There is a Wide Distribution of Outcomes in Aging

Aging kills all of us eventually, given how little today's medical technology can do to intervene in the causes of age-related degeneration, but along the way there is a quite a distribution of outcomes in health and frailty. Some people live longer than others, obviously. But also, some people do comparatively well until close to the end of life, while others suffer considerable pain and disability for a much longer period of time in later life. Some of these differences are the result of poor lifestyle choices, but others result from chance and the interaction of genetic variations with growing levels of biochemical damage. A lot of effort goes into studying these variations in the state of aging, but really, that funding and the time would be better directed towards finding ways to repair the cell and tissue damage that causes aging. Success on that front would make the unmodified progression of aging a historical curio, and produce far longer healthy lives for all.

You might believe that older adults who deal with extensive chronic illnesses or serious diseases would be more likely to be frail and to have a poorer quality of life than healthier older adults. That may be true for some elders - but not for all. Researchers suggest that an undefined coping mechanism of some sort may play a role in how well older adults are able to live despite having burdensome illnesses.

The researchers examined three groups of participants enrolled in the Cardiovascular Health Study, a large research project that examined adults 65-years-old and older from four cities around the country. Researchers assigned people to one of three groups, based on the extent of their disease and their level of vigor or frailty: (1) The expected agers (3,528 people) had higher disease but also higher frailty levels. They spent 47 percent of the remainder of their lives able and healthy. (2) The adapters (882 people) had higher disease levels as well as relatively high vigor (being active and mobile) levels. They spent 55 percent of the reminder of their lives able and healthy. (3) The prematurely frail (885 people) had lower disease levels but higher frailty levels. They spent 37 percent of their remaining lives able and healthy.

The researchers said "adapter" older adults who were more vigorous than expected, based on their disease burden, lived longer lives when compared to those who were more frail than expected based on their disease burden. These "adapters" could have unique characteristics, perhaps some undefined coping mechanism, that should be studied further, suggested the researchers.



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