America is aging in health, wealth

A graying population promises profound social, economic impact


Older Americans are healthier, wealthier and better educated than ever, but the expected doubling of the elderly population by 2030 will create profound social and economic challenges, according to a federal report released yesterday.

The report, by the U.S. Census Bureau and National Institute on Aging, contains hopeful and humbling news about growing old.

People over 65 live with fewer disabilities than in years past, but that often means taking multiple medications and depending on artificial joints, pacemakers and other devices.

Although they're living longer than previous generations, today's elderly are not working longer, which has troubling, long-range economic implications.

And despite the unprecedented wealth of today's 65-and-older population, pockets of poverty remain. Most troubling, perhaps, is the fact that 40 percent of older black and Hispanic women who live alone also live in poverty.

Overall, the report contains a rosy view of aging in America.

"There is little question, I think, that the present older population is better off in terms of health, disability and quality of life than in the past," said Dr. Richard J. Hodes, director of the National Institute on Aging and one of several officials at a briefing yesterday.

Those key findings did not surprise Betty Barth, 69, a retired executive secretary from Phoenix, Baltimore County, who has remained active since getting a knee replacement five years ago.

For two hours at a time, three or four days a week, she works the treadmill, recumbent bicycle and weights at the busy Cockeysville Senior Center, which opened an exercise gym in 2003.

"I knew it was the healthy thing to do, and I wanted to keep it up," said Barth, who also dropped the 15 pounds she gained after she quit smoking five years ago. "It's better than looking up at dirt."

The report offers no new research but assembles data from a variety of Census surveys and federal statistical sources, including the Centers for Disease Control and Prevention, Bureau of Labor Statistics and Medicare claims.

The authors said they didn't want to recommend particular actions, instead providing detailed information for policymakers in a single volume.

As the welfare of older Americans has improved, fewer are working, the report showed. Almost half of men 65 and older worked or looked for work in 1950; fewer than 20 percent were in the labor force by 2003. Employment rates for women changed little over that period, hovering around 10 percent.

With the first baby boomers turning 65 in five years, the older population is expected to reach 72 million by 2030, twice the number in 2000.

The oldest portion of the population - those 85 and older - will also double during that period, reaching 9.6 million. Likewise, the number who have celebrated their 100th birthday rose from 37,000 in 1990 to more than 50,000 a decade later. It will grow further in years to come.

These changes coincide with a steady rise in life expectancy, which reached an all-time high of 77 years in 2000, compared with 70.8 years in 1970 and just 47.3 years in 1900.

Officials attribute much of this to far lower mortality rates for heart disease. But they warn that as the population ages, more people will suffer the mental debilitation of Alzheimer's, which costs society $100 billion a year.

Dr. Richard M. Suzman, associate director of behavioral research at the aging institute, also warned that rising obesity among the young could erase health gains.

"There's a dark cloud out there," he said. "Some have estimated that the increase in obesity could neutralize the positive trends in the future. It's likely to have more of an impact on disability than on life expectancy."

Health and longer lives don't eliminate seniors' need for medical services. Those services - including replacement hips and blood pressure drugs - are reducing the percentage of disabled seniors.

In a separate study, researchers at the Johns Hopkins Bloomberg School of Public Health found that half of all people 65 and older have three or more chronic illnesses, while 20 percent had five or more. These include diabetes, hypertension, clogged arteries and arthritis - each of which can require one or more medications.

"Many of these aren't things that are going to kill you dead, at least not for a while," said Dr. Albert Wu, a senior author and a professor of health policy and management. "But you may need a pacemaker, you may need a defibrillator and some stents in your vessels. These are things to look forward to because they are better than the alternative - but all these things come at a price."

The report shows that seniors receive plenty of medical attention. A quarter of those over 75 make an emergency room visit each year, according to the report. About the same percentage had 10 or more medical visits a year - and 65 percent at least four visits.

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