TABLE 10.3
Death rates for diseases of the heart, by sex, race, Hispanic origin, and age, 1950–2001
[Data are based on death certificates]
| Sex, race, Hispanic origin, and age | 19501 | 19601 | 1970 | 1980 | 1990 | 1995 | 2000 | 2001 |
| American Indian or Alaska Native male3 | Deaths per 100,000 resident population | |||||||
| All ages, age adjusted2 | - - - | - - - | - - - | 320.5 | 264.1 | 256.4 | 222.2 | 200.7 |
| All ages, crude | - - - | - - - | - - - | 130.6 | 108.0 | 101.0 | 90.1 | 89.1 |
| 45–54 years | - - - | - - - | - - - | 238.1 | 173.8 | 136.2 | 108.5 | 109.1 |
| 55–64 years | - - - | - - - | - - - | 496.3 | 411.0 | 375.7 | 285.0 | 301.1 |
| 65–74 years | - - - | - - - | - - - | 1,009.4 | 839.1 | 938.2 | 748.2 | 682.1 |
| 75–84 years | - - - | - - - | - - - | 2,062.2 | 1,788.8 | 1,858.5 | 1,655.7 | 1,384.5 |
| 85 years and over | - - - | - - - | - - - | 4,413.7 | 3,860.3 | 3,306.5 | 3,318.3 | 2,895.7 |
| Asian or Pacific Islander male3 | ||||||||
| All ages, age adjusted2 | - - - | - - - | - - - | 286.9 | 220.7 | 214.5 | 185.5 | 169.8 |
| All ages, crude | - - - | - - - | - - - | 119.8 | 88.7 | 93.2 | 90.6 | 87.3 |
| 45–54 years | - - - | - - - | - - - | 112.0 | 70.4 | 69.8 | 61.1 | 60.1 |
| 55–64 years | - - - | - - - | - - - | 306.7 | 226.1 | 205.4 | 182.6 | 162.0 |
| 65–74 years. | - - - | - - - | - - - | 852.4 | 623.5 | 581.0 | 482.5 | 439.1 |
| 75–84 years | - - - | - - - | - - - | 2,010.9 | 1,642.2 | 1,533.8 | 1,354.7 | 1,273.8 |
| 85 years and over | - - - | - - - | - - - | 5,923.0 | 4,617.8 | 4,888.9 | 4,154.2 | 3,688.1 |
| Hispanic or Latino male3,5 | ||||||||
| All ages, age adjusted2 | - - - | - - - | - - - | - - - | 270.0 | 260.8 | 238.2 | 232.6 |
| All ages, crude | - - - | - - - | - - - | - - - | 91.0 | 83.1 | 74.7 | 74.6 |
| 45–54 years | - - - | - - - | - - - | - - - | 116.4 | 102.0 | 84.3 | 82.9 |
| 55–64 years | - - - | - - - | - - - | - - - | 363.0 | 311.2 | 264.8 | 242.2 |
| 65–74 years | - - - | - - - | - - - | - - - | 829.9 | 784.6 | 684.8 | 683.7 |
| 75–84 years | - - - | - - - | - - - | - - - | 1,971.3 | 1,854.0 | 1,733.2 | 1,702.7 |
| 85 years and over | - - - | - - - | - - - | - - - | 4,711.9 | 5,104.0 | 4,897.5 | 4,784.3 |
| White, not Hispanic or Latino male5 | ||||||||
| All ages, age adjusted2 | - - - | - - - | - - - | - - - | 413.6 | 369.1 | 319.9 | 304.8 |
| All ages, crude | - - - | - - - | - - - | - - - | 336.5 | 320.6 | 297.5 | 289.5 |
| 45–54 years | - - - | - - - | - - - | - - - | 172.8 | 155.9 | 134.3 | 130.7 |
| 55–64 years | - - - | - - - | - - - | - - - | 521.3 | 443.2 | 356.3 | 335.8 |
| 65–74 years | - - - | - - - | - - - | - - - | 1,243.4 | 1,077.0 | 885.1 | 834.7 |
| 75–84 years | - - - | - - - | - - - | - - - | 3,007.7 | 2,635.3 | 2,261.9 | 2,190.4 |
| 85 years and over | - - - | - - - | - - - | - - - | 7,663.4 | 7,156.4 | 6,606.6 | 6,195.4 |
| White female3 | ||||||||
| All ages, age adjusted2 | 478.0 | 441.7 | 376.7 | 315.9 | 250.9 | 230.8 | 205.6 | 198.7 |
| All ages, crude | 289.4 | 306.5 | 313.8 | 319.2 | 298.4 | 294.7 | 274.5 | 267.7 |
| 45–54 years | 141.9 | 103.4 | 91.4 | 71.2 | 50.2 | 45.5 | 40.9 | 41.5 |
| 55–64 years | 460.2 | 383.0 | 317.7 | 248.1 | 192.4 | 172.0 | 141.3 | 134.3 |
| 65–74 years | 1,400.9 | 1,229.8 | 1,044.0 | 796.7 | 583.6 | 523.2 | 445.2 | 429.0 |
| 75–84 years | 3,925.2 | 3,629.7 | 3,143.5 | 2,493.6 | 1,874.3 | 1,670.3 | 1,452.4 | 1,407.9 |
