Special Article
Aging, Health Risks, and Cumulative Disability
N Engl J Med 1998; 338:1035-1041April 9, 1998
- Abstract
Background
Persons with lower health risks tend to live longer than those with higher health risks, but there has been concern that greater longevity may bring with it greater disability. We performed a longitudinal study to determine whether persons with lower potentially modifiable health risks have more or less cumulative disability.
Methods
We studied 1741 university alumni who were surveyed first in 1962 (average age, 43 years) and then annually starting in 1986. Strata of high, moderate, and low risk were defined on the basis of smoking, body-mass index, and exercise patterns. Cumulative disability was determined with a health-assessment questionnaire and scored on a scale of 0 to 3. Cumulative disability from 1986 to 1994 (average age in 1994, 75 years) or death was the measure of lifetime disability.
Results
Persons with high health risks in 1962 or 1986 had twice the cumulative disability of those with low health risks (disability index, 1.02 vs. 0.49; P<0.001). The results were consistent among survivors, subjects who died, men, and women and for both the last year and the last two years of observation. The onset of disability was postponed by more than five years in the low-risk group as compared with the high-risk group. The disability index for the low-risk subjects who died was half that for the high-risk subjects in the last one or two years of observation.
Conclusions
Smoking, body-mass index, and exercise patterns in midlife and late adulthood are predictors of subsequent disability. Not only do persons with better health habits survive longer, but in such persons, disability is postponed and compressed into fewer years at the end of life.
Media in This Article
Figure 3
Mean (±SE) Cumulative Disability According to Health Risk in 1986.Figure 1
Disability Index from 1986 to 1994 in 1741 Subjects, According to the Year and Level of Health Risk in 1986.Article Activity
- Article
The compression-of-morbidity hypothesis1-3 suggests that it may be possible to reduce cumulative lifetime morbidity. Since chronic illness and disability usually occur late in life, cumulative lifetime disability could be reduced if primary-prevention measures postponed the onset of chronic illness. However, decreases in health risks may also increase the average age at death.4-9 The compression-of-morbidity hypothesis predicts that the age at the time of initial disability will increase more than the gain in longevity, resulting in fewer years of disability and a lower level of cumulative lifetime disability.
Some contend that healthier lifestyles may actually increase morbidity (and health expenditures) late in life by increasing the number of years of chronic illness and disability.9-12 Thus, cumulative lifetime disability could actually be greater in persons with lower health risks than in those with higher health risks.4-9
The data on cumulative lifetime disability are limited, particularly data on cumulative disability in persons with different levels of health risk. National trends in health behavior have been inconsistent. In recent years, for example, the prevalence of smoking has decreased, but the prevalence of obesity has increased.13,14 Hence, it is difficult to evaluate the effect of changes in health behavior on the onset of disability, life expectancy, and cumulative disability. Recent studies suggest a decrease in cumulative disability over time.15-18 In addition, persons with higher socioeconomic status19 and higher educational levels20 and those who engage in regular aerobic activity21-24 have substantially better health,25 suggesting the possibility of a compression of morbidity in such persons.
We tested the compression-of-morbidity hypothesis by performing a longitudinal study of cumulative disability in relation to three levels of health risk. Our hypothesis was that persons with lower health risks will have disability later in life, will have less disability at any given age, and will have less cumulative disability than persons with greater health risks.
Methods
In 1986, investigators for the Arthritis, Rheumatism, and Aging Medical Information System acquired access to a unique set of data from persons attending the University of Pennsylvania in 1939 and 1940, who were studied at that time and were subsequently surveyed in 1962, 1976, and 1980.26-30 Since 1986, 2841 alumni have been studied. Mailed health-assessment questionnaires have been used to obtain information on disability, medical history, and health habits in this population on an approximately annual basis. Seven surveys were performed between November 1986 and March 1994.
The survey participants were included in this study if they met three criteria. First, they had to have completed at least two consecutive questionnaires, so that at least two consecutive years of disability data would be available preceding any deaths; 397 subjects were excluded because they did not meet this criterion. Second, the subjects had to have completed all survey questionnaires since 1986 or, in the case of those who died, all questionnaires preceding their deaths; 306 participants (11 percent) were lost to follow-up and it was not known whether they were dead or alive. Third, the participants had to be between 63 and 72 years old in 1986; an additional 397 subjects did not meet this criterion. The resulting study population consisted of 1741 subjects; 77 percent were men, and 99 percent were white. Complete data on disability were available for more than 97 percent of the subjects. The mean (±SD) age in 1986 was 67.0±2.8 years.
Variables of interest included age, sex, body-mass index (the weight in kilograms divided by the square of the height in meters), smoking habits, exercise, number of chronic conditions, use of medical services, and disability index. Exercise was defined as the number of minutes per week during which the subject engaged in physical activity and became short of breath or worked up a sweat. Body-mass index was calculated by dividing the weight in kilograms by the square of the height in meters. Chronic conditions included arthritis, back pain, osteoporosis, heart disease, high blood pressure, stroke, diabetes, cancer, and lung diseases.
The health-assessment questionnaire, used to measure the dependent variable, assesses activities of daily living. Each of eight activities (dressing, rising, eating, walking, grooming, reaching, gripping, and performing errands) is scored as 0 (no difficulty), 1 (some difficulty), 2 (much difficulty), or 3 (unable to do), and the scores are averaged across the eight activities. A cumulative-disability index of 3.0 could represent the inability to perform any one of the eight activities for one year, some difficulty performing all eight activities for three years, or the inability to perform two activities for four years. The average disability index is 1.2 per year for patients with rheumatoid arthritis and 0.8 per year for those with osteoarthritis. Minimal disability (an index of 0.1) represents some difficulty in performing one of the eight activities. This disability measure has been widely used, is sensitive to change, and has been extensively validated.31-35
The three end points of the study were disability in the last year of observation, disability in the last two years of observation, and cumulative disability, which was calculated as the sum of the disability indexes since 1986. Cumulative disability was used as a surrogate measure for total disability. For the deceased participants, cumulative disability was estimated as the sum of the disability values from 1986 until the last completed questionnaire. The last disability index was the index based on the last survey before death, for the subjects who died, and the index in 1994, for the survivors. Disability in the last two years was calculated as the sum of the last two indexes.
Body-mass index, smoking, and exercise were selected as stratification variables on the basis of the known associations between these variables and disability.21,23,24,36-38 Subjects were assigned scores of 0 to 3 for body-mass index (<22.5, 22.5 to <24.0, 24.0 to <26.0, or >26.0), number of cigarettes per day (0, 1 to 20, 21 to 30, or >30), and minutes of vigorous exercise per week (>240, 120 to 239, 1 to 119, or 0), as determined in 1986 and also in 1962. Body-mass index had a J-shaped relation to subsequent disability in this data set, and although the power of the study may have been decreased as a result, we selected cutoff points for stratification to be consistent with those in other studies.22-24,36-38 The scores for the three risk factors were totaled, and the subjects were assigned a level of risk according to the total score (low risk, 0 to 2; moderate risk, 3 or 4; high risk, 5 to 9).
To eliminate the effect of base-line disability, parallel analyses were performed with data from participants without initial disability. The postponement of disability was assessed by comparing the average age at the onset of minimal disability (score, 0.1) in the three strata. We repeated the main analyses with strata determined on the basis of the 1962 data, when the average age of the participants was 43 years, allowing an assessment of the association between disability and the health-risk score at midlife, 32 years before the last observation (i.e., at a time when minimal disability would be expected).
