Aging Begins at 30

Less Disability in Our Old Age

Ian Maclean Smith, M.D.
Emeritus Professor
Department of Internal Medicine
University of Iowa Hospitals and Clinics
Creation Date: January 2003
Last Revision Date: January 2003
Peer Review Status: Internally Peer Reviewed

Dr. J.F. Fries of Palo Alto (JAMA Editorial, Dec. 25, 2002, pg. 3164), has hypothesized that if disability can be postponed then total disability over a lifetime could be reduced. Mortality is indeed declining about one percent annually. He calls this the compression of morbidity or disease.

Bad trends are the increasing prevalence of obesity, the occurrence of diabetes and the general lack of exercise. An important goal would be to establish health promotion as a Medicare-supported health benefit. This has not happened. Despite the hopeful improvement in self-health management, access to medical care and the provision of prescription drugs have not improved.

Cataract operations and joint replacements have doubled and high cholesterol and diabetes are being treated more aggressively in older adults. Many elderly folks believe in their continued good health and this appears to feed back beneficially.

Dr. Fries believes these many factors are acting synergistically and hopefully will gain momentum, just like the anti-smoking campaigns of recent decades. Healthy graduates of the University of Pennsylvania without health-deleterious bad habits have added eight years of life compared to obese, smoking, couch potato alumni controls. In addition those who died without these risky behaviors, had a slow ten-year decline to death contrasted to non-compliers to healthy behavior who had a lot of disability especially in the two years before death. There will be a steady increase in the number of elderly citizens in the coming years and it will be important to see that these seniors stay healthy. Disabilities accumulate: one may be tolerable but three or more can be intolerable.

Ask yourself if you can climb one flight of stairs or walk a quarter of a mile, if not why not? About 42 million in the United States have a disability and this costs about $170 billion annually!

Dr. Fries's editorial refers to the systematic review of published articles on disability and function in the United States elderly by Freedman and Associates, which is published in the same JAMA issue. Dr. Fries summarizes his editorial as, "The Sunny Side of Aging." It brings back to me happy memories of visiting at age nine, my happy, smiling, great aunt and great uncle when they were in their mid-eighties.

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See related Patient Topics Seniors' Health or Seniors' Health--General.

See related Provider Topics Seniors' Health or Seniors' Health--General.

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