The goals of healthy aging and the compression of morbidity

The goals of healthy aging and the compression of morbidity

To many, the focus of healthy aging is to live as long as possible. We have seen the life expectancy in the United States increased from 47 years to 79 years over the last 150 years, but the maximum lifespan (oldest age people are capable of living to) has only increased marginally during the same period. There appears to be an age between 70 and 100 years old where our bodies are naturally no longer able to keep up with the challenges of everyday life and as a result, shut down (Fries, 2005). Therefore, the primary goal of healthy aging is to live through our physiologically set lifespan with the highest quality of life.

The compression of morbidity hypothesis was developed by James F. Fries of Stanford University School of Medicine and proposes that living an active lifestyle with good nutrition and practicing abstinence from dangerous habits such as smoking delays the onset of disability until the last years of life (Fries, 2005). For example, a sedentary and active senior may both live to 85 years old, but the sedentary senior may become disabled at age 75, while the active senior may not reach the same level of disability until age 84. The active senior will be able to maintain their lifestyle of choice for an additional 9 years.

A 21 year-long study following a group of runners with an average starting age of 58 years old found that the runners developed a disability corresponding to challenges performing one activity of daily living, such as walking, 8.6 years later than the control group (Chakravarty et al. 2008). The differences between groups diverged increasingly at higher levels of disability.

Additionally, the runners did not experience more osteoarthritis and had fewer knee and hip replacements than controls (Chakravarty et al. 2008; Chakravarty et al. 2008).

Habits like exercise, healthy nutrition, and not smoking are important because the occurrence of a significant medical event late in life often leads to disability. Seniors should exercise as protection against injuries that could threaten their self-sufficiency. It is never too early or too late for anyone to start.

Seniors can benefit from the cardiovascular components of aerobic exercises (e.g. hiking) and the improvements in strength and stability that come from intelligently programmed weight training. In the runner study, the investigators note that the runners should be viewed as multidisciplinary athletes because many of them gave up running for other training modalities during the study (Chakravarty et al. 2008). Fries suggests that the most important thing is to find an activity you like and stay as active as possible (Fell, 2015).

Understanding the concepts behind the compression of morbidity can lengthen the time seniors can live full, independent lives.

Further Reading:

Chicago Tribune Article

Overview of Compression of Morbidity

Review of research

Influence of lifestyle risk factors on compression of morbidity

123prevailTyler Paras – Prevail Intern

B.S. – Cellular Molecular Biology (Westmont)

Matriculating M.D. Candidate – University of Pittsburgh School of Medicine

Tyler was born and raised in Santa Barbara, California and began training at Prevail in October 2016. He attended Westmont College and will be attending medical school this fall. While at Westmont he graduated Summa Cum Laude, led a student-run homeless outreach program, and volunteered with medical clinics in Mexico and Bolivia.

After Tyler’s mother was diagnosed with rheumatoid arthritis (RA), he became interested in the cellular mechanisms behind the disease. He conducted his Major Honors project at Westmont on the role of the microbiome in inflammatory arthritis and conducted summers of research at Harvard Medical School studying the role of macrophages in RA. Including his critical care clinical research at Cottage Hospital, his research has resulted in seven presentations, three at national medical conferences.

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