Implications of Population Aging for Geriatric Health
Agree, Emily M.
Freedman, Vicki A.
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This analysis examines four theories about the relationships between mortality, morbidity, and disability in old age in the US and discusses the evidence. The theories include the pandemic of Chronic Diseases, Compression of Morbidity, Life Span Expansion, and Dynamic Equilibrium. Chronic Diseases theory (Gruenberg) posits that the age at onset of chronic diseases remains the same, but the number of years spent morbid or disabled will expand with increases in longevity. Compression of Morbidity theory (Fries) posits that the age at onset of chronic diseases will increase and more deaths will cluster around the maximum average life span. Life Span Expansion theory (Walford) posits that the onset of morbidity would shift to later ages but the years lived with morbidity and disability would remain unchanged. The Dynamic Equilibrium theory (Manton) assumes that life expectancy is increased through postponement of disease onset, reductions in severity of disease and speed of progression, and improved techniques for clinical management. All three curves for morbidity, mortality, and disability will increase, and the relationship between the curves will remain unknown. Evidence indicates that there have been increases in active and disabled life expectancy, the time spent in an active state, and the share of life expectancy due to active life expectancy. The data support Manton's Dynamic Equilibrium theory. Doctors and medical staff have a large role to play in determining the direction of changes in the health status of the elderly and in recovery-rehabilitation. The elderly's health situation will become even more diverse.