Healthy Aging. Prepared for. Blaine House Conference on Aging September Prepared by

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1 Healthy Agig Prepared for Blaie House Coferece o Agig September 2006 Prepared by Mary Walsh, M. Ed. Maie Departmet of Health ad Huma Services, Office of Elder Services Augusta, ME Peggy Hayes, M.P.A. MaieHealth s Partership for Healthy Agig Portlad, ME Chris Sady, M.S, R.D., L.D. ad Matt L Italie, M.S., R.D. Uiversity of Souther Maie, Muskie School of Public Service, Maie Nutritio Network This report was prepared uder a Cooperative Agreemet betwee the Muskie School of Public Service ad the Maie Departmet of Health ad Huma Services

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3 Backgroud Poor health is ot a ievitable cosequece of agig. It has bee scietifically prove that prevetive measures such as regular physical activity ad healthy eatig are crucial i maitaiig good health, reducig the impact of disease, delayig disability ad reducig the eed for expesive log-term care for older adults. Research also shows that it is ever too late to take prevetive measures such as quittig smokig, becomig more active or improvig oe s utritioal health to improve the quality of oe s life. Makig lifestyle chages helps lead to better health ad fuctio ad the icreased ability to remai idepedet the primary goal for most older adults of Maie's populatio is 65 or older (represetig 183,589 people). Maie is the oldest state i the atio, with a media age of 40.6 i ad raks third i the coutry for the highest percetage of older adults i its populatio. Problem Statemet I Maie, for persos aged 65 ad older, 43 are overweight, 18 are obese ad 36 do ot do ay leisure time physical activities. ii Most older people i Maie suffer from oe or more chroic health problems, such as arthritis, diabetes, cacer, lug disease, cardiovascular disease, hypertesio, ad depressio. These chroic diseases are ofte prevetable by makig improvemets i three behavioral risk factors tobacco addictio, physical iactivity, ad poor utritio. Research has show that healthy lifestyle behaviors, such as beig physically active, eatig a healthy diet ad ot smokig, are more ifluetial tha geetic factors i helpig older people avoid the deterioratio traditioally associated with agig. By maitaiig just three healthy habits moderate physical activity, good utritio ad o smokig older people ca delay disability by as much as 10 years. Stayig active throughout later life may prolog oe s life. Researchers at the Natioal Istitute o Agig tracked three types of activity groups amog 300 adults, ages 70 to 82, for a period of six years. Durig the time of the study, the most active group s mortality rate was 12, the midrage group was 18, ad the least active group was 25 [ Joural of the America Medical Associatio (July 2006)]. The struggle to maage multiple chroic coditios ofte leads to icreased isolatio, decreased physical activity levels, ad loss of muscle stregth ad balace - all of which icrease the risk of falls. A aalysis of uitetioal fall ijuries amog 65 + year old Maie residets who were treated i emergecy rooms i 2004 shows that: uitetioal falls are the leadig cause of ijury; rates of ijuries as a result of falls are higher for females (4,700.9 per 100,000) tha males (2,807.1 per 100,000); fallig, ad attedat ijury, icreases with age - 2,449.7 falls per 100,000 for year olds, risig to 8,269.9 falls per 100,000 for 85+ year olds; the largest percetage of uitetioal falls occur at home (14); ad 93 of patiets are discharged to the commuity. Each year i Maie, oe of every three adults age 65 or older falls. The U.S. Prevetive Services Task Force recommeds regular physical activity, especially balace exercises for the prevetio of falls. While falls are a very real cocer for older adults, 1

4 sigificat evidece exists which demostrates that the fear of fallig ca be extremely debilitatig, begiig a sequece of evets that ca lead to a icreased risk for falls. Treds 43 of Maie persos aged 65 ad older are overweight; 18 are obese ad 55 do ot meet the physical activity recommedatio for adults (Maie BRFSS 2005). Accordig to Healthy Maie 2010, about 70 of Maie people die from oly 4 diseases cardiovascular disease (heart attack ad stroke), cacer, chroic lug disease (primarily emphysema) ad diabetes. These chroic diseases are ofte prevetable by makig improvemets i 3 behavioral risk factors tobacco addictio, physical iactivity ad poor utritio. Maie has the 4 th highest percet of people i the atio who die from these 4 chroic coditios (accordig to CDC data from 1997). These 4 chroic diseases cost Maie about $2.5 billio per year i health care costs. Falls are the leadig cause of uitetioal ijury ad death i older adults. 95 of hip fractures are caused by falls, 20 of these people die withi a year after a hip fracture ad 25 are i a ursig home oe year later. Growth i the populatio 65 ad older will substatially exceed growth i total populatio i Maie from I the curret decade, the elderly growth rate is more tha double that of total populatio growth, but i the ext two decades the elderly populatio growth rate will be sigificatly higher tha that of geeral populatio growth. The growth i Maie s elderly populatio will be drive by agig of Maie residets plus a iflux of retirees, who will primarily move to coastal couties. York Couty will show the fastest growth rates, followed by Licol-Sagadahoc Couties, ad Cumberlad Couty. I 2030, the oldest regios i Maie (defied as those with a populatio 65 or older greater tha the state average) will be the coastal retiremet ceters i Hacock, York, ad Licol-Sagadahoc Couties plus Aroostook Couty. The ilad regios of cetral ad wester Maie will have slightly smaller proportios of elderly. Cumberlad Couty will be at about the state average proportio. York, Waldo-Kox, Licol-Sagadahoc, ad Cumberlad Couties will see the largest chage i their share of populatio 65 ad over. Optios The followig strategies should be cosidered: Welless Programs o Expad availability of prove programs such as EhaceWelless ad Chroic Disease Self-Maagemet o Ecourage use of prevetive beefits provided to people with Medicare (See Attachmets) Physical Activities o Expad availability of prove exercise programs such as EhaceFitess o Ecourage developmet of eviromets that support physical activities such as good sidewalks, walkig trails ad places to walk idoors 2

