Health-Related Behaviors
Nearly 40% of deaths in America can be attributed to smoking, physical
inactivity, poor diet, or alcohol misuse-behaviors practiced by many people
every day for much of their lives. Adopting healthy behaviors such as eating
nutritious foods, being physically active, and avoiding tobacco use can prevent
or control the devastating effects of many of the nation's leading causes of
death regardless of one's age.
Regular physical activity greatly reduces a person's risk from dying of
heart disease, and decreases the risk for colon cancer, diabetes, and high
blood pressure. Physical activity also helps to control weight; contributes to
healthy bones, muscles, and joints; helps to relieve the pain of arthritis;
reduces symptoms of anxiety and depression; and can decrease the need for
hospitalizations, physician visits, and medications. Finally, physical activity
does not need to be strenuous to be beneficial; people of all ages benefit from
moderate physical activity. However, people tend to be less active as they age.
By age 75, about one in three men and one in two women do not engage in any
physical activity.1 Organizations and agencies who are looking for
assistance in planning strategies to help older adults increase their physical
activity can use
Good nutrition, including a diet that is low in saturated fats and
contains five or more servings of fruits and vegetables each day is vital in
maintaining good health. Improving the diet of older adults could extend the
productive life span of Americans and reduce the occurrence of chronic diseases
such as heart disease, stroke, some types of cancer, diabetes, and
osteoporosis. Less than one-third of adults 65 years and older meet the 5 A Day
recommendation.2
Tobacco Use is the single most preventable cause of death and disease in
the United States. The American Cancer Society estimates that cigarette smoking
is responsible for one of every five deaths in the United States, or more than
440,000 deaths each year. Tobacco use increases the risk for diseases of the
heart and cancer. Smoking cessation has major and immediate health benefits for
men and women of all ages, regardless of whether they have a smoking-related
disease.
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Chronic Diseases
Chronic Diseases are generally not prevented by vaccines or cured by
medication, nor do they just disappear. To a large degree, the major chronic
disease killers — heart disease, cancer, stroke, and diabetes — are an
extension of what people do, or not do, as they go about their daily lives.
Eighty-eight percent of those over 65 years of age have at least one chronic
health condition.3 Health damaging behaviors — particularly tobacco
use, lack of physical activity, and poor eating habits — are major contributors
to the nation's leading chronic diseases. Clearly, promoting healthy behavior
choices, through education and through community policies and practices, is
essential to reducing the burden of chronic diseases.
Arthritis and related conditions are the leading cause
of disability in the United States affecting nearly 43 million Americans.
Although cost-effective interventions are available to reduce the burden of
arthritis, they are currently underused. Regular, moderate exercise offers a
whole host of benefits to people with arthritis by reducing joint pain and
stiffness, building strong muscle around the joints, and increasing flexibility
and endurance.
More about arthritis
Cardiovascular Health is a growing concern for all
Americans. Heart disease is the nation's leading cause of death. Three
health-related behaviors—tobacco use, lack of physical activity, and poor
nutrition—contribute markedly to heart disease. Modifying these behaviors is
critical for both preventing and controlling heart disease. Modest changes in
one or more of these risk factors among the population could have a profound
public health impact.
Cancer is the second most common cause of death in the
United States. Cancer is largely controllable through prevention, early
detection, and treatment. Reducing the nation's cancer burden requires reducing
the prevalence of the behavioral and environmental factors that increase cancer
risk. It also requires ensuring that cancer screening services and high-quality
treatment are available and accessible, particularly to medically underserved
populations.
Colorectal cancer is the second
leading cause of cancer-related deaths in the UnitedStates, accounting for 10%
of all cancer deaths. The risk of developing colorectal cancer increases with
advancing age. Lack of physical activity, low fruit and vegetable intake, a
low-fiber diet, obesity, alcohol consumption, and tobacco use may contribute to
the risk for colorectal cancer.
Three screening tools flexible sigmoidoscopy, colonoscopy, and the fecal occult
blood test (FOBT) are widely accepted and used to detect colorectal cancer in
its earliest stages, when treatment is most effective. In 1999, 66% of
Americans aged 50 years or older reported not having had a sigmoidoscopy or
colonoscopy within the last five years, and 79% reported not having had a fecal
occult blood test within the last year.
Breast Cancer is best detected
in its earliest, most treatable stage by mammography. Seventy-six percent of
all diagnosed cases of breast cancer (are among women aged 50 years or older.
Diabetes is a serious, costly, and increasingly common
chronic disease. Early detection, improved delivery of care, and better
self-management are the key strategies for preventing much of the burden of
diabetes. Seven million persons aged 65 years or older (20.1% of all people in
this age group) have diabetes.
More about diabetes
Epilepsy and seizures affect about 2.3 million
Americans, and result in an estimated $12.5 billion in medical costs and lost
or reduced earnings and production annually. People of all ages are affected,
but particularly the very young and the elderly. About 10% of Americans will
experience a seizure, and about 3% will have or will have had a diagnosis of
epilepsy by age 80.
