See Also: • CDCs Healthy Aging Web Site • State and Program Examples (83K–PDF)

Healthy Aging
Preserving Function and Improving
Quality of Life Among Older Americans

At A Glance 2008

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“The aging of the U.S. population is one of the major public health challenges of the 21st century. With more than 70 million baby boomers in the United States poised to join the ranks of those aged 65 or older, preventing disease and injury is one of the few tools available to reduce the expected growth of health care and long-term care costs.”

Julie Louise Gerberding, MD, MPH
Director
Centers for Disease Control and Prevention

The Health and Economic Effects of an Aging Society

By 2030, the proportion of the U.S. population aged 65 years or older will double to about 71 million older adults. The far-reaching implications of the increasing number of older Americans and their growing diversity will include unprecedented demands on public health, aging services, and the nation’s health care system.

Medicare spending has grown about nine-fold in the past 25 years, from $37 billion in 1980 to $336 billion in 2005. By 2030, health care spending will increase 25%, largely because of the aging population.

Chronic diseases disproportionately affect older adults and are associated with disability, diminished quality of life, and increased costs for health care and long-term care. Today, about 80% of older adults have at least one chronic condition, and 50% have at least two. These conditions can cause years of pain and loss of function. Public health efforts can help Americans avoid preventable illness and disability as they age. Research has shown that poor health is not an inevitable consequence of aging. Effective public health strategies already exist to help older adults remain independent longer, improve their quality of life, and potentially delay the need for long-term care.

Opportunities To Improve Older Americans’ Health and Quality of Life

Our growing knowledge of critical factors that help to protect and promote health has led to opportunities to address emerging public health issues that affect older adults. These include opportunities to

• Promote an up-to-date measure for clinical preventive services. Population-based data on preventive services recommended for older adults, such as immunizations and regular health screenings, are currently monitored individually. An up-to-date measure would help us to promote these services and collect better data to improve public health services and guide policy.
   
• Address depression. Depression affects nearly 7 million older adults, but many do not receive treatment. Undiagnosed and untreated depression among older adults can increase complications from other conditions, such as heart disease and disability, as well as risk for death.
   
• Promote caregiving interventions. In 2004, about 35 million people were providing unpaid care for family members, friends, and neighbors for adults aged 50 years or older. This number is expected to rise sharply as the U.S. population ages. Family caregiving has been associated with increased levels of depression and anxiety, as well as with high use of psychoactive medications, poor self-reported physical health, compromised immune function, and increased mortality among caregivers.
   
• Address end-of-life issues. The public health community has only recently come to recognize end-of-life issues as a public health concern. These issues are important because of the substantial burden and impact on people who are dying and their family members, as well as the financial costs for individuals and society and the potential to prevent suffering.

CDC’s Roles in Promoting Healthy Aging

CDC is committed to ensuring that all people, especially those at greater risk for health disparities, achieve their optimal lifespan with the best possible quality of health in every stage of life. With agency-wide health protection goals that support healthy people in healthy places across all life stages, CDC is setting the agenda to enable people to enjoy a healthy life by delaying death and the onset of illness and disability through public health measures designed to accelerate improvements in public health.

Within CDC’s National Center for Chronic Disease Prevention and Health Promotion, the Healthy Aging Program serves as the focal point for older adult health at CDC. The Healthy Aging Program is engaged in many activities designed to provide a comprehensive approach to helping older adults live longer, high-quality, productive, and independent lives. This approach is implemented in collaboration with CDC’s internal partners (e.g., those focusing on injury prevention, disability prevention, and adult immunizations) and key external groups. It includes the following activities conducted by CDC’s Healthy Aging Program:

1. Enhance the ability of states and communities to identify and implement effective strategies, policies, and programs to promote and protect the health of older adults. Research shows that if older adults maintain just three health habits—moderate physical activity, good nutrition, and not smoking—they can delay disability by as much as 10 years. The benefits of this research will never be realized unless this knowledge is applied through community level strategies. The Healthy Aging Program supports the Healthy Aging Research Network (HAN), a group of nine CDC-supported Prevention Research Centers (see map, page 2) focused on improving the health of older Americans by conducting prevention research, sharing their findings, and translating research into health practices. Current HAN projects include reviewing evidence-based interventions for depression and emotional health and assessing public perceptions of cognitive health.

