Wednesday, September 12, 2007
Leo M. Cooney Jr., 63, chief of geriatrics at Yale University School of Medicine
Q How do older people compare physically with seniors in the past?
A There have been a series of studies over the past 20 years which show that people in their 70s, 80s and 90s are functioning at a substantially higher level than they were only 20 years ago, and there is a much lower percentage of disability in older people than there was 20 years ago. And of course, life expectancy has gone up dramatically, as you're well aware, for the last 80 years.
What do you mean "disability"?
What I'm talking about is a series of evaluations that looked at disability among the Medicare population, looking at the difficulty of performing what are called daily living activities, and instrumental daily living activities. Daily living activities are the ability to bathe, feed, dress, groom, toilet yourself, walk and get out of bed.
Would this imply we could live on our own longer?
Yes. We are more functional. That is actually more important than disease. Function is a very important predictor of your ability to live independently, but also your ability to live, period.
Are older Americans better off cognitively than in the past?
That has not been as carefully tested. One would presume that people are a bit more cognitively capable at the same age as they were 30 years ago because they can do more. The studies have looked at one's ability to drive, to pay bills, to do the so-called instrumental daily living activities. And again, there is less disability now than there was 20 years ago.
Are there health differences by race, income and class in later years?
One of the most important predictors of successful outcome from disease is socioeconomic status. People of higher socioeconomic status do better, they live longer, they respond better after illness or injury. It's not just their medical care. Because a lot of these studies come from Great Britain, patients of the National Health Service. There's something about high socioeconomic status that gives you a real leg up when it comes to what we call morbidity and mortality.
Morbidity simply means you have a complication, that you have an illness. Mortality is you die.
Can people work longer into their later years because of less physical disability?
Despite the fact that people look like they can work longer, they are actually still retiring early. This is internationally. One would think there would be more of a demand for the aging worker. Do I think that 65- and 70-year-olds can function very well in the workplace? Yes. I think they can. They have to adapt, obviously, to changes in the computer world and things like that. But if they can do that, they can function very well.
You're 63, which is considered young now. When do you imagine you'll retire?
Good question. I'll probably step down from some administrative jobs in the next couple of years because I think I should. I'm head of geriatrics now, but I won't do that for too much longer. I hope to be able to continue teaching and seeing patients probably until I'm 70 or so. I work for a university, and I want to make sure that I'm not hanging on beyond my period of value. I have sort mixed feelings about this. I love doing what I do, so I'm not anxious to give it up. But by the same token, I don't want to clog up our program when young people should be coming through. I don't want to give it up. But by the same token, I think I can. I hope I can.