Older adults are among the fastest growing population in the US, and the District of Columbia is similarly preparing for expected growth among the 50+ year old population. As Americans live longer, growth in the number of older adults is a new challenge for cities and communities all over the country. In 2017, adults 65+ years old accounted for 11.9% of the District resident population, and nationally accounted for 14.9% of the US population . While there are fewer older adults living in the District compared to the national average, more older adults, 14.3% of adults 65+ are living below the federal poverty line, compared to 9.2% of older adults nationwide .
As people age, they also often have to manage chronic and other diseases that affect quality of life. It’s estimated that 60% of older adults manage two or more chronic conditions . In the District, 60% of older adults reported being diagnosed with high blood pressure, 16.2 % have been diagnosed with cancer, 9.4% have been diagnosed with Chronic Obstructive Pulmonary Disease (COPD), and 19.2% have been diagnosed with diabetes .
The District of Columbia is striving to become an age-friendly city, which is an international process coordinated by the World Health Organization. Cities are evaluated comprehensively for age-friendliness by assessing the built environment, social and civic participation, technology, community support, and preparedness/resilience, to name a few. The District’s AARP Livability Index score, which measures how livable a neighborhood is, is 57 (on a scale from zero, very poor, through 100, excellent).
The DC Healthy People 2020 goals for this topic area include:
1. Older adults live in an ‘age-friendly’ environment where all people can participate in society in a manner that enhances their personal growth, respect, and social inclusion
2. Older adults have access to and information about active recreation, healthful food, and safe and walkable neighborhoods to promote healthy lifestyles.
Fall & Injury Prevention
As the leading cause of fatal and nonfatal injuries among older adults, preventing fall injuries and deaths is an important priority for older adults in the District. Every year in the US, 1 out of 3 older adults fall, yet less than half tell their doctor . Fall-related injuries and deaths can be prevented by addressing risk factors. The Age-Friendly DC plan aims to provide and increase access to home services, clinics and programs that promote wellness and active aging. Programs like “Safe at Home” finance home accessibility adaptations for people living with disabilities and residents over the age of 60 to allow for aging in place. Eligible residents receive up to $10,000 for adaptations to reduce the risk of falls and remove mobility barriers .
Caregivers help people needing ongoing assistance with activities of daily living. The need for unpaid and paid caregivers will likely increase as the US population ages. Approximately 25% of US adults reported providing care or assistance to a person with a long-term illness or disability in the past 30 days . While some aspects of caregiving may be rewarding, caregivers can also be at increased risk for negative health consequences, including stress and depression, and need increased support to preserve their own health. These risks are greater for caregivers of people with Alzheimer’s and related dementia. Over half of caregivers indicate that a decline in their health compromises their ability to provide care .
As the number of older District residents increases, so will the number of caregivers needed to provide care. The number of people 65 years old and older in the US is expected to double between 2000 and 2030, and with that influx it is expected that there will be 71 million people aged 65 years old and older when all baby boomers are at least 65 years old in 2030. Currently, there are seven potential family caregivers per adult. By 2030, there will be only 4 potential family caregivers per adult .
Alzheimer’s is the most common type of dementia, a progressive disease that impacts memory loss and a person’s ability to undertake daily activity . Nationally, over five million Americans are living with Alzheimer’s and this number is expected to triple by the year 2060. In the District, 12.1% of those older than 45 have reported to have experienced subjective cognitive decline, a confusion and memory loss that is getting worse . In 2017, Alzheimer’s was among the top 10 leading causes of death in all Wards except Wards 7 and 8 [DC Mortality Report].
Similar to other diseases, Alzheimer’s disproportionately affects minority populations. A recent CDC study found that among people ages 65 and older in the US, African American populations have the highest prevalence of Alzheimer’s disease and related dementias (13.8%), followed by Hispanic populations (12.2%), and non-Hispanic White populations (10.3%). Age and family history are known risk factors for developing Alzheimer’s. Recent research have also focused on the link between physical and cognitive health. There is growing evidence that indicate physical, mental, and social activities may reduce the risk of Alzheimer’s disease .
Assets & Resources
Promising Practices & Policies:
• OA-I Include screening in preventive care and prenatal visits related to abuse of elderly and vulnerable adults.
• OA-II Increase access to technology (computers, tablets, smartphones, and wifi) at home and in public places for low-income residents age 50+
• OA-III Increase older adults (50+) who volunteer or participate in civic activities.
• OA-IV When renovating playgrounds and parks, design new infrastructure for active recreation, including workout equipment, for all ages and abilities.
• Activity programs for older adults offer educational, social, or physical activities in group settings that encourage personal interactions, regular attendance, and community involvement. Activity programs are a potential means to reduce social isolation; isolation among older adults is associated with poorer health outcomes.
Citations & Additional Data Resources
1. United States Census Bureau. 2017 American Community Survey, 5-year estimates
2. Healthy People 2020. Older Adults. 2018
4. CDC. Injury, Violence and Safety-Take a Stand on Falls. 2017
5. DC Office of Aging. Age-Friendly 2017, Five-year progress report. 2017
6. CDC. Caregiving- A Public Health Priority. 2018
8. CDC. Alzheimer’s Disease. 2018
Chess Dupont Circle. Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)