Evidence From the Gothenburg Longitudinal Study
ALVAR SVANBORG, M.D., PH.D.
One must wait until the evening to see how splendid the day has been. Sophocles
In gerontology one of the most urgent questions concerns a better understanding of how ageing in itself, as distinguished from disease, influences our vitality, and to what extent it would be possible to postpone at least certain of the negative functional consequences of ageing. What are the determinants for a prolongation of life with reasonable quality? In other words: can we postpone the negative functional consequences of ageing?
One obvious problem is to differentiate between manifestations of ageing and symptoms of disease, especially if disease might be an unavoidable consequence of ageing. Might it be possible to reduce the current drastic age-related increase in incidence of morbidity? Might it be that certain disorders closely associated with chronological age are, in fact, not directly related to ageing per se?
It is also apparent that adequate medical services are a determinant of vitality and survival. To what extent are currently available medical services adapted to the specific needs of the old patient? Would improvements in diagnostic criteria, therapy, and assistance to regain functional performance after episodes of acute disease or disorder contribute to better vitality and health, and lower disability and the need for care in older persons? Would systematic health screening of older persons allow diagnosis and treatment before disease has increased disability and reduced the likelihood of regaining functional performance or reactivation?
A prerequisite for attempting to answer these questions must be an improvement of the knowledge about how to differentiate manifestations of ageing from symptoms of definable disease and disorder. The main approach to obtaining such knowledge is through longitudinal studies of representative population samples.