According to the 2019 Profile of Older Adults (POA) published by the Administration for Community Living, an operating division of the US Department of Health and Human Services, the population of adults 65 years and older increased 35% to more than 52 million from 2008 to 2018 and is projected to increase to nearly 95 million by 2060. Even more notable is the prediction that the 85 years and older group is expected to more than double by 2040. Approximately one-fourth (23%) of older adults are currently of racial and ethnic minorities and that proportion is expected to increase to 34% by 2040.

Rehabilitation services are most often provided to older adults who are receiving inpatient care in a hospital, skilled nursing facility, or other institutional setting. However, according to the National Institutes of Health, the majority of older adults (93.5%) live in the community. In 2017, close to 13 million households were headed by people 75 years and older and about half of older adults lived with a spouse or partner.

Nearly half (45%) of older adults living in the community rate their own health as very good or excellent according to the 2019 POA. However, most aging adults have at least one chronic condition and many have multimorbidities. According to the American Geriatrics Society, more than half of those 65 years and older have 3 or more chronic conditions and that increases to more than 80% of those 85 years and older. The Health & Retirement Study (2010-2012) found combinations of at least 2 of the following chronic diseases to be common: hypertension, cardiovascular disease, lung disease, diabetes, cancer, arthritis, stroke, cognitive impairment, and depression. Numerous studies have demonstrated the value of activity and exercise to effectively treat and reduce the negative impact of these conditions on function in older adults.

In 2010, the American Association of Retired Persons found that 88% of those surveyed want to age in place and 92% want to stay in their communities. In addition to being the preference of the majority of older adults, providing them with health and social benefits, aging in place can offer potential health cost savings to families and society. However, to support aging adults to remain in their homes and communities, there is a need for community-based support services.

Rehabilitation therapists are uniquely qualified and positioned to promote health and wellness in the older population and assist them with remaining active and engaged in their communities. Through assessment, interventions, and education, the occupational therapy, physical therapy, and speech-language-hearing professions can provide some of those highly needed community-based services. As more of the population is vaccinated and COVID-19 is better controlled, aging adults will need programs to help them regain the physical abilities and fitness they may have lost while staying in and they will likely be anxious to get involved in community-based activities again.

In this issue of Topics in Geriatric Rehabilitation, we present several evidence-based studies and informative articles about community-based rehabilitation programs and services. Several articles describe innovative collaborative programs between rehabilitation and community agencies. Conditions common to older adults including fall risk, dementia, social isolation, and depression and how those can be addressed in community-dwelling older adults are covered. When it comes to working with older adults, let's be encouraged and empowered to "take it to where they live."

-Debra L. Gray, PT, DPT, DHS, MEd

Issue Editor