CONTROLLING AGING: WHAT WOULD/COULD/SHOULD HAPPEN?  (Revised Fall 2017)
 

Presider:
        Kenneth Kaloustian, Ph.D., Chair of Biomedical Sciences, Quinnipiac College
Other presenters:
        Donald J. Mulcare, Ph.D., Director of Gerontology Programs, Gerontology Center, University of Massachusetts Dartmouth
        Augustine G. DiGiovanna, Ph.D., Professor of Biology, Salisbury University, Salisbury, MD.
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For classroom discussion or debate format, go to Controlling Aging: What Would/Could/Should Happen?

Symposium Outline and Page Index
1. Questionnaire about controlling aging: what would/could/should happen?
2.a. Information presented
    Demographics projections 
    Graphs 
    Tables

    Potential methods for changing aging, ML, XL and improving quality of life
        Diet
        Exercise
        Better diagnosis
        Pharmacy
        Surgery
        Supplements
        Caloric restriction (CR)
        Hormones
        Genetics
2.b. Possible consequences from altering mean longevity, maximum longevity, or both;
    Quality of life
    Increased mean longevity
    Increased maximum longevity
    Changes in demographics
        Statistics
        Possible societal impact
        US
2.c. Possible conclusions.
3. The relevance of offering this type of discussion in gerontology programs.
4. Additional summaries, notes, and bibliographies.
    Hormones and Aging
    Genes and Aging
    Bibliography

International view

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CONTROLLING AGING: WHAT WOULD/COULD/SHOULD HAPPEN?

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1. Questionnaire about controlling aging: what would/could/should happen?

To investigate knowledge of and opinions regarding how human aging could or should be controlled.

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2.a. Information for us to present

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Demographics projections

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       - How the US Census makes population projections. List the criteria used and the cohort method for population projections.

        Methodology and Assumptions for the Population Projections of the United States: 1999 to 2100
      
https://www.census.gov/population/www/documentation/twps0038/twps0038.html

      Projections of the Size and Composition of the U.S. Population: 2014 to 2060
      https://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf


           - The US Census makes three different projections; lowest, middle, and highest. The lowest and highest are the OUTSIDE LIMITS of what is "possible" given their minimum and maximum values used in their equations. The middle values are their "best guess" based on their assumptions, including that expected the MLs are in the 80s, and there is no mention of XLs. Given these assumptions and if MLs or XLs are increased, then the US Census highest projections should be considered extremely conservative if not unrealistically low.
                - (1) Making projections is a complex process.
                - (2) Some of the important data and equations are in the US Census Bureau computer and are not accessible by the public.
                - (3) One cannot simply change one number, such as ML, and get answers because each assumption, such as ML, is developed for each small segment of the population (e.g., age, race, national origin, sex), so there are a multitude (a matrix) of numbers used for each year's projections, and the entire matrix changes for each year. The matrix includes assumptions for things like birth rates for different types for females (e.g., age, race), death rates for people of different ages and for different family sizes and different economic status, and more. We are not able to see easily what might happen in real numbers if ML or XL were to change or if death rates for people of different age groups were to change.

        - US projections are now available to the year 2100. Since many people being born now can expect to live almost that long.

       - Many other projections other than total population { e.g.,  geographic distributions, sex ratios, MLs, age distributions and pyramids, available care facilities, health status, diseases, care expenses} are available from the US Census Bureau..

       - Note that projections change as years pass due to changing conditions and assumptions.

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Potential methods for changing aging, ML and XL and improving quality of life

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     "Intercompensating mortality factors"; i.e., if the major causes of aging and diseases are reduced or eliminated, they will be replaced with other factors so it is futile to try to increase ML or XL significantly.

Why many people would not, even if they could!

    - Affordability
            - Your Money or Your Life
            - The Cost Of Life Extension
            - Retirement Planning Is Tough Enough
            - Outliving One's Pension
            - Work Until You Drop?
    - Diet, Exercise Ignored
    - Obesity & Diabetes
    - Sci/Fi Vision of Extreme Old Age
    - Science Vs. Snake Oil
    - Conspiracy Theory
    - Following The Wrong Advice

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Diet
           - good nutrition is known the prevent many diseases and to correct many others (e.g., atherosclerosis, heart attacks, strokes, diabetes mellitus, osteoporosis, intestinal diseases (e.g., constipation, diverticulosis, cancer)
           - the diet for a healthy older person is the same as the diet for a young adult except for adjustments in caloric intake to compensate for the usual age-related decreases in energy demands (e.g., muscle mass, physical activity)

Exercise
           - exercise is known the prevent many diseases and to correct many others (e.g., atherosclerosis, heart attacks, strokes, diabetes mellitus, osteoporosis, intestinal diseases (e.g., constipation, diverticulosis)
           - types of exercises needed for a healthy older person are the same as those for a young adult except for modifications in speed, strength, and coordination to compensate for the usual age-related changes in the skeletal, muscle, and nervous systems.
           - Use it or lose it.
           - Use it to improve it.

