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4833.0.55.001 - Health of Older People in Australia: A Snapshot, 2004-05  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 28/09/2006  First Issue
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INTRODUCTION

This article provides a brief overview of the health of older people in Australia, defined in this article as people aged 65 years and over, which represents a span of over 40 years. This article presents some data by age groups to explore differences within the age structure. Some comparisons are also provided with the younger population. Older people represent an increasing proportion of the Australian population, with this increase projected to continue until at least 2051.


DATA SOURCES

Information for this article is drawn from the ABS 2001 and 2004-05 National Health Surveys, the 2003 Survey of Disability, Ageing and Carers, the 2004-05 National Aboriginal and Torres Strait Islander Health Survey, and the 2004 causes of Death collection. Unless otherwise stated, older people are those aged 65 years and over.

It should be noted that data from the 2001 and 2004-05 NHS, and the 2004-05 National Aboriginal and Torres Strait Islander Health Survey relate only to persons in private dwellings. Persons in hospitals, nursing and convalescent homes and hospices are excluded, and the data may therefore not fully represent the health of older people aged 85 years and over.


INQUIRIES

For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070 or email client.services@abs.gov.au.


HEALTH OF OLDER PEOPLE

Increasing age is related to long-term health conditions, higher rates of disability and poorer reported health status. Population ageing, and the health of older people, is likely to impact on the overall health status of the Australian community.

CHANGING DEMOGRAPHICS

  • At 30 June 2004 the number of older persons aged 65 years or more in Australia was estimated to be 2.6 million, or around 13% of the total population (ABS 2005). The proportion of older people in the population is projected to increase over time to 26% in 2051, and to 27% in 2101 (Series B) or to 28% and 31% respectively (Series C) (ABS 2005).

Projected population by age (a), 2004 to 2101
Graph: Projected population by age, 2004 to 2101

  • Not all countries are experiencing the same population changes. Of all 32 OECD countries, in 2020, Australia is projected to have the 13th lowest proportion of people aged 65 years or more in the population (16%), with the highest ratio in Japan (26%), and the lowest in Turkey (7%) (OECD 2006).
  • Females born in 2002-04 are expected to live to 83.0 years and males to 78.1 years (ABS 2005a).
  • OECD data for 2003 indicate that Australian males aged 65 years had the third highest life expectancy of all OECD countries (17.6) years, after Japan (18.0 years) and Iceland (17.8 years). Females had the equal third highest with Switzerland (21.0 years), after Japan (23.0 years) and France (21.3 years) (OECD 2005).
  • Between 2004 and 2101 the proportion of males in the 85 years or more age group is projected to increase, from 32% of all people aged 85 years or more in 2004 to between 44%-47% in 2101. This is due to the expected narrowing of the gap between male and female life expectancy (ABS 2005).


LIVING ARRANGEMENTS

The differences in marital status for older males and females impact on living arrangements and other forms of support. Over time older people experience loss, not only of a partner, but often incremental loss of independence through disability and other factors associated with ageing.
  • The longer life span of females is reflected in the marital status data for older people. Across the older age groups, the proportion of both males and females in the widowed category increases with age, with more females widowed than males in each age group (ABS 2006a).

Registered marital status, married or widowed, by age and sex
Graph: Registered marital status, married or widowed, by age and sex

  • In 2003 the proportion of older people residing in cared accommodation (hospitals, nursing homes, aged and disability hostels, and other large congregate care facilities for the frail aged or people with a disability) increased with age, from 1% of people aged 65 to 74 years, to 7% of people aged 75 to 84 years, and up to 31% of people aged 85 years or more (ABS 2004a).
  • Of older people living in households in 2003, 28% lived alone (this rate was 20% for males and 35% for females). The proportion living alone increased with age within this group, from 22% of people aged 65-74 years (16% for males and 27% for females) to 53% of people aged 85 years or more (42.% for males and 60% for females) (ABS 2004a).


