Skip to main content
Log in

Aging, cumulative disability, and the compression of morbidity

  • Original Article
  • Published:
Comprehensive Therapy

Abstract

The Compression of Morbidity paradigm emphasizes reduction in cumulative disability by postponing chronic infirmity. This article describes the model, reviews data suggesting morbidity compression over time, establishes associations between health risks and subsequent disability, and describes risk reduction interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fries JF, Crapo LM. Vitality and Aging. San Francisco: W. H. Freeman, 1981.

    Google Scholar 

  2. Gruenberg EM. The failures of success. Milbank Q. 1977;55: 3–24.

    CAS  Google Scholar 

  3. Fries JF. Aging, natural death, and the compression of morbidity. N Engl J Med. 1980;303:130–135.

    Article  PubMed  CAS  Google Scholar 

  4. Fries JF. The compression of morbidity: near or far?. Milbank Q. 1989;67:208–232.

    Article  PubMed  CAS  Google Scholar 

  5. Myers GC, Manton KG. Compression of mortality: myth or reality? Gerontologist. 1984;24:346–353.

    PubMed  CAS  Google Scholar 

  6. Manton KG. Changing concepts of morbidity and mortality in the elderly population. Milbank Q. 1982;60:183–244.

    CAS  Google Scholar 

  7. Verbrugge LM. Longer life but worsening health? Trends in health and mortality of middle-aged and older persons. Milbank Q. 1984;62:475–519.

    CAS  Google Scholar 

  8. Kranczer S. Continued United States longevity increases: RECAP Recent Trends in Expectation of Life. Statistical Bulletin. Oct–Dec 1999:20–27.

    Google Scholar 

  9. Lubitz J, Beebe J, Baker C. Longevity and medicare expenditures. N Engl J Med. 1995;332:999–1003.

    Article  PubMed  CAS  Google Scholar 

  10. Liao Y, McGee DL, Cao G, Cooper RS. Quality of the last year of life of older adults. JAMA 2000;283:512–518.

    Article  PubMed  CAS  Google Scholar 

  11. Freedman VA, Martin LG. Understanding trends in functional limitations among older Americans. Am J Public Health. 1998;88:1457–1462.

    PubMed  CAS  Google Scholar 

  12. Allaire SH, LaValley MP, Evans RE, et al. Evidence for decline in disability and improved health among persons aged 55 to 70 years: The Framingham Heart Study. Am J Public Health. 1999;89:1678–1682.

    PubMed  CAS  Google Scholar 

  13. House JS, Kessler RC, Herzog AR, Mero RP, Kinney AM, Breslow MJ. Age, socioeconomic status, and health. Milbank Q. 1990;68:383–411.

    Article  PubMed  CAS  Google Scholar 

  14. Vita AJ, Terry RB, Hubert HB, Fries JF. Aging, health risks, and cumulative disability. N Engl J Med. 1998;338:1035–1041.

    Article  PubMed  CAS  Google Scholar 

  15. Wang BWE, Ramey DR, Fries JF. Postponed development of disability in senior runners: a controlled 13-year longitudinal study. Arthritis Rheum. 1999;42:574

    Article  Google Scholar 

  16. Fries JF, Singh G, Morfeld D, Hubert HB, Lane NE, Brown BW Jr. Running and the development of disability with age. Ann Intern Med. 1994;121:502–509.

    PubMed  CAS  Google Scholar 

  17. Stearns SC, Bernard SL, Fasick SB, et al. The economic implications of self-care: the effect of lifestyle, functional adaptations, and medical self-care among a national sample of medicare beneficiaries. Am J Public Health. 2000;90:1608–1612.

    PubMed  CAS  Google Scholar 

  18. Reed DM, Foley DJ, White LR, Heimovitz H, Burchfiel CM, Masaki K. Predictors of healthy aging in men with high life expectancies. Am J Public Health. 1998;88:1463–1468.

    Article  PubMed  CAS  Google Scholar 

  19. Daviglus ML, Liu K, Greenland P, et al. Benefit of a favorable cardiovascular risk-factor profile in middle age with respect to medicare costs. N Engl J Med. 1998;339:1122–1129.

    Article  PubMed  CAS  Google Scholar 

  20. Blair SN, Wei M. Sedentary habits, health, and function in older women and men. Am J Health Promot. 2000;15:1–8.

    Article  PubMed  CAS  Google Scholar 

  21. Fries JF, Bloch DA, Harrington H, Richardson N, Beck R. Two-year results of a randomized controlled trial of a health promotion program in a retiree population: The Bank of America Study. Am J. Med. 1993;94:455–462.

    Article  PubMed  CAS  Google Scholar 

  22. Fries JF, Harrington H, Edwards R, Kent LA, Richardson N. Randomized controlled trial of cost reduction from a health education program: The California Public Employees' Retirement System (PERS) Study. Am J Health Promot. 1994; 8:216–223.

    PubMed  CAS  Google Scholar 

  23. Gale FM, Kirk JC, Eidetics, Watertown MA, Davis R, Beth Israel Hospital, Harvard School of Public Health. Patient education and self-management: randomized study of effects on health status of a mail-delivered program. Arthritis Rheum. 1994;37:S197.

    Google Scholar 

  24. Montgomery EB, Lieberman A, Singh G, Fries JF. Patient education and health promotion can be effective in Parkinson's disease: a randomized controlled trial. Am J Med. 1994;97:429–435.

    Article  PubMed  Google Scholar 

  25. Pelletier KR. A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: 1995–1998 update (IV). Am J Health Promot. 1999;13:333–345.

    PubMed  CAS  Google Scholar 

  26. Ozminkowski RJ, Goetzel RZ, Smith MW, Cantor RI, Shaughnessy A, Harrison M. The impact of the Citibank, NA, health management program on changes in employee health risks over time. J Occup Environ Med. 2000;42(5):502–511.

    Article  PubMed  CAS  Google Scholar 

  27. Fries JF, Koop CE, Beadle CE, et al. Reducing health care costs by reducing the need and demand for medical services. N Engl J Med. 1993;329:321–325.

    Article  PubMed  CAS  Google Scholar 

  28. Fries JF, Koop CE, Sokolov J, Beadle CE, Wright D. Beyond health promotion: reducing need and demand for medical care. Health Affairs. 1998;17:70–84

    Article  PubMed  CAS  Google Scholar 

  29. Rowe JW. Geriatrics, prevention, and the remodeling of medicare. N Engl J Med. 1999;340:720–721.

    Article  PubMed  CAS  Google Scholar 

  30. Breslow L. From disease prevention to health promotion. JAMA. 1999;281:1030–1033.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Fries, J.F. Aging, cumulative disability, and the compression of morbidity. Compr Ther 27, 322–329 (2001). https://doi.org/10.1007/s12019-001-0030-4

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12019-001-0030-4

Keywords

Navigation