5 o Stress that ay activity couts housework, gardeig, walkig just move (See Attachmets) o Ecourage older adults to fid social support by joiig frieds i regular physical activity Falls Prevetio o Expasio of evidece-based programs such as A Matter of Balace o Exercise to improve stregth ad balace o Kow ad maage risk factors o Collaboratio betwee older adults, health care providers ad commuity programs to maage ad reduce the risk of falls Nutritio o Icrease the cosumptio of fruits ad vegetables to at least five servigs per day (See attachmet). o Improve access to food by icreasig the rates of food stamp usage ad developig iitiatives to address food security issues for low-icome elders Cross-Cuttig o Build elder friedly commuity cocepts ito commuity comprehesive plaig guidelies o Educate older adults ad health care providers about the importace of physical activity, maagig fall risk factors, ad maagig chroic coditios o Social marketig campaigs that iclude older adults i Maie s public health messages Barriers Weather is a factor which ca limit the ability of older people to participate i physical activity. This ca be because of extremes i temperature either too hot or too cold or poor road coditios. Trasportatio to sites where physical activity/fall prevetio programs are located ca be a challege for older adults as well as the lack of kowledge amog older adults about ways to take resposibility for makig chages i their behavior. Frequetly there is a fee associated with programs which ca preset a barrier for some older adults. Nutritio couselig ad other assistace to iform older people about makig good utritio choices i the food they buy are ot readily available. Implicatios By prevetig disease ad ijury, older people ca remai idepedet for as log as possible, which ca improve their quality of life ad delay the eed for costly log-term care. Public health prevetio expertise, itegrated with the agig services etwork could lead to opportuities to improve the health of older adults. Commuities ca ehace opportuities for improved physical activities for older people by cosiderig evirometal chages whe repairs ad reovatio are made to streets ad sidewalks. 3

6 Medicare offers umerous prevetive services, but ot all people with Medicare are aware of this. CMS (Ceters for Medicare ad Medicaid Services) is workig with local SHIPs (State Health Isurace Iformatio Couselig ad Assistace Programs) ad other state ad local orgaizatios to make people with Medicare aware of these services, which ca help people stay healthy ad fid health problems early, whe treatmet works best. A listig of these beefits is attached. Leadig a healthy lifestyle has importat implicatios i the ability of older people to maitai their idepedece. 4

7 Attachmet 1 Medicare & You Medicare Prevetive Beefits 5

8 Attachmet 1 Medicare & You Medicare Prevetive Beefits (Cotiued) 6

9 Attachmet 2 Maie 2005: Physical Activity Adults with 30+ miutes of moderate physical activity five or more days per week, or vigorous physical activity for 20+ miutes three or more days per week* Age: No Yes ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 360 * From the Natioal Ceter for Chroic Disease Prevetio & Health Promotio: Behavioral Risk Factor Surveillace System = Percetage, = Cofidece Iterval, = Cell Size Percetages are weighted to populatio characteristics. Use cautio i iterpretig cell sizes less tha 50. N/A = Not available if the uweighted sample size for the deomiator was < 50 or the half width was > 10 for ay cell, or if the state did ot collect data for that caledar year. 7

10 Attachmet 2 Maie 2005: Physical Activity (Cotiued) 8

11 Attachmet 3 Maie 2005: Fruits ad Vegetables Adults who have cosumed fruits ad vegetables five or more times per day* Age: Cosume 5 or more times per day Cosume less tha 5 times per day ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 560 * From the Natioal Ceter for Chroic Disease Prevetio & Health Promotio: Behavioral Risk Factor Surveillace System = Percetage, = Cofidece Iterval, = Cell Size Percetages are weighted to populatio characteristics. Use cautio i iterpretig cell sizes less tha 50. N/A = Not available if the uweighted sample size for the deomiator was < 50 or the half width was > 10 for ay cell, or if the state did ot collect data for that caledar year. 9

12 Attachmet 3 Maie 2005: Fruits ad Vegetables (Cotiued) i Accordig to Federal Cesus Estimates ii Maie Behavioral Risk Factor Surveillace System