By Howard M. Fillit MD, Kenneth Rockwood, Kenneth Woodhouse
Read or Download Brocklehurst's Textbook of Geriatric Medicine and Gerontology, Seventh Edition: Expert Consult - Online and Print (Brocklehurst's Textbook of Geriatric Medicine & Gerontology) PDF
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Additional info for Brocklehurst's Textbook of Geriatric Medicine and Gerontology, Seventh Edition: Expert Consult - Online and Print (Brocklehurst's Textbook of Geriatric Medicine & Gerontology)
Although these proportions are larger than in the census projections, they are not grossly different from the 25% of the Japanese population expected to be over age 65 in 2025. If fertility and immigration is lower than assumed in Japanese census projections, then the proportion of the population over age 65 and over 85 would be higher. 26 These slow increases in mortality are apparently because of the high mortality rates of very elderly persons with high levels of disability. 139 The question emerges of how a society and economy must change to deal with a population with such a high proportion of elderly, and quite possibly healthy and functional, persons.
Whether or not improvements in health and functioning continue at late ages, and can be accelerated by judicious public health and medical innovations and investments, will affect how the United States’ and other developed countries’ social and economic institutions respond in the future to a growing elderly population. A difficulty in anticipating future improvements in health at, for example, ages 85 and 95, is that changes depend in part upon both historical and future conditions. Historical factors are important because the individuals who will be the elderly and oldest-old cohorts in the next 65 years are already alive and have accumulated significant early exposures that partly determine the age trajectories of health parameters.
A recent major clinical trial, however, calls those benefits into question, although reanalysis of those data suggested female Hormone Replacement Therapy has to be initiated shortly after menopause to have positive effects. Negative effects of HRT seemed most manifest in very elderly women where HRT was initiated 15 to 20 years postmenopause. Further analysis is needed to clarify the dynamics of treatment and response. Evidence suggests that testosterone supplementation may have benefits for males in terms of reduced dementia risk.
Brocklehurst's Textbook of Geriatric Medicine and Gerontology, Seventh Edition: Expert Consult - Online and Print (Brocklehurst's Textbook of Geriatric Medicine & Gerontology) by Howard M. Fillit MD, Kenneth Rockwood, Kenneth Woodhouse