Healthcare on the brink: navigating the challenges of an aging society in the United States
Bureau, U. C. Older Population and Aging. United States Census Bureau (2023).
Chamie, J., Berkman, L., Hayutin, A. M., Smith, J. P. & Hoeksema, M. J. Why Population Ageing Matters: A Global Perspectives (Center for Migration Studies, 2007).
CDC. Equitably Addressing Social Determinants of Health and Chronic Diseases, CDC (2022).
Lopes, L., Montero, A., Presiado, M., Liz H. Americans’ Challenges with Health Care Costs. KFF (2023).
Chetty, R. et al. The association between income and life expectancy in the United States, 2001-2014. JAMA 315, 1750–1766 (2016).
Google Scholar
He, Y., Wei, B. & Li, Y. The impact of using community home-based elderly care services on older adults’ self-reported health: fresh evidence from China. Front. Public Health 11, 1257463 (2023).
Google Scholar
WHO. Global Health Workforce statistics database. WHO (2023).
Dall, T. et al. The Complexities of Physician Supply and Demand: Projections From 2018 to 2033. AAMC (2020).
Gurwitz, J. H. The paradoxical decline of geriatric medicine as a profession. JAMA 330, 693–694 (2023).
Jones, C. H., Jenkins, M. P., Adam Williams, B., Welch, V. L. & True, J. M. Exploring the future adult vaccine landscape—crowded schedules and new dynamics. npj Vaccines 9, 27 (2024).
Google Scholar
Staff, A. C. 2020 Census Will Help Policymakers Prepare for the Incoming Wave of Aging Boomers. United States Census Bureau (2019).
2023 National Population Projections Tables: Main Series. United States Census Bureau (2023).
QuickFacts: New York. United States Census Bureau (2023).
Davis-Ajami, M. L., Lu, Z. K. & Wu, J. Multiple chronic conditions and associated health care expenses in US adults with cancer: a 2010–2015 Medical Expenditure Panel Survey study. BMC Health Serv. Res. 19, 1–10 (2019).
Google Scholar
Goodman, R. A., Posner, S. F., Huang, E. S., Parekh, A. K. & Koh, H. K. Peer reviewed: defining and measuring chronic conditions: imperatives for research, policy, program, and practice. Prev. Chronic Dis. 10, E66 (2013).
Google Scholar
Machlin, S. R. & Soni, A. Health care expenditures for adults with multiple treated chronic conditions: estimates from the Medical Expenditure Panel Survey, 2009. Prev. Chronic Dis. 10, E63 (2013).
Google Scholar
Crimmins, E. M. & Beltrán-Sánchez, H. Mortality and morbidity trends: is there compression of morbidity? J. Gerontol. B: Psychol. Sci. Soc. Sci. 66, 75–86 (2011).
Google Scholar
Masnoon, N., Shakib, S., Kalisch-Ellett, L. & Caughey, G. E. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 17, 1–10 (2017).
Google Scholar
Cohen, R. A. & Boersma, P. Strategies used by adults aged 65 and over to reduce their prescription drug costs, 2016-2017. NCHS Data Brief 335, 1–8 (2019).
Qato, D. M., Wilder, J., Schumm, L. P., Gillet, V. & Alexander, G. C. Changes in prescription and over-the-counter medication and dietary supplement use among older adults in the United States, 2005 vs 2011. JAMA Intern. Med. 176, 473–482 (2016).
Google Scholar
The 2020 Long-Term Budget Outlook. Congressional Budget Office (2020).
Health, United States, 2014: With Special Feature on Adults Aged 55–64. National Center for Health Statistics (2015).
Cubanski, J., Neuman T., Griffin, S., and Damico, A. Medicare Spending at the End of Life: A Snapshot of Beneficiaries Who Died in 2014 and the Cost of Their Care. KFF (2016).
Zhang, X., Lin, D., Pforsich, H. & Lin, V. W. Physician workforce in the United States of America: forecasting nationwide shortages. Hum Resour Health 18, 8 (2020).
Google Scholar
Gaynor, M. & Town, R. the Impact of Hospital Consolidation—update (The Synthesis Project, Robert Wood Johnson Foundation, 2012).
2017 Infrastructure Report Card. ASCE (2017).
McGinnis, J. M., Stuckhardt, L., Saunders, R. & Smith, M. Best care at lower cost: the path to continuously learning health care in America (National Academies Press, 2013).
Wennberg, J. E., Fisher, E. S. & Skinner, J. S. Geography and the debate over medicare reform: A reform proposal that addresses some underlying causes of Medicare funding woes: geographic variation and lack of incentive for efficient medical practices. Health Affairs 21, W96–W112 (2002).
Google Scholar
The Dartmouth Atlas of Health Care. Dartmouth Atlas Project (2024).
Hospital Beds per 1,000 Population by Ownership Type. KFF (2022).
Health Care Resources: Hospital Beds. OECD (2020).
