Compression of morbidity thesis
Given that physical disability is the most prevalent major health problem of older adults in the United States 30 31public health policies aimed at reducing this burden are of great importance.
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Death certificates were also obtained. Discussion These results make a compelling argument for the compression of morbidity hypothesis, that is, the reduction and postponement of disability with healthier lifestyles.
The delayed decline for those at moderate risk and the lack of any identifiable increase in the risk-factor—free group further illustrate the advantage of these lower risk groups.
Alternative explanations for these findings, including differences between groups in age, gender, ethnicity, and educational attainment, are not apparent. The rate of change in disability i. The illustrative use of age 55 years as the present age of onset of chronic morbidity is drawn from the data of Bruce B et al showing this to be the median age of detectable chronic disability Bruce. The conclusion? James F. Compression of Morbidity Theory Figure 1. In other words, we want to minimize the number of years that a person spends suffering from chronic illnesses while maximizing that person's total number of years. Figure 1 extends a common representation of the compression of morbidity [ 4 ]. They included body mass index weight in kilograms divided by height in meters squared , cigarette smoking, and vigorous physical activity jogging, brisk walking, swimming, bicycling, racquet sports, or exercise that worked up a sweat. James Fries in Morbidity and disability then would decrease for the typical person, and medical care costs might decline as well, providing relief for cost pressures on Medicare. It has been argued that healthy lifestyles and other preventive measures now will exert their greatest influence by postponing the onset of debilitating morbidity while increasing the life span by only a small amount. Manton, K. Analyses of the bootstrap samples validated these results. While homogeneity may limit the generalizability of these results, it has served to strengthen our ability to draw inferences from the risk group comparisons.
Under the compression of morbidity hypothesis, disability would be lower and acceleration in the rate of change increased slope closer to the time of death in a lower compared with a higher risk group.
Prior data showed that nonresponders compared to participants were 1.
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The points also described the variability in the estimated time when a steeper slope occurred. If accelerated decline in this group occurred closer to the time of death than our 3-month window could detect, it would still argue in favor of a reduction and postponement of disability with healthier lifestyles. Fries et al. Vita, A. However, there were too few deaths to obtain statistically reliable estimates for women. The above analyses by risk category were repeated for men separately to eliminate the possible confounding effects of gender. In contrast, those with two or more factors maintained a greater level of disability throughout follow-up and experienced an increase in the rate of decline 1. Deaths were ascertained through the participants' families or friends as well as through the National and Social Security Death Indices. Three risk groups were created based on the number of unhealthy factors at study entry: none low-risk , one moderate-risk , and two or more high-risk. There are three stages in developing documentary evidence to support health policies directed at improving senior health: 1 a theoretical framework, as represented by the compression of morbidity hypothesis; 2 the epidemiologic data to establish proof of the concept; 3 randomized trials to establish the ability to intervene successfully. Although the data were analyzed in a continuous fashion, average disability scores at 3-month intervals are superimposed on the fitted models. The conclusion? Chosen risk factors were those that were lifestyle-related, potentially modifiable, and associated with functional status in other studies of aging. Analyses that address the question of confounding by gender do not change the study findings. Introduction The Compression of Morbidity paradigm was introduced as a hypothesis of healthy aging in [ 1 ].
Compression of morbidity since has become one of the goals of healthy aging and longevity: living disease-free and illness-free for as long as possible.
Fries said, then the healthy time saved could lessen the burden of illness over a person's lifetime. Thus, preventive health measures, including intervention on modifiable risk factors, have the potential to offset increases in disabling morbidity as well as the concomitant burden of care resulting from greater longevity among today's aging populations.
based on 106 review