| 85 years and over | 9,084.7 | 9,280.8 | 7,839.9 | 7,501.6 | 6,563.4 | 6,251.3 | 5,801.4 | 5,582.5 |
| Black or African American female3 | ||||||||
| All ages, age adjusted2 | 536.9 | 488.9 | 435.6 | 378.6 | 327.5 | 304.0 | 277.6 | 269.8 |
| All ages, crude | 287.6 | 268.5 | 261.0 | 249.7 | 237.0 | 226.3 | 212.6 | 208.6 |
| 45–54 years | 525.3 | 360.7 | 290.9 | 202.4 | 155.3 | 141.5 | 125.0 | 125.9 |
| 55–64 years | 1,210.2 | 952.3 | 710.5 | 530.1 | 442.0 | 386.0 | 332.8 | 323.1 |
| 65–74 years | 1,659.4 | 1,680.5 | 1,553.2 | 1,210.3 | 1,017.5 | 938.2 | 815.2 | 768.0 |
| 75–84 years4 | 3,499.3 | 2,926.9 | 2,964.1 | 2,707.2 | 2,250.9 | 2,100.7 | 1,913.1 | 1,849.6 |
| 85 years and over | - - - | 5,650.0 | 5,003.8 | 5,796.5 | 5,766.1 | 5,448.5 | 5,298.7 | 5,207.3 |
of dementia include loss of language functions, inability to think abstractly, inability to care for oneself, personality change, emotional instability, and loss of a sense of time or place.
Dementia has become a serious health problem in developed countries, including the United States, because older adults are living even longer. In 2000 the Federal Interagency Forum on Aging-Related Statistics estimated that approximately 10 percent of those older than 65 years of age, 20 percent of those older than 75 years of age, and nearly 36 percent of those over 85 suffer from dementia.
Alzheimer's Disease
Alzheimer's disease (AD) is the single most common cause of dementia. It is a progressive, degenerative disease that attacks the brain and results in severely impaired memory, thinking, and behavior. First described in 1906 by the German neuropathologist Alois Alzheimer, the disorder may strike people in their forties and fifties, but most victims are over age 65.
TABLE 10.3
Death rates for diseases of the heart, by sex, race, Hispanic origin, and age, 1950–2001
[Data are based on death certificates]
| Sex, race, Hispanic origin, and age | 19501 | 19601 | 1970 | 1980 | 1990 | 1995 | 2000 | 2001 | |
| American Indian or Alaska Native female3 | Deaths per 100,000 resident population | ||||||||
| All ages, age adjusted2 | - - - | - - - | - - - | 175.4 | 153.1 | 164.8 | 143.6 | 127.0 | |
| All ages, crude | - - - | - - - | - - - | 80.3 | 77.5 | 80.2 | 71.9 | 68.2 | |
| 45–54 years | - - - | - - - | - - - | 65.2 | 62.0 | 62.4 | 40.2 | 42.7 | |
| 55–64 years | - - - | - - - | - - - | 193.5 | 197.0 | 200.7 | 149.4 | 126.5 | |
| 65–74 years | - - - | - - - | - - - | 577.2 | 492.8 | 514.2 | 391.8 | 384.2 | |
| 75–84 years | - - - | - - - | - - - | 1,364.3 | 1,050.3 | 1,184.3 | 1,044.1 | 934.3 | |
| 85 years and over | - - - | - - - | - - - | 2,893.3 | 2,868.7 | 3,118.1 | 3,146.3 | 2,510.3 | |
| Asian or Pacific Islander female3 | |||||||||
| All ages, age adjusted2 | - - - | - - - | - - - | 132.3 | 149.2 | 137.6 | 115.7 | 112.9 | |
| All ages, crude | - - - | - - - | - - - | 57.0 | 62.0 | 66.3 | 65.0 | 67.9 | |
| 45–54 years | - - - | - - - | - - - | 28.6 | 17.5 | 20.8 | 15.9 | 18.4 | |
| 55–64 years | - - - | - - - | - - - | 92.9 | 99.0 | 89.5 | 68.8 | 62.8 | |
| 65–74 years | - - - | - - - | - - - | 313.3 | 323.9 | 288.3 | 229.6 | 241.7 | |
| 75–84 years | - - - | - - - | - - - | 1,053.2 | 1,130.9 | 1,001.8 | 866.2 | 848.7 | |
| 85 years and over | - - - | - - - | - - - | 3,211.0 | 4,161.2 | 3,942.4 | 3,367.2 | 3,186.3 | |
| Hispanic or Latino female3,5 | |||||||||
