Gains Found in Numbers, Health of the Elderly

The oldest of America’s old are undergoing a population boom and--thanks to a combination of improved medication, better health care, more exercise and more education--are enjoying their waning years in remarkably good health.

The number of Americans 85 and older surged 37% during the 1990s, when the nation’s total population rose just 13%, according to Census Bureau figures being issued today.

Members of the 85-and-over set, according to a recent research report, are far less likely to suffer from disabilities than people who reached that age 10 or 20 years ago.

Nursing homes housed about 1.8 million disabled elderly Americans in 1994, according to Duke University’s Center for Demographic Studies. By 1999, only 1.6 million people with disabilities lived in institutions--1.2 million of them in nursing homes and the rest in assisted-living facilities, which offer a lower level of care.

Better Health to Affect Policy

The survey findings are “astounding,” said Richard Suzman, associate director for behavioral and social research at the National Institute on Aging. “That’s great news. One would wish the nursing homes would go the way of the iron lung,” he said, referring to the apparatus once used to keep polio patients breathing.

The improving health of the elderly may have profound effects on public policy issues such as the future of Social Security and Medicare and the demand for senior housing.

Today’s 85-year-olds are the parents and grandparents of the huge baby boom generation--the 76 million Americans born from 1946 through 1964. The public and personal management and financing of retirement and health care for the baby boomers themselves will be one of the biggest questions facing society in coming decades.

The research suggests that big investments in medical care and treatment are paying dividends by giving the elderly more high-quality years than ever.

“As we wring our hands over the cost of health care and the cost of prescription drugs, we have to keep in mind the benefits,” said John Rother, director of public policy for the AARP. “We get a return in terms of extended good years.”

Accompanying the quality-of-life dividends are financial savings for individuals and taxpayers. The decline in the nursing-home population, for example, was credited with saving $19 billion last year, as 400,000 fewer people needed such care--at an average annual cost of $47,000--than would have if disability trends had continued unchanged from 1994 through 1999.

There were 4.2 million Americans 85 and older last year, a dramatic increase from the 3.1 million tallied in 1990. This category, officially called the “oldest-old” by demographers, accounted for 1.5% of the population, up from 1.2% a decade ago.

Overall, the median age of the U.S. population rose from 32.9 in 1990 to 35.3 in 2000, the highest it has ever been, as the first baby boomers piled into their late 40s and early 50s.

The 65-plus population grew more slowly, reflecting the low birthrates during the Depression. There were 35 million people 65 and older, or 12.4% of the population, compared with 31.2 million, or 12.6%, in 1990.

Disability Rates Dropping Old

Duke, which has sampled the Medicare population in 1982, 1989, 1994 and 1999, has found disability rates declining at each step. For whites 85 and older with the lowest education levels, for example, the disability rate fell from 69% in 1981 to 57% in 1999.

People are considered to be disabled if they need help with one or more of the basic activities of daily living: getting in and out of bed; using the toilet; dressing; eating; bathing; or getting in and out of a chair.

The number of Americans 85 and older soared by 93% from 1982 to 1999, while the percentage living in nursing homes dropped from 21.9% to 19.9%.

Why are the elderly healthier? Reasons include:

* Medical care. “We are keeping damaged hearts working better and allowing people to get around better and have less problems,” said Dr. Kenneth Langa, assistant professor of internal medicine at the University of Michigan. Controlling high blood pressure and diabetes also reduces disability.

* Unexpected side effects of some drugs. Anti-inflammatories, aspirin and brand-name compounds taken to combat arthritis may have some benefit in fighting the onset of Alzheimer’s disease and some cancers.

* Education. As a rule, people who go to school longer enjoy better health as adults, and the members of each new group of elderly are more likely to have completed high school than the last. Better-educated people probably take better care of themselves, and more time in school studying may have a physiological effect on the brain, slowing the development of abnormal brain growths that accompany Alzheimer’s disease.

Other medical treatments now becoming standard have significant promise for reducing the disability rate still further, said Kenneth Manton, a Duke demographer who has directed the studies since 1982 and helped prepare the recent report.

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Older Than Ever

Taken as whole, Americans are older than ever. The median age is 35.3, compared with 32.9 for the 248.7 million people in 1990.

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Sources: U.S. Census Bureau, AP