1%) between 2000 and 2010 than did the total US population (9.7%). Between the years 2010 and 2050, the number of Americans aged ≥65 years is projected to have doubled. In the rapidly changing arena of healthcare 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 essential. This chapter defines successful and healthy aging, highlights recommendations for health promotion and disease prevention, and describes key elements in geriatric assessment.

Aging is a physiologic 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 40-1). Healthcare 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.

Table 40–1.Factors associated with healthy aging.

While there are common physiologic changes associated with aging, the geriatric population is a highly heterogeneous group with varying degrees of chronic disease, and physical and cognitive disability within individuals. A number of chronic conditions commonly affect this population (Table 40-2). The overall health status and well-being of older adults is highly complex and results from many interacting processes, including risk factor exposure (tobacco, alcohol, drugs, diet, sedentary lifestyle), biological age-related changes, and the development and consequences of functional impairments. Many of the conditions previously considered “normal aging” are now known to be modifiable or even preventable with appropriate disease prevention and health promotion strategies.

Table 40–2.Most common conditions associated with aging.
Bryant  LL  et al.. In their own ...

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