Stats Flashcards
Population Demographics
16% of UK population >65yo
65% of IP >65yo
LE: M 81.8y, F84.6y
LE increasing 2y/decade
proportion of population active and sedentary
29%M, 21% F active 55-74y
41%/32% gen pop
9/4% >75y
33/38% sedentary 55-74y
23%/24% gen pop
40%/65% >80y
Physical ability stats: walk/stairs/stand/outside
50% can't walk 3mph 12% >65y can't walk independently 9% can't use stairs 30%M 50% F 65-74y can't stand from low chair 50% RH residents don't go outside
Inactivity burden stats
17% inactive (RH/NH higher)
2x smoking or HTN
3% of disease burdern, 1.9 m deaths (35,000 UK)
£8.2m/year cost
Loss of physical ability
muscles strength (max effort): 1% from 50, 3% 70y
muscle power: quick force (efficiency): lost 3-4% per year
activity: 10% per decade
bone density: 1% M, 2-3 F lost
Ageing stats
11.3m pension (65M 60F)
368,150 >90y, 26% M
96% own homes; 20% LT care homes
4000 >90yo give >50h care
increasing proportion (UK fertility rate 1.84 - below replacement)
Terminal Care stats (death location)
500,000 deaths per year
54% of complaints
approx 55% prefer home, approx 20% actually die at home (25% cancer pt)
approx 25% prefer hospice, 5% actual (20% cancer)
approx 10% hospital, actual 60% (45% cancer)
approx 5% nursing home, actual 15% (10% cancer)
Long term care stats (location and cost)
living alone: ^#population, ^institutionalisation risk
60yo: 20%M 45% F
80yo: 35%M 65% F
spending:
EU15: 7.6% health, 9.1% pensions; mostly instiutions
England LTC: 50:50 formal:institutions; 1.2% GDP
private england: 0.5% GDP, 85% institutional
Long term care - comorbidity prevalence
cognitive impairment: 50-75%
urinary incontinence: 50-75%
mobility issues (chair/bed bound): 25-50%
multiple diagnoses and medications: average 6.2 Dx, median 8 meds
behavioural Sx: 67%
malnutrition: 30% malnourished, 56% at risk
life expectancy: 1y in NH, 2y in RH
Carers - prevalence, incidence, time
1in8 people; 6.5 million, 9 million by 2037 6,000 new per day, 2m/y 58% F; peak 50-59y (20%) 3million working age, 1in5 give up work 13m >50h/week
Carer - demographics
58% F, 20% 50-59yo parents/in-laws 40% partner 26% friend/neighbour 9% grandparents 4% other relatives 7%
Carers - health impact
2x risk of permanent illness/disability 625000 direct physical/mental issues 83% neg physical, 87% neg mental 40% delay own treatments longer care duration increases risk
Carers - social impact
isolation, relationships, asking for help
37% no support
29% family but no SS support
40% no break in 18 months, no holiday in 5 years
reduced/stopped work - £30,000 lost
struggling to pay: 74% bills, 78% home repairs, 52% reducing food, 32% rent/mortgage issues
Elder abuse - prevalence/perpetrator
4% prevalence (342000 per year)
2.1% of men, 5.4% of women in past year
35% partner, 33% family, 9% home help, 3% friend, 33% neighbours
can be institutions
Elder abuse - types
5% verbal abuse
2% physical abuse
2% financial abuse
Proportions:
34% psychological, 20% financial, 19% physical, 12% neglect, 3% sexual, rest = other
Delirium - types
hypo 40%
hyper 25%
mixed 35%
Delirium - IP prevalence
20% IP prevalence
AMU 10%, post-op 15%, stroke 25%, HCOP 30%, post-op hip 50%, ITU 60%, palliative 80%
Delirium - GP and Dementia
1-2% GP;
50% have dementia (5-10x risk);
affects 67% of dementia IP
delirium = 3x future dementia risk
