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Senior Citizens Enjoying Health, Life Much Longer
than Expected
Most common health problems reported were poor
vision, hearing loss and mood
Dec. 28, 2005 - Older Americans enjoy good health
for a longer period than previously realized, and many factors that
compromise health in the elderly can be modified to maintain their
health, according to recent findings from a large multi-university study led
by Duke University Medical Center. Consequently, researchers said,
physicians should understand that long spans of illness and disability
are not necessarily part of normal aging.
The study shows the majority of people enjoy good
or excellent health, even past age 85. Later life is not necessarily
defined by a steady decline in health, but rather by more healthy years
followed by a much shorter period of ill health immediately before
death.
The results of the study will be published in the
February 2006 issue of the Journal of the American Geriatrics Society.
The study was funded by the National Institute on Aging, part of the
National Institutes of Health.
"Older people are healthy, and it is important for
health providers to keep this optimistic perspective and share it with
their elderly clients," said Truls Ostbye, M.D., Ph.D., lead study
author and professor in Duke's Department of Community and Family
Medicine. "We hear a lot about disease and disability among the elderly,
but the quality of life in older individuals is actually, by most
measures used, high up to the oldest of age."
These findings, Ostbye said, contradict the
generally held perceptions among the public that elderly individuals
begin a slow decline into ill health decades before they actually do.
Participants were all residents of the same county
in Northern Utah and were involved in the "Cache County Memory Study," a
larger, four-institution epidemiological study of aging and dementia.
The participants in this very long-lived
population, many living beyond age 80, self-reported their overall
health on 10 measures, including their ability to carry out activities
of daily living (ADLs), such as dressing or bathing; the presence of any
major illness, such as cardiovascular disease, diabetes or cancer; and
their level of social activity. The researchers said that few previous
studies have included data on as many health dimensions.
The study included nearly 3,500 men and women over
age 65. Between 80 percent and 90 percent of participants ages 65 to 75
reported excellent or good health, and approximately 60 percent of those
over age 85 did so. The participants were asked to describe their
overall health as excellent, good, fair and poor. Participant cognition
was also tested with the Mini-Mental Status Examination, a widely used
20-question test of reasoning and memory.
According to the researchers' analysis of the data,
nearly 90 percent of participants were healthy enough to live at home,
including those age 85 and over.
More than 90 percent of men and women ages 65 to 84
were independent in all ADLs, and more than two-thirds over age 85 could
complete these tasks alone. The 2004 National Health Interview Survey
indicates that individuals of the same age perform similarly nationwide.
While up to 50 percent of participants were free
from any major disease, the rest were living with at least one physical
ailment.
According to the researchers, most continued to
report at least fair health and the ability to perform most ADLs and
other physical activities despite the chronic conditions.
The percentage of participants without chronic
illness fell slightly as individuals aged, but 40 percent of men age 85
and older and 42 percent of women in the same age group still did not
suffer from any major disease.
"Many people in this study with chronic diseases
were not in bad overall health," Katrina Krause, a co-author of the
study, said. "And as they got older, a chronic disease did not
necessarily mean they were disabled."
Many of the problems older individuals listed as
impairing their overall health and quality of life could potentially be
modified, said Krause.
The three most common factors affecting
self-reported health – poor vision, hearing loss and mood – can often be
treated with clinical interventions, such as prescriptive lenses,
hearing aids or antidepressive therapy.
The occurrence of depression, however, in this
study was low – less than 10 percent of participants were affected.
Individuals over age 85 reported the most cases of depression, perhaps,
Ostbye said, because they had fewer opportunities for social
participation.
During data analysis, researchers discovered that
gender did play a role in the level of self-reported good health as
individuals got older. Women over age 85 were more likely to be frail
and less likely to be able to perform certain activities of daily
living.
Co-authors are Maria C. Norton, Ph.D., Utah State
University, JoAnn Tschanz, Ph.D., Utah State University, Linda Sanders,
MPH, Duke University Medical Center, Kathleen Hayden, Ph.D., Duke
University Medical Center, Carl Pieper, DrPH, Duke University Medical
Center, Kathleen A. Welsh-Bohmer, Ph.D., Duke University Medical Center,
Katrina M. Krause, Duke University Medical Center. Investigators from
Johns Hopkins Medical Center and the University of Washington are also
involved in the Cache County study.
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