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Format: 04/18/2014
Format: 04/18/2014


Pittsburgh Tribune-Review: Growing number of centenarians to challenge cultural roles

Tuesday, December 8th, 2009

By Tom Fontaine

Tribune Review

Nic Mari, a third-grader at Moon's Hyde Elementary, looks forward to turning 100 someday.

"It would be awesome because you get to sleep more and you get to have Jell-O," said Nic, 8, who thinks old age starts at 44.

But fellow Hyde pupil Anthony Cap, 8, isn't eager to hit the century mark. Centenarians, he says, "can't run fast."

The youngsters have at least a 1 in 2 chance of reaching 100, according to a report in the British medical journal The Lancet. The October report, "Aging Populations: The Challenges Ahead," said more than half of all children born this decade in the United States and other developed nations will become centenarians.

About half of the Moon third-graders polled were thrilled by the prospect, often for reasons as simple as bottomless bowls of Jell-O or being old enough to get on all the rides at Kennywood. Others said they wanted to meet future generations and see world-changing advances to come. The other half, however, expressed concerns about wrinkles, limited mobility and being on death's doorstep.

"I think it would be cool to be 100, besides the fact that your life is almost over," said Erica Shorak, 8, of Hyde Elementary.

Fred Feldman, a Monessen native who lives in Pittsburgh's Southwestern Veterans Center, doesn't have any complaints about being a centenarian, despite relying on a wheelchair to get around and being hard of hearing.

"I like being 100. Every new day is wonderful. I want to continue to be alive and have more birthdays," said Feldman, who turned 100 on Nov. 13.

Can society handle it?

Aside from predicting that huge numbers of Americans will live into their 100s, the Lancet report says people should be able to live longer without severe disabilities or day-to-day limitations.

That's a finding that doesn't surprise experts on aging and doctors. But it's unclear how society might deal with larger numbers of the oldest old.

"What we find as solutions for dealing with the aging baby-boom population in the coming decades will probably become the status quo moving forward for years to come," said Dr. Alfred L. Fisher, assistant professor in geriatric medicine at the University of Pittsburgh's School of Medicine.

Just 0.03 percent of U.S. children born in 1900 lived to be 100. The average life expectancy then was 47.3 years, and 13 percent of babies didn't survive their first year.

Life expectancy hit 77.9 years in 2007, up 1.1 years from the start of the decade, according to federal data. More than 99.3 percent of U.S. babies survive their first year, ranking 30th in the world, the National Center for Health Statistics said this month.

The oldest age expected to be reached by at least half of all children born in a particular year has risen even more rapidly than life expectancy, from 101 for children born in 2000 to 104 for ones born in 2007, the Lancet report said.

"Continued progress in the longest-living populations suggests that we are not close to a limit" for age, the report said.

But there might be a limit on what society, and its health and social systems in particular, can handle.

Resources strained

Today, there are roughly 100,000 centenarians in the United States, federal data show. If the Lancet study is right, more than 20 times as many future centenarians have been born each year this decade — presuming at least half of the 4 million-plus children born each year will live into their 100s, as the study predicts.

"As it is, we already have more demand than we can fulfill," said Mildred E. Morrison, administrator of the Allegheny County Agency on Aging, which provides direct services for about 7,500 of the county's 290,000 residents older than 60.

"Demand will only increase in the years to come, and we'll have to keep adapting with the resources we have available. Whether those resources expand will be determined by those who create the laws and policies," Morrison said.

Dr. Anne B. Newman, director of the Center for Aging and Population Health at the University of Pittsburgh's Graduate School of Public Health, said the role of older people likely will change.

"Once people retire, they're not paying (as many) taxes into the system. That's just going to have to change," Newman said. "What you'll see is people continuing to work longer, and I think lots of people will like doing that. But it will change the roles older people play in society. They are going to have to be more active participants."

"We're really going to have to rethink the concept of retirement," Fisher said. The Lancet report said it's likely older people increasingly will work up to 25 hours a week well into their 70s, if not older, something that actually could "contribute to increases in life expectancy and health."

'50-50 chance of dementia'

Although Morrison said there has been a shift toward home-based nursing care for many seniors, Dr. Daniel Bubenheim, interim chair of Allegheny General Hospital's Department of Family Medicine, said medical staffs and facilities will need to grow.

"There's already a need for more primary care physicians, and that's what a lot of elderly folks really need — doctors who can catch and start treatment for diseases and other problems before they become acute or difficult to treat," Bubenheim said.

Obesity poses a threat, but medications combat many related ailments, such as diabetes, high blood pressure and heart disease, experts said.

Of greater concern, Newman said, "dementia and arthritis need a lot more (research) effort to push those off a little more. There are not a lot of good ways to treat them right now."

Fisher agreed. "The average 85-year-old has a 50-50 chance of developing dementia. That is a real worry," he said. "We could be living longer, but we could have a large legion of folks out there with dementia. We have to dedicate more health care resources and really take that on."

Loneliness, uncertainty

Is turning 100 something to look forward to, or dread?

"I don't have a clue because I don't know what tomorrow's 100 will look like. It might be fabulous, it could be quite difficult, but it won't be the exact equivalent of what we see today," Morrison said.

"All of my older patients say, 'Doc, don't get old,' " said Dr. Mohan Patel, an internal medicine and geriatric specialist at West Penn Allegheny Health System's Alle-Kiski Medical Center in Tarentum. "The biggest curse to living to be 100 is that you're often all alone."

"It can be pretty lonely. No one wants to be the only one left (among family members and friends)," Newman said. "But if more people are going to join you to be old, it might not be so bad."

To read more, visit the Tribune-Review web site.



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