Diseases - Diseases Of An Aging Baby Boom?

Diseases are not all created equal — and they do not affect all age groups in the same way. With the exception of childhood diseases, sexually transmitted diseases (which affect, initially, the sexually active), and maternal mortality, most chronic ailments fall on the aging with special force. Some, like Alzheimer's disease, carry off the oldest age group by preference, those aged 85 and older.

We are entering a period when the post-war Baby Boom is approaching its seniority. In our times, the Baby Boom has been, directly or indirectly, the social indicator par excellance. Therefore we present trends in major disease groupings in this panel for those aged 65 and older. Data are for nearly two decades and show age-adjusted death rates (comparable one year to the next) per 100,000 population.

Two trends come to the fore immediately. The first is presented by the significant decline in the death rate for heart disease and for the closely related killer, stroke. Heart disease, the nation's foremost killer, in a sense paces the death rate. As heart disease and stroke decrease, so life expectancy goes up. Heart disease is under attack from all kinds of directions — medical interventions and techniques are preventing its onset and mitigating its consequences; we know more about the links between nutrition and heart disease/stroke; and we know that exercise is an important element in postponing heart conditions. This trend suggests that the Baby Boom will also affect the "senior scene" for a longer time and in a deeper way than other, earlier cohorts. Its members will live longer, will have the votes, and will almost certainly transform health care yet again.

The second important trend is that the death rate from cancer continues to grow — suggesting that more members of the Baby Boom will die from it than previous age cohorts. Cancer is a complex disease and is proving toughly resistant to the kinds of medical strategies that have brought infectious diseases to heel (at least until bacterial and viral strains develop resistance).

Chronic, obstructive pulmonary diseases are trending up. The term covers primarily emphysema and chronic bronchitis, both associated with smoking — also, to a lesser extent, with industrial pollution. The growth rate, however, is declining. In the 1980 to 1984 period, the death rate rose 17.9%, in the 1994 to 1998 period, it rose 5.5%. The effects of the programs against smoking are showing up in disease statistics.

Pneumonia and influenza also are growing, albeit at a slower pace. Pneumonia is an inflammation of the lungs caused by bacteria, viruses, or fungi. Influenza is a viral disease Both tend to be fatal in older people whose constitutions are weakened.

Although the main graphic does not show it, the death rate for diabetes, in this age group, has shown rather dramatic growth, as shown in the insert to the left. The rate remained roughly flat from 1980 to 1988. Then it shot up. So did our collective weight. Americans are more obese now than ever before in history — and there is a clear link between our weight, our lack of movement, and the onset of Type II (non-insulin-dependent) diabetes.

Obesity, at present, is getting close national scrutiny — as is the increase in the incidence of diabetes. The disease is much easier to bring under control using known techniques and pharmaceutical regimens than is cancer. No doubt, therefore, the focus of the next two decades will be on bringing cancer under control. The Baby Boom will see to it. We hope.

Source: National Institute on Aging, drawing data from the National Vital Statistics System. National Center for Health Statistics. U.S. Department of Health and Human Services. Online. Available://www.nia.nih.gov/.