Diagnosed Dementia in Adults Age 65 and Older:United States, 2022.

Objectives-This report presents estimates of diagnosed dementia in the U.S. civilian noninstitutionalized population age 65 and older by selected sociodemographic characteristics. Methods-Data from the 2022 National Health Interview Survey were used to estimate the percentage of noninstitutionalized older adults with a dementia diagnosis. Information was self-reported unless a knowledgeable proxy responded to questions when the respondent was physically or mentally unable to answer. Prevalence of diagnosed dementia among older adults is presented by age, sex, race and Hispanic origin, veteran status, education, family income as a percentage of the federal poverty level, urbanization, and region. Estimates of dementia reporting by proxy respondent status and interview mode also are presented. Results-In 2022, 4.0% of adults age 65 and older reported ever having received a dementia diagnosis. The percentage of adults with a dementia diagnosis was similar for men (3.8%) and women (4.2%). The percentage of adults with a dementia diagnosis increased with age, from 1.7% in those ages 65-74 to 13.1% in those age 85 and older, and decreased with rising education level, from 7.9% in adults age 65 and older with less than a high school diploma to 2.2% in those with a college degree or higher. Overall levels of older adults with a dementia diagnosis did not vary significantly by mode of interview (telephone or in person).

Current Electronic Cigarette Use Among Adults Aged 18 and Over: United States, 2021.

Use of electronic cigarettes (e-cigarettes) has increased among some adults (1-3).Reducing the use of any tobacco product, including e-cigarettes, is a Healthy People 2030 objective (4). E-cigarettes have the potential to benefit some adults who smoke and are not pregnant if they are used as a complete substitute for regular cigarettes or other tobacco products (5). However, concerns exist about dual use of e-cigarettes and cigarettes (6-9). Use of e-cigarettes among young adults is also a concern because nicotine adversely impacts brain development, which continues into the early to mid-20s (5,10). This report uses 2021 National Health Interview Survey data to describe the percentage of adults aged 18 and over who currently use e-cigarettes by selected sociodemographic characteristics and dual use of e-cigarettes and cigarettes.

JYNNEOS Vaccination Coverage Among Persons at Risk for Mpox - United States, May 22, 2022-January 31, 2023.

From May 2022 through the end of January 2023, approximately 30,000 cases of monkeypox (mpox) have been reported in the United States and >86,000 cases reported internationally.* JYNNEOS (Modified Vaccinia Ankara vaccine, Bavarian Nordic) is recommended for subcutaneous administration to persons at increased risk for mpox (1,2) and has been demonstrated to provide protection against infection (3-5). To increase the total number of vaccine doses available, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) on August 9, 2022, recommending administration of the vaccine intradermally (0.1 mL per dose) for persons aged ≥18 years who are recommended to receive it (6); intradermal administration can generate an equivalent immune response to that achieved through subcutaneous injection using approximately one fifth the subcutaneous dose (7). CDC analyzed JYNNEOS vaccine administration data submitted to CDC from jurisdictional immunization information systems (IIS)† to assess the impact of the EUA and to estimate vaccination coverage among the population at risk for mpox. During May 22, 2022-January 31, 2023, a total of 1,189,651 JYNNEOS doses (734,510 first doses and 452,884 second doses)§ were administered. Through the week of August 20, 2022, the predominant route of administration was subcutaneous, after which intradermal administration became predominant, in accordance with FDA guidance. As of January 31, 2023, 1-dose and 2-dose (full vaccination) coverage among persons at risk for mpox is estimated to have reached 36.7% and 22.7%, respectively. Despite a steady decline in mpox cases from a 7-day daily average of more than 400 cases on August 1, 2022, to five cases on January 31, 2023, vaccination for persons at risk for mpox continues to be recommended (1). Targeted outreach and continued access to and availability of mpox vaccines to persons at risk are important to help prevent and minimize the impact of a resurgence of mpox.

Drug Overdose Deaths in Adults Aged 65 and Over: United States, 2000-2020.

