 |
|
|
  
 |
The
passages to middle and old age are full of transitions. They are attended
by change-in work, in family roles, often in economic status, sometimes
in living arrangements. According to the stereotype of aging, productivity
and creativity may decline. Some research, on the other hand, suggests
that they can increase. In fact, social and behavioral research is
now transforming many of our notions about aging. Major social research
issues at NIA include retirement, health and aging among America's
ethnic and racial minority groups, and the status of one of the most
rapidly growing population groups in this country - those 85 and over,
the oldest old. |
Retirement
Many people approaching their own retirement can remember that of
their grandfather. It seemed a final milestone. After the ceremonies
were over, the older couple settled down to a life of leisure, comfort,
and financial security. Whether or not this was always true - and
studies have challenged that rosy picture - retirement was indeed
one of the late milestones in life. Around the middle of this century,
when 65 was a typical retirement age, most people lived only 10 or
12 years after they left the workforce.
That part of the picture
is changing. With increases in life expectancy and earlier retirement
ages, many people now may live a quarter of their lives after they
leave their jobs. The person who retires early - perhaps at age
55 - and embarks on a new career or part-time work is no longer
unusual.
|
Productivity and creativity do not decline inevitably with age.
William Edmondson began carving at age 61. At 67, his work appeared
at the Museum of Modern Art in New York. |
In fact, almost three-fourths of people now approaching retirement would
like to phase down from full-time to part-time work rather than stop working
abruptly, according to the NIA's landmark Health and Retirement Survey
(HRS) at the University of Michigan. The first study to provide an up-to-date
picture of work, retirement, and mid-life family roles in the 1990s, the
HRS is following nearly 13,000 people for at least 12 years, beginning
when they are between the ages of 51 and 61.
The first wave of the survey in 1992 showed that people in this age
group not only want to continue working but also are actively engaged
in family roles and responsibilities. About 70 percent of mid-life married
couples are part of four-generation families, according to the survey,
and they provide substantial assistance, personal and financial, to both
their adult children and their parents.
Americans approach retirement today with a different set of expectations
and needs than in their grandparent's time. As the HRS follows its respondents
into the next century, it will show how they make decisions about retirement
and how they fare, economically and in terms of health, as they pass through
this transition. The findings will help shape employment, health, and
social policies that respond to the new face of retirement.
Ethnic
and Racial Minority Groups
A hundred blocks above Times Square, Broadway turns into the main
street of Washington Heights-Inwood, a New York neighborhood where
bodegas-small Hispanic groceries-are more common than neon. On side
streets that slope down to the Hudson, brownstones adjoin churches
and playgrounds. The shops sell soul food, pizza, bagels, and school
supplies. Washington Heights-Inwood is home to families, many of whom
have lived here for years, and while it may be fascinating to sociologists
by virtue of its ethnic variety, it attracts gerontologists for another
reason: In its 10 square miles live 35,000 people over the age of
60.
This and other multicultural
communities around the country give researchers a chance to study
one of the most important questions in gerontology: How do health
and aging differ among America's ethnic groups? The question is
critical because some ethnic minority groups face higher health
risks than the general population, especially among older people.
African Americans, for example, have higher rates of high blood
pressure, stroke, heart disease, many cancers, diabetes, glaucoma
- all problems that increase with age. Black life expectancy remains
about 5 years below that of whites. Hispanic Americans also have
a higher-than-average prevalence of diabetes, cardiovascular disease,
disability, and other health problems.
|
Photographs by members of the Fort Washington Houses Senior Center
(above and below) capture some of the flavor of Washington Heights-Inwood,
where the North Manhattan Aging Project is gathering data on aging
among various ethnic groups.
|
Many gaps exist in our knowledge of minority aging, including basic data
on the rates of disease. In the New York neighborhood, the North Manhattan
Aging Project is comparing rates and risk factors for dementia among African
Americans, whites, and Hispanics. In Honolulu, dementia among Japanese
Americans is the focus. An in five southwestern states, researchers are
gathering basic epidemiologic data on health and disease among thousands
of older Mexican Americans as part of NIA's Hispanic Health Initiative.
 |
 |
The Oldest Old
Up until the mid-1980s,
one age group in America existed in a sort of demographic limbo. Sometimes
called "statistically invisible," they constituted a small group in
absolute numbers and were, for a variety of reasons, difficult to
study. These were the oldest old, those aged 85 and older, the people
who had survived beyond the better-studied age groups of the "young
old" (65 to 74) and the "old" (75-84). Available surveys rarely provided
detailed information on them.
