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"Be on the alert to recognize your prime at whatever time of your life it may occur."

—Muriel Spark


By the end of this chapter, readers will be able to:

  1. Discuss the challenges in defining old age and provide historical and current definitions.

  2. Describe historical perspectives on aging and old age.

  3. Identify reasons for increased longevity in modern times.

  4. Identify demographic characteristics, including age, education, gender, and ethnicity, of older adults in the United States and globally.

  5. Discuss how these demographic characteristics affect the experience of aging.

  6. Analyze the effect of place of residence on the experience of aging.

  7. Identify the impact of cohort effects and individual differences on the experience of aging.

  8. Describe the interaction of public policy with the experience of aging.

  9. Describe models of positive aging.

  10. Discuss the importance of these factors to the health-care provider working with older adults.

Clinical Vignette

An inner-city community in a large city in the United States has experienced a change in demographics over the past 3 decades. Formerly home primarily to upper-class couples, the population of older adults has increased as younger couples have moved to the suburbs to raise their families. At the same time, the average income in the community has gone down, and the number of disadvantaged minority elders has increased. At present, more than 20 percent of the population is over age 60, and more than 50 percent of the population has incomes below the poverty level.

  1. How do you think the change in average age in the community has changed the nature of life there?

  2. What do you think might be some specific considerations in terms of the services the community might need to provide?

  3. Would you like to live in such a community? Why or why not?

  4. What might be some implications of these factors for provision of health care in that community?

The world is growing older. In the United States, the population of people over age 65 is projected to increase from 40.2 million in 2010 to 88.5 million in 2050 (Werner, 2011). Between 1990 and 2011, the adult mortality rate around the globe decreased from 204 per 1,000 to 160 per 1,000 (World Health Organization [WHO], 2013). As the WHO (2012) notes, "Population ageing is a global phenomenon that is now occurring fastest in low- and middle-income countries" (p. 5).

This demographic trend is, in part, the result of improved wellness practices and improved health care. However, in the United States, more than a third of individuals over age 65 have at least one disability (Administration on Aging [AOA], 2012). By age 80, three-quarters reported at least one disability, and 50 percent reported a serious disability.

image AROUND THE GLOBE: Demographics of Aging

The number of older adults globally will be larger than the number of children by 2050. In ...

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