Trends and Issuesin Aging

Megan Shaw

CSULB

October 14, 2010REC 573

What is a TREND?

An inclination A general movement A line of development

What are some trends in aging?

Rapid growth of 65+ Baby Boomers (turning 65 next year)

High concentration of older adults in Florida, California, Arizona, Texas, and North Carolina due to aging in place and migration

More Trends in Aging

Declining retirement age (may be reversing)

Even if reversing, increase in years spent in retirement

Increases in life expectancy

Trends Continued

Number of Alzheimer’s cases will increase, but incidence may decrease due to scientific advances

Larger proportion of mild Alzheimer’s due to drugs that slow the progression

Increase in chronic conditions Increase in obesity

Trends Continued

Sex ratio skewed towards women in later years

Greater ethnic diversity Increasing education level Increasing economic disparities among

ethnicities Married older adults declining Compression of morbidity

Activity

Write down what age you expect to retire at or what age you would like to retire at

Now..

Write down your life expectancy

Expectation of Life:United States, 2006

Men Women

75.1 80.2

MATH!

Subtract your age of retirement from your life expectancy

EX: 80.2 – 62 = 18.2 (Life Expectancy)-(Retirement Age)

•Notice that there is a considerable amount of time between your retirement age and the end of life

•What does this mean for older adults?

Evolution of Life Expectancy at Age 65 in the U.S. by sex: 1950-2003

Increasing Time Between Retirement and Death

Trend: Compression of Morbidity

Life expectancy has risen, but how much of life will be lived free of severe disability?

James Fries: Compression of Morbidity– The onset of chronic, irreversible illness will be delayed toward the end

of life so morbidity (severe disability) is compressed into a shorter period before death

1980s & 1990s: Started the DECLINE in people 65+ that had impaired ADLs and IADLs

Rectangularization

The Compression of Morbidity theory shows rectangular disability curves, with a longer period without disability and then a steeper decline

Aiming for Compression

Many of the studies done on the COM theory use exercise as a tool for testing the theory

The way to achieve a COM is by preventing disease and disability: exercise is an obvious variable that would prevent or delay morbidity

For example, Fries did a study where he compared a physically active group against a control group in the community

– GOAL: find out if running deferred the onset of disability, or caused injury to joints and other structures that resulted in accelerated disability

Progression of Disability

Disability Level by Age

Fries

The study confirmed that physical activity, in this case running, deferred the onset of disability

Therefore, this supported the COM theory

Limitations

Every theory has its limitations The Compression of Morbidity theory is

limited by social class and education level Several studies done on the COM theory

have shown that there is a “rectangularization” of the disability curve, however, this shift is not as evident in the lower socioeconomic population

What does COM mean for older adults?

If people are living longer and they are free from severe disability until the very end of life, they will be active and needing something to do between retirement and death

Retirement age has been decreasing, as previously mentioned

Even if this trend is reversing, time between age of retirement and death will remain at least constant because life expectancy is increasing

More Time for Leisure

As we saw during the activity, after retirement the Compression of Morbidity theory shows that there will be a substantial period of time before morbidity occurs

This leaves time for leisure!

Conclusion

The trend of morbidity being pushed further and further back into the later years of life has profound significance for older adults, and leisure is just one part of that

Leisure time can be meaningful for older adults because they are free to do things that they find pleasure in without the constraints of a daily job and family to raise

The Compression of Morbidity theory provides a framework for looking at later life with the expectation that much time will be spent with the ability to continue to do what we choose, which is one of the best parts of getting older

References

Cai, L., & Lubitz, J. (2007). Was there compression of disability for older Americans from 1992 to 2003? Demography, 44(3), 479-495.

Fries, J. F. (1996). Physical activity, the compression of morbidity, and the health of the elderly. Journal of the Royal Society of Medicine 89, 64-68.

Kinsella, Kevn, & He, W. (2009). U.S. Census Bureau, international population reports, P95/09-1. An Aging World: 2008. U.S. Government Printing Office: Washington, DC.

Parker, M. G, & Thorslund, M. (2007). Health trends in the elderly population: Getting better and getting worse. The Gerontologist, 47(2), 150-158.

Wilmoth, J., & Longino Jr., C. (2006). Demographic trends that will shape U.S. policy in the twenty-first century. Research on Aging, 28(3), 269-288.