Two new reports from the CDC show drug and alcohol-related deaths are on the rise for Americans 65 and over. Deaths from drug overdoses have more than tripled over the past 20 years, with over 5000 people over 65 dying of a drug overdose in 2020, and 11,616 dying of alcohol-related causes. "It's important to describe changes in these causes of death for all ages, including the older population," says Ellen Kramarow, one of the authors of the new reports and health statistician at the National Center for Health Statistics. While the CDC didn't explore the factors behind these behaviors, Kramarow believes they are universal. "It's not unreasonable to think that the forces affecting younger people also affect people 65 and older," she says. "Among both men and women, drug overdose death rates among 65 year-olds are higher among non-Hispanic Black people," the CDC report says. "The exception is among women ages 75 and over: non-Hispanic white women in this age group have the highest death rates. Death rates from alcohol-induced causes among people ages 65 and over were highest among American Indian or Alaskan Native people. Alcohol-induced death rates for this group were over twice as high as for the next highest group (Hispanics). Rates increased 46.5% for AIAN people in only one year, from 2019 to 2020." Synthetic opioids such as Fentanyl have had an impact on the health of seniors, with death rates increasing 53% from 2019 to 2020 among people aged 65 and over. "As we get older, the way that we metabolize drugs changes, and as a consequence, the effects of alcohol differ as we age," says Peter Hendricks, a professor at the University of Alabama at Birmingham School of Public Health Department of Health Behavior. "For many people, what may have been a reasonable or moderate degree of alcohol consumption at some point in the past is now enough to result in significant intoxication or inebriation. The risk of falls, motor vehicle accidents and other types of accidents increases as you get older due to age-related changes in motor coordination. What might be considered 'casual' alcohol consumption could ultimately turn deadly as alcohol further impairs motor coordination. This could lead, for example, to a lethal fall at home." Five other leading causes of death and illness for people over 65 are as follows. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.
Heart disease is one of the leading causes of death for people over 65. Statistics show that people with a low risk of coronary heart disease live ten years longer than people who are high risk—so understanding the risk factors is important. "We prefer preventing heart attacks in the first place," says Johns Hopkins cardiologist Seth Martin, M.D., M.H.S. "And to do that, we want to identify and manage risks as early as possible. Age alone doesn't cause coronary artery disease, but the older you get and the longer you've been exposed to the effects of risks such as high blood pressure or an unhealthy lifestyle, the greater your overall risk." Risk factors for heart disease are age, blood pressure, cholesterol, diabetes, excess weight, smoking, and other lifestyle factors such as exercise. "A healthy diet is one of the best weapons you have to fight cardiovascular disease," says the American Heart Association. "The food you eat (and the amount) can affect other controllable risk factors: cholesterol, blood pressure, diabetes and being overweight. Choose nutrient-rich foods — which have vitamins, minerals, fiber and other nutrients but are lower in calories — over nutrient-poor foods. Choose a diet that emphasizes intake of vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils, and nuts; and limits intake of sweets, sugar-sweetened beverages, and red meats. And to maintain a healthy weight, coordinate your diet with your physical activity level so you're using up as many calories as you take in."
Cancer is a leading cause of death for people over 65. "Age is the highest risk factor for developing a majority of cancers, with a few exceptions," says Andrei V. Gudkov, PhD, DSci. "According to the National Cancer Institute (NCI), the median patient age at the time of a cancer diagnosis is 66. The majority of cancer patients — 60% of them — are 65 or older. In fact, one-quarter of new cancer cases are diagnosed in people between the ages of 65 and 74. And the most common cancers occur more often in older patients. The median age for breast cancer is 61; for colorectal cancer, it is 68 and for lung cancer, it is 70. Aging increases cancer risks in our bodies in several ways. The older we are, the higher the proportion we acquire of cells with mutations. And these cells create populations of high risk for recruiting cancer-initiating cells." Lifestyle factors can make a significant impact on cancer prevention. "First and most important, we need to understand and find ways to treat aging to extend a person's ability to remain healthy," Dr. Gudkov says. "Current science is massively shifting toward development of anti-aging therapies. In anticipation of these emerging solutions, which are expected to cardinally change the situation to better, we can still help ourselves by practicing healthy life habits to slow down aging and thereby reduce the risk of cancer. These include following a healthy diet, consuming antioxidants and treating chronic inflammations. Besides preventive measures, the best anticancer defense is education and preparedness: knowing that cancer risk increases as we age, we need to follow recommended cancer early-detection procedures and be aware of steps we may need to take if we do get cancer and need to choose a treatment regimen."
COVID-19 has been deadly for seniors—statistics show nearly 9 out of 10 COVID deaths are people over 65. "On average, older adults are less resilient. They don't have the same ability to bounce back from serious illness," says Dr. Ken Cohen, executive director of translational research for Optum Care. Gregg Gonsalves, an associate professor at the Yale School of Public Health, believes the COVID-19 pandemic is far from over. In an open letter he and other experts had published Oct. 7 in the BMJ, emphasis was made that pandemics don't just abruptly go away. "Booster coverage, even among older Americans, is abysmal, with only half of vaccinated adults having received a booster. This places the US 73rd globally for booster coverage. Fewer than 6% of immunocompromised Americans—a group that accounted for nearly 1 in 5 hospital admissions during the BA.2 surge—have received Evusheld, a therapy to help prevent covid-19. The US continues to have worse covid-19 outcomes than most of its peer countries. The US's rate of deaths per capita has outpaced other high-income countries in the last year—lowering the country's average life expectancy for the second year in a row. We need a full-court press this fall to reverse these trends and reach more of the public with boosters and antivirals."
According to the CDC, 41.9% of men and 45.9% of women aged 65-74 are obese. "Obesity can occur at any age, even in young children," says the Mayo Clinic. "But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. Generally, lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs and can make it harder to keep off excess weight. If you don't consciously control what you eat and become more physically active as you age, you'll likely gain weight." Obesity in the elderly can result in fewer years of independence and good health. "Among older adults, physical function of the upper and lower extremities and the ability to perform activities of daily living are key for their day to day functioning, and thus important indicators of health," says Dr Rahul Malhotra, Head of Research at Centre for Ageing Research and Education, Assistant Professor at Health Services and Systems Research Programme, Duke-NUS Medical School. "We investigated whether older adults with pre-obesity and obesity, versus those with normal weight, have the same or fewer years of healthy life, when health is defined using these relevant indicators."
[slidetitle num="5"]High Blood Pressure
66.7% of men and 74.3% of women aged 65-74 have high blood pressure, or hypertension. "Early detection of high blood pressure is very important. Often referred to as the 'silent killer' because it may show no symptoms, high blood pressure puts you at an increased risk for heart disease, heart failure, and stroke, among other things," says the FDA. "According to the Centers for Disease Control and Prevention, in 2013, more than 360,000 deaths in the United States included high blood pressure as a primary or contributing cause." "Blood pressure is measured in millimeters of mercury (mm Hg). In general, hypertension is a blood pressure reading of 130/80 mm Hg or higher," says nephrologist Leslie Thomas, MD. "Risks for the development of primary hypertension include family history, advancing age, obesity, high sodium diet, alcohol consumption and physical inactivity… Healthy lifestyle habits —such as not smoking, exercising and eating well — can help prevent and treat high blood pressure. Some people need medicine to treat high blood pressure."
How to Stay Safe Out There
Follow the public health fundamentals and help end this pandemic, no matter where you live—get vaccinated or boosted ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don't travel, social distance, avoid large crowds, don't go indoors with people you're not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.