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The State of Health in New Mexico 2018

4. Healthy Seniors

Aging Well through Healthy Lifestyles and Early Disease Detection

With aging comes a higher risk of health problems, including chronic disease, disability and death. To stay disease- and disability-free as long as possible, healthy lifestyles along with early detection and management of chronic diseases are needed.

Hospitalization

Older adults use more health care than their younger counterparts. In New Mexico, the top reasons for hospitalization among adults aged 65 years and older are heart disease, unintentional injury, septicemia, and influenza and pneumonia. The majority of injury hospitalizations are due to injuries from falls, and older adults hospitalized for injuries are likely to be transferred to another inpatient facility, such as a skilled nursing facility or an inpatient rehab facility, instead of being discharged to their home. A decrease in bone density increases the likelihood of serious injury from falls. Bone density, strength, and balance can be increased through physical exercise. Other interventions that have been shown to be effective in preventing falls include doing Tai Chi, home safety assessment and modification, switching from multifocal lenses to single lens glasses, and gradual withdrawal of psychotropic medications such as sedatives.

Influenza is highly contagious, as are most kinds of pneumonia. Older adults are more susceptible to complications if they become ill. The national goals for seasonal influenza and pneumococcal vaccination among adults aged 65+ are each 90%. In New Mexico in 2015-16 flu seasoin, 58.1% of older adults reported having an influenza vaccination in the last year and in 2016, 72.6% reported ever having had a pneumococcal vaccination.

Leading Causes of Death

The leading causes of death among adults aged 65 years and older are coronary heart disease, cancer, chronic lower respiratory diseases and stroke (Figure 1). Four-fifths of all heart attacks in New Mexico occur in people aged 65 years and older, and 13.3% of New Mexico adults aged 65 years and older report that they have had a heart attack. Modifiable risk factors include high blood pressure, high cholesterol, cigarette smoking, and physical inactivity. Heart disease deaths have been decreasing in New Mexico and elsewhere. While changes in lifestyle have played a role in reducing heart disease deaths, advances in medical treatment have probably been a bigger factor.

Cancer was the second-leading cause of death from 2014-2016 for New Mexicans aged 65 years and older. The most common cancer deaths among older adults are lung and colorectal cancer. Cancer risk factors under our control include quitting smoking, drinking alcohol in moderation or not at all, eating a healthy diet, being physically active, keeping a healthy weight, and limiting exposure to the sun. Routine cancer screening, such as mammography and colonoscopy, allows cancer to be detected early and is an important step in reducing death and disability from cancer.

Chronic obstructive pulmonary disease, or COPD, is characterized by lung damage and breathing problems and includes conditions such as emphysema and chronic bronchitis. Chronic lower respiratory disease (CLRD), includes COPD and asthma. While asthma is typically reversible, COPD is not. COPD is a progressive disease and is more likely to be diagnosed among older adults. In 2016, 12% of New Mexico adults aged 65 years and older (almost 41,000 adults) had been diagnosed with COPD. COPD is caused primarily by cigarette smoking, exposure to second-hand smoke and air pollution, although there are also some genetic components. COPD is more common among Black/African American and White adults.

The risk of stroke increases with age. About one in 13 adults aged 65 years and older report they have had a stroke, compared with one in 53 for adults aged 18 to 64. Almost 90% of all stroke deaths in New Mexico are among adults aged 65 years and older. A stroke occurs when an artery in the brain is either ruptured or clogged. The affected area of the brain can be damaged within minutes, potentially causing long-term disability or impairment. Timely treatment by a medical professional is imperative, so if you are having symptoms of a stroke, call 9-1-1.

In 2016, two-thirds of all unintentional injury deaths among older adults were due to falls. Older adult deaths from fall injuries decreased from 2008 to 2013, but have increased in recent years.

Life Expectancy

Life expectancy from birth measures health status across all age groups. Life expectancy from age 65 is the number of years that a person who is age 65 can be expected to live and is often used as a measure of a healthy adult population. Life expectancy from birth is very sensitive to infant mortality and child injury deaths, life expectancy from age 65 largely reflects the burden that chronic disease mortality places on a population. Life expectancy from age 65 in New Mexico was 20.7 years in 2016, compared with 19.4 years in the U.S. Years of life expectancy from age 65 was lower in southeastern New Mexico and and generally higher in northern counties (Figure 2).

Contributing Factors

Risk and Resiliency Factors

Older adults are more likely to report fair/poor health (Figure 3). But older adults also reported lower smoking rates and a lower prevalence of obesity. Cigarette smoking is a major risk factor for the leading causes of death and illness, including heart disease, stroke, cancer and chronic obstructive pulmonary disease.

The 2008 Physical Activity Guidelines for Americans report suggests healthy adults should have at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week. The report also includes specific guidelines, including balance exercises, for adults age 65 and over. Physical inactivity is associated with heart disease, diabetes, high blood pressure, and colon cancer. Regular activity also builds and maintains healthy bones, muscles and joints. of older New Mexico adults were more likely to be inactive than their younger counterparts. In 2016, 28% of older adults had no leisure-time physical activity, compared with 20.7% among younger adults.

A healthy diet, one that contains less fat and more fresh fruits and vegetables, is associated with a reduction in obesity, heart disease, diabetes, and some cancers. Older New Mexicans were only slightly less likely (17.2%) than younger adults (18.1%) to eat five fruits and vegetables a day.

Health Disparities

Risk of death from various causes among older persons varies significantly by race/ethnicity. Heart disease death rates were highest among Whites and lowest for Asian and Pacific Islanders. The risk of death from cancer was highest among White, Black and Hispanic persons, and lower in American Indian and Asian/Pacific Islander groups. Risk of death from COPD was highest among Whites, and risk of death from diabetes was highest in the American Indian population.

