The Scott Advisory | Understanding Aging and Incremental Loss
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Understanding Aging and Incremental Loss

Understanding the link between longer lives, disease and quality of life.

Fragility is an emerging concept in the study of health outcomes that is specific to older age. It is a downward trajectory in health and ability to perform daily tasks resulting from the accumulation of acute and chronic diseases as well as physiological decline.

Aging is humanity’s biggest problem, because it causes the most death and suffering compared to all other causes put together. That includes causes such as starvation, violence, infectious diseases, environmental degradation, accidents—you name it. Aging is also much more likely to affect you personally and most of the people you know more than any other problem. Concerns about the effects of defeating aging are legitimate but do not outweigh the merits of saving so many lives and alleviating so much suffering.


Besides being the leading cause of death, aging also inflicts the most human misery compared to all other causes before eventually killing its victims. Most people do not die of aging instantly; few die peacefully in their sleep without struggling for years with chronic, debilitating, age-related disease. Usually, the older people become the more likely they are to develop diseases caused by the aging process such as cancer, diabetes, heart disease, Alzheimer’s disease, and Parkinson’s disease. In the United States:


  • 74 percent of people between the ages of 65 to 69 have at least one chronic disease.
  • Of those aged 85 and over, 86 percent have at least one chronic disease.
  • 28 percent of those aged 85 and over suffer from five or more chronic diseases.
  • Almost 40 percent of people aged 85 and over either cannot walk or find walking to be very difficult.
  • Nearly 50 percent of those over age 85 develop some form of dementia such as Alzheimer’s disease.(Centers for Disease Control, 2014)


Age-related diseases relentlessly increase disability and frailty years and often a decade or more before eventually killing their victims. Families have to watch helplessly the inexorable physical and mental decline of an affected family member. Other family members are often forced to become caregivers and independence is lost both for themselves as well as for their disabled family member.



Americans are living longer than ever before. Life expectancies at both age 65 and age 85 have increased. Under current mortality conditions, people who survive to age 65 can expect to live an average of 19.2 more years, nearly 5 years longer than people age 65 in 1960. In 2009, the life expectancy of people who survive to age 85 was 7 years for women and 5.9 years for men.


Life expectancy at age 65 in the United States is lower than that of many other industrialized nations. In 2009, women age 65 in Japan could expect to live on average 3.7 years longer than women in the United States. Among men, the difference was 1.3 years.

Almost three-fourths of seniors have at least one chronic illness. Almost half of seniors have at least two chronic illnesses. They account for two-third of healthcare costs in the United States. (Centers for Disease Control, 2013 State of Aging and Health in America)


A 2006 report from the Institute of Medicine estimated that every year, there are 450,000 injuries resulting from medication errors in hospitals, and perhaps many more that are unreported. What’s especially frightening about these hospital risks is they “seem” completely beyond your control. How would you even know what medicines you need, or how much, or how often? How can you stop a doctor’s poor handwriting on a prescription from being misread by a pharmacist or nurse?Where are you on the spectrum of wellness? Are you on a path towards developing a chronic disease?


You can make a difference in your life and future generations.



According to a study by Israeli researchers, the average patient in a hospital requires an average of 178 physician or healthcare worker actions every day. This can include temperature checks, medication administration, blood sugar monitoring and more. Since patients often see dozens of different healthcare employees during the course of their treatment, the risk of errors is very high.


In the Israeli study, researchers discovered that error rates in hospitals are approximately one percent. Since the average patient has 178 daily actions provided by healthcare workers, it’s very likely that there are one or more errors in patient care for each day a patient remains hospitalized.

While some of these errors may be benign, others can be very serious. Most hospitals have checklists to make sure that advanced care requirements are met; however, many lower-level healthcare tasks are just as important. For example, patients who are bedridden can experience a variety of serious health issues if their care isn’t managed in a proactive way. Clotted veins, bone mass loss, muscle atrophy, pressure ulcers and cardiovascular disease can all be caused by a lack of daily movement. Left unbrushed for days, a patient’s teeth can harbor bacteria that significantly increase the risk of pneumonia. When advanced care equipment like dialysis systems, respirators and other devices are added in, the number of potential failure points increases exponentially. (The Checklist Manifesto, 2010)