| All ages, age adjusted2 | - - - | - - - | - - - | - - - | 177.2 | 173.8 | 163.7 | 161.0 | |
| All ages, crude | - - - | - - - | - - - | - - - | 79.4 | 76.5 | 71.5 | 71.8 | |
| 45–54 years | - - - | - - - | - - - | - - - | 43.5 | 32.0 | 28.2 | 27.9 | |
| 55–64 years | - - - | - - - | - - - | - - - | 153.2 | 141.0 | 111.2 | 107.2 | |
| 65–74 years | - - - | - - - | - - - | - - - | 460.4 | 419.0 | 366.3 | 363.1 | |
| 75–84 years | - - - | - - - | - - - | - - - | 1,259.7 | 1,231.3 | 1,169.4 | 1,155.7 | |
| 85 years and over | - - - | - - - | - - - | - - - | 4,440.3 | 4,653.1 | 4,605.8 | 4,521.1 | |
| White, not Hispanic or Latino female5 | |||||||||
| All ages, age adjusted2 | - - - | - - - | - - - | - - - | 252.6 | 231.5 | 206.8 | 200.0 | |
| All ages, crude | - - - | - - - | - - - | - - - | 320.0 | 319.7 | 304.9 | 298.4 | |
| 45–54 years | - - - | - - - | - - - | - - - | 50.2 | 46.1 | 41.9 | 42.7 | |
| 55–64 years | - - - | - - - | - - - | - - - | 193.6 | 172.0 | 142.9 | 136.0 | |
| 65–74 years | - - - | - - - | - - - | - - - | 584.7 | 525.2 | 448.5 | 431.8 | |
| 75–84 years | - - - | - - - | - - - | - - - | 1,890.2 | 1,674.9 | 1,458.9 | 1,414.7 | |
| 85 years and over | - - - | - - - | - - - | - - - | 6,615.2 | 6,265.8 | 5,822.7 | 5,601.6 | |
| - - - Data not available. | |||||||||
| 1Includes deaths of persons who were not residents of the 50 states and the District of Columbia. | |||||||||
| 2Age-adjusted rates are calculated using the year 2000 standard population. | |||||||||
| 3The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of Hispanic origin may be of any race. Death rates for the American Indian or Alaska Native and Asian or Pacific Islander populations are known to be underestimated. | |||||||||
| 4In 1950 rate is for the age group 75 years and over. | |||||||||
| 5Prior to 1997, excludes data from states lacking an Hispanic-origin item on the death certificate. | |||||||||
| SOURCE: "Table 36. Death Rates for Diseases of Heart, according to Sex, Race, Hispanic Origin, and Age: United States, Selected Years 1950–2001," in Health, United States, 2003, Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, Hyattsville, MD, 2003 | |||||||||
Dr. Alzheimer's autopsy of a severely demented 55-year-old woman revealed deposits of "neuritic plaques" and "neurofibrillary tangles." The latter characteristic, the presence of twisted and tangled fibers in the brain cells, is the anatomical hallmark of the disease.
SYMPTOMS.
AD has been described as "a dementia of gradual onset and progressive decline." Mild or early AD is not easily distinguishable from the characteristics of normal aging—mild episodes of forgetfulness and disorientation. Gradually, the AD patient may experience confusion; language problems, such as trouble finding words; impaired judgment; disorientation in place and time; and changes in mood, behavior, and personality. The speed with which these changes occur varies, but eventually the disease leaves patients unable to care for themselves.
In the terminal stages of AD, patients require care 24 hours a day. They no longer recognize family members or themselves, and need help with simple daily activities, such as eating, dressing, bathing, and using the toilet. Eventually, they may become incontinent, blind, and unable to communicate. The course of the disease varies widely—some patients die within a few years of diagnosis, while others have lived as long as 25 years.