Lower income and education levels put older adults at higher risk for a number of health problems. Older adults with annual incomes under $15,000 were more likely to have diabetes and be physically inactive. They were three times more likely to smoke cigarettes, twice as likely to be physically inactive, and four times as likely to report that their health is "fair" or "poor" compared to those with incomes over $50,000. Those with less than a high school education were more likely to have diabetes and more likely to be overweight or obese. They were more than twice as likely to smoke cigarettes, more than twice as likely to be physically inactive, and more than three times as likely to report that their health was "fair" or "poor" compared to those who were college graduates.

Assets and Resources

The New Mexico Aging and Long-Term Services Department (ALTSD) provides an array of services and supports to older adults that promote healthy and active lifestyles.

The ALTSD also supports the Healthy Aging Campaign - " Know Your Numbers, Change Your Numbers, Change Your Life". This campaign was created by the late NMDOH Secretary Retta Ward during her tenure as the ALTSD Secretary. She believed it was never too late to make changes that can improve your health.

ALTSD, through its contract providers, also supports services to assist family caregivers. Caregiver health can be at risk due to the stresses of caregiving tasks. At 1-800-432-2080 a resource specialist can direct caregivers to appropriate resources. You may also visit the Caregivers Information page to get started.

New Mexico's Area Agencies on Aging provide services throughout the state and support several evidence-based, community programs, such as EnhanceFitness®, that provide health benefits and promote disease and injury prevention. Visit the Healthy Aging & Prevention page for a list of programs.

Paths to Health NM: Tools for Healthier Living / Caminos de Salud NM: Técnicas para Vivir Mejor uses a statewide referral system to connect older adults with evidence-based community programs that have been proven to work. These programs empower older adults with chronic conditions to develop essential disease management skills to prevent or manage chronic health conditions or injuries and have been shown to improve quality of life and reduce falls. (www.pathstohealthnm.org)

Summary

The contribution of unintentional injury, and specifically fall injury, to morbidity and impact on quality of life makes it an important health issue for older New Mexicans. Heart disease was the leading cause of death as well as the leading reason for inpatient hospitalization among this group, and cancer was the second leading cause of death among New Mexicans age 65 years and over, with lung cancer as the leading cause of cancer death and the second leading reason for cancer hospitalization among this age group. Factors contributing to falls, hearth disease and lung cancer incidence and death overlap to some degree. Physical activity is key for building bone density, balance, and strength to avoid life-threatening fall injuries and also for maintaining cardiovascular fitness. Use of clinical preventive health care is essential for early detection, treatment, and managment of heart disease as well as most types of cancer. Routine health screenings can also detect high blood pressure and cholesterol that contribute to heart disease and stroke. On balance, the evidence suggests that the top modifiable health issues for older adults are physical activity and getting routine clinical preventive care. A life history of cigarette smoking is a major contributor to heart disease and lung cancer (as well as chronic lower respiratory disease and stroke, the third and fourth leading causes of death). Cigarette smoking prevalence was relatively low among older New Mexicans, but for those who smoke, quitting smoking is the number one opportunity to improve their health. References
  1. John N. Morris, Elizabeth P. Howard, Knight Steel, Katherine Berg, Achille Tchalla, Amy Munankarmi, and Daniel David. Strategies to reduce the risk of falling: Cohort study analysis with 1-year follow-up in community dwelling older adults. BMC Geriatr. 2016; 16: 92. «
  2. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD007146. doi: 10.1002/14651858.CD007146.pub3. «


Figure 1. Six Leading Causes of Death By Age Group, New Mexico, 2014-2016 Six Leading Causes of Death By Age Group, New Mexico, 2014-2016 Sources: NMDOH BVRHS, UNM GPS Program Figure 2. Life Expectancy from Age 65 by County, New Mexico, 2014-2016 Life Expectancy from Age 65 Sources: NMDOH BVRHS, UNM GPS Program Figure 3. Health Risk and Resiliency Factors by Age Group, New Mexico Adults, 2014-2016 Health Risk Factors for Adults by Age Group Younger adults were 18-64 years (colorectal screening & mammography age 50-64 years). Older adults were aged 65 years or more, (colorectal screening age 65-75 years, mammography age 65-74 years).
* Data were not reported for adults under age 65 years.
(1) 2015. (2) 2014 and 2016, combined.
Sources: NMDOH BRFSS

What is Being Done?

  • Offering evidence-based programs such as the Tai Chi: Moving for Better Balance program, the Enhance Fitness program, the Chronic Disease Self Management program, the Strong Women (and men) Strong Bones program.
  • Increasing awareness about fall risks and fall prevention at health fairs and other venues where older adults participate.
  • Influenza and pneumonia surveillance and vaccination programs.

What Needs to be Done?

  • Continue vigilance with clinical management of high blood pressure, high cholesterol, diabetes, arthritis, and other chronic diseases.
  • Coordinate care between multiple health care providers, especially with regard to medications.
  • Create a comprehensive coordinated approach to using evidence-based healthy aging programs and services statewide.
  • Identify mechanisms for reimbursement for fall screening and prevention activities.
The information provided above is from the New Mexico Department of Health's NM-IBIS web site (http://ibis.health.state.nm.us). The information published on this website may be reproduced without permission. Please use the following citation: "Retrieved Wed, 26 June 2019 from New Mexico Department of Health, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.nm.us".

Content updated: Tue, 29 May 2018 17:33:13 MDT