Dana Goldman’s “Heterogeneity in Healthy Aging” Featured in the Journals of Gerontology.

Growing Older But Not Growing Old

For many, growing older is not accompanied by life-limiting declines in health, according to a new study in the Journals of Gerontology [subscription access only].

Researchers at RAND, the School of Public Health at the University of Illinois at Chicago, Stanford University School of Medicine and the USC Schaeffer Center for Health Policy & Economics sought to learn more about the proportion of the U.S. population that stays healthy and active at both older and younger ages.

By analyzing extensive survey data of Americans aged 51 and older, they found that a substantial group of individuals at all ages experienced not just exceptional health, but their mental and physical functioning was at a level exhibited by people decades younger.

“We found a surprisingly large proportion of older Americans who are in exceptional health – this includes people aged 85 and older who report their health as ‘excellent’ or ‘very good’, who say that they don’t need help with daily activities, and are operating mentally and physically just like people who are decades younger,” says S. Jay Olshansky, School of Public Health, University of Illinois at Chicago. “The documented presence of excellent health among some people at older ages confirms what many people know by experience – that for them or their friends or relatives, age is just a number.”

Among their results, they found that those older than 85 years of age are over half as likely to report that they were in excellent or very good health as those aged 51-54.  They also found that nearly one-third of Americans over 85 years old have not been diagnosed with any of the top 5 chronic diseases: cancer, diabetes, heart disease, lung disease or stroke.

The researchers also looked at how much quality-of–life and medical expenses vary among people of similar ages.

“Overall, age is a very imprecise predictor of health status and health care costs,” writes David J. Lowsky, lead author of the study. “Instead, different people appear to be experiencing widely different health trajectories with widely different health outcomes at the same ages.”

In particular, the authors found that medical expenses for each of the age groups studied ranged from less than $800 to greater than $10,200 in any given age group from those 51-54 to those over 85 years old.

They also cite the importance of better understanding the drivers of these differences in long-term health outcomes, particularly those factors most strongly associated with positive long-term outcomes, as holding promise to guide more Americans to enter later ages on the positive side of the health spectrum and maintain their health for a longer period of time.

The authors emphasize the importance of healthy, older Americans for the country. Healthy, older Americans’ “social costs will be smaller and their social contributions larger, than those of their less able counterparts,” according to the article.

Although there may be a significant section of the older population that remains healthy, and willing and able to contribute to society, this goes against the notion that has been the basis of many age-based policies.

“Some employers force their employees to retire at a certain age and all Americans are eligible for Medicare at 65,” says Dana Goldman, Norman Topping Chair in Medicine and Public Policy at USC and director of the USC Schaeffer Center for Health Policy & Economics. “These findings tell us that we may need to take a closer look at these policies that presume that age, health decline, and dependency all go hand-in hand.”

This research was supported by the MacArthur Foundation Research Network on an Aging Society and the National Institute on Aging through the Roybal Center for Health Policy Simulation.