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Better diagnosis
    - better diagnoses are known the prevent many diseases and to help correct many others (e.g., atherosclerosis, heart attacks, strokes, diabetes mellitus, osteoporosis, intestinal diseases (e.g., constipation, diverticulosis, cancers)
    - diagnoses for elders is more complicated because of altered signs and symptoms and because of the higher presence of multiple diseases in each person.

Pharmacy
     - new and better medications and herbal substances are known that prevent many diseases and to help correct many others (e.g., atherosclerosis, heart attacks, strokes, osteoporosis, intestinal diseases (e.g., constipation, diverticulosis, cancers, cosmetic surgery)

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Surgery

Replacement Cells and Organs

             - tissue transplants and organ transplants are known the prevent some diseases and to help correct others (e.g., brain cells for parkinsonism, pancreatic islet cells for diabetics, bone marrow for leukemia and for marrow- destroying diseases and treatments, hearts, livers, skin graphs, skeletal joints, arteries, hearts, inner ears for hearing, cosmetic prostheses)
           - new and better surgical procedures are known the prevent many diseases and to help correct many others (e.g., atherosclerosis, heart attacks, strokes, osteoporosis, intestinal diseases (e.g., constipation, diverticulosis, cancers, cosmetic surgery)
        - robotics, prosthetics replacement organs hips, knees, skin, blood, hearts, bones
        - immune system modifications
            - cell implants
            - organ transplants and replacement (e.g., human donors, animal donors, organ "cloning)
            - implants for the brain  (e.g., dopamine, acetylcholine, embryo brain parts)

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Supplements

Vitamins and minerals
                - except for vitamin E, supplements help only by augmenting a poor diet or compensating for a disease condition (e.g., intestinal, kidney)
                - vitamin E serves and an antioxidant, which seems to help prevent atherosclerosis, heart attacks, and strokes

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Herbal remedies
                - inconclusive
                - placebo effect

Antioxidants (synthetic, organic)
              - antioxidants other than vitamin E reduce certain age changes in animal experiments but have not been shown consistently to increase ML or XL
              - oxidants are necessary as useful entities (e.g., neuronal signals, hormonal signals, WBC and immune defense responses).
              - there is inadequate knowledge about which FRs are dangerous and how to specify antioxidant therapy

Caloric restriction (CR)
           - definition in humans vs ad lib
           - CR is know to increase ML and reduce diseases in many animals including monkeys (e.g., cancers, diabetes mellitus)
           - compliance with CR may be difficult. Note preponderance of overweight and obesity now.
           - would it be possible to use anti-appetite drugs to suppress hunger (possible abuse)
           - CR may have adverse effects on quality of life (e.g., constant hunger, limited energy expenditures (e.g., work, recreation), poor concentration, altered behaviors and personality traits, poorer healing, reduced tolerance of and recovery from serious illness (i.e., lower body reserves)
        - For detailed notes click here.

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Hormones

         Go to Hormones and Aging

                 - hormone supplements have been shown to slow or reverse some age changes and some diseases. However, research shows significant adverse side effects. Hormone supplementation is not yet known to alter ML or XL. Some hormones (e.g., melatonin, DHEA) are not regulated in any way (e.g., production, availability, doses)
             - GH improves muscle and bone and skin but may promote diabetes mellitus and cancers. Exercise helps maintain GH levels and also promotes all the benefits of GH supplements without the drawbacks.
             - Melatonin is a potent antioxidant but also affects biorhythms (e.g., sleep:wakefulness), including rhythms of other hormones (e.g., ADH, glucocorticoids). Some sources of melatonin are contaminated with toxic materials and are unregulated.
             - The normal functions of DHEA are unknown. DHEA may reduce some diseases, but results are inconclusive and controversial. DHEA supplementation produces dangerous by-products.
             - Estrogen reduces some age changes (e.g., bone loss, memory loss) and some diseases (e.g., atherosclerosis, heart attacks, strokes, Alzheimer's) but has adverse side effects for some women (e.g., cancers, blood clots)

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Genetics

        Go to Genes and Aging

        - (e.g., gene therapy, transgenes from non-humans, man-made genes, telomerase)
        - genetic engineering works in animals (e.g., selective breeding, altering genes, "designer" genes from humans, synthetic genes, transgenes from non- humans,))
         - additional effects while altering ML and XL are not well studied or documented
         - correct congenital defects
         - correct late life defects
         - enhance vitality.

