Hi Linda!
It's not about being young or old :) but about how much you know that person.
To your mother, father, brothers or friends you should say "¿Cómo estás (tú)?".
But when you talk to your teacher, to your doctor or to someone you don't know in the street to ask for directions, it'd be more advisable to use "¿Cómo está (usted)?" It's way more respectful.
Hope that helped!!