/publications/issue/2011/July2011iPad/Pharmacy-Insights

Pharmacy Insights: Making Sense of the Aging of America

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As more baby boomers continue to reach retirement age every day, much is made of their impact on the US economy and health care. A recent study released by the Agency for Healthcare Research and Quality found that of the patients who were in the top 10% of health care spenders in 2008 and 2009, 40% were 65 or older. Understanding the implications of America’s aging population consumes many people—from savvy marketers and political candidates to the news media and health care professionals, including pharmacists.

A Slow Process

The average life expectancy in the United States is very gradually increasing, according to new data in a report from the Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics. This oft-cited measure of health and longevity climbed from an average of 78.6 years in 2009 to 78.7 years in 2010. At the same time, the death rate declined between 2009 to 2010 to its lowest rate ever, 746.2 deaths per 100,000 individuals. “In many regards, I think the health of the nation is improving and people are living to an older age, so that’s good news,” David McClellan, MD, national regional chair of family and community medicine at Texas A&M Health Science Center College of Medicine told HealthDay. “But we are starting to see age-related diseases have more prominence.”

Shifting Disease States

According to the CDC report, heart disease and cancer remained the most common causes of mortality between 2009 and 2010, although deaths from both declined overall. Deaths from 2 diseases often associated with aging, Alzheimer’s disease and Parkinson’s disease, both increased—by 3.3% and 4.6%, respectively. For the first time since 1965, homicide was not among the top 15 most common causes of death. It was replaced by pneumonitis, an inflammatory condition that occurs by inhaling foreign particles that is often seen in elderly individuals who become too debilitated to swallow properly. The emergence of pneumonitis as a major cause of death reinforces the notion that managing age-related diseases will play an increasing role in health care in the coming years.

Pharmacy’s Impact

The CDC report contained news that should hearten immunizing pharmacists, however. The grouped ranking of influenza/ pneumonia fell from the 8th most common cause of death in 2009 to 9th in 2010. Furthermore, the number of deaths caused by these 2 diseases declined by a combined 8.5%. Michael Niderman, MD, chairman of medicine at Winthrop University Hospital in Mineola, New York, said, “To me, this is very encouraging, because we’re dealing with older populations where many patients frequently have pneumonia, but this affirms the national priority on immunization, both influenza and pneumococcal.”