Now emerging
from obscurity, the oldest old are the focus of increasing study.
One reason is their growing numbers. Between 1960 and 1990, this
age group grew by 232 percent, far outstripping the 39 percent growth
rate for the total U.S. population. The number of centenarians,
people 100 years and older, more than doubled between 1980 and 1990.
The numbers continue to rise. In coming years, the 85-and-over age
group could make up almost a fourth of the older population.
To find out
who the oldest old are and how they live, NIA has launched a major
and ongoing initiative, involving the U.S. Bureau of the Census
and others. Findings to date show women in this age group, most
of them widows, outnumber men by 2 to 1. Disability rates are high
after age 85 and poverty is prevalent. Women in particular are more
likely to be poor and more likely to be institutionalized than men.
The economic
and social impact of the rapid increase in this age group could
be enormous. The oldest old need nursing homes and other forms of
long-term care in much greater numbers than the young old. Even
among people not in institutions, 40 percent of those aged 85 and
over need help from another person in at least one of the activities
of daily living (basic actions like eating, bathing, and dressing).
This assistance frequently comes from the young old, who themselves
are in the early stages of retirement. As the oldest old grow in
numbers, more and more people of retirement age may find themselves
caring for older relatives, a phenomenon with no historical precedent.
The Health and Retirement Study at the University of Michigan found,
for example, that about two-thirds of the survey respondents, who
were between the ages of 51 and 61, have living parents or parents-in-law.
About one-third of older parents were frail, in need of personal
care, or required supervision. In response to these trends, new
patterns of living and caregiving may emerge while health care costs
and quality of life could become ever more critical issues.
|
The rates and risks of disease
among different ethnic and racial groups can offer valuable clues to risk
factors for disease. For instance, preliminary findings from the Honolulu
Aging Study suggest that the prevalence of Alzheimer's disease and other
forms of dementia may be lower among Japanese Americans in this study
than among American and European participants in other studies. If true,
research on the reasons for that difference could bring new insight into
what causes dementia as people age.
Cultural differences among ethnic
groups also provide valuable insight into aging, particularly on issues
surrounding quality of life and independence. A California study of race
differences in coping with cancer found that African-American women were
more likely to rely on family members and friends for help with housekeeping
tasks after leaving the hospital, while white women were more likely to
do the housekeeping themselves. A tendency to have and rely on social
networks for support has also been found in studies with other minority
groups.
On the other side of this coin,
some minority groups use formal care, such as nursing homes, less than
the general population, even though rates of disability are higher among
minorities. While economic status may account for some of this disparity,
researchers suspect that cultural differences - in attitudes toward the
elderly, perhaps, or family caregiving patterns-may also be important.
NIA-supported researchers have found that African-Americans caring for
family members with Alzheimer's disease perceive the burden to be less
than do their white counterparts.
Investigators following these leads
are now studying social networks and caregiving practices among some of
the Nation's major ethnic groups. Part of NIA's Minority Long-Term Care
Initiative, their studies will be valuable in designing caregiving services
for the 21st century.
In North Carolina, the Piedmont Health Survey of the Elderly -
one of four Established Populations for Epidemiological Studies of
the Elderly (EPESE) sponsored by NIA - is determining the prevalence
of diseases such as hypertension and diabetes among its 4,000 participants
54 percent of whom are Black. EPESE studies also collect data on social
networks, health care use, and more. |
|
|
