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AGING AND GERIATRIC CARE
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DEMOGRAPHICS OF AGING AND ITS IMPLICATIONS FOR GERIATRIC CARE
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The United States and other countries will continue to experience a rapid increase in the number of older adults who seek health care. The most rapidly growing segment of the population in the United States and many other developed countries is those older than 80 (Fig. 477-1). According to the United Nations 2019 Aging Report, 1 in 6 people in the world will be 65 years old or older by the year 2050. Gender composition of the aging population around the world is also expected to change. Although females outlive males, an improvement in survival of the oldest-old males could result in more balanced gender distribution in the geriatric population in the future.
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Based on the previously mentioned United Nations report, in high-income countries, consumption of health care resources will be most affected by the shift in the age distribution of the population over the next several decades. The World Health Organization continues to work actively to raise awareness of the changes necessary in current health care systems beyond increments in their budgets. Planning is increasingly being based on expected levels of disability and comorbidity. As life span increases, efforts should continue to focus on promoting healthy aging to reduce the burden of disability in health care systems all over the world.
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IMPLICATIONS OF THE AGING POPULATION FOR HEALTH CARE SYSTEMS AND SYSTEM-BASED PRACTICE
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The geriatric population requires different approaches to care for several reasons. For any variable that can be measured in humans, the range of variation increases with age. The wide variations seen in aging make it difficult to develop age-related guidelines for diagnosis and treatment. For example, acute illnesses are most often not treated in isolation, but in the context of multiple comorbidities. Close to half of those older than 80 have three chronic conditions, and about one-third have four or more chronic conditions (Fig. 477-2). Functional disabilities are prevalent (Fig. 477-3), which require careful attention in the evaluation of the older patient, along with assessment of social supports available for assistance when needed for independent and safe living.
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