How Likely Are We To Develop Chronic Health Conditions As We Age

Developing chronic conditions later in life

Almost 100 million Americans have chronic conditions, and millions more will develop them as America ages.  Some individuals are at risk for chronic conditions because of factors that cannot be modified, such as genetic predisposition, gender and age.

Risk factors related to health behaviors, however, can be modified.  The majority of adults approaching their later years have risk factors for chronic conditions because of their health related behaviors.

Risk factors alone can affect health and quality of life.  Adults who have modifiable risks factors for common chronic conditions-but do not have the conditions are less healthy and more limited in their daily activities than those who are not at risk.

Individuals who modify their health related behaviors can reduce the risk of developing chronic conditions and enhance the quality of their lives.

The prevalence of risk factors among adults

Older adults are increasingly at risk for chronic conditions simply because of their age.  The vast majority of the population 51 to 61- 89 percent have at least one modifiable risk factor, and almost one fifth-have three or more modifiable risk factors.

• Almost two-thirds of the population are overweight, and mor e then one third of those who are overweight are obese.
• About half of the population does not engage in light physical activity three or more times per week.  This is a conservative estimate.  The Centers for Disease Control and Prevention recommends vigorous physical activity at least three times a week.  Some 87 percent of the population fail to meet this recommendation.
• Smoking is also a major threat to health.  Over on-quarter of adults 51 to 61 smoke cigarettes, but almost two-thirds-63percent have smoked cigarettes at some point in their lives.

What does it mean to be at risk?

Five modifiable risk factor’s related to health behaviors among people age 51 to 61 who do not have any of the five well known chronic conditions associated with five modifiable risk factors: hypertension, heart disease, diabetes, cancer and stroke.  The five risk factors are:

• Being overweight
• Not exercising enough
• Smoking cigarettes
• Having high cholesterol
• Consuming more than two alcoholic drinks per day

Individuals with three or more of these five risk factors are considered part of the “at risk” for chronic conditions.

A very small proportion of people with any one of the chronic conditions have no risk factors.  About one quarter of people with either hypertension, heart disease, diabetes, or stoke have have three or more risk factors. Lack of exercise and being overweight are the most common risk factors.  For example, 76 percent of people with hypertension and 72 percent of people with heart disease are overweight.

Most people with common chronic conditions have risk factors

Most modifiable risk factors are associated with the development of five well-known chronic conditions-hypertension, heart disease, diabetes, cancer and stroke among adults 51 to 61.  Hypertension is the most common, affecting 40 percent of the people age 51 to 61.

The Health and Financial Risks of Obesity are Large

Overweight and obese individuals are more likely to die prematurely than individuals who are not overweight.  The association between excess weight an increased risk of dying from heart disease or cancer is especially clear.

Obesity is second only to smoking as the leading cause of preventable death in the U.S..  Currently, about one in five U.S. adults is obese.

The cost to the U.S. health system of treating obesity and its resulting complications was in the billions of dollars.

The At-Risk are Less Healthy than the Risk-free Population

Adults at risk for chronic conditions are much more limited in their activities of daily living, or ADL’s, such as bathing, dressing, eating, using the toilet, walking, and getting in and out of bed, than adults without any risk factors.

The At-Risk are Less Socially Active than the Risk-free Population

Adults at risk for chronic conditions are less socially active, both formally and informally, than risk free adults.

Participation in organized social events, such as volunteer work and religious services, is less common among adults at risk than among adults that are risk free.

Not only do people at risk have fewer good friends in their neighborhood, they also socialize less frequently with their neighbors than those who are risk free.  For example, just over one quarter-26 percent of adults at risk, compared to almost one third- 31 percent of risk free adults, socialize with their neighbors on a weekly basis.

Quality of life is lower for the at-risk population compared to the risk-free

The population at risk for chronic conditions is less satisfied with several aspects of their life compared to the risk-free population.  The largest disparity between the two populations is related to dissatisfaction with health or physical condition.  This likely contributes to a difference in satisfaction with “life as a whole.”

Given the lower level of satisfaction among the at-risk population, it is not surprising that this population has more symptoms of depression than the risk-free population.  Some 38 person of the at-risk population report symptoms of depression, compared to just less than one quarter-24 percent of the risk free population.

Retirement decisions also reflect the negative aspect of risk factors

Risk status appears to play some role in retirement decisions.  Some 11 percent of the population at risk, compared to 8 percent of the risk-free population, are completely retired.

Poor health often plays a large role in a person’s decision to retire, and may lead to an early retirement.  Among completely retired individuals, some 42 percent of those at risk report that poor health was a very important reason in the decision to retire, compared to 14 percent of those who are risk-free.

Satisfaction in retirement is also much lower for the at-risk population, compared to the risk-free population.  And a smaller proportion- 40 percent of those at risk wanted to retire compared to those who are risk-free.

Decisions regarding work are related to risk status.  Being at risk for chronic conditions does not have much of an impact on decisions about whether or not to work.

Decisions regarding the type or amount of work individuals do, however, appear to related to work status.

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