   The Healthy Aging Program also supported the HAN symposium, Effective Community-Based Physical Activity Programs for Older Adults. The symposium brought together researchers and service providers to review evidence-based programs and successful strategies. The result was development and dissemination of a guide for public health practitioners called Moving Ahead: Strategies and Tools to Plan, Conduct, and Maintain Effective Community-Based Physical Activity Programs for Older Adults. This guide is available online at http://www.cdc.gov/aging/pdf/Community-Based_Physical_Activity_Programs
   _For_Older_Adults.pdf.
    

2. Expand efforts to integrate public health and aging services and enhance outreach for health promotion and disease prevention for older adults. As described in the Older Americans Act, CDC advises the aging services network, which reaches older adults in nearly every U.S. community. The Healthy Aging Program strives to integrate public health’s expertise in research, health tracking, and prevention programs with the experience and reach of the aging services network. For example, through the National Association of Chronic Disease Directors, CDC funds SENIOR (State-based Examples of Network Innovation, Opportunity, and Replication) grants in several states (see map, page 2). The grants are intended to help state health departments create effective partnerships with state aging agencies to take strategic action at state and local levels and to promote state policies that recognize the importance of integrating healthy aging efforts into chronic disease and other programs.

   CDC is the lead national agency responsible for collecting data and monitoring changes over time in the health of older Americans. This information helps to strengthen efforts to prevent disease, disability, and injury and to highlight health-related disparities among older adults. In 2007, CDC’s Healthy Aging Program, in collaboration with The Merck Company Foundation, released The State of Aging and Health in America 2007. This report equips public health and aging services professionals with national and state data on 15 key indicators of older adult health. It also provides calls to action and a special feature on falls. A searchable online version is available at http://www.cdc.gov/aging/saha.htm.
    

3. Promote health and preserve health-related quality of life for older adults within the health care and other systems. Medicare pays for many critical preventive services, yet in 2004, only 38.4% of men and 31.6% of women aged 65 or older were up-to-date on selected preventive services (flu vaccine, pneumonia vaccine, and colorectal cancer screening for men; these services plus mammography for women). CDC’s Healthy Aging Program supports a model program called SPARC (Sickness Prevention Achieved through Regional Collaboration) that has shown documented success in broadening the use of clinical preventive services among older adults. SPARC promotes public access to services and strengthens local accountability for service delivery. In 2007, CDC’s Healthy Aging Program worked with the Atlanta Regional Commission to guide a SPARC pilot in two Atlanta-area counties. Results show that SPARC provides a practical and appealing approach to improving the delivery of preventive services and can galvanize local health care providers to develop innovative and effective community-tailored interventions.

Future Directions 

State and local health departments, the aging services network, and other groups that serve older adults look to CDC for scientific and programmatic expertise and to identify and develop strategies that reduce long-term care needs and preserve health and quality of life for older adults. In response, CDC and its partners are advancing work in several areas, including

• Synthesizing evidence-based information on interventions and policies that may promote and protect older adult health (including cognitive and emotional health) with plans to disseminate results through conferences and to create an inventory of recommendations.
   

• Developing measures to assess and monitor critical issues in aging, such as the impact of cognitive decline, to provide data at state and local levels.
   

• Conducting research on minority populations to identify health disparities (e.g., examining the health and characteristics of American Indian and Alaska Native caregivers).
   

• Assessing state health departments’ needs, priorities, and activities related to older adult health to better support state-based efforts.

Page last reviewed: February 12, 2008
Page last modified: February 12, 2008
Content source: National Center for Chronic Disease Prevention and Health Promotion