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[Dependency: possible risk or inevitable outcome?]

J P Michel1, R Kressig, G Gold

  • 1Département de gériatrie Belle-Idée, Hôpitaux universitaires de Genève, Thônex-Genève.

Schweizerische Medizinische Wochenschrift
|January 31, 1998
PubMed
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Dependency in old age is a hazard, not an inevitability. Understanding the difference between independence and autonomy is key. Proactive prevention strategies can mitigate risks associated with aging and chronic diseases.

Area of Science:

  • Gerontology and Public Health
  • Sociology of Aging

Background:

  • Increased human longevity has led to a growing elderly population, significantly impacting societal structures and individual lives.
  • Distinguishing between independence (physical daily activities) and autonomy (decision-making capacity) is crucial for understanding aging.
  • Societal shifts include smaller households and increased reliance on medico-social institutions, highlighting changing support systems for the elderly.

Purpose of the Study:

  • To critically examine whether dependency in advanced age is a predictable hazard or an unavoidable inevitability.
  • To explore the multifaceted nature of aging, encompassing physiological changes, lifestyle repercussions, and cumulative risk factors.
  • To analyze the role of chronic diseases and their functional consequences (impairment, disability, social handicap) in dependency.

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Main Methods:

  • Historical review of human longevity trends and demographic shifts, specifically examining the aging population in Geneva.
  • Analysis of changes in household size and the utilization of medico-social institutions over time.
  • Conceptual framework integrating physiological aging, risk factors, and disease consequences to understand dependency.

Main Results:

  • The proportion of individuals over 65 has significantly increased, accompanied by a substantial rise in life expectancy.
  • A notable decrease in average household size and an increase in residents of medico-social institutions were observed.
  • Dependency, except in cases of violent trauma, is primarily a consequence of health hazards and disease, not an inevitable outcome of aging.

Conclusions:

  • Dependency in older adults is largely a hazard that can be influenced by various factors, including lifestyle and disease.
  • The study emphasizes the importance of understanding the determinants of disease and its impact on functional capacity.
  • A call for proactive and comprehensive prevention strategies, including primary, secondary, and tertiary interventions, to mitigate dependency and preserve autonomy.