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Bridging The Gaps In Mature Health

Gender & Education Play A Role

Elder care nurse playing jigsaw puzzle with senior woman in nursing home

By John Salak –

Getting a handle on the issues faced by mature adults is an increasingly critical consideration for caregivers, families, public health officials and organizations and facilities that assist aging individuals.

Challenges can range from cardiovascular disease to diabetes and issues with general frailty. Foremost among these concerns, however, is the growing problem with age-related dementia. It currently affects more than 5 million adults, a number that is expected to double in the coming decades. In line with this, more than 20 million people in the U.S. alone provide unpaid care for someone suffering with dementia. With no immediate cure in hand, caring for someone plagued by dementia usually means managing its symptoms and reducing discomfort.

The most common issues for those with dementia include pain, agitation, anxiety and resistance to care, according to Indiana’s Regenstrief Institute. The group noted that these issues occur with the same frequency and intensity whether the individual is in a treatment center or being looked after by unpaid caregivers.

“We found that both the rate and types of symptoms suffered by community-dwelling people with dementia were very similar to those in a nursing home setting,” explained Dr. Kurt Kroenke, citing Regenstrief research. “More than 40 percent of these people were experiencing these symptoms at least weekly. The symptoms are not subtle, they are not infrequent, and they do have a significant impact on the quality of life for patients and caregivers.”

While extensive research on treatment is underway, establishing an early handle on the causes or conditions that seem to accelerate the disease’s hold on individuals is also essential for public health officials and treatment facilities.

A recent Japanese microsimulation of that country’s aging population has lent some insights that might help. Relying on a database of 40 million people, the research found the country’s population will live longer on average during the next 20 years and that individuals will spend fewer years dealing living with dementia than in the past.  That’s the good news, especially for a country known for having relatively long lifespans.

The simulation model, however, revealed that demographics and economic factors seem to have a marked impact on how mature health issues shake out.

The research suggests, for example, that Japanese women with a less than high school education aged 75 and over may be disproportionately affected by both dementia and frailty. The University of Tokyo, which helped sponsor the study, noted that having a better understanding of where health gaps exist is critical for proactively attacking these problems. Deeper insights also help caregivers, public health officials and treatment facilities deal with these issues.

The Japanese University, in conjunction with researchers at Stanford University, looked to discover these gaps by creating a new microsimulation model that accounted for more diverse conditions than previous models.

“We developed a new Japanese microsimulation model that accounts for 13 chronic conditions, including heart disease, stroke, diabetes, depression and dependency, as well as frailty and dementia,” explained

Professor Hideki Hashimoto. “Using an ultra large data system, we were able to ‘follow’ a virtual cohort of more than 40 million people aged 60 and over from 2016 to 2043.”

The new microsimulation approach yielded some important highlights.

“I believe that problems of aging are a matter of health gaps over the course of people’s lives,” he said. “Our projection brings attention to a widening health gap among older people. It highlighted that women with a less than high school education aged 75 or over are more likely to be affected,” Hashimoto added.

The Japanese study admittedly focused on a single country, but the research developed can be applied to the issues of aging worldwide.

“People might believe that an increase in cases of dementia is inescapable, given population aging. However, in this study we found that in Japan, despite an aging population, the number of people with dementia is expected to decrease over the next two decades,” Hashimoto said. “Population aging does not necessarily mean an increase of social burden for care, but it does bring a diversity of problems that require careful study and science-based policy attention, to close the health gap.”

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