Baby boomers show high rate of chronic disease

Issue: May 2013

Aging baby boomers are living longer but have higher rates of chronic disease, more disability and lower self-rated health compared with the previous generation, investigators reported in a research letter in JAMA Internal Medicine.

Perspective from Rasa Kazlauskaite, MD, MSc, FACE

However, baby boomers are less likely to smoke cigarettes and have lower rates of emphysema and MI vs. the previous generation at the same age.

Using National Health and Nutrition Examination Survey data, researchers compared health status, functional and work disability, and chronic disease presence in the 1988-1994 cohort (previous generation) and 2007-2010 cohort (baby boomers). The focus was on respondents aged 46 to 64 years during either period.

Cohort demographics were similar, except for racial/ethnic proportions. There was a greater proportion of non-Hispanic blacks (11.3% vs. 9.4%) and Hispanics (9.8% vs. 3.7%) in the current baby boomers compared with the previous generation (P<.001).

Overall, 13.2% of baby boomers reported “excellent” health compared with 32% of the previous generation (P<.001). Compared with the previous generation, baby boomers were more likely to have hypertension (43% vs. 36.4%; P<.001), take hypertensive medication (35.4% vs. 23.2%; P<.001), have diabetes (15.5% vs. 12%; P=.003), take diabetes medication (11.3% vs. 6.2%; P<.001), have hypercholesterolemia (73.5% vs. 33.8%; P<.001) and take hypercholesterolemia medication (25.9% vs. 1.5%; P<.001).

The researchers found a slight but nonsignificant trend toward higher prevalence of cancer in baby boomers and a decrease in the frequency of emphysema and MI.

In other results, compared with the previous generation, baby boomers were more likely to be obese, use a walking assist device and have functional limitation and less likely to participate in regular exercise and smoke.

“Given the link between positive, healthy lifestyles and subsequent health in this age group, the present study demonstrates a clear need for policies that expand efforts at prevention and healthy lifestyle promotion in the baby boomer generation,” Dana E. King, MD, MS, professor and chair of the department of family medicine, West Virginia University School of Medicine, and colleagues wrote in the research letter.

For more information:

King DE. JAMA Intern Med. 2013;doi:10.1001/jamainternmed.2013.2006.

Disclosure: The researchers report no relevant financial disclosures.

Perspective

Rasa Kazlauskaite, MD, MSc, FACE

Baby boomers are likely to live longer but sicker lives. This is the principal implication of the NHANES data analysis. It raises a plethora of questions pertaining to public health and individual perspective. One wonders how baby boomers compare to other countries. For example, European Union countries keep statistics not only on life expectancy, but also on years with disability. Where would baby boomers fit in this figure?

The bad news is that baby boomers have higher rates of cardiometabolic conditions (obesity, hypertension and lipid abnormalities), leading to a parallel increase in rates of disability, related to chronic non-communicable diseases. Such diseases — specifically diabetes, HF and atrial fibrillation — continue to increase in prevalence, despite advances in science.

If one would ask health economists the question — ‘Would we have a financial crisis in health care, if we eliminate the need to treat diabetes and HF?’ — the answer most probably would be, ‘Unlikely.’

The good news is that these cardiometabolic conditions are preventable. At the Rush University Prevention Center we believe that changes in food, physical activity, quality rest and stress resilience are four key lifestyle components to foster healthy and productive lives of baby boomers. We support personalized and integrated cardiometabolic prevention in a health care setting for moderate and high-risk individuals, who are unable to achieve their health targets via their wellness effort.

Concerted preventive efforts on the individual, social, community and policy levels would have the most powerful effect. The first step is mindfulness about the current health situation and engagement at all levels toward a common purpose to lead healthy and productive lives. The second important component is unbiased information and mastery of the lifestyle and medical changes that will translate into reversing the trends in prevalence of diabetes and CVD, particularly HF.

The third necessary component is creating the environment in which individuals have autonomy to make healthy choices and receive treatment to prevent diabetes and CVD. I believe the preventive effort needs both — wellness environment and health care.

Rasa Kazlauskaite, MD, MSc, FACE

Assistant Professor

Departments of Preventive Medicine and Internal Medicine

Rush University Prevention Center

Disclosures: Kazlauskaite reports no relevant financial disclosures.