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2.b. Possible consequences from altering mean longevity, maximum longevity, or both;

    Should we? Is It Worth The Cost?
            - Species Approach applied to humans (Ethical Cost)
            - Health Resources Needed Elsewhere
            - No Guarantee That Later Years Would Be Better
            - Harvard Study: (East Boston) 47% of >85 Apparent SDAT
        There Is More To Life That This?
            - Spiritual Dimension
            - Patrick Henry

Quality of life

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There are different criteria used to establish quality of life.
       - physical independence, medical status, economic status, social status and situation, life satisfaction, self-efficacy, self-determination

Increased mean longevity
   - with or without increasing quality of later life

Increased maximum longevity
   - with or without increasing quality of later life

Changes in demographics
   
    Graphs of demographics

        Projected U.S. Population  - 2000-2100 
            The range between the highest and lowest series is the 95% confidence interval.
   
    Populations of Elders - 1900-2050 
            The changes in the numbers of elders and the percentages of elders at 65+ and at 85+.
        Elders as Percent of Population - 2000-2100 (Middle Series)  
            The changes in elders as percentages of the total population.
        Projected Life Expectancies at Birth - 1995-2050   (Table)
            The 95% confidence intervals and average life expectancies of women and of men.
        Projected Life Expectancies at Birth - 2000-2100    (Table)
            The 95% confidence intervals and average life expectancies of women and of men.
        Projected Life Expectancies at Age 65 - 1995-2050 
            The 95% confidence intervals and average life expectancies of women and of men age 65.
        Age Pyramids 
(Slow download)  
            The age distributions at different years.

        Survival Curves 1999-2100   
            The present and projected survival curves based on middle series.

        Projected Percent Female Elders 65+ - 2000-2100
            The changes in women as a percentage of the population of elders 65+.
        Projected Number of Females and Males 65 - 2000-2100
            The changes in numbers of elderly women and men.
        Population Ages 25-64 by State - 1995-2025   (Table)
 
            The present and projected changes in the distribution of young adults among states. Compare the differences in the present and projected numbers and proportions of elders among states.
        Population Ages 65+ by State - 1995-2025   (Table)
 
            The present and projected changes in the distribution of elders 65+ among states. Compare the differences in the present and projected numbers and proportions of elders among states.

    Tables of demographics 
(Slow download for tables)
   
     Projected Life Expectancies at Birth - 1995-2050 - All Series  (Graph)
        Projected Life Expectancies at Birth - 2000 to 2100  (Graph)
   
     Population Ages 24-64 by State - 1995-2025    (Graph)  
        Population Ages 65+ by State - 1995-2025 
  (Graph)  

 


Updated changes in demographics

      Topics
         Demographics and Populations Statistics
         Health
         Births, Mortality, Deaths
 
          International data and statistics
         Diverse topics
    
Demographics and Populations Statistics

Population Projections of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050
http://www.census.gov/prod/1/pop/p25-1130.pdf 

An Aging Nation: The Older Population in the United States
https://www.census.gov/library/publications/2014/demo/p25-1140.html

2014 National Population Projections Tables
https://www.census.gov/data/tables/2014/demo/popproj/2014-summary-tables.html

Census Data & Population Estimates
https://www.acl.gov/aging-and-disability-in-america/data-and-research/census-data-population-estimates

The Nation's Median Age Continues to Rise
https://www.census.gov/library/visualizations/2017/comm/median-age.html
 

Millennials Outnumber Baby Boomers and Are Far More Diverse, Census Bureau Reports

https://www.census.gov/newsroom/press-releases/2015/cb15-113.html

The Nation’s Older Population Is Still Growing, Census Bureau Reports
https://www.census.gov/newsroom/press-releases/2017/cb17-100.html

News Releases by Year: This page displays the most recent news releases published by the U.S. Census Bureau.

https://www.census.gov/newsroom/press-releases/by-year.html   Health

Health, United States, 2016
https://www.cdc.gov/nchs/hus/index.htm  - 
(for previous years, see (https://www.cdc.gov/nchs/hus/previous.htm)

