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 Particularly in caring for older adults, doctors should consider
more than just physical health, the researchers say.
"We’re a mosaic of all of these traits," said lead author Martha
McClintock, of The University of Chicago. "In order to see the
picture of health, you need to look at them together."
Traditionally, health and well-being is measured with the so-called
medical model, which is based on physical health and the absence of
disease.
McClintock and her colleagues adapted the medical model to create
what they call the comprehensive model, which includes medical,
physical, psychological, functional and sensory factors.
To compare the two models, they used 2005-2006 data from the U.S.
National Social Life, Health and Aging Project on a nationally
representative sample of people ages 57 to 85.
According to the medical model, about two-thirds of the U.S.
population in that age group is generally healthy. But in the
comprehensive model, half of that population has health problems
that increases their risk of death or incapacitation over the next
five years.
The comprehensive model also identified two groups left out of the
medical model: people with poor mental health, and those with healed
bones that were broken after age 45. Between 14 and 19 percent of
people in those classes would likely be dead within five years,
compared to 6 to 16 percent of people in generally good health.
These two health classes "comprised a quarter of the U.S. population
of people this age that were not predicted by the medical model at
all," McClintock told Reuters Health.
The newer model also showed a complex relationship between obesity
and old age. For example, obesity in older people without other
health issues appears to confer little risk, but that's not true for
people with other conditions like diabetes and poor mental health.
The researchers also report in the Proceedings of the National
Academy of Science that diagnoses like cancer and high blood
pressure, and behaviors like smoking, might not always have as big
an impact as some mental health and sensory issues.
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This doesn't mean that cancer, high blood pressure and smoking
aren't important, said McClintock, but factors like loneliness and
poor hearing were better predictors of being dead or incapacitated
within five years.
She said the findings challenge the idea of chronological aging,
when people progress from stage 1 to stage 2 and so on. Instead, she
said, aging is more like a water system.
"I think of it as we’re going down a river as we age," said
McClintock. "When we’re young adults or middle aged, we’re pretty
much in the same boat, but then with aging the stream splits up
(and) we start zigging and zagging on different pathways."
Her team is working to confirm these findings among Baby Boomers,
who would have grown up in a different era than the people in this
study.
In the meantime, she said, older people can use this knowledge to
find a healthcare team trained to think of health as constellations
of conditions. They should tell their doctors about more than just
their physical health, she advises, and should visit an audiologist
and get a home safety study done. They can also become more socially
active by joining community groups.
SOURCE: http://bit.ly/1Ce9Qyo Proceedings of the National Academy of
Sciences, online May 16, 2016.
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