Older Age Health and Longevity: A Long-Term View

描述（由申请人提供）：在整个二十世纪，老年人死亡率一直在下降。到2050年，预计美国至少有20%的人口将超过64岁。死亡率下降对老年人健康的影响仍然存在争议。一种观点认为，寿命的延长可能会增加慢性病和残疾率。另一种观点认为，慢性病和残疾率的出现都可能被推迟。另一种情况是，尽管死亡率的下降可能会增加慢性病的发病率，但慢性病的进展速度以及因此致残的速度可能会下降。尽管死亡率下降对老年人健康的短期影响可能与长期影响不同，但有证据表明，从长期来看，人口老龄化一直伴随着老年人健康的改善。有几个因素可以解释老年人健康状况的长期改善和老年人寿命的延长。该项目将使用最近和过去人口的数据来调查老龄化的可塑性，以评估疾病、残疾和死亡的长期趋势。考虑的解释包括传染病发病率降低、职业风险降低和社会经济地位的改善以及营养摄入的改善。该项目将重点关注这些因素在老年人和年轻人健康指标中的作用，以确定传染病、职业风险、社会经济地位和营养摄入何时影响健康下降。该项目将研究这些因素不仅在疾病和死亡率方面的作用，而且在老年人的认知功能方面的作用。该项目还将通过调查残疾与劳动力参与之间关系的变化来审视残疾的社会建构。此外，它还将估计慢性病、残疾和死亡率改善所带来的经济收益，并将经济收益分配给传染病发病率降低和社会经济地位改变所带来的经济收益。这些发现对衰老理论有启示；预测未来的健康和死亡率趋势；评估旨在减少社会保障、老年保险和医疗保险财政赤字的政策；评估生物技术投资和医疗创新的经济收益。

DESCRIPTION (provided by applicant): Mortality rates at older ages have been falling throughout the twentieth century. By 2050 at least 20 percent of the population of the United States is expected to be older than 64. The consequences of mortality decline for older age health are still disputed. One view holds that rising longevity may increase both chronic disease and disability rates. Another view holds that the onset of both chronic disease and disability rates may be postponed. Alternatively, even though declines in mortality may increase the prevalence of chronic disease rates, the rate of progression of chronic disease and therefore of disability may fall. Although the short-run consequences of mortality declines for older age health may differ from the long-run consequences, the evidence suggests that in the long-run population aging has been accompanied by improvements in elderly health. Several factors could account both for long-term improvements in elderly health and for increases in longevity at older ages. This project will use data on both recent and past populations to investigate the plasticity of aging to assess explanations for long-run trends in disease, disability, and death. Among the explanations considered will be reduced infectious disease rates, reduced occupational risk and improvements in socioeconomic status, and improved nutritional intake. The project will focus on the role of these factors in both older age and young adult health proxies to determine the timing of when infectious disease, occupational risk, socioeconomic status, and nutritional intake affect health declines. The project will examine the role of these factors not just in disease and mortality rates, but also in cognitive functioning at older ages. The project will also examine the social construction of disability by investigating changes in the relationship between disability and labor force participation. In addition, it will estimate the economic gains to improvements in chronic disease, disability, and death rates, apportioning the economic gains to those due to improvements in reduced infectious disease rates and to changes in socioeconomic status. The findings have implications for theories of aging; for forecasting future health and mortality trends; for assessing policies aimed at reducing the fiscal deficits in Social Security Old Age Insurance and Medicare; and for assessing the economic gains to investments in biotechnology and innovations in medical care.