Seniors and Boomers: Living Longer, Living Healthier ... - Waterpik

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epresenting 44% of all new cases in 2008. It affects the nervous system, and almost 30% of people with diabetes over age 40 have impaired sensation in their feet while diabetes is responsible for more than 60% of non-traumatic limb amputations. People with diabetes may be more susceptible to other illnesses, and once they get them, they often have a worse prognosis. Those who contract pneumonia or influenza have a higher risk of death. People with diabetes are also twice as likely as those who don’t have it to suffer from depression. The cost of all of these complications results in medical expenditures that are two times higher than in the absence of diabetes. 10 In addition to recognized systemic complications, having diabetes has been associated with increased cognitive decline and physical disability. Men and women over age 60 with diabetes were more likely to be unable to walk a quarter of a mile, climb stairs, and do housework when compared to similar-aged cohorts without diabetes. 11 Emerging evidence also seems to indicate that people with type 2 diabetes are more likely to have Alzheimer’s disease and/or vascular dementia. 14 Being overweight/obese is the strongest environmental risk factor for type 2. More than 85% of people with type 2 diabetes are overweight. 15 Obesity influences metabolic and endocrine functions resulting in a greater production of agents that increase insulin resistance and systemic inflammation. 16 Overweight is defined by a body mass index (BMI) of 25–29.9. Those with a BMI of 30 and over are considered obese. 15,17 Waist circumference is another way to measure the health risk of being overweight. Excess weight in the abdominal area is thought to increase the risks for obesityrelated diseases more than fat on other areas of the body. It is recommended that women have a waist measurement of no more than 35 inches and men no more than 40 inches. 15,17 Data from the National Health and Nutrition Examination Survey (NHANES) 2009–2010 indicate that over 78 million adults or 35.7% are obese. Those over 60 are more likely to be obese; men at 36.6% and women at 42.3%. 18 Results from the Framingham Heart Study indicate that overweight and obesity in adulthood are associated with decreases in life expectancy. 19 Lung Cancer and Chronic Obstructive Pulmonary Disease (COPD) Lung cancer is the leading cause of cancer death among people 65 and older. 3 Eighty-one percent of people with lung cancer are over 60. In 1987, lung cancer surpassed breast cancer as the leading cause of cancer death in women. Lung cancer causes more death than the three most common cancers (colon, breast, prostate) combined. The five-year survival rate is only 16.3% compared to 65.2% for colon, 90% for breast, and 99.9% for prostate. Over half the people with lung cancer die within a year of being diagnosed. Blacks are more likely to develop and die from lung cancer than any other group. Their incidence rate is 47% higher than for whites, even though their overall exposure to cigarette smoke is similiar. 20 Smoking is the prime contributor to the development of lung cancer. Men who smoke are 23 times more likely to develop lung cancer and women 13 times more likely compared to their nonsmoking counterparts. Secondhand smoke is also a contributor. Nonsmokers who are exposed to secondhand smoke at home or work increase their risk of developing lung cancer by 20%–30%. 20 Chronic Obstructive Pulmonary Disease (COPD) is a term that refers to chronic bronchitis and emphysema, lung diseases that obstruct airflow and interfere with breathing. These diseases often co-exist. COPD is the third leading cause of death in the United States; more women succumb to COPD than men. It is estimated that 13.1 million adults have COPD. Another 24 million have evidence of impaired lung function indicating a possible underdiagnosis of COPD. 21 Smoking is the primary risk factor for COPD. It contributes to 85%–90% of all COPD deaths. Smokers are more likely to die from COPD—13 times more likely for women and 12 times more likely for men—than those who have never smoked. Secondhand smoke and pollution may also play a role. People with COPD report significant life limitations from the disease (Table 1). They often experience shortness of breath and, in advanced stages, may require supplemental oxygen and mechanical respiratory assistance. 21 Table 1: Percent of People with COPD Experiencing Limitations to Daily Life Activities 21 Normal physical exertion 70% Household chores 56% Social activities 53% Limited ability to work 51% Sleeping 50% Family activities 46% Oral Cancer In the US, It is estimated that in 2012, 35,000 people will be diagnosed with oral cancer, and 6,800 will die from it. It affects twice as many men as women. The average age of diagnosis is 62, although one-third of cases occur in those under 55. 22 The most common sites are (Table 2): Table 2: Common Sites for Oral Cancer 22 Tongue 25–30% Tonsils 15–20% Minor salivary glands 10–15% Tobacco and alcohol use are the strongest risk factor for oral cancer. People who are heavy tobacco users and heavy drinkers are 100 times more likely to develop oral cancer. Recently, the human papilloma virus (HPV) has been shown to be a factor in 4
