The population of the United States, like that of other industrialized nations, is aging. The US population of adults age ≥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 ≥65 years old 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. 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 is characterized by (1) low burden 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 older adults in developing competence in directing and managing their health and promoting their autonomy and quality of life.
Table 40–1.Factors associated with healthy aging. |Favorite Table|Download (.pdf) Table 40–1. Factors associated with healthy aging.
|“Going and doing” is worthwhile and desirable to the individual |
| Social activities |
| Reading |
| Travel |
| Housework |
| Fishing |
| Creative outlets: eg, music, arts, dance, needlework |
|Sufficient abilities to accomplish valued activities |
| Mobility |
| Vision |
| Cognitive functioning |
| Coping |
| Independence |
|Having appropriate resources to support the activity |
| Valued relationships: friends and family |
| Healthcare and health information |
|Optimistic attitude |
| Self-esteem, self-efficacy, self-confidence |
Although 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. Many chronic conditions commonly affect this population (Table 40–2). The overall health status and well-being of older adults are highly complex and result from many interacting processes, including risk factor exposure (tobacco, alcohol, illicit drugs, diet, sedentary lifestyle, environmental toxins), 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. |Favorite Table|Download (.pdf) Table 40–2. Most common conditions associated with aging.
|Heart disease |
|Hearing loss |
|Orthopedic impairments |
|Chronic sinusitis |
|Diabetes mellitus |
|Visual impairments |
|Urinary incontinence |
|Varicose veins |
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