Centenarians prove the compression of morbidity hypothesis, but what about the rest of us who are genetically less fortunate?
For those who believe that the longer people live into old age, the longer they will live with chronic disability (the expansion of morbidity hypothesis), the current increase in average life expectancy that we are experiencing portends an even greater increase in health care costs and morbidity associated with old age. On the other hand, other scholars assert that if medical science is able to facilitate people's living to an age near or at the maximum lifespan (by curing or markedly delaying illnesses that cause premature mortality), we should observe a compression of morbidity near the end of life. Our experience in the New England Centenarian Study indicates that compression of morbidity does occur among centenarians. Demographic selection or selective survival produces a cohort of successfully aging individuals at very old age as those with illnesses that cause premature mortality are weeded out of the aging population. Unfortunately, the majority of us who are weeded out by the early to mid-eighties (the average life expectancy), succumb to illnesses that are likely to lead to an expansion of morbidity as medical science and healthier lifestyles facilitate longer life expectancies.
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Gerontology Division, Beth Israel Hospital, Boston, MA 02215, USA.
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D006801:Humans; D008017:Life Expectancy; D009017:Morbidity