In 2020, 5,209 drug overdose deaths in adults aged 65 and over were recorded (1). Drug overdose death rates for older adults were lower than for other age groups but have increased in the past 2 decades (1,2). This report presents age-adjusted trends in drug overdose death rates, including trends in the type of opioid drug involved, for adults aged 65 and over for 2000-2020 using mortality data from the National Vital Statistics System (NVSS). Age- and sex-specific death rates for adults aged 65-74 and 75 and over are shown by race and Hispanic origin for 2019 and 2020.

COVID-19 Mortality in Adults Aged 65 and Over: United States, 2020.

COVID-19 was the underlying cause of death for a total of 350,381 deaths in the United States in 2020 (1). Although COVID-19 can affect people of any age, older adults were especially impacted during the first year of the pandemic: 81% of COVID-19 deaths in 2020 (282,836) occurred among those aged 65 and over. In this age group, COVID-19 was the third leading cause of death, after heart disease and cancer (1). This report describes COVID-19 mortality in 2020 by selected characteristics in the population aged 65 and over.

Physical Activity Among Adults Aged 18 and Over: United States, 2020.

Regular physical activity can improve overall health and prevent negative health outcomes in people of all ages (1). Increasing the proportion of adults meeting the 2018 Physical Activity Guidelines for Americans for both aerobic and muscle-strengthening activities is a Healthy People 2030 Leading Health Indicator (2), highlighting its priority for well-being. Research shows that health benefits occur with at least 150 minutes a week of moderate-intensity aerobic activity, and that both aerobic and muscle-strengthening activities are beneficial (1). Using data from the 2020 National Health Interview Survey (NHIS), this report presents estimates of the percentage of men and women aged 18 and over meeting guidelines for both aerobic and musclestrengthening activities, by age, race and Hispanic origin, and family income.

Sepsis-related Mortality Among Adults Aged 65 and Over: United States, 2019.

Sepsis is the body's extreme response to an infection and, if not identified and treated quickly, may lead to serious medical consequences and death (1). Sepsis can occur at any age, but infants, people with chronic conditions, people with weakened immune systems, and older adults are at high risk (1). In 2019, there were 201,092 deaths in the United States involving sepsis, with three-fourths of those deaths occurring among persons aged 65 and over (2). This report describes sepsis-related mortality among adults aged 65 and over by age, sex, race and Hispanic origin, and urbanicity.

Health of Former Cigarette Smokers Aged 65 and Over: United States, 2018.

Objective-This report describes select measures of health among former cigarette smokers aged 65 and over. Methods-Data from the 2018 National Health Interview Survey were used to describe the health of former cigarette smokers aged 65 and over by estimating the percentage with fair or poor health, chronic obstructive pulmonary disease (COPD), four or more chronic conditions, and limitations in social participation. The health measures were adjusted for age, sex, race and Hispanic origin, and education and presented by the number of years that the former smoker smoked. The number of years smoked was estimated from responses to questions on the age the former smoker started to smoke regularly and how long ago they quit smoking cigarettes. Results-Among adults aged 65 and over, 49.4% of men and 30.6% of women were former cigarette smokers. Almost one-fourth of former smokers smoked for 40 years or more. Controlling for sociodemographic characteristics, former smokers reported higher levels of fair or poor health, COPD, and four or more chronic conditions compared with never smokers and similar levels of fair or poor health, four or more chronic conditions, and limitations in social participation compared with current smokers. Former smokers had higher levels of fair or poor health, COPD, four or more chronic conditions, and social participation limitations as their years of smoking increased. Conclusions-Smoking cessation has been shown to be beneficial at any age. However, even after quitting smoking, the length of time a person smoked is reflected in current health measures among people aged 65 and over.

Cognitive Performance in Adults Aged 60 and Over: National Health and Nutrition Examination Survey, 2011-2014.