Depression - prevalence (OPD/IPD)
commonest mental disorder in elderly
affects 30% community, 15-20% clinically depressed
1 in 5 GP attendees have psychological symptoms
1 in 6 don’t discuss Sx with GP
23% of RH, 30-35% of NH,
29% acute med IP, 40-45% post-stroke
Depression - effects
1 in 20 are likely to respond to ADD
85% also have anxiety
25% of suicides are elderly
10-20% have delirium
Depression - suicide
25% of suicides are elderly
1 in 4 success rate (others = 1 in 15-20)
less expressed
Dementia - prevalence
prevalence: 17-25m worldwide; 850,000 UK (>1m by 2025; 40% increase in next 15y) 33% >95yo; 20% >80yo; 15,000 are younger (~1in20) F>M (2x) 64% of care home residents 10-15% had MCI
Dementia - M/M
60,000 deaths per year;
comorbidity: 70% have CMs; 61% anx/depp, 41% lonely, 52% lacking support, 24% feel isolated, 28% lacking capacity/decisions, 90% house-bound
10% delirium
Dementia - cost/burden
cost: £26b to NHS yearly; family carers save NHS £6b; more than stroke + cancer + CHD; >1% GDP
£11.6b unpaid care, 4.3 health care, 4.5 state social care, 5.8 private social care; other = 0.1b
Dementia - types
AD 62% (500,000); 7y LE, 3% make 14y;
Vasc 17%
Mixed (A/V) 10%
LBD 4%, 25,000 (
Falls - prevalence
50% >80yo fall at least 1/y; 33% of >65yo
50% fall again within 1y
>75y = F>M, F (2x)
50% mobility issues
Falls - M/M
fractures in 20%, injury in 75% after #hip, 33% fully dependent, 50% partial 1% of falls » hip fracture #NOF 1y mortality is 20-35% 10% mortality within 12/12 after a fall
Pressure sores, incontinence, and falls cost
PS: 1.4-2 billion
incontinence £354 million
Falls: 1.8 billion (1%)
Incontinence - prevalence
200m worldwide (~1 in 30); F >M
40% of women >60y; overall 25-45%
men 5-39%
increases with age: YA 20-30%, middle-age 30-40%, elderly 30-50%
Incontinence - urinary/faecal/catheter stats
urinary +/- double: 30% acute, 57% HCE, 29% RH, 63% NH
faecal 4/3/3/4%;
catheter 17/17/4/13%
Stroke - M/M
3rd leading M&M:
130,000 affected each year (1 every 5 minutes);
incidence 174-216 per 100,000/y
dysphagia 30-50%
Stroke - TIA stats
TIA: 35 per 100,000; 1/3 stroke later;
5%
Stroke - prognosis
TACS at 1 year: 60% dead, 35% dependent, 5% independent, 5% recurrence
PACS: 15% dead, 30% dependent, 55% independent, 20% recurrence
LACS (best): 10% dead, 30% dependent, 60% independent, 10% recurrence
POCS: 20% dead, 30% dependent, 50% independent, 20% recurrence
Stroke - cost
cost: £7b per year (£2.8b NHS, £2.4b informal care, £1.8 lost productivity)
Stroke - RF (odds/risk ratio)
HTN (3-4x), DM (2-4x), AF, IHD (2-4x), CCF (2-4x), IE
smoking (1.5-3x), alcohol (4x) cholesterol, pro-thrombo, IVDU
age, male, PMH, FHx
age risk doubles every decade >55y
Stroke - thrombolysis effects
risks: 5% ICH, 1% fatal ICH; 3-5% get worse, 1% shortened life
benefits: 20-33% improve, 10% independent
Polypharmacy - stats
90% of older people have prescriptions
>50% of 65-74yo take 3+ (>70% >75y);
12.6% of interactions involve polypharma
ADR risk factors
cognition (12x), 4+ comorbidities (8x) dependent (4x), non-adherence (2x) impaired renal function (2.5x) polypharma (2.7x)
NSAIDs involved in 29%
ADR - stats
30% of ADRs occur in elderly;
6-17% of elderly IP have ADR
10-12% of acute Ax due to prescriptions;
1in4 older adults over 5y;
6.5% of all Ax are ADRs; 30-55% avoidable
