Older Age Health and Longevity: A Long-Term View

描述（由申请人提供）：在整个世纪，老年人死亡率一直在下降。到2050年，预计至少有20%的美国人口将超过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，慢性病发病率和残疾率都可能推迟。另一方面，即使死亡率下降可能会增加慢性病的发病率，但慢性病的进展率和残疾率可能会下降。虽然死亡率下降对老年人健康的短期后果可能与长期后果不同，但有证据表明，从长期来看，人口老龄化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衰老的可塑性，以评估疾病，残疾和死亡的长期趋势的解释。考虑的解释将包括传染病发病率降低、职业风险降低和社会经济地位改善以及营养摄入改善。该项目将重点关注这些因素在老年人和年轻人健康代理中的作用，以确定传染病，职业风险，社会经济地位和营养摄入影响健康下降的时间。该项目将研究这些因素不仅在疾病和死亡率中的作用，而且在老年认知功能中的作用。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研究残疾的社会结构。此外，它还将估计慢性病、残疾和死亡率的改善带来的经济收益，并将经济收益分配给因传染病发病率降低和社会经济地位变化而带来的经济收益。这些发现对老龄化理论、预测未来健康和死亡率趋势、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以及评估生物技术投资和医疗创新的经济收益都有意义。

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.