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ABOUT THIS PUBLICATION

This report examines the health of older persons across a number of dimensions including demographics, health status and disability, and health service use. The data used are mainly derived from the 2001 National Health Survey (NHS), which surveyed persons in private dwellings only, and the 2003 Survey of Disability, Ageing and Carers. It is important to note that the scope of the National Health Survey excludes persons in aged care accommodation, including nursing homes.

EFFECTS OF ROUNDING

Where estimates have been rounded, discrepancies may occur between sums of the component items and the total.

ACKNOWLEDGEMENTS

Austrlian Bureau of Statistics (ABS) publications draw extensively on information provided freely by individuals, businesses, governments and other organisations. Their continued cooperation is very much appreciated. Without it, the wide range of statistics published by the ABS would not be available. Information recieved by the ABS is treated in strict confidence as required by the Census and Statistics Act 1905.

Inquiries

For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070.

Summary Commentary


INTRODUCTION

At June 2003 the number of older persons aged 65 years and over in Australia was 2.5 million people, or around 13% of the total population (ABS 2003c). A considerably smaller proportion of Australia's Indigenous population (3%) were aged 65 years and over (ABS 1998a). Over time the proportion of older persons in the population is expected to increase such that by 2051, it is estimated that between 27% (Series B) and 30% (Series C) of the population will be aged 65 years and over (ABS 2003d). Older persons are defined in this paper as those aged 65 years and over.

HEALTH CONDITIONS

Long-term conditions

The most common long-term conditions that affected the health of older persons in 2001 included diseases of the eye, particularly long-sightedness (hyperopia 46%, and 34% with presbyopia), and short-sightedness (31%). Diseases of the eye increased consistently with age: the reported prevalence of long-sightedness was 24% and presbyopia 7% for persons aged 15-64 years in 2001. Older persons reported having osteoarthritis at a higher rate (29%) than those aged 15-64 years (6%). The reported prevalence of hypertensive disease (40% for older persons, 8% for persons aged 15-64 years), and total and partial deafness (33% for older persons, 9% for 15-64 year olds) also increased with age. In contrast, asthma was reported at a slightly lower rate for older persons (9%) compared to a rate of 12% for persons aged 15-64 years.

Selected long-term conditions, Persons aged 65 years and over- 2001
		65-74		75 and over		Total 65 and over
		Males	Females	Males	Females	Males	Females
		%	%	%	%	%	%
Diseases of circulatory system		49.3	55.7	56.8	65.3	52.2	60.2
	Hypertensive disease	35.1	41.6	35.8	46.4	35.4	43.8
	Ischaemic heart diseases	11.2	5.2	13.1	13.2	11.9	8.9
	Cerebrovascular diseases	2.6	*1.9	*3.6	4.3	3.0	3.0
Chronic lower respiratory diseases		13.3	14.9	16.8	13.9	14.6	14.4
	Asthma	8.8	10.9	5.9	8.3	7.7	9.7
Diseases of musculoskeletal system and connective tissue		57.9	64.9	62.1	69.4	59.6	67.0
	Osteoporosis	*2.0	10.2	*3.2	15.1	2.5	12.5
	Arthritis - Osteoarthritis	18.6	33.2	23.6	37.4	20.5	35.1
	Arthritis - Rheumatoid	5.9	7.0	6.8	8.6	6.3	7.7
Diabetes mellitus		10.3	12.3	10.0	10.0	10.2	11.3
Total and partial deafness		34.0	17.5	53.4	34.8	41.6	25.6
Disorders of ocular muscles binocular movement accommodation & refraction		92.7	94.2	91.9	88.6	92.4	91.6
	Short sighted/myopia	30.3	34.0	31.6	26.4	30.8	30.5
	Long sighted/hyperopia	47.6	48.1	42.3	44.3	45.5	46.3
	Presbyopia	30.5	32.2	37.4	36.3	33.2	34.1
Cataract		6.0	9.7	11.6	22.8	8.2	15.8
Other long-term conditions		69.1	70.2	74.4	68.8	71.2	69.6
Total with a long-term condition		99.0	99.7	98.6	99.2	98.9	99.5
Without a long-term condition		*1.0	-	*1.4	*0.8	*1.1	*0.5
Total		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
ABS, 2001 NHS

Mental health

In 2001 rates of psychological distress among older persons living in private dwellings were lower than the overall population rates, with 9% of older persons (11% of females, 7% of males) reporting high to very high psychological distress compared with 13% of the population aged 18 years and over (15% of females, 10% of males) (ABS 2002c).

The 2001 NHS shows that prevalence of self-reported mood or affective disorders decreases substantially in the older age groups. This result was also evident in the 1997 Survey of Mental Health and Wellbeing of Adults, where persons aged 65 years and over reported the lowest rates of mental disorders (6% compared to 18% for all persons aged 18 years and over living in private dwellings).

