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Epidemiology of Aging

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Survival Curves for Australian Males, 1988: Proportion Surviving ... Trends in Disability (Women Only) Are today's elderly healthier than yesterday's? ... – PowerPoint PPT presentation

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Title: Epidemiology of Aging


1
Epidemiology of Aging
  • A.M.Clarfield MD, FRCPC
  • Professor of Gerontology
  • Ben Gurion University,
  • Israel
  • Open Health Institute, Moscow
  • Saturday, Jul 10 , 2004

2
Scope of Problem Large

3
Aging A Biological Definition
  • A progressive, generalized impairment of
    function resulting in a loss of adaptive response
    to stress (loss of biological reserve) and in a
    growing risk of age-associated disease.

After Kirkwood T, 1996
4
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6
Squaring of the curve ideal situation
7
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8
Demography
  • elderly depends on
  • 1. fertility
  • 2. mortality
  • 3. migration

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14
Squaring of the curve ideal situation
15
Stages of the Demographic Transition
Bangladesh
Israel
Sweden
16
Survival Curves for Australian Males,
1988Proportion Surviving ()
17
Are todays elderly healthier than yesterdays?
18
Increase in life expectancy
19
Alois Alzheimer et al
20
Prevalence of AD in US3 Projections( Arch
Neurol 2003 )
21
Aggregate Changes in Severe Cognitive Impairment
Among Older Americans 1993-1998 (Freedman VA
et al. J Gerontol 2001)
22
  • Examined 7443 (1993) and 7624 (1998)
    non-institutionalized elderly (70)
  • Percentage with severe cognitive impairment
  • 1993 6.1
  • 1998 3.6


plt0.001
23
Trends in Institutionalization (Jacobzone S.
Health Affairs, 2000)
24
Trends in Disability (Women Only)
25
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26
Are todays elderly healthier than yesterdays?
27
What can explain this phenomenon?
28
What can explain this phenomenon?
  • Genetics?

29
What can explain this phenomenon?
  • Money/ education?

30
What can explain this phenomenon?
  • Classic public health measures e.g.
    Hygiene/ diet/ water/ milk ?

31
What can explain this phenomenon?
  • Medical technology ( atx, ASA, statins, stents?)

32
What can explain this phenomenon?
  • Secular trend (McKeown)

33
What can explain this phenomenon?
  • Lifestyle/health behaviour
  • - ? smoking
  • - diet
  • - ? exercise
  • - alcohol

34
What can explain this phenomenon?
  • Use of aids
  • - canes, handrails
  • - microwave ovens

35
What can explain this phenomenon?
  • Social support

36
What can explain this phenomenon?
  • Something else?
  • All of the above?

37
The Situation in Russia
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40
Age structure -Russia
  • 13.7 65 ( cf. Israel 10, UK 18)
  • 60 1990 16
  • 2015 20
  • Very rapid growth in old-old (80)

41
The Situation in Russia
  • Catastrophic impact of WW 1, WW2 ,famine
  • - eg 36? 100 ?
  • - female advantage for life expectancy is
  • widest in the world 10.4 yr. ( cf. 4 yr.
    in
  • Israel )
  • Low fertility ?? 65
  • ?poverty, esp. among 65
    (? pension, ?cost of living)

42
The Situation in Russia
  • Degradation of health and social services
  • ? life expectancy in the middle aged men (trauma,
    alcohol, suicide)
  • MORE OLD PEOPLE

43
What is to be done?
44
?
45
  • Thank You
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