Maintenance of functioning in the elderly

Dramatic declines in age-specific mortality have led to large increases in the number of older people in the United States and other industrialized populations. While increased survival time is to be desired, it is important to consider the functional ability of those who survive to older ages, and whether preventive activities can lead to higher levels of functioning. Using data from the Alameda County Study, results indicating that incident chronic diseases are associated with poorer levels of physical functioning are presented. Many of the behavioral, social, and demographic risk factors that are associated with risk of chronic disease and mortality in this cohort are also associated with poorer physical functioning. Thus, interventions that reduce or delay the development of chronic diseases in the elderly may also result in higher levels of physical functioning. These same risk factors also modify the impact of chronic disease on functioning. Therefore, interventions that reduce risk factors for chronic disease may increase levels of functioning in those who survive with or without disease.