Nearly 56 million Americans are 65 and older, with projections estimating that the population of older adults will grow to 94.7 million in 2060.1 On average, a 65-year old can expect to live another 17 years.2 For most older adults, good health ensures independence, security, and productivity as they age. Unfortunately, millions struggle every day with challenges such as chronic diseases, falls, physical inactivity, oral health concerns, and behavioral health issues—all of which can severely impact quality of life.

Chronic Diseases

  • Older adults are disproportionately affected by chronic conditions, such as diabetes, arthritis, and heart disease. Nearly 95% have at least one chronic condition, and nearly 80% of have two or more.3
  • The leading causes of death among older adults in the U.S. are heart disease, cancer, COVID-19, stroke, chronic lower respiratory diseases, Alzheimer’s disease, and diabetes.4
  • Chronic diseases can limit a person’s ability to perform daily activities, cause them to lose their independence, and result in the need for institutional care, in-home caregivers, or other long-term services and supports.5
  • Multiple chronic diseases account for two-thirds of all health care costs5 and 93% of Medicare spending.6 Yet, less than 3% of U.S. health care dollars is spent on prevention to improve overall health.7

Falls

  • More than one out of four older adults falls each year.8
  • 3 million adults 65+ are treated in emergency departments for unintentional fall injuries each year.8a
  • As a result of falls, every 11 seconds, an older adult is treated in the emergency room; every 19 minutes, an older adult dies.9
  • Falls are the leading cause of fatal and nonfatal injuries among older adults, causing hip fractures, head trauma, and death.9
  • Older adults are hospitalized for fall-related injuries five times more often than for injuries from other causes.9
  • Between 2000 and 2020, rates of deadly falls increased for all older adults, with the greatest increase among those age 85 and older. For adults 85+, the rate tripled among women from 99.2 per 100,000 population in 2000 to 269.8 in 2020 and doubled among men from 145.4 in 2000 to 329.6 in 2020.8a
  • The nation spends $50 billion a year treating older adults for the effects of falls, 75% of which is paid for by Medicare and Medicaid.10 If falls rates are not reduced, direct treatment costs are projected to reach $101 billion by 2030.11
  • Fear of falling can lead older adults to limit their activities, which can result in more falls, further physical decline, depression, and social isolation.12, 13

Physical Activity

  • Regular exercise can help older adults stay independent and prevent many health problems that come with age. According to the 2018 Physical Activity Guidelines for Americans, older adults should do two types of physical activities each week to improve their health—aerobic and muscle-strengthening.14
  • These guidelines recommend that older adults engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous aerobic activity a week and muscle strengthening activities on two or more days a week.14
  • A 2014 study found that 28% of adults aged 50 and over surveyed reported no physical activity, aside from their regular job, over the past month.15

Oral Health

  • Oral health is important for overall health and well-being, but 35% of older adults have not seen a dentist in the last year.16 
  • About 17% of older adults no longer have any natural teeth.17
  • Of those with teeth, about 16% of older adults have untreated tooth decay,17 and over 70% have periodontal (gum) disease.18
  • Poor oral health can negatively impact nutrition and proper management of chronic conditions.

Behavioral Health

  • One in four older adults experiences a behavioral health problem such as depression, anxiety, or substance abuse.19
  • These problems can complicate the treatment of other medical conditions, reduce quality of life, increase use of health care services, and lead to premature death.19
  • In 2020, nearly 14,500 people 60+ died by suicide. Men aged 85+ have a suicide rate that is about four times higher than the rate for all ages.20
  • Excessive alcohol use accounts for more than 23,000 deaths among older Americans each year.21
  • Depression and other behavioral health problems are not a normal part of aging and can be treated. Despite the availability of effective interventions, 66% of older adults are not receiving the care they need.22

Infectious Disease Prevention

  • More than nine in 10 deaths from COVID were among people 50 and over in 2020-2023, and 70-85% of seasonal flu-related deaths occur in adults 65+, according to the U.S. Centers for Disease Control and Prevention.23,24
  • While lifesaving vaccines are available, research shows COVID vaccine uptake has slowed among older adults.
  • New research shows that older adults may be at a higher risk of Long COVID, a post-COVID condition in which virus symptoms persist, return or develop. According to the National Institutes of Health (NIH), possible risk factors include older age and preexisting health conditions.25

National Council on Aging’s Role

The National Council on Aging’s (NCOA) Center for Healthy Aging believe that every person has a right to age well and focuses on improving the lives of older adults by producing solutions that address social and behavioral determinants of health and wellbeing. The Center houses three National Resource Centers funded by the U.S. Administration for Community Living’s Administration on Aging.

Chronic Disease Management

NCOA’s National Chronic Disease Self-Management Education Resource Center provides leadership, technical assistance, and resources to support state and community-based partners in expanding and sustaining evidence-based programs, including the suite of Chronic Disease Self-Management Education Programs, originally developed by Stanford University. These programs, which are available in the community and online, help older adults better manage their chronic conditions and improve their quality of life.

Falls Prevention

NCOA’s National Falls Prevention Resource Center serves as a national clearinghouse for information on falls prevention and supports the implementation and sustainability of evidence-based Falls Prevention Programs. The Falls Free® Initiative, a national effort, includes State Coalitions and the 2015 Falls Free® National Action Plan to reduce falls and fall-related injuries among older adults.

Modernizing Senior Centers Resource Center

The Modernizing Senior Centers Resource Center helps senior centers address their challenges and amplify their successes as they strive to meet the ever-changing needs of older adults. The overarching goal of the new Resource Center is to ensure that senior centers have the capacity, tools, and resources necessary to develop and implement programs and services that meet the current and future needs of diverse older adults.