Health Information for Older Adults https://www.cdc.gov/aging/aginginfo/index.htm   National Center for Health Statistics https://www.cdc.gov/nchs/   National Center for Health Statistics: Diseases and Conditions https://www.cdc.gov/nchs/fastats/diseases-and-conditions.htm  

Percent of U.S. Adults 55 and Over with Chronic Conditions: National Center for Health Statistics:

https://www.cdc.gov/nchs/health_policy/adult_chronic_conditions.htm

Overweight & Obesity

https://www.cdc.gov/obesity/index.html   Births, Mortality, Deaths

Deaths: Final Data for 2014 : Life expectancy, mortality statistics, causes of death
https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf

National Vital Statistics System

https://www.cdc.gov/nchs/nvss/index.htm   International data and statistics

International Programs Data
https://www.census.gov/population/international/data/

U.S. and World Population Clock

https://www.census.gov/popclock/

Diverse topics

National Institute on Aging: Many types of data and information on aging and elders.
https://www.nia.nih.gov/

American FactFinder – from the US Census Bureau
https://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml
“American FactFinder provides access to data about the United States, Puerto Rico and the Island Areas. The data in American FactFinder come from several censuses and surveys.”

National Archive of Computerized Data on Aging (NACDA)
http://www.icpsr.umich.edu/icpsrweb/NACDA/search.jsp

Search for any variable or select:

                   I.            Demographic characteristics of older adults

                II.            Social characteristics of older adults

             III.            Economic characteristics of older adults

             IV.            Psychological characteristics, mental health, and well-being of older adults

                V.            Physical health and functioning of older adults

             VI.            Health care needs, utilization, and financing for older adults
 

CDC Newsroom Releases: 2017 News Releases
  https://www.cdc.gov/media/archives.htm  

CDC Newsroom Archives: for years before 2017

https://www.cdc.gov/media/archives.htm

 

Changes in demographics (Web Sites in original presentation)

Web Sites for demographic data and graphs
       One of the most complete sources with very diverse types of data, table, and wonderful graphs is "65+ in the United States" at
           http://www.census.gov:80/prod/1/pop/p23-190/p23-190.html   (Broken Link)
        Other good ones are at
           http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/index.aspx  (Broken Link)
           http://www.aoa.gov/AoARoot/Aging_Statistics/index.aspx  (Broken Link)
           http://www.census.gov/prod/1/pop/p25-1130.pdf    Population Projections of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050
           http://www.census.gov/population/www/projections/popproj.html   (Broken Link)
           http://www.cdc.gov/nchs/data/hus/hus05.pdf (especially page xiii and page 70)

       Life Tables
           http://www.census.gov:80/population/www/projections/natdet-D5.html  (Broken Link)

Statistics
   - size of U.S. population
        http://www.census.gov/prod/1/pop/p25-1130/  (Broken Link)
        http://www.census.gov/population/www/projections/natsum-T3.html  (Broken Link)
        http://www.census.gov/population/projections/nation/summary/np-t1.txt  (Broken Link)
        http://www.census.gov/population/www/projections/natsum.html  (Broken Link)
        http://www.census.gov/population/www/projections/natdet-D1A.html  (Broken Link)
   - size of global population
       https://www.census.gov/population/international/ or  http://www.census.gov/ipc/www/ 
   - age distributions and age pyramids
        http://www.census.gov/population/www/projections/natchart.html  (Broken Link)
   - geographic distribution of elders
        http://www.census.gov/population/www/socdemo/age.html#elderly   (Broken Link)
   - health status of population
        http://www.cdc.gov/nchs/agingact.htm   (Broken Link)
       https://www.cdc.gov/nchs/hus/index.htm - Health, United States, 2016
              (for previous years, see (https://www.cdc.gov/nchs/hus/previous.htm)

try this - https://www.census.gov/population/www/socdemo/related_sites.html    (Broken Link)

Possible societal impact from demographic changes (i.e., changes in groups)

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See the US Census Bureau and the AOA sites above and in the bibliography for projections about economy, social status (e.g., men/women ratios, living arrangements, nursing homes, institutionalization, health care costs).

Note the projections about HMOs and the cost of health care, Social Security, prescription drugs.

