A More Holistic Approach to Health

The Lancet researchers also reviewed a number of studies focused on
health trends among older populations -- some negative, some positive,
says Vaupel, although "on balance, things are probably getting better."
On the positive side, for example, "rapid progress is being made in
reducing heart attacks and other cardiovascular illness, some progress
is being made against cancer, although it's slow, and there are some
indications we are beginning to understand Alzheimer's disease better,"
he says. Doblhammer-Reiter also cites advances in medical technology
and life style changes -- being more active and cutting down on smoking
-- as positive directions.

What is not improving is the outlook for obesity and diabetes. "They
seem to be deteriorating rather than improving over time," says
Doblhammer-Reiter. Indeed, note the researchers in the article,
"obesity is a widely discussed risk factor that threatens improvements
in health [and] has been increasing in almost all populations....
Obesity is related to various poor health outcomes, including raised
risk of diabetes, arthritis and stroke." Meanwhile, the number of
diabetes cases is expected to more than double worldwide due to the
ageing population, with the largest increase occurring among people 65
and older.

The study also looks at existing data on disability, mobility, hearing
problems and other age-related conditions, but points out that "little
is known about trends in cognitive function and dementia" -- an area
that Vaupel, among others, feels would benefit from significantly more
research. "There is good evidence that we are living longer and
healthier in terms of physical function, but the evidence is more mixed
on cognitive function," he says. Further studies are needed to find out
"what people can do to keep their cognitive functions going as they get
older." He also calls for an increase in geriatric medicine. "Today's
system is organized around specialists -- cancer, heart, brain, etc. --
but older people, even relatively healthy ones, generally have several
different problems. As a public policy issue, there needs to be better
coordination to make sure that individual doctors are not prescribing
medicines that interfere with each other. We need to start treating
people holistically."

According to Mitchell, "Economists like to say that health is another
component of our human capital -- the source of our strength and
versatility in dealing with the future." It's not about "just being fit
as a child or a young adult, but about making an investment in good
health throughout your whole life so that you will be a fitter
100-year-old as well." Mitchell and others recently completed "The
Health and Retirement Study" that looked, in part, at attitudes of
people age 50 and older now, compared to those 50 and older 12 years
ago. "We saw a big change between the two groups, in that today's baby
boomers expect to have more complex careers in the second half of their
lives. Many of them think they will continue to work in some capacity,
perhaps not in the same job, but consulting, possibly starting their
own business -- this was before the financial crisis -- and doing more
volunteer projects. We can expect this trend to continue as people
retire later and later in their lives."