However, the use of medications for mental wellbeing increased with age. Of older persons, around 37% (40% of females, 33% of males) reported taking sleeping tablets or capsules and 15% (16% of females, 13% of males) reported taking antidepressants. Of the population aged 18 years and over, around 4% reported using sleeping tablets and around 5% reported using antidepressants.

Disability and Carers

According to the 2003 Survey of Disability, Ageing and Carers, 56% of persons aged 65 years and over had a disability. This included 23% with a profound or severe core-activity limitation, and nearly all older people in cared accommodation (97%). Those who lived in private dwellings were far less likely to have a disability (52%). Of those older persons with a profound or severe core-activity limitation, 68% lived in private dwellings, while 27% lived in cared accommodation.

Disability status - 2003

HEALTH ACTIONS

Use of hospital/medical services

The most commonly reported use of health services were visits to a general practitioner (GP) (38% of older persons), followed by visits to specialists (10%), and dental consultations (6%). Visits to a GP increased substantially with age, such that 48% of persons aged 85 years and over had visited a GP in the two weeks prior to the interview. Older persons also reported a higher rate of hospital admissions than those aged less than 65 years in the 12 months prior to the 2001 NHS. Overall, around 21% of persons aged 65 years and over had a hospital admission during this time compared to 12% of all persons aged 15 years and over.

Private Health Insurance

Around 43% of older Australians had some form of private health insurance in 2001, less than the estimated rate of coverage for all Australians (51%). Those aged 75-84 years had the lowest rates of coverage of around 36%, in contrast to those aged 65-74 years (around 47% coverage), and 85 years and over (45%).

RISK FACTORS

Body mass

In 2001, almost half of all older persons (48%) were either overweight (34%) or obese (14%), while 39% reported being within the normal range for body mass. This represents an increase from 1995, when 39% of older persons reported being overweight or obese and 46% reported being within the normal weight range. Of older people aged 65 years and over, those aged 65-74 years were more likely to be overweight or obese than older age groups. Overall in this age group, 59% of males and 52% of females were overweight or obese.

Smoking

Around 9% of older persons were current smokers, with a lower rate for those aged 85 years and over (4%). This is considerably lower than the proportion of smokers in the general population, where in 2001, 24% of persons aged 18 years and over were current smokers (28% of males and 21% of females). However, 40% of older persons reported being ex-smokers, with considerably higher rates for males (59% compared to 24% of female ex-smokers).

Alcohol consumption

The majority of older people either did not consume alcohol, or consumed at low risk levels (94%). In the general population, males are more likely to drink at risky levels than females, however this difference was marginal for older persons, with 7% of males drinking at risky to high risk levels compared to 6% of females.

Physical activity

In 2001, there was a substantial difference in exercise levels between the different groups of older people. While 35% of persons aged 65-74 reported being sedentary, almost half (49%) of persons aged 75-84 years and 63% of persons aged 85 years and over reported being sedentary in the two weeks prior to the survey.

GENERAL CHARACTERISTICS

Marital status

At the 2001 Census, almost three-quarters of males aged 65 years and over were married (72%); for females in this age group, around 43% were married. This discrepancy can be explained by the considerably higher proportion of widows (45%) to widowers (14%) in this age group (ABS 2002a).

Marital status, Persons aged 65 years and over - 2001

WELLBEING

Life Satisfaction

In 2001 most people (76%) reported being satisfied with their life, including 77% of those aged 65 years and over. This was significantly higher than the estimate for persons aged between 35-64 years (around 73%). Of the 65 years and over group, 12% reported being 'delighted', 24% were 'pleased' and 41% were 'mostly satisfied'. Although there is a decrease in the intensity of life satisfaction with ageing, only 6% of this age group reported that they felt either mostly dissatisfied, unhappy or terrible about their lives, the same estimate for the overall population.

Self-assessed health status

In 2001 most older people rated their health as good (35%), and almost another third (32%) rated their health as excellent to very good. This compares to 55% of persons aged 15-64 years who rated their health as excellent to very good (including 41% of persons aged 55-64 years), and 30% who rated their health as good. The proportion of older people who reported excellent to very good health was generally lower in the older age groups.

Social contacts and activities

In 2002, 94% of older persons reported having weekly contact with family or friends, including 96% of those aged 85 years and over. Only 1% reported no recent such contact. Around 71% of older people had attended selected culture and leisure venues and activities in the 12 months prior to the General Social Survey (GSS), but this attendance reduced in older age groups, to around 45% of persons 85 years and over (49% of females and 37% of males). Around one in five (21%) of older persons had attended a sporting event in the last 12 months (16% of females, 27% of males), which also declined with age to 11% of those aged 85 years and over. In a time of crisis, families were the main sources of support for older persons (82%), followed by friends (44%) and neighbours (39%). While 28% of older persons reported they had participated in unpaid voluntary work, females aged 65-74 were the most likely to have been involved in voluntary work (36%).

