Approximately 49 million Americans are 65 and older, with projections estimating that the population of older adults will grow to 98 million in 2060.¹ On average, a 65-year old can expect to live another 19 years.² For most older adults, good health ensures independence, security, and productivity as they age. Unfortunately, millions struggle every day with challenges such as chronic diseases, falls, physical inactivity, oral health concerns, and behavioral health issues—all of which can severely impact quality of life. 

Chronic Diseases  

• Older adults are disproportionally affected by chronic conditions, such as diabetes, arthritis, and heart disease. Eighty percent have at least one chronic condition³, and nearly 70% of Medicare beneficiaries have two or more.⁴ 
• The leading causes of death among older adults in the U.S. are chronic diseases—heart disease, cancer, chronic lower respiratory diseases, stroke, Alzheimer’s disease, and diabetes.⁵ 
• Chronic diseases can limit a person’s ability to perform daily activities, cause them to lose their independence, and result in the need for institutional care, in-home caregivers, or other long-term services and supports.⁶ 
• Multiple chronic diseases account for two-thirds of all health care costs6 and 93% of Medicare spending.⁴ Yet, less than 1% of U.S. health care dollars is spent on prevention to improve overall health.⁷ 

Falls  

• One out of four older adults falls each year.⁸ 
• As a result of falls, every 11 seconds, an older adult is treated in the emergency room; every 19 minutes, an older adult dies.⁹  
• Falls are the leading cause of fatal and nonfatal injuries among older adults, causing hip fractures, head trauma, and death.⁹ 
• Older adults are hospitalized for fall-related injuries five times more often than for injuries from other causes.⁹  
• The nation spends $50 billion a year treating older adults for the effects of falls, 75% of which is paid for by Medicare and Medicaid. 10 If falls rates are not reduced, direct treatment costs are projected to reach $101 billion by 2030.¹¹  
• Fear of falling can lead older adults to limit their activities, which can result in more falls, further physical decline, depression, and social isolation.^{12, 13} 

Physical Activity 

• Regular exercise can help older adults stay independent and prevent many health problems that come with age. According to the 2008 Physical Activity Guidelines for Americans, older adults should do two types of physical activities each week to improve their health—aerobic and muscle-strengthening.¹⁴  
• These guidelines recommend that older adults engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous aerobic activity a week and muscle strengthening activities on two or more days a week.¹⁴  
• A 2014 study found that 28% of adults aged 50 and over surveyed reported no physical activity, aside from their regular job, over the past month.¹⁵ 

Oral Health  

• Oral health is important for overall health and wellbeing, but 40% of older adults have not seen a dentist in the last year.¹⁶  
• About 19% of older adults no longer have any natural teeth.¹⁷  
• Of those with teeth, about 19% of older adults have untreated tooth decay, 17 and over 70% have periodontal (gum) disease.¹⁸  
• Poor oral health can negatively impact nutrition and proper management of chronic conditions. 

Behavioral Health  

• One in four older adults experiences a behavioral health problem such as depression, anxiety, or substance abuse.¹⁹  
• These problems can complicate the treatment of other medical conditions, reduce quality of life, increase use of health care services, and lead to premature death.¹⁹  
• In 2014, nearly 11,000 people 60+ died by suicide. Men aged 85+ have a suicide rate that is about four times higher than the rate for all ages.²⁰  
• Excessive alcohol use accounts for more than 23,000 deaths among older Americans each year.²¹ 
• Depression and other behavioral health problems are not a normal part of aging and can be treated. Despite the availability of effective interventions, 66% of older adults are not receiving the care they need.²² 

National Council on Aging's Role 

The National Council on Aging's (NCOA) Center for Healthy Aging believe that every person has a right to age well and focuses on improving the lives of older adults by producing solutions that address social and behavioral determinants of health and wellbeing. The Center houses two National Resource Centers funded by the U.S. Administration for Community Living’s Administration on Aging. 

Chronic Disease Management  

NCOA’s National Chronic Disease Self-Management Education Resource Center provides leadership, technical assistance, and resources to support state and community-based partners in expanding and sustaining evidence-based programs, including the suite of Chronic Disease Self-Management Education Programs, originally developed by Stanford University. These programs, which are available in the community and online, help older adults better manage their chronic conditions and improve their quality of life.  