US

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           Medical
                 Increases in certain diseases
                      Cataracts
                      Dementias
                      Alzheimer's
                      Cancers
                      ?????
           Ecological
                Pollution
                Erosion
                Effects on habitat
                Increases in endangered and extinct species
                Loss of wilderness
                Loss of species diversity (altered evolution and lowered survivability)
                Alterations in human environments (e.g., drinking water, insecticides and herbicides, antibiotic resistance, urban sprawl, aesthetic quality)
           Social
                Maintaining and transferring culture
                     Family structure
                        - multiple generation families
                        - "sandwich generations"
                Care giver  burdens
                Institutionalization
                Racial and ethic shifts
           Psychological
                There Is More To Life That This?
                    - Spiritual Dimension
                    - Patrick Henry
           Economic
                - Who will afford necessary techniques (e.g., diet vs supplement vs surgery)
                - Prioritization of medical research funds
                - Who should pay for necessary techniques
                - Aging of the "rich"
                - Health care costs
                - Personal resources
                - Medicare/medicaid
                - HMOs
                - Available health care workers and facilities
                - Costs for research
                - Costs for treatments and care
                - Education
                - Work force and employment
                - Competition for employment
                - Retirement plans and pensions
                - Poverty
           Political
                - Elections
                - Public policy
                - Legislation
                - Budget re-allocations
           Ethical
                - Means vs ends?
                - Returns vs investments?
                - Contributions by elders
                - Effects on younger generations and future generations
                - Quality vs quantity of life
                - Ecological and environmental responsibilities
                - Care giver burden on family and friends
                There Is More To Life That This?
                    - Spiritual dimension
                    - Patrick Henry
Note the current difficulties with the federal and state governments and with families and friends dealing with problems related to the elderly.

     International
          - Global conditions
          - International politics

2.c. Possible conclusions.

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      - These derive from Item 2.
      - Some believe that work toward increasing ML and XL will have negligible effects on total population sizes and small effects on the size of elder populations because new or unrecognized age-related problems will only replace ones that we may be able to solve in the near future (e.g., increases in cancers, genetic limitations).

3. The relevance of offering this type of discussion in gerontology programs.

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    1. Show students ethical implications of altering ML or XL.
    2. Shows interdisciplinary aspects and therefore need for interdisciplinary education for gerontology students. Wouldn't this be a great class discussion in any gerontology course regardless of its special focus (e.g., sociology, psychology, economics, biology, philosophy, etc.).
    3. Provide opportunities for students to progress up Bloom's categories (i.e., knowledge, {name, define, list, describe}; comprehension {explain, interpret, predict, summarize}; application {apply, modify, construct}; analysis {show how or why something relates or works}; synthesis {design an experiment or study, make predictions, use data to support a position}; evaluation {compare and contrast, decide, select the best})
    4. Allows students with different backgrounds, value systems, and backgrounds to contribute and to appreciate the contributions and perspectives of others.
    5. Contributes to more expansive thinking by faculty teaching courses.
    6. Shows need for VERY long range thinking about outcomes from short range changes (e.g., "small" increase in ML and how that could make MAJOR differences within one's lifetime and certainly within the lifetimes of ones children - many college-age folks plan to have children within a few years of their graduation.)
    7. Show students opportunities for and importance of continued research.
    8. Show students importance of being educated about gerontology to be educated citizens and career professionals prepared to address inevitable questions about altering aging and its outcomes.

4. Summaries, notes, and bibliographies with current references about what would/could/should happen regarding controlling human aging.

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Bibliography

Books and articles:

(no author): "Births, Marriages, Divorces, and Deaths for November 1996." Monthly Vital Statistics Report, U.S. Department of Health and Human Services 45(11) May 15 (1997).

(no author): "Births, Marriages, Divorces, and Deaths for November 1997." Monthly Vital Statistics Report, U.S. Department of Health and Human Services, 4(12) July 28 (1998).

(no author): "Historical Statistics of the United States: Colonial Times to 1970: Part 1." U.S. Department of Commerce, September (1975).

(no author): "Resident Population of the United States: Estimates, by Age and Sex." U.S. Bureau of the Census, August 28 (1998).

(no author): "Sixty-five Plus in the United States." U.S. Census Bureau: the Official Statistics Economics and Statistics Administration, U.S. Department of Commerce, May (1995).

(no author): "Statistical Abstract of the United States 1997." The National Data Book, 117th Edition, U.S. Department of Commerce, October (1997).

(no author): "Trends in the Health of Older Americans: United States, 1994." Vital and Health Statistics, U.S. Department of Health and Human Services, Series 3: Analytic and Epidemiological Studies No. 30, DHHS Publication No. (PHS) 95-1414 April (1995).