HEALTH STATUS

Self-assessed health status is considered to be a strong predictor of morbidity and mortality (Gerdtham et el 1999: McCallum et al 1994)
  • In 2005 many older people rated their health as good (32%), and more than a third rated their health as very good to excellent (36%) - an increase from 2001 (32%) (ABS 2006a). However, these rates are lower than for younger people aged 18 to 64 years where 28% rated their health as good, and more than half rated their health as very good to excellent (59%).
  • Long-term health conditions are more common with increasing age. In 2005 nearly 100% of people aged 65 years or more reported at least one long-term health condition.
  • The most commonly reported conditions were diseases of the eye (90%), particularly long sightedness (hyperopia 62%, presbyopia 14%), and short sightedness 35%.
  • Other reported conditions were musculoskeletal conditions (66%), diseases of the circulatory system (57%), osteoarthritis (28%) and respiratory conditions (15%).
  • The reporting of many conditions increased with age. In the 75 years or more age group total or partial deafness was reported by 55% of males and 33% of females respectively, up from 35% and 18% for the 65-74 age group. Cataracts were reported by 15% and 18% of males and females respectively, up from 6% and 10% for the 65-74 age group.
  • Gender differences were particularly pronounced for osteoporosis, with 4% of males and 22% of females aged 65 years or more reporting this condition (ABS 2006a).

Most common reported conditions, by selected age group, 2005

24-64 years
%
65-74 years
%
75 years and over
%

Long sightedness
32
Long sightedness
64
Long sightedness
59
Short sightedness
27
Arthritis
49
Arthritis
50
Back pain/problems nec, disc disorders
21
Hypertension
38
Deafness (complete/partial)
42
Hayfever and allergic rhinitis
19
Short sightedness
36
Hypertension
41
Arthritis
17
Deafness (complete/partial)
26
Short sightedness
34
Source: National Health Survey, 2004-05


Selected Long Term Conditions, persons aged 65 years or more, by sex, 2005

65-74 years
75 years and over
Total 65 years and over



Males
Females
Males
Females
Males
Females
Total
%
%
%
%
%
%
%

Diseases of the circulatory system
50.8
54.5
65.4
61.6
56.8
57.9
57.4
Hypertensive disease
35.4
40.4
38.6
43.3
36.7
41.8
39.5
Ischaemic heart disease
9.1
5.3
14.6
9.5
11.4
7.3
9.2
Cerebrovascular disease
1.9*
0.0**
4.4
0.0**
2.9
0.0
1.3
Chronic lower respiratory disease
14.0
16.3
16.7
13.1
15.1
14.8
14.9
Asthma
8.9
12.3
7.3
8.3
8.2
10.4
9.4
Diseases of musculoskeletal system and connective tissue
58.5
73.6
61.7
70.2
59.8
72.0
66.4
Osteoporosis
3.8
19.3
4.7
26.2
4.2
22.5
14.1
Arthritis - Osteoarthritis
19.3
32.9
25.5
34.2
21.9
33.5
28.2
Arthritis - Rheumatoid
6.9
10.1
6.5
5.9
6.7
8.1
7.5
Diabetes mellitus
16.3
11.7
16.1
11.2
16.2
11.5
13.7
Total and partial deafness
35.3
18.1
54.6
33.0
43.3
25.2
33.5
Disorders of ocular muscles
binocular movement
accommodation and refraction
91.3
92.7
87.3
88.8
89.7
90.9
90.3
Short sighted/myopia
35.4
35.9
32.1
36.1
34.0
36.0
35.1
Long sighted/hyperopia
63.8
63.8
58.8
59.6
61.8
61.8
61.8
Presbyopia
11.8
13.7
13.7
15.6
12.6
14.6
13.7
Cataract
5.9
9.9
15.2
17.5
9.7
13.5
11.8
Other long-term conditions
72.6
71.5
77.8
72.9
74.7
72.1
73.3
Total with a long-term condition
99.9
99.3
100.0
99.9
99.9
99.6
99.7
Total
100.0
100.0
100.0
100.0
100.0
100.0
100.0
* estimate has a relative standard error of 25% to 50% and should be used with caution
** estimate has a relative standard greater than 50% and is considered too unreliable for general use
Source: National Health Survey, 2004-05