PREVALENCE.
In 2001, 53,245 deaths from AD were reported for those 65 and older. (See Table 10.2.) Liesi E. Hebert, et al., in "Alzheimer Disease in the U.S. Population: Prevalence Estimates Using the 2000 Census," Archives of Neurology, vol. 60, no. 8, August 2003), reported that the prevalence of Alzheimer's disease and the proportion of severe disease increased dramatically with
TABLE 10.4
Probability of developing invasive cancers over selected age intervals, by sex, 1998–20001
| Birth to 39 (%) | 40 to 59 (%) | 60 to 79 (%) | Birth to death (%) | ||
| All sites2 | Male | 1.36 (1 in 73) | 8.03 (1 in 12) | 33.92 (1 in 3) | 44.77 (1 in 2) |
| Female | 1.92 (1 in 52) | 9.01 (1 in 11) | 22.61 (1 in 4) | 38.03 (1 in 3) | |
| Bladder | Male | .02 (1 in 4603) | .40 (1 in 250) | 2.36 (1 in 42) | 3.46 (1 in 29) |
| Female | .01 (1 in 9557) | .12 (1 in 831) | .64 (1 in 157) | 1.10 (1 in 91) | |
| Breast | Female | .44 (1 in 229) | 4.14 (1 in 24) | 7.53 (1 in 13) | 13.36 (1 in 7) |
| Colon &rectum | Male | .06 (1 in 1678) | .86 (1 in 116) | 3.94 (1 in 25) | 5.88 (1 in 17) |
| Female | .06 (1 in 1651) | .67 (1 in 150) | 3.05 (1 in 33) | 5.49 (1 in 18) | |
| Leukemia | Male | .15 (1 in 649) | .20 (1 in 495) | .82 (1 in 122) | 1.45 (1 in 70) |
| Female | .13 (1 in 789) | .14 (1 in 706) | .46 (1 in 219) | 1.00 (1 in 100) | |
| Lung &bronchus | Male | .03 (1 in 3439) | 1.02 (1 in 98) | 5.80 (1 in 17) | 7.69 (1 in 13) |
| Female | .03 (1 in 3046) | .79 (1 in 126) | 3.93 (1 in 25) | 5.73 (1 in 17) | |
| Melanoma | Male | .12 (1 in 809) | .49 (1 in 205) | .97 (1 in 103) | 1.81 (1 in 55) |
| of skin | Female | .19 (1 in 532) | .39 (1 in 255) | .51 (1 in 197) | 1.22 (1 in 82) |
| Non-Hodgkin | Male | .14 (1 in 739) | .45 (1 in 224) | 1.27 (1 in 79) | 2.10 (1 in 48) |
| lymphoma | Female | .08 (1 in 1258) | .30 (1 in 332) | .98 (1 in 102) | 1.76 (1 in 57) |
| Prostate | Male | .01 (1 in 12833) | 2.28 (1 in 44) | 14.20 (1 in 7) | 17.15 (1 in 6) |
| Uterine cervix | Female | .16 (1 in 632) | .31 (1 in 322) | .27 (1 in 368) | .78 (1 in 128) |
| Uterine corpus | Female | .05 (1 in 1832) | .69 (1 in 144) | 1.57 (1 in 64) | 2.60 (1 in 38) |
| 1For those free of cancer at beginning of age interval. Based on cancer cases diagnosed during 1998–2000. The "1 in" statistic and the inverse of the percentage may not be equivalent due to rounding. | |||||
| 2All sites exclude basal and squamous cell skin cancers and in situ car cinomas except urinary bladder. | |||||
| 3Includes invasive and in situ cancer cases. | |||||
| SOURCE: "Probability of Developing Invasive Cancers Over Selected Age Intervals, by Sex, U.S., 1998–2000," in Cancer Facts and Figures 2004, American Cancer Society, Atlanta, GA, 2004 | |||||
age after 65. (See Figure 10.1.) While AD can strike as early as the third, fourth, or fifth decade of life, 90 percent of victims are older than 65 when it becomes apparent.
Hebert and colleagues also noted that the number of people with AD in the U.S. population and their age distribution will change substantially over the next 50 years. In 2000, 4.5 million people aged 65 and older were living with AD. By the year 2050, between 11.3 and 16.0 million people of this age group are expected to be affected with the disease. (See Table 10.7.)
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