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December 4, 1996

Preventing Disability: Beyond the Black Box

Author Affiliations

From the Multicampus Program in Geriatric Medicine and Gerontology, University of California, Los Angeles.

JAMA. 1996;276(21):1756-1757. doi:10.1001/jama.1996.03540210064036

Health and social care services required by older persons in this country will be a growing burden and a major societal concern for much of the next century.1 The long-accepted theories of Gompertz—that mortality rates increase at predictable trajectories—have been challenged because age trajectories of mortality do not follow predictable curves.2 In fact, in humans, mortality rates decelerate with age. Projections from the US Bureau of the Census have not taken this and other factors into account, however, and the US population of older persons continues to be dramatically underestimated.3 Thus, the 1990 projection of the number of older people who will be living in the United States in the year 2000 is 34.9 million,4 while Manton5 predicts 40.3 million, of whom a substantial proportion will be older than 85 years of age.

See also p 1725.

Projections of the numbers of disabled elderly in