Analyses were performed with SAS software.39 Pearson's correlation coefficients were calculated with cumulative disability as the dependent variable. Two-tailed t-tests were performed for the three disability end points, with comparisons of the low- and moderate-risk groups and the low- and high-risk groups. Tests for trend were performed by fitting the dependent variables to the risk-factor strata, coded as 1, 2, and 3.
Results
The mean disability index in 1986 was low (0.06±0.16), and 74 percent of the subjects had no disability, suggesting that the disability index in 1962 (not available) would have been close to zero.37 Univariate correlations between cumulative disability and the independent variables, as determined in 1986, were analyzed; initial values for the disability index had the highest correlation (r = 0.64, P<0.001). Female sex and a greater number of chronic conditions were also correlated with cumulative disability (r = -0.16 and r = 0.20, respectively; P<0.001 for both comparisons). Age and educational level were not significantly associated with cumulative disability (r = 0.02 for both comparisons), probably because of the nearly uniform age and educational level in this population. Greater cumulative disability was associated with a larger number of cigarettes smoked per day (r = 0.09, P<0.001), less exercise per week (r = -0.11, P = 0.001), and a higher body-mass index (r = 0.11, P = 0.001), suggesting approximately equal contributions from each of the three risk factors.
The results were similar in the group of subjects who were excluded from our study, although they were slightly older (70.0 vs. 68.2 years) and had a higher initial disability index (0.10 vs. 0.08) and lower exercise levels (111 vs. 133 minutes). A significantly larger proportion of deceased subjects were men (84 percent, vs. 77 percent of survivors) with a higher initial disability index (0.15 vs. 0.06), a larger number of cigarettes smoked per day (3.3 vs. 1.6), and a larger number of chronic conditions (0.66 vs. 0.46).
The disability outcomes are shown in Table 1Table 1
Disability According to Health Risk in 1986. according to risk strata (based on body-mass index, exercise, and smoking). The initial age and the number of questionnaires completed were similar in the low-, moderate-, and high-risk groups, with an average of 6.94, 6.99, and 6.99 questionnaires completed by the surviving subjects, respectively, and 4.6, 4.5, and 4.2 completed by those who died, respectively. The subjects in the high-risk group had an average cumulative-disability index of 1.02, and the values for the subjects in the moderate- and low-risk groups were 0.71 and 0.49, respectively (P for trend, <0.001). There were similar differences among the three risk groups for disability in the last year and the last two years of observation. For subjects with no initial disability, the cumulative values showed a similar trend (P<0.01). For all comparisons, there was substantially more disability with higher risk than with lower risk. For the total study population, the disability indexes in the high- and low-risk groups differed by approximately a factor of two. Mortality rates also differed among the three groups, although the differences were smaller: 11.9 percent in the high-risk group, 9.9 percent in the moderate-risk group, and 7.9 percent in the low-risk group. Thus, the high-risk group had approximately a 50 percent higher mortality rate and approximately 100 percent greater disability than the low-risk group.Surviving subjects in the high-risk group had a cumulative-disability index of 0.91, whereas those in the moderate- and low-risk groups had values of 0.68 and 0.45, respectively (P for trend, <0.001). For the subjects without initial disability, the differences persisted but were somewhat less striking. Among deceased subjects, the high-risk group had a cumulative-disability index of 1.8, whereas the moderate- and low-risk groups had average values of 0.93 and 0.86, respectively (P for trend, <0.05). In the group of deceased subjects without initial disability, the most striking difference in cumulative disability was in the high-risk group as compared with the other two groups.
Since men were overrepresented in the high-risk group, sex-specific analyses were performed. Women had substantially more disability by all measures; however, the differences among the three health-risk groups were similar for men and women (Table 1).
Table 2Table 2
Disability According to Health Risk in 1962. shows the results of analyses of disability according to the health risk in 1962 (similarly determined according to body-mass index, exercise, and smoking in subjects for whom these data were available). These data, obtained when the average age of the subjects was 43 years, are assumed to represent minimal disability, given an average disability index of only 0.06 in 1986, and to reflect health risks at midlife. The results of these analyses are consistent with those shown in Table 1, with disability scores in the high-risk group that were approximately twice those in the low-risk group (P<0.001).Figure 1Figure 1
Disability Index from 1986 to 1994 in 1741 Subjects, According to the Year and Level of Health Risk in 1986. shows the disability index in the three risk groups according to the year. The rates of progression were similar in the three groups although slightly more rapid in the high-risk group than in the other two groups. The onset of minimal disability (an index of 0.1) was postponed by approximately five years in the low-risk group as compared with the high-risk group. An analysis of disability according to age (Figure 2Figure 2
Disability Index According to Age at the Time of the Last Survey and Health Risk in 1986.) showed that the onset of minimal disability was postponed by approximately seven years in the low-risk group as compared with the high-risk group.Figure 3Figure 3
Mean (±SE) Cumulative Disability According to Health Risk in 1986. shows the cumulative disability in all subjects, those without disability in 1986, those who survived, and those who died, according to the level of risk. The results are robust and consistent for the study end points and for the subgroups of subjects.Discussion
This study shows that persons with lower health risks (defined in terms of smoking, body-mass index, and exercise) have initial disability at an older age and have lower levels of cumulative disability and disability at any given age than do persons with higher health risks. These findings suggest that for the average person, efforts to reduce modifiable health risks may result in a postponement of initial disability and decreased lifetime disability.
The main results of the study were similar in men and women, in persons with no initial disability and those with initial disability, and in persons who survived and those who died during the study period. The marked differences in the degree of disability among the three risk groups persisted throughout nearly eight years of follow-up, to an average age of 75 years. The results were similar whether the risk strata were defined on the basis of midlife (1962) data or 1986 data. Disability indexes in the low- and high-risk groups differed by a factor of approximately two, and the differences were statistically significant. Disability was postponed by more than five years in the low-risk group as compared with the high-risk group. Among the subjects who died, both cumulative disability and disability in the one or two years before death were much lower in the low- and moderate-risk groups than in the high-risk group. Similarly, among the survivors, cumulative disability was much lower in the low-risk group than in the other two groups.
Caveats apply to the results. The study population had a high educational level, was relatively homogeneous in terms of age and socioeconomic status, and was almost entirely white. Over three fourths of the subjects were men, but separate analyses of men and women had similar results. In addition, since the study end points were determined on the basis of responses to a questionnaire, there is the possibility of bias. However, the health-assessment questionnaire used to determine disability has been repeatedly validated.31-35 In a study of runners and controls, for example, we found no differences between the two groups in reliability or in correlations with spousal estimates of disability.21 However, for the subjects in our study, the time of greatest disability (after the age of 85 years) is still in the future. As the study continues, it will be possible to assess the effects of changes in specific risk factors such as cessation of smoking.
Eleven percent of the subjects were lost to follow-up and their status (dead or alive) was not known, which is another potential source of bias. These subjects were slightly older and more disabled and had more hospitalizations in 1986 than the subjects who were followed, and it is possible that many of them died or were institutionalized. If more low-risk persons than moderate- or high-risk persons were lost to follow-up, the imbalance could produce a bias. However, the proportions of persons lost to follow-up were similar in the low-, moderate-, and high-risk groups and in the groups of patients with and without disability in 1986.
