Table 3.2 summarizes population information by age and ethnic group (white, black, and Hispanic). In 1986, about 89% of seniors and about 80% of non-seniors were white. The white population has a higher proportion of seniors than other ethnic groups (13% versus 8% and 5% for black and Hispanic populations, respectively) and a higher proportion of seniors (i.e., people aged 75 and older). The proportion of older persons belonging to minorities is expected to increase significantly over the next decade (Special Committee on Ageing, 1987-1988). The U.S. will see continued growth in the overall population and senior population, especially in the older age groups. Between 2000 and 2040, the baby boom generation will be 65 years old, and with it the demands placed on the health insurance program and the long-term care system. WHO is carrying out this work in line with the Global Strategy and Plan of Action on Ageing and Health 2016–2020 and the United Nations Decade on Healthy Ageing 2021–2030 in the following four areas of action: Wealth accounts for about 26% of the income of older persons. Other sources of income for seniors include wages (17% of total income), pensions (16%) and other sources (2%).
The support rate of seniors is defined as the ratio of people aged 65 and over to working-age people aged 18 to 64. Due to longer life expectancy and reduced family size, the ratio of seniors to working-age individuals is increasing significantly. In 1900, there were about 7 elderly persons for every 100 persons of working age; In 1986, the ratio was about 20 per cent. This ratio is projected to reach 37 older persons per 100 working-age persons by 2030 (Special Committee on Aging, 1987-1988). The support rate of older people is important in economic terms, as the labour force can be seen as supporting inactive age groups, although raising the retirement age may mitigate the economic impact somewhat. The vast majority of seniors (95%) live in the community. Of this group, 54% live with a spouse, nearly 30% live alone, and the remaining 16% share a home with children, other relatives or friends. Along with widowhood, the proportion of seniors living alone increases with age. For example, about 24% of people aged 65 to 74 live alone; The figures for 75-84 year olds and for those over 85 are 39 and 45% respectively. The poverty rate for seniors would be higher than it is today if poverty standards were the same for seniors and non-seniors. In this case, the proportion of poor older persons would increase from about 13 per cent to about 15.2 per cent of the total group of older persons. At this stage, the poverty rate of the elderly would be higher than that of the population as a whole (Villers Foundation, 1987).
Several aspects are essential to studies of healthy aging. Medical research should focus not only on diseases, but also on changes before and after the onset of a disease that can help prevent these processes and increase the intrinsic capacity of older adults. Clinical trials need to determine how older adults with multimorbidities respond to different drugs and interventions. In addition, treatment outcomes should be evaluated not only in terms of disease markers, but also in terms of intrinsic capacity. The ratio of women to men in the elderly population will continue to increase. In addition, older women have, on average, a higher prevalence of restrictions in activities of daily living, visit doctors more often, and use hospital and nursing home care more frequently than men. These trends have a significant impact on the medicare program and the demands of the long-term care system. By 2030, 1 in 6 people worldwide will be 60 years of age or older. Currently, the proportion of the population aged 60 and over will increase from 1 billion in 2020 to 1.4 billion. By 2050, the world`s population of people aged 60 and over will double (2.1 billion). The number of people aged 80 and over is expected to triple between 2020 and 2050, reaching 426 million. Neglect, abuse and violence against older persons occur in all social, economic, ethnic and geographical areas.
Age discrimination is defined as stereotyping and discrimination against individuals or groups based on their age. One of the fundamental measures to promote healthy practices is to combat age discrimination. Negative attitudes and assumptions about older adults can influence individual behaviour, social values and norms. Laws to protect against direct or indirect discrimination on the basis of age must be adopted [[38], [39], [40]]. The media should strive to present a balanced picture of aging, not conceptualize older adults as a burden, and move away from unrealistic assumptions that today`s older adults can somehow avoid health problems on their own without support. Most of these services are not covered by Medicare, and a significant number of non-institutionalized people who need such services do not receive them. Of the elderly in need of care living in the community in 1985, almost 74% received all their care from informal caregivers; only a small percentage depended solely on formal sources of supply of the type mentioned above (Scanlon, 1988). The top ten causes of death in the United States have changed since 1900, with the most notable change being the shift from infectious to non-infectious diseases.
Today, heart disease, cancer, cerebrovascular disease and stroke are the top three causes of death among the elderly; Two out of three people die from one of these conditions. The stroke mortality rate has declined over the past 30 years, likely due to better hypertension control and better diagnosis, treatment and rehabilitation of stroke victims. The death rate from heart disease has also declined in recent decades, but the death rate from cancer has increased. The fifth element of the Global Strategy is to improve the monitoring, monitoring and study of healthy ageing. Effective methods and indicators to assess these exponents are needed to understand satisfactorily and correctly the health problems of older people. Modern and effective measures are needed to assess the health problems of older people and improve the current situation. The main activities are to develop agreed methods for measuring, analysing, describing and monitoring healthy ageing and to develop opportunities for scientific research on this topic. In addition, evidence of healthy aging should be collected and submitted. Depression is the most common psychiatric disorder in older adults; It is more common than all forms of dementia and psychosis (Frengley, 1987).
Symptoms of depression have been reported in up to 15% of community residents (Special Committee on Aging, 1987-1988). However, this rate can be misleading because it represents primary depression or depression that occurs for reasons other than physical causes or medication side effects, rather than secondary depression due to illness or medication side effects. Older adults have a higher risk of secondary depression than any other age group. Older persons are more dependent on social security for their income than on any other source of income, and social security is becoming an increasingly important component of older persons` income, while other sources are becoming less important (Figure 3.1). In 1986, 38 per cent of the income of the elderly came from social security; For 31% of older people, social security accounts for at least 80% of their income. Until now, economic evaluations that examine whether integrated care interventions can achieve value for money have become increasingly common, but systematic reviews or meta-analyses are generally inconclusive. The explanation for this indecision lies in the different definitions and components of integrated care in the studies as well as in the methodological quality of the assessments. Although the average economic well-being of older persons has improved considerably in recent decades, the incomes of older persons remain lower on average. than those of non-elderly persons. In addition, there are large differences between subgroups of the older population in terms of economic well-being. Again, these factors affect health, demand for care, and ability to pay for care out of pocket. Traditionally, the term “seniors” refers to people 65 years of age and older.
According to this definition, there were just over 30 million seniors in the United States in 1987, or more than 12% of the total U.S. population of nearly 252 million (Table 3.1). This group makes up the vast majority, nearly 96%, of Medicare beneficiaries.1 More than four in five seniors have at least one chronic disease, and many have several, although these conditions do not necessarily limit important daily activities. The most common chronic diseases (expressed in terms of morbidity of these diseases) among seniors include arthritis, hypertension, hearing loss, and heart disease (Table 3.15). In 1985, 80% of seniors who needed assistance with activities of daily living (ADLs) lived at home. Women were 2:1 in the majority of males in this population (GAO, 1988). Health services are generally focused on the treatment of acute illnesses. With age, health problems become chronic, and the coexistence of many complaints and diseases is not uncommon. With age, physical, sensory, and cognitive impairments are more common, and disorders such as urinary incontinence, frailty, and an increased risk of falling can lead to loss of functionality.[33] .