Epidemiologic Aspects
A common definition (World Health Organization 2011) describes elderly individuals as persons aged 65 and over. A previous definition given by the WHO even defined persons only 60 or more years old as elderly, but this cutoff is not generally accepted. In
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Definition of the Elderly A common definition (World Health Organization 2011) describes elderly individuals as persons aged 65 and over. A previous definition given by the WHO even defined persons only 60 or more years old as elderly, but this cutoff is not generally accepted. In this context, it is necessary to discuss the definition of age. The definition of an calendarian cutoff for defined age groups merely depends on social consensus and not primarily on physiological changes that may occur even years before. Age-associated physiological changes in the endocrine system or in lens elasticity may start much earlier even in healthy subjects: between age 40 and age 45 for the endocrine system and during puberty for lens elasticity. A reliable and valid threshold value for significant changes in physiology cannot be calculated and applied due to a great variety of interindividual aging patterns and courses. Within the large group of elderly individuals, persons at age 80 years and older may form a special subgroup presenting with increased prevalence rates of typical geriatric problems; for that reason, they may be defined as belonging to a separate age group—some call them the fourth
H. Burkhardt (*) IVth Department of Medicine, Geriatrics, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany e-mail: [email protected]
age. Octogenarians (more so even older people) show a significant decline in key functionalities such as locomotion, continence, and cognition; therefore, functionality and impairment are a major topic when considering health-related aspects of high age.
Methodological Aspects Epidemiologic data comprise a variety of data sources. Global trends mainly rely on national census data and international data platforms such as U.N. organizations or the WHO. For many countries, such data provide reliable information on the age distribution of the population, life expectancies, and regional and global trends for defined age groups. Functionality and impairment data or descriptions of special barriers are often not sufficiently represented in census data; health insurance organizations or population-based large scale cohort studies may provide more sophisticated data sets. Remarkable regional differences due to the heterogeneity of health care systems and epidemiologic approaches need to be considered. Therefore, an international comparison of prevalence data has to utilize global surveys such as those by the WHO. The WHO provides data retrieved by the World Health Survey, which include entries on the prevalence of functional limitations among the elderly population in different countries. Unfortunately, not all countries are participating in this survey for a variety of reasons,
M. Wehling (ed.), Drug Therapy for the Elderly, DOI 10.1007/978-3-7091-0912-0_2, # Springer-Verlag Wien 2013
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and not all standardized questions are suitable for all regions, rendering a global comparison difficult to impossible. There is no global consensus how to measure function
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