two of three oral cancers. These oral cancers seem to occur more often in the tonsils. People who develop oral cancer due to an HPV infection are often young, male, and less likely to be a heavy drinker or smoker. People diagnosed with HPV-related oral cancer seem to have a better prognosis than those with oral cancer caused by tobacco or alcohol. 22 Dementia: Alzheimer’s Disease There are numerous types of dementia, the most common being Alzheimer’s disease, which accounts for about 60–80% of all dementia cases. With dementia, nerve cells in the brain cease to function and die. This results in changes to memory, behavior, and the ability to think clearly. In Alzheimer’s disease, the ability to remember recent events is often the first sign. Vascular dementia is the second most common type of dementia, often occurring after a brain injury such as a stroke. Symptoms for this type of dementia are more likely to center on impaired judgment or inability to make plans versus memory loss. Many people have mixed dementia— both vascular and Alzheimer’s. People affected by Parkinson’s disease may also experience dementia in later stages. 23 Of the 5.4 million people with Alzheimer’s disease, 5.2 million are over 65. This translates to 1 in 8 or 13% of those 65 and over. Of those over 85, 45% are afflicted. Two-thirds of Alzheimer’s victims are women. This occurs because women live longer, not necessarily because they are more susceptible. As the number of the elderly population increase, it estimated that by 2050 the incidence of Alzheimer’s and dementia will have doubled. 23 Alzheimer’s is believed to be caused by multiple factors. Aging, family history, presence of CVD risk factors, and previous head/ brain trauma have been identified as potential risk factors for Alzheimer’s. There is some evidence to indicate that controlling cholesterol and blood pressure, managing diabetes, quitting smoking, losing weight, and increasing physical activity may help in avoiding cognitive decline. 23 Alzheimer’s is the sixth leading cause of death overall, and fifth in those over 65. People with Alzheimer’s live an estimated 4–6 years once they have been diagnosed, although some live as many as 20 years post-diagnosis. Fifteen million people provide unpaid care for a family member or friend with Alzheimer’s/dementia. Eighty percent of this care is provided at home. Almost half of caregivers are taking care of a parent. Thirty percent of caregivers are also caring for a child or grandchild under age 18. This equates to about 17 billion hours in unpaid care that would be valued at over $210 billion. Caregiving takes a toll on the health of the caregiver, with many experiencing emotional stress, depression, or other health issues. 23 FUNCTIONAL LIMITATIONS AND DISABILITIES Growing evidence indicates that the prevalence of disability is declining. Earlier detection of disease, better treatments, and access to rehabilitation services have contributed to this advancement. 2 The ability to delay the onset of disability has been shown to be a stronger predictor of longevity than staving off disease. About a third of people living past age 100 have coped with chronic illness for 15 years or more prior to turning 100. 24 Staving off disability may mean that seniors have greater opportunity for social interaction. Older women with large social networks have been shown to have better cognitive function and are less likely to be diagnosed with dementia. 25 The ability to delay the onset of disability is a stronger predictor of longevity than staving off disease. 24 Disability may be defined as a substantial limitation in a major life activity. This includes not just the ability to reach, bend, stoop, stand, sit, or lift, but activities of daily living (ADL) including bathing, eating, toileting, dressing, and getting out of bed or a chair. Individuals may also be considered disabled if they cannot fix their own meals, do light housework, manage their own money, and use the telephone or shop for personal items (Instrumental Activities of Daily Living). About 14 million people over 70 have some type of disability. Disability can result from chronic diseases including diabetes, CVD, COPD, Alzheimer’s, osteoporosis, or arthritis. Older individuals are also more likely to have vision or hearing impairments that may decrease their functional independence. 3 Osteoporosis and Hip Fractures The National Osteoporosis Foundations estimates that about 10 million people in the United States have osteoporosis. Of this number, 8 million are women. It is estimated that 34 million have low bone mass. Women can lose up to 20% of their bone mass in the 5–7 years post-menopause. People often do not even know they have osteoporosis until they break a bone. Factors that increase the risk for osteoporosis include advanced age, low calcium and vitamin D intake, an inactive lifestyle, cigarette smoking, and excessive use of alcohol. 26 Table 3: Yearly Osteoporosis-Related Fractures: 26 • 297,000 hip fractures • 547,000 vertebral fractures • 397,000 wrist fractures • 135,000 pelvic fractures • 675,000 fractures at other sites Osteoporosis can lead to bone fragility and increased risks for fracture. It is responsible for more than 2 million fractures yearly (Table 3). It is expected to rise to 3 million by 2025. One in two women and one in four men over 50 will experience an 5
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Seniors and Boomers: Living Longer, Living Healthier ... - Waterpik

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