Bone Health Among Aging Baby Boomers

摘要

The first baby boomers will reach the age of 65 in 2011. Demographers and social policy analysts predict that they will have a major impact on the health care delivery system as they age. Boomers may not think much about osteoporosis because they regard it as a disease affecting older women. Without appropriate prevention and treatment strategies, however, osteoporosis can begin in early adulthood and progress throughout life. The most costly effect of osteoporosis is a fracture of the hip. Hip fractures can cause complications that require months of expensive rehabilitation or contribute to deteriorating health. Advanced practice nurses need to teach aging baby boomers about osteoporosis, including the common risk factors, methods of prevention, and new diagnostic and treatment options. Bone Health in Aging Baby Boomers The effects of baby boomer aging are yet to be determined. About 78 million baby boomers are between the ages of 39 and 57 in 2003. According to Dychtwald, “baby boomers radically transform every stage of life through which they travel.” (1) While arrival of the baby boom generation expanded growth of hospitals and pediatric practices in the 1950s and 1960s, demographers and social policy analysts now predict that there will be a dangerous shortage of eldercare services when baby boomers reach their 60s and 70s. Medicare, the primary source of health care payment for adults age 65 and older, is expected to be solvent only through the year 2015; however, the number needing Medicare will double from the year 2000 to 2030.(2)Boomers influence financial, social, political, and interpersonal forces in society. As this large demographic cohort reaches middle age and anticipates older adulthood, how will society be affected? Will the boomers be healthier when they reach their 60s, 70s, and 80s than older adults today? Will they be more proactive in maintaining their health and in their contact with the health care delivery system than today's older adults? Will their health-care problems and needs require a change in the place and way long-term care is delivered? In an AARP study of 2,127baby boomers aged 38 through 56, 80% of respondents said their “savings aren't on track,” 69% said that they “need to pay more attention to health,” but 63% said that they “feel good about relationships with family and friends.”(3) Osteoporosis Osteoporosis means porous bones, which are weak and thin and can result in fractures. During the aging process osteoclasts, which destroy bone cells, are more active than osteoblasts, which build bone cells. Osteoporosis is a major health problem, and it will continue to be a concern for Americans in the future. Healthy People 2010 addresses this health problem through Objective 2.9: “Reduce the proportion of adults, aged 50 and older, who have osteoporosis from 10% (1988-1994) to 8%.”(4) It is estimated that 55% of people currently 50 years old or older have either osteoporosis or low bone mass. Of 10 million people estimated to have osteoporosis in 2002, 80% were women.(5) Without changes in lifestyle behavior and health management, the number of people with osteoporosis will grow to 12 million in 2010 and 14 million in 2020.(6)Osteoporosis causes 1.5 million fractures a year.(5) Many complications can occur following a fracture, particularly a hip fracture. Limited mobility can cause decreased appetite, increased malnutrition and dehydration, circulatory problems, skin problems, depression, and problems with co-morbid conditions. Without education and primary prevention strategies styled for baby boomers, the incidence of osteoporosis and subsequent complications will increase in this and future decades. Advanced practice nurses have an important role and responsibility in preventing osteoporosis among at-risk boomers, while diagnosing and treating those boomers already beset by bone loss.