Objective-This report describes cognitive performance in the U.S. noninstitutionalized population of older adults. The association of sociodemographic factors and self-reported cognitive and health status with low cognitive performance is also investigated. Methods-During 2011-2014, the cognitive performance of participants aged 60 and over was assessed during the National Health and Nutrition Examination Survey (NHANES). Cognitive assessment was based on scores from established objective cognitive tests (word list learning with immediate and delayed recall, animal naming, and a digit symbol substitution test). Mean scores and percentile distributions were described by sociodemographic characteristics. Logistic regression modeling was conducted to evaluate the relationship of sociodemographic and self-reported health factors with low cognitive performance, defined by scores in the lowest 25th percentile. The relationship between objective cognitive functioning measures and subjective cognitive decline also was evaluated by calculating sensitivity and specificity measures. Results-A total of 3,181 adults completed at least one of four objective cognitive tests. Mean scores for men were lower than for women in three of four assessments. Mean scores decreased with increasing age and with decreasing level of income and education. Persons reporting poorer health status and subjective cognitive decline were more likely to have low performance on the four assessments. The subjective cognitive decline question had low sensitivity (22.9%-26.7%) in identifying low cognitive performers, but had high specificity in identifying those who did not score low on the cognitive assessments (89.3%-90.9%). Conclusions-Cognitive performance has important implications for the U.S. aging population. Subjective cognitive decline along with older age, low income, low educational attainment, and fair or poor self-reported health were independently associated with lower cognitive performance in a representative sample of U.S. older adults.

Dental Care Among Adults Aged 65 and Over, 2017.

Dental care is often an overlooked aspect of overall health care among older adults. Regular dental care is recommended for all older adults, even those with full dentures (1). Because Medicare does not cover routine dental care, older adults may have trouble accessing appropriate dental care (2). This report describes the prevalence, overall and by selected characteristics, of dental insurance, dental visits, and unmet need for dental care due to cost among adults aged 65 and over.

Dementia Mortality in the United States, 2000-2017.

Objectives-This report presents data on mortality attributable to dementia. Data for dementia as an underlying cause of death from 2000 through 2017 are shown by selected characteristics such as age, sex, race and Hispanic origin, and state of residence. Trends in dementia deaths overall and by specific cause are presented. The reporting of dementia as a contributing cause of death is also described. Methods-Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia. Using multiple cause-of-death data files, dementia is considered to include deaths attributed to unspecified dementia; Alzheimer disease; vascular dementia; and other degenerative diseases of nervous system, not elsewhere classified. Results-In 2017, a total of 261,914 deaths attributable to dementia as an underlying cause of death were reported in the United States. Forty-six percent of these deaths were due to Alzheimer disease. In 2017, the age-adjusted death rate for dementia as an underlying cause of death was 66.7 deaths per 100,000 U.S. standard population. Age-adjusted death rates were higher for females (72.7) than for males (56.4). Death rates increased with age from 56.9 deaths per 100,000 among people aged 65-74 to 2,707.3 deaths per 100,000 among people aged 85 and over. Age-adjusted death rates were higher among the non-Hispanic white population (70.8) compared with the non-Hispanic black population (65.0) and the Hispanic population (46.0). Age-adjusted death rates for dementia varied by state and urbanization category. Overall, age-adjusted death rates for dementia increased from 2000 to 2017. Rates were steady from 2013 through 2016, and increased from 2016 to 2017. Patterns of reporting the individual dementia causes varied across states and across time.

Veteran Status, Sociodemographic Characteristics, and Healthcare Factors Associated with Visiting a Mental Health Professional.

Using data from a nationally representative study of the community-dwelling U.S. population, we estimated the percentage of male veterans who visited a mental health professional in the past year, compared it to an estimate from non-veteran males, and examined factors associated with visiting a mental health professional. We found that 10.5% of male veterans visited a mental health professional in the past year, compared to only 5.6% of male non-veterans. In the regression models, veteran status, sociodemographic factors, and healthcare utilization were independently associated with visiting a mental health professional. These findings demonstrate the importance of using nationally representative data to assess the mental healthcare needs of veterans.

Hospitalization, Readmission, and Death Experience of Noninstitutionalized Medicare Fee-for-service Beneficiaries Aged 65 and Over.