LIFE EXPECTANCY

Australia has one of the highest life expectancy at birth rankings in the world at 80.4 years, with females born in 2000-2002 expected to live 82.6 years and males expected to live 77.4 years (ABS 2004b; ABS 2003a). It is more difficult to assess national trends in Indigenous life expectancy because many of the historical data are of poor quality. What is known is that Indigenous Australians do not live as long, and that the difference is marked (ABS 2004b).

While population estimates from 2002 show an almost equal proportion of males to females in the total population (50.3% females), females were over-represented in the 65 years and over population with 56% being female. In addition, 69% of the population aged 85 years and over were female (ABS 2003c).

CAUSES OF DEATH

In 2002, the death rate for persons aged 65 years and over was 4,250 per 100,000 older persons, with the male death rate higher at 4,641 per 100,000 males compared with a rate of 3,939 per 100,000 females. When looking at broad groupings of causes of death, the leading causes of death for older persons in 2002 were diseases of the circulatory system and malignant neoplasms. For persons aged 65-74 years, all malignant neoplasms (cancers) were the leading cause of death at a rate of 740 per 100,000 persons. By 75 years and over, all circulatory conditions become the leading cause of death, peaking at a rate of 7,513 per 100,000 persons for those aged 85 years and over.

Alternatively, when looking at more specific causes, the leading causes of death for older males and females in 2002 were ischaemic heart diseases (angina and acute myocardial infarction), followed by cerebrovascular diseases (cerebral haemorrhage and cerebral infarction).

Leading causes of death, Males aged 65 years and over - 2002
	Total no. of deaths	Death rate per 100,000	Rank
All causes	51,322	4,641	n.a.
Ischaemic heart diseases (I20-I25)	11,277	1,020	1
Cerebrovascular diseases (I60-I69)	4,452	403	2
Lung cancer (C33,C34)	3,582	324	3
Chronic lower respiratory diseases (J40-J47)	3,199	289	4
Prostate cancer (C61)	2,634	238	5
Colo-rectal cancer (C18-C21)	1,786	161	6
Cancer of lymphoid, haematopoietic and related tissue (C81-C96)	1,543	140	7
Diabetes mellitus (E10-E14)	1,414	128	8
Dementia and Alzheimer's disease (F01,F03,G30)	1,368	124	9
Influenza and pneumonia (J10-J18)	1,223	111	10
ABS Causes of death collection, data available on request.

Leading causes of death, Females aged 65 years and over - 2002
	Total no. of deaths	Death rate per 100,000	Rank
All causes	54,553	3,939	n.a.
Ischaemic heart diseases (I20-I25)	11,592	837	1
Cerebrovascular diseases (I60-I69)	7,232	522	2
Dementia and Alzheimer's disease (F01,F03,G30)	2,938	212	3
Chronic lower respiratory diseases (J40-J47)	2,371	171	4
Heart failure and complications and ill-defined heart diseases (I50-I51)	2,000	144	5
Lung cancer (C33,C34)	1,816	131	6
Colo-rectal cancer (C18-C21)	1,716	124	7
Influenza and pneumonia (J10-J18)	1,628	118	8
Diseases of the urinary system (N00-N39)	1,546	112	9
Breast cancer (C50)	1,457	105	10
ABS, Causes of death collection, data available on request.

Falls

Another significant issue associated with ageing is the increased incidence of deaths from falls, particularly for persons aged 80 years and over. The death rate from falls for persons aged 65 years and over was 18 per 100,000 people, peaking at 81 per 100,000 for persons aged 85 years and over.

Suicides

Although not a leading cause of death among the older population, suicide rates are vastly different between males and females, a difference that is maintained across all age groups. For older persons the male suicide rate is 4.0 times higher than the female suicide rate. The higher male suicide rate is particularly evident for males aged 85 years and over, with a rate of 33 per 100,000 population.

REFERENCES

Australian Bureau of Statistics (ABS) 1998, Experimental Projections of the Aboriginal and Torres Strait Islander Population, 30 June 1996 to 30 June 2006, cat.no.3231.0, ABS, Canberra.

ABS 1998, Mental Health and Wellbeing: Profile of Adults, Australia, 1997, cat. no. 4326.0, ABS, Canberra.

ABS 2001, Census of Population and Housing, 2001, data available on request.

ABS 2002a, Census Basic Community Profile, 2001, cat. no. 2001.0, ABS, Canberra.

ABS 2002b, General Social Survey, data available on request.

ABS 2002c, National Health Survey: Summary of Results, 2001, cat. no. 4364.0, ABS, Canberra.