Epidemiology and the Challenge of Ageing

Abstract

This paper reviews the antecedents and consequences of population aging the data on mortality and morbidity among those 65 years of age and over and the need for greater application of epidemiologic skills in this field. The demographic process of population aging derives from changes in both fertility and mortality. In 1980 the proportion of the population over 60 years of age was 15% in the worlds more developed regions and only 6.2% in less developed regions. The proportion of older persons is expected to increase in all regions until at least 2020. Not only are populations getting older but the old themselves are living longer and mortality at the higher ages is falling. In the more developed countries 75% of deaths over age 65 years are attributable to cardiovascular diseases and cancer. Measures of morbidity subjective health limited activity use of services and index of activities of daily living have not been sufficiently developed to derive an overall index of health of the aged. Although the majority of diseases and impairments of old age cannot at this point be prevented there is a need to study the epidemiology of these conditions and to measure the risk factors. Epidemiology could play an essential role in the planning and evaluation of services if the amount of health care and social support needed to achieve some acceptable minimum quality of life and preservation of autonomy could be computed. It is concluded that the needs of the elderly are so complex they require the scientific base that can come only from the holistic and unifying approach of the epidemiologist.