Other Initiatives

  • NCOA promotes physical activity, behavioral health, and other evidence-based programs.
  • NCOA implements the Aging Mastery Program®, an in-person and online education and behavior change incentive program to help older adults age well.
  • COVID-19 and Influenza Vaccine Uptake Initiative: NCOA has received a $50 million grant from the U.S. Administration for Community Living to implement a nationwide campaign to ensure older adults and people with disabilities get the latest COVID and flu vaccines.

Sources

1. Administration on Aging. 2021 Profile of Older Americans. November 2022. Found on the internet at https://acl.gov/sites/default/files/Profile%20of%20OA/2021%20Profile%20of%20OA/2021ProfileOlderAmericans_508.pdf

2. Organisation for Economic Cooperation and Development. Health Status—Life Expectancy at 65. Found on the internet at https://data.oecd.org/healthstat/life-expectancy-at-65.htm

3. National Council on Aging. Chronic Inequities: Measuring Disease Cost Burden Among Older Adults in the U.S.  A Health and Retirement Study Analysis. Page 5, Figure 2. April 2022. Found on the internet at https://ncoa.org/article/the-inequities-in-the-cost-of-chronic-disease-why-it-matters-for-older-adults

4. Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Mortality 2018-2021 on CDC WONDER Online Database, released in 2021. Data are from the Multiple Cause of Death Files, 2018-2021, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10-expanded.html on March 13, 2023.

5. Centers for Disease Control and Prevention. The State of Aging and Health in America 2013. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. 

6. Centers for Medicare and Medicaid Services. Multiple Chronic Conditions. Found on the internet at https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/MCC_Main

7. Rabah Kamal and Julie Hudman. What do we know about spending related to public health in the U.S. and comparable countries? Peterson-KFF Health System Tracker. Sept. 20, 2020. Found on the internet at https://www.healthsystemtracker.org/chart-collection/what-do-we-know-about-spending-related-to-public-health-in-the-u-s-and-comparable-countries/

8. Centers for Disease Control and Prevention. Older Adult Fall Prevention. Facts About Falls. Found on the internet at https://www.cdc.gov/falls/facts.html

8a. Centers for Disease Control and Prevention. National Center for Health Statistics. Unintentional Fall Deaths Among Adults Aged 65 and Over: United States, 2020. November 2022. Found on the internet at https://www.cdc.gov/nchs/products/databriefs/db449.htm

9. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Found on the internet at http://www.cdc.gov/injury/wisqars

10. Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics Society 2018; 66(4):693-698. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/29512120/ 

11. Houry D, Florence C, Baldwin G, Stevens J, McClure R. The CDC Injury Center’s response to the growing public health problem of falls among older adults. American Journal of Lifestyle Medicine 2016;10:74-77. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/26688674/

12. Gillespie, LD, Robertson, MC, Gillespie, WH, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2012, Issue 9. 

13. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age and Ageing. May 1997. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/9223714/ 

14. U.S. Department of Health and Human Services (HHS), Office of Disease Prevention and Health Promotion. Physical Activity Guidelines for Americans, 2nd Edition. 2018. Found on the internet at https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf

15. Watson KB, Carlson SA, Gunn JP, et al. Physical Inactivity Among Adults Aged 50 Years and Older—United States, 2014. MMWR Morb Mortal Wkly Rep 2016;65:954–958. DOI: http://dx.doi.org/10.15585/mmwr.mm6536a3. Found on the internet at https://www.cdc.gov/mmwr/volumes/65/wr/mm6536a3.htm

16. National Center for Health Statistics. Health, United States, 2020-2021. Found on the internet at https://www.cdc.gov/nchs/data/hus/2020-2021/DentAd.pdf

17. Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2019. Found on the internet at https://www.cdc.gov/oralhealth/pdfs_and_other_files/oral-health-surveillance-report-2019-h.pdf

18. Eke PI, Dye B, Wei L, Thornton-Evans G, Genco R. Prevalence of Periodontitis in Adults in the United States: 2009 and 2010.J Dent Res. Published online 30 August 2012:1–7

19. Wyatt Koma, et al. One in Four Older Adults Report Anxiety or Depression Amid the COVID-19 Pandemic. Kaiser Family Foundation. Oct. 9, 2020. Found on the internet at https://www.kff.org/medicare/issue-brief/one-in-four-older-adults-report-anxiety-or-depression-amid-the-covid-19-pandemic/

20. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Data. (2020) Found on the internet at https://wisqars.cdc.gov/fatal-reports

21. Centers for Disease Control and Prevention. Alcohol-related disease impact (ARDI) software. Alcohol and Public Health Web site. Found on the internet at http://nccd.cdc.gov/DPH_ARDI/default/default.aspx

22. Garrido, M. M., R. L. Kane, M. Kaas, and R. A. Kane. 2011. Use of mental health care by community-dwelling older adults. Journal of the American Geriatrics Society 59(1):50-56

23.  Centers for Disease Control and Prevention. Deaths by Select Demographic and Geographic Characteristics. Provisional Death Counts for COVID-19. Found on the internet at https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#SexAndAge

24. Centers for Disease Control and Prevention. Past Seasons Estimated Influenza Disease Burden. (2022) Found on the internet at https://www.cdc.gov/flu/about/burden/past-seasons.html. 

25. National Institutes of Health. Long COVID. Oct. 5, 2022. Found on the internet at https://covid19.nih.gov/covid-19-topics/long-covid

 

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