Schroll M
Geriatric Department HL, Kommunehospitalet, Copenhagen.
Dan Med Bull. 1992 Jun;39(3):258-61.
From Danish results, it is argued that longer life need not imply worse health. If we as individuals and society will prevent the "pawnbroker-diseases," increase access to geriatric rehabilitation, and supply necessary services in an individualised way, most added years can be active years. The following conclusions are drawn: In the first decades after the year 2000, morbidity, disability and mortality will be postponed, but treatment will be more important for prolongation of life than prevention. Therefore, the net result will be extension of morbidity. The next question is how severe disability will be among the increased number of people who have a disease, but are not dying from it. The elderly will be more healthy in the future, but the prevalence of chronic disabling diseases may not change, or may even increase. That is because healthy men and women can postpone disability and death until higher ages (successful aging), but some elderly persons live with premature disabling diseases, which might have killed them some decades ago. When elderly people make the transition from autonomy to dependence in the course of a disease, it is possible by early geriatric intervention and rehabilitation to restore them to functional levels and provide them with more active years. It is possible to disseminate geriatric rehabilitation to a much wider population of elderly with multipathology and social problems. In this way, disability can be overcome in a higher fraction of diseased elderly.(ABSTRACT TRUNCATED AT 250 WORDS)
从丹麦的研究结果来看,有人认为寿命延长并不一定意味着健康状况变差。如果我们个人和社会能够预防“典当商疾病”,增加老年康复服务的可及性,并以个性化方式提供必要服务,那么增加的岁月大多可以是活跃的岁月。得出了以下结论:在2000年后的头几十年里,发病率、残疾率和死亡率将会推迟出现,但治疗对于延长寿命将比预防更为重要。因此,最终结果将是发病率的延长。下一个问题是,在患有一种疾病但不会因此死亡的人数增加的情况下,严重残疾的情况会怎样。未来老年人会更健康,但慢性致残疾病的患病率可能不会改变,甚至可能增加。这是因为健康的男性和女性可以将残疾和死亡推迟到更高年龄(成功老龄化),但一些老年人患有过早出现的致残疾病,这些疾病在几十年前可能就会致其死亡。当老年人在疾病过程中从自主状态转变为依赖状态时,通过早期的老年干预和康复,有可能使他们恢复到功能水平,并为他们提供更多活跃的岁月。有可能将老年康复服务推广到更多患有多种疾病和存在社会问题的老年人群体中。这样,就可以使更高比例的患病老年人克服残疾问题。(摘要截选至250字)