MORTALITY
  • In 2004 the death rate for persons aged 65 years or more was 4,046 per 100,000, with males (4,390 per 100,000) higher than females (3,768 per 100,000).
  • The leading causes of death for older persons aged 65 years or more were diseases of the circulatory system and malignant neoplasms (particularly lung, prostate, and colorectal cancers). The respective rates per 100,000 increased with age from 451 and 691 for 65-74 year olds to 6,823 and 1,930 for those aged 85 years or more.

Selected causes of death (a), 2004
Graph: Selected causes of death, 2004


  • Accidental falls are a significant issue with ageing, with 4% of those aged 75 years and over having reported an injury event from low falls in the four weeks prior to interview (ABS 2006). Compared to younger age groups there is a much higher rate of death from accidental falls in the 75 years and over population, and particularly for people aged 80 years and over.

Deaths, accidental falls(a), 2004
Graph: Deaths, accidental falls, 2004



DISABILITY
  • In 2004-2005 11% of older persons living in households reported a high or very high level of psychological distress compared to 9% in 2001. This was lower than the proportion for the overall population aged 18 years or over which was 13% in 2004-05.
  • In 2003, 56% of all older persons had a reported disability, with 22% having a profound or severe core activity limitation. These rates varied within the age group from 45% and 12% respectively for 65-74 year olds to 82% and 58% for people aged 85 years or older. This is in contrast to younger people where 15% had a reported disability, and 4% having a profound or severe core activity limitation.

Disability status by age, 2003
Graph: Disability status by age, 2003


INDIGENOUS AUSTRALIANS
  • The Indigenous population is relatively young compared with the non-Indigenous population, reflecting both higher rates of fertility and deaths occurring at younger ages. Among Indigenous people born in the period 1996–2001, the life expectancy for males was estimated to be 59.4 years, and for females, 64.8 years; approximately 17 years lower than for Australian males and females born in the period 1998–2000 (ABS & AIHW 2005).
  • The proportion of Indigenous people aged 65 years or over was projected to be 13,600 in 2005 — 2.8% of the total Indigenous population. In comparison, people aged 65 years and over comprised 13.1% of the estimated resident population of Australia in 2005 (ABS 2004b and ABS 2006c).
  • In 2004–05, one in five older Indigenous Australians (21%) assessed their health as excellent or very good, a further 34% reported good health and 45% reported fair or poor health. Among Australians aged 65 years and over, Indigenous people were 1.4 times more likely than non-Indigenous people to have reported fair or poor health.
  • The most prevalent long-term health conditions among older Indigenous Australians in 2004–05 were eye/sight problems (89%), heart and circulatory problems/diseases (61%), arthritis (49%) and diabetes/high sugar levels (36%).
  • In non-remote parts of Australia in 2002, older Indigenous people were 1.6 times more likely than non-Indigenous people to have a profound or severe core activity limitation, meaning that they sometimes or always needed assistance with at least one activity of everyday living (self-care, mobility or communication) (ABS & AIHW 2005).


