Study finds elderly aren't that frail many disabilities can be prevented

January 08, 1991|By Ronald Kotulak | Ronald Kotulak,Chicago Tribune

Many of the disabilities of elderly people are preventable, but are allowed to occur because of the widespread misconception that frailty and dependence are an unavoidable consequence of aging, a committee of the Institute of Medicine has reported.

The panel was particularly harsh in blaming doctors and public health experts for writing off the older generation as being beyond help.

"Our misplaced pessimism gives rise to the particularly troubling consequence that many more individuals who could experience a fulfilling maturity are denied the chance by these stereotypes," said the committee.

Its report, called "The Second 50 Years," is intended to "dissuade health professionals from the belief that growing old necessarily means growing frail," the committee said.

The truth is that many people live healthy, active lives into advanced old age, and there is growing evidence that 70-year-olds today are healthier as a group than their counterparts were 15 years ago, said Dr. Robert Berg, committee chairman and professor emeritus of preventive and rehabilitative medicine at the University of Rochester School Medicine and Dentistry.

"But it is clear that a lot of physicians don't think about the disability part of a patient's illness," he said.

Unlike younger patients with the same diseases, older patients run the risk that disease will trigger a process of physical impairment, the committee said. Whereas a younger patient may bounce back, an older one may experience loss of independent function, emotional difficulties and impediments to daily work and social activities, all of which can be treated and reversed, the report said.

"Many older persons can be spared all or part of this progression to dependency and diminished function," it said, "but reversing such a course requires attention by health professionals not only to the disease itself but also to its consequences."

The committee listed 13 areas where immediate action and future research are needed: control of high blood pressure, undiagnosed reactions to medications, preventable infections, osteoporosis, sensory loss, inadequate oral health, lack of cancer screening, poor nutrition, cigarette smoking, depression, physical inactivity, social isolation and falls.

Improving care for the elderly is becoming increasingly urgent because of the rapid aging of the U.S. population, the committee said. There are 30 million Americans aged 65 and older, who now make up 12.4 percent of the population. This group is expected to increase to 22 percent of the population by 2030.

Scientists from the University of Chicago and Argonne National Laboratory have reported that the average American lifespan is reaching what some scientists believe to be its biological limit of 85 years. As of 1988, average life expectancy was 75 years.

The Chicago researchers warned that the number of frail and dependent elderly will grow, precipitating a health-care crisis, if efforts are not made to reduce age-related disabilities.

The Institute of Medicine report said major changes are needed in medical school curriculums, health insurance coverage by both private and governmental agencies, and public understanding to emphasize disability-prevention measures.

"It's clear that a lot of the disabilities of the elderly could have been avoided if physicians had done the things that we know could be done," said Berg. "We need to do the things we know and to find out what more we can do."

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