Chronic diseases are not generally 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. Almost 90% of those over 65 years of age have at least one chronic health condition. Health damaging behaviors, particularly tobacco use, lack of physical activity for aging, and poor eating habits, are major contributors to the nation’s leading chronic diseases. Clearly, promoting healthy behavior choices, through education, community policies, and practices, is essential to reducing the burden of aging diseases.
Cardiovascular heart disease is a growing concern for all Americans. Heart cardiovascular disease is the nation’s leading cause of death. Three health-related behaviors—tobacco use, lack of physical activity for healthy aging, and poor nutrition—contribute markedly to chronic 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.
Arthritis and related conditions are the leading cause of disability in the United States, affecting nearly 40 million Americans. Although cost-effective interventions are available to reduce the burden of rheumatoid 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 endurance and flexibility.
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% of all people in this age group) have diabetes.
Colorectal cancer is the second leading cause of cancer-related deaths in the United States, accounting for 10% of all cancer deaths. The possibility of developing colorectal cancer risk increases with advancing age. Lack of physical activity, low fruit and vegetable intake, a low diet, obesity, alcohol consumption, and tobacco use may contribute to colorectal cancer risk. Three colorectal cancer 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. However, according to the CDC, in 2000, only 44% of men and 40% of women aged 50 years or older had undergone a sigmoidoscopy or colonoscopy within the previous 10 years or had used an FOBT home test kit within the preceding year.
Oral health care is an important and often overlooked component of an older adult’s general health and well-being. Oral health problems, such as ill-fitting dentures, poor condition of the teeth and gums, or side effects from medications, 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 oral health care and dental care.
Obesity has reached epidemic proportions among Americans in all age groups. Obesity among adults has doubled since 1980. Of Americans over the age of 50, 28% are now considered obese. People who are obese or overweight are at increased risk factors heart disease, high blood pressure, diabetes, arthritis-related disabilities, and some cancers. After the age of 50, metabolic rates drop sharply; metabolism may drop by 30% over the course of a lifetime. A decreased calorie need must be taken into account when considering elder nutrition: as people age, most simply do not need to eat as much. Although body fat tends to rise with age, muscle mass tends to drop. To maintain muscle mass, higher amounts of recommended daily protein but fewer calories may be required.