RISK FACTORS

Lifestyle behaviours such as smoking, alcohol consumption, diet and exercise can impact on a person's health.
  • In 2005 almost half of all older persons (48%) were classified as either overweight (33%) or obese (15%). This is a similar rate to that for younger people aged 18 to 64 years (33% and 17% respectively). The proportion overweight or obese decreases with age, down to 28% for people 85 years or more with 10% of this age group underweight in comparison to 3% of all older people. Normal weight was reported for 39%. (ABS 2006a).
  • Exercise levels in 2005 varied within the older age group. Of people aged 65-74 years, 36% reported being sedentary in the two weeks prior to interview. This rate rose to 53% for those aged 75-84 years and 68% for those aged 85 years or older. These rates were all slightly higher than in 2001 (35%, 49%, and 63% respectively) (ABS 2006a).
  • Around 8% of older persons in 2005 were current smokers, down from 9% in 2001 (males 10% and females 6%). Within the age group, people aged 65-74 years were more likely to be current smokers (10%) than people aged 75-84 years (4%), or those aged 85 years and over (5%). These rates were lower than for people in the younger 18-64 year age group where 26% were current smokers (ABS 2006a).


MANAGING CONDITIONS, AND LIFESTYLE CHANGES
  • Some 38% of people aged 65-74 years visited the doctor in the two weeks prior to interview, and 23% were hospitalised within the previous 12 months. Corresponding rates for people aged 75-84 years were 47% and 29%, and for people aged 85 years or more 50% and 25%. This compares to 20% and 13% respectively for all people under 65 years of age (ABS 2006a).
  • Older people reported having influenza vaccinations within the 12 months prior to interview at higher rates (74%), ranging from 70% of those aged 65-74 years to 78% for those aged 75-84 years and 77% for those aged 85 years or more. This compares to 27% for people aged 50-64 years (ABS 2006a).
  • Of females aged 65 years or more, 8% reported currently using Hormone Replacement Therapy. The use of Hormone Replacement Therapy was highest in the 65-74 year age group, dropping to 4% of women aged 75-84 years, and down to 1% of women aged 85 years and over (ABS 2006a).


LIST OF REFERENCES

Australian Bureau of Statistics 2006, National Health Survey: Summary of Results, Australia 2004-05, cat. no. 4364.0, ABS, Canberra.

Australian Bureau of Statistics 2006a, National Health Survey, Australia, 2004-05, unpublished data.

Australian Bureau of Statistics 2006b, Causes of Death, Australia, 2004, cat. no. 3303.0, ABS, Canberra.

Australian Bureau of Statistics 2006c, Population by Age and Sex, Australia, June 2005, cat. no. 3235.0.55.001, ABS, Canberra.

Australian Bureau of Statistics 2005, Population Projections, Australia, 2004-2101, cat. no. 3222.0, ABS, Canberra.

Australian Bureau of Statistics 2005a, Deaths, Australia, 2004, cat. no. 3302.0, ABS, Canberra.

Australian Bureau of Statistics & Australian Institute of Health and Welfare 2005, The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, 2005, ABS cat. no. 4704.0, AIHW cat. no. IHW14, ABS & AIHW, Canberra.

Australian Bureau of Statistics 2004, Disability, Ageing and Carers: Summary of Findings, Australia, 2003, cat. no. 4430.0, ABS, Canberra.

Australian Bureau of Statistics 2004a, Survey of Disability, Ageing and Carers, Australia, 2003, unpublished data.

Australian Bureau of Statistics 2004b, Experimental Estimates and Projections, Aboriginal and Torres Strait Islander Australians, 30 June 1991 to 30 June 2009, cat. no. 3238.0, ABS, Canberra.

Gerdtham, U, Johannesson, M, Lundberg, L & Isacson, D 1999, ' A note on validating Wagstaff and Dooslairs health measure in the analysis of inequality in health', Journal of Health Economics, vol. 18, no. 1, pp. 117-224.

McCallum, J, Shadbolt, B & Wang, D 1994, 'Self-rated health and survival: a 7-year follow-up study of Australian elderly', American Journal of Public Health, vol. 85, no. 7, pp. 1100-1105.

Organisation for Economic Co-operation and Development (OECD) 2006, OECD Countries, 1950 to 2020 (OECD Factbook 2006), OECD, Geneva.

Organisation for Economic Co-operation and Development (OECD) 2005b, Health at a Glance, OECD Indicators 2005, OECD, Geneva.



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