Indirect Influences on Health in Older Adults

Older adults who maintain social contact, whether it be with a spouse, with friends, or through outside interests, have fewer health problems. For example, older adults who are married or who live with a roommate tend to be in better health than those who live alone. Older adults who live with someone also have lower rates of hospitalization and nursing home admissions than those who live alone.

When older people live alone, lack social interaction, or both, new problems and symptoms may not be reported because no one notices. These older adults may have no one to help them take their medications as instructed. They may not prepare and eat balanced meals because physical impairments interfere, because they are lonely, or because they cannot drive or walk to a grocery store. Also, older adults living alone are more likely to be lonely and depressed.

Occasionally, living with a relative or another person causes problems. Older adults may conceal or minimize health problems because they do not want to impose on or inconvenience the relative. If any member of the household is not pleased with the living arrangement, older adults may be neglected or mistreated (psychologically or even physically).

In people with higher levels of education, disorders tend to be detected earlier, and health outcomes tend to be better, even when a disorder is not detected early.

In the United States, poverty is more common among older adults than among the general population, despite the financial help provided by Medicare, Social Security, and Medicaid. Medicare Part D (the prescription medication program), has made medication costs more manageable especially for older adults with a low income. Yet, despite these programs, some older adults still have significant out-of-pocket expenses, making it difficult to pay for health care. When paying for health care is difficult, otherwise treatable disorders are often undertreated or untreated or are treated at a late stage.

Older adults may have difficulty coping with the many changes that occur with aging, such as retirement, loss of loved ones, and development of disorders. In response, older adults may feel lonely, useless, powerless, or sad. They may lose their self-esteem. They may worry about becoming a burden to their family. They may become depressed, especially if they have a disorder that leads to temporary or permanent loss of independence or when they see their friends and loved ones die. These feelings may make older adults less likely to see a health care professional, possibly delaying the diagnosis of a serious disorder. But research has shown that older adults cope with these challenges better than younger adults.

Age-related changes and older adults' responses to them can make treating disorders in older adults complicated. Thus, older adults often benefit from interdisciplinary care—care provided by a team of health care professionals working together. This team may consist of doctors, nurses, social workers, therapists, pharmacists, and psychologists. The care team evaluates the person’s needs and plans, coordinates, and implements care, including social services. Team members actively look for possible problems and take measures to correct or prevent them.