Arking R: "Biology of Aging: Observations and Principles." Prentice Hall, Englewood Cliffs, NJ (1999).

Austad SN: "Why We Age: What Science Is Discovering about the Body's Journey Through Life." John Wiley & Sons, Inc., NY (1997).

Carter WR: A Means to an End: The Biological Basis of Aging and Death." Oxford University Press, NY (1999)

Comfort A: The Biology of Senescence.(Third Edition),New York:Elsevier (1979).

DiGiovanna AG: "Human Aging: Biological Perspectives." McGraw-Hill, NY (2000).

Diplock AT: "Will the 'good fairies' please prove to us that vitamin E lessens human degenerative disease?." Free Radic Res (1997) Nov;27(5):511-532.

Gardner P, Rosenberg HM: "Leading Causes of Death by Age, Sex, Race, and Hispanic Origin: United States, 1992." Vital and Health Statistics Series 20: Data on Mortality, No. 29 U.S. Department of Health and Human Services DHHS Publication No. (PHS) 96-1857 June (1996).

Hayflick L: "How and Why We Age." Ballantine Books, NY (1994).

Kilama: WL:  HEALTH CHALLENGES EARLY IN TWENTY FIRST CENTURY SUB-SAHARAN AFRICA, LECTURE  DELIVERED AT THE 19TH AFRICAN HEALTH SCIENCES CONGRESS INCORPORATING THE 16TH AJSC, NIMR, TANZANIA ARUSHA 15 APRIL (1998)

Klemera P, Doubal S: "Human mortality at very advanced age might be constant." Mechanisms of Ageing and Development (1997) Nov;98(2):167-176.

Kurian GT: "Datapedia of the United States 1790-2000 America Year by Year" Bernan Press, Lanham, MD (1994).

Lane MA, Ingram DJ, Roth GS: "Beyond the rodent model: calorie restriction in rhesus monkeys." Age (1997) 20:39-50.

Lundh U, Nolan M: "Aging and quality of life. 1: Towards a better understanding." British Journal of Nursing (1996) Nov 14;5(20):1248-1251.

O'Boyle CA : "Measuring the quality of later life." Philos Trans R Soc Lond B Biol Sci. (1997) Dec 29;352(1363) 1871-9.

Olshansky SJ, Carnes BA: "Ever since Gompertz." Demography (1997) Feb;34(1):1-15.

Pickle LW, Mungiole M, Jones GK, White AA: "Atlas of United States Mortality." U.S. Department of Health and Human Services, DHHS Publication No. (PHS) 97-1015 December (1996).

Rowe JW, Kahn RL: "Successful aging." Gerontologist (1997) Aug;37(4):433-440.

Rowe JW, Kahn RL: "Successful Aging." Pantheon Books, NY (1998).

Thurman JE, Mooradian AD: "Vitamin supplementation therapy in the elderly." Drugs and Aging (1997) Dec;11(6):433-449.

Vita AJ, Terry RB, Hubert HB, Fries JF: "Aging, health risks, and cumulative disability." New England Journal of Medicine (1998) Apr 9;338(15):1035-1041.

Ward JA: "Should antioxidant vitamins be routinely recommended for older people?." Drugs and Aging (1998) Mar;12(3):169-175.

Weindruch R, Walford, RL: "The retardation of aging and disease by dietary restriction." Charles C. Thomas, Springfield, IL, (1998).

Weindruch R: "Caloric restriction and aging." Scientific American (1996) Jan 46-52.

Wickens A:  The Causes of Aging. Amsterdam: Harwood Academic Publishers (1998).
 

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Internet sites:

 65+ in the United States - U.S. Census Bureau
 http://www.census.gov/prod/1/pop/p23-190/p23-190.html

  Administration on Aging
 http://pr.aoa.dhhs.gov/aoa/stats/statpage.html
       Statistics pages

 Centers for Disease Control and Prevention (CDC)
 http://www.cdc.gov/epo/prevent.htm
  Prevention and cost estimates of diseases

 National Center for Health Statistics
 http://www.cdc.gov/nchs/

 U.S. Census Bureau
 http://www.census.gov/

 International statistics - U.S. Census Bureau
 http://www.census.gov/ipc/www/

Mortality statistics - National Center for Health Statistics
http://www.cdc.gov/nchs/about/major/dvs/mortdata.htm

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Copyright 2017 - Augustine G. DiGiovanna - All rights reserved.
This material may not be reproduced or distributed in any form or by any means, or stored in any data base or retrieval system. Salisbury University - agdigiovanna@Salisbury.edu