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Age No Longer the Best Mortality Predictor
An important study is now showing that age plays almost no role in accounting for differences in older people’s health and well-being. A large-scale study by a multidisciplinary team of researchers at the University of Chicago, using what they call a “comprehensive model” of health and aging, has shown how other factors such as psychological well-being, sensory function, mobility and health behaviors are essential parts of an overall health profile that better predicts mortality.
Up until now the ‘medical model” has depended upon the usual checklist of illnesses that are common for older adults; e.g, heart disease, cancer, diabetes, high blood pressure and cholesterol levels to determine health classifications. With these new study results, some people with chronic disease are revealed as having strengths that lead to their reclassification as quite healthy, with low risks of death and incapacity.
The study results released in 2014, are part of the National Social Life, Health, and Aging Project, and supported by the National Institute on Aging of the National Institutes of Health, are the result of a major survey of a representative sample of 3,000 people aged 57 to 85 done by an independent research organization at the University of Chicago.
This study is the first of its kind to collect this sort of information from a scientifically selected group of people, and yielded comprehensive new data about the experience of aging in America. In addition to finding that age plays little or no role in determining differences in health, the research found that:
•Cancer itself is not related to other conditions that undermine health.
•Poor mental health, which afflicts one in eight older adults, undermines health in ways not previously recognized.
•Obesity seems to pose little risk to older adults with excellent physical and mental health.
•Sensory function and social participation play critical roles in sustaining or undermining health.
•Breaking a bone after age 45 is a major marker for future health issues.
•Older men and women have different patterns of health and well-being during aging.
•Mobility is one of the best markers of well-being.
The comprehensive model’s healthiest category represented 22 percent of older Americans. This group was typified by higher obesity and blood pressure, but had fewer organ system diseases, better mobility, sensory function and psychological health. They had the lowest prevalence of dying or becoming incapacitated (six percent) five years into the study.
A second category had normal weight, low prevalence of cardiovascular disease and diabetes, but had one minor disease such as thyroid disease, peptic ulcers or anemia and were twice as likely to have died or become incapacitated within five years.
Two emerging vulnerable classes of health traits, completely overlooked by the medical model, included 28 percent of the older population. One group included people who had broken a bone after age 45. A second new class had mental health problems, in addition to poor sleep patterns, engaged in heavy drinking, had a poor sense of smell and walked slowly, all of which correlate with depression.
The most vulnerable older people were in two classes characterized by immobility and uncontrolled diabetes and hypertension. A majority of people in each of these categories were women, who tend to outlive men.
Recommendations for improving our health in older age based on these study results include that we shift our attention from disease-focused management, to overall well-being across many areas. For example, instead of developing healthcare policies focused on reducing obesity as a much lamented health condition, greater support for reducing loneliness among isolated older adults or restoring sensory functions would be more effective in enhancing health and well-being in the older population, the study researchers stated.
What does this mean for each of us? We need to take an objective look at ourselves and our family members and see where we can reduce our vulnerabilities, especially regarding mobility, sleep, drinking, and socialization. Of course we also need stay on top of our health issues, but note that we need to do more than that if we want to live a longer more satisfying life.
**This information exerpted from: “An Empirical Redefinition of Comprehensive Health and Well-being in the Older Adults of the U.S.,” in a current issue of the Proceedings of the National Academy of Sciences.
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Content copyright © 2018 by Patricia Villani, MPA, PhD. All rights reserved.
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