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Unhealthy ageing: functional and socioeconomic impact

J. Avorn*,a,b

a Brigham and Women's Hospital, Division of Pharmacoepidemiology and Pharmacoeconomics, Boston, Massachusetts, U.S.A.
b Harvard Medical School, Boston, Massachusetts, U.S.A.

* Correspondence: Jerry Avorn, MD, Brigham and Women's Hospital, Division of Pharmacoepidemiology and Pharmacoeconomics, 221 Longwood Avenue, Boston, MA 02115, U.S.A.

Abstract

The long-term impacts of disease on functional status and on cost loom larger in the elderly than in any other age group. In older patients, the chronic sequelae of myocardial infarction and stroke often account for greater functional disability and resource utilization than does the initial acute presentation. In order to study this, quantitative measures from clinical and functional status assessments must be related to lifelong resource use. Rigorous measurement of such outcomes can render it possible to measure the impact on the health care system of specific cardiovascular and cerebrovascular consequences of ‘unhealthy ageing’. If performed in the context of a randomized clinical trial studying the effect of preventive measures, this approach can also lay the groundwork for assessment of the clinical and economic benefits of measures taken to reduce such morbidity.

Key Words: atherosclerosis • 3-hydroxy-3-methylglutaryl enzyme A (HMG-CoA) reductase inhibitors (statins) • outcomes • pravastatin • Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) study


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