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百岁老人证明了发病期压缩假说,但像我们这些在基因上没那么幸运的人又如何呢?

Centenarians prove the compression of morbidity hypothesis, but what about the rest of us who are genetically less fortunate?

作者信息

Perls T T

机构信息

Gerontology Division, Beth Israel Hospital, Boston, MA 02215, USA.

出版信息

Med Hypotheses. 1997 Nov;49(5):405-7. doi: 10.1016/s0306-9877(97)90086-4.

Abstract

For those who believe that the longer people live into old age, the longer they will live with chronic disability (the expansion of morbidity hypothesis), the current increase in average life expectancy that we are experiencing portends an even greater increase in health care costs and morbidity associated with old age. On the other hand, other scholars assert that if medical science is able to facilitate people's living to an age near or at the maximum lifespan (by curing or markedly delaying illnesses that cause premature mortality), we should observe a compression of morbidity near the end of life. Our experience in the New England Centenarian Study indicates that compression of morbidity does occur among centenarians. Demographic selection or selective survival produces a cohort of successfully aging individuals at very old age as those with illnesses that cause premature mortality are weeded out of the aging population. Unfortunately, the majority of us who are weeded out by the early to mid-eighties (the average life expectancy), succumb to illnesses that are likely to lead to an expansion of morbidity as medical science and healthier lifestyles facilitate longer life expectancies.

摘要

对于那些认为人们步入老年后活得越久,患慢性残疾的时间就越长(发病率扩张假说)的人来说,我们目前正在经历的平均预期寿命的增加预示着与老年相关的医疗保健成本和发病率将进一步大幅上升。另一方面,其他学者断言,如果医学能够帮助人们活到接近或达到最大寿命的年龄(通过治愈或显著推迟导致过早死亡的疾病),那么我们应该会在生命末期观察到发病率的压缩。我们在新英格兰百岁老人研究中的经验表明,发病率压缩现象确实在百岁老人中出现。人口统计学选择或选择性生存会在非常高寿的人群中产生一批成功老龄化的个体,因为那些患有导致过早死亡疾病的人会从老龄化人口中被淘汰。不幸的是,我们大多数人在八十多岁早期到中期(平均预期寿命)就被淘汰了,随着医学科学和更健康的生活方式延长了预期寿命,我们往往死于那些可能导致发病率上升的疾病。

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