OBJECTIVE: This report provides descriptive measures of hospitalization, readmission, and death among the noninstitutionalized population aged 65 and over using data from a national survey of the noninstitutionalized population linked to Medicare data and the National Death Index. The estimates are presented by self-reported demographic, socioeconomic, heath status, and other characteristics gathered during the interview with the survey participants. METHODS: Data are from the 2000­2005 National Health Interview Survey (NHIS) linked to 2000­2006 Medicare data and the National Center for Health Statistics 2011 Linked Mortality Files. Findings are based on in-home interviews with 25,593 linkage-eligible noninstitutionalized respondents aged 65 and over who were enrolled in fee-for-service (FFS) Medicare during the year following the interview. Among them, 1,100 died during the year following the interview, 5,456 were hospitalized with 3,490 hospitalized once, 1,192 hospitalized twice, and 774 hospitalized three or more times. Among those hospitalized, 1,491 were readmitted to the hospital within 30 days since the discharge. Both population-based and discharge-based measures are used to present the estimates. RESULTS: This is the first report presenting national estimates on hospitalization, readmission, and death using NHIS data linked to the Medicare claims and death data. Among noninstitutionalized Medicare FFS beneficiaries aged 65 and over, 4.5% died in the year following the interview and 21.6% were hospitalized, with a discharge rate of 348.4 per 1,000 population. Among those who were hospitalized and discharged alive, 17.3% were readmitted within 30 days after discharge. About one-quarter of the deceased died in the hospital (including 7.1% who died during a readmission stay).

Deaths from unintentional injury among adults aged 65 and over: United States, 2000-2013.

KEY FINDINGS: In 2012-2013, 55% of all unintentional injury deaths among adults aged 65 and over were due to falls. From 2000 through 2013, the age-adjusted fall injury death rate among adults aged 65 and over nearly doubled from 29.6 per 100,000 to 56.7 per 100,000. In 2012-2013, the death rate due to suffocation was more than 8 times higher among adults aged 85 and over (26.5 per 100,000) compared with adults aged 65-74 (3.1 per 100,000). Among adults aged 65 and over, the death rate due to fire was more than twice as high for non-Hispanic black adults as for non-Hispanic white and Hispanic adults. The death rate from motor vehicle traffic crashes among adults aged 65 and over was 1.7 times higher in nonmetropolitan areas compared with metropolitan areas.

Prevalence of incontinence among older americans.

Objective - This report presents national estimates of incontinence prevalence in the United States using data source-specific definitions of incontinence among persons aged 65 and over by sociodemographic characteristics during 2007-2010. Methods - Data are from the 2007-2010 National Health and Nutrition Examination Survey (NHANES), the 2010 National Survey of Residential Care Facilities (NSRCF), the 2007 National Home and Hospice Care Survey (NHHCS), and the 2009 Long Term Care Minimum Data Set (MDS). Findings are based on in-home interviews with 2,625 noninstitutionalized respondents (NHANES) and reports provided by designated facility or agency staff members for 6,856 residential care facility (RCF) residents (NSRCF), 3,226 current home health care patients (NHHCS), 3,918 hospice discharges (NHHCS), and 2,416,705 nursing home residents (MDS). Response rates for incontinence questions were 84% among noninstitutionalized persons (NHANES), 98% among RCF residents and home health and hospice care patients (NSRCF and NHHCS), and 99% for nursing home residents (MDS). Results - This is the first report presenting national estimates on incontinence for subpopulations of older persons sampled in the Centers for Disease Control and Prevention's National Center for Health Statistics surveys and the Centers for Medicare and Medicaid Services' Long Term Care Minimum Data Set. Because a different definition of incontinence is used by each data collection system, it is not possible to make data comparisons between them or to summarize results across all surveys. Accordingly, only survey-specific results are presented. Including recent data from all of these data collection systems facilitates a multidimensional picture of incontinence, while underscoring the need for a standardized definition.

Food-related choking deaths among the elderly.

