… how to shorten the time that people live with serious illnesses. It’s a concept known as “compression of morbidity,” and it could be a literal life-changer.
The idea is to delay the start of serious illnesses or conditions like frailty until later in life—to actually shorten the time that people are more seriously debilitated. That would help more people live more years as healthy, productive members of society, remain in the work force, contribute to the economy and put less strain on the health care system. Scientists have been pursuing the theory ever since it was first proposed in 1980 by James Fries, MD, a researcher at the Stanford University School of Medicine.
Science has made great strides in the last century to help people live to older ages. Many people routinely live into their 80s, 90s and beyond, thanks to improved screenings, prevention and detection to find and treat life-threatening diseases earlier. And new drug breakthroughs mean many serious conditions have become less deadly. But it also means people live with diseases longer, so lifetime health costs rise along with lifespan.
Compressing morbidity would shorten the period of expensive disability and frailty before death—more like a Niagara Falls approach to dying than a gently sloping, slow decline. It’s something many people with exceptional longevity, those age 95 and older, already experience. For many centenarians, physical health problems and cognitive decline begin at a much later age, so their healthy years are nearly equal to their lifespan.
To increase healthy years of life, we need to slow down the aging process itself, according to S. Jay Olshansky, PhD, a professor at the University of Illinois School of Medicine. Olshansky and others in this field, known as geroscience, believe the longer we live, the more that biological aging—the actual process of growing old—makes us vulnerable to age-related diseases and conditions. Treatments aimed at one disease usually don’t impact other diseases, so the idea is to go after the biological process of aging to slow the decline in our ability to function.
Geroscientists suspect our bodies have something akin to switches that affect how rapidly we age and that they may be adjustable. Research has identified some of these processes down to molecular and cellular levels. We’re also learning how certain diseases may cause us to age faster, and we are experimenting with specific approaches to affect biological progression, at least in laboratory mice. These discoveries are slowly making their way into potential drug therapies and medical treatments.
Delayed aging could be one of the most promising weapons available to fight disease, extend healthy lifespan, compress morbidity and lower health care costs. Olshansky describes the economic benefits that would accrue from delayed aging as “the longevity dividend.” People would stay in the work force longer, thereby increasing their personal wealth, and continue contributing to the economy; they would also use programs like Medicare later, thereby reducing pressure on them.
The sooner we understand and slow the biological processes of aging, the better, according to researchers. Almost every country in the world faces the economic and health pressures of caring for a rapidly aging population. By 2020, the World Health Organization says the number of people worldwide over age 60 will outnumber those under five for the first time in history. The Census Bureau estimates that by 2050, the US population 65 and over will reach an estimated 83.7 million, almost double the 2012 population of 43.1 million.
As we live longer, health costs to care for everyone over 65 will increase dramatically. Medicare spending generally doubles for a person between 70 and 96. Delaying aging could help reduce the financial impact on Medicare and Medicaid by keeping people healthier longer and by avoiding costly institutional care. While we can currently lower some of the costs of long term care through programs that help older adults remain in their homes and communities longer, future funding for services that help them avoid nursing homes are at risk from proposed budget cuts in Congress. Reduced funding also threatens the National Institutes of Health and other organizations that support aging-related research.
Extending health span, compressing morbidity and leveraging the longevity dividend could significantly reduce pressure on the systems, the institutions and the families who care for older adults. More research is vital, as are funding for community programs and services for aging adults, safety-net programs like Medicaid for low-income elderly, and better access to high quality health care.
Freelance journalist Liz Seegert has been writing about health for nearly 30 years. Her work has appeared in Consumer Reports and Kaiser Health News, on the AARP and New America Media websites and on WBAI-FM/Pacifica Radio. She covers aging for the Association of Health Care Journalists. A native of Queens, NY, she loves to walk with her rescue dog, Duke. You can follow Liz on Twitter: @lseegert.