Journal of Gerontological Nursing

EPILOGUE 

NIA: A National Resource for the Elderly and Nursing

Daniel Cowell, MD, MLS

Abstract

The National Institute of Aging (NIAJ was created by an act of Congress, the Research on Aging Act of 1974 (PL 93-296) "for the conduct and support of biomedical, social and behavioral research and training related to the aging process and the diseases and other special problems and needs of the aged." NIA is the newest and smallest of the Institutes, or research organizations, which comprise the Federal governments National Institutes of Health complex in Bethesda, Maryland.

The demographic data which support the Congress' desire to ensure that our nation's elderly receive the benefit of the best information medical science has to offer are now more widely known and are indeed impressive: the average life expectancy has risen to 73.7 years, 77.6 for women, 69.9 for men, compared to an average for both sexes of 45 years in 1900; persons 65 years of age and older comprise 1 1% of the US population compared to 4% in 1900; the fastest growing segment of the US population is the over 75 and over 85 year old age groups - the so-called "old-old" or "frail elderly." Eighty percent of elderly persons have one or more chronic illnesses or disorders, yet only 5% reside in long-term care facilities. Another way to dramatize these trends is to say that each day there is a net increase of 1600 Americans over the age of 65.

This extension of life has, in realily been very much of a mixed blessing. It reflects a stunning triumph of survivorship of our older population, yet this triumph is overshadowed by such serious concerns as livable housing, fulfilling and dignified retirement and leisure time activities, adequate income, safety, and, perhaps most important, a sufficient number of physicians and nurses knowledgeable about geriatric medicine, nursing and mental health, to provide an adequate scope, level and quality of care. Indeed, the tremendous achievement of extended life carries with it the responsibility to ensure the health and well-being of the elderly to the fui/est extent possible in order to forestall the development of premature disability and dependence which could turn those added years into a cruel and empty joke.

We recognize today that aging itself is a relatively benign process: In the absence of significant chronic disease, older persons can maintain active and independent lives into their 80s and beyond. Promising evidence from numerous studies indicates that the current high rates of morbidity and institutionalization can be significantly reduced and that gradual deterioration, decreased physical and mental functioning and eventual institutionalization are not inevitable consequences of growing old.

The principal goals of the NIA research strategy are to enhance the quality of life, maximize functional independence, increase understanding leading to effective treatment of the dementias that occur in older people (including Alzheimers disease), promote health and effective functioning, and develop of leadership in geriatrics and gerontology. Aging is seen as a fundamental human process, not a particular illness or set of illnesses. Fundamental to delaying the onset of disease states and the prevention of premature disability and dependence is an understanding of the mechanisms underlying time - dependent and age-related changes.

The collection of papers in this issue of the Journal of Gerontological Nursing represent a small sample of the studies being supported by NIA in areas of high research priority. The Institute is especially pleased to collaborate with the Journal of Gerontological Nursing in presenting these papers in a special NIA issue. We were also particularly fortunate to have Dr. Ida Martinson, a former member of the National Advisory Council on Aging (the advisory body to NIA), comment on them as an…

The National Institute of Aging (NIAJ was created by an act of Congress, the Research on Aging Act of 1974 (PL 93-296) "for the conduct and support of biomedical, social and behavioral research and training related to the aging process and the diseases and other special problems and needs of the aged." NIA is the newest and smallest of the Institutes, or research organizations, which comprise the Federal governments National Institutes of Health complex in Bethesda, Maryland.

The demographic data which support the Congress' desire to ensure that our nation's elderly receive the benefit of the best information medical science has to offer are now more widely known and are indeed impressive: the average life expectancy has risen to 73.7 years, 77.6 for women, 69.9 for men, compared to an average for both sexes of 45 years in 1900; persons 65 years of age and older comprise 1 1% of the US population compared to 4% in 1900; the fastest growing segment of the US population is the over 75 and over 85 year old age groups - the so-called "old-old" or "frail elderly." Eighty percent of elderly persons have one or more chronic illnesses or disorders, yet only 5% reside in long-term care facilities. Another way to dramatize these trends is to say that each day there is a net increase of 1600 Americans over the age of 65.

This extension of life has, in realily been very much of a mixed blessing. It reflects a stunning triumph of survivorship of our older population, yet this triumph is overshadowed by such serious concerns as livable housing, fulfilling and dignified retirement and leisure time activities, adequate income, safety, and, perhaps most important, a sufficient number of physicians and nurses knowledgeable about geriatric medicine, nursing and mental health, to provide an adequate scope, level and quality of care. Indeed, the tremendous achievement of extended life carries with it the responsibility to ensure the health and well-being of the elderly to the fui/est extent possible in order to forestall the development of premature disability and dependence which could turn those added years into a cruel and empty joke.

We recognize today that aging itself is a relatively benign process: In the absence of significant chronic disease, older persons can maintain active and independent lives into their 80s and beyond. Promising evidence from numerous studies indicates that the current high rates of morbidity and institutionalization can be significantly reduced and that gradual deterioration, decreased physical and mental functioning and eventual institutionalization are not inevitable consequences of growing old.

The principal goals of the NIA research strategy are to enhance the quality of life, maximize functional independence, increase understanding leading to effective treatment of the dementias that occur in older people (including Alzheimers disease), promote health and effective functioning, and develop of leadership in geriatrics and gerontology. Aging is seen as a fundamental human process, not a particular illness or set of illnesses. Fundamental to delaying the onset of disease states and the prevention of premature disability and dependence is an understanding of the mechanisms underlying time - dependent and age-related changes.

The collection of papers in this issue of the Journal of Gerontological Nursing represent a small sample of the studies being supported by NIA in areas of high research priority. The Institute is especially pleased to collaborate with the Journal of Gerontological Nursing in presenting these papers in a special NIA issue. We were also particularly fortunate to have Dr. Ida Martinson, a former member of the National Advisory Council on Aging (the advisory body to NIA), comment on them as an oven/iew We hope that this effort will serve to strengthen the natural alliance between geriatric medicine and gerontological nursing which is so critical for the proper health care of older persons.

10.3928/0098-9134-19841001-16

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