AGEING increases the risk of chronic diseases such as dementias, heart disease, type 2 diabetes, arthritis, and cancer. These are the leading drivers of illness, disability, death, and health-care costs.

The risk of Alzheimer’s disease and other dementias increases with age, and these conditions are most common in adults 65 and older. In 2021, health care and long-term care costs associated with Alzheimer’s and other dementias in the United States alone were $355 billion, making them some of the costliest conditions to society.

Dementia

Alzheimer’s disease, the most common type of dementia, is an irreversible, progressive brain disease that affects millions of adults worldwide. It is the fifth-leading cause of death for those aged 65 or older.

Alzheimer’s disease and other dementias slowly destroy the brain. They lead to cognitive declines, such as memory loss, language problems, or poor executive function, and functional declines, such as less ability to do daily activities and self-care. In some cases, dementias can lead to behavioural and personality changes, such as depression, paranoia, hallucinations, delusions, or agitation.

People with cognitive decline may find it hard to stay healthy or manage other chronic conditions. Early detection of cognitive decline, including Alzheimer’s and other dementias, provides an opportunity to manage other chronic health conditions and create health-care plans.

People are living longer and dementia and other disabling chronic conditions are becoming more common, so the need for caregivers, both unpaid (family and friends) and paid (professionals) will increase significantly as the population ages.

Although caregiving can be rewarding, caregivers are at risk of increased stress, depression, worse health, cognitive decline, and poor attention to their own health. Caregivers of people with dementia are at even higher risk, and they may delay dealing with their own health needs.

Unpaid caregivers provide most of the long-term and supportive care in people’s homes. According to 2015–2018 Behavioral Risk Factor Surveillance System (BRFSS) data, about 20 per cent of US adults aged 18 or older reported providing care or assistance to a person with a long-term illness or disability in the past 30 days. More than half of these caregivers help with personal care (such as bathing), and four in five manage household tasks such as finances or cleaning. In 2020, the value of this unpaid care for people with dementia was an estimated US$257 billion.

Improve the health of older adults by:

* Helping those with dementia remain active, independent, and involved in their community as long as possible.

* Providing resources to help caregivers stay healthy and deliver quality care to their care recipients.

* Increasing early assessment and diagnosis, risk reduction, and prevention and management of chronic diseases for people with or at risk of

Alzheimer’s disease and other dementias.

* Increasing the use of other clinical preventive services like blood pressure checks, cancer screenings, and blood sugar testing.

* Increasing the number of people who speak to a health-care provider about their worsening memory.

* Promoting physical activity programmes to reduce the risk of dementia and arthritis pain.

Arthritis

In the United States, half of all adults aged 65 and older, or more than 27 million people, have arthritis. The CDC said it recognised the following proven approaches to reduce arthritis symptoms, steps which can be taken by other countries:

* Participate in a self-management education programmes that teaches the skills and confidence to live well with arthritis every day.

* Be active. Physical activity — such as walking, bicycling, and swimming — decreases arthritis pain and improves function, mood, and quality of life. Adults with arthritis should move more and sit less throughout the day. Getting at least 150 minutes of moderate-intensity physical activity each week is recommended. However, any physical activity is better than none. Physical activity programmes can improve health for participants with arthritis.

* Maintain a healthy weight. People can reduce their risk of knee osteoarthritis by controlling their weight.

* Protect your joints. People can help prevent osteoarthritis by avoiding activities that are more likely to cause joint injuries.

* Talk with a doctor. Recommendations from health-care providers can motivate people to be physically active and join a self-management education programme. People with inflammatory arthritis, such as rheumatoid arthritis, have a better quality of life if they are diagnosed early, receive treatment, and learn how to manage their condition.

Clinical preventive services

Clinical preventive services can prevent disease or find it early, when treatment is more effective. These services include:

* Screenings for chronic conditions such as cancer, high blood pressure, and type 2 diabetes.

* Immunisations for diseases such as flu and pneumonia.

* Counselling about personal health behaviours.

Source: US CDC