Healthcare provisions in an aging society: U.S. perspective

Abstract

The number of the people 65 years and older continues to increase rapidly, both in absolute numbers and as a percentage of the population. The reasons are varied, including declining birth rates, improved life expectancy, and immigration. This is leading to significant demographic changes, changes in social structures, and economic stresses. However, the older population is a heterogeneous group, and a nuanced approach is required to deal with the challenges of this population. The old and very old patients are the major user group of medications and also the fastest growing population with the potential need for medicines [1]. The older population is frail, has different pharmacokinetics, experiences a greater number of side effects and has to deal with multiple medications with the potential for multiple drug interactions. No or inadequate medical insurance coverage, especially for medications, is compounded by decreased purchasing power due to lack of income, changing insurance rules, and increased out-of-pocket expenses for physician visits, hospitalizations, caregivers and care facilities. Developing drugs for this population is difficult, and is compounded by the lack of inclusion of this demographic in many drug trials for various reasons. Formulations of appropriate doses for the elderly, as well as appropriate packaging for ease of administration in this population with many physical challenges, are equally important. There is also a need for awareness, continuous training and sensitization of providers to these issues.