Falls Prevention  

• NCOA’s National Falls Prevention Resource Center serves as a national clearinghouse for information on falls prevention and supports the implementation and sustainability of evidence-based Falls Prevention Programs.  
• The Falls Free® Initiative, a national effort, includes State Coalitions and the 2015 Falls Free® National Action Plan to reduce falls and fall-related injuries among older adults.  

Other Initiatives  

• NCOA promotes physical activity, behavioral health, and other evidence-based programs.  
• NCOA implements the Aging Mastery Program®, an in-person and online education and behavior change incentive program to help older adults age well.  

Sources 

1. Administration on Aging. Profile of Older Americans: 2017. Found on the internet at https://www.acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2017OlderAmericansProfile.pdf

2. Kochanek KD, Murphy SL, Xu JQ, Arias E. Mortality in the United States, 2016. NCHS Data Brief, no 293. Hyattsville, MD: National Center for Health Statistics. 2017. 

3. Centers forDisease Control and Prevention. Healthy Aging at a Glance 2011. Found on the internet at http://stacks.cdc.gov/view/cdc/22022

4. Chronic Conditions Charts: 2015. Baltimore, MD: Centers for Medicare & Medicaid Services. Found on the internet at https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ChronicConditions/Chartbook_Charts.html

5. National Center for Health Statistics. Health, United States, 2016: With Chartbook on Long-term Trends in Health. Hyattsville, MD. 2017. 

6. Centers for Disease Control and Prevention. The State of Aging and Health in America 2013. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. 

7. The State of Chronic Disease Prevention: Hearing Before the Committee on Health, Education, Labor, and Pensions. (6) 2011. Found on the internet at https://www.gpo.gov/fdsys/pkg/CHRG-112shrg87561/pdf/CHRG-112shrg87561.pdf

8. Stevens JA, Ballesteros MF, Mack KA, Rudd RA, DeCaro E, Adler G. Gender differences in seeking care for falls in the aged Medicare Population. Am J Prev Med 2012;43:59–62. 

9. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (2005) [cited 2016 5 11]. Found on the internet at http://www.cdc.gov/injury/wisqars

10. Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics Society 2018;66(4):693-698. 

11. Houry D, Florence C, Baldwin G, Stevens J, McClure R. The CDC Injury Center's response to the growing public health problem of falls among older adults. American Journal of Lifestyle Medicine 2016;10:74-77. 

12. Gillespie, LD, Robertson, MC, Gillespie, WH, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2012, Issue 9. 

13. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age and Ageing1997;26:189–193 

14. U.S. Department of Health and Human Services (HHS), Office of Disease Prevention and Health Promotion. 2008 Physical ActivityGuidelines for Americans.October, 2008. Found on the internet at http://health.gov/paguidelines/guidelines/

15. Watson KB, Carlson SA, Gunn JP, et al. Physical Inactivity Among Adults Aged 50 Years and Older—United States, 2014. MMWR Morb Mortal Wkly Rep 2016;65:954–958. DOI: http://dx.doi.org/10.15585/mmwr.mm6536a3 

16. National Center for Health Statistics. Health, United States, 2016. Hyattsville, Maryland. 2016. Table 78. Found on the internet at https://www.cdc.gov/nchs/data/hus/hus16.pdf#078

17. Dye BA, Thornton-Evans G, Li X, Iafolla TJ. Dental caries and tooth loss in adults in the United States, 2011– 2012. NCHS data brief, no 197. Hyattsville, MD: National Center for Health Statistics. 2015. 

18. Eke PI, Dye B, Wei L, Thornton-Evans G, Genco R. Prevalence of Periodontitis in Adults in the United States: 2009 and 2010.J Dent Res. Published online 30 August 2012:1–7 

19. Substance Abuse and Mental Health Services Administration (SAMHSA) and Administration on Aging (AoA) Older Americans Behavioral Health Issue Briefs. Found on the internet at ncoa.org/professionals/health/behavioral-health

20. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Data. (2014) Found on the internet at http://webappa.cdc.gov/sasweb/ncipc/mortrate10_us.html

21. Centers for Disease Control and Prevention. Alcohol-related disease impact (ARDI) software. Alcohol and Public Health Web site. Found on the internet at http://nccd.cdc.gov/DPH_ARDI/default/default.aspx

22. Garrido, M. M., R. L. Kane, M. Kaas, and R. A. Kane. 2011. Use of mental health care by community-dwelling older adults. Journal of the American Geriatrics Society 59(1):50-56