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Americans Live Healthier Lives Much Longer Than Realized

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Duke Health News 919-660-1306

DURHAM, N.C. -- 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
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 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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