Adler-Milstein, J. & Jha, A. K. HITECH Act drove large gains in hospital electronic health record adoption. Health Aff 36, 1416–1422 (2017).
Google Scholar
Slawomirski, L. et al. Progress on implementing and using electronic health record systems. OECD (2023).
Artzi, N. S. et al. Prediction of gestational diabetes based on nationwide electronic health records. Nat. Med. 26, 71–76 (2020).
Google Scholar
Amit, G. et al. Estimation of postpartum depression risk from electronic health records using machine learning. BMC Pregnancy Childbirth 21, 630 (2021).
Google Scholar
Wood, A. et al. Linked electronic health records for research on a nationwide cohort of more than 54 million people in England: data resource. BMJ 373 (2021).
Wang, Q. Q., Kaelber, D. C., Xu, R. & Volkow, N. D. COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States. Mol. Psychiatry 26, 30–39 (2021).
Google Scholar
Collaborative, O. et al. OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. MedRxiv (2020).
Ayala Solares, J. R. et al. Deep learning for electronic health records: a comparative review of multiple deep neural architectures. J. Biomed. Inform. 101, 103337 (2020).
Google Scholar
Li, Y. et al. BEHRT: transformer for electronic health records. Sci. Rep. 10, 7155 (2020).
Google Scholar
Huang, S.-C., Pareek, A., Seyyedi, S., Banerjee, I. & Lungren, M. P. Fusion of medical imaging and electronic health records using deep learning: a systematic review and implementation guidelines. NPJ Digit Med. 3, 136 (2020).
Google Scholar
Keshta, I. & Odeh, A. Security and privacy of electronic health records: Concerns and challenges. Egypt Inform. J. 22, 177–183 (2021).
Google Scholar
Osborn, R., Doty, M. M., Moulds, D., Sarnak, D. O. & Shah, A. Older Americans were sicker and faced more financial barriers to health care than counterparts in other countries. Health Aff. 36, 2123–2132 (2017).
Google Scholar
Topol, E. J. High-performance medicine: the convergence of human and artificial intelligence. Nat. Med. 25, 44–56 (2019).
Google Scholar
Shortell, S. M. & McCurdy, R. K. Integrated health systems. IKMS 8, 369–382 (2009).
O’Malley, A. S. & Rich, E. C. Measuring comprehensiveness of primary care: challenges and opportunities. J. Gen. Intern. Med. 30, 568–575 (2015).
Google Scholar
Pham, H. H., Schrag, D., O’Malley, A. S., Wu, B. & Bach, P. B. Care patterns in Medicare and their implications for pay for performance. NEJM 356, 1130–1139 (2007).
Google Scholar
Komisar, H. The Effects of Rising Health Care Costs on Middle-Class Economic Security, (2013).
Shi, L., Regan, J., Politzer, R. M. & Luo, J. Community Health Centers and racial/ethnic disparities in healthy life. Int J Health Serv 31, 567–582 (2001).
Google Scholar
Braveman, P. & Gruskin, S. Defining equity in health. JECH 57, 254 (2003).
Google Scholar
Kennedy, B. K. et al. Geroscience: linking aging to chronic disease. Cell 159, 709–713 (2014).
Google Scholar
Babu, M. & Snyder, M. Multi-omics profiling for health. Mol Cell Proteomics 22, 100561 (2023).
Google Scholar
Alzheimer’s Disease. NIH (2021).
Tenchov, R., Sasso, J. M., Wang, X. & Zhou, Q. A. Aging Hallmarks and progression and age-related diseases: a landscape view of research advancement. ACS Chem Neurosci 15, 1–30 (2024).
Google Scholar
Tran Van Hoi, E. et al. Biomarkers of the ageing immune system and their association with frailty—a systematic review. Exp. Gerontol. 176, 112163 (2023).
Google Scholar
Wilbon, S. S. & Kolonin, M. G. GLP1 receptor Agonists—effects beyond obesity and diabetes. Cells 13, 65 (2024).
Google Scholar
Grevendonk, L. et al. Impact of aging and exercise on skeletal muscle mitochondrial capacity, energy metabolism, and physical function. Nat. Commun. 12, 4773 (2021).
Google Scholar
Sousa-Victor, P., García-Prat, L. & Muñoz-Cánoves, P. Control of satellite cell function in muscle regeneration and its disruption in ageing. Nat. Rev. Mol. Cell Biol. 23, 204–226 (2022).
Google Scholar
Kapsalyamov, A., Hussain, S. & Jamwal, P. K. State-of-the-art assistive powered upper limb exoskeletons for elderly. IEEE Access 8, 178991–179001 (2020).
Google Scholar
Patel, N., Dulau-Florea, A. & Calvo, K. R. Characteristic bone marrow findings in patients with UBA1 somatic mutations and VEXAS syndrome. Semin. Hematol. 58, 204–211 (2021).
Google Scholar
Park, S. J. & Bejar, R. Clonal hematopoiesis in cancer. Exp. Hematol. 83, 105–112 (2020).
