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The Theory and Practice of Active Aging

DOI: 10.1155/2012/420637

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Abstract:

“Active aging” connotes a radically nontraditional paradigm of aging which posits possible improvement in health despite increasing longevity. The new paradigm is based upon postponing functional declines more than mortality declines and compressing morbidity into a shorter period later in life. This paradigm (Compression of Morbidity) contrasts with the old, where increasing longevity inevitably leads to increasing morbidity. We have focused our research on controlled longitudinal studies of aging. The Runners and Community Controls study began at age 58 in 1984 and the Health Risk Cohorts study at age 70 in 1986. We noted that disability was postponed by 14 to 16 years in vigorous exercisers compared with controls and postponed by 10 years in low-risk cohorts compared with higher risk. Mortality was also postponed, but too few persons had died for valid comparison of mortality and morbidity. With the new data presented here, age at death at 30% mortality is postponed by 7 years in Runners and age at death at 50% (median) mortality by 3.3 years compared to controls. Postponement of disability is more than double that of mortality in both studies. These differences increase over time, occur in all subgroups, and persist after statistical adjustment. 1. Introduction “Active aging” and the related terms “healthy aging,” “successful aging,” “productive aging,” “aging well,” “living well,” “senior wellness,” and “compression of morbidity” endorse a radically nontraditional paradigm of human aging, which includes gains as well as losses and which posits possible improvement in future human health despite increasing longevity. Each of these terms, discussed briefly below, foresees a new paradigm for gerontology, based upon postponing functional declines into older ages with a goal of postponement of morbidity more than mortality, compressing morbidity into a shorter period later in life, and decreasing cumulative lifetime morbidity [1]. The new paradigm contrasts strikingly with the old “Failures of Success” paradigm, where improvements in longevity would inevitably lead to ever larger numbers of persons in ever poorer health [2]. There are differences in nuance between these terms and in the metrics by which they might be measured, and confusion might be reduced by greater agreement on terminology. We are most comfortable with “Compression of Morbidity” since it implies a strategy for improving health, the theory behind the strategy, and the means of testing progress, albeit a more technical term than alternatives. Of alternative terms, we prefer the term

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