During 2007-2010 in the USA, 2214 deaths among people aged ≥65 were attributed to choking on food. The death rate for this cause is higher among the elderly than among any other age group. Using data from the US National Vital Statistics System, we examined the relationship between food suffocation and other causes of death listed on the death certificate. Among decedents aged ≥65, the three most common additional conditions listed on the death certificate were heart disease, dementia and diabetes. However, after estimating the expected joint frequency of other causes based on the overall distribution of all causes of death, we find that three causes-dementia (including Alzheimer's disease), Parkinson's disease and pneumonitis-are most strongly associated with deaths from choking on food among older people.

Trends in late-life activity limitations in the United States: an update from five national surveys.

This article updates trends from five national U.S. surveys to determine whether the prevalence of activity limitations among the older population continued to decline in the first decade of the twenty-first century. Findings across studies suggest that personal care and domestic activity limitations may have continued to decline for those ages 85 and older from 2000 to 2008, but generally were flat since 2000 for those ages 65-84. Modest increases were observed for the 55- to 64-year-old group approaching late life, although prevalence remained low for this age group. Inclusion of the institutional population is important for assessing trends among those ages 85 and older in particular.

Trends in the coronary heart disease risk profile of middle-aged adults.

PURPOSE: To examine recent trends in the coronary heart disease (CHD) risk profiles of the population aged 45 to 64 in the United States. METHODS: Data from the National Health and Nutrition Examination Surveys (NHANES) from 2 time periods (1988-1994 and 2005-2008) are used to estimate the CHD risk functions derived from the Framingham Heart Study. The risk functions take account of levels of blood pressure (systolic and diastolic), total and high-density lipoprotein serum cholesterol, diabetes (doctor diagnosed or based on fasting glucose), and smoking status to estimate the 10-year risk of myocardial infarction or coronary death. We estimate the risk functions by gender, race, and age group (45-54 and 55-64). RESULTS: The CHD risk profile of middle-aged adults has improved over time. For example, the mean 10-year risk of heart attack or CHD death among persons 55 to 64 years has declined from 7.1% to 5.2%. Declines are seen among both men and women and among non-Hispanic Blacks and non-Hispanic whites. CONCLUSIONS: Despite increases in diabetes and obesity, the CHD risk profile of middle-aged adults improved during the period from 1988-1994 to 2005-2008.

The health of male veterans and nonveterans aged 25-64: United States, 2007-2010.

The well-being of military personnel and their families is a topic of growing concern in public health. The effects of military service on physical and psychological health, especially after extended overseas deployments, are complex. There may also be long-term consequences of military service for the health and health care utilization of veterans as they age (1). Today, over 12 million men aged 25-64 in the United States are veterans, representing 15% of the total U.S. male population at those ages (2). More attention is now being paid to gathering accurate data to help veterans readjust to civilian life (3). Many studies of veterans only use information from military or veteran databases, which limits the ability to make comparisons with the overall population. This report uses data from the 2007-2010 National Health Interview Survey (NHIS) to describe the health status of community-dwelling male veterans aged 25-64. It directly compares the health status of veterans with nonveterans on a variety of measures.

Identifying chronic conditions in Medicare claims data: evaluating the Chronic Condition Data Warehouse algorithm.

OBJECTIVE: To examine the strengths and limitations of the Center for Medicare and Medicaid Services' Chronic Condition Data Warehouse (CCW) algorithm for identifying chronic conditions in older persons from Medicare beneficiary data. DATA SOURCES: Records from participants of the NHANES I Epidemiologic Follow-up Study (NHEFS 1971-1992) linked to Medicare claims data from 1991 to 2000. STUDY DESIGN: We estimated the percent of preexisting cases of chronic conditions correctly identified by the CCW algorithm during its reference period and the number of years of claims data necessary to find a preexisting condition. PRINCIPAL FINDINGS: The CCW algorithm identified 69 percent of preexisting diabetes cases but only 17 percent of preexisting arthritis cases. Cases identified by the CCW are a mix of preexisting and newly diagnosed conditions. CONCLUSIONS: The prevalence of conditions needing less frequent health care utilization (e.g., arthritis) may be underestimated by the CCW algorithm. The CCW reference periods may not be sufficient for all analytic purposes.