If you haven’t noticed already, your patient population is aging. Baby Boomers, those adults born between 1946 and 1964, were the largest demographic ever born in the United States, until the Millennials were born between 1981 and 1996. Baby Boomers started turning 65 in 2011 and that is the root cause of the aging of America.
By their sheer numbers as a demographic – 46 million – they have changed services, industries, and consumer trends as they moved through them. As they age, they are single-handedly causing the explosion of assisted living, memory assisted and long-term care facilities. They are consuming more healthcare than previous generations and focused on aging well. They will be arriving at your door in increasing numbers. That is why, unless you are a pediatrician, your patient population is going to be aging significantly in the coming years.
One of the most comprehensive reports on aging in America is Older Americans Key Indicators of Well-Being 2016, issued by the Federal Interagency Forum on Age-Related Statistics (Forum). Comprised of nine federal agencies, the Forum uses data from a dozen different national sources to develop indicators on the well-being of the older population and monitor trends. It is one of the best sources for statistics on the 65+ population in the US.
Here is an overview of the statistics in the report. We’re not to going to comment much because the numbers speak for themselves. Buckle your seatbelt, your patients are aging and fast.
Number of aging people in the US
The 65+ population is growing, but the 85+ population, called the “oldest old”, is exploding.
- In 2014, 46 million people age 65 and over lived in the US, accounting for 15% of the total population.
- The older population grew from 3 million in 1900 to 46 million in 2014.
- The “oldest old” population (age 85+) grew from just over 100,000 in 1900 to 6 million in 2014.
The Baby Boomers population is doubling.
- The number of Baby Boomers 65+ is expected to grow from 35 million to 74 million by 2030, representing nearly 21% of the total US population.
As Baby Boomers age, the oldest old population will expand
- Baby Boomers will move into the 85+ population after 2030.
- The US Census Bureau projects that the population age 85+ could grow from 6 million in 2014 to 20 million by 2060.
Life Expectancy is Growing
- Under current mortality conditions, people who survive to age 65 can expect to live an average of 19.3 more years.
- In 2014, the life expectancy of people who survive to age 85 was 7.0 years for women and 5.9 years for men.
A more detailed look at life expectancy in the US shows that white people live longer until they reach the “oldest old” category and women live longer than men.
- At age 65, white people can expect to live an average of 1.1 years longer than black people.
- For those over the age of 85, black people live 6.9 years longer and white people live 6.5 years longer.
Women live longer than men:
- At age 65, women can expect to live 2.5 years longer than men.
- At age 85, women can expect to live 1.1 years longer than men.
Causes of Mortality
Heart disease continues to be the leading cause of death in people over the age of 65, followed by cancer and other chronic diseases. In 2014 the statistics were as follows:
- Heart disease: 1,062 deaths per 100,000 people
- Cancer: 915 per 100,000
- Chronic lower respiratory diseases: 277 per 100,000
- Stroke: 247 per 100,000
- Alzheimer’s disease: 200 per 100,000
- Diabetes: 119 per 100,000
- Influenza and pneumonia: 97 per 100,000
Death rates for heart disease and stroke were higher among non-Hispanic blacks than among non-Hispanic whites and Hispanics.
The good news is that according to the Forum, “age-adjusted death rates for all causes of death among people age 65 and over declined by 20%”, between 1999 and 2014.
- Death rates declined for heart disease, cancer, chronic lower respiratory disease, stroke, diabetes, and influenza and pneumonia.
- However, death rates for Alzheimer’s disease increased
- Women had higher death rates from Alzheimer’s disease than men; 222 per 100,000 compared with 161 per 100,000
Chronic Health Conditions
Men and women suffer from chronic health conditions at different rates. For example:
- Women reported higher levels of asthma and arthritis than men
- Men reported higher levels of heart disease, cancer, and diabetes than women
Among people aged 65+, there are different rates of chronic disease depending upon race and ethnicity.
- When it comes to hypertension, blacks have higher rates than non-Hispanic whites: 71% compared to 54%
- Blacks have higher rates of diabetes than non-Hispanic whites: 32% compared to 18%
Dementia Rates are Increasing
Dementia creates its own special set of challenges for physicians. It requires finding a way to deliver care to patients whose ability to understand and comply with care plans is impaired. In many instances, it also means communicating with an extended care team that includes family caregivers. As the population ages, you can expect to see more of this complex dynamic.
Although the rate of dementia in the US may be declining, the number of people with the disease may still increase as population numbers increase.
The rate of dementia differs according to age. As people age, the rate of dementia changes according to gender.
- For adults aged 65 to 74: 5% of men have dementia compared with 3% of women
- For adults age 85+: 24% of men have dementia compared with 30% of women
These are the highlights from the report. As you can see, aging in America is not something to be taken lightly. It is going to change the diseases and co-morbidities you see. It is going to change the way you communicate with patients. In short, it is going to alter the make-up of your patient population for decades to come. Knowing about it will allow you to prepare for it and deliver the care your aging patient population requires.