The elderly as a sensitive population in environmental exposures: making the case.

The US population is aging. CDC has estimated that 20% of all Americans will be 65 or older by the year 2030. As a part of the aging process, the body gradually deteriorates and physiologic and metabolic limitations arise. Changes that occur in organ anatomy and function present challenges for dealing with environmental stressors of all kinds, ranging from temperature regulation to drug metabolism and excretion. The elderly are not just older adults, but rather are individuals with unique challenges and different medical needs than younger adults. The ability of the body to respond to physiological challenge presented by environmental chemicals is dependent upon the health of the organ systems that eliminate those substances from the body. Any compromise in the function of those organ systems may result in a decrease in the body's ability to protect itself from the adverse effects of xenobiotics. To investigate this issue, we performed an organ system-by-organ system review of the effects of human aging and the implications for such aging on susceptibility to drugs and xenobiotics. Birnbaum (1991) reported almost 20 years ago that it was clear that the pharmacokinetic behavior of environmental chemicals is, in many cases, altered during aging. Yet, to date, there is a paucity of data regarding recorded effects of environmental chemicals on elderly individuals. As a result, we have to rely on what is known about the effects of aging and the existing data regarding the metabolism, excretion, and adverse effects of prescription medications in that population to determine whether the elderly might be at greater risk when exposed to environmental substances. With increasing life expectancy, more and more people will confront the problems associated with advancing years. Moreover, although proper diet and exercise may lessen the immediate severity of some aspects of aging, the process will continue to gradually degrade the ability to cope with a variety of injuries and diseases. Thus, the adverse effects of long-term, low-level exposure to environmental substances will have a longer time to be manifested in a physiologically weakened elderly population. When such exposures are coupled with concurrent exposure to prescription medications, the effects could be devastating. Public health officials must be knowledgeable about the sensitivity of the growing elderly population, and ensure that the use of health guidance values (HGVs) for environmental contaminants and other substances give consideration to this physiologically compromised segment of the population.

Elderly health disparities on the U.S.-México border.

The Ageless Health Needs Assessment is a multi-phase project designed to assess the health and quality of life of the 60 and older population along the U.S.-México border. The present study used a health survey, which was administered to 1,450 participants by telephone and through face-to-face interviews in Western Texas and Southern New Mexico. Several demographic differences were found between the samples: 52% of the Texas sample was Hispanic compared to 23% of the New Mexico sample; 63% of the Texas sample was born in the U.S. compared to 92% of the New Mexico sample; and Texans reported less education and lower incomes than New Mexicans. Exploratory factor analysis revealed four health-related factors, which were labeled Physical Health, Emotional Health, General Health, and Activity Potential. A MANCOVA showed significant differences between groups after controlling for socioeconomic status and age.