Intended for healthcare professionals

Education And Debate

A healthy old age: realistic or futile goal?

BMJ 2000; 321 doi: (Published 04 November 2000) Cite this as: BMJ 2000;321:1149
  1. Marion E T McMurdo, professor of ageing and health (
  1. Department of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY

    Based on a presentation from the Millennium Festival of Medicine

    The undreamed of improvements in average life expectancy in the 20th century have thrust ageing to the forefront of attention, and more old people are alive today than at any time in history. People over 60 currently constitute a fifth of the UK population and will constitute one third by 2030 (figure). Though increasing life expectancy is hailed by some as one of the greatest achievements of the 20th century, a more common reaction is a doom-laden prediction of health and social budgets being drained by caring for dependent old people. Indeed some have argued that directing resources away from old people can be justified.1 Sensible debate about the impact of the changing age structure of the population has been hampered by media coverage edged with hysteria.

    Of course, we need to consider how to care for the growing number of old people, but this aspect has dominated discussion to the virtual exclusion of a search for strategies which might improve their overall health. This negative tenor has been fuelled partly by a misunderstanding about health in old age. Certainly older people in general have poorer health than younger people, and this is due partly to the higher rates of disease in old age. The incidence of heart disease, for example, increases with age, but this does not mean that ageing itself is a cause of heart disease. Nor does it mean that heart disease is inevitable in old age. The crucial distinction between the effects of age alone and the effects of disease do need to be reinforced in the minds of both the public and health professionals. Finally laying to rest the pervasive misconception that all the ills of old age are “just your age” would represent …

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