The aging of the aged: challenges for gerontology & geriatrics in the United States.

Abstract

It comes as no surprise that global graying will be one of the most pressing issues of the coming century. The most rapidly growing age group in all developed countries is the one with persons aged 85 and older. Often referred to as the "oldest old", the aging of the aged reflects a universal concern being experienced in the United States as well as in other industrialized countries, such as Japan. This paper addresses the challenges that such changes present for gerontology and geriatrics. Contextual projections of population trends and of life expectancy, as well as actual health care costs and estimated government health care expenditures will be compared for the United States and for Japan. Among the geriatric challenges being confronted are (1) the need to separate aging from disease, (2) the need for more geriatric centers and available geriatricians to serve the aged, (3) the introduction of health care strategies of prevention and case management, (4) responses to the notion of health care rationing, and (5) the ultimate importance of research ranging from the biological and molecular to the behavioral, social, and health service delivery. Global aging presents a gerontological imperative that may best be understood by examining policy recommendations and future policy decisions.