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Projects
Healthy Aging
Sponsor
Centers for Medicare and Medicaid Services
Staff
Dr. Laurence Rubenstein (RAND/UCLA) - Overall Principal Investigator
Dr. Paul Shekelle (RAND) - Principal Investigator, Phase I
Dr. Sally Morton (RAND) - (Principal Investigator, Phase II)
With the dramatic increase in U.S. life expectancy, the number of Medicare and Medicaid beneficiaries who are living long enough to experience functional losses has also increased significantly. The Centers for Medicare and Medicaid Services commissioned the Healthy Aging project to identify interventions that will promote health and prevent functional decline in older populations. The project is being conducted in two phases:
In Phase I, we reviewed the available literature on health promotion and disease prevention interventions targeted at the senior population. In Phase II, we are implementing interventions to reduce behavioral risk factors in the senior population. A smoking cessation intervention is currently being implemented in seven states.
During Phase I, we produced the following reports:
- Clinical preventive screening services
- Smoking cessation programs
- Health risk appraisals
- Falls prevention
- Chronic disease self-management
- Exercise
Interventions that Increase the Utilization of Medicare-Funded Preventive Services for Persons Age 65 and Older. Preventive services such as screenings and immunizations are underutilized among older adults. This report presents a systematic review of the literature on interventions — such as standing orders and other organizational changes — aimed at increasing the use of influenza immunizations, pneumococcal vaccinations, mammography, Pap tests, and colon cancer screening in the over-65 population.
Interventions to Promote Smoking Cessation in the Medicare Population. Smoking remains a leading cause of morbidity and mortality among older adults. This report presents the findings of a systematic review of the research aimed at examining which interventions — such as counseling and pharmacotherapy — are most effective at encouraging older smokers to quit.
Health Risk Appraisals and Medicare. Surveys of self-reported health status and risk behaviors are commonly used both to assess individuals' risks and to promote changes in health behavior. This report presents the findings of a systematic review of the research examining the effectiveness of health risk appraisals and health promotion programs that use them in bringing about health behavior change among those 65 and over. Some outcomes examined include exercise habits, weight, diastolic blood pressure, use of seat belts, and general health.
Falls Prevention Interventions in the Medicare Population. Falls are a leading contributor to morbidity and mortality in the over-65 population. This report presents the findings of a systematic review of the research examining the causes of falls and the effectiveness of prevention strategies in the elderly.
Chronic Disease Self Management. More than 80 percent of community-dwelling elderly Americans has one of the seven chronic diseases most common in this age group: diabetes, hypertension, arthritis, heart disease, respiratory disease, stroke, and cancer. Although not necessarily life-threatening, the cost of managing these conditions places a major burden on the health care system. Increasing evidence suggests that self-management can reduce the morbidity associated with these conditions. This report presents the findings of a systematic review of the evidence regarding strategies that promote self-management.
Exercise and Older Adults. Some evidence has suggested that exercise programs, even those begun in later years, may help prevent or delay some of the morbidity associated with aging. This report presents the findings of a systematic review of the evidence regarding the health benefits of exercise programs among older adults.
For more information, contact: Paul Shekelle.
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