The Personal Context of Later Life: Physical, Cognitive, and Mental Health Issues

The Demographics of Aging

Physical, Cognitive, and Mental Health Issues

Introduction

Sarah is an 87-year-old African American woman who comes from a family of long- lived individuals. She has never been to a physician, and she has never been seriously ill. Sarah figures it’s just as well that she has never needed a physician, because for most of her life she had no health insurance. Because she feels healthy and has more living that she wants to do, Sarah believes that she’ll live for several more years. What is it like to be old? Do you want your late life to be described by the words and phrases you wrote at the beginning of the chapter? Most of us probably want to be like Sarah and enjoy a long, healthy life. Growing old is not something we think about very much until we have to. Most of us experience the coming of old age as a surprise. It’s as if we go to bed one night middle-aged and wake up the next day feeling old. But we can take comfort in knowing that when the day comes, we will have plenty of company.

 The Demographics of Aging

There have never been as many older adults alive as there are now, so you see many more older people than your great-grandparents (or even your parents) did. The propor- tion of older adults in the population of industrialized countries has increased tremen- dously, mainly due to better health care and to lowering women’s mortality rate during childbirth. People who study population trends, called demographers, use a graphic technique called a population pyramid to illustrate these changes.Figure 14.1 shows population pyramids for the most developed and least developed countries combined around the world. Let’s consider developed countries first (they’re designated by the darker color in the figure). Notice the shape of the population pyramid in 1950, shown in the top panel of the figure. In the middle of the 20th century, there were fewer people over age 60 than under age 60; so the figure tapers toward the top.

Comparing this to projections for 2050, you can see that a dramatic change will occur in the number of people over 65. These changes also occur in developing countries, shown in the lighter color. The figures for both 1950 and 2014 look more like pyramids because there are substantially fewer older adults than younger people. But by 2050, the number of older adults in developing countries will have increased dramatically, changing the shape of the figure.

The Diversity of Older Adults

Older women outnumber older men in all ethnic groups in the United States. The number of older adults among ethnic minority groups is increasing faster than the number among European Americans (Pew Research Center, 2014). Older adults in the future will be better educated too. By 2030, it is estimated that 85% will have a high-school diploma and about 75% will have a college degree (U.S. Census Bureau, 2014b). Better-educated people tend to live longer—mostly because they have higher incomes, which give them better access to good health care and a chance to follow healthier lifestyles. Internationally, the number of older adults is also growing rapidly (Pew Research Center, 2014). These rapid increases are due mostly to improved health care. Nearly all countries are facing the need to adapt social policies to incorporate these changing demographics and resulting societal needs.

 Longevity

The number of years a person can expect to live, termed longevity, is jointly determined by genetic and environmental factors. Researchers distinguish among three types of longevity: average life expectancy, useful life expectancy, and maximum life expectancy. Average life expectancy (or median life expectancy) is the age at which half of the people born in a particular year will have died. As you can see in Figure 14.3, average life expectancy at birth for people in the United States has increased, mainly due to significant declines in infant mortality and in the number of women dying during childbirth, elimination of major diseases, and improvements in medical technology. Currently, average life expectancy at birth for American women is 81 years; for men, it’s 76.2 years (National Center for Health Statistics, 2014b).