Past, Present, and Future of Healthy Life Expectancy
Past, Present, and Future of Healthy Life Expectancy
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DOI：
10.1101/cshperspect.a025957
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发表时间：
2015-11-01
影响因子：
5.4
通讯作者：
Crimmins, Eileen M.
中科院分区：
文献类型：
--
作者：
Beltran-Sanchez, Hiram;Soneji, Samir;Crimmins, Eileen M.
目前建立在“疾病模型”基础上的生物医学范式的成功在未来可能会受到限制，因为大量的并存疾病会对老年人造成影响。近年来，越来越多的基于动物模型的经验证据表明，衰老过程可能会被推迟，这一过程可能会导致预期寿命的延长，同时老年人的健康状况也会有所改善。在这篇综述中，我们探讨了健康预期寿命的过去、现在和未来的前景，并检查了与延缓衰老相关的平均寿命的延长是否与老年人无残疾生活的额外年限有关。健康预期寿命的趋势表明，美国老年人的状况有所改善，尽管年轻人群似乎正在步入老年，虚弱和残疾水平越来越高。肥胖和吸烟等健康风险因素的趋势显示出令人担忧的迹象，在不久的将来对成年人的健康和死亡率产生负面影响。然而，基于人类延缓衰老的模拟模型的结果表明，它不仅有可能增加寿命，而且还有可能增加老年人无残疾度过的时间和年数。延缓衰老可能会带来额外的总成本。如果延缓衰老得到广泛应用，人们愿意将更健康的身体转化为更长时间的工作，这些成本就可以抵消。
The success of the current biomedical paradigm based on a "disease model" may be limited in the future because of large number of comorbidities inflicting older people. In recent years, there has been growing empirical evidence, based on animal models, suggesting that the aging process could be delayed and that this process may lead to increases in life expectancy accompanied by improvements in health at older ages. In this review, we explore past, present, and future prospects of healthy life expectancy and examine whether increases in average length of life associated with delayed aging link with additional years lived disability-free at older ages. Trends in healthy life expectancy suggest improvements among older people in the United States, although younger cohorts appear to be reaching old age with increasing levels of frailty and disability. Trends in health risk factors, such as obesity and smoking, show worrisome signs of negative impacts on adult health and mortality in the near future. However, results based on a simulation model of delayed aging in humans indicate that it has the potential to increase not only the length of life but also the fraction and number of years spent disability-free at older ages. Delayed aging would likely come with additional aggregate costs. These costs could be offset if delayed aging is widely applied and people are willing to convert their greater healthiness into more years of work.