Google Scholar
Revêchon, G., Merino, L. G., Machtel, P. & Eriksson, M. Somatic mutations in vascular wall function and age-associated disease. Eur. Heart J. 44, 4208–4210 (2023).
Google Scholar
Feusier, J. E. et al. Large-scale identification of clonal hematopoiesis and mutations recurrent in blood cancers. Blood Cancer Discov. 2, 226–237 (2021).
Google Scholar
House, J. S., Kessler, R. C. & Herzog, A. R. Age, socioeconomic status, and health. Milbank Q. 68, 383–411 (1990).
Rowe, J. W. & Berkman, L. Decompression of morbidity and the workforce. Nat. Aging 2, 3–4 (2022).
Google Scholar
Kingsolver, B. Demon Copperhead (Harper, 2022).
The Affordable Care Act: A Stronger Medicare Program in 2012. CMS (2013).
Ochieng, N., Biniek, J. F., Freed, M., Damico, A., Neuman, T. Medicare Advantage in 2023: Enrollment Update and Key Trends. KFF (2023).
ACOs & Cost Savings. NAACOS (2022).
Home- and Community-Based Services. CMS (2023).
Chidambaram, P., Burns, A., Rudowitz, R. Who Uses Medicaid Long-Term Services and Supports? KFF (2023).
Aging in Place: Growing Older at Home. NIH (2023).
Burns, A., Mohamed, M., Watts, M. O. M. Pandemic-Era Changes to Medicaid Home- and Community-Based Services (HCBS): A Closer Look at Family Caregiver Policies. KFF (2023).
Wienecke, D. How does Germany care for the elderly? Medium (2023).
Busse, R., Blümel, M., Knieps, F. & Bärnighausen, T. Statutory health insurance in Germany: a health system shaped by 135 years of solidarity, self-governance, and competition. Lancet 390, 882–897 (2017).
Google Scholar
Yamada, M. & Arai, H. Long-term care system in Japan. Ann. Geriatr. Med. Res. 24, 174–180 (2020).
Google Scholar
Okamoto, S. & Komamura, K. Towards universal health coverage in the context of population ageing: a narrative review on the implications from the long-term care system in Japan. Arch. Pub. Health 80, 210 (2022).
Google Scholar
Wright, J. Inside Japan’s long experiment in automating elder care. Technology Review (2023).
Koh, S. Tech-Assisted Healthcare: Revolutionizing Senior Care in Singapore. Medium (2024).
Country Comparisons—Life expectancy at birth. CIA (2024).
Lorenzoni, L. Case Study—Sweden. Organization for Economic Co-operation and Development (2021).
Auerbach, D. I. & Staiger, D. O. How fast will the registered nurse workforce grow through 2030? Projections in nine regions of the country. Nurs. Outlook 65, 116–122 (2017).
Google Scholar
Supply and Demand Projections of the Nursing Workforce: 2014-2030. National Center for Health Workforce Analysis (2017).
State Physician Workforce Data Report. AAMC (2019).
Nursing Shortage Fact Sheet. AACN (2022).
Health Workforce Shortage Areas. HRSA (2024).
Geriatrics Workforce Enhancement Program. HRSA (2019).
American Nurses Association Well-Being Initiative. ANA (2019).
Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide. Medscape (2020).
Ferrucci, L. & Fabbri, E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat. Rev. Cardiol. 15, 505–522 (2018).
Google Scholar
Chia, C. W., Egan, J. M. & Ferrucci, L. Age-related changes in glucose metabolism, hyperglycemia, and cardiovascular risk. Circ. Res. 123, 886–904 (2018).
Google Scholar
Lena, A., Coats, A. J. S. & Anker, M. S. Metabolic disorders in heart failure and cancer. ESC Heart Fail 5, 1092–1098 (2018).
Google Scholar
Martin, L. et al. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J. Clin. Oncol. 31, 1539–1547 (2013).
Google Scholar
Tchkonia, T., Zhu, Y., Van Deursen, J., Campisi, J. & Kirkland, J. L. Cellular senescence and the senescent secretory phenotype: therapeutic opportunities. JCI 123, 966–972 (2013).
Google Scholar
Dominguez, L. J. & Barbagallo, M. The biology of the metabolic syndrome and aging. Curr. Opin. Clin. Nutr. Metab. Care 19, 5–11 (2016).
Google Scholar
Guo, Y. et al. Plasma proteomic profiles predict future dementia in healthy adults. Nat. Aging 4, 247–260 (2024).
Rizvi, S., Raza, S. T. & Mahdi, F. Telomere length variations in aging and age-related diseases. Curr. Aging Sci. 7, 161–167 (2014).
Google Scholar
Liguori, I. et al. Oxidative stress, aging, and diseases. Clin. Interv. Aging 13, 757–772 (2018).
Google Scholar
Meehan, M. & Penckofer, S. The role of vitamin D in the aging adult. J. Aging Gerontol. 2, 60–71 (2014).
Google Scholar
link
