Research Debunks Myths on Aging

Aging is not a slow, debilitating decline that lasts decades.

A study of northern Utah residents found, instead, reports of often good or excellent health even past age 85, punctuated by a short period of illness immediately before death. Seniors may enjoy robust health until they are "at the oldest of age."
  The decade-long study of senior citizens in Cache County, to be published in the February issue of the Journal of the American Geriatrics Society, also found that social interaction was an important factor in sustaining a high quality of life. Seniors complained about problems such as vision or hearing loss or depression. The good news, researchers said, is those can be treated with some degree of success.
  Northern Utah was chosen for the national multi-university research that has become the Cache County Memory Study because many of its residents enjoy healthy senior years and live well beyond typical American life spans, said Kathleen Welsh-Bohmer, professor of medical psychology at Duke University and one of the study's authors.
  Duke University headed the study team, which includes researchers from Utah State University, Johns Hopkins Medical Center and the University of Washington. The study was funded by the National Institute on Aging and focuses primarily on aging and dementia.
  This research is based on self-reporting, with the nearly 3,500 participants over age 65 ranking quality of life and general health on 10 different measures, including ability to dress and bathe themselves, major illnesses like cardiovascular disease and diabetes, social involvement, religious practices, vision and hearing, among others.
  "Most reported good function in all the dimensions," Welsh-Bohmer said. "That was something we learned. Many are beyond 85 and still enjoying good health."
  Welsh-Bohmer said the researchers were surprised by the aging complaints they did list. "We were expecting them to be cognition — poor memory — and thought that would be related to quality of life. That certainly was related to mortality. But what most related to overall health were factors like vision, hearing, lack of independence and involvement in social activities."

Those factors were the "most salient and related to poorer health outcomes," she said.
  They are also factors that can be modified to some extent with glasses, cataract surgery, hearing aids and more opportunities for the elderly to interact with others, she said.
  "Some of those may be things we can do something about. They are at least areas for future research."
  Between 80 and 90 percent of those 65 to 75 reported excellent or good health, as did about 60 percent of those over age 85. Cognition was also tested, using the 20-question Mini-Mental Status Examination, which tests reasoning and memory.
  Nearly 90 percent of participants were healthy enough to live at home, including those 85 and older. More than 90 percent of those 65 to 84 were independent in all their "ADLs," or activities of daily living, such as bathing, and more than two-thirds of those over 85 could complete those tasks alone. The 2004 National Health Interview Survey found similar results nationwide, as did a Medicare survey. It's not unique to Utah's population.
  About half were free of any major disease and the other half were living with at least one physical ailment. Still, most reported at least fair health and the ability to perform most ADLs. The percentage of participants without chronic conditions fell slightly as individuals aged, but 40 percent of men 85 and older and 42 percent of women in the same age group did not report any major disease. Fewer than 10 percent of participants reported suffering depression, which was most common in those over 85 because of fewer social opportunities.
  Women older than 85 were more apt to be frail and less likely to be able to perform certain activities of daily living.
  The researchers don't claim that people don't slow down some or experience some functional decline, said Welsh-Bohmer. "Participants are able to put some of that into perspective. People are reporting excellent to very good function despite physical conditions. If there's some deterioration with aging, they're OK with that and it doesn't diminish quality of life."
  Inability to participate in activities and social gatherings, or depression, however, matter very much, she said. And that will open doors to more specific research to determine what types of activities and social engagements are important to people as they get older.
  The question of successful aging is particularly important as "many, many more people" are going to be advancing in age, Welsh-Bohmer said. "It's important to plan ahead and develop social systems that can be beneficial. It's a starting point."
  Lead author on the study is Dr. Truls Ostbye, professor in Duke University Medical Center's Department of Community and Family Medicine. Co-authors are Maria C. Norton and JoAnn Tschanz of Utah State University; Katrina Krause, Linda Sanders, Kathleen Hayden, Welsh-Bohmer, Carl Pieper and Katrina M. Krause, all of Duke.

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