o Neurocognitive disorder (dementia)
About 7 million people in the US have Alzheimer’s disease or related dementias
(55.8 million adults in the US are ≥ age 65)
15-20% of adults ≥ 65 y. o. have mild cognitive impairment (may progress to dementia)
Black Americans have twice the risk of whites
Hispanic Americans have 1 ½ times the risk of whites
Delaying onset by 5 years might reduce dementia prevalence by half
o Alzheimer’s disease
-60-70% of dementia cases
-characterized by amyloid plaques and beta tangles
-symptoms include impairments of memory, language, and visuospatial skills
o Lewy body dementia
5% of dementia cases
-characterized by lewy body protein deposits on nerve cells
-symptoms include hallucinations, disordered sleep, impaired thinking, and motor skills
o Parkinson’s disease
- Be able to list the three age ranges of late adulthood.
o The “young-old”: 65-74 years
o The “old-old”: 75-84 years
o The “oldest-old”: 85 years and above
- Be able to describe the effects of older age on sleep patterns.
o Circadian rhythm shifts:
o Early to bed, early to rise
o Napping
o Broken sleep
o Needing less sleep
o Pain can interfere with sleep
o Insomnia can lead to self-medication
- Be able to identify and to describe four common vision problems of older adulthood.
o PRESBYOPIA (FAR-SIGHTEDNESS)
o Begins around age 40; normal and progressive
o CATARACTS
o Almost every older adult develops cataracts. Not all have impaired vision.
o Cataract surgery today is a quick procedure that can restore excellent vision.
o DIABETIC RETINOPATHY
o Damage to the retina due to diabetes
o GLAUCOMA
o About 1% of adults in their 70s; 10% of those in their 90s
o Open-angle glaucoma: the common type. Adults over age 40 should have routine eye pressure screening. Usual treatment is prescription eye drops; must be used consistently as prescribed to prevent blindness.
o Closed-angle glaucoma: less common overall (~1% of 65+ y.o.), but more prevalent (~3%) among Asians.
o MACULAR DEGENERATION
o Deterioration of the retina
o “Dry” macular degeneration can progress to “wet” (sight-threatening).
o Causes “donut hole” in central vision. Early treatment can slow progression.
- Be able to state the rates of severe hearing loss in older adulthood.
o Most older adults lose some hearing acuity
o Nearly 25% of 65-to-74-year-olds, and 50% of those 75 and older, have severe hearing loss.
o Hearing aids have been notoriously expensive
o Not covered by Medicare
o In 2023, the FDA legalized OTC hearing aids to correct mild-to- moderate hearing loss.
- Be able to identify common effects of vision and hearing losses.
o Social isolation
o Motor vehicle and pedestrian accidents
o Falls
o Cognitive impairment and dementias
- Be able to recognize potentially modifiable risk factors for dementia (i.e., factors that, if minimized or eliminated, may prevent or delay the onset of dementia). Don’t attempt to memorize the list of risk factors.
- Be able to explain reasons for older adults’ vulnerability to severe or fatal Covid-19 infection.
o SARS CoV-2, the virus that causes Covid-19, is especially dangerous for older adults
The immune response becomes less effective in old age
In 2017-2020, 41.5% of adults age 60 and over had obesity
In 2019, 29% of adults over age 65 had Type II diabetes1
o Vaccination campaigns must prioritize older adults.
o Both appointment scheduling and vaccine administration must be made accessible.
o Routine healthcare must also be accessible, to maximize overall health and resistance to infectious disease.
