Health of Older Adults

As people get older, they are likely to experience a chronic disease such as cardiovascular disease, cancer, diabetes, osteoarthritis, and chronic pulmonary disease just to mention a few. This is very serious considering older adults are the fastest growing age groups especially in the U.S. More reports show that by 2030 more than 37 million adults will manage more than 1 chronic condition (Healthy People 2020). Cardiovascular disease is on the rise especially among the aging population. It is one of the leading diseases that lead to the hospitalization, death, and social security disability as well. For many years cardiovascular disease has had a greater impact on the aging population. These chronic diseases claim many lives of the older population around the world. The chronic conditions in the aging population are in most cases accompanied by other chronic comorbidities.

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Cardiovascular disease is one of the most chronic diseases that accompany people in their old age. Cardiovascular disease generally refers to those conditions that are associated with narrowed or blocked blood vessels that usually lead to conditions like heart attack, angina (pain in the chest), or stroke. Cardiovascular disease as well as other chronic diseases are at the top of the list of the most dangerous diseases that kill people all over the world (Healthy People 2020). The older population is mostly affected by these diseases and if not well managed or treated, or even diagnosed on time, they are likely to cause death at a very high rate. The prevalence of multiple chronic diseases is very high in older people and is projected to rise with the increasing older population. Older people with more than one chronic diseases have increased risk of mortality but the discordant effects on survival depend on specific disease combination. However, patients who have the increased likelihood of opportunity for care from their physician are more likely to have the comorbid diseases detected at an earlier stage and managed (Moreno & Mangione, 2013). Majority of clinical practice and research is mostly centered on a single-disease-based paradigm and this may not be suitable for older patients with multiple morbidities. Primary care must become more centered on the whole patient rather than individual diseases.

Type 2 diabetes is one of the leading causes of chronic kidney disease. Cardiovascular disease on the other hand, is an associated comorbidity in patients with type 2 diabetes and chronic kidney disease (Stevens et al., 2010). A cross-sectional survey study was done to evaluate the characteristics of chronic kidney disease and associated comorbidities in patients with type 2 diabetes and chronic kidney disease. The study showed that people suffering from chronic kidney disease and type 2 diabetes have a significantly elevated prevalence of cardiovascular disease compared to non-diabetic patients. Thus, older people who are suffering from type 2 diabetes and chronic kidney disorder are at a high risk of developing a cardiovascular disease. The combination of comorbidities observed in patients with chronic kidney disease and type 2 diabetes as defined in the study shows that this population has distinct requirements for coordinated treatment (Stevens et al., 2010). At the same time, the data reported by the study suggest that there is much potential to improve patient outcomes and reinforce the imperative for physicians to follow evidence-based guidance in risk factor management.

Two of the commonest chronic diseases experienced by older adults are cardiovascular diseases and osteoarthritis (Prior et al., 2012). These two chronic diseases co-occur but this is partly explained by age. Despite this, there have been very few studies that has focused on investigating a priori hypotheses in testing the comorbid interaction between two chronic diseases and the related health and healthcare outcomes. As life spans are increasing, there is likelihood that each individual person is will experience multiple chronic diseases. Yet, most studies are only focusing on one chronic disease. Such approaches do not address the common experience of older populations with multiple chronic diseases such as cardiovascular and osteoarthritis. In addition, cardiovascular disease shares many of the chronic disease characteristics as shown by osteoarthritis and thus it is an important cause of disability and mortality as well (Healthy People 2020).

Chronic obstructive pulmonary disease is one of the top most causes of death in the whole world. High mortality that is observed in older people with chronic obstructive pulmonary disease is in part attributable to comorbidities. Diabetes mellitus, chronic renal failure, as well as congestive heart failure are known to be comorbidities increasing cardiovascular risk especially in those patients who are suffering with chronic obstructive pulmonary disease (Mazza et al., 2010). Reports show that the relationship that exist between pulse pressure and mortality is greater in older adults with than without chronic obstructive pulmonary disease (Healthy People 2020). This suggests that chronic obstructive pulmonary disease together with pulse hypertension is a condition able to increase the risk of cardiovascular mortality.

In conclusion, disease comorbidity and mortality has become very common especially among people in the ageing population. In most cases, the mortality rates as well as morbidity associated with chronic diseases are irreversible. However, the situation can be reversible if there is the implementation of appropriate procedures in healthcare systems. Therefore, healthcare providers need to concentrate on all the chronic comorbidities and not only one, and through this the comorbid conditions of the aged population will be well managed. This will lead to improved quality of life and a decrease in mortality rate.

References

Healthy People 2020. HealthyPeople.gov. http://www.healthypeople.gov/2020/topics-objectives/topic/older-adults

Mazza, A., Zamboni, S., Rubello, D., Schiavon, L., Zorzan, S., & Casiglia, E. (2010). Chronic obstructive pulmonary disease and cardiovascular mortality in elderly subjects from general population. Blood Pressure, 19(2), 67-74. doi:10.3109/08037050903464642

Moreno, G., & Mangione, C. M. (2013). Management of Cardiovascular Disease Risk Factors in Older Adults with Type 2 Diabetes Mellitus: 2002-2012 Literature Review. Journal Of The American Geriatrics Society, 61(11), 2027-2037. doi:10.1111/jgs.12513

Prior, J. A., Rushton, C. A., Jordan, K. P., & Kadam, .. K. (2012). Comorbidity Cohort (2C) study: Cardiovascular disease severity and comorbid osteoarthritis in primary care. BMC Health Services Research, 12(1), 295-305. doi:10.1186/1472-6963-12-295

Stevens, P. E., Schernthaner, G., Raptis, S., Wanner, C., Scherhag, A., & Lameire, N. (2010). Characteristics, Cardiovascular Comorbidity and Medicines Management in Patients with Type 2 Diabetes and CKD: Results of the IRIDIEM Study. Kidney & Blood Pressure Research, 33(2), 119-128. doi:10.1159/000313595