Obesity has reached epidemic proportions among Americans
in all age groups. Obesity among adults has doubled since 1980. People who are
obese or overweight are at increased risk for heart disease, high blood
pressure, diabetes, arthritis-related disabilities, and some cancers.
Oral health is an important and often overlooked
component of an older adult's general health and well-being. Oral health
problems can cause pain and suffering as well as difficulty in speaking,
chewing, swallowing, and maintaining a nutritious diet. During the past 50
years, the oral health and use of dental services among older adults have
improved. Although this trend is expected to continue, additional improvement
will depend on access to appropriate dental care.
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Infectious Diseases
West Nile virus is a flavivirus commonly found in Africa, West Asia, and
the Middle East. It was first detected on the east coast of the United States
in 1999. Since then the virus has rapidly spread westward and West Nile virus
has been detected in nearly every state in the country. The main route of human
infection with West Nile virus is through the bite of an infected mosquito. The
easiest and best way to avoid West Nile virus is to prevent mosquito bites.
People over the age of 50 are more likely to develop serious symptoms from West
Nile virus infection and should take special care to avoid mosquito bites.
applying insect repellent containing DEET (Look for:
N,N-diethyl-meta-toluamide); 2) when possible, wear long-sleeves, long pants
and socks when outdoors to reduce the amount of bare skin exposed to mosquitoes
and; 3) reduce the amount of time you are outdoors during dusk and dawn when
mosquitoes are most active. There are other things you can do to reduce your
risk of exposure to West Nile virus in your home and community.
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Immunizations for Adults
Although infectious diseases are no longer the most common causes of death,
pneumonia and influenza remain among the top ten causes of death for older
adults. In 2000, pneumonia and influenza were responsible for 3.3% or 58,557
deaths among people 65 years of age and older.6 Influenza
vaccination can reduce both direct health-care costs (physician visits and
antibiotic use) as well as indirect costs from work absenteeism associated with
influenza illness. Among person aged 65 years and older, influenza vaccination
levels have increased from 33% in 1989 to 66% in 1999, surpassing the Healthy
People 2000
goal of 60%.
Pneumonia is one of the most serious infections in older adults, especially
among women and the oldest old. In a study of nursing home acquired pneumonia
patients, pneumonia resulted in death among 40% of individuals who required
hospitalization.
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Injuries Among Older Adults
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| In the United States, one of every three persons aged 65 years and
older falls each year. Among older adults, falls are the leading cause of
injuries, hospital admissions for trauma, and deaths due to injury. In 1999,
about 10,097 seniors died of fall-related injuries.9 Fractures are
the most serious health consequence of falls. Approximately 250,000 hip
fractures, the most serious fracture, occur each year among people over age 65.
Many of these falls and resulting injuries can be prevented. Strategies to
prevent falls among older adults include exercises to improve strength,
balance, and flexibility; reviews of medications that may affect balance; and
home modifications that reduce fall hazards such as installing grab bars,
improving lighting, and removing items that may cause tripping.
While rates of motor vehicle related death and nonfatal motor vehicle related
injuries among older adults vary by state, there are some consistencies. In
most states, the fatality rates for men are twice those for women. In all
states, motor vehicle-related fatalities are higher among adults 75 years and
older, as compared with adults between 65 and 74 years of age. Among older
adult drivers, the number of motor vehicle-related fatalities increased 30% and
the number of nonfatal injuries increased 21% between 1990 and 1997. However,
the number of fatalities and nonfatal injuries among older adult pedestrians
declined during these same years (23% and 24%, respectively).
Risk factors for suicide among the elderly differ from those among the young.
Older persons have a higher prevalence of depression, a greater use of highly
lethal methods and greater social isolation. From 1980–1998, the largest
relative increases in suicide rates occurred among those 80–84 years of age.
The rate of suicide is higher for elderly white men than for any other age
group, including adolescents.
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References:
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Department of Health and Human Services. Physical Activity and Health: A Report
of the Surgeon General. Atlanta, GA: Centers for Disease Control
and Prevention, 1996.
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Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance
System.
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Physical Activity Interventions Targeting Older Adults, Am J. Prev. Med
1998;15(4):316–333.
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Centers for Disease Control and Prevention. The Burden of Chronic Diseases and
Their Risk Factors: National and State Perspectives.
Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease
Control and Prevention, 2002.
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Centers for Disease Control and Prevention. National diabetes fact sheet:
general information and national estimates on diabetes in the United States
, 2000. Atlanta, GA: U.S. Department of Health and Human Services, Centers for
Disease Control and Prevention, 2002.
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Centers for Disease Control and Prevention. Prevention and Control of Influenza
— Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR
2002;3:5–6.
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Marrie TJ. Pneumonia. Clin Geriatr Med
1992;8:721–34.
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Centers for Disease Control and Prevention.Web-based Injury Statistics query
and Reporting System (WISQARS) [Online]. (2001). National Center for Injury
Prevention and Control, Center for Disease Control and Prevention
(producer).
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