This study documents a strong association between the level of health risk and subsequent disability but does not prove causality. It is possible that other, unmeasured variables are correlated both with risk-factor scores and with cumulative disability. However, with age, education, and race essentially held constant in our study, and with prior studies indicating that smoking, obesity, and level of exercise are independently related to disability, it is difficult to think of additional causal variables.
Initial disability might have been a confounding variable, since it is strongly associated with cumulative disability and since health habits might have been modified in response to early disability. In the group of subjects without initial disability, the results were less robust. It is more likely, however, that the early disability was the result of a high health risk before the study began. We examined this issue both by performing a separate analysis of the subjects without initial disability and by assigning the subjects to risk groups at an average age of 43 years, when disability should have been minimal. In both instances, the results were consistent with those in the overall study population.
Our data base contains serial data on disability, which are available in few other data bases. Previous longitudinal studies have not examined the relation between cumulative disability or mortality and health risks, despite the relevance of such studies to health policy issues.23,40,41 None of these previous studies have reported on disability until the end of life, which permits a direct estimation of total lifetime disability.
Our study provides evidence that persons with lower health risks have less lifetime disability, as well as less disability at any given age. The results are consistent with the hope that future increases in the number of elderly persons will be offset in part by greater vitality on the part of the elderly, if there are improvements in modifiable health risks. Thus, the implications for public health are important. Primary prevention is a positive approach to reducing mortality and morbidity.42,43 Some have feared that preventive measures may lead to an expanding population of frail, disabled persons. This study suggests instead that lower health risks will result, on average, in less lifetime disability.
Supported by grants from the National Institute of Child Health and Human Development (R01 HD35641-01), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR43584), and the Donald and Delia Baxter Foundation.
We are indebted to Daniel A. Bloch, Ph.D., and Raymond Balise, Ph.D., for statistical assistance and to Dena Ramey for editorial assistance.
Source Information
From the Department of Medicine, Stanford University School of Medicine, Stanford, Calif.
Address reprint requests to Dr. Fries at 1000 Welch Rd., Suite 203, Palo Alto, CA 94304-1808.
- References
References
1
Fries JF . Aging, natural death, and the compression of morbidity. N Engl J Med 1980;303:130-135
Full Text | Web of Science | Medline2
Fries JF, Crapo LM. Vitality and aging. San Francisco: W.H. Freeman, 1981.
3
Fries JF . The compression of morbidity: near or far? Milbank Q 1989;67:208-232
CrossRef | Web of Science | Medline4
Myers GC ,Manton KG . Compression of mortality: myth or reality? Gerontologist 1984;24:346-353
CrossRef | Web of Science | Medline5
Manton KG . Changing concepts of morbidity and mortality in the elderly population. Milbank Q 1982;60:183-244
Web of Science6
Verbrugge LM . Longer life but worsening health? Trends in health and mortality of middle-aged and older persons. Milbank Q 1984;62:475-519
Web of Science7
Gruenberg EM . The failures of success. Milbank Q 1977;55:3-24
Web of Science8
Crimmins EM . Are Americans healthier as well as longer-lived? J Insur Med 1990;22:89-929
Olshansky SJ ,Ault AB . The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases. Milbank Q 1986;64:355-391
CrossRef | Web of Science | Medline10
Hjermann T ,Velve Byre K ,Holme I ,Leren P . Effect of diet and smoking intervention on the incidence of coronary heart disease: report from the Oslo Study Group of a randomized trial in healthy men. Lancet 1981;2:1303-1310
CrossRef | Web of Science | Medline11
Warner KE ,Wickizer TM ,Wolfe RA ,Schildroth JE ,Samuelson MH . Economic implications of workplace health promotion programs: review of the literature. J Occup Med 1988;30:106-112
Medline12
Warner KE . Effects of workplace health promotion not demonstrated. Am J Public Health 1992;82:126-127
CrossRef | Web of Science | Medline13
Lewis CE ,Smith DE ,Wallace DD ,Williams OD ,Bild DE ,Jacobs DR Jr . Seven-year trends in body weight and associations with lifestyle and behavioral characteristics in black and white young adults: the CARDIA study. Am J Public Health 1997;87:635-642
CrossRef | Web of Science | Medline14
Department of Health and Human Services. Health United States 1995. Washington, D.C.: Government Printing Office, 1996. (DHHS publication no. (PHS) 96-1232.)
15
Rogers A ,Rogers RG ,Belanger A . Longer life but worse health? Measurement and dynamics. Gerontologist 1990;30:640-649
CrossRef | Web of Science | Medline16
Manton KG ,Corder LS ,Stallard E . Estimates of change in chronic disability and institutional incidence and prevalence rates in the U.S. elderly population from 1982, 1984, and 1989 National Long Term Care Survey. J Gerontol B Psychol Sci Soc Sci 1993;48:S153-S166
Web of Science17
Waidmann T ,Bound J ,Schoenbaum M . The illusion of failure: trends in the self-reported health of the U.S. elderly. Milbank Q 1995;73:253-287
CrossRef | Web of Science | Medline18
Nusselder WJ ,Mackenbach JP . Rectangularization of the survival curve in the Netherlands, 1950-1992. Gerontologist 1996;36:773-782
CrossRef | Web of Science | Medline19
House JS ,Kessler RC ,Herzog AR ,Mero RP ,Kinney AM ,Breslow MJ . Age, socioeconomic status, and health. Milbank Q 1990;68:383-411
CrossRef | Web of Science | Medline20
Leigh JP ,Fries JF . Education, gender, and the compression of morbidity. Int J Aging Hum Dev 1994;39:233-246
CrossRef | Web of Science | Medline21
Fries JF ,Singh G ,Morfeld D ,Hubert HB ,Lane NE ,Brown BW Jr . Running and the development of disability with age. Ann Intern Med 1994;121:502-509
Web of Science | Medline22
Stewart AL ,King AC ,Haskell WL . Endurance exercise and health-related quality of life in 50-65 year-old adults. Gerontologist 1993;33:782-789
CrossRef | Web of Science | Medline23
Simonsick EM ,Lafferty ME ,Phillips CL , et al. Risk due to inactivity in physically capable older adults. Am J Public Health 1993;83:1443-1450
CrossRef | Web of Science | Medline24
Lee IM ,Hsieh CC ,Paffenbarger RS Jr . Exercise intensity and longevity in men: the Harvard Alumni Health Study. JAMA 1995;273:1179-1184
CrossRef | Web of Science | Medline25
Duffy ME ,MacDonald E . Determinants of functional health of older persons. Gerontologist 1990;30:503-509
CrossRef | Web of Science | Medline26
Blair SN ,Kohl HW III ,Barlow CE ,Paffenbarger RS Jr ,Gibbons LW ,Macera CA . Changes in physical fitness and all-cause mortality: a prospective study of healthy and unhealthy men. JAMA 1995;273:1093-1098
CrossRef | Web of Science | Medline27
Paffenbarger RS Jr ,Hyde RT ,Wing AL ,Lee I-M ,Jung DL ,Kampert JB . The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993;328:538-545
Full Text | Web of Science | Medline28
Paffenbarger RS Jr ,Kampert JB ,Lee IM ,Hyde RT ,Leung RW ,Wing AL . Changes in physical activity and other lifeway patterns influencing longevity. Med Sci Sports Exerc 1994;26:857-865
Web of Science | Medline29
Paffenbarger RS Jr ,Wing AL ,Hyde RT . Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol 1978;108:161-175
Web of Science | Medline30
Lee IM ,Manson JE ,Hennekens CH ,Paffenbarger RS Jr . Body weight and mortality: a 27-year follow-up of middle-aged men. JAMA 1993;270:2823-2828
CrossRef | Web of Science | Medline31
Fries JF ,Spitz P ,Kraines RG ,Holman HR . Measurement of patient outcome in arthritis. Arthritis Rheum 1980;23:137-145
CrossRef | Web of Science | Medline32
Fries JF ,Spitz PW ,Young DY . The dimensions of health outcomes: the health assessment questionnaire, disability and pain scales. J Rheumatol 1982;9:789-793
Web of Science | Medline33
Brown JH ,Kazis LE ,Spitz PW ,Gertman P ,Fries JF ,Meenan RF . The dimensions of health outcomes: a cross-validated examination of health status measurement. Am J Public Health 1984;74:159-161
CrossRef | Web of Science | Medline34
Ramey DR ,Raynauld JP ,Fries JF . The health assessment questionnaire 1992: status and review. Arthritis Care Res 1992;5:119-129
CrossRef | Medline35
Ramey DR, Fries JF, Singh G. The health assessment questionnaire 1995 — status and review. In: Spilker B, ed. Quality of life and pharmacoeconomics in clinical trials. 2nd ed. Philadelphia: Lippincott-Raven, 1996:227-37.
36
Hubert HB ,Bloch DA ,Fries JF . Risk factors for physical disability in an aging cohort: the NHANES I Epidemiologic Followup Study. J Rheumatol 1993;20:480-488
Web of Science | Medline37
Hubert HB ,Fries JF . Predictors of physical disability after age 50: six-year longitudinal study in a runners club and a university population. Ann Epidemiol 1994;4:285-294
CrossRef | Medline38
O'Connor GT ,Hennekens CH ,Willett WC , et al. Physical exercise and reduced risk of nonfatal myocardial infarction. Am J Epidemiol 1995;142:1147-1156
Web of Science | Medline39
SAS/STAT user's guide, version 6. 4th ed. Cary, N.C.: SAS Institute, 1989.
40
Paffenbarger RS Jr ,Hyde RT ,Wing AL ,Hsieh C-C . Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med 1986;314:605-613
Full Text | Web of Science | Medline41
Sandvik L ,Erikssen J ,Thaulow E ,Erikssen G ,Mundal R ,Rodahl K . Physical fitness as a predictor of mortality among healthy, middle-aged Norwegian men. N Engl J Med 1993;328:533-537
Full Text | Web of Science | Medline42
Department of Health and Human Services. Healthy People 2000: national health promotion and disease prevention objectives. Washington, D.C.: Government Printing Office, 1990. (DHHS publication no. (PHS) 91-50213.)
43
Fries JF ,Koop CE ,Beadle CE , et al. Reducing health care costs by reducing the need and demand for medical services. N Engl J Med 1993;329:321-325
Full Text | Web of Science | Medline
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Michael P O'Donnell. (2011) Reflections on the 25th Anniversary of Publishing the American Journal of Health Promotion : People, Scientific Progress, and Missteps. American Journal of Health Promotion 25:4, iv-xi
CrossRef17
Laura Romeu Gordo. (2011) Compression of morbidity and the labour supply of older people. Applied Economics 43:4, 503-513
CrossRef18
Pedro Olivares-Tirado, Nanako Tamiya, Masayo Kashiwagi, Kimikazu Kashiwagi. (2011) Predictors of the highest long-term care expenditures in Japan. BMC Health Services Research 11:1, 103
CrossRef19
James F. Fries, Bonnie Bruce, Eliza Chakravarty. (2011) Compression of Morbidity 1980–2011: A Focused Review of Paradigms and Progress. Journal of Aging Research 2011, 1-10
CrossRef20
B. H. Strand, G. Mishra, D. Kuh, J. M. Guralnik, K. V. Patel. (2011) Smoking History and Physical Performance in Midlife: Results From the British 1946 Birth Cohort. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 66A:1, 142-149
CrossRef21
Lodewijk de Groot, Helmy Hinkema, Johanna Westra, Andries J. Smit, Cees G.M. Kallenberg, Marc Bijl, Marcel D. Posthumus. (2011) Advanced Glycation Endproducts are increased in RA patients with controlled disease.. Arthritis Research & Therapy 13:6, R205
CrossRef22
David Melzer, Iain Lang. 2010. Chronological and Functional Ageing. , 65-69.
CrossRef23
F. Breyer, J. Costa-Font, S. Felder. (2010) Ageing, health, and health care. Oxford Review of Economic Policy 26:4, 674-690
CrossRef24
Marco Inzitari. (2010) Estudios longitudinales sobre envejecimiento: pasado, presente y futuro. Revista Española de Geriatría y Gerontología 45:2, 103-105
CrossRef25
Shannon Freeman, Hajime Kurosawa, Satoru Ebihara, Masahiro Kohzuki. (2010) Understanding the oldest old in northern Japan: An overview of the functional ability and characteristics of centenarians. Geriatrics & Gerontology International 10:1, 78-84
CrossRef26
M. D. Koller, D. Aletaha, J. Funovits, A. Pangan, D. Baker, J. S. Smolen. (2009) Response of elderly patients with rheumatoid arthritis to methotrexate or TNF inhibitors compared with younger patients. Rheumatology 48:12, 1575-1580
CrossRef27
Emaad Abdel-Rahman, Jean L. Holley. (2009) A Review of the Effects of Growth Hormone Changes on Symptoms of Frailty in the Elderly with Chronic Kidney Disease. Seminars in Dialysis 22:5, 532-538
CrossRef28
Amanda K. Buttery, Finbarr C. Martin. (2009) Knowledge, attitudes and intentions about participation in physical activity of older post-acute hospital inpatients. Physiotherapy 95:3, 192-198
CrossRef29
Emilio Mordini, David Wright, Kush Wadhwa, Paul Hert, Eugenio Mantovani, Jesper Thestrup, Guido Steendam, Antonio D’Amico, Ira Vater. (2009) Senior citizens and the ethics of e-inclusion. Ethics and Information Technology 11:3, 203-220
CrossRef30
R. J. Colman, R. M. Anderson, S. C. Johnson, E. K. Kastman, K. J. Kosmatka, T. M. Beasley, D. B. Allison, C. Cruzen, H. A. Simmons, J. W. Kemnitz, R. Weindruch. (2009) Caloric Restriction Delays Disease Onset and Mortality in Rhesus Monkeys. Science 325:5937, 201-204
CrossRef31
M. B. von Bonsdorff, T. Rantanen, R. Leinonen, U. M. Kujala, T. Tormakangas, M. Manty, E. Heikkinen. (2009) Physical Activity History and End-of-Life Hospital and Long-Term Care. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 64A:7, 778-784
CrossRef32
Lorraine M Reiser, Elizabeth A Schlenk. (2009) Clinical use of physical activity measures. Journal of the American Academy of Nurse Practitioners 21:2, 87-94
CrossRef33
(2009) The Art of Health Promotion. American Journal of Health Promotion 23:3, TAHP-1-TAHP-12
CrossRef34
Sheena E. Ramsay, Peter H. Whincup, Richard W. Morris, Lucy T. Lennon, S.G. Wannamethee. (2008) Extent of Social Inequalities in Disability in the Elderly: Results From a Population-based Study of British Men. Annals of Epidemiology 18:12, 896-903
CrossRef35
Erik J. Giltay, Frans G. Zitman, Daan Kromhout. (2008) Cardiovascular Risk Profile and Subsequent Disability and Mental Well-being: The Zutphen Elderly Study. American Journal of Geriatric Psychiatry 16:11, 874-882
CrossRef36
Claudiu Iordache, Trudy Woudstra, Alan Thomson, Laurie Drozdowski. 2008. Lipid Absorption in Aging. , 113-147.
CrossRef37
Hussein Naji Yassine, Craig Stump. 2008. Cardiometabolic Syndrome, Diabetes and Oxidative Stress. , 91-102.
CrossRef38
F. Cecchi, A. Mannoni, R. Molino-Lova, S. Ceppatelli, E. Benvenuti, S. Bandinelli, F. Lauretani, C. Macchi, L. Ferrucci. (2008) Epidemiology of hip and knee pain in a community based sample of Italian persons aged 65 and older. Osteoarthritis and Cartilage 16:9, 1039-1046
CrossRef39
Albert I. Wertheimer, Joaquima Serradell. (2008) A discussion paper on self-care and its implications for pharmacists. Pharmacy World & Science 30:4, 309-315
CrossRef40
Anat A. Shemesh, Iris Rasooly, Pamela Horowitz, John Lemberger, Yosefa Ben-Moshe, Josefa Kachal, Josepha Danziger, A. Mark Clarfield, Elliot Rosenberg. (2008) Health behaviors and their determinants in multiethnic, active Israeli seniors. Archives of Gerontology and Geriatrics 47:1, 63-77
CrossRef41
T. M. Gill, E. A. Gahbauer. (2008) Evaluating Disability Over Discrete Periods of Time. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 63:6, 588-594
CrossRef42
A. Swartz. (2008) James Fries: Healthy Aging Pioneer. American Journal of Public Health 98:7, 1163-1166
CrossRef43
Thomas M. Gill, Zhenchao Guo, Heather G. Allore. (2008) Subtypes of Disability in Older Persons over the Course of Nearly 8 Years. Journal of the American Geriatrics Society 56:3, 436-443
CrossRef44
C Flexner. (2008) Pharmacoecology: A New Name for an Old Science. Clinical Pharmacology & Therapeutics 83:3, 375-379
CrossRef45
Tariqah A. Nuriddin, Carolyn C. Perrucci. 2008. Surviving widowhood: Gender and race effects on health-related coping strategies. , 197-215.
CrossRef46
C. M. Novak, J. A. Levine. (2007) Central Neural and Endocrine Mechanisms of Non-Exercise Activity Thermogenesis and Their Potential Impact on Obesity. Journal of Neuroendocrinology 19:12, 923-940
CrossRef47
Ron Z Goetzel, David Shechter, Ronald J Ozminkowski, David C Stapleton, Pauline J Lapin, J Michael McGinnis, Catherine R Gordon, Lester Breslow. (2007) Can health promotion programs save Medicare money?. Clinical Interventions in Aging 2:1, 117-122
CrossRef48
James N. Laditka, Sarah B. Laditka, Bankole Olatosi, Keith T. Elder. (2007) The Health Trade-off of Rural Residence for Impaired Older Adults: Longer Life, More Impairment. The Journal of Rural Health 23:2, 124-132
CrossRef49
Martin Weigl, Alarcos Cieza, Pedro Cantista, Gerold Stucki. (2007) Physical disability due to musculoskeletal conditions. Best Practice & Research Clinical Rheumatology 21:1, 167-190
CrossRef50
Elżbieta Biernat, Grzegorz Zalewski, Romuald Stupnicki. (2007) Leisure physical activity of male youths training football. Physical Education and Sport 51:-1, 36-39
CrossRef51
Tadashi Nagao, Taishiro Chikamori, Satoshi Hida, Yuko Igarashi, Yoichi Kuwabara, Shigeyuki Nishimura, Junichi Yamazaki, Akira Yamashina, The Q-PROVE Study Group. (2007) Quantitative Gated Single-Photon Emission Computed Tomography With 99mTc Sestamibi Predicts Major Cardiac Events in Elderly Patients With Known or Suspected Coronary Artery Disease. Circulation Journal 71:7, 1029-1034
CrossRef52
Renato Maia Guimarães. (2007) Health Capital, Life Course and Ageing. Gerontology 53:2, 96-101
CrossRef53
Vesna Turkulov, Nadezda Madle-Samardzija, Olja Niciforovic-Surkovic, Cedomir Gavrancic. (2007) Demographic aspects of aging. Medicinski pregled 60:5-6, 247-250
CrossRef54
Jeffrey H. Boyd. (2006) Are Americans Getting Sicker or Healthier?. Journal of Religion and Health 45:4, 559-585
CrossRef55
Ronald J. Ozminkowski, Ron Z. Goetzel, Feifei Wang, Teresa B. Gibson, David Shechter, Shirley Musich, Joel Bender, Dee W. Edington. (2006) The Savings Gained From Participation in Health Promotion Programs for Medicare Beneficiaries. Journal of Occupational and Environmental Medicine 48:11, 1125-1132
CrossRef56
Monica Ortendahl, James F. Fries. (2006) A low tension between individual and societal time aspects in health improved outcomes. Journal of Clinical Epidemiology 59:11, 1222-1227
CrossRef57
Tuulikki Sokka, Hannu Kautiainen, Pekka Hannonen, Theodore Pincus. (2006) Changes in Health Assessment Questionnaire disability scores over five years in patients with rheumatoid arthritis compared with the general population. Arthritis & Rheumatism 54:10, 3113-3118
CrossRef58
. (2006) Looking forward to a general theory on population aging. Tijdschrift voor Gerontologie en Geriatrie 37:4, 209-217
CrossRef59
U. Christensen, N. Stovring, K. Schultz-Larsen, M. Schroll, K. Avlund. (2006) Functional ability at age 75: is there an impact of physical inactivity from middle age to early old age?. Scandinavian Journal of Medicine and Science in Sports 16:4, 245-251
CrossRef60
A. Kruse. (2006) Alterspolitik und Gesundheit. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 49:6, 513-522
CrossRef61
Jane D. Saxton. (2006) Food Is Information. Journal of Hospital Librarianship 6:1, 57-63
CrossRef62
Andrew Steptoe, Caroline Wright, Sabine R. Kunz-Ebrecht, Steve Iliffe. (2006) Dispositional optimism and health behaviour in community-dwelling older people: Associations with healthy ageing. British Journal of Health Psychology 11:1, 71-84
CrossRef63
Jeffrey Bland. 2006. Nutrigenomics. , 27-41.
CrossRef64
Marita Kloseck, Richard G. Crilly, Roger C. Mannell. (2006) Involving the Community Elderly in the Planning and Provision of Health Services: Predictors of Volunteerism and Leadership. Canadian Journal on Aging / La Revue canadienne du vieillissement 25:01, 77
CrossRef65
D. R. Berk, H. B. Hubert, J. F. Fries. (2006) Associations of Changes in Exercise Level With Subsequent Disability Among Seniors: A 16-Year Longitudinal Study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 61:1, 97-102
CrossRef66
Joe Feinglass, Jason A. Thompson, Xiaoxing Z. He, Whitney Witt, Rowland W. Chang, David W. Baker. (2005) Effect of physical activity on functional status among older middle-age adults with arthritis. Arthritis & Rheumatism 53:6, 879-885
CrossRef67
Dellara F. Terry, Michael J. Pencina, Ramachandran S. Vasan, Joanne M. Murabito, Philip A. Wolf, Margaret Kelly Hayes, Daniel Levy, Ralph B. D'Agostino, Emelia J. Benjamin. (2005) Cardiovascular Risk Factors Predictive for Survival and Morbidity-Free Survival in the Oldest-Old Framingham Heart Study Participants. Journal of the American Geriatrics Society 53:11, 1944-1950
CrossRef68
M Zamboni, G Mazzali, E Zoico, T B Harris, J B Meigs, V Di Francesco, F Fantin, L Bissoli, O Bosello. (2005) Health consequences of obesity in the elderly: a review of four unresolved questions. International Journal of Obesity 29:9, 1011-1029
CrossRef69
Vincent Mor. (2005) The Compression of Morbidity Hypothesis: A Review of Research and Prospects for the Future. Journal of the American Geriatrics Society 53:9s, S308-S309
CrossRef70
Ilija Batljan, Mårten Lagergren. (2005) Future demand for formal long-term care in Sweden. European Journal of Ageing 2:3, 216-224
CrossRef71
Piercarlo Sarzi-Puttini, Marco A. Cimmino, Raffaele Scarpa, Roberto Caporali, Fabio Parazzini, Augusto Zaninelli, Fabiola Atzeni, Bianca Canesi. (2005) Osteoarthritis: An Overview of the Disease and Its Treatment Strategies. Seminars in Arthritis and Rheumatism 35:1, 1-10
CrossRef72
Katharina Meyer, Linda Rezny, Andreas E. Stuck. (2005) Physical activity in the second half of life—current situation in Switzerland. Journal of Public Health 13:4, 179-184
CrossRef73
S. Goya Wannamethee, Shah Ebrahim, Olia Papacosta, A. Gerald Shaper. (2005) From a postal questionnaire of older men, healthy lifestyle factors reduced the onset of and may have increased recovery from mobility limitation. Journal of Clinical Epidemiology 58:8, 831-840
CrossRef74
Gail S. Kerr, J. Steuart Richards, E. Nigel Harris. (2005) Rheumatic Diseases in Minority Populations. Medical Clinics of North America 89:4, 829-868
CrossRef75
Jarmo Malmberg, Seppo Miilunpalo, Matti Pasanen, Ilkka Vuori, Pekka Oja. (2005) Characteristics of leisure time physical activity associated with risk of decline in perceived health—a 10-year follow-up of middle-aged and elderly men and women. Preventive Medicine 41:1, 141-150
CrossRef76
Ulrike Dapp, Jennifer Anders, Wolfgang Renteln-Kruse, Hans Peter Meier-Baumgartner. (2005) Active health promotion in old age: methodology of a preventive intervention programme provided by an interdisciplinary health advisory team for independent older people. Journal of Public Health 13:3, 122-127
CrossRef77
Kaori Ohmori, Shinichi Kuriyama, Atsushi Hozawa, Takayoshi Ohkubo, Yoshitaka Tsubono, Ichiro Tsuji. (2005) Modifiable Factors for the Length of Life with Disability before Death: Mortality Retrospective Study in Japan. Gerontology 51:3, 186-191
CrossRef78
Sarah J Goodlin. (2005) Heart failure in the elderly. Expert Review of Cardiovascular Therapy 3:1, 99-106
CrossRef79
Adam deJong, Barry A. Franklin. (2004) Prescribing exercise for the elderly: Current research and recommendations. Current Sports Medicine Reports 3:6, 337-343
CrossRef80
Ramesh Nair, Jane M. Bell, Patrick D. Walker. (2004) Renal biopsy in patients aged 80 years and older. American Journal of Kidney Diseases 44:4, 618-626
CrossRef81
Thomas Perls. (2004) Centenarians who avoid dementia. Trends in Neurosciences 27:10, 633-636
CrossRef82
Michael O'Donnell. (2004) Health-Promotion Behaviors That Promote Self-Healing. The Journal of Alternative and Complementary Medicine 10:supplement 1, S-49-S-60
CrossRef83
X. Z. He, D. W. Baker. (2004) Body Mass Index, Physical Activity, and the Risk of Decline in Overall Health and Physical Functioning in Late Middle Age. American Journal of Public Health 94:9, 1567-1573
CrossRef84
K. N. Murtagh, H. B. Hubert. (2004) Gender Differences in Physical Disability Among an Elderly Cohort. American Journal of Public Health 94:8, 1406-1411
CrossRef85
Ira B. Tager, Thaddeus Haight, Barbara Sternfeld, Zhuo Yu, Mark van Der Laan. (2004) Effects of Physical Activity and Body Composition on Functional Limitation in the Elderly. Epidemiology 15:4, 479-493
CrossRef86
J.-M. Robine, J.-P. Michel. (2004) Looking Forward to a General Theory on Population Aging. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59:6, M590-M597
CrossRef87
J. F. Fries. (2004) : Commentary. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59:6, M603-M605
CrossRef88
J. M. Guralnik. (2004) : Population Aging Across Time and Cultures: Can We Move From Theory to Evidence?. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59:6, M606-M608
CrossRef89
Arto Strandberg, Timo E Strandberg, Veikko V Salomaa, Kaisu Pitkälä, Olli Häppölä, Tatu A Miettinen. (2004) A follow-up study found that cardiovascular risk in middle age predicted mortality and quality of life in old age. Journal of Clinical Epidemiology 57:4, 415-421
CrossRef90
D. F. Terry, M. A. Wilcox, M. A. McCormick, T. T. Perls. (2004) Cardiovascular Disease Delay in Centenarian Offspring. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59:4, M385-M389
CrossRef91
Eswar Krishnan, Tuulikki Sokka, Arja H
kkinen, Helen Hubert, Pekka Hannonen. (2004) Normative values for the Health Assessment Questionnaire Disability Index: Benchmarking disability in the general population. Arthritis & Rheumatism 50:3, 953-960
CrossRef92
Robert E. Aronson, Roy F. Oman. (2004) Views on Exercise and Physical Activity Among Rural-Dwelling Senior Citizens. The Journal of Rural Health 20:1, 76-79
CrossRef93
Stefania Fulle, Feliciano Protasi, Guglielmo Di Tano, Tiziana Pietrangelo, Andrea Beltramin, Simona Boncompagni, Leonardo Vecchiet, Giorgio Fanò. (2004) The contribution of reactive oxygen species to sarcopenia and muscle ageing. Experimental Gerontology 39:1, 17-24
CrossRef94
José A. Luchsinger, Wei-nch Lee, Olveen Carrasquillo, Daniel Rabinowitz, Steven Shea. (2003) Body Mass Index and Hospitalization in the Elderly. Journal of the American Geriatrics Society 51:11, 1615-1620
CrossRef95
Paul Dieppe, Kenneth D Brandt. (2003) What is important in treating osteoarthritis? Whom should we treat and how should we treat them?. Rheumatic Disease Clinics of North America 29:4, 687-716
CrossRef96
Klaus Hauer, Mathias Pfisterer, Mattias Schuler, Peter Bärtsch, Peter Oster. (2003) Two years later: a prospective long-term follow-up of a training intervention in geriatric patients with a history of severe falls. Archives of Physical Medicine and Rehabilitation 84:10, 1426-1432
CrossRef97
Lubitz, James, Cai, Liming, Kramarow, Ellen, Lentzner, Harold, . (2003) Health, Life Expectancy, and Health Care Spending among the Elderly. New England Journal of Medicine 349:11, 1048-1055
Full Text98
David B. Reuben, Leslie Judd-Hamilton, Tamara B. Harris, Teresa E. Seeman. (2003) The Associations Between Physical Activity and Inflammatory Markers in High-Functioning Older Persons: MacArthur Studies of Successful Aging. Journal of the American Geriatrics Society 51:8, 1125-1130
CrossRef99
Eva von Strauss, Hedda Agüero-Torres, Ingemar Kåreholt, Bengt Winblad, Laura Fratiglioni. (2003) Women are more disabled in basic activities of daily living than men only in very advanced ages: A study on disability, morbidity, and mortality from the Kungsholmen Project. Journal of Clinical Epidemiology 56:7, 669-677
CrossRef100
Thomas Perls, Dellara Terry. (2003) Genetics of exceptional longevity. Experimental Gerontology 38:7, 725-730
CrossRef101
B. R. Levy. (2003) Mind Matters: Cognitive and Physical Effects of Aging Self-Stereotypes. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 58:4, P203-P211
CrossRef102
M. D. Zaretsky. (2003) Communication Between Identical Twins: Health Behavior and Social Factors Are Associated With Longevity That Is Greater Among Identical Than Fraternal U.S. World War II Veteran Twins. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:6, M566-M572
CrossRef103
Ilene C. Siegler, Hayden B. Bosworth, Merrill F. Elias. 2003. Adult Development and Aging. .
CrossRef104
A. Mark Clarfield. (2003) Commentary on Special Article, The Aging Syndrome. Journal of the American Geriatrics Society 51:4, 562-563
CrossRef105
J. Evert, E. Lawler, H. Bogan, T. Perls. (2003) Morbidity Profiles of Centenarians: Survivors, Delayers, and Escapers. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:3, M232-M237
CrossRef106
Louis Kuritzky, Arthur Weaver. (2003) Advances in Rheumatology. Journal of Pain and Symptom Management 25:2, 6-20
CrossRef107
Toshiki Ota. (2003) Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 40:5, 466-469
CrossRef108
Sandra K. Pope, Valorie M. Shue, Cornelia Beck. (2003) W
ILL A HEALTHY LIFESTYLE HELP PREVENT ALZHEIMER'S DISEASE ?. Annual Review of Public Health 24:1, 111-132
CrossRef109
Timo E Strandberg, Kaisu H Pitkala, Reijo S Tilvis. (2003) Benefits of Optimising Drug Treatment in Home-Dwelling Elderly Patients with Coronary Artery Disease. Drugs & Aging 20:8, 585-595
CrossRef110
T. M. Gill, B. Kurland. (2003) The Burden and Patterns of Disability in Activities of Daily Living Among Community-living Older Persons. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:1, M70-M75
CrossRef111
Catherine A. Sarkisian, Ron D. Hays, Carol M. Mangione. (2002) Do Older Adults Expect to Age Successfully? The Association Between Expectations Regarding Aging and Beliefs Regarding Healthcare Seeking Among Older Adults. Journal of the American Geriatrics Society 50:11, 1837-1843
CrossRef112
Judith A Long, Jeannette R Ickovics, Thomas M Gill, Ralph I Horwitz. (2002) Social class and mortality in older women. Journal of Clinical Epidemiology 55:10, 952-958
CrossRef113
Thomas M. Gill, Susan E. Hardy, Christianna S. Williams. (2002) Underestimation of Disability in Community-Living Older Persons. Journal of the American Geriatrics Society 50:9, 1492-1497
CrossRef114
James R. Knickman, Emily K. Snell. (2002) The 2030 Problem: Caring for Aging Baby Boomers. Health Services Research 37:4, 849-884
CrossRef115
Thomas Perls, Louis M. Kunkel, Annibale A. Puca. (2002) The genetics of exceptional human longevity. Journal of Molecular Neuroscience 19:1-2, 233-238
CrossRef116
S. J. Olshansky, L. Hayflick, B. A. Carnes. (2002) Position Statement on Human Aging. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:8, B292-B297
CrossRef117
Thomas Perls, Annibale Puca. (2002) The genetics of aging – implications for pharmacogenomics. Pharmacogenomics 3:4, 469-484
CrossRef118
H. B. Hubert, D. A. Bloch, J. W. Oehlert, J. F. Fries. (2002) Lifestyle Habits and Compression of Morbidity. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:6, M347-M351
CrossRef119
David Hamerman. (2002) Geriatric Practice Revisited: Toward Collaboration with Primary Care Medicine. Journal of the American Geriatrics Society 50:5, 971-972
CrossRef120
Truls ÃStbye, Donald Hugh Taylor, Katrina M. Krause, Lynn Van Scoyoc. (2002) The Role of Smoking and Other Modifiable Lifestyle Risk Factors in Maintaining and Restoring Lower Body Mobility in Middle-Aged and Older Americans: Results from the HRS and AHEAD. Journal of the American Geriatrics Society 50:4, 691-699
CrossRef121
David B. Reuben, Anna I. Cheh, Tamara B. Harris, Luigi Ferrucci, John W. Rowe, Russell P. Tracy, Teresa E. Seeman. (2002) Peripheral Blood Markers of Inflammation Predict Mortality and Functional Decline in High-Functioning Community-Dwelling Older Persons. Journal of the American Geriatrics Society 50:4, 638-644
CrossRef122
THOMAS PERLS. (2002) Genetic and Environmental Influences on Exceptional Longevity and the AGE Nomogram. Annals of the New York Academy of Sciences 959:1, 1-13
CrossRef123
Truls Østbye, Donald Hugh Taylor, Sang-Hyuk Jung. (2002) A Longitudinal Study of the Effects of Tobacco Smoking and Other Modifiable Risk Factors on Ill Health in Middle-Aged and Old Americans. Preventive Medicine 34:3, 334-345
CrossRef124
Thomas Perls, Louis M. Kunkel, Annibale A. Puca. (2002) The Genetics of Exceptional Human Longevity. Journal of the American Geriatrics Society 50:2, 359-368
CrossRef125
Sarah B. Laditka. (2002) Introduction: Health Expectations for Older Women: International Perspectives. Journal of Women & Aging 14:1-2, 1-7
CrossRef126
Ilene C. Siegler, Lori A. Bastian, David C. Steffens, Hayden B. Bosworth, Paul T. Costa. (2002) Behavioral medicine and aging.. Journal of Consulting and Clinical Psychology 70:3, 843-851
CrossRef127
Sarah B. Laditka, James N. Laditka. (2002) Recent Perspectives on Active Life Expectancy for Older Women. Journal of Women & Aging 14:1-2, 163-184
CrossRef128
James F. Fries. (2001) Aging, cumulative disability, and the compression of morbidity. Comprehensive Therapy 27:4, 322-329
CrossRef129
Kate R. Lorig, Philip Ritter, Anita L. Stewart, David S. Sobel, Byron William Brown, Albert Bandura, Virginia M. Gonzalez, Diana D. Laurent, Halsted R. Holman. (2001) Chronic Disease Self-Management Program. Medical Care 39:11, 1217-1223
CrossRef130
Ilkka Winblad, Minna Jääskeläinen, Sirkka-Liisa Kivelä, Pirkko Hiltunen, Pekka Laippala. (2001) Prevalence of disability in three birth cohorts at old age over time spans of 10 and 20 years. Journal of Clinical Epidemiology 54:10, 1019-1024
CrossRef131
Catherine A. Sarkisian, Ron D. Hays, Sandra H. Berry, Carol M. Mangione. (2001) Expectations Regarding Aging Among Older Adults and Physicians Who Care for Older Adults. Medical Care 39:9, 1025-1036
CrossRef132
Roy J. Shephard, Barry Franklin. (2001) Changes in the Quality of Life: A Major Goal of Cardiac Rehabilitation. Journal of Cardiopulmonary Rehabilitation 21:4, 189-200
CrossRef133
Paula M Lantz, John W Lynch, James S House, James M Lepkowski, Richard P Mero, Marc A Musick, David R Williams. (2001) Socioeconomic disparities in health change in a longitudinal study of US adults: the role of health-risk behaviors. Social Science & Medicine 53:1, 29-40
CrossRef134
WANEEN W. SPIRDUSO, D. LEILANI CRONIN. (2001) Exercise dose-response effects on quality of life and independent living in older adults. Medicine and Science in Sports and Exercise 33:Supplement, S598-S608
CrossRef135
K. H. Pitkala, J. Valvanne, S. Kulp, T. E. Strandberg, R. S. Tilvis. (2001) Secular Trends in Self-Reported Functioning, Need for Assistance and Attitudes Towards Life: 10-Year Differences of Three Older Cohorts. Journal of the American Geriatrics Society 49:5, 596-600
CrossRef136
C.J.K. Henry, J. Webster-Gandy, C. Varakamin. (2001) A comparison of physical activity levels in two contrasting elderly populations in Thailand. American Journal of Human Biology 13:3, 310-315
CrossRef137
Youlian Liao, Daniel L. McGee, Guichan Cao, Richard S. Cooper. (2001) Recent Changes in the Health Status of the Older U.S. Population: Findings from the 1984 and 1994 Supplement on Aging. Journal of the American Geriatrics Society 49:4, 443-449
CrossRef138
Sarita M. Bhalotra, Phyllis H. Mutschler. (2001) Primary Prevention for Older Adults. Journal of Aging & Social Policy 12:2, 5-22
CrossRef139
James N. Laditka. (2001) Providing Behavioral Incentives for Improved Health in Aging and Medicare Cost Control. Journal of Health & Social Policy 13:4, 75-90
CrossRef140
D. Hamerman, J. Zeleznik. (2001) Translating basic aging research into geriatric health care. Experimental Gerontology 36:2, 193-203
CrossRef141
T. Perls. (2001) Guest Editorial: Genetic and Phenotypic Markers Among Centenarians. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 56:2, M67-M70
CrossRef142
J.F. Fries. 2001. Compression of Morbidity. , 2449-2453.
CrossRef143
Emmanuelle Cambois, Jean-Marie Robine. (2001) Apport des indicateurs d'espérance de vie sans incapacité à l'étude des inégalités sociales de santé. Santé Publique 13:2, 137
CrossRef144
Kelly M. Everard, Helen W. Lach, Bret L.. (2000) THE DEVELOPMENT OF HEALTHSTAGES: A UNIQUE UNIVERSITY AND NOT-FOR-PROFIT COLLABORATION TO ENHANCE SUCCESSFUL AGING. Educational Gerontology 26:8, 715-724
CrossRef145
V. A. Freedman, L. G. Martin. (2000) Contribution of chronic conditions to aggregate changes in old-age functioning. American Journal of Public Health 90:11, 1755-1760
CrossRef146
Carlo Franzini, Aurelia Berlusconi, Chiara Favarelli, Simona Brambilla. (2000) Low frequency of elevated serum transferrin saturation in elderly subjects. Clinica Chimica Acta 298:1-2, 181-186
CrossRef147
Nancy G. Kutner, Donna Brogan, W.Dallas Hall, Michael Haber, Danni S. Daniels. (2000) Functional impairment, depression, and life satisfaction among older hemodialysis patients and age-matched controls: A prospective study. Archives of Physical Medicine and Rehabilitation 81:4, 453-459
CrossRef148
Callahan, Daniel, . (2000) Death and the Research Imperative. New England Journal of Medicine 342:9, 654-656
Full Text149
Laura L. Tosi. (2000) Women and the Orthopaedic Surgeon. Clinical Orthopaedics and Related Research 372, 17-31
CrossRef150
James F Fries. (2000) Compression of morbidity in the elderly. Vaccine 18:16, 1584-1589
CrossRef151
Monica J. Daley, Warwick L. Spinks. (2000) Exercise, Mobility and Aging. Sports Medicine 29:1, 1-12
CrossRef152
James N. Laditka, Sarah B. Laditka. (2000) The Morbidity Compression Debate: Risks, Opportunities, and Policy Options for Women. Journal of Women & Aging 12:1-2, 23-38
CrossRef153
KAREN L. WEBB, WILLIAM N. SCHOFIELD, ROSS LAZARUS, WAYNE SMITH, PAUL MITCHELL, STEPHEN R. LEEDER. (1999) Prevalence and socio-demographic predictors of dietary goal attainment in an older population. Australian and New Zealand Journal of Public Health 23:6, 578-584
CrossRef154
Cecilia Florvall Müller, Tina Monrad, Fin Biering-Sørensen, Erik Darre, Allan Deis, Peter Kryger. (1999) The Influence of Previous Low Back Trouble, General Health, and Working Conditions on Future Sick-Listing Because of Low Back Trouble. Spine 24:15, 1562
CrossRef155
Nortin M. Hadler. (1999) Laboring for Longevity. Journal of Occupational and Environmental Medicine 41:8, 617-621
CrossRef156
Eric Bruckert. (1999) Prevention of cardiovascular events in elderly hypercholesterolemic patients. Current Atherosclerosis Reports 1:1, 9-15
CrossRef157
Shah Ebrahim. (1999) Disability in older people: a mass problem requiring mass solutions. The Lancet 353:9169, 1990-1992
CrossRef158
Rowe, John W., . (1999) Geriatrics, Prevention, and the Remodeling of Medicare. New England Journal of Medicine 340:9, 720-721
Full Text159
AS Dontas, J Moschandreas, A Kafatos. (1999) Physical activity and nutrition in older adults. Public Health Nutrition 2:3a,
CrossRef160
Ronald Lee, Jonathan Skinner. (1999) Will Aging Baby Boomers Bust the Federal Budget?. Journal of Economic Perspectives 13:1, 117-140
CrossRef161
Andreas E Stuck, Jutta M Walthert, Thorsten Nikolaus, Christophe J Büla, Christoph Hohmann, John C Beck. (1999) Risk factors for functional status decline in community-living elderly people: a systematic literature review. Social Science & Medicine 48:4, 445-469
CrossRef162
B. J. Kennedy. (1998) Cancer death and older age. Cancer 83:6, 1066-1068
CrossRef163
(1998) Aging, Health Risks, and Cumulative Disability. New England Journal of Medicine 339:7, 481-482
Full Text164
Campion, Edward W., . (1998) Aging Better. New England Journal of Medicine 338:15, 1064-1066
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