Epidemiology in the Elderly with Heart Disease
Epidemiology in the Elderly with Heart Disease Epidemiology in the Elderly with Heart Disease Public health promotes healthy living for each community through epidemiology. Disease prevention and control is the common goal of epidemiology, nursing practice, and public health. “Epidemiology is the study of the population in order to monitor the health of the population, understand the determinants of health and disease in the community, and investigate and evaluate interventions to prevent disease and maintain health” (Stanhope & Lancaster. 2008). Epidemiologists have developed many parameters to slow the spread of disease.
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For example, cardiovascular disease including hypertension, coronary heart disease, and rhythmic disorders have become increasingly common with advancing age across the country. Epidemiology is the study of health related events, characteristics, and determinant patterns in a population. Public health researchers use epidemiology to help make policies and identifying risk factors for disease and preventable medicine through evidence based studies. Epidemiology looks at diseases such as cardiovascular disease along with infectious diseases such as influenza.
Epidemiologists take into account health behaviors such as diet and activity, social conditions such as poverty and housing, health services and research. Epidemiology can be either descriptive or analytical. Descriptive epidemiology is the study of the distribution of health-related states or events. It refers to the occurrence of disease, in term of person, place, and time (Stanhope & Lancaster 2008). It rules out chance, bias, confounding as explanations of observed differences, and draws conclusions as causal hypotheses. It also includes public health surveillance.
Analytic epidemiology studies the determinants of health related states or events. It measures and tests the causes and associations (the how and why), from descriptive studies hypotheses, controls for chance, bias, confounding in the study design, analyzing data and drawing conclusions. Heart disease in the elderly population is an example of how the principles of epidemiology are applied in vulnerable populations. The methods used to quantify the existence or occurrences of the disease are frequency, distribution, and causes. Frequency has two components.
The incidence is a measure of new cases of disease that develop in a population during a specific time. It also measures the probability that unaffected persons will develop the disease. Prevalence is the proportion of individuals in a population with disease or condition at a specific point of time. It provides an idea of how severe a problem may be. Distribution shows the risk factors that might be the cause of the disease. The epidemiologic triangle is used to help scientists with studying health problems. It helps understand diseases and how they spread.
The triangle has three corners, the agent or cause of the disease (the what), the host or organism harboring the disease (the who), and the environment or external factors (the where). In the center of the triangle is time. Time refers to the incubation period or the time that the symptoms occur. Chronic heart diseases found in the elderly such as Congestive Heart Failure or CHF follow the epidemiologic triangle. There may be many causes of CHF including obesity and hypertension. External factors such as stress contribute to the risk of heart disease. Although many people live a healthy life style, they are not immune to heart disease.
The steps of the epidemiologic methods are surveillance versus research, and common epidemiologic measures that are quantitative and qualitative. Quantitative measures are continuous numbers, and discrete numbers. Qualitative measures are nominal categorical, ethnicity, and ordinal. Epidemiology step methods are design, implementation, analysis, interpretation, and reporting. Public health is ongoing with systematic collection, interpretation, analysis, and dissemination of the data. This is used in public health to reduce the mortality rate and improve the health of the population.
The risk for high blood pressure increases with age, therefore complications associated to high blood pressure increase. These risks are stroke, kidney disease, heart attack, and heart failure. By the age of 70 almost half of all Americans have high blood pressure due to unknown causes. Half of all heart attacks happen to those over the age of 65. Coronary heart disease is the leading killer in the elderly. Men are higher at risk for heart disease than women during middle age, women’s risk increases after menopause leading to equality in risk. Aortic valve disease is the most common heart valve disease in the elderly.
The aortic valve allows blood to pump form the left ventricle to the rest of the body. Aortic sclerosis is the process of thickening and stiffening in this valve. This disease affects about one third of all elderly people. Heart rhythm and electrical system problems are more common with age. Arrhythmia’s can have no symptoms or be very slight causing palpations, dizziness, fainting, or light headedness. If the hearts rhythm is too slow, this is called bradycardia. If it is too fast, this is called tachycardia. Dysrhythmias are also common among the elderly. Heart failure is a major public health concern among the elderly.
As the population ages, the prevalence of heart failure continues to increase. Assessing a patient through interview and obtaining an accurate medical history, doing a physical exam and electrocardiogram provides a great deal of information about the heart and risk factors. Further testing such as echocardiograms and nuclear scan will help to reveal more information about the structure of the heart and its function. Cardiac catheterization, a more invasive study, may be necessary to help determine treatment or provide a map for surgery. The elderly need to be considered frail and may be too weak to undergo such invasive testing.
Although treatment for young and elderly is about the same, the age of the person needs to be taken into account when doing invasive testing. By the age of 65, the heart beats more than 100,000 times a day. It has pumped about 2,000 gallons of blood through 60,000 miles of blood vessels each day. The heart is the largest muscle in the body. Even at the age of 65, it has many more years of service. As people age the natural physiologic changes decrease the efficiency of the heart. The older the heart becomes the less elastic the muscle becomes, so it is not able to relax completely between each beat.
The wall of the heart thickens, especially the chambers that are responsible for pumping the blood. The thickening of the walls causes the heart to enlarge. As the heart ages it becomes less receptive to adrenaline. This decreases the hearts ability to prepare for exercise. Adrenaline helps the heart increase strength and rate of contractions per minute. By the year 2013, it is estimated that one in every five Americans will be over the age of 65. Cognitive impairment can become a problem with ethical and legal issues such as informed consent for a test and getting accurate information when conducting an interview.
Giving the elderly autonomy and respecting their decisions when it comes to heart disease is sometimes hard to do as a health care provider. Many times the older population only gets their income from Social Security and therefore do not have enough money for prescription medications and other treatment for their heart disease. It is the responsibility of the public health nurse to help the elderly get the help they need to get adequate treatment. Contacting the local Department of Health and Human Services may give the elder assistance with healthcare. These departments have special units just for elder assistance.
Many drug companies will also give discounts for prescription medications. Giving the contact information to the older population is necessary. Many elderly will not tell the public health professional about their needs out of pride. Heart disease may be the leading cause of death, but prevention can be done. Stop smoking or don’t start smoking. Chemicals in tobacco damage the heart and blood vessels, leading to narrowing of the arteries. Regular exercise reduces the risk of heart disease by controlling weight and reduces the chances of getting other diseases that strain the heart muscle.
Eating a healthy diet which is low in salt, cholesterol and saturated fats can help protect the aging heart as well. Maintaining a healthy weight and getting regular medical checkups can help prevent heart disease. Regular medical exams can detect disease early and given the chance, reverse the disease all together. Early detection and prevention saves lives, especially in the elderly population. The type of epidemiology used in this paper is descriptive because it describes how heart disease affects the aging population.
It quantifies the existence or the occurrence of heart disease in the aging population. Descriptive epidemiologists consider the frequency and pattern of the heart disease. The frequency evaluates the rate of the disease and the pattern helps suggest the risk factors of heart diseases. They evaluate frequency and pattern by examining the person, place, and time in relation to heart disease. Epidemiology to the public health professional provides a systematic approach to caring for the public at large and treating by performing several tasks including surveillance, investigation, analysis, and evaluation.
Different disease rates are used to target disease intervention and to generate a hypothesis about risk factors and the cause of diseases. Epidemiology is the core to public health and defines health in all dimensions. This paper analyzed the components of epidemiology as a science and its application to heart disease in the elderly. It also considers other sciences to help understand and prevent diseases and infection. Epidemiology opens the doors to the vast field of the public health goal to preserve life and human well-being. By preventing a disease, public health officials can help the public live healthier happier lives.