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concern. According to the National Institute of Mental Health, depression is a widely under-recognized and under-treated medi- cal illness among older adults. The risk of depression significantly increases when other disabling or compromising illnesses are present. Depression rates also increase in seniors who require long-term hospitalization or hospice care. An estimated 5 million older adults have subsyndromal depression, a precursor to major depression. Perhaps most alarming, up to 75% of seniors who commit suicide visit a physician within a month before death, suggesting that early detection measures for mental health issues are in need of improvement. An Ounce of Prevention Indeed, early detection and preventive care may be the key to addressing the growing health needs of the senior population. A 2009 CDC report, Enhancing Use of Clinical Preventive Services Among Older Adults: Closing the Gap, culled data from across the country to reveal a sizable deficit in preventive care among seniors. According to the report: + 31% of older adults did not receive an influenza vaccination in 2009. + More than 33% of older adults had never received a pneumo- coccal vaccination. + More than 36% of older adults did not receive a colorectal cancer screening in 2008. + 31% of older adults without diagnosed diabetes did not receive a blood sugar or diabetes test in the prior three years. + More than half of women who qualify for both Medicare and Medicaid had never been screened for osteoporosis. Caregivers: The Silent Victims The lack of geriatric care in America has taken a toll on family members and friends of the elderly, as well. More than 65 million people — nearly one-third of the U.S. population — are unpaid caregivers. Family caregivers in the United States spend more money on providing long-term care than Medicaid does — roughly $375 billion a year. Since the 2009 economic downturn, the cost of caregiving has increased, causing many caregivers to expend most or all of their savings in order to continue providing care to an aging loved one. Their own health has been affected, too. Up to half of family caregivers meet multiple criteria for major depression, and long-term caregiving increases a person's risk for poor health, chronic illness and early death. MDNEWS.COM n MD NEWS Twin Cities | 13 As the legislative underpinnings of U.S. health care continue to change, policymakers and health care leaders will have to adapt to meet the needs of a growing elderly population and their caregivers. n THE GROWING NEED FOR GERIATRICIANS BY 2030, ONE in five Americans will be 65 or older, which begs the question: Is our health care system fit to handle this influx? The numbers say no. While the elderly population is growing, the number of geriatricians is decreasing. Previous studies by physician groups estimated 36,000 additional geriatricians would be needed by 2030. A new report published earlier this year in the Journal of the American Geriatric Society says that figure is unlikely to be reached, citing that fewer than 320 physicians enrolled in geriatric fellowship training between 2004 and 2008. As medical school costs soar, pursuing a career in geriatric medicine — which fetches a lower salary than most other medical specialties — is becoming increasingly unattractive to medical students. ANSWERING THE CALL Health care policymakers are doing something about it. In May 2011, senators reintroduced the Caring for an Aging America Act, which would provide gerontologists and geriatricians loan repayment opportunities in exchange for working in underserved areas.

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