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Elderly people are growing
healthier, happier and more independent, say American scientists. The
results of a 14-year study to be announced later this month reveal that the
diseases associated with old age are afflicting fewer and fewer people and
when they do strike, it is much later in life.
In the last 14 years, the
National Long-term Health Care Survey has gathered data on the health and
lifestyles of more than 20,000 men and women over 65. Researchers, now
analysing the results of data gathered in 1994, say arthritis, high blood
pressure and circulation problems - the major medical complaints in this
age group - are troubling a smaller proportion every year. And the data
confirms that the rate at which these diseases are declining continues to
accelerate. Other diseases of old age - dementia, stroke, arteriosclerosis
and emphysema - are also troubling fewer and fewer people.
'It really raises the question
of what should be considered normal ageing,' says Kenneth Manton, a
demographer from Duke University in North Carolina. He says the problems
doctors accepted as normal in a 65-year-old in 1982 are often not appearing
until people are 70 or 75.
Clearly, certain diseases are
beating a retreat in the face of medical advances. But there may be other
contributing factors. Improvements in childhood nutrition in the first
quarter of the twentieth century, for example, gave today's elderly people
a better start in life than their predecessors.
On the downside, the data also
reveals failures in public health that have caused surges in some illnesses.
An increase in some cancers and bronchitis may reflect changing smoking
habits and poorer air quality, say the researchers. 'These may be subtle
influences,' says Manton, 'but our subjects have been exposed to worse and
worse pollution for over 60 years. It's not surprising we see some effect.'
One interesting correlation
Manton uncovered is that better-educated people are likely to live longer.
For example, 65-year-old women with fewer than eight years of schooling are
expected, on average, to live to 82. Those who continued their education
live an extra seven years. Although some of this can be attributed to a
higher income, Manton believes it is mainly because educated people seek
more medical attention.
The survey also assessed how
independent people over 65 were, and again found a striking trend. Almost
80% of those in the 1994 survey could complete everyday activities ranging
from eating and dressing unaided to complex tasks such as cooking and
managing their finances. That represents a significant drop in the number
of disabled old people in the population. If the trends apparent in the
United States 14 years ago had continued,
researchers calculate there
would be an additional one million disabled elderly people in today's
population. According to Manton, slowing the trend has saved the United
States government's Medicare system more than $200 billion, suggesting that
the greying of America's population may prove less of a financial burden
than expected.
The increasing self-reliance
of many elderly people is probably linked to a massive increase in the use
of simple home medical aids. For instance, the use of raised toilet seats
has more than doubled since the start of the study, and the use of bath
seats has grown by more than 50%. These developments also bring some health
benefits, according to a report from the MacArthur Foundation's research
group on successful ageing. The group found that those elderly people who
were able to retain a sense of independence were more likely to stay healthy
in old age.
Maintaining a level of daily
physical activity may help mental functioning, says Carl Cotman, a
neuroscientist at the University of California at Irvine. He found that
rats that exercise on a treadmill have raised levels of brain-derived neurotrophic
factor coursing through their brains. Cotman believes this hormone, which
keeps neurons functioning, may prevent the brains of active humans from
deteriorating.
As part of the same study,
Teresa Seeman, a social epidemiologist at the University of Southern
California in Los Angeles, found a connection between self-esteem and
stress in people over 70. In laboratory simulations of challenging
activities such as driving, those who felt in control of their lives pumped
out lower levels of stress hormones such as cortisol. Chronically high
levels of these hormones have been linked to heart disease.
But independence can have
drawbacks. Seeman found that elderly people who felt emotionally isolated
maintained higher levels of stress hormones even when asleep. The research
suggests that older people fare best when they feel independent but know
they can get help when they need it.
'Like much research into
ageing, these results support common sense,' says Seeman. They also show
that we may be underestimating the impact of these simple factors. 'The
sort of thing that your grandmother always told you turns out to be right
on target,' she says.
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