The United States is aging at an unprecedented pace. The number of Americans ages 65 and older has nearly doubled since 2000—reaching 61 million in 2024, or more than 1 in 6 Americans—and is projected to climb to 82 million by 2050. The oldest Americans, those ages 85 and older, are the fastest-growing age group and most likely to need extensive support and care.
Living longer is a profound achievement. But longer lives do not automatically mean healthier, more secure, or more equal ones. Across two decades of research, a consistent picture has emerged: The experience of aging in the United States differs enormously—and those differences are not random. They are shaped by education, income, geography, racial disparities, and early-life experiences long before people reach older adulthood.
Health and economic gaps between older Americans are large and, in some cases, widening. Black and Hispanic/Latino older adults are more likely than white older adults to develop dementia, experience disability, and go without needed care. Women outlive men but spend more of those added years with chronic illness and disability. Rural communities are aging the fastest while losing the health workers and services needed to care for their older populations. And for millions of older adults, the combination of chronic disease, inadequate care access, and social isolation creates a quiet crisis largely invisible in national statistics.
Understanding these patterns and what drives them is essential to closing the gaps. Over the past two decades, studies supported by the National Institute on Aging (NIA) made it possible to track how health, disability, caregiving, and inequality evolve across the life course, and identify which policies and conditions make the greatest difference. This brief summarizes what that research has taught us.
Key Findings
- Americans ages 65 and older now number 61 million—18% of the population—and are projected to reach 82 million by 2050, straining caregiving systems, retirement programs, and health care.
- U.S. life expectancy reached a record high of 79 years in 2024 but remains nearly four years shorter than the average among comparable wealthy nations, and racial and educational gaps within the United States are large and persistent.
- Dementia prevalence declined among older Americans between 2000 and 2015, driven largely by rising education, but the trend may be slowing. Roughly 7.4 million Americans ages 65 and older now live with dementia, and the number is projected to approach 14 million by 2060.
- Aging is shaped by social conditions: Black Americans show biomarkers of aging nine biological years older on average than white Americans of the same chronological age, with chronic stress and socioeconomic inequality explaining a large share of the gap.
- The unpaid caregiving provided by family members—valued at $600 billion annually—is the foundation of the U.S. long-term care system, yet the pool of potential family caregivers under age 55 has declined in recent years, while the share of people ages 65 and older has increased.
- More than 600,000 older Americans are on waiting lists for Medicaid home-care services, and nursing home care costs 40% to 60% more than home-based care—a structural policy imbalance with direct consequences for quality of life.
- Social isolation affects roughly 1 in 4 older Americans and is associated with faster biological aging, higher dementia risk, and mortality rates comparable to smoking. It falls most heavily on those who are already disadvantaged by income, race, and disability.
- State policy environments independently shape how long Americans live: Connecticut residents now live approximately five years longer than Oklahoma residents, a gap that did not exist in 1959 and reflects diverging policy choices over decades.