Introduction

Preventative health care once you've got a diagnosis of chronic disease? Why bother? After all, once you've got it, there's nothing to expect except disability and death. The truth is "It ain't necessarily so!"

Method

In a continuation of the Framingham Heart Study begun in the late 1940's, new data shows that older Americans continue to enjoy better health than previous generations.

Between 1948 and 1951, in a suburban community outside of Boston, Massachusetts, more than five thousand residents of Framingham were asked questions about their health, abilities to perform tasks of daily living, and health behaviors. Nearly thirty years later another five thousand residents of the same community were asked the same questions. Almost seventy percent of the second group were the adult children of the first study sample, and the remainder were the spouses of the children.

Data about those participants between the ages of 55 and 70 years was extracted from the total samples. A comparison between the incidence of selected chronic diseases within the two groups was made, including diabetes, hypertension, chronic obstructive pulmonary disease, arthritis, and cardiovascular disease. The cardiovascular diseases considered included history of myocardial infarctions (heart attacks), angina pectoris (heart pain), congestive heart failure, history of cerebral vascular accidents (strokes), and intermittent claudication (leg pain with exercise related to atherosclerosis or vascular disease).
One chronic disease was more prevalent in the second group - diabetes. This may be due at least in part to a change in the diagnostic criteria for the disease, more frequently performed screenings for the disease, and improved treatment and therefore increased longevity of diabetics.
Participants were asked about their abilities to perform physical activities including pushing and pulling large objects; stooping, kneeling, or squatting; reaching high and low; handling small objects; standing and sitting; and lifting less than or more than ten pounds. Gross motor functions were evaluated by three functions: the ability to walk a half mile; to climb up and down a flight of stairs; and to do heavy house work. Their ability to perform activities of daily living (ADLs) including bathing, dressing, eating, and transferring was also addressed.

Comment

When a comparison was made including only those people with a diagnosed chronic disease, there was another dramatic improvement in their functional abilities. In the earlier group, nearly two-thirds of people with a chronic disease had at least one functional limitation. Only half of the second group reported any limitation. For both groups, most of the reported disabilities were related to physical activities. Finally, it is important to note that among these two groups of people with diagnosed chronic diseases, there was a sixty percent decline in the frequency with which individuals described their health as only fair or poor.

One chronic disease was more prevalent in the second group - diabetes. Reasons for this were not discussed in this report. The increase may be due at least in part to a change in the diagnostic criteria for the disease, more frequently performed screenings for the disease, and improved treatment and therefore increased longevity of diabetics.

A lot has been said in the popular press and media about the increasing longevity of the American public. Often this aging of the Baby Boomers is mentioned in discussions about the anticipated burden these elders will impose on society and families. The truth is many of us will in fact have one or more chronic disease in our middle and later years. But with a healthy lifestyle